Placentia City Council
November 19, 2024

(Use of City Bond Form is Required)

LABOR AND MATERIAL PAYMENT BOND

PUBLIC WORK (CALIFORNIA)
Bond Number: 101218165
KNOW ALL MEN BY THESE PRESENT:

WHEREAS, Sequel Contractors, Inc. , as Principal,
has entered into a contract dated November 19, 2024 , with the City of Placentia (Obligee) referred to and made a part hereof to perform the following work, to wit: FY 2023-24.ARTERIAL STREETS REHABILITATION PROJECT and all appurtenant work in accordance with PROJECT NO. , which requires Principal to file this bond to secure claims made in relation to the project.

NOW THEREFORE, we, Sequel Contractors, Inc. as
Principal, and Merchants Bonding Company (Mutual) , a corporation organized under the laws of Iowa and duly authorized to transact business in the State of California, as Surety, are held firmly bound unto the City of Placentia, as Obligee, and all sub -contractors, laborers, material persons and other persons employed in the performance of the referenced agreement, in the sum of Two million eight hundred and twenty four thousand six tlANC94 dollars and forty cents Dollars ($2.824.600.40) .00), lawful money of the United States of America, for the payment whereof well and truly to be made the Principal and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.

If the above bounden PRINCIPAL, his or its heirs, executors, administrators, successors, assigns, or any of his or its sub -contractors, fails to pay for any materials, provisions, provender, or other supplies, or teams, implements or machinery, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor to persons named in Section 9100 or the Civil Code, thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work or labor deducted, withheld and paid over to the Employment Development Department from the wages of employees of the contractor and sub- contractors pursuant to Section 13020 of the Unemployment Insurance Code, that the SURETY on this bond will pay the same, in an amount not exceeding the sum specified in this bond, AND ALSO, in case suit is brought upon this bond, a reasonable attorney's fee, which shall be awarded by the court to the prevailing party in said suit, said attorney's fee to be taxed as costs in said suit and to be included in the judgment herein rendered.

As part of the obligation secured hereby, the SURETY shall not be exonerated or released from the obligation of the bond by any change, alteration, or modification in or of any contract, plans, specifications, or agreement pertaining or relating to any scheme or work of improvement or pertaining or relating to the furnishing of labor, materials, or equipment therefor, nor by any change or modification of any terms of payment or extension of the time for any payment pertaining or relating to any scheme of work of improvement, nor by any rescission or attempted rescission of the contract, agreement or bond, nor by any conditions precedent or subsequent in the bond attempting to limit the right of recovery of claimants otherwise entitled to recover under any such contract or agreement, or under the bond, nor, where the bond is given D-19
401

for the benefit of claimants, by any fraud practiced by any person other than the claimant seeking to recover on the bond.

This bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims under the CMI Code so as to give them a right of action in a suit on this bond.

This bond is executed for the purpose of complying with the laws of the State of California and shall inure to the benefit of any of the persons named in Section 9100 of the Civil Code of the State of California.

IN IMTNESS THEREOF, we have hereunto set our hands and seals this 7th day of NcavPr 2014 .
(Corporate Seal)
(Corporate Seal)
APPROVED AS TO FORM:

Is! Christian L. Bettenhausen
City Attorney
Sequel Contra o :, Inc.

Principal
Th. mas S. Pack, President
Title
Merchants Bonding Company (Mutual)
imp Surety
By _--S�r�.

Timothy D. R -a -op. Attorney in aet,
Title
D-20
402

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 A
County of Les kd ti
)
On 101121 before me, Daniel matt, Notary Public
Date (� Q I H re Insert Name and Title of the Officer
personally appeared h15 S. Y+� [�ltlydt�l
Narne(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person whose namele) is/are subscribed to the within instrument and acknowledged to me that he//they executed the same in his/I-awl-Oak authorized capacity(jsj, and that by his/1 rftl*r signaturNej on the instrument the person($, or the entity upon behalf of which the persons } acted, executed the instrument. 44944#40944144444414/404404400441044400@444
;.."` „ DANIEL BUSTAMANTE
_• �{, art" ,`1 COMM. #2349514
S : - !!.1'/) NOTARY PUBLIC • CALIFORNIA p
''``- / LOS ANGELES COUNTY -'
4 1'o 4, '.' My Comm [),[liars MAI-2CH 1, 2625 p
1444014444441004441040410144144140400404400
Place Notary Seal Above
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.

Signature
Signature of Notary Public

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:

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 ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other: _
Signer Is Representing:

Number of Pages:

Signer's Name:

Corporate Officer — Title(s):
0 Partner —I_ J Limited ❑ General
Ti� Individual ❑ Attorney in Fact
O Trustee ❑ Guardian or Conservator
❑ Other:

Signer is Representing:
©2016 National Notary Association • www.NationalNotary.org 1 -800 -US NOTARY (1-800-876-6827) Item #5907 403

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 document.

State of California
County of Orange
On
November 7, 2024
before me, Debra Swanson. Notary Public
(insert name and title of the officer)
personally appeared Timothy D. Rapp
who proved to me on the basis of satisfactory evidence to be the person{) whose name) isMim subscribed to the within instrument and acknowledged to me that he9 executed the same in hisOluswillOPLOrr authorized capacity,(140, and that by his/lrsignature* on the instrument the person(), or the entity upon behalf of which the person() 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.

Signature
(Seat)

DEBRA SWANSON
COMM. # 2502022
NOTARY PUBLIC•CALIFORNIA 7-3

ORANGE COUNTY N
MY COMM, EXP. NOV 10, 2028 r
404

MERCHANT -7%k,
B ON i G C M.i:. N Y -u

POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BANDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appotnt, Individually, Douglas A Rapp; Timothy D Rapp
their true and lawful Attomey(s)-in-Fact, to sign its name as surety(iee) and to execute, seal and acknowledge- any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted In any actions or proceedings allowed by law.

This Power -of Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adapted by the Board of Directors of Merchants National Bonding, Inc., en October 16, 2015.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shalt have power and authority to appoint Attorneys -in -Fact; and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Flonida Department of Transportation. It is fully understood that consenling to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not. relieve this surety company of any of its obligations tinder its bond.

In connection with obligations in favor of the Kentucky Department of Highways only, if is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.

In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 3rd day ofFebruary , 2024 .. 193
a ;.093 ; ;.� - By
7, ‘, - - ,
ms's
• • ' p p:— k,• President
STATE OF IOWA s••• `f �:�+`s « li'
COUNTY OF DALLAS ss. ''R"'"'"`�+ ,+
On this 3rd day of February 2024 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL_) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seats of the Companies; and that the said Instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors.

AS"S.S' Penni Hitler ,
Z 011th Commission Number 787952 i
• •,•�11u • My Commission Expires
January 20, 2flZ7�` �gh

MERCHANTS BONDING COMPANY (MUTUAL)

MERCHANTS NATIONAL BONDING, INC,
d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY
IOWA-
(Expiration
OWA
(Expiration of notaryis commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked,
in Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies an this Gs:'.4, Y
:2:t -0- X9'•01 ci-;• - +
:x. ,'th . . 1933 •
I0% 2003 .,1„e ... :"> , •
POA 0018 (1/24)
•
7th day of November, 2024.

Secretary
„ „At
405

(Use of City Form is Required)

SUPPLEMENTAL INFORMATION TO BE COMPLETED BY PRINCIPAL
If an individual, so state. if a firm or co -partnership, state the firm and give the names of all individual co-partners composing the partnership. If a Corporation, state legal name of corporation; state also the names of the president, secretary, treasurer and manager thereof.

Sequel Contractors Inc
Thomas S. Pack President
Abel Magallanes, Vice President
Michael A. Mahler, Secretary
Business Address:
13546 Imperial Highway, Santa Fe Springs Ca 90670
Telephone Number:

Date:

Print Name:

Signature:
(562) 802-7227
11/7/24
406

(Use of City Form is Required)

TAX IDENTIFICATION NUMBER
The Tax Equity and Fiscal Responsibility Act of 1982 requires the payer (City of Placentia) to report to the Internal Revenue Service taxable payments to payees.

You (as a payee) are required by Law to provide us with your Taxpayer Identification Number (if an individual or partnership, your Social Security Number). If you do not provide us with your correct identification number, you may be subject to a penalty imposed by the Internal Revenue Service. The payments subject to withholdings may include, but are not limited to, interest, dividends, or other payments the City of Placentia and/or the Placentia Redevelopment Agency made to you. Other payments may include rents, royalties, commissions and fees for service of non -employees.

If you are exempt from income tax, we are still required, by law, to maintain a Tax Identification Number on file. PLEASE PROVIDE YOUR TAX IDENTIFICATION NUMBER next to the appropriate listing below, sign, date and return to:

CITY OF PLACENTIA FINANCE DEPARTMENT
401 E. Chapman Ave.

Placentia, CA 92870
Exempt: Yes No X Telephone ( 562)802 7227
CORPORATION: Sequel Contractors Inc
U.S.A. OR ANY AGENCIES THEREOF:
95-43014242
IRS CODE #501 TAX-EXEMPT ORGANIZATION: n/a
A NON-COMMISSIONED CITY OF PLACENTIA EMPLOYEE: n/a
SOLE PROPRIETOR: Na
A PARTNERSHIP: nia
OTHER: n/a J (Explain)
Signature/Tit '/J/Date: 11/7/24
Pack President
407

BID GUARANTEE

TO THE CITY OF PLACENTIA
PROJECT NO, FY 2023-24 ARTERIAL STREETS REHABILITATION PROJECT FY 2023-24 ARTERIAL
As a material inducement to the City to award the contract for Project No.STREETS REHABILITATION PROJECT to Sequel Contractors Inc , the undersigned ("Guarantor") has agreed to enter into this guarantee. The Guarantor hereby unconditionally guarantees to the fullest extent allowed by law the following work included in this project: SEE EXHIBIT A ("the work").

Guarantor guarantees that the materials and equipment used by itself and its subcontractors will be free from defects and that the work will conform to the plans and specifications. Should any of the materials or equipment prove defective or should the work as a whole, or any part thereof, prove defective for any reason whatsoever (except due to intentional torts by the City), or should the work as a whole or any part thereof fail to operate properly or fail to comply with the plans and specifications, Guarantor will, at the City's sole election: 1) reimburse the City, upon written demand, for all of the City's expenses incurred replacing or restoring any such equipment or materials, including the cost of any work necessary to make such replacement or repairs; or 2) replace any such defective material or equipment and repair said work completely, all without any cost to the City. Guarantor further guarantees that any such repair work will conform to the plans and specifications for the project. This guarantee will remain in effect for five years from the date on which the contracted for work is accepted for use by the City.

Guarantor understands and agrees that the City shall have the unqualified option to make any replacements or repairs itself or to have such replacement, repair, performed by the undersigned.

The City shall have no obligation to consult with Guarantor before the City proceeds to perform any repair, replacement, or work itself. If the City elects to have Guarantor perform said repair, replacement, or work, Guarantor agrees that the repair, replacement, or work shall be performed within 15 days after receipt of a written demand from the City.

If the City elects to perform the replacement, repairs itself, Guarantor agrees to make reimbursement payment within 15 days after receipt of a written demand for payment from the City.

If the Guarantor fails or refuses to comply with this guarantee, the City shall be entitled to all costs and expenses, including attorneys and expert fees, reasonably incurred by reason of Guarantor's failure or refusal.

Guarantor Date: 11170
Contractor: Sequel Contractors Inc
Title: Thomas S. Pack President
408

STATEMENT OF NON COLLUSION BY CONTRACTOR
The undersigned who submits herewith to the City of Placentia a bid or proposal does hereby certify:
a. That all statements of fact in such bid or proposal are true. b. That such bid or proposal was not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization or corporation. c. That such bid or proposal is genuine and not collusive or sham. d. That said bidder has not, directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interest of the City of Placentia or of any other bidder or anyone else interested in the proposed procurement. - e. Did not, directly or indirectly, collude, conspire, connive or agree with anyone else that said bidder or anyone else would submit a false or sham bid or proposal, or that anyone should refrain from bidding or withdraw his bid or proposal.
f. Did not in any manner, directly or indirectly seek by agreement, communication or conference with anyone to raise or fix the bid or proposal price of said bidder or of anyone else, or to raise or fix any overhead, profit or cost element of his bid or proposal price, or that of anyone else. g. Did not, directly or indirectly, submit his bid or proposal price or any breakdown thereof, or the contents thereof, or divulge information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member agent thereof, or to any individual or group of individuals, except to the City of Placentia, or to any person or persons who have a partnership or their financial interest with said bidder in his business. h. Did not provide, directly or indirectly to any officer or employee of the City of Placentia any gratuity, entertainment, meals, or anything of value, whatsoever, which could be objectively construed as intending to invoke any form of reciprocation or favorable treatment. i. That no officer or principal of the undersigned firm is related to any officer or employee of the city by blood or marriage within the third degree or is employed, either full or part time, by the City of Placentia either currently or within the last two (2) years.

That no officer or principal of the undersigned firm nor any subcontractor to be engaged by the principal has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy or any other act in violation of any State or Federal antitrust law in connection with the bidding upon award of, or performance of, any public work contract, with any public entity, within the last three years.
j.
1 certify, under penalty of perjury under the laws of the State of California, tha the foregoing is true and correct and that this certification was executed:

On 11/7/24 at Santa Fe Springs,
Firm Sequel Contractors Inc
Street 13546 Imperial Highway
City Santa Fe Springs State ca Zip 90670
California.
ignature)
Thomas S. Pack President
(Print Name & Title)
409

EXHIBIT A

SCOPE OF SERVICES
The general items of work consist of: construction of ARHM pavement, cold mill, AC pavement reconstruction, signing, striping, markings, and pavement legends, adjust to grade existing manholes, adjust to grade existing water valves, protect existing utilities, construct catch basins, construct storm drain junction structure and pipes, sewer lining, sewer excavation point repair, survey markers and monument preservation and restoration, construction staking and such other items or details, not mentioned above, that are required to complete the project. 410

EXHIBIT B

SCHEDULE OF PERFORMANCE
All work must be complete within 80 working days from the Notice to Proceed. 411

EXHIBIT C

INSURANCE REQUIREMENTS
A. Minimum Scope and Limits of Insurance
City reserves the right to review any and all of the required insurance policies and/or endorsements, but has no obligation to do so. Failure to demand evidence of full compliance with the insurance requirements set forth in this Agreement or failure to identify any insurance deficiency shall not relieve Contractor from, nor be construed or deemed a waiver of, its obligation to maintain the required insurance at all times during the performance, including any extension thereof, of this Agreement.

Consultant shall obtain, maintain, and keep in full force and effect during the life of this Agreement, including any extension thereof, all of the following minimum scope of insurance coverages:

1. Commercial General Liability Insurance
• Commercial general liability insurance no less broad than Insurance Services Office (ISO) form CG 00 01.
• Minimum Limits: $2,000,000.00 per occurrence; $4,000,000.00 general aggregate; $4,000,000.00 products/completed operations aggregate. The aggregate limit, encompassing the above coverage, shall apply separately to this project/location. The required limits may be provided by a combination of general liability insurance and commercial excess or umbrella liability insurance. If Contractor maintains higher limits than the specified minimum limits, City requires and shall be entitled to coverage for the higher limits maintained by the Contractor.
• Any deductible or self-insured retention shall be shown on the certificate of insurance.

If the deductible or self-insured retention exceeds $25,000.00, it must be approved in advance by City. Contractor is responsible for any deductible or self-insured retention and shall fund it upon City's written request, regardless of whether Contractor has a claim against the insurance or is named as a party in any action involving City. • Coverage shall be continued for three (3) years after completion of the work. • City shall be endorsed as an additional insured for liability arising out of ongoing and completed operations by or on behalf of the Contractor. City shall continue to be an additional insured for completed operations for three (3) years after completion of the work. General liability coverage can be provided in the form of an endorsement to the Contractor's insurance at least as broad as one of the following ISO ongoing operations forms: CG 20 10 or CG 20 26 or CG 20 33 (not allowed from subcontractors), or CG 20 38; and one of the following ISO completed operations forms: CG 20 37, 2039 (not allowed from subcontractors), or CG 20 40. • The policy definition of "insured contract" shall include assumptions of liability arising out of both ongoing operations and the products/completed operations hazard ("f" definition of insured contract in ISO form CG 00 01, or equivalent). • The insurance provided to the additional insureds shall be primary to, and non- contributory with, any insurance or self-insurance program maintained by them. 412

• The policy shall cover inter -insured suits and include a "separation of insureds" or "severability" clause which treats each insured separately. • The policy shall be endorsed to include a written waiver of the insurer's right to subrogate against all persons or entities that are, or are required to be, additional insureds.
• The policy shall not contain a contractors' warranty or other similar language which eliminates or restricts insurance because of a subcontractor's failure to carry specific insurance or to supply evidence of such insurance.
• Reauired evidence of coverage:

1. Copy of the endorsements naming the City of Placentia, its officers, officials, employees, agents, and volunteers as additional insureds;

2. Copy of the endorsement or policy language indicating that coverage applicable to the additional insureds is primary and non-contributory;

3. Properly completed certificate of insurance; and

4. Completed and signed Agent/Broker Questionnaire with supporting documentation as required.

2. Business Automobile Liability Insurance
• Minimum Limit: $2,000,000.00 combined single limit per accident. • Coverage shall apply to all owned, hired, leased, and non -owned vehicles. • City shall be endorsed as additional insured.
• Reauired evidence of coverage:

1. Copy of the endorsement naming the City of Placentia, its officers, officials, employees, agents, and volunteers as additional insureds; and

2. Properly completed certificate of insurance.

3. Workers' Compensation & Employer's Liability Insurance • Workers' compensation insurance with statutory limits as required by the Labor Code of the State of California.
• Employer's liability with limits of $1,000,000.00 per accident; $1,000,000.00 disease per employee; $1,000,000.00 disease per policy.
• The policy shall include a written waiver of the insurer's right to subrogate against City. • Required evidence of coverage:

1. Subrogation waiver endorsement; and

2. Properly completed certificate of insurance.

4. Contractor's Pollution Liability Insurance
• Minimum Limits: $2,000,000.00 per pollution incident; $2,000,000.00 policy aggregate. • Coverage shall apply to pollution incidents at or from any location at which Contractor 413

is performing work under this Agreement.
• Any deductible or self-insured retention shall be shown on the certificate of insurance.

If the deductible or self-insured retention exceeds $25,000.00, it shall be approved in advance by City. Contractor is responsible for any deductible or self-insured retention and shall fund it upon City written request, regardless of whether Contractor has a claim against the insurance or is named as a party in any action involving City. • City shall be endorsed as an additional insured for liability arising out of ongoing and completed operations by or on behalf of the Contractor. Additional insured status shall continue for three (3) years after completion of the work. • The insurance provided to the additional insureds shall apply on a primary and non- contributory basis with respect to any insurance or self-insurance program maintained by them.
• The insurance shall be continued for three (3) years after completion of the work. • Required evidence of coverage:

1. Copy of the endorsement naming the City of Placentia, its officers, officials, employees, agents, and volunteers as additional insureds;

2. Copy of the endorsement or policy language indicating that coverage for the additional insureds is primary and non-contributory; and

3. Properly completed certificate of insurance.

5. Surety Bonds
• Bid bond.
• Performance and payment bonds for the entire contract price. • The surety must be authorized to issue these bonds in the State of California.

6. Standards for Insurance Companies
• All insurance policies shall be issued by an insurance company currently authorized by the Insurance Commission to transact business of insurance or is on the List of Approved Surplus Line Insurers in the State of California, with an assigned policyholders' rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide.

B. Documentation and Other Provisions

1. The certificate of insurance shall include the following reference: FY 2023-24 Arterial Streets Rehabilitation Project

2. The name and address for additional insured endorsements and certificates of insurance is: City of Placentia, 401 E. Chapman Ave., Placentia, CA 92870.

3. Defense fees and costs shall not deplete the limits of any insurance provided under this Agreement.

4. Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure the City is an additional 414

insured on insurance required from subcontractors.

5. Contractor agrees to waive and to obtain endorsements from insurers waiving subrogation rights against the City of Placentia, its officers, officials, employees, agents, and volunteers for losses arising from work performed by Contractor for the City and to require each of its subcontractors, if any, to do likewise under their insurance policies.

6. The Contractor's insurance coverage shall be primary insurance coverage at least as broad as ISO CG 20 01 04 13 as respects the City of Placentia, its officers, officials, agents, employees, and volunteers. Any other insurance maintained by the City of Placentia shall be excess and not contributing with the insurance provided by this policy.

7. Coverage shall be on a standard occurrence form. Claims-made forms are not acceptable. Modified, limited, or restricted occurrence forms are not acceptable.

8. Said policies shall not terminate, nor shall they be cancelled or coverage reduced, without at least thirty (30) days' written notice to the City. In the event of any cancellation or reduction in coverage or limits of any insurance, Contractor shall forthwith obtain and submit proof of substitute insurance. Should Contractor fail to immediately procure other insurance, as specified, to substitute for any cancelled policy or reduction in the required insurance limits, the City may procure such insurance at Contractor's sole cost and expense.

9. Current evidence of coverage shall be provided for the entire required period of insurance.

10. Upon written request, certified copies of required insurance policies shall be provided within thirty (30) days.
415

EXHIBIT D

CERTIFICATES OF INSURANCE AND ENDORSEMENTS
416

ACORN®
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)
11/11/2024

PRODUCER
Alliant Insurance Services, Inc.
701 B Street 6th Floor
San Diego CA 92101

INSURED
Sequel Contractors, Inc.
13546 Imperial Highway
Santa Fe Springs CA 90670

COVERAGES
License#: 0C36861
SEQUCON-01

CONTACT
NAME: Susan Koelle
PHONE
(A/C. No. Ext): 619-541-4851
E-MAIL
ADDRESS: Susan.Koelle p�ialliant.com

INSURER(S) AFFORDING COVERAGE
INSURER A: Travelers Property Casualty Co
INSURER B : Navigators Specialty Insurance
INSURER C :

INSURER D :

INSURER E :

FAX
(A/C, No):

INSURER F :

CERTIFICATE NUMBER: 1006620238 REVISION NUMBER:

NAIC #
25674
36056

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS

LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
A X COMMERCIAL GENERAL LIABILITY DTCO7Y714153TIL24 10/1/2024 10/1/2025 EACHOCCURRENCE

CLAIMS -MADE
X
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY X PRO-
JECT
OTHER:

A AUTOMOBILE LIABILITY
B
A

X ANY AUTO
X
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY

UMBRELLA LIAB

X EXCESS LIAR
■

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
X
OCCUR

CLAIMS -MADE
DED RETENT ON $

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
A Employee Benefits Liability
Y/N
N/A
810 -7Y767030 -24-26-G
SE24EXCZ0J4AXIC
UB7Y7678412426G
DTCO7Y714153TIL24
10/1/2024 10/1/2025
10/1/2024 10/1/2025
10/1/2024 10/1/2025

DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)

PROPERTY DAMAGE
(Per accident)

EACH OCCURRENCE

AGGREGATE
$ 2,000,000
$ 300,000
$ 5,000
$ 2,000,000
$ 4,000,000
$ 4,000,000
$ 1,000,000
$ 3,000,000
$ 3,000,000

X PER OTH-

STATUTE ER
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
10/1/2024 10/1/2025 Aggregate 2,000,000
Each Employee 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage: Excess Commercial Liability - 2nd Layer
Policy Period: 10/1/2024 - 10/1/2025
Policy Number: ESXS241000399401
Carrier: Ascot Specialty Insurance Company
Each Occurrence Limit: $4,000,000
Aggregate Limit: $4,000,000
Coverage: Pollution Liability
See Attached...

CERTIFICATE HOLDER CANCELLATION
Proof of Insurance

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 417

ACORN®
AGENCY
Alliant Insurance Services, Inc.

POLICY NUMBER

CARRIER

ADDITIONAL REMARKS
AGENCY CUSTOMER ID: SEQUCON-01
LOC #:

ADDITIONAL REMARKS SCHEDULE

NAIC CODE

NAMED INSURED
Sequel Contractors, Inc.
13546 Imperial Highway
Santa Fe Springs CA 90670
EFFECTIVE DATE:

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Policy Period: 10/1/2023 - 10/1/2025
Policy Number: G70967145 005
Carrier: Westchester Surplus Lines Insurance Company
Occurrence Limit: $2,000,000
Aggregate Limit: $4,000,000
Proof of Insurance.

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD
418

COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:

Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omissions of such
person or organization .

The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.

This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
b. The insurance provided to such additional
insured does not apply to:

CG D2 46 04 19
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury" or "property damage"
caused by "your work" and included in the
"products -completed operations hazard"
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
(2) If a claim is made or "suit" is brought against
the additional insured:
© 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 419

COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit" as soon as practicable.
(3) Immediately send us copies of all legal
papers received in connection with the claim
or "suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit", and otherwise
comply with all policy conditions.

(4) Tender the defense and indemnity of any
claim or "suit" to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
© 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 420

POLICY NUMBER: DT -CO -7Y714153 -TIL -24

COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 10-15-24
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

DESIGNATED PROJECT(S)

GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under t he following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE
Designated Project(s):

EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN

A WRITTEN CONTRACT WHICH IS IN EFFECT DURING

THIS POLICY PERIOD, TO PROVIDE A SEPARATE

GENERAL AGGREGATE LIMIT, PROVIDED THAT THE
CONTRACT IS SIGNED BY YOU BEFORE THE "BODILY
INJURY" OR "PROPERTY DAMAGE" OCCURS.

A. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION I), and
for all medical expenses caused by accidents un-
der COVERAGE C (SECTION I), which can be
attributed only to operations at a single desig-
nated "project" shown in the Schedule abo ve:

1. A separate Designated Project General Ag-
gregate Limit applies to each designated "pro-
ject", and that limit is equal to the amount of
the General Aggregate Limit shown in the
Declarations, unless separate Designated
Project General Aggregate(s) are sched-
uled above.

2. The Designated Project General Aggregate
Limit is the most we will pay for the sum of all
damages under COVERAGE A., except
damages because of "bodily injury" or "prop-
erty damage" included in the "products -
completed operations hazard", and for medi-
cal expenses under COVERAGE C, regard-
less of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims
or bringing "suits".

CG D2 11 01 04
Designated Project
General Aggregate(s):

GENERAL AGGREGATE

LIMIT SHOWN ON THE

DECLARATIONS

3. Any payments made under COVERAGE A.
for damages or under COVERAGE C. for
medical expenses shall reduce the Desig-
nated Project General Aggregate Limit for
that designated "project". Such payments
shall not reduce the General Aggregate Limit
shown in the Declarations nor shall they re-
duce any other Designated Project General
Aggregate Limit for any other designated
"project" shown in the Schedule above.

4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented
To You and Medical Expense continue to
apply. However, instead of being subject to
the General Aggregate Limit shown in the
Declarations, such limits will be subject to the
applicable Designated Project General Ag-
gregate Li mit.

B. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under COVERAGE A. (SECTION I), and
for all medical expenses caused by accidents un-
der COVERAGE C. (SECTION I), which cannot
be attributed only to operations at a single desig-
nated "project" shown in the Schedule abo ve:

Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 421

COMMERCIAL GENERAL LIABILITY

1. Any payments made under COVERAGE A.
for damages or under COVERAGE C. for
medical expenses shall reduce the amount
available under the General Aggregate Limit
or the Products -Completed Operations Ag-
gregate Limit, whichever is applicable; and

2. Such payments shall not reduce any Desig-
nated Project General Aggregate L imit.

C. Part 2. of SECTION III — LIMITS OF INSURANCE
is deleted and rep laced by the following:

2. The General Aggregate Limit is the most we
will pay for the sum of:
a. Damages under Coverage B; and
b. Damages from "occurrences" under
COVERAGE A (SECTION I) and for all
medical expenses caused by accidents
under COVERAGE C (SECTION I) which
cannot be attributed only to operations at
a single designated "project" shown in the
SCHEDULE above.

D. When coverage for liability arising out of the
"products -completed operations hazard" is pro -

vided, any payments for damages because of
"bodily injury" or "property damage" included in
the "products -completed operations hazard" will
reduce the Products -Completed Operations Ag-
gregate Limit, and not reduce the General Aggre-
gate Limit nor the Designated Project General
Aggregate Li mit.

E. For the purposes of this endorsement the Defini-
tions Section is amended by the addition of the
following definition:
"Project" means an area away from premises
owned by or rented to you at which you are per-
forming operations pursuant to a contract or
agreement. For the purposes of determining the
applicable aggregate limit of insurance, each
"project" that includes premises involving the
same or connecting lots, or premises whose con-
nection is interrupted only by a street, roadway,
waterway or right-of-way of a railroad shall be
considered a single "project".

F. The provisions of SECTION III — LIMITS OF
INSURANCE not otherwise modified by this en-
dorsement shall continue to apply as stipulated.

Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04 422

COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. Who Is An Insured — Unnamed Subsidiaries
B. Blanket Additional Insured — Governmental
Entities — Permits Or Authorizations Relating To
Operations

PROVISIONS
A. WHO IS AN INSURED — UNNAMED

SUBSIDIARIES
The following is added to SECTION 11 — WHO IS
AN INSURED:

Any of your subsidiaries, other than a partnership,
joint venture or limited liability company, that is
not shown as a Named Insured in the
Declarations is a Named Insured if:
a. You are the sole owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured under
similar other insurance.

No such subsidiary is an insured for "bodily injury"
or "property damage" that occurred, or "personal
and advertising injury" caused by an offense
committed:
a. Before you maintained an ownership interest
of more than 50% in such subsidiary; or
b. After the date, if any, during the policy period
that you no longer maintain an ownership
interest of more than 50% in such subsidiary.

For purposes of Paragraph 1. of Section II — Who
Is An Insured, each such subsidiary will be
deemed to be designated in the Declarations as:

CG D3 16 02 19
C. Incidental Medical Malpractice
D. Blanket Waiver Of Subrogation
E. Contractual Liability — Railroads
F. Damage To Premises Rented To You
a. An organization other than a partnership, joint
venture or limited liability company; or
b. A trust;
as indicated in its name or the documents that
govern its structure.

B. BLANKET ADDITIONAL INSURED —
GOVERNMENTAL ENTITIES — PERMITS OR

AUTHORIZATIONS RELATING TO OPERATIONS
The following is added to SECTION II — WHO IS
AN INSURED:

Any governmental entity that has issued a permit
or authorization with respect to operations
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liabi lity for "bodily injury", "property damage" or "personal and
advertising injury" arising out of such operations.

The insurance provided to such governmental
entity does not apply to:
a. Any "bodily injury", "property damage" or
"personal and advertising injury" arising out of
operations performed for the governmental
entity; or
b. Any "bodily injury" or "property damage"
included in the "products -completed
operations hazard".
© 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 423

COMMERCIAL GENERAL LIABILITY
C. INCIDENTAL MEDICAL MALPRACTICE

1. The following replaces Paragraph b. of the
definition of "occurrence" in the
DEFINITIONS Section:
b. An act or omission committed in providing
or failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to a person, unless you are in
the business or occupation of providing
professional health care services.

2. The following replaces the last paragraph of
Paragraph 2.a.(1) of SECTION II — WHO IS
AN INSURED:

Unless you are in the business or occupation
of providing professional health care services,
Paragraphs (1)(a), (b), (c) and (d) above do
not apply to "bodily injury" arising out of
providing or failing to provide:
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor. Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
services" during their work hours for you
will be deemed to be acting within the
scope of their employment by you or
performing duties related to the conduct
of your business.

3. The following replaces the last sentence of
Paragraph 5. of SECTION III — LIMITS OF
INSURANCE:

For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or omissions committed in providing or
failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to any one person will be deemed to
be one "occurrence".

4. The following exclusion is added to
Paragraph 2., Exclusions, of SECTION I —
COVERAGES — COVERAGE A — BODILY

INJURY AND PROPERTY DAMAGE
LIABILITY:

Sale Of Pharmaceuticals
"Bodily injury" or "property damage" arising
out of the violation of a penal statute or
ordinance relating to the sale of

pharmaceuticals committed by, or with the
knowledge or consent of, the insured.

5. The following is added to the DEFINITIONS
Section:
"Incidental medical services" means:
a. Medical, surgical, dental, laboratory, x-ray
or nursing service or treatment, advice or
instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.

6. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV —

COMMERCIAL GENERAL LIABILITY
CONDITIONS:

This insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other basis, that
is available to any of your "employees" for
"bodily injury" that arises out of providing or
failing to provide "incidental medical services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section II — Who Is An
Insured.

D. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph 8., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:

If the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization, but only for payments we make
because of:
a. "Bodily injury" or "property damage" that
occurs; or
b. "Personal and advertising injury" caused by
an offense that is committed;
subsequent to the execution of the contract or
agreement.

E. CONTRACTUAL LIABILITY — RAILROADS

1. The following replaces Paragraph c. of the
definition of "insured contract" in the
DEFINITIONS Section:
c. Any easement or license agreement;
© 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 424

2. Paragraph f.(1) of the definition of "insured
contract" in the DEFINITIONS Section is
deleted.

F. DAMAGE TO PREMISES RENTED TO YOU
The following replaces the definition of "premises
damage" in the DEFINITIONS Section:
"Premises damage" means "property damage" to:

CG D3 16 02 19

COMMERCIAL GENERAL LIABILITY
a. Any premises while rented to you or
temporarily occupied by you with permission
of the owner; or
b. The contents of any premises while such
premises is rented to you, if you rent such
premises for a period of seven or fewer
consecutive days.
© 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 425

COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE — GLASS

PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:

Any organization you newly acquire or form dur-
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.

Coverage under this provision is afforded only un-
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.

B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:

Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
CA T3 53 02 15
H.

I.

J.

K.

L.

M.

N.

C.

HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT

PERSONAL PROPERTY

AIRBAGS

NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS

BLANKET WAIVER OF SUBROGATION

UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.

EMPLOYEE HIRED AUTO

1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION II — COV-
ERED AUTOS LIABILITY COVERAGE:

An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi-
ness.

2. The following replaces Paragraph b. in B.5.,
Other Insurance, of SECTION IV — BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name, with your
© 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 426

COMMERCIAL AUTO
permission, while performing duties
related to the conduct of your busi-
ness.

However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto".

D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:

Any "employee" of yours is an "insured" while us-
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs.

E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS

1. The following replaces Paragraph A.2.a.(2),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viola-
tions) required because of an "accident"
we cover. We do not have to furnish
these bonds.

2. The following replaces Paragraph A.2.a.(4),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(4) All reasonable expenses incurred by the
"insured" at our request, including actual
loss of earnings up to $500 a day be-
cause of time off from work.

F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
The following replaces Subparagraph (5) in Para-
graph B.7., Policy Period, Coverage Territory,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
(5) Anywhere in the world, except any country or
jurisdiction while any trade sanction, em-
bargo, or similar regulation imposed by the
United States of America applies to and pro-
hibits the transaction of business with or
within such country or jurisdiction, for Cov-
ered Autos Liability Coverage for any covered
"auto" that you lease, hire, rent or borrow
without a driver for a period of 30 days or less
and that is not an "auto" you lease, hire, rent
or borrow from any of your "employees",
partners (if you are a partnership), members
(if you are a limited liability company) or
members of their households.

(a) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and possessions
of the United States of America, Puerto
Rico and Canada:
(i) You must arrange to defend the "in-
sured" against, and investigate or set-
tle any such claim or "suit" and keep
us advised of all proceedings and ac-
tions.
(ii) Neither you nor any other involved
"insured" will make any settlement
without our consent.
(iii) We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
(iv) We will reimburse the "insured" for
sums that the "insured" legally must
pay as damages because of "bodily
injury" or "property damage" to which
this insurance applies, that the "in-
sured" pays with our consent, but
only up to the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II — COVERED AUTOS
LIABILITY COVERAGE.
(v) We will reimburse the "insured" for
the reasonable expenses incurred
with our consent for your investiga-
tion of such claims and your defense
of the "insured" against any such
"suit", but only up to and included
within the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II — COVERED AUTOS
LIABILITY COVERAGE, and not in
addition to such limit. Our duty to
make such payments ends when we
have used up the applicable limit of
insurance in payments for damages,
settlements or defense expenses.
(b) This insurance is excess over any valid
and collectible other insurance available
to the "insured" whether primary, excess,
contingent or on any other basis.
(c) This insurance is not a substitute for re-
quired or compulsory insurance in any
country outside the United States, its ter-
ritories and possessions, Puerto Rico and
Canada.
© 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 427

You agree to maintain all required or
compulsory insurance in any such coun-
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.
(d) It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.

G. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III — PHYSICAL DAMAGE
COVERAGE:

No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.

H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
The following replaces the last sentence of Para-
graph A.4.b., Loss Of Use Expenses, of SEC-
TION III — PHYSICAL DAMAGE COVERAGE:

However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".

I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER-
AGE:

We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.

J. PERSONAL PROPERTY
The following is added to Paragraph A.4., Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:

Personal Property
We will pay up to $400 for "loss" to wearing ap-
parel and other personal property which is:
(1) Owned by an "insured"; and
CA T3 53 02 15

COMMERCIAL AUTO
(2) In or on your covered "auto".

This coverage applies only in the event of a total
theft of your covered "auto".

No deductibles apply to this Personal Property
coverage.

K. AIRBAGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III — PHYSICAL DAMAGE
COVERAGE:

Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.

We will pay up to a maximum of $1,000 for any
one "loss".

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV — BUSINESS AUTO CONDITIONS:

Your duty to give us or our authorized representa-
tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" is known
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-
pany);
(d) An executive officer, director or insurance
manager (if you are a corporation or other or-
ganization); or
(e) Any "employee" authorized by you to give no-
tice of the "accident" or "loss".

M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.5., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS :

5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to the ex-
tent required of you by a written contract
signed and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
© 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 428

COMMERCIAL AUTO
such contract. The waiver applies only to the
person or organization designated in such
contract.

N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2., Con-
cealment, Misrepresentation, Or Fraud, of
SECTION IV — BUSINESS AUTO CONDITIONS:

The unintentional omission of, or unintentional
error in, any information given by you shall not
prejudice your rights under this insurance. How-
ever this provision does not affect our right to col-
lect additional premium or exercise our right of
cancellation or non -renewal.
© 2015 The Travelers Indemnity Compa ny. All rights reserved . CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 429

COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BLANKET ADDITIONAL INSURED - PRIMARY AND

NON-CONTRIBUTORY WITH OTHER INSURANCE -

CONTRACTORS
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

PROVISIONS

1. The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:

This includes any person or organization who you
are required under a written contract or
agreement, that is signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
as an additional insured for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent of
that person's or organization's liability for the
conduct of another "insured".

CA T4 99 02 16

2. The following is added to Paragraph B.5., Other
Insurance of SECTION IV — BUSINESS AUTO
CONDITIONS:

Regardless of the provisions of paragraph a. and
paragraph d. of this part 5. Other Insurance, this
insurance is primary to and non-contributory with
applicable other insurance under which an
additional insured person or organization is a
named insured when a written contract or
agreement with you, that is signed by you before
the "bodily injury" or "property damage" occurs
and that is in effect during the policy period,
requires this insurance to be primary and non-
contributory.
© 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 430

TRAVELERS)

ONE TOWER SQUARE
HARTFORD CT 06183

WORKERS COMPENSATION
AND

EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 99 03 76 ( A) - 001
POLICY NUMBER: UB -7Y767841 -24-26-G

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS

ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule.

The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium.

Schedule
Person or Organization

ANY PERSON OR ORGANIZATION FOR

WHICH THE INSURED HAS AGREED

BY WRITTEN CONTRACT EXECUTED

PRIOR TO LOSS TO FURNISH THIS
WAIVER.

Job Description
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective Policy No. Endorsement No.

Insured Premium
Insurance Company Countersigned by
DATE OF ISSUE: 10-14-24 ST ASSIGN: Page 1 of 1
431

Agenda Item No: 3.c

PLACENTIA CITY COUNCIL AGENDA REPORT
Meeting Date: November 19, 2024
Submitted by: Jeannette Ortega
From: Community Services
Subject:

Review the 35% rendering of the Proposed Placentia Dog Park Project No. 7405 Financial Impact:

Fiscal Impact:

Expense: $106,050 RHA Architectural and Engineering Services for Phase II Budget: $ 56,250 FY 2023-24 CIP Budget (QUIMBY)
$ 49,800 Parks & Rec Impact Fee fund
Summary:

On October 5, 2023, the City issued and publicly advertised a Request for Proposal (RFP) for professional landscape architecture design services for the proposed Placentia Dog Park Project No. 24705 (the "Project"). This proposed Project will include two separate off -leash spaces for large and small dogs. Additionally, improvements will include agility course features, site furnishings, landscape, optimal surface material, perimeter fencing, and automated irrigation system.

Staff received four (4) proposals, and after a thorough review selected RHA Landscape Architects Planners Inc. (RHA), based upon their response to the requirements of the RFP, their qualifications, and their experience in designing similar dog park projects. The agreement with RHA for Phase I includes providing the City with the most suitable location for a proposed dog park, project management, preliminary conceptual design, and cost estimates.

On January 23, 2024, the City Council approved Phase I of the 35% design concept in the amount of $80,000. During this time, a City Council Dog Park Ad -Hoc Committee was formed to assist Staff and RHA in the design and location of the proposed dog park. The Ad -Hoc Committee is comprised of two Council Members and one Commissioner from the Parks, Arts, and Recreation Commission ("PARC").

During Phase I, RHA worked with Staff and the Ad -Hoc Committee to prepare conceptual plans based on Staff and Council's input and for consideration by the City's Parks, Arts, and Recreation Commission. Based on this input, RHA completed the conceptual design at 35%.

This action tonight reviews the conceptual design at 35% and it is at this time that the City Council may elect to proceed with Phase II in the amount of $106,050 with RHA. Phase II will fund the costs needed to complete the remaining 65% design of the project. It is estimated that the total construction costs would be just under $2,000,000. At this time, there has been no 432

community input gathered for this project and no funding has been allocated for the balance of the Phase 11 of design or the estimated project construction cost and future maintenance costs.

Recommendation:

Recommended Action:

It is recommended that the City Council:

1. Review the 35% design renderings and provide feedback and direction for Staff.

Strategic Plan Statement:

There is no specific strategic planning goal or objective associated with this agenda item.

Discussion:

The City Council budgeted $80,000 for design services for the proposed Dog Park Project ("Project") in the Fiscal Year 2023-24 Capital Improvement Program. The general scope of work proposed for this Project includes identifying the most suitable location for the proposed dog park and designing two separate off -leash spaces for large and small dogs. Additionally, improvements include agility course features, site furnishings, landscape, optimal surface material, perimeter fencing, and automated irrigation system.

Staff publicly advertised a notice inviting proposals for professional landscape architecture design services for this project on October 5, 2023. The City received a total of four (4) proposals from well-qualified landscape architecture firms, all of whom have extensive experience in dog park design and development. The Proposal Review Committee consisted of the Director of Community Services, the Deputy Director of Community Services, the Public Works Senior Management Analyst, and the Community Services Management Analyst. The proposals were reviewed and scored based on the scoring criteria outlined within the request for proposals. RHA Landscape Architects Planners Inc. (RHA) ranked first based on their experience and expertise with similar projects and understanding of the work scope and approach of the City's proposed project. The contract scope of work includes conceptual design for all improvements and architecture services for the proposed design project.

During Phase I, RHA worked with Staff and the Ad -Hoc Committee to prepare conceptual plans based on Staff and Council's input and for consideration by the City's Parks, Arts, and Recreation Commission. Based on this input, RHA completed the conceptual design at 35%.

This action tonight reviews the conceptual design at 35% and it is at this time that the City Council may elect to proceed with Phase 11 in the amount of $ 106,050 with RHA, which will fund the costs needed to complete the remaining 65% design of the project.

At this time, there is no funding allocated for this project, and the community input process has not been completed. These two factors play a significant role in completing this project. Staff is requesting that council consider the following options:

1. Put the project on hold until community input is gathered, and funding is acquired for 100% design and Construction completion:
a. Design would remain as presented tonight, however, would not move further until funding was acquired and community input was gathered and analyzed. b. Direct Staff to begin the community input process and propose alternate locations as "pilot" options for temporary dog parks before moving forward with the current design. c. Through the community input process, Staff can gather insight into different locations 433

that could be used as "pilot" locations for a standard dog park by using temporary fencing. This allows the greater community to see the benefits of a dog park as well as provide Staff with considerations on areas to avoid for future planning. Pilot location dog parks would potentially remain open until funding is available to complete construction.

2. Continue with design concepts and move the project into 100% Design with prepared construction documents:
a. Funding for Construction would need to be allocated, with an estimated cost being just under $2,000,000.

Fiscal Impact Summary:

The total cost for the services for Phase II of the proposed Dog Park design project amounts to $106,050 to complete the remaining 65% of the design. Should the City Council approve proceeding with Phase II, the remaining design project cost of $106,050 will be allocated to the Capital Improvement Program Budget for Fiscal Year 2024-25 during the City's regular mid- year budget review. At this time $56,250 has been allocated for Phase II with Quimby funds, with the remaining balance of $49,800 proposed to be funded from the Parks & Rec Impact fee fund.

Attachments
Rendering of the Proposed Dog Park.docx
434

Rendering of the Proposed Dog Park
from the Street view along Bradford Avenue
Between the Backs Community Building on the right and the Commercial Building on the left Small Dog Park on the right
Large Dog Park on the left
1 435

Aerial View
Backs Community Building is situated on the top and the Commercial building on the bottom Small Dog Park on the top
Large Dog Park on the bottom
2 436

Street Level View From Kreamer Park
Backs Community Building is situated on the left and the Commercial building on the right Small Dog Park on the left
Large Dog Park on the right
3 437

Aerial View of the Small Dog Park
4 438

Street level view of the Small Dog Park
5 439

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� � -fi l�Illnl Ir Y11R I A �` �i
]III ii }}ij1I ItUIIIIIJI ;1°
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Street level view of the Small Dog Park
6 440

Aerial View of the Large Dog Park
Main Entrance on the Right
7 441

Aerial View of the Large Dog Park
Secondary Entrance
8 442

Street level view of the Large Dog Park
(image of the Small Dog Park in the foreground)
9 443

Street level view of the Large Dog Park
10 444

Street level view of the Level Dog Park
11 445

Street level view of the Level Dog Park
Secondary Entrance
12 446

Agenda Item No: 3.d

PLACENTIA CITY COUNCIL AGENDA REPORT
Meeting Date: November 19, 2024
Submitted by: Nicolette Drulias
From: City Administrator
Subject:

Study Session: Establishment of the Placentia Centennial Celebration Steering Committee Financial Impact:

Fiscal Impact:

There is no fiscal impact associated with this item at this time.

Summary:

The City of Placentia created a working group of Staff from the City Administrator's Office, Community Services, and Public Works to begin initial planning efforts for the City's upcoming centennial celebration in 2026. The City will celebrate its centennial on December 2, 2026, and plans to celebrate all year long with centennial -themed events, merchandise, a new City logo and updated branding, community involvement, and a special birthday party celebration in December 2026. In order to promote community involvement and ensure we include unique community events and programs for this celebration, Staff is recommending the establishment of a Steering Committee comprised of different City organizations, non -profits, and recognized community groups. The Steering Committee will split off into Subcommittees working with Staff and other members to prepare recommendations for programming, events, and other items associated with the centennial celebrations.

Recommendation:

Recommended Action: It is recommended that the City Council:

1. Receive and File the Staff Report; and

2. Ask any questions of Staff; and

3. Review and approve the composition of the Centennial Steering Committee; and

4. Designate two (2) City Council Members to serve on the Centennial Steering Committee; and

5. Review and approve the application for the Centennial Steering Committee; and

6. Authorize Staff to begin recruitment for the Steering Committee Members.

Strategic Plan Statement:

This item is consistent with the City Council approved 5 -Year Strategic Goal to Increase Community Engagement/ under Objectives #4.1 and #4.2, which is to Evaluate Alternative and More Creative Methods of Community Outreach and Increase Community Engagement/Outreach.
447

Discussion:

The City of Placentia is approaching a significant milestone, with its centennial celebration scheduled for December 2, 2026. Recognizing the importance of this historic event, the City has initiated early planning efforts by creating a working group composed of key staff members from the City Administrator's Office, Community Services, and Public Works. This working group has already begun laying the groundwork for a year-long celebration with community engagement efforts and activities highlighting Placentia's rich history and strong community. As part of the centennial celebration, the City plans to introduce centennial - themed merchandise, unveil a new City logo and update branding, and organize various events throughout 2026. These efforts will culminate in a birthday party celebration in December, commemorating the official 100th anniversary of Placentia's incorporation. The centennial allows the community to unite, honor our past, and encourage participation among residents, businesses, and local organizations.

To ensure that this celebration is inclusive and reflects the City's heritage, Staff recommends forming a Centennial Steering Committee of representatives from each City Department and seventeen (17) members from the following organizations:

Two (2) City Council Members or their designee
*Five (5) Representatives from each City Council District One (1) Representative from the Kiwanis Club of Placentia One (1) Representative from the Rotary Club of Placentia One (1) Representative from the Placentia Library Board of Trustees One (1) Representative from the Placita Santa Fe Merchants One (1) Representative from the Placentia Chamber of Commerce Board One (1) Representative from the Placentia Women's Round Table One (1) Representative from the PYLUSD Staff/Board
Two (2) Representatives from the Placentia Historical Committee One (1) Representative from the Senior Advisory Committee *The five (5) City Council District designees will be chosen in January by the 2025 City Council Members.

City staff will reach out to each of these groups and attend any necessary meetings to inform them of our goals for the Steering Committee and provide them with the information to designate one of their members to serve on the Steering Committee. In order to be a part of this Steering Committee, prospective members will submit an application for consideration.

The draft application can be seen in Attachment #1.

A majority of the workload related to the Centennial planning is carried out by task -focused subcommittees. Subcommittees encapsulate objectives and tasks deemed essential by the Steering Committee. The recommended subcommittees include:
• Marketing Subcommittee
The Marketing Subcommittee will work with a contractor to aid in the selection of the Placentia Centennial logo and branding design. The final design will be presented to the City Council for consideration and approval. This subcommittee will also be responsible for approving logo use on all Centennial materials. The logo and color palettes will be incorporated on flyers, brochures, promotional items, and other Centennial materials such as posters and volunteer shirts. The Subcommittee will also create a Centennial 448

Celebration website platform on the City website, assist with content suggestions, and maintain accountability for the relevancy and accuracy of posted information. The Marketing Subcommittee will work to provide the community with essential information about the upcoming celebrations, a finalized event and activities timeline, and dissemination of core marketing materials across various social media platforms and mailers.
• Community/Business Participation Subcommittee
The Community/Business Participation Subcommittee will work closely with local businesses to integrate centennial themes into their branding, promotions, and store displays throughout 2026. This may involve creating centennial -themed window displays, offering special promotions, and incorporating Placentia's 100 -year celebration into product packaging. The subcommittee can also encourage businesses to sponsor centennial events and display their support through branded materials, such as banners or merchandise. Additionally, the subcommittee could engage the community in beautification projects, like mural paintings and historical landmark clean-ups, and organize volunteer efforts for centennial activities at the annual Love Placentia Day of Service event. Collaborating with businesses to host pop-up centennial booths would provide a platform for sharing historical information and merchandise. Business leaders could be recruited as Centennial Ambassadors, promoting the celebration and encouraging widespread business participation.
• Special Events Subcommittee
The Special Events Subcommittee will help plan the grand birthday celebration in December 2026, marking Placentia's official 100th anniversary. In addition, they will incorporate centennial themes into all city events throughout the year, enhancing celebrations with special activities and programming. The subcommittee will also assist in recruiting volunteers to support the birthday event and staff centennial booths at various city events, ensuring broad community involvement. • Historical Subcommittee
The Historical Subcommittee will collaborate with local historians, the Placentia Library, and the Placentia Historical Committee to gather historical documents, photos, and stories for a centennial history book. The Subcommittee will oversee drafts and provide feedback to ensure the book accurately reflects the city's history and achievements.

They will make recommendations for incorporating historical displays and exhibits into City events throughout 2026. They will also assist with extracting the time capsule and coordinate the creation and burial of a new one to be opened at a future milestone celebration.
• Sponsorship Subcommittee
The Sponsorship Program Subcommittee is tasked with developing an exciting and donor -flexible sponsorship program highlighting Placentia's Centennial Celebration plans and garners support from businesses and community members. This sponsorship program will also assist in subsidizing event direct costs. To enhance sponsor visibility, a recognition program will be created to highlight sponsors through social media, newsletters, and acknowledgments during centennial events. In-kind sponsorship options, where businesses contribute products or services instead of cash, could also be promoted, allowing for contributions like catering, printing, or donated items for raffles.

Additionally, the Subcommittee could work with the Community/Business Participation 449

Subcommittee to feature a "Local Business Spotlight" at centennial events, allowing selected sponsors to showcase their products or services.

Fiscal Impact Summary:

There is no fiscal impact associated with this item at this time. The recommended actions will provide Staff with feedback and direction for beginning the centennial planning process and recruiting for the Centennial Steering Committee. Staff hopes to start recruiting for the Steering Committee once the committee's composition is approved, with the goal of beginning to meet with the Steering Committee at the end of February 2025. A total of $30,000 was budgeted in the FY 2024-25 Budget to secure a contractor for the Centennial logo design and branding. As such, sufficient funds exist to begin the planning efforts and more will be budgeted in the next fiscal year.

Attachments
Centennial Steering Committee Application.pdf
City Council Presentation 11-19-24.pptx
450

City of Placentia
Application for
Centennial Steering Committee
Centennial Steering Committee members will be divided into smaller subcommittees. Please indicate which subcommittee(s) you would be interested in serving on. If more than one, please rank in order of interest.

Community/Business Subcommittee
Historical Subcommittee
Marketing Subcommittee
First Name: Middle Name:

Home Address:

Home Phone: Driver's License No.:

Present Employer: Work Address:

Occupation:

How long have you lived in the City of Placentia?
Former places of employment: From:

To:

Former places of employment: From:

Sponsorship Subcommittee
Special Events Subcommittee
Last Name:

City:

Email Address.:

Work Phone:

Are you a U.S. Citizen?
El Yes n No
Job Title & Description:

Job Title & Description:

Zip Code:

City & Zip Code:

Have you ever filed bankruptcy?
flYes [ To
To:

What are your qualifications, strengths, and experience relevant to the Centennial Steering Committee and desired Subcommittee? Reasons you are interested in serving on the Centennial Steering Committee:

Property Interests in Placentia:

Stock or Business Affiliations with organizations that may provide materials or services to the City of Placentia:

Please Return the Completed Application via mail to:

City of Placentia
Attn: Nicolette Drulias
401 East Chapman Avenue
Placentia, CA 92870
Or via email at: ndruliasaolacentia.ora
For any questions, please contact Communications and Marketing Manager Nicolette Drulias at (714) 993-8107 or ndruliasplacentia.orq. 451

City of Placentia
Application for
Centennial Steering Committee
Background Information
You must respond to all of the following questions:

1. Were you ever employed by or have you served in any capacity at the City of Placentia? Yes
If yes, please describe:

No

2. Are any of your relatives (by blood or marriage) employed by or have they served in any capacity at the City of Placentia?
nYes nNo

3. Have you ever been convicted of any crime or violated any law, ordinance, or statute (this includes traffic citations) other than a parking violation? nYes nNo
• If the answer to any of the above is "Yes," explain in detail in the space provided below.

Notice: The City of Placentia is committed to reasonable accommodation for disabled persons. If you believe you may need reasonable accommodation to perform the duties of the position for which you are applying, you are encouraged to state it in the space below. (use additional sheet if necessary)

PLEASE READ CAREFULLY - APPLICANT'S CERTIFICATION AND AGREEMENT (MUST BE SIGNED AND DATED)
I hereby certify that the facts set forth in the above application are true and complete to the best of my knowledge. I understand that, if appointed, false statements on this application shall be considered sufficient cause for dismissal. I understand that, if appointed, such appointment will be subject to verification of data provided in my application and any related documents or resume. I authorize education institutions, employers, law enforcement authorities, organizations and individuals having relevant information concerning my qualifications for appointment to release such information; and I release all concerned from any liability in connection therewith; and I understand that I can make a written request as to the nature and scope of said information. I understand that if appointed the City will conduct a DMV/criminal background check including fingerprinting. I understand that if appointed, I will be required to know, and comply with, all rules and regulations. I understand that the benefits, rules and regulations may be changed, modified, deleted, or added to at any time at the City's sole option, and without prior notice.

Signature: Date:

Please see the following pages for descriptions of the Centennial Steering Committee and Subcommittees.
452

DESCRIPTIONS OF THE CENTENNIAL STEERING COMMITTEE AND SUBCOMMITTEES

CENTENNIAL STEERING COMMITTEE
The core duties of the Centennial Steering Committee will revolve around guiding and coordinating the City's year-long celebration of its 100th anniversary in 2026. The committee will be responsible for ensuring the events and activities reflect the city's heritage, honor its past, and promote active participation from residents, businesses, and local organizations. The Steering Committee will be divided into five (5) task -oriented subcommittees, each focused on specific aspects of the celebration.

These subcommittees will handle areas like marketing, historical preservation, special event planning, community and business engagement, and sponsorship acquisition. The committee's primary functions will include providing recommendations on centennial programming and events, working closely with city staff and contractors, and ensuring broad community involvement. They will also collaborate with various local organizations, non -profits, and recognized community groups to ensure the centennial celebration is inclusive and representative of the city's diverse interests. The Committee shall meet at least once a month beginning in 2025 through the end of 2026.

MARKETING SUBCOMMITTEE
The Marketing Subcommittee will work with a contractor to aid in the selection of the Placentia Centennial logo and branding design. This Subcommittee will present their final logo to the City Council for consideration and approval. They will also be responsible for approving logo use on all Centennial materials. The logo and color palettes will be incorporated on flyers, brochures, promotional items, and other Centennial materials such as posters and volunteer shirts. They will also create a Centennial Celebration website platform on the City website, assist with content suggestions, and maintain accountability for the relevancy and accuracy of posted information. The Marketing Subcommittee will work to provide the community with essential information about the upcoming celebrations, a finalized event and activities timeline, and dissemination of core marketing materials across various social media platforms and mailers.

COMMUNITY/BUSINESS PARTICIPATION SUBCOMMITTEE
The Community/Business Participation Subcommittee will work closely with local businesses to integrate centennial themes into their branding, promotions, and store displays throughout 2026. This may involve creating centennial -themed window displays, offering special promotions, and incorporating Placentia's 100 -year celebration into product packaging. The subcommittee can also encourage businesses to sponsor centennial events and display their support through branded materials, such as banners or merchandise. Additionally, the subcommittee could engage the community in beautification projects, like mural paintings and historical landmark clean-ups, and organize volunteer efforts for centennial activities at the annual Love Placentia Day of Service event.

Collaborating with businesses to host pop-up centennial booths would provide a platform for sharing historical information and merchandise. Business leaders could be recruited as Centennial Ambassadors, promoting the celebration and encouraging widespread business participation.

SPECIAL EVENTS SUBCOMMITTEE
The Special Events Subcommittee will help plan the grand birthday celebration in December 2026, marking Placentia's official 100th anniversary. In addition, they will incorporate centennial themes into all city events throughout the year, enhancing celebrations with special activities and programming. The subcommittee will also assist in recruiting volunteers to support the birthday event and staff centennial booths at various city events, ensuring broad community involvement.

HISTORICAL SUBCOMMITTEE
The Historical Subcommittee will collaborate with local historians, the Placentia Library, and the Placentia Historical Committee to gather historical documents, photos, and stories for a centennial history book. The subcommittee will oversee drafts and provide feedback to ensure the book accurately reflects the city's history and achievements. They will make recommendations for incorporating historical displays and exhibits into City events throughout 2026. They will also assist with digging up the time capsule and coordinate the creation and burial of a new one to be opened at a future milestone celebration.
453

SPONSORSHIP SUBCOMMITTEE
The Sponsorship Program Subcommittee is tasked with developing an exciting and donor-flexible sponsorship program that innovatively highlights Placentia's Centennial Celebration plans and garners support from businesses and community members that may never have financially supported general community efforts until this opportunity. To enhance sponsor visibility, a recognition program could be created to highlight sponsors through social media, newsletters, and acknowledgments during centennial events. In-kind sponsorship options, where businesses contribute products or services instead of cash, could also be promoted, allowing for contributions like catering, printing, or donated items for raffles. Additionally, the subcommittee could work with the Community/Business Participation Subcommittee to feature a "Local Business Spotlight" at centennial events, allowing selected sponsors to showcase their products or services.
454

Study Session: Establishment of the Placentia
Centennial Celebration Steering Committee
November 19, 2024
1 455

Background
• Official Placentia Centennial Date: December 2, 2026. • The City formed a working group of Staff from the City Administrator's Office, Community Services, and Public Works for initial centennial planning and ideas.
• The goal is to plan for a year-long celebration with centennial -themed events, merchandise, a new City logo and updated branding. • Special birthday party celebration in December 2026.
• Emphasis on community involvement.
• Steering Committee to include City organizations, non -profits, and community groups.
• Subcommittees to work on event programming and celebration plans with Staff.
456

Steering Committee Composition
• To ensure that this celebration is inclusive and reflects the City's heritage, Staff recommends forming a Centennial Steering Committee comprised of representatives from each City Department and seventeen (17) members from the following organizations:

Two (2) City Council Members or their designee
■ *Five (5) Representatives from each City Council District (one person from each District) One (1) Representative from the Kiwanis Club of Placentia One (1) Representative from the Rotary Club of Placentia One (1) Representative from the Placentia Library Board of Trustees One (1) Representative from the Placita Santa Fe Merchants One (1) Representative from the Placentia Chamber of Commerce Board One (1) Representative from the Placentia Women's Round Table One (1) Representative from the PYLUSD Staff/Board Member Two (2) Representatives from the Placentia Historical Committee One (1) Representative from the Senior Advisory Committee *The five (5) City Council District designees will be chosen in January once the new City Council Member is aboard.
457

Steering Committee Application and
Subcommittees
• In order to be a part of this Steering Committee, prospective members will submit an application for consideration.
• The draft application can be seen in Attachment #1 in the City Council Agenda Packet.
• The application is modeled after our regular Commissions/Committees application and asks prospective members to indicate their preference for subcommittees to work on.
• A majority of the workload related to Centennial strategies is carried out by task -focused subcommittees. Subcommittees encapsulate objectives and tasks deemed essential by the Steering Committee. 458

Marketing Subcommittee
• The Marketing Subcommittee will:

Collaborate with a contractor on the selection of the Placentia Centennial logo and branding
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Approve logo usage on all Centennial materials
Ensure the logo and color palette are included on:

Flyers, brochures, promotional items, posters, and volunteer shirts Create a Centennial Celebration website platform on the City website Assist with content suggestions and ensure relevancy and accuracy of information Provide essential information about the Centennial celebrations Finalized event and activities timeline
Disseminate core marketing materials via social media platforms and mailers 459

Community/Business Participation
Subcommittee
• The Community/Business Participation Subcommittee will:

Collaborate with local businesses to integrate centennial themes into:

Branding, promotions, and store displays throughout 2026 Centennial -themed window displays, special promotions, and product packaging Encourage businesses to sponsor centennial events
Display support through branded materials like banners or merchandise Engage the community in beautification projects, including:

Mural paintings and historical landmark clean-ups
Organize volunteer efforts for centennial activities during Love Placentia Day of Service Collaborate with businesses to host pop-up centennial booths for:

Sharing historical information and selling centennial merchandise Recruit business leaders as Centennial Ambassadors to:

Promote the celebration and encourage widespread participation 460

Special Events Subcommittee
• The Special Events Subcommittee will:

Plan the grand birthday celebration in December 2026 for Placentia's 100th anniversary
Incorporate centennial themes into all city events throughout 2026 Enhance celebrations with special activities and programming • Assist in recruiting volunteers for the birthday event • Staff centennial booths at various city events to ensure community involvement
461

Historical Subcommittee
• The Historical Subcommittee will:

Collaborate with local historians, Placentia Library, and Placentia Historical Committee to gather:

Historical documents, photos, and stories for a centennial history book Oversee drafts and provide feedback to ensure the history book reflects the city's history and achievements
Recommend incorporating historical displays and exhibits into city events throughout 2026
Assist with digging up the existing time capsule
Coordinate the creation and burial of a new time capsule for a fu u milestone celebration
e

PLACENTIA
462

Sponsorship Subcommittee
• The Sponsorship Program Subcommittee will:

Develop a donor -flexible sponsorship program to support Placentia's Centennial Celebration
Target businesses and community members, including those new to supporting community efforts
Create a sponsor recognition program to highlight sponsors via:

Social media, newsletters, and acknowledgments at centennial events Promote in-kind sponsorship options where businesses can contribute:

Products or services such as catering, printing, or items for raffles Collaborate with the Community/Business Participation Subcommittee to feature a "Local Business Spotlight" at centennial events Allow selected sponsors to showcase their products or services 463

Recommendations
• It is recommended that the City Council take the following actions:

Receive and File the Staff Report; and
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Review and Approve the composition of the Centennial
Steering Committee; and
Designate two (2) City Council Members to serve on the
Centennial Steering Committee; and
Review and Approve the application for the Centennial
Steering Committee; and
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Committee Members.
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464

Questions & Comments
11 1

Agenda Item No: 3.e

PLACENTIA CITY COUNCIL AGENDA REPORT
Meeting Date: November 19, 2024
Submitted by: Carole Wayman
From: City Clerk
Subject:

Appointment to the Orange County Vector Control District Financial Impact:

Fiscal Impact: None
Summary:

The Mayor and City Council have received a letter from the Orange County Vector Control District (OCVCD) to reappoint Mr. Craig S. Green, or a successor, to the Board of Trustees for the next term of office beginning in 2025 for two (2) or four (4) years. Mr. Green has expressed his desire to continue serving as the City's representative on the OCVCD Board of Trustees.

The City Council has final discretion on the appointment and term.

Mr. Green's current term on the OCVCD Board of Trustees will expire on January 6, 2025. He was first appointed to the OCVCD Board in January 2017 and subsequently reappointed for several terms. He has attended 82 of the 87 meetings held for a 94 percent record of attendance during his term.

Recommendation:

Recommended Action: It is recommended that the City Council:

1. Consider Mr. Craig S. Green for reappointment to the Orange County Vector Control District (OCVCD) Board of Trustees, or a successor, for a two (2) or four (4) year term; and

2. Direct Staff to notify the OCVCD of the City Council's appointment; and

3. Direct Staff to update the City's intergovernmental agencies, associations and subcommittees list.

Discussion:

On January 10, 2023, the City Council approved former Council Member Craig S. Green to serve a two-year term for the OCVCD Board of Trustees. The Board of Trustees is comprised of 35 members, one from each of Orange County's 34 cities and one representing the County at large. The stipend for serving on the OCVCD Board of Trustees is $100 per month. Mr.

Green has expressed his desire to continue to serve on the OCVCD Board of Trustees.

OCVCD submitted an official correspondence (Attachment 1) on October 7, 2024 to request that Mr. Green be reappointed, or a successor, be appointed to the Board of trustees. As 466

stated in the letter, California Health and Safety Code that governs the duties and responsibilities of vector control agencies in Cailfornia, permits and encourages a member of the City Council, or a member of the public that resides within the appointing agency's jurisdiction. The City Council has the discretion of determining the length of the terms, either for two (2) or four (4) years.

Attachments
OCVCD Letter.pdf
467

2024 BOARD OFFICERS

PRESIDENT
Craig Green

VICE-PRESIDENT
Cecilia Hupp

SECRETARY
Robert Ruesch
DISTRICT MANAGER Lora B. Young
CLERK OF THE BOARD Tawnia E. Pett
2024 BOARD OF TRUSTEES

ALISO VIEJO
Richard Hurt

ANAHEIM
Carlos Leon
BREA
Cecilia Hupp

BUENA PARK
Joyce Ahn

COSTA MESA
William Turpit

CYPRESS
Bonnie Peat

DANA POINT
John Gabbard

FOUNTAIN VALLEY
Kim Constantine

FULLERTON
Shana Charles

GARDEN GROVE
Stephanie Klopfenstein

HUNTINGTON BEACH
Pat Bums
IRVINE
Tammy Kim

LA HABRA
James Gomez

LA PALMA
Debbie S. Baker

LAGUNA BEACH
Mark Orgill

LAGUNA HILLS
Erica Pezold

LAGUNA NIGUEL
Gene Johns

LAGUNA WOODS
Shari L. Home

LAKE FOREST
Robert Pequeno

LOS ALAMITOS
Tanya Doby

MISSION VIEJO
Robert Ruesch

NEWPORT BEACH
Erik Weigand
ORANGE
Jonathan Dumitru

PLACENTIA
Craig Green

RANCHO SANTA MARGARITA
April Josephson

SAN CLEMENTE
Steve Knoblock

SAN JUAN CAPISTRANO
John Taylor

SANTA ANA
Nelida Mendoza

SEAL BEACH
Nathan Steele

STANTON
Gary Taylor
TUSTIN
Rebecca Gomez

VILLA PARK
Crystal Miles

WESTMINSTER
Amy Phan West

YORBA LINDA
Peggy Huang

COUNTY OF ORANGE
Lisa Fernandez
October 7, 2024
Placentia City Council
City of Placentia
401 E Chapman Ave.

Placentia, CA 92870
Dear Mayor and Council Members:
03 13001 Garden Grove Boulevarc
Garden Grove, CA 92843-2102
(714) 971-2421
FAX: (714) 971-3940
[email protected]
www.ocvector.org
0p ocvectorcontrol
X ocvector

RECEIVED
OCT 10 2024

CITY CLERK'S OFFICE

CITY OF PLACENTIA
The term of office of your representative, Craig Green, will expire on the first Monday in January 2025. As you know, Craig Green was appointed in January 2017, and has attended 82 of the 87 meetings held for 94 percent record of attendance.

The qualifications for your representative on the Board of Trustees are stated in Section 2022 of the California Health and Safety Code as follows:
"Section 2022. (b) Each person appointed by a city council to be a member of a board of trustees shall be a voter in that city and a resident of the portion of the city that is within the district."
Your representative is appointed to a two or four year term of office (Section 2024 of the Health and Safety Code) and cannot be replaced except for cause. "Section 2024. (a) Except as provided in Section 2023, the term of office for a member of the board of trustees shall be for a term of two or four years, at the discretion of the appointing authority. Terms of office commence at noon on the first Monday in January."
It is the Board's request that you reappoint Craig Green, or a successor, for the next term of office for either two or four years. Once an appointment is made, please send notification to the District by mail or e-mail to: [email protected].
tep
cc: Craig Green
Sincerely,
Tawnia Pett
Executive Assistant/Clerk of the Board
An independent special district serving Orange County since 1947.

The mission of the Orange County Mosquito and Vector Control District is to educate and protect Orange County from vectors and prevent vector-borne diseases in an environmentally responsible manner.