HomeMy WebLinkAboutAGMT - American Youth Soccer Organization (AYSO) • •
RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
City Clerk
City of Seal Beach
211 Eighth Street
Seal Beach, California 90740
Exemet from fees ler Government Code § 27383
(space above for recorder's use)
FACILITY LICENSE
This Facility License Agreement ("License") is made as of July 9, 2012 by and between
the City of Seal Beach, a California municipal corporation ("the City"), and American Youth
Soccer Organization Region No. 159.
RECITALS
WHEREAS City holds a long term lease for,the property located at 4665 Lampson Ave,
Seal Beach ("Arbor Park");
WHEREAS, AYSO159 holds community soccer programs consisting of practices and
games at Arbor Park;
WHEREAS, AYSO159 has operated soccer programs at Arbor Park for over 13 years;
WHEREAS, The City and AYSO159 have the mutual interest in providing youth soccer
programs for the benefit of the community.
NOW, THEREFORE, CITY AND AYSO159 AGREE AS FOLLOWS:
AGREEMENT
Grant of License
1.1 City grants to AYSO159 a license to conduct parent soccer programs upon the
portion of Arbor Park depicted on Exhibit A, attached hereto and incorporated by this reference
(hereinafter the "Premises"). AYSO159's license shall be used in accordance with the Schedule
of Use indicated on Exhibit B, attached hereto and incorporated by this reference (hereinafter the
"Schedule of Use") and the terms and conditions set forth herein below. AYSO159 shall not use
the Premises in any manner contrary to the terms of this License without City's prior written
consent. This license will not be in effect until the City obtains the consent of the Army Corp. of
Engineers.
1.2 No Leasehold. No legal title or leasehold interest in the Premises is created or
vested in AYSO159 by the grant of this License.
Consideration
2.1 Landscape Maintenance. In consideration of the license granted by City,
AYSO159 shall be responsible for all costs related to landscape maintenance of all fields at
1
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Arbor Park year round (12 Months). The field quality will be regularly inspected by City Staff
to insure that all standards are met.
2.2 AYSO159 shall provide to the City a copy of all contracts between AYSO159 and
contractors for field maintenance and services of the Premises. All contractors must provide an
insurance policy naming the City of Seal Beach as additionally insured.
Term
3.1 The operating term of this License shall begin July 9, 2012 and may be terminated
by the City upon giving 30 days written notice to AYSO159.
Relationship of the Parties
4.1 The only relationship created by this License is of that of licensor and licensee.
Neither City nor any of its officers, employees, or agents shall have control over the means of
service or means of production of AYSO159 or any of its officers, agents, or employees.
AYSO159 is solely responsible for all aspects of its programs and operations including, without
limitation, its use of the Premises. AYSO159 shall not, at any time or in any manner, represent
that it or any of its officers, agents, or employees are in any manner agents or employees of City.
4.2 AYSO159 shall indemnify and hold harmless City and its elected officials,
officers and employees, servants, designated volunteers, and agents serving as independent
contractors in the role of city officials, from any and all liability, damages, claims, costs and
expenses of any nature to the extent arising from AYSO159's personnel practices.
Use of Premises
5.1 Schedule of Use. AYSO159 shall comply with the Schedule of Use. City
reserves the right to use, sublease, or license the Premises to third parties, so long as such third
party use, sublease, or license does not conflict with AYSO159's scheduled use of the Premises.
AYSO159 is aware and acknowledges that the Schedule of Use is subject to change to meet the
scheduling and maintenance needs of the City and agrees to indemnify and hold City harmless
for any such changes to the Scheduled Hours of Use.
5.2 Risk Management. AYSO159 shall follow the principles of a sound risk
management program. Whenever possible, risk shall be avoided.
5.3 Utilities and Landscape Maintenance Costs. City shall be responsible for paying
costs of utilities for the Premises.
5.4 No Unlawful Uses. AYSO159 shall only be permitted to use the Premises for
soccer activities and programs and AYSO159 agrees not to use the Premises for any immoral or
unlawful purpose.
5.5 Preservation of Insurance. AYSO159 shall not commit any acts on the Premises,
nor use the Premises in any manner that will cause the cancellation of any fire, liability, or other
insurance policy insuring the Premises or the improvements on the Premises.
2
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•
5.6 No Waste or Nuisance. AYSO159 shall not commit any waste or any public or
private nuisance upon the Premises.
5.7 Legal Compliance. AYSO159 shall not violate any law, rule, or order of any
federal, state, or municipal government or agency that may be applicable to use of the Premises.
5.8 Vacating Premises. On or before the effective date of termination of this License,
AYSO159 shall vacate the Premises, remove all of AYSO159's personal property from the
Premises, and leave the Premises in good order and repair, subject to the satisfaction of City.
Indemnity
6.1 To the fullest extent permitted by law, AYSO159 shall indemnify, defend and
hold harmless the City, its governing board and commissions and the individuals thereof, and all
its officers, agents, employees and representatives (collectively hereinafter referred to as the
"City" in this Section 6) from and against any and all demands, debts, liens, claims, losses,
damages, liability, costs, expenses, including, but not by way of limitation, fees and costs
actually incurred, whether or not litigation has commenced, judgments or obligations, action, or
causes of actions whatsoever, for or in connection to any injury, damage or loss, including, but
not limited to bodily injury, death, personal injury, property damage, violation of any applicable
Municipal, County, State, and Federal laws and regulations, Court Rules or ordinances, or any
other type of loss (collectively "Claims") sustained or claimed to have been sustained by any
person or persons, or corporation, or public or private entity arising out of the performance or
nonperformance of services, operations, duties, and other obligations of the AYSO159, its
officers, agents, employees, representatives, and subcontractors under this License, excepting
any such claims arising from the sole negligence or willful misconduct of the City. The
provisions of this indemnification clause shall not be limited to the availability or ability to
collect insurance coverage, and shall survive the termination of this agreement.
Insurance
7.1 AYSO159, at its own expense, shall obtain and maintain in effect at all times
during the term of this License, all insurance coverage related to every aspect of its programs.
AYSO159 is responsible for securing and maintaining all insurance coverage to operate pursuant
to requirements of City, State, or Federal statutes. AYSO159 shall provide proof of general
liability, workers compensation, vehicle, and other insurance to City before the commencement
of the operating term and again prior to each anniversary of the commencement of the operating
term. AYSO159 shall obtain and maintain general liability insurance of$2,000,000. City shall
be named as additional insured.
Notices
8.1 All notices and demands that may be required or permitted by this License must
be made in writing. All notices and demands must be sent by national overnight delivery service
(e.g., Federal Express) or certified U.S. mail, return receipt requested, to the addresses specified
below, or to any other place that the respective party may from time to time designate in a notice
to the other.
3
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City: City Manager
City of Seal Beach
211 8th Street
Seal Beach, CA 90740
CO-OP: AYSO159
2842 Coleridge
Los Alamitos, CA 90720
Assignment Prohibited
9.1 This License is personal to AYSO159 and shall not be assigned. Any attempt by
AYSO159 to assign this License shall result in its automatic termination.
Miscellaneous
10.1 Entire Agreement. This License, dated July 9, 2012 contains the entire agreement
between the parties hereto with respect to the subject matter hereof, and any other purported
agreement made shall be ineffective to change, modify, discharge or effect an abandonment of
this License in whole or in part unless such purported agreement is in writing and signed by the
party against whom enforcement is sought.
10.2 Applicable Law. This License shall be governed and interpreted in accordance
with the laws of the State of California.
10.3 No Brokers. Each party represents to the other that it has not engaged or used the
services of any broker, finder, or salesperson in connection with this License.
10.4 Counterparts. This License may be executed in multiple counterparts each of
which shall be deemed an original for all purposes.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first
written above.
CITY OF SEAL BEACH AMERICAN YOUTH SOCCER
ORGANIZATION, REGION NO. 159
By: "! I R • ' i. By:
fir. . Ingram, City ger ohn Herron, President
ATTESTED: APPROVED AS TO FORM:
BYM i . �/L.i BYla_ , �
Linda Devine, City Clerk Quinn Barrow, City Attorney
4
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Exhibit A
Depiction of Premises
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Exhibit B
Schedule of Use
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57296-0001AI 167561 v4.doc
Exhibit B
Schedule of Use
Except as otherwise specified in this paragraph, the term "Dusk" as used in this
Agreement is defined as thirty minutes after Sunset. Sunset shall be the time
reported daily by the National Weather Service. Notwithstanding the foregoing, if
lights are later added to all or part of the FIELDS at Arbor with the approval of the
City, then Dusk" is defended to provide use for AYSO159 until 8:00 p.m.
During the Term of the Agreement, AYSO159 shall have the sole use of the
FIELDS as follows:
July 10 to February 28/29 — Fall Season — Primary Season
Times:
Monday to Friday: 3:00 pm to Dusk. The FIELDS are open to
other users at all other times.
Saturdays and Sundays: 6:30 a.m. to dusk.
Spring Camp: A one week period, typically held during the Spring
break period of the Los Alamitos Unified School District. The
precise dates and times of the Spring Camp are subject to the
approval of the City Manager or his designee.
Summer Camps: Two one week periods beginning or ending
during summer Monday to Friday. The precise dates and times of
the Summer Camps are subject to the approval of the City Manager
or his designee.
March 1 to May 31 — Spring Season — Secondary Season
Times:
Monday to Friday: 3:00pm to Dusk. Notwithstanding the foregoing,
if the City grants a use permit to another organization. The fields
are open to other users at all other times.
Saturdays: 6:30am to Dusk. (AYSO by March 14 of each year will
notify the City of the Saturday dates that are not being used).
• p vl e t 11 ! 1<i :' L
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FIELD USE AND MAINTENANCE AGREEMENT
This Field Use and Maintenance Agreement ( "Agreement ") is made and entered into as of this
day off , 2003, by and between the City of Seal Beach ( "City "), a municipal corporation, and
American Youth Soccer Organization, Region 159, a non - profit community based organization
( "AYSO 159 ").
RECITALS
A. The City leases land located near Lampson Avenue, known as Arbor Park ( "Arbor ").
B. AYSO159 with the consent of the City, through its Parks and Recreation Department, has
used Arbor for the past 7 years for its youth- oriented community based soccer program, and
AYSO159 has provided maintenance and repairs on an as -need basis.
C. AYSO159 wishes to continue its use of Arbor for its community based soccer program.
D. The City wishes to obtain the services of a skilled and experienced organization which will
help maintain Arbor and use it for the benefit of the community.
AGREEMENT
NOW, THEREFORE, the parties agree as follows:
1. Definitions.
a. Maintenance. "Maintenance" includes: mowing, watering, maintaining the watering system,
repairing and replacing broken pipes, valves and sprinkler heads, yearly and regularly
scheduled fertilizing, reseeding and aeration. Maintenance does not include any capital or
extensive improvements to the fields such as installing a new watering system or major
components to it, or the revamping or upgrading of the entire irrigation system of the site, or
grading or drainage.
b. Use. The term "Use" as provided herein is defined as using the open field space areas
located on the FIELDS for AYSO159 soccer programs (practices, scrimmages, games,
tournaments and training) and includes the use of the parking area, ingress and egress, the
placement and maintaining of storage containers for soccer and field equipment and portable
toilets (subject to the rules of placement as determined by the City) and if authorized by the
City, lights. A general description of the field areas is attached to this Agreement as Exhibit
"A," attached hereto and incorporated herein by this reference.
2. Term Of The Agreement. The Term Of The Agreement is for a period of five (5) years from -
the date of execution or for the duration of the term of the City's lease of Arbor, whichever is
shorter. The use of the FIELDS is subject to any existing leases and written agreements
between the City and owner /lessor of the FIELDS and such use shall be commensurate with
the uses granted to the City and as may be renewed by it.
3. Scope of Non - Exclusive Use. AYSOI 59 is granted the use of the fields on the dates and
time set forth in Exhibit `B," attached hereto and incorporated herein by this reference. Such
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S7296.0001.Fields Use Agreement
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Fields Use and Maintenance Agreement: Arbor Park
Page 2
use is non - exclusive as the FIELDS are available for use by the City and other community
based organizations at dates and times not set forth in Exhibit `B."
4. Yearly User Fees.
(a) AYSO159 shall pay a yearly User Fee to the City in the amount of twelve
thousand dollars ($12,000.00) per year.
(b) AYSO159 shall pay any utility costs for lighting and electricity if separately
metered.
(c) Upon receipt of the User Fee, the City shall deposit the entire amount into a
separate account. Unless otherwise agreed by the parties, funds deposited
into the account shall be used solely for the benefit of Maintenance and
improvements to the FIELDS.
(d) For the first year of the Term Of The Agreement, AYSO159 shall pay the
User Fee pursuant to the following schedule:
(i) Thirty days after execution of this Agreement: $ 5,000.00
(ii) Six months after execution of this Agreement: $ 5,000.00
(iii) Eleven months after execution of this Agreement: $ 2,000.00
(e) For the second and subsequent years of the Term Of The Agreement,
AYSO159 shall pay the User Fee as a lump sum of twelve thousand dollars
($12,000.00) no later than thirty (30) days after the anniversary of the
execution date of the Agreement each year.
(f) Failure to pay the fee in the amounts listed above and according to the
schedule listed above shall result in immediate termination of this
Agreement.
5. Insurance. AYSO159 shall at all times during the term of this Agreement carry, maintain,
and keep in full force and effect a general liability insurance policy that shall have a
minimum combined single limit of one million dollars in coverage and which meets the
City's requirements for insurance. The policy shall contain an endorsement naming the City
as an additional insured. AYSO159 shall maintain a current certificate of such insurance on
file with the City Clerk.
6. Oblieations and Covenants of the City. The City shall:
a. Grant AYSO159 use of the FIELDS pursuant to the schedule listed in Exhibit `B ";
b. Not authorize any other event or organization to use the FIELDS at a time AYSO159 is using
and is authorized to use the FIELDS under the schedule in Exhibit `B" except as may be
agreed in writing between the City and AYSO159;
c. Not authorize any use, construction or maintenance of the FIELDS that would permanently
destroy the turf or the irrigation system.
S7296.0001.729050 -1
Fields Use and Maintenance Agreement: Arbor Park
Page 3
7. Maintenance of FIELDS.
a. The City shall hire a contractor of its choice to perform Maintenance on the FIELDS and
facilities.
b. In the event the City determines that it is necessary to temporarily close the FIELDS for
repairs, Maintenance, or restoration work during a time the FIELDS are approved for use by
AYSO159, the City shall obtain the agreement of AYSO159 in writing prior to the closure.
Such closures shall not affect AYSO159's obligations to pay the fees specified in this
Agreement.
8. Notice. Any notices to be given under this Agreement shall be sent via first class mail,
postage prepaid or by personal service and sent or delivered to:
the City at: City of Sea} i
Attn:
211 8th Street/
Seal Beach, CA 90740
AYSO159 at: Regional Commissioner
AYSO 159
Po "T g.53( 11 4 14
LD5 iteAvilirbS, CA cloizo- -l11'!
Any change in an address shall be sent in writing to the other party. Any notice required by
this Agreement shall be deemed received (a) three (3) business days following the date of
deposit in the United States mail, postage prepaid, to the addresses above, or to such other
address as the parties have such other addresses as the parties have designated in writing; or
(b) the day of delivery if delivered by hand or overnight courier service during regular
business hours. Notice by facsimile is acceptable, provided a hard copy of the entire notice is
promptly sent via U.S. mail. Service may not be made by e -mail or by any internet
transmission.
9. Entire Agreement. This instrument constitutes the sole and only Agreement of the parties
hereto respecting the above subject matter and correctly sets forth the rights, duties, and
obligations of each to the other in relation thereto as of its date. Any prior agreements,
promises, negotiations, or representations concerning its subject matter not expressly set
forth in this Agreement are of no force or effect.
10. Right of Entry and Right to Observe. At all times City shall have the permanent right to _
enter the FIELDS and observe and monitor all activities conducted by AYSO159 at the
FIELDS.
11. No Additions. AYSO159 shall not erect or permit to be erected any permanent structures at
the FIELDS.
12. Prohibited Conduct. Nothing in this Agreement implies permission to conduct any business
or allow any other occupancy or use except for the purposes stated herein. Disorderly,
S7296.0001.729050 -1
Fields Use and Maintenance Agreement: Arbor Park
Page 4
objectionable, or illegal conduct by AYSO159 or those occupying the Park with its
permission shall be cause for termination of this Agreement.
13. Governing Law. This Agreement shall be interpreted, enforced and governed by the laws of
the State of California.
14. Severability. Whenever possible, each provision of this Agreement shall be interpreted in
such a manner as to be valid under applicable law. If any provision of this Agreement is
determined by a court of competent jurisdiction to be invalid, void or unenforceable, the
remaining provisions shall nevertheless continue in full force and effect.
15. Waiver. The waiver by any party of any breach of any term, covenant or condition herein
shall not be deemed to be a waiver of such term, covenant or condition or any subsequent
breach of the same or any other term, covenant or condition herein contained.
16. Non - assignment. This Agreement may not be assigned in whole or in part by either party
without the prior written consent of the City.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year
first above written.
City: City of Seal Beach, California
By: AtA
Mayor
ATTE :
By:K. 1.4G.1Lo
City Clerk
• APPROVED AS TO FORM:
By: C P- &I.-/fr
City Attorney
AYSO159: American utl occer anization, Region 159
By:
By: -_ es, -1� 11.
Secretary f--"ir1d t. 6megis /siv+ _
S7296.0001.729050 -1
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Fields Use and Maintenance Agreement: Arbor Park
Page 5
EXHIBIT "A"
DESCRIPTION OF FIELDS
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Fields Use and Maintenance Agreement: Arbor Park
Page 6
EXHIBIT `B"
SCHEDULE OF USE
Except as otherwise specified in this paragraph, the term "Dusk" as used in this Agreement is
defined as thirty minutes after Sunset. Sunset shall be the time reported daily by the National
Weather Service. Notwithstanding the foregoing, if lights are later added to all or part of the
FIELDS at Arbor with the approval of the City, then "Dusk" is defined to provide use for AYSO159
until 8:00 p.m.
During the Term Of The Agreement, AYSO159 shall have the sole use of the FIELDS as follows:
August 1 to February 28/29
Times:
Monday to Friday, 3:00 pm to Dusk. The FIELDS are open to other users at all other
times.
Saturdays, 6:30 a.m. to Dusk.
Federal and State Holidays that occur on a Monday to Friday, 3:00 p.m. to Dusk.
Spring Camp: A one week period, typically held during the Spring break period of
the Los Alamitos Unified School District. The precise dates and times of the Spring
Camp are subject to the approval of the City Manager or his designee.
August Summer Camp: A one week period beginning or ending during the month of
August: Monday to Saturday. The precise dates and times of the August Summer
Camp are subject to the approval of the City Manager or his designee.
March 1 to May 31
Times:
Monday to Friday, 3:00 pm to Dusk. Notwithstanding the foregoing, if the City
grants a use permit to another organization, then AYSO159's use during this period
is Tuesdays & Thursdays, 3:00 pm to Dusk. The FIELDS are open to other users at
all other times.
Saturdays, 6:30 a.m. to Dusk. (AYSO159 by March 10 of each year will notify the
City of the Saturday dates that are not being used.)
Federal and State Holidays that occur on a Monday to Friday, 3:00 p.m. to Dusk
(except July 4` Notwithstanding the foregoing, if the City grants a use permit to
another organization, then AYSO159's use on Federal and State Holidays during this
period is Tuesdays & Thursdays, 3:00 pm to Dusk.
57296.0001.729050 -1
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Fields Use and Maintenance Agreement: Arbor Park
Page 7
Sundays, 7:00 am to Dusk, but only from December 1 to March 31. AYSO159 may also use
the FIELDS on Sundays outside this period if AYSO159 requests the use no later than sixty
(60) days in advance and the City Manager or his designee consents to the use.
Tournaments: AYSO159 may also use the FIELDS on any combination of consecutive
days (Monday to /through Sunday) for an AYSO- sponsored tournament or event for not less
than three (3), two -to -four consecutive day tournaments at any time between January 1 and
December 31, inclusive, except for the period between June 1 to July 31, inclusive, provided
AYSO159 gives advance written notice of not less than ninety (90) days before the first day
of use, the City Manager or his designee consents to the use, and the use does not conflict
with a use permit that the City has granted to another organization.
June 1 to July 31. Except for approved Tournaments or an approved August Summer Camp
that partially takes place in July, AYSO159 will not use the fields during these months.
S7296.0001.729050 -1
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Arbor Park
ACORO"' CERTIFICATE OF LIABILITY INSURANCE Date(mm/dd /yy)
L - 6/16/2010
Producer THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
Willis Insurance Services of Atlanta, Inc.
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
One Glanlake, Suite 1100 COVERAGE AFFORDED BY THE POLICIES BELOW
Atlanta, GA 30328 INSURERS AFFORDING COVERAGE
INSURER Philadelphia Insurance Companies
A
(800) 872 -2976 INSURER
www.soccer.org (310) 643 -5310 B
Insured INSURER
AYSO Region 0159 C
12501 S. Isis Avenue INSURER
Hawthorne CA 90250 D
INSURER
E
COVERAGES
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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY POLICY
INSR EFFECTIVE EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE DATE LIMITS
MM /DD/YY MM /DD/YY
A T GENERAL LIABILITY PHPK556214 7/1/2010 7/1/2011 EACH OCCURRENCE $ 1000000
A V COMMERCIAL GENERAL LIAB FIRE DAMAGE (Any one fire) $ 1000000
A ICLAIMS MADE ZI OCCUR MED EXP (Any one person) $ 5000
✓ Participant PERSONAL & ADV INJURY $ 1000000
L Legal Lob GENERAL AGGREGATE $ 3000000
GEN'L AGG LIMIT APPLIES PER PRODUCTS- COMP /OP AGG $ 3000000
POLICY I IPROJECTRI LOC $
AUTOMOBILE LIABILITY
_ ANY AUTO COMBINED SINGLE LIMIT
S
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS BODILY INJURY
NON -OWNED AUTOS (Per accident) $
PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ZANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR 0 CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS' COMPENSATION & (STATUTORY LIMIT 1 !OTHER
EMPLOYERS' LIABILITY EL EACH ACCIDENT $
EL DISEASE - EA EMPLOYEE $
EL DISEASE - POLICY LIMIT $
A Sexual Abuse & PHPK556214 7/1/2010 7/1/2011 1,000,000 Per Person
Molestation Sublimit 2,000,000 Policy Agg
DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
General Aggregate Limit Applies on a Per Region basis S /A/R:
Certificate Holder is an Additional Insured with respect to American Youth Soccer Organization sanctioned events only.
Waiver of Subrogation applies in favor of Additional Insured as respects General Liability where required by contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
City of Seal Beach LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
Attention: Tim Kelsey OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
211 8th Street SENTATIVES * 10 Days for Non - Payment of Premium.
Seal Beach CA 90740 AUTHORIZED
REPRESENTATIVE e'r •
Terry Michelitch
ACORD 25 -S (7/97) ® ACORD CORPORATION 1988
CERT NO.. 7595010 Region 0159 6/16/2010 2 :31:45 PM Page 1 of 2
•
• •
PHPK556214 6/16/2010
PI -AS -010 (04/2004)
- - - -- - THIS ENDORSEMENT CHANGES THE POLICY:
ADDITIONAL INSURED: OWNERS AND / OR LESSORS OF PREMISES, LESSORS
OF LEASED EQUIPMENT, SPONSORS OR CO- PROMOTERS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
This policy is amended to include as an additional Insured any person or organization of the types
designated below, but only with respect to liability arising out of your operations:
1. Owners and / or lessors of the premises leased, rented, or loaned to you, subject to the following
additional exclusions:
a. This insurance applies only to an "occurrence" which takes place while you are a tenant in
the premises;
b. This insurance does not apply to "bodily injury" or "property damage" resulting from
structural alterations, new construction or demolition operations performed by or on behalf
of the owner and / or lessor of the premises;
c. This insurance does not apply to liability of the owners and / or lessors for "bodily injury" or
"property damage" arising out of any design defect or structural maintenance of the
premises or Toss caused by a premises defect.
With respect to any additional insured included under this policy, this insurance does not apply to
the sole negligence of such additional insured.
2. Lessor of Leased Equipment, but only with respect to liability for "bodily injury", "property damage"
or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or
use of equipment leased to you by such person(s) or organization(s) subject to the following
additional exclusions:
a. This insurance does not apply to any "occurrence" which takes place after the equipment
lease expires.
3. Sponsors
4. Co- Promoters
City of Seal Beach
Attention: Tim Kelsey
211 8th Street
Seal Beach CA 90740
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