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Insurance Certificates 2017/18 Los Angeles SMSA LP DBA Verizon WirelesstaQal�trcv CEM ofthr DESERT — MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Angela Ferreira DATE: -F fYlcc, l ?�SL� RE: Land Lease and License Agreement - Verizon/Fritz Burns Park Attached for your signature are Land Lease and License Agreement and Memorandum of Land Lease Agreement Requesting department shall check and attach the items below as a ra riate: _N/A_ Contract payments will be charged to account number: _X_ Amount of Agreement, Amendment, Change Order, etc.: $2,500 per month _N/A_ A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or reportable interests _N/A_ A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: Approved by the City Council on February 20, 2018 _N/A City Manager's signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less. _N/A_ Initial to certify that 3 written informal bids or proposals were received and considered in selection The fatlowing required documents are attached to thea reement: —X_ Insurance certificates as required by the agreement (approved by Risk Manager on L ? ,, ate) j� 1� _N/A_ Performance bonds as required by the agreement (originals) ! 5 _N/A_ City of La Quinta Business License number _N/A_ A requisition for a Purchase Order has been prepared (amounts over $5,000) A copy of this Cover Memo has been emailed to Finance (Sandra) Revised May 2017 Party to the other hereunder. Otherwise, the LESSEE shall have no further obligations for the payment of rent to LESSOR. (c) LESSOR and LESSEE acknowledge and agree that the Property is subject to that certain Grant Deed dated December 27, 1988 and recorded January 31, 1989 ("Deed"), which contains certain use restrictions on the Property. Pursuant to the Deed, the Fritz B. Burns Foundation ("Grantor") granted the Property to LESSOR with a provision ("Deed Restriction") stating that the Property shall not be used "for any purpose except as a public community park and recreational and community uses related to park uses." Notwithstanding that, Grantor has indicated to LESSEE's representative that it does not object to LESSEE's proposed use of the Property, in the event a court having competent jurisdiction makes a determination which is final and non -appealable or which is affirmed and becomes final after the exhaustion of all available appeals, that LESSEE's use of the Property as provided herein must be removed due to a violation of the Restriction, LESSEE shall remove its facility as provided in Paragraph 14 below. 7. UTILITIES. LESSEE shall pay for the utilities it consumes in its operations at the Premises at the rate charged by the servicing utility company. LESSEE shall have the right to obtain separate utility service from any utility company that will provide service to the Premises. LESSEE shall design its utility runs to be underground. If above ground utility runs are required by a servicing utility company, LESSEE must request and obtain approval of the design of the above ground utility from LESSOR, which consent shall not be unreasonably withheld, conditioned or delayed, provided that LESSEE installs all such utilities in compliance with applicable laws and any requirements of LESSOR in its jurisdictional capacity. LESSOR agrees to sign such documents or easements as may be required by said utility companies to provide such service to the Premises, including the grant to LESSEE or to the servicing utility company at no cost to the LESSOR, of an easement in, over, across, or through the Property as required by such servicing utility company to provide utility services to LESSEE as provided herein. Any easement necessary for such power or other utilities will be at a location reasonably acceptable to LESSOR and the servicing utility company. Prior to commencing construction of LESSEE's facilities, LESSOR and LESSEE shall meet to discuss the locations of the existing underground utilities and irrigation in order to minimize any accidental contact therewith. In the event LESSEE, or any entity providing utility services to the Property pursuant to this Section, damages said utilities and/or irrigation, or any other portion of or appurtenance to the Property, LESSEE shall cause such damages to be repaired at LESSEE's sole cost and expense, and to LESSOR's reasonable satisfaction. 8. HOLDOVER. LESSEE has no right to retain possession of the Premises or any part thereof beyond the expiration of that removal period set forth in Paragraph 13 herein, unless the Parties are negotiating a new lease or lease extension in good faith. In the event that the Parties are not in process of negotiating a new lease or lease extension in good faith, and LESSEE holds over in violation of Paragraph 13 and this Paragraph 8, then the rent then in effect payable from and after the time of the expiration or earlier removal period set forth in Paragraph 13 shall be equal to 150% of the rent applicable during the month immediately preceding such expiration or earlier termination. 9. INSURANCE. The Parties hereby waive and release any and all rights of action for negligence against the other which may hereafter arise on account of damage to the Premises 2545/015610-0081 11296581.4 a12/05/17 Lessee Site Name: Chihuahua Page 4 of 16 or to the Property, resulting from any fire, or other casualty of the kind covered by standard fire insurance policies with extended coverage, regardless of whether or not, or in what amounts, such insurance is now or hereafter carried by the Parties, or either of them. These waivers and releases shall apply between the Parties and they shall also apply to any claims under or through either Party as a result of any asserted right of subrogation. All such policies of insurance obtained by either Party concerning the Premises or the Property shall waive the insurer's right of subrogation against the other Party. (a) LESSEE will maintain at its own cost; i. Commercial General Liability insurance with limits not less than One Million Dollars and No/100 ($1,000,000.00) for injury to or death of one or more persons in any one occurrence and Five Hundred Thousand Dollars and No/100 ($500,000.00) for damage or destruction to property in any one occurrence; ii. Commercial Auto Liability insurance on all owned, non -owned and hired automobiles with a minimum combined limit of not less than One Million Dollars and No/ 100 ($1,000,000.00) per occurrence ill. Workers Compensation insurance providing the statutory benefits and not less than One Million Dollars and No/100 ($1,000,000.00) of Employers Liability coverage. LESSEE will include the LESSOR as an additional insured on the Commercial General Liability and Auto Liability policies. (b) LESSOR will maintain at its own cost commercial general liability insurance with limits not less than One Million Dollars and No/100 ($1,000,000.00) for injury to or death of one or more persons in any one occurrence and Five Hundred Thousand Dollars and No/100 ($500,000.00) for damage or destruction to property in anyone occurrence. LESSOR will include the LESSEE as an additional insured. 10. LIABILITY AND INDEMNITY. LESSEE shall indemnify, defend and hold LESSOR harmless from and against all claims, losses, liabilities, damages, costs and expenses (including reasonable attorneys' and reasonable consultants' fees, costs and expenses) (collectively "Losses") to the extent arising from LESSEE's breach of any term or condition of this Agreement or from the negligence or willful misconduct of LESSEE and/or LESSEE's agents, employees or contractors in or about the Property, except to the extent caused by the gross negligence or willful misconduct of LESSOR and LESSOR's agents, employees and contractors. The duties described in this Paragraph 10 shall apply as of the Effective Date of this Agreement and survive the termination of this Agreement. Neither Party shall be liable to the other, or any of their respective agents, representatives or employees for any lost revenue, lost profits, loss of technology, rights or services, incidental, punitive, indirect, special or consequential damages, loss of data, or interruption or loss of use of service, even if advised of the possibility of such damages, whether under theory of contract, tort (including negligence), strict liability or otherwise. 2545/015610-0081 11296581.4 a12/05/17 Lessee Site Name: Chihuahua Page 5 of 16 Notwithstanding the foregoing, in light of the Deed Restriction discussed in Section 6(c) of this Agreement, LESSOR and LESSEE acknowledge that LESSOR shall have no responsibility or obligation to either defend or otherwise support LESSEE's use of the property. Conversely, LESSEE aknowledges and agrees to defend and hold harmless from and against all claims, losses, liabilities, damages, costs and expenses (including reasonable attorneys' and reasonable consultants' fees, costs and expenses) to the extent arising from any conflict or disagreement regarding the Deed Restriction. By way of example, if an individual brings a lawsuit to enjoin such a use of the Property, LESSEE agrees that it will both defend and reimburse City for any costs related to such a cause of action. 11. INTERFERENCE. LESSEE shall install and operate its Facilities in compliance with all applicable Federal Communications Commission ("FCC") requirements and in a manner that will not cause harmful interference to LESSOR or other lessees or licensees of the Property, provided that any such installations predate that of LESSEE's facilities and operate in compliance with applicable laws. In the event LESSEE's Facilities causes such interference, and after LESSOR has notified LESSEE of such interference pursuant to this Agreement, LESSEE will take all commercially reasonable steps necessary to correct and eliminate the interference within thirty (30) days of said notice; provided, however, LESSEE shall have such extended period as may be required beyond the thirty (30) days if the nature of the cure for such interference is such that it reasonably requires more than thirty (30) days and LESSEE commences the cure within the thirty (30) day period and thereafter continuously and diligently pursues the cure to completion. LESSOR acknowledges that interference may come from different sources, and LESSEE shall only be responsible to correct interference to the extent caused by LESSEE's Facilities. In the event LESSEE fails to so correct such interference after said notice and time period as described in this Paragraph 11, LESSEE shall be in default of this Agreement. Subsequent to the installation of LESSEE's facilities, LESSOR will not, and LESSOR will not permit its lessees or licensees to, install new equipment on or make any alterations to the Property contiguous thereto owned or controlled by LESSOR, if such modifications will cause harmful interference with LESSEE's operation of LESSEE's facilities. In the event harmful interference occurs, LESSOR agrees to use best efforts to eliminate such harmful interference in a reasonable time period. LESSOR's failure to comply with this Paragraph shall be a material breach of this Agreement. 12. TERMINATION. (a) This Agreement may be terminated without further liability on thirty (30) days prior written notice as follows: (i) by either Party upon a default of any covenant or term hereof by the other Party, which default is not cured within a sixty (60) day "grace period" following receipt of written notice of default, except that this Agreement shall not be terminated if the default cannot reasonably be cured within such sixty (60) day grace period and the defaulting Party has commenced to cure the default within such sixty (60) day grace period and diligently pursues the cure to completion; provided that the grace period for any monetary default is ten (10) days from receipt of written notice; (ii) by LESSOR, in the event that LESSOR determines that it is necessary to protect persons on the Property or in the immediate community, or both, from conditions dangerous to their health or safety caused by LESSEE's use of the Property, as determined by proper City of La Quinta procedure as it may be amended from time to time; (iii) for purposes of condemnation as further described in Paragraph 29 herein and (iv) for purposes outlined in Paragraph 6 herein. 2545/015610-0081 11296581.4 a12/05/17 Lessee Site Name: Chihuahua Page 6 of 16 A n® CERTIFICATE OF LIABILITY INSURANCE DATE(MM01/24//20182018 V) 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). PRODUCER Aon Risk Services Northeast, Inc. New York NY Office CONTACT NAME. IAIC�No. Esti: (866) 283-7122 StiC Na (800) 363-0105 E-MAIL ADDRESS: 199 Water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins CO Of Pittsburgh 19445 Los Anqeles SMSA LP dba verizon wireless 1095 Avenue of the Americas INSURER B: New Hampshire Insurance Company 23841 INSURER C: American Home Assurance Co. 19380 New York NY 10036 USA INSURER D: Illinois National Insurance Co 23817 INSURER E: General Liability INSURER F: COVERAGES CERTIFICATE NUMBER: 570070052904 REVISION NUMBER: 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. Limits shown are as requested LTR TYPE OF INSURANCE ADD .D] SUBRI HND POLICY NUMBER M Y err POLICYEXP MMlDD LIMITS A X COMMERCIAL GENERAL LIABILITY y G 96564 Ub/'5U/[Ul7 Ub/3U/"'8 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR General Liability UAMAUL l U KLN I tU $2,000,000 PREMISES Ea occurrence MED EXP (Any one person) $10,000 X XCU Included PERSONAL& ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ❑ JECT ❑ LOC PRODUCTS - COMPIOPAGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY CA 286-73-91 AOS 06/30/2017 06/30/2018 COMBINED SINGLE LIMIT $1,000,000 Ea accident BODILY INJURY (Per person) A X ANY AUTO CA 286-73-92 06/30/2017 06/30/2018 OWNED SCHEDULED MA BODILY INJURY(Per accident) A AUTOS ONLY AUTOS CA 286-73-93 06/30/2017 06/30/2018 HIREDAUTOS NON -OWNED ONLY AUTOS ONLY VA PROPERTY DAMAGE (Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS -MADE DED RETENTION B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFF ICERIMEMBEREXCLUDED? (Mandatory in NH) NIA WC063724385 AOS wC063724388 MN 06/30/2U17 06/30/2017 06/31) 2018X 06/30/2018 PER oTH- s ATU E E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 I If s, describe under DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Cell site Name: Chihuahua, Location Code: 273852, Real Estate Protect Number: 20130940459, Address: 78060 Francis Hack Lane, La Quinta, CA 92253, APN: 770-184-011-7, known as Fritz Burns Park. The City of La Quinta, a Municipal Corporation and Charter City are included as Additional Insured with respect to the General Liability and Automobile Liability policies. The General Liability policy shall applyas Primary and Non -Contributory Insurance to each Additional Insured listed herein. where permitted by law, the Named Insured parties listed herein waive all rights against The City of La Quinta, a Municipal Corporation and Charter City listed herein for recovery of damages to the extent these damages are covered by the General Liability, Automobile Liability and Workers' Compensation policies referenced herein and, as further limited by written CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of a Municipal La Quinta corporation and Charter City AUTHORIZED REPRESENTATIVE 78-495 Calle La Quinta CA Tampico 92253 USA y ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000027366 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED Los Angeles SMSA LP POLICY NUMBER See Certificate Number: 570070052904 CARRIER See Certificate Number: 570070052904 NAIC CODE EFFECTIVE DATE: ADDITIONALREMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER TYPE OF INSURANCE INSURER SUBR wVD INSURER POLITY EFFECTIVE DATE MM/DD/YYYI'1 INSURER LIMITS ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR wVD POLICYNUMBER POLITY EFFECTIVE DATE MM/DD/YYYI'1 POLICY EXPIRATION DATE (MM/DD LIMITS WORKERS COMPENSATION C N/A wc063724384 CA 06/30/2017 06%30/2018 D N/A Wc063724386 FL 06/30/2017 06/30/2018 B N/A WC063724387 ME 06/30/2017 06/30/2018 B N/A wc063724383 N7,NY,TX,VA 06/30/2017 06/30/2018 B N/A wc063724389 MA,ND,OH,WA,WI,WY 06/30/2017 06/30/2018 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000027366 LOC #: A"W ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMEDINsukED Los Angeles SMSA LP POLICY NUMBER see Certificate Number: 570070052904 CARRIER NAIC CODE See Certificate Number: 570070052904 1 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles: contract between the parties. ACORD 101 (2008101) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GL 5196564 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization (s): ny person or rganization whom you become obligated to include as an additional isured as a result of any contract or agreement you have entered Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 0 BLANKET WAIVER OF OUR RIGHT TO. RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 06/30/2017 forms a part of Policy No. WC 063-72-4384 Issuedto VERIZON COMMUNICATIONS INC. By AMERICAN HOME ASSURANCE COMPANY We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium for this policy. WC 04 03 61 Countersigned by (Ed. 11/90) T T Authorized Representative POLICY NUMBER: GL 5196564 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETEDOPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribu- tion from any other insurance available to the additional insured. CG 20 01 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1