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Time Warner Cable - Wellness Center WiFi 16 TO: Frank J. Spevacek, City Manager FROM: Jaime Torres, Management Assistant DATE: January 4, 2016 RE: The City grants permission to Time Warner Cable Enterprises LLC ("TWC") to attach, install, maintain, operate, upgrade and remove the equipment, cables, and devices described in exhibit A (the "Equipment") to and at the property located at 78450 Avenida La Fonda La Quinta, CA 92253. Attached for your signature is the agreement with Time Warner Cable for additional Wifi Services at 78450 Avenida La Fonda La Quinta, CA 92253. Please sign the attached agreement(s) and return it to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: N/A Contract payments will be charged to account number:________________________________. 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: N/A Approved by the City Council on ___ _X_ City Manager’s signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: _X_ Insurance certificates as required by the agreement (initialed by Risk Manager on _____________ N/A Performance bonds as required by the agreement (originals) N/A City of La Quinta Business License (copy or note number & expiration date here ___________________ N/A Purchase Order number _______________ Wellness Center FRANK J. SPEVACEK CITY MANAGER JANUARY _____, 2016 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 ATTEST TO CITY MANAGER'S SIGNATURE: . ____________________________________________ SUSAN MAYSELS, CITY CLERK . . . DOCUMENT APPROVED AS TO FORM: . ____________________________________________ WILIAM H. IHRKE, CITY ATTORNEY Exhibit A Equipment Time Warner Cable currently uses the following Ruckus Wireless models, however final equipment selection is based on the network design process. A formal design plan including equipment selection will be provided to the City for sign off prior to any deployment. 8218394_2 The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 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). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORDs provided by Forms Boss. www.FormsBoss.com; (c) Impressive Publishing 800-208-1977 $3,000,000.00 $5,000,000.00 $10,000.00 42307 A WC 1103548 $25,000,000.00 Excess Auto Only $1,000,000.00 1/1/2017 TIME WARNER CABLE ENTERPRISES LLC 17777 CENTER COURT DRIVE, SUITE 800 CERRITOS, CA 90703 City of La Quinta Attn: Frank Spevacek City Manager 78-495 Calle Tampico La Quinta, CA 92253 $5,000,000.00 $3,000,000.00 1/1/2017 $5,000,000.00 X 22667 23841 N $5,000,000.00 COMPANY B: Navigators Insurance Company COMPANY E: New Hampshire Insurance Company Excess WC OH ($5M Retention) 174667 NY16EXC702201 IV 1/1/2017 Employers Liability G27933518 001 X 19410 B X Marsh USA, INC. 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 X 1/1/2016 COMPANY F: Insurance Company of State of PA (714) 414-1471 CA 9734297 (AOS) CA 9734298 (VA) CA 9734299 (MA) 1/1/2016 $5,000,000.00 $20,000,000.00 19429 Geoff Spickler GL 2039205 19445 See second page for specific policy information. 1/1/2017 1/1/2016 X COMPANY C: Commerce and Industry Insurance Company A A A C 1/1/2017 geoffrey.spickler@twcable.com Please see page 2 for additional insureds and any additional language. Each Occurrence D X $2,500,000.00 $5,000,000.00 1/1/2016 X 12/28/2015 X 1/1/2016 $25,000,000.00 Kimberly Parks COMPANY A: National Union Fire Ins Co Pittsburgh PA COMPANY D: ACE American Insurance Company 1/1/2016 1/1/2017 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED EFFECTIVE DATE: 25 01/01/2016 One Federal Street Boston, MA 02110 USA TIME WARNER CABLE ENTERPRISES LLC 17777 CENTER COURT DRIVE, SUITE 800 CERRITOS, CA 90703 Certificate of Liability Insurance Certificate Reference: 174667 WORKERS COMPENSATION POLICY INFORMATION Insurer Policy Number Effective Date Expiration Date ------------------------------------------------------------------------------------------- E WC 66830255 (ME) 1/1/2016 1/1/2017 E WC 66830256 (AOS) 1/1/2016 1/1/2017 E WC 66830257 (AZ,IL,KY,NC,NH,NJ,PA,UT,VA) 1/1/2016 1/1/2017 E WC 66830258 (CA) 1/1/2016 1/1/2017 E WC 66830259 (FL) 1/1/2016 1/1/2017 F WC 66830260 (MA,ND,WA,WI,WY) 1/1/2016 1/1/2017 E WC 66830261 (MN) 1/1/2016 1/1/2017 F WC 66830262 (OR) 1/1/2016 1/1/2017