COMPLETED BOARD ORDER"�|E�
�59
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement No.: A-10766
a. Approve Amendment No. 6 to Operations and Services
Agreement No. A-10766 with the Pajaro/Sunny Mesa
Community Services District to continue to provide
tasks associated with operational and maintenance
services for the wastewater collection system in the
Pajaro County Sanitation District, in the amount of
$182,000 for a total amount not to exceed $918,000
and extend the term through February 9, 2012; and
b. Authorize the Chair to execute Amendment No. 6 to
Operations and Services Agreement No. A-10766 and
future amendments that do not significantly alter the
scope of work or change the approved Agreement
amount
Upon motion of Director Calcagno, seconded by Director Salinas, and carried by those
members present, the Board hereby:
a. Approved Amendment No. 6 to Operations and Services Agreement No. A- 10766
with the Pajaro/Sunny Mesa Community Services District to continue to provide
tasks associated with operational and maintenance services for the wastewater
collection system in the Pajaro County Sanitation District, in the amount of
$182,000 for a total amount not to exceed $918,000 and extend the term through
February 9, 2012; and
b. Authorized the Chair to execute Amendment No. 6 to Operations and Services
Agreement No. A-10766 and future amendments that do not significantly alter the
scope of work or change the approved Agreement amount.
PASSED AND ADOPTED this 11th day of January 2011, by the following vote, to wit:
AYES: Directors Armenta, Calcagno, Salinas, Parker, Potter
NOES: None
ABSENT: None
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California,
hereby certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made
and entered in the minutes thereof of Minute Book 75 for the meeting on January 11, 2011.
Dated: January 24, 2011 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By K'-) V-'k CI,C C~~
Deputy
BIB]
40576-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO97017-U03
MG97055-U03
AS97081-U03
AS97089-U03
AI97774-U03
DO98208-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
2/1/2011-U04
BORENM-U04
15942-U05
1-U06
A.-U07
APPROVE-U07
AMENDMENT-U07
NO.-U07
6-U07
TO-U07
OPERATIONS-U07
SERVICES-U07
AGREEMENT-U07
NO.-U07
A-10766-U07
THE-U07
PAJARO/SUNNY-U07
MESA-U07
MONTEREY-U08
COUNTY-U08
HANCOCK-U09
DENISE-U09
HANCOCKD-U10
12/30/2010-U011
COMMUNITY-U012
SERVICES-U012
DISTRICT-U012
TO-U012
CONTINUE-U012
TO-U012
PROVIDE-U012
TASKS-U012
ASSOCIATED-U012
OPERATIONAL-U012
MAINTENANCE-U012
SERVICES-U012
THE-U012
WASTEWATER-U012
COLLECTION-U012
SYSTEM-U012
IN-U012
THE-U012
PAJARO-U012
COUNTY-U012
SANITATION-U012
DISTRICT,-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$182,000-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$918,000-U012
EXTEND-U012
THE-U012
TERM-U012
THROUGH-U012
FEBRUARY-U012
9,-U012
2012;-U012
B.-U012
AUTHORIZE-U012
THE-U012
CHAIR-U012
TO-U012
EXECUTE-U012
AMENDMENT-U012
NO.-U012
6-U012
TO-U012
OPERATIONS-U012
SERVICES-U012
AGREEMENT-U012
NO.-U012
A-10766-U012
FUTURE-U012
AMENDMENTS-U012
DO-U012
SIGNIFICANTLY-U012
ALTER-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
CHANGE-U012
THE-U012
APPROVED-U012
AGREEMENT-U012
AMOUNT.-U012
SIGNED BOARD REPORT"�|E��MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: January 11, 2011 Consent Special District AGENDA NO.: 59
SUBJECT: a. Approve Amendment No. 6 to Operations and Services Agreement No. A-
10766 with the Pajaro/Sunny Mesa Community Services District to
continue to provide tasks associated with operational and maintenance
services for the wastewater collection system in the Pajaro County
Sanitation District, in the amount of $182,000 for a total amount not to
exceed $918,000 and extend the term through February 9, 2012; and
b. Authorize the Chair to execute Amendment No. 6 to Operations and
Services Agreement No. A-10766 and future amendments that do not
significantly alter the scope of work or change the approved Agreement
amount. J
DEPARTMENT: RMA Public Works
RECOMMENDATIONS:
It is recommended that the Board of Supervisors:
a. Approve Amendment No. 6 to Operations and Services Agreement No. A-10766 with the
Pajaro/Sunny Mesa Community Services District to continue to provide tasks associated
with operational and maintenance services for the wastewater collection system in the
Pajaro County Sanitation District, in the amount of $182,000 for a total amount not to
exceed $918,000 and extend the term through February 9, 2012; and
b. Authorize the Chair to execute Amendment No. 6 to Operations and Services Agreement No.
A- 10766 and future amendments that do not significantly alter the scope of work or change
the approved Agreement amount.
SUMMARY/DISCUSSION:
On January 9, 2007, the Board of Supervisors approved Operations and Services Agreement No.
A-10766 with the Pajaro/Sunny Mesa Community Services District in the amount of $132,000 to
provide operational and maintenance services for the wastewater collection system in the Pajaro
County Sanitation District from January 9, 2007 through January 9, 2008. In addition, the Pajaro
County Sanitation District compensated the Pajaro/Sunny Mesa Community Services District in
the amount of $100,000 for all funds expended in preparation for the assumption of this
Agreement.
On February 12, 2008, the Board of Supervisors approved Amendment No.I to Agreement No.
A-10766 in the amount of $168,000 for a total amount not to exceed $400,000 to provide
additional operational and maintenance services for the wastewater collection system in the
Pajaro County Sanitation District and extend the term through January 9, 2009.
On December 9, 2008, the Board of Supervisors approved Amendment No. 2 to Agreement No.
A-10766 in the amount of $168,000 for a total amount not to exceed $568,000 to provide for
additional operational and maintenance services for the wastewater collection system in the
Pajaro County Sanitation District and extend the term through January 9, 2010.
On January 6, 2010, the Chair of the Board of Supervisors executed Amendment No. 3 to
Agreement No. A-10766 to extend the term through January 9, 2011 to continue to provide for
tasks associated with operational and maintenance services for the wastewater collection system
in the Pajaro County Sanitation District, but did not increase funding for the extended term of the
Agreement.
BIB]
40576-U01
SIGNED-U02
BOARD-U02
REPORT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO97017-U03
MG97055-U03
AS97081-U03
AS97089-U03
AI97774-U03
DO98209-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
2/1/2011-U04
BORENM-U04
15942-U05
1-U06
A.-U07
APPROVE-U07
AMENDMENT-U07
NO.-U07
6-U07
TO-U07
OPERATIONS-U07
SERVICES-U07
AGREEMENT-U07
NO.-U07
A-10766-U07
THE-U07
PAJARO/SUNNY-U07
MESA-U07
MONTEREY-U08
COUNTY-U08
HANCOCK-U09
DENISE-U09
HANCOCKD-U10
12/30/2010-U011
COMMUNITY-U012
SERVICES-U012
DISTRICT-U012
TO-U012
CONTINUE-U012
TO-U012
PROVIDE-U012
TASKS-U012
ASSOCIATED-U012
OPERATIONAL-U012
MAINTENANCE-U012
SERVICES-U012
THE-U012
WASTEWATER-U012
COLLECTION-U012
SYSTEM-U012
IN-U012
THE-U012
PAJARO-U012
COUNTY-U012
SANITATION-U012
DISTRICT,-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$182,000-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$918,000-U012
EXTEND-U012
THE-U012
TERM-U012
THROUGH-U012
FEBRUARY-U012
9,-U012
2012;-U012
B.-U012
AUTHORIZE-U012
THE-U012
CHAIR-U012
TO-U012
EXECUTE-U012
AMENDMENT-U012
NO.-U012
6-U012
TO-U012
OPERATIONS-U012
SERVICES-U012
AGREEMENT-U012
NO.-U012
A-10766-U012
FUTURE-U012
AMENDMENTS-U012
DO-U012
SIGNIFICANTLY-U012
ALTER-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
CHANGE-U012
THE-U012
APPROVED-U012
AGREEMENT-U012
AMOUNT.-U012
SIGNED BOARD REPORT"�|E��Amendment No. 6 to Agreement No. A-10766
January 11, 2011
Page 2
On February 2, 2010, the Board of Supervisors approved Amendment No. 4 to Agreement No.
A-10766 in the amount of $168,000 for a total amount not to exceed $736,000 to continue to
provide tasks associated with operational and maintenance services for the wastewater collection
system in the Pajaro County Sanitation District.
On December 17, 2010, the Chair of the Board of Supervisors executed Amendment No. 5 to
Agreement No. A-10766 to extend the term through February 9, 2011 to continue to provide for
tasks associated with operational and maintenance services for the wastewater collection system
in the Pajaro County Sanitation District, but did not increase funding for the extended term of the
Agreement.
Amendment No. 6 will increase this Agreement by $182,000 for a total amount not to exceed
$918,000 to continue to provide for tasks associated with operational and maintenance services
for the wastewater collection system in the Pajaro County Sanitation District and extend the term
through February 9, 2012.
OTHER AGENCY INVOLVEMENT:
County Counsel, Auditor-Controller, Risk Management, and Contracts/Purchasing Offices have
reviewed and approved Amendment No. 6 as to form and legality, and fiscal and insurance
provisions, respectively.
FINANCING:
The costs associated with Amendment No. 6 will be financed by appropriations in the Pajaro
County Sanitation District Budget Fund 151, Unit 8197, Department 3000, Appropriation
RMA040, Account 6613) for Fiscal Year 2010-11 and Fiscal Year 2011-12.
Prepared by:
Dirk J. Medema, P.E. U Yazdan T. Emrani, M.S., P.E.
Environmental Services Manager Director of Public Works
831) 784-5647 831) 755-4831
Date: January 3, 2011
Attachments: Board Order; Operations and Services Agreement on file with the Clerk of the
Board); Location Maps
BIB]
40576-U01
SIGNED-U02
BOARD-U02
REPORT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO97017-U03
MG97055-U03
AS97081-U03
AS97089-U03
AI97774-U03
DO98209-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
2/1/2011-U04
BORENM-U04
15942-U05
1-U06
A.-U07
APPROVE-U07
AMENDMENT-U07
NO.-U07
6-U07
TO-U07
OPERATIONS-U07
SERVICES-U07
AGREEMENT-U07
NO.-U07
A-10766-U07
THE-U07
PAJARO/SUNNY-U07
MESA-U07
MONTEREY-U08
COUNTY-U08
HANCOCK-U09
DENISE-U09
HANCOCKD-U10
12/30/2010-U011
COMMUNITY-U012
SERVICES-U012
DISTRICT-U012
TO-U012
CONTINUE-U012
TO-U012
PROVIDE-U012
TASKS-U012
ASSOCIATED-U012
OPERATIONAL-U012
MAINTENANCE-U012
SERVICES-U012
THE-U012
WASTEWATER-U012
COLLECTION-U012
SYSTEM-U012
IN-U012
THE-U012
PAJARO-U012
COUNTY-U012
SANITATION-U012
DISTRICT,-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$182,000-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$918,000-U012
EXTEND-U012
THE-U012
TERM-U012
THROUGH-U012
FEBRUARY-U012
9,-U012
2012;-U012
B.-U012
AUTHORIZE-U012
THE-U012
CHAIR-U012
TO-U012
EXECUTE-U012
AMENDMENT-U012
NO.-U012
6-U012
TO-U012
OPERATIONS-U012
SERVICES-U012
AGREEMENT-U012
NO.-U012
A-10766-U012
FUTURE-U012
AMENDMENTS-U012
DO-U012
SIGNIFICANTLY-U012
ALTER-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
CHANGE-U012
THE-U012
APPROVED-U012
AGREEMENT-U012
AMOUNT.-U012
SIGNED AGREEMENT��"�|E���A
AMENDMENT NO. 6 TO
OPERATIONS AND SERVICES AGREEMENT
BETWEEN PAJARO/SUNNY MESA COMMUNITY SERVICES DISTRICT AND
PAJARO COUNTY SANITATION DISTRICT
THIS AMENDMENT NO. 6 to the Operations and Services Agreement between the Pajaro/Sunny
Mesa Community Services District, a political subdivision of the State of California hereinafter,
Community Services District"), and the Pajaro County Sanitation District hereinafter, County
Sanitation District") is hereby entered into between the Community Services District and the County
Sanitation District.
WHEREAS, County Sanitation District entered into an Operations and Services Agreement with
Community Services District on January 9, 2007 hereinafter, Agreement"); and
WHEREAS, Agreement was amended by the parties on February 12, 2008 hereinafter,
Amendment No. I"), December 17, 2008 hereinafter, Amendment No. 2"), January 6, 2010
hereinafter, Amendment No. 3"), February 3, 2010 hereinafter, Amendment No. 4"); and
December 17, 2010 hereinafter, Amendment No. 5"); and
WHEREAS, operational and maintenance services for the wastewater collection system in the Pajaro
County Sanitation District have not been completed and continuing work is necessary; and
WHEREAS, the Community Services District and the County Sanitation District wish to further
amend the Agreement to extend the term to February 9, 2012 and increase the dollar amount to
continue to provide tasks associated with operational and maintenance services for the wastewater
collection system in the Pajaro County Sanitation District.
NOW, THEREFORE, the parties agree to amend the Agreement as follows:
1. Amend the first sentence of Paragraph 2, Term", to read as follows:
The term of this Agreement shall commence on January 9, 2007 and shall end on February 9,
2012 unless sooner terminated by the parties.
2. Amendment No. 6 to Agreement hereby increases the Agreement amount by $182,000 for a
total amount not to exceed $918,000.
3. All other terms and conditions of the Agreement remain unchanged and in full force.
4. This Amendment No. 6 shall be attached to the Agreement and incorporated therein as if
fully set forth in the Agreement.
Amendment No. 6 to Operations and Services Agreement
Pajaro/Sunny Mesa Community Services District
Operational and Maintenance Services for the
Wastewater Collection System in the Pajaro County Sanitation District
RMA Department of Public Works
Term: January 9, 2007 February 9, 2012
Not to Exceed: $918,000
Page 1 of 2
BIB]
40576-U01
SIGNED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO97017-U03
MG97055-U03
AS97081-U03
AS97089-U03
AI97774-U03
DO98210-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
2/1/2011-U04
BORENM-U04
15942-U05
1-U06
A.-U07
APPROVE-U07
AMENDMENT-U07
NO.-U07
6-U07
TO-U07
OPERATIONS-U07
SERVICES-U07
AGREEMENT-U07
NO.-U07
A-10766-U07
THE-U07
PAJARO/SUNNY-U07
MESA-U07
MONTEREY-U08
COUNTY-U08
HANCOCK-U09
DENISE-U09
HANCOCKD-U10
12/30/2010-U011
COMMUNITY-U012
SERVICES-U012
DISTRICT-U012
TO-U012
CONTINUE-U012
TO-U012
PROVIDE-U012
TASKS-U012
ASSOCIATED-U012
OPERATIONAL-U012
MAINTENANCE-U012
SERVICES-U012
THE-U012
WASTEWATER-U012
COLLECTION-U012
SYSTEM-U012
IN-U012
THE-U012
PAJARO-U012
COUNTY-U012
SANITATION-U012
DISTRICT,-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$182,000-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$918,000-U012
EXTEND-U012
THE-U012
TERM-U012
THROUGH-U012
FEBRUARY-U012
9,-U012
2012;-U012
B.-U012
AUTHORIZE-U012
THE-U012
CHAIR-U012
TO-U012
EXECUTE-U012
AMENDMENT-U012
NO.-U012
6-U012
TO-U012
OPERATIONS-U012
SERVICES-U012
AGREEMENT-U012
NO.-U012
A-10766-U012
FUTURE-U012
AMENDMENTS-U012
DO-U012
SIGNIFICANTLY-U012
ALTER-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
CHANGE-U012
THE-U012
APPROVED-U012
AGREEMENT-U012
AMOUNT.-U012
SIGNED AGREEMENT��"�|E���IN WITNESS WHEREOF, the parties hereto have executed this Amendment No. 6 to the Agreement
as of the day and year written below:
COUNTY OF MONTEREY
7
By:
Chair of the Board of Supervisors
Date:
COMMUNITY SERVICES DISTRICT
By: 4--c-
Don Rosa, Interim General Manager
Date: / 2 / Zc� 0
Approved as to Indemnity and Insurance Provisions
By:
Risk Management
Date:
Amendment No. 6 to Operations and Services Agreement
Pajaro/Sunny Mesa Community Services District
Operational and Maintenance Services for the
Wastewater Collection System in the Pajaro County Sanitation District
RMA Department of Public Works
Term: January 9, 2007 February 9, 2012
Not to Exceed: $918,000
Page 2 of 2
BIB]
40576-U01
SIGNED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO97017-U03
MG97055-U03
AS97081-U03
AS97089-U03
AI97774-U03
DO98210-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
2/1/2011-U04
BORENM-U04
15942-U05
1-U06
A.-U07
APPROVE-U07
AMENDMENT-U07
NO.-U07
6-U07
TO-U07
OPERATIONS-U07
SERVICES-U07
AGREEMENT-U07
NO.-U07
A-10766-U07
THE-U07
PAJARO/SUNNY-U07
MESA-U07
MONTEREY-U08
COUNTY-U08
HANCOCK-U09
DENISE-U09
HANCOCKD-U10
12/30/2010-U011
COMMUNITY-U012
SERVICES-U012
DISTRICT-U012
TO-U012
CONTINUE-U012
TO-U012
PROVIDE-U012
TASKS-U012
ASSOCIATED-U012
OPERATIONAL-U012
MAINTENANCE-U012
SERVICES-U012
THE-U012
WASTEWATER-U012
COLLECTION-U012
SYSTEM-U012
IN-U012
THE-U012
PAJARO-U012
COUNTY-U012
SANITATION-U012
DISTRICT,-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$182,000-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$918,000-U012
EXTEND-U012
THE-U012
TERM-U012
THROUGH-U012
FEBRUARY-U012
9,-U012
2012;-U012
B.-U012
AUTHORIZE-U012
THE-U012
CHAIR-U012
TO-U012
EXECUTE-U012
AMENDMENT-U012
NO.-U012
6-U012
TO-U012
OPERATIONS-U012
SERVICES-U012
AGREEMENT-U012
NO.-U012
A-10766-U012
FUTURE-U012
AMENDMENTS-U012
DO-U012
SIGNIFICANTLY-U012
ALTER-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
CHANGE-U012
THE-U012
APPROVED-U012
AGREEMENT-U012
AMOUNT.-U012
SIGNED AGREEMENT��"�|E���ACORl3� CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDDlYYYY)
/ 12/10/2010
PRODUCER 831) 724-1085 FAX: 831) 724-1089
KBK Insurance Agency CDI License #0426333
1006 Freedom Boulevard
Watsonville
INSURED
CA 95076
Pajaro Sunny Mesa Community Services
136 San Juan Rd
Watsonville CA 95076
COVERAGES
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURER A. Scottsdale Indemnity Co.
INSURER B: National Casualty Ins. Co
INSURER C:
INSURER D
INSURER E:
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 SUB JECT TO ALL THE TE RMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
JNSR DD'1 POLICY EFFECTIVE I POLICY EXPIRATION
R P F POLICY NUMBER DAO M D DATE MMID YYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
DAMI AGE TO REN'fiE
COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 100000
A X CLAIMS MADE_ X OCCUR WA10002326 9/8/2010 9/8/2011 MED EXP Any one person) 15 5000
PERSONAL & ADV INJURY i S 1000000
GENERAL AGGREGATE $ 3000000
GEN L AGGREGATE LJM I APPLIES PER.
PRODUCTS COMP/OP AGG $
3000000
POLICY PRO-
LOC
JICT
AUTOMOBILE LIABILITY j
E
IT 1
C
ANY AUTO $
OMBINED SINGL
LIM
Ea accident)
A X, ALL OWNED AUTOS A10002326 9/8/2010 9/8/2011 BODILY INJURY
$
Per person) 1,000,000
X SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS Per accident)
Physical Damage As per schedule in
PROPERTY DAMAGE $
Agency Office Per accident)
GARAGE LIABILITY AUTO ONLY- EAACCIDENT $
ANY AUTO
i EA ACC $
OTHER THAN
AUTO ONLY: AGG S
EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ 2 0
0Q,
000
OCCUR CLAIMS MADE i AGGREGATE $ 2000000
B DEDUCTIBLE tJM00032B32 9/8/2010 9/8/2011
it RETENTION S S
WORKERS COMPENSATION WC STATU- 1 OTH-:
AND EMPLOYERS' LIABILITY YIN TORY 10MI~
ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT S
OFFICERIMEMBER EXCLUDED?
Mandatory in NH) E L DISEASE EA EMPLOYEE S
If yes, describe under
SPECIAL PROVISIONS be:ow
E.L. DISEASE POLICY LIMIT S
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
County of Monterey, its agents, officers and employees and the Pajaro County Sanita tion District, its agents, officers
and employees are named as additional insu=eds
Th'-s insurance is primary and non-contributory
CERTIFICATE HOLDER
County of Monterey and
Pajaro County Sanitation District
Shelley Dickinson
168 W Alisal Street, 2nd Fr
Salinas, CA 93901
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Jo',r_ Kane 1__/JUDY
ACORD 25 2009101) 1988-2009 ACORD CORPORATION All rights reserved
INS025(200goli The ACORD name and logo are registered marks of ACORD
BIB]
40576-U01
SIGNED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO97017-U03
MG97055-U03
AS97081-U03
AS97089-U03
AI97774-U03
DO98210-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
2/1/2011-U04
BORENM-U04
15942-U05
1-U06
A.-U07
APPROVE-U07
AMENDMENT-U07
NO.-U07
6-U07
TO-U07
OPERATIONS-U07
SERVICES-U07
AGREEMENT-U07
NO.-U07
A-10766-U07
THE-U07
PAJARO/SUNNY-U07
MESA-U07
MONTEREY-U08
COUNTY-U08
HANCOCK-U09
DENISE-U09
HANCOCKD-U10
12/30/2010-U011
COMMUNITY-U012
SERVICES-U012
DISTRICT-U012
TO-U012
CONTINUE-U012
TO-U012
PROVIDE-U012
TASKS-U012
ASSOCIATED-U012
OPERATIONAL-U012
MAINTENANCE-U012
SERVICES-U012
THE-U012
WASTEWATER-U012
COLLECTION-U012
SYSTEM-U012
IN-U012
THE-U012
PAJARO-U012
COUNTY-U012
SANITATION-U012
DISTRICT,-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$182,000-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$918,000-U012
EXTEND-U012
THE-U012
TERM-U012
THROUGH-U012
FEBRUARY-U012
9,-U012
2012;-U012
B.-U012
AUTHORIZE-U012
THE-U012
CHAIR-U012
TO-U012
EXECUTE-U012
AMENDMENT-U012
NO.-U012
6-U012
TO-U012
OPERATIONS-U012
SERVICES-U012
AGREEMENT-U012
NO.-U012
A-10766-U012
FUTURE-U012
AMENDMENTS-U012
DO-U012
SIGNIFICANTLY-U012
ALTER-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
CHANGE-U012
THE-U012
APPROVED-U012
AGREEMENT-U012
AMOUNT.-U012
SIGNED AGREEMENT��"�|E���ISSUE DATE: 12-02-2010
CERTHOLDER COPY
P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
MONTEREY COUNTY PUBLIC WORKS DEPT
168 W ALISAL ST 2ND FL
SALINAS CA 93901-243B
NG
GROUP: 000266
POLICY NUMBER: 0000300-2010
CERTIFICATE ID: 3
CERTIFICATE EXPIRES: 07-01-2011
07-01-2010/07-01-2011
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
Authorized Representative \-J President and CEO
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2010-12-02 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL
MONTEREY COUNTY PUBLIC WORKS DEPT INSURED:
EMPLOYER
PAJARO/SUNNY MESA COMMUNITY SERVICES DISTRICT
AN INC. PUB. AGCY.)
136 SAN JUAN RD
ROYAL OAI'S CA 95076
SA5, CS)
NG
Mr.Vr 8-2010) PRINTED 12-02-2010
BIB]
40576-U01
SIGNED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO97017-U03
MG97055-U03
AS97081-U03
AS97089-U03
AI97774-U03
DO98210-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
2/1/2011-U04
BORENM-U04
15942-U05
1-U06
A.-U07
APPROVE-U07
AMENDMENT-U07
NO.-U07
6-U07
TO-U07
OPERATIONS-U07
SERVICES-U07
AGREEMENT-U07
NO.-U07
A-10766-U07
THE-U07
PAJARO/SUNNY-U07
MESA-U07
MONTEREY-U08
COUNTY-U08
HANCOCK-U09
DENISE-U09
HANCOCKD-U10
12/30/2010-U011
COMMUNITY-U012
SERVICES-U012
DISTRICT-U012
TO-U012
CONTINUE-U012
TO-U012
PROVIDE-U012
TASKS-U012
ASSOCIATED-U012
OPERATIONAL-U012
MAINTENANCE-U012
SERVICES-U012
THE-U012
WASTEWATER-U012
COLLECTION-U012
SYSTEM-U012
IN-U012
THE-U012
PAJARO-U012
COUNTY-U012
SANITATION-U012
DISTRICT,-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$182,000-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$918,000-U012
EXTEND-U012
THE-U012
TERM-U012
THROUGH-U012
FEBRUARY-U012
9,-U012
2012;-U012
B.-U012
AUTHORIZE-U012
THE-U012
CHAIR-U012
TO-U012
EXECUTE-U012
AMENDMENT-U012
NO.-U012
6-U012
TO-U012
OPERATIONS-U012
SERVICES-U012
AGREEMENT-U012
NO.-U012
A-10766-U012
FUTURE-U012
AMENDMENTS-U012
DO-U012
SIGNIFICANTLY-U012
ALTER-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
CHANGE-U012
THE-U012
APPROVED-U012
AGREEMENT-U012
AMOUNT.-U012