Loading...
Agr - Costa Mesa Community Athletic Association - 2022-09Costa Mesa Sanitary District Rental Agreement In consideration of the permission granted by the Costa Mesa Sanitary District (District) to the undersigned (Renter) for the use of the District Board/Community Room, between the hours of I � 3oAkA-1:44(}y1 on q.%'+ o.1 l•9 �.120� the undersigned agrees to pay by a Cleaning/Damage Deposit in the sum of $150 from which the District may deduct for breakage, damage, loss, cleaning, administrative fees, and loss of use incurred by the District. The Cleaning/Damage Deposit, less any such deductions, will be returned no later than thirty (30) days after the rental period upon inspection of the Premises. 1. Renter will use the Premises solely for a local, non-profit organization's event or to facilitate a government organization's function. All rentals must be "invite only" if a private party, "members only" if a non-profit event, or "reserved attendee" if a Government function. Rentals are not to be advertised as unrestricted access by the general public or through public media. There shall be no commercial, for -profit business or other similar use unless agreed to in writing before the event by the District's authorized representative. 2. Renter is responsible for the preservation of the Premises during the rental and for leaving the Premises in good order and condition at the end of the rental. Renter will not borrow property or equipment from the District. Renter shall reimburse the District for the cost of repairs and replacement of property damaged during the rental. 3. Renter shall cause the Premises to be vacated no later than 1 hour after the scheduled end of the event and/or no later than 11:00 PM. All personal property brought to the Premises by or on behalf of the Renter must be removed by the end of the rental. 4. Renter will confine all activities during the rental to the Board/Community Room of the District building, and shall not use any other part of the District property. 5. Renter shall have vehicular ingress and egress and reasonable use of only the specific parking spaces designated for handicapped permits. Fire lanes must be strictly maintained. 6. Renter's Cleaning/Damage Deposit is due not less than thirty (30) days before the commencement of the rental period, along with the Certificate of Insurance required by this Agreement. If cancellation is made more than 30 days from date of event, the Cleaning/Damage Deposit will be returned. However, if the event is canceled within 30 days of the date of the event, the Cleaning/Damage Deposit will be retained by the District as compensation for the District's administrative costs. 7. Renter will not: (i) Commit or allow any unlawful act to be committed on the Premises. (ii) Use or permit the use of any liquor or supplies belonging to the District which Renter may find on the Premises. (iii) Sell or allow the sale of any alcoholic beverage. (iv) Permit smoking within the District building. SUMMARY OF CHARGES: Rental Fee Cleaning/Damage Deposit 150 Total Rental Fees The Cleaning/Damage Deposit will be returned following inspection of the District after the event. Date: ct' I `E A • II Q I1 •i`i Rental -Time: Prep/SetUp: to Event Time: 3 o to 9 : ° O Clean -Up: to Day of the Week: (.J C D h j�--S A 'A`/ Purpose of Meeting/Program: I p A r � � i r& ct0 r s Anticipated Attendance: MA X i Y Equipment Requests: (i.e. Podium, microphones, tables, chairs, etc.) Payment Method: as hec (payable to Costa Mesa Sanitary District) redit Car Name on Card Credit Card No.: — Expiration Date: 3 Digit Security No.: J Amount to be Charged: $ Billing Address: — City: State — Zip Authorized Signature: a 4 Ali o® CERTIFICATE OF LIABILITY INSURANCE DATE 9�9�0 2YY) 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(les) 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). PRODUCER CONTACT Ken Modem CPCU NAME: Wigmore Insurance Agency Inc. PHONE (714)979-6543 FAX 11341549-2943 880 W. 19th St. AIL ADDRESS: comercialOwigmoreins. com INSURERS AFFORDING COVERAGE NAIC X License #0811959 INSURERA:United States Liability Ina. Company 25895 Costa Mesa CA 92627 INSURED INSURER B Costa Mesa Community Athletic Association INSURER C: INSURER D: DBA: Costa Mesa United 1700 Adams Ave #212 INSURER E: INSURER F: Costa Mesa CA 92626 COVERAGES CERTIFICATE NUMBER:22/23 ALL LINES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 Lm TYPE OF INSURANCE AD L SUOR POLICY NUMBER POLICYEFF MMIOD POLICY EXP MMmD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 A X CIAIMG-MADE OCCUR DI PREMISES Ea occoaen $100,000 lL MED ExP (my ono arson) $ 5,000 Hired 6 Non -Owned Auto E MP1564027 5/31/2022 5/31/2023 Included PERSONAL &ADV INJURY $ 2, DOG, 000 GEWLAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY 0 PR6ECT LOC J PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Es accident) $ BODILY INJURY (Per person) t ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS X BODILY INJURY Per accident)S HIREDAUTOS NED AUTOS AUTOS PROPPerERTY DAMAGE aaidenl $ 5 UMBRELLALIAB OCCUR EACH OCCURRENCE 8 AGGREGATE $ EXCESS LJA13 CLAIMSMADE DELI I I RETENTION $ $ WORMRS COMPENSATION I PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERrEXECUTIVE OFFICEIVMEMSER EXCLUDED? El NIA E.L. DISEASE -FAEMPLOYEE $ (Mandatory in NH) If yes, desaibe under DESCRIPTION OF OPERATIONS be. E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarha Schedule, may be eaacbed H more space Is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED PER BLANEET ADDITIONAL INSURED ENDORSEMENT BP 145 NPP (06-10). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa Sanitary District THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 174 W. Wilson Street ACCORDANCE WITH THE POLICY PROVISIONS. Costa Mesa, CA 92627 AUTHORIZED REPRESENTATNE Timothy Wigmore/K140 ACORD 25 (2014101) INS025 (20101) O 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS The Costa Mesa Sanitary District, It's elected and appointed officials, agents, officers, volunteers and employees are included as additional insured. I OFREMARK COPYRIGHT 2000, AMS SERVICES INC. I UNITED STATES LIABILITY INSURANCE GROUP WAYNE, PENNSYLVANIA This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM BLANKET ADDITIONAL INSURED ENDORSEMENT Section II — LIABILITY, C., Who Is An Insured is amended to include as an insured any person, entity or organization that is: 1. A franchisor under a franchise agreement with the Named Insured as franchisee relating to "your work"; or 2. A licensor under a license agreement with the Named Insured as licensee relating to "your work"; or 3. A co-owner with the Named Insured in premises used for "your work"; or 4. A majority owner with a controlling interest in the Named Insured but only with respect to liability arising out of such owner's (i) financial or operational control of the Named Insured; or (ii) ownership, maintenance or use of premises leased or occupied by the Named Insured for purposes of "your work'; or 5. A mortgagee, assignee or receiver of the Named Insured relating to "your work"; or 6. A lessor, or an agent of a lessor, under a lease agreement with the Named Insured as lessee relating to "your work'; or 7. A grantor of a permit to the Named Insured as permitee relating to "your work". However, if the grantor of a permit is a federal, state or local government or political subdivision, there is coverage under this endorsement only for liability arising from: a. The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or b. The construction, erection or removal of elevators; or c. The ownership, maintenance or use of any elevators covered by this insurance; or 8. A lessor of equipment leased to the Named Insured relating to "your work"; or 9. A contributor, benefactor, or supporter who provides financial assistance to the Named Insured in connection with "your work". but only to the extent the Named Insured is required to add such person, entity or organization as an additional insured to this policy under a written contract, written permit or written agreement relating to "your work". Such person, entity or organization is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" that is caused, in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf in connection with "your work" while such written contract, written permit or written BP 145 NPP (06-10) Page I of 2 agreement is in effect. EXCLUSIONS There is no coverage under this endorsement for loss or expense, including but not limited to the cost of defense for "bodily injury", "property damage" or "personal and advertising injury": 1. That occurs after all of "your work", including materials, parts or equipment furnished in connection with "your work" and performed under a written contract, written permit or written agreement has ended; or When that portion of "your work" out of which the "bodily injury", "property damage" or "personal and advertising injury" arises and performed under a written contract, written permit or written agreement has been put to its intended use by any person(s) or organization(s); whichever occurs first. 2. Arising directly or indirectly from construction or demolition operations of any kind performed by you. 3. Caused or alleged to be caused by the sole negligence of an additional insured under this endorsement. 4. Arising out of "your work" performed for a federal, state or local government or political subdivision under a written permit; or 5. Included within the "products -completed operations hazard". CONDITIONS Coverage provided by this endorsement will be excess over any insurance available to any additional insured under this endorsement unless a written contract, written permit or written agreement specifically requires that coverage under this endorsement is primary. All other terms and conditions of this policy remain unchanged. This endorsement is a part of your policy and takes effect on the effective date of your policy unless another effective date is shown. BP 145 NPP (06-10) Page 2 of 2