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Home My WebLink About2012-016 RESOLUTION NO. 2012-16 1 2 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO AUTHORIZING THE EXECUTION OF AN AGREEMENT 3 BETWEEN THE CITY OF SAN BERNARDINO AND THE SAN BERNARDINO BLACK CUL TURE FOUNDATION FOR FINANCIAL ASSISTANCE FROM THE 4 2011/2012 CIVIC AND PROMOTION FUND FOR THE 2012 BLACK HISTORY 5 PARADE 6 7 8 9 10 11 12 13 14 15 16 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO THAT: SECTION 1. The City Manager is hereby authorized and directed to execute an Agreement, a copy of which is attached hereto as Exhibit "A" and incorporated herein by reference as fully as though set forth at length, between the City of San Bernardino and the San Bernardino Black Culture Foundation for financial assistance from the 201112012 Civic and Promotion Fund for the 2012 Black History Parade. SECTION 2. The authorization to execute the above referenced agreement is rescinded if the parties to the agreement fail to execute it within sixty (60) days of the adoption of this Resolution. 17 11/ 18 19 20 III 21 III 22 III 23 III 24 25 III 26 III III 27 III 28 I II 2012-16 1 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO AUTHORIZING THE EXECUTION OF AN AGREEMENT 2 BETWEEN THE CITY OF SAN BERNARDINO AND THE SAN BERNARDINO BLACK CULTURE FOUNDATION FOR FINANCIAL ASSISTANCE FROM THE 3 2011/2012 CIVIC AND PROMOTION FUND FOR THE 2012 BLACK HISTORY 4 PARADE 5 6 I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor and 7 Common Council of the City of San Bernardino at a joint regular meeting 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 thereof, held on the 23rddayof January ,2012, by the following vote, to wit: Council Members: AYES NAYS ABSTAIN ABSENT MARQUEZ X - JENKINS X BRINKER X - SHORETT X KELLEY X JOHNSON X X MCCAMMACK ~~k'~C~ The foregoing Resolution is hereby approved thisd 4.~~ day of January ,2012. ~~' tric J. Morris, a - City of San Bernardino Approved as to form: JAMES F. PENMAN, City ttorney 2012- 16 AGREEMENT Civic and Promotional Funding Agreement This AGREEMENT is entered into between the CITY OF SAN BERNARDINO, a municipal corporation, hereby referred to as "City", and the SAN BERNARDINO BLACK CULTURE FOUNDATION, INC., a non-profit organization, hereby referred to as "Organization." The parties agree to as follows: 1. Recitals. A. Organization has requested financial assistance from City for the Fiscal Year 2011/12 in order to assist in defraying the expense of events related to the 2012 Black History Week celebration, as outlined in their Request for Funding to the Mayor and Common Council, a copy of which is attached hereto and marked as Attachment A. The terms of the request are incorporated herein by reference and shall govern the uses of the funds provided herein. The financial assistance provided for in this Agreement is made on a one-time basis and receipt of said funds shall not imply a continuing obligation of the City beyond the terms of this Agreement. B. The expenditure is for a valid municipal public purpose, which is the conduct of events related to the 2012 Black History Week Celebration and Black History Parade scheduled for February 4, 2012. 2. Payment. Upon presentation of a claim to the City's Finance Director, City shall pay the total sum of $6,000 to Organization from the FY 2011/12 Civic and Promotion Fund. 3. Use of Funds. The funds paid to Organization shall be used solely for the purposes set forth in Paragraph 1 above. No deviation from these provisions shall be made without the express written 1 2012-16 AGREEMENT BETWEEN CITY OF SAN BERNARDINO AND BLACK CULTURE FOUNDATION FOR FINANCIAL ASSISTANCE FROM FY 2011/2012 CIVIC AND PROMOTION FUND. approval of the City of San Bernardino. Any unexpended funds shall be returned to the City by Organization. 4. Accountability. Financial records shall be maintained in accordance with generally accepted accounting principles by Organization in such manner as to permit City to easily trace the expenditure of the funds. All books and records of Organization are to be kept open for inspection at any time during the business day by the City or its officers or agents. Failure to submit the financial records in accordance with this Section will result in the Organization reimbursing the City in the full amount received by Organization. At the conclusion of the program, Organization shall present the City Manager or his designee a written accounting of all expenditures and revenues connected with said event. Organization will further supply City with any and all receipts relating to accounting of expenditures if so requested by City. If Organization does not submit an accounting of expenditures and revenues which City deems appropriate, such failure will result in the Organization reimbursing the City in the full amount received by Organization. 5. Hold Harmless. Organization covenants and agrees to defend, indemnify, and hold harmless the City, its departments, agencies, boards, commissions, elected officials, officers, attorneys, employees and agents from all liabilities and charges, expenses (including attorney fees), suits, or losses, however occurring, or damages arising or growing out of the use or receipt of the funds paid hereunder and all operations under this Agreement. Payments hereunder are made with the understanding that the City is not involved in the performance of services or other activities of Organization. The costs, salary and expenses of the City Attorney and members of his office in enforcing this Agreement on behalf of the City shall be considered as "attorney fees" for the purposes of this paragraph. 2 2012-.16 AGREEMENT BETWEEN CITY OF SAN BERNARDINO AND BLACK CULTURE FOUNDATION FOR FINANCIAL ASSISTANCE FROM FY 2011/2012 CIVIC AND PROMOTION FUND. 6. Insurance. While not restricting or limiting the foregoing, during the term of this Agreement, Organization shall maintain in effect policies of comprehensive public, general and automobile liability insurance, in the amount of $1 ,000,000, per occurrence combined single limit, naming the City of San Bernardino, its officers, employees and agents, as additionally insured. Said coverage shall require ten (10) day written notice to the City if insurance is terminated or materially altered. 7. Termination. City shall have the right to terminate this Agreement by mailing a ten-day written notice to Organization and this Agreement shall terminate ten days after the mailing of such notice. In the event this Agreement is terminated for reasons of improper use of funds or use of funds for any purpose other than those authorized, any unexpended portion of the funds provided by City shall be returned to City. In addition, Organization shall reimburse to City any funds expended which were used for any purpose other than those authorized under the terms of this Agreement. 8. Authorization to Execute. Organization hereby covenants that it has taken all actions necessary to make the adherence to the obligations imposed by this Agreement a binding obligation of the organization. 9. Notices. All notices herein required shall be in writing and delivered in person or sent by certified mail, postage prepaid, addressed as follows: As to City: City of San Bernardino 300 North "D" Street San Bernardino, CA 92418 Attn: City Manager, 6th Floor As to Organization: Black Culture Foundation P.O. Box 7288 San Bernardino, CA 92411 Attn: Joann Roberts, President 3 2012- 16 AGREEMENT BETWEEN CITY OF SAN BERNARDINO AND BLACK CULTURE FOUNDATION FOR FINANCIAL ASSISTANCE FROM FY 2011/2012 CIVIC AND PROMOTION FUND. 10. Entire Agreement. This Agreement and any documents or instruments attached hereto or referred herein integrate all terms and conditions mentioned herein or incidental hereto and supersede all negotiations and prior writing in respect to the subject matter hereof. In the event of conflict between the terms, conditions or provisions of this Agreement, and any such document or instrument, the terms and conditions of this Agreement shall prevail. In witness whereof, the parties hereto have executed this Agreement on the day and date first above shown. D.te:Jh/JL By. D.te:~ ATTEST: By:a~./;J. C~ '" City Clerk Approved as to form: James F. Penman City Attorney By: k 7~ {l 4 Genevieve G~echols 1st Vice President TaY/or Avory 2nd Vice presiflent Charles Burris Treasurer Evelyn Gonzalez Secretary ADVISORS w: Robert Faw/(e Maf9l!retB. Hill Joseph Smith Jr. Frank Washington 111 CORPORATE SPONSORS SAN~MANUEL IlANDOF' ,'\1551~ INDIANS SPONSORS Community Hospital of San Bernatdlno San BemardlnoCifY Unified School District Ed/son International The Gas Company 2012-1.6 San Bernardino Black Culture Foundation P. O. Box 7288 San Bernardino, CA 92411..0288 October 17, 2011 Mayor and Common Council City of San Bernardino 300 North D Street San Bernardino, Oa.92418 Re: 2011 Black History Parade - Theme ("Give Thanks to the Past, Appreciate the Present, and Leave a Legacy for the Future") The 43rd Annual Black History Parade will be held at 12:00 p.m., Saturday, February 04, 2012. The parade is to start at Eight and E Streets, proceed south and end at Third and D Streets. As a non-profit organization, we request financial assistanCe from the City to defray the cost of the parade and its other activities, as reflectedln theattached.budget. We request a waiver of fees and support seNices,ialosing of streets, and barricades along the parade route. Additionally, we request the loan and delivery of the following: a. one large stage to be placed in front of the Carousel Mal/Parking structure on tiE" Street along with twenty chairs and two tables which wi/I be used to seat our special guest. . b. Use of Court Street Square and Public restrooms at Court Street Square. c. Bleachers, Chairs, Tables, and Viewing Stand from the City of San Bernardino and crews to transport same. A Hold Harmless Agreement has been prepared and a map of-the parade route is attached. We have obtained sufficient insurance to cover all events and a copy of the Certificate of Insurance is attached. Should you require additioval information, please contact Ms. Evelyn Gonzalez at (909) 888-1696 or (909) 763-9483. Thank you for considering our request and we hope to hear from you soon. ~/'.n. carely. ,i,.j I _,- Olftt1fJ l1tOty:tt;-' J(jnn Roberts, President I_~' I", , JR/eg Enel 2012-..16 ':.P~E/~PEISIAL.. .JUllllJCATION .. .CITY OP'SAN'B.ERNARDINO. MUNICIPALeop~ 5;42. - _ -.....:' 1;"-"'oL<o ... ~ "",. - ~"':jlj"..". 0'; , ~ ~ ~ G -:. -'-. CheCk. One: 'faParade CJSpeolal event. . SAN .B:El\~ARDINO BLACK CULTURE FOUNDATION. INC SpDIlIcW,~"""~ P.O. BOX 7288 SAN BERNARDINO, CA 92411 lJIcII MIlWII . . FEBRUARY 4, 201:2 Dal8 of Ewnt 1, 2 : 0 0 'P;m. S1artIno 11,. . . . 2:00 p.m. Esdm818d EndnlI TIme Celebrating div.ers:itv in Therneor~ city of San Bernar~ino ~AddmI (9~' 763-94R~ LliCII . (90P.) ~PRone ~or8ul/nlllHad the Loi:eI~or.~H.M TAYLO~ AVERY Eiint(lbll/lllllll . EVELYN GONZALEZ EWnt......~ . Re'cognizing Black .His~ory I .90-9-386-2602 .. I'hGIIt . 909-763-9483 t"flOI18 ~AsserrtJly Area. 8th and liE" Street: EstIm~ed Spectators 3,000 " NUmber Of Vehicles and Persons tn E8ch 1 2 5 E. n t r i ~ q oe~ Sot,I~ Arq:>1IfyIng ~~ntto be used C omm e r cia 1 Describe Training ~ Insttuctibns Given to PartIcIpantS Par a.d e L i n e UP 1) ire c 1: ion. . ,. N~.of.RestrOOmsand ~ater FacIlllles Six yort:ahlPQ An~ ~9udQ.ij at Ce~rt BlLccL 3~. The und9fSiglJ6d makes~ for a ~ event and lit suppa" of saidapptlCBf/On. certifieS that all statements, Itereln (118 "., .accurate anctQO~FaIsIiic:etion or unappr.oved cIJtlIf1BII.may rsSuItln th8 cancellation oft~ 'application. APPlicant acJcnl1WIedtI- ~." ofa copy of ths 18(JUIaflons and /n$I1UCfi01IS. , 0~~1l'dOlL w~~~ ~ ~ RJSK.3,01 (8-llOJ Name of Organization: Date/Tune of Event: Location: Type of Event: E\o'ent Chairman:Phone #: D:a!e: 2012- 16 SAN BERNARDINO BLACK CULTURE FOUNDATION, INC FEBRUARY 4, 2Q12 12tOO p.m. 8TH AND "E" STREETS BLACK HISTORY ~ARADE TAYLOR AVERY 909-3~6-2602/EVELYN GONZALEZ 909-7639483 o C TO BE R 1 7, 2 0 11 (The date that .the organization picked up the parade package - Application, Instructions, Hold Harmless) ." 2012- 16 SAN BERNARDINO REQUEST FOR CIVIC AND PROMOTION FUNDING (PART I) Name of Organization S': ER \ DINO BLACK CULTURE FOUNDATION, INC Address POST OFFICE BOX 7288, SAN BERNARDINO, CA 92411 Contact Person Phone Fax Designation of 5-1 c (3) non-profit status of Organization Date of Event Location Estimated No. of Attendees 3 000 Purpose of Funding 2012 BLACK HISTORY MONTH ACTIVITIES CONSISTING OF: MISS BLACK SAN BERNARDINO PAGEANT, CROWNING OF THE SENIOR KING AND QUEEN, ANNUAL PARADE, EXPOSITION, AWARDS BANQUET AND GOSPEL PROGRAM. PROPOSED CURRENT BUDGET A. REVENUES: (List all anticipated revenues other than City of San Bernardino) AMOUNT TOTAL Soonsorshios cl:,; gOO Reaistrations -rl- Promotions. concessions, souvenirs oroaram sales _n_ Donations (sr.nnT.41?~nT'PC:::'\ do") nnn In Kind Services (Other than City Services) ct? nnn (PARADE VEHICLES. CHANNEL 3) Total Dollar Amount Reauested of City $/fi,000 A. TOTAL PROPOSED REVENUES $1'< 900 2012-16 REQUEST FOR CIVIC AND PROMOTION FUNDING PROPOSED CURRENT BUDGET (PART II) MUST BE SU8IIITTED TO CITY MANAGER'S OFFICE 110 DA YS PRIOR TO EVENT FOR WHICH FUNDING IS REQUESTED. NO EXCEPTIONS. NAME OF ORGANIZATION: SAN BERNARDINO BLACK CULTURE .FOUNDATION. INC. B. EXPENDITURES: (Include all known direct expenses connected with event) EXPENSES AMOUNT TOTAL Personnel/Salaries Permits " Fire Business License ABC Other Exno<:;1-;on H",..1i'h n..ni' 'Pprmii' <1:"''9 nf\ Insurance '1:5 200 .00 City of San BernardinQ (attached Yes x No ) Park Damaae Bond do' "H~ nn Park Clean UP DepositlDamaaeBond Securitv S..B.P.D. .. Private Securitv Other s ~: III{TTV F'RNCTNG $ 9 0_0 . 00 Advertisina Radio Newspaper <l:s:t~ no Banners Fivers do/.o::n no Other Entertainment Music ~7?<; on Sound Svstem $350 . 00 Other $550. 00 Promotional Items Trophies do., nnn nn Ribbons and/or Plaaues .4:75. 00 T~Shirts $465 .00 Other Sanitation Portable Restrooms - Public Services 4!')Qn nn Soecial Events Banquets Facilities """1,0 nn Parade (T . -O..........,b-+..~.. n+n'l 4!o::nn nn Other - Parks. Recreation B. TOtAL PROPOSED EXPENDITURES ** (SEE ATTACHED) $ ~, 7 680:: nn Summary: A. Total Revenues B. Total Expenditures C. Total Fee Waivers- (from Part III) $ 1",Qnn,nl) $-J.Lr6--85.00 $ 26,357.77 D. Total Amount Requested $ 6.000.00 2012-. 16 REQUEST FOR CIVIC AND PROMOTION FUNDING REQUEST FOR FEE WAIVERS (PART III) NAME OF ORGANIZATION: ~Afil ~'F.'RNA'RnTNO lH Ar.V r.m.'I'TT'RI<' r.I<'OTTl\TnA'I'Tnl\T) TNC. (List all City services for which you are requesting fee waivers) C. Fee Waivers AMOUNT Police t1R 1.<:lR su; Securitv Traffic Control Other Fire Site Inspections Crowd Control Facilities Sound System Civic Center Use Permit Public Services Refuse Bins Street Sweeoina t ~AR RR Development Services Plannina TUP Buildina ENGINEERING $ 2.422.03 Other (Explain) PAR KS AN'n 'REr.'R'F.A'I'ION $ 2..628.00 COURT STREET SOUARE $ 2.500.00 Total Amount of Fee Waivers (In-Kind Services) $26.357. 77 For Office Use Only: Departmental Costs In: Police Fire Public Services Public Works Development Services Facilities Previous Year's Accounting Reviewed: Admin: Finance ,....".."",",.",....~,,~..__....__..........-j'___~.__'<',,_t_,,~""',...."..i,~"..;;,.".,."'.-~~".~~"'.~ .. t ,-"", . ..~>........ '--" I' . '. ---.. -, ,r..,_"..~,.._",~_~ .'~ 2012-16 2012 C) IJ;J t'3 - ~ tr.I en td IT i IT 11 ,., Ii 0 (\) (\) .... (\) ~ (p rt' IT /'1' c:: '" .. - 9th S'treat Div' 1 c I'Q 8th street .n -I u ? I>> tf.l I"l niv 3 rt St:urges g, . @ Auditorium CD (J) tn' rt . . 7th street "'';u )I gPolice Victoria ;:;.stat.ion en .6th street Public , Library 5th street 4th Street >c.. Carousel Mall H I: CD Q, PHQ ;-Court street .... , l:l Court Street 0 tQ Square ,.... . fI) . g 2nd Street li=i - --.. ....e J:i~':ls .~ . I-' Rial to . Arrowhead Credit ,. . . .., Onion Park '280 South E street" . l 2012-16 HOLD HARMLESS AND INDEMNIFICA nON LicenseelPennittee shall protect, defend, indemnify and hold the City and its elective and appointive boards, cOtn1l1issions, officers, agents, employees and servants free and harmless from any and all losses, claims, liens, demands and causes of action of every kind and character including, but not limited to, the amounts of judgments, penalties, interests, court costs, legal fees, and all other expenses incurred by the City arising in favor of any party, including claims, liens, debts, personal injuries, including employees of the City, death or damages to property (including property of the City) and without lit:nitati(}n by enumeration, all other claims or demands of every character occurring or in any ways incident to, in connection with or arising directly or indirectly out of this agreement. LicenseelPermittee shall investigate, handle, respond to, provide defense for and defend any such claims, demand, or suit at the sole expense of the Licensee/Permittee. Licensee/Permittee shall also bear all other costs and expenses related thereto, even if the claim or claims alleged are groundless, false or fraudulent. This provision is not intended to create any cause of action in favor of any third party against LicenseelPermitteeor the City otto enlarge in any way the LicenseelPermittee's liability but is intended solely to provide for indemnification of the City from liability for damage or injuries to third persons or property arising from LicenseelPermittee's performance hereunder. /o~ 1---/( DATED San Bernardino Black Culture Foundation. Inc LicenseelPermitte~~ ." I ." BY: Title: i Attach a certified copy of documentation, which will authorize Applicant to contract on behalf of corporationlbusiness. . wI Form W-9 2012- 16 Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. (Rev. January 2011) DllPlIrtment of the TI'Il8SUfY Imamal ReYIlnUllSei'Vlce Name (lIS shown on your income tax return) San Bernardil1() BhJc:kCulture Foundation, Inc. N Business nameldisregllrded entity name, If different from above cD i 0. CheckapprQPriate box for federal tax <: o classification (required): 0 IndividuaVsole proprietor &~ ,i:'.. ~i it -._2 !ill Other (see instructiQns) ~ !e Address (l1umber, Slr8l'l, al1d apt. or suite no.) j 1Il en o C Corporation o S Corporation o Partnership 0 Trust/estate o Exempt payee o Umlted liability company. Enter the tax classification (C=C corporation, S=S corporatIon, P=partnership)" Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name"nne to avoid back\.lp withholding. For individuals, this Is your social security number (SSM. However, for a resident alien, ~Ie proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is yOUr employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Intemal Revenue Service (IRS) that I am SUbject to back\.lp withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer s\.lbject to backUp withholding, and 3. I am a U.S. citizen or other U.S. person (defined belOW). Certification instrucrtlQns. You must cross out item 2 above if you have been notified by the IRS that YO\.l are cummtly subject to backup withholding beca\.lse you have failed to report all interest and dividends on your tax retum. For real estate transactions, item 2 does not apply. For mortgage interest paid, acq\.llsition or abandonment of secured property, cancellation of debt, contrib\.ltlons to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, YO\.l are not req\.lired to sign the certification, b\Jt you mustprovide YO\.lr correct TIN. See the instructions on page 4. Sign ~re ~~~ Note. .If a requester gives YO\.l a form other than Form W-9 to req\.lest your TIN, you must \.Ise the req\.lester's form if it is s\.Ibstantfally similar to this Form W-9. Definition of a U.S. person. For federal tax p\.lrposes, you are considered a U.S. person if you are: . An indlvld\.lal who Is a U.S. citizen or U.S. resident alien, . A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, . An estate (other than a foreign estate), or . A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that cond\.lct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of Income from s\.lch b\.lslness. F\.Irther, in certain cases where a Form W-9 has not been received, a partnership is req\.lired to presume that a partner is a foreign person, and pay the withholding tax. ThElrefore, if yo\.l are a U.S. person that is a partner In a partnership conducting a trade or b\JSlness in the United States, provide Form W-9 to the partnership to establish your U.S. stat\.ls and avoid withholding on YO\.lr share of partnership income. Post Office Box 7288 City, state, and ZIP code San Bernardino, CA 92411 List account number(s) here (optional) Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to repOrt, for example, incorne paid to yO\.l, real estate transactions, mortgage interest you paid,acq\.lisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person ~ncl\.ldlng a resident alien), to provide yoor correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting fOra number to be iss\.led), 2. Certify that you are not subject to back\.lp withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are alsO certifying that as a U.S. person, YO\.lr allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. 501 (c)3 Requester's name and address (optiona~ County of San Bernardino Department of Public Health Nutrition Program S~al security number [ill -OJ -[[OJ Cat. No. 10231X Form W-9(Rev.1-2011) ..fit ( . ... 2012- 16 ACORDe CERTIFICA TE OF LIABILITY INSURANCE I DATE CMMIDD/YYYY) ~ 10/1712011 PRODUCER THIS CERTIFICATION IS ISSUED ASA MAlTER OF INFORMATION ECHOLS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 219 S ORANGE AVENUE HOLDER. THI$ CERTIFICATE DOES NOT AMEND, EXTEND OR RIAL TO, CA.92376 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (909) 874-3763 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: NORTHWEST INSURANCE AGENCY SAN BERNARDINO BLACK CULTURE FOUNDATION INSURER B: PO BOX 7288 INSURER C: SAN BERNARDINO, CA. 92411 INSURER 0: 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, TERMORCONDITIONOF 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. 11'181 ~~~ TYPE OF INSURANCE POLICY NUMBER Pc"l.{i~:~68~ Pg~fll~~IO~~N LIMITS LTR I~ERALLtABILITY NBA 1550384 01/30/2012 01/30/2013 EACH OCCURRENCE $ 1,000,000 A X X COMMERCIAL GENERAL LIABILITY ~~~~~s TEa occurence) $ I CLAIMS MADE o OCCUR -------- MEO EXP (Anyone pel8On) $ PERSONAl &. AOV INJURY $ f-- 2,000,000 ~ GENERAL AGGREGATE $ ~N'L AGG~n ~~M6: APnS PER: PRODUCTS - COMP/OP AGG $ X POLICY JECT LOC $ I~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) I-- 1- ALL O\MIIEO AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) 1- HIRED AUTOS BODILY INJURY 1- $ NON-O\MIIED AUTOS (Per accident) I- I- ----- PROPERTY DAMAGE $ (Per eccldent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXceSSlUMBRELILA LIABILITY EACH OCCURRENCE $ tJ OCCUR 0 CLAIMS MADE AGGREGATE $ $ 1=1 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION ANO I T~-lI~Ns I IO~ EMPLOyeRS' uABILlTY ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEI $ If YG". describe under SPECIAL PRoVISlnNS below E.L. DISEASE - POLICY LIMIT $ OTHeR DESCRIPTION OF OPERATIONS I lOCATIONS I veHICLes I EXCLUSIONS ADDeD BY eNOORSEMENT I SPECIAL PROVISIONS ANNUAL PARADE & EXPO TO BE HELD ON FEBRUARY 4,2012 CERTIFICATE HOLDER IS NAMED AS AN ADDITONAL INSURED AS THEIR INTEREST MAY APPEAR CITY OF SAN BERNARDINO 300 N "0" STREET SAN BERNARDINO, CA. 92410 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENPEAVOR TO MAIL _ DAYS WRITTeN E CERTIFICATE HOLDER NAMED TO THE LEFt, BUT FAILURE TO DO SO SHALL BLlGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CERTIFICATE HOLDER ACORD 25 (2001/08) @ACORDCORPORATION1988