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HomeMy WebLinkAboutVendor Agreement Ins 1-2 El Pillin.signed.pdf 1 LICENSE AGREEMENT 2 THIS LICENSE AGREEMENT ("Agreement") is dated April 18, 2025 and is between 3 4 El Pillin sole ro rietor (name of contractor), a p p (type of entity) ("LICENSEE"), and the County of Fresno, a political subdivision of the State of California 5 ("COUNTY") (collectively, "Parties"). 6 Winton Park WHEREAS, COUNTY owns and/or operates (name of park) 7 25314 E Trimmer Springs Rd Sanger, CA 93657 located at (address of park), 8 hereinafter referred to as "PREMISES;" and, 9 WHEREAS, COUNTY and LICENSEE mutually desire to allow LICENSEE to use the 10 Sales of can/bottle beverages,chips,toys, 11 PREMISES for the operation of Mexican Snacks service unit(s) or services, hereinafter referred to as "SERVICE"; and, 12 WHEREAS, COUNTY finds that LICENSEE'S operation of said SERVICE is in the 13 14 public interest and that the LICENSEE'S operating on the PREMISES will not substantially 15 conflict or interfere with the use of the PREMISES by COUNTY or County residents. 16 NOW, THEREFORE, in consideration of the mutual promises, covenants and 17 conditions herein contained, the Parties and each of them do agree as follows: 18 1. GRANT OF LICENSE: COUNTY grants to LICENSEE a non-exclusive right to 19 provide SERVICE on the PREMISES for the benefit of employees, guests, and patrons of the 20 PREMISES ("LICENSE"). LICENSEE must have LICENSEE'S business name printed legibly 21 and visible on all vehicles and equipment operating on the PREMISES. Failure to do so may 22 result in not being allowed access to the PREMISES. The LICENSE is personal to the 23 LICENSEE. The LICENSE does not constitute a lease. By grant of this LICENSE, the COUNTY does not grant a possessory interest in the PREMISES under this LICENSE. 24 2. LOCATION: COUNTY shall designate areas within the PREMISES, as shown in 25 Exhibit "A" which is attached hereto and by this reference incorporated herein, as the location 26 27 for LICENSEE'S service equipment. LICENSEE shall operate solely from the designated 28 location(s) specified in Exhibit "A". LICENSEE shall not solicit customers by any means COUNTY OF FRESNO Fresno,California 1 1 including signs, handouts or amplified sounds outside of the designated location(s). 2 LICENSEE shall not affix signs or banners on trees, bushes or County owned structures. Said 3 location(s) may be changed upon mutual written agreement between the Parties. The Service 4 facilities, and all ancillary equipment, shall be removed at the end of each day of operation. No 5 equipment shall be left at the PREMISES overnight. LICENSEE'S setup shall not interfere with 6 pedestrian traffic. Ample travel ways shall be maintained at all times by LICENSEE. 7 3. TERM 8 The term of this Agreement shall be for 9 months, commencing 9 April 18, 202J and terminating December 31, 2025 unless terminated earlier in the 10 manner specified below in paragraph 4 "Termination". Upon expiration of said term as 11 established above, this Agreement shall not automatically renew and a new license application 12 will need to be submitted. 13 4. TERMINATION: 14 A. Breach of Contract- The COUNTY may immediately suspend or terminate this 15 Agreement in whole or in part, upon the determination by COUNTY that there 16 is on the part of the LICENSEE: 17 1) Improperly performed service; 18 2) A failure to comply with any terms of this Agreement; or 19 3) A substantially incorrect or incomplete report or false information 20 submitted to the COUNTY. 21 In no event shall any receipt of any funds by the COUNTY constitute a waiver by the COUNTY 22 of any breach of this Agreement or any default which may then exist on the part of the 23 LICENSEE with regard to any additional funds payable to COUNTY in connection with this 24 Agreement. Neither shall such payment impair or prejudice any remedy available to the 25 COUNTY with respect to the breach or default for any additional funds owed by LICENSEE to 26 COUNTY. 27 In the event of breach of this Agreement by LICENSEE, COUNTY may immediately terminate 28 this Agreement and LICENSEE will not be eligible for future agreements with the COUNTY for COUNTY OF FRESNO Fresno,California 2 1 Services. 2 B. Without Cause- Under circumstances other than those set forth above, this 3 Agreement may be terminated by either the COUNTY or LICENSEE upon the 4 giving of fifteen (15) days advance written notice of an intention to terminate to the 5 other party. 6 5. COMPENSATION: In consideration for granting this non-exclusive Agreement, 7 LICENSEE shall pay to COUNTY the sum of ten percent (10%) of the gross daily sales by the 8 5th of each month for the use of the PREMISES. If payment is not made by the 7th of each 9 month, a 10% late penalty charge will be due and payable with said payment. If payment is not 10 made within two (2) weeks of the first of each month, this Agreement may be terminated 11 immediately, and the LICENSEE will not be eligible to continue to offer SERVICES within the 12 PREMISES. Payment shall be made to the County of Fresno, Department of Public Works and 13 Planning, ATTN: Resources Manager—2220 Tulare Street, 6th Floor, Fresno, CA 93721-2120. 14 6. DAMAGE DEPOSIT: Upon execution of Agreement, the LICENSEE shall provide 15 a damage deposit of Five Hundred Dollars ($500) to the COUNTY. The damage deposit is 16 refundable, provided however, such deposit shall not be refunded to the extent that the 17 COUNTY incurs costs or expenses related to the LICENSEE's performance of Service. 18 7. INDEPENDENT CONTRACTOR: In performance of the work, duties and 19 obligations assumed by LICENSEE under this Agreement, it is mutually understood and 20 agreed that LICENSEE, including any and all of the LICENSEE'S officers, agents, and 21 employees will at all times be acting and performing as an independent contractor, and shall 22 act in an independent capacity and not as an officer, agent, servant, employee,joint venturer, 23 partner, or associate of the COUNTY. Furthermore, COUNTY shall have no right to control or 24 supervise or direct the manner or method by which LICENSEE shall perform its work and 25 function. However, COUNTY shall retain the right to administer this Agreement so as to verify 26 that LICENSEE is performing its obligations in accordance with the terms and conditions 27 thereof. LICENSEE and COUNTY shall comply with all applicable provisions of law and the 28 rules and regulations, if any, of governmental authorities having jurisdiction over matters the COUNTY OF FRESNO Fresno,California 3 1 subject thereof. 2 Because of its status as an independent contractor, LICENSEE shall have absolutely 3 no right to employment rights and benefits available to COUNTY employees. LICENSEE shall 4 be solely liable and responsible for providing to, or on behalf of, its employees all legally 5 required employee benefits. In addition, LICENSEE shall be solely responsible and save 6 COUNTY harmless from all matters relating to payment of LICENSEE'S employees, including 7 compliance with Social Security withholding and all other regulations governing such matters. 8 It is acknowledged that during the term of this Agreement, LICENSEE may be providing 9 services to others unrelated to the COUNTY or to this Agreement. 10 8. MODIFICATION: Any matters of this Agreement may be modified from time to 11 time by the written consent of all the Parties without, in any way, affecting the remainder. 12 9. NON-ASSIGNMENT: Neither party shall assign, transfer or sub-contract this 13 Agreement or its respective rights or duties under this Agreement without the prior written 14 consent of the other party. 15 10. INDEMNITY AND DEFENSE: LICENSEE shall indemnify and hold harmless and 16 defend the COUNTY (including its officers, agents, employees, and volunteers) against all 17 claims, demands, injuries, damages, costs, expenses (including attorney fees and costs), fines, 18 penalties, and liabilities of any kind to the COUNTY, the LICENSEE, or any third party that 19 arise from or relate to the performance or failure to perform by the LICENSEE (or any of its 20 officers, agents, sublicensees, or employees) under this Agreement. The COUNTY may 21 conduct or participate in its own defense without affecting the LICENSEE's obligation to 22 indemnify and hold harmless or defend the County. This section survives the termination of this 23 Agreement. 24 11. INSURANCE: The LICENSEE shall comply with all the insurance requirements in 25 Exhibit B to this Agreement. 26 12. PERMITS: LICENSEE shall provide to the foregoing address a copy of any and 27 all permits required by the local governing authority(ies), such as a business license required 28 by the local applicable authority, and a valid Permit To Operate ("Permit") issued by the County COUNTY OF FRESNO Fresno,California 4 1 of Fresno, Department of Community Health, Environmental Health Division not later than 2 fourteen (14) days following the beginning of the Term of this Agreement. LICENSEE 3 understands that said Permit must be obtained on an annual basis and LICENSEE shall 4 provide a copy of any new annual Permit to the aforementioned address within fourteen (14) 5 days of obtaining the Permit. LICENSEE understands that Permits are not transferable or 6 refundable and said Permits become void upon change of ownership. LICENSEE also 7 understands that any new owner(s) and/or operator(s), if an assignment is approved by 8 COUNTY in writing, as required in Section 9 above, must obtain a new Permit in his/her/its own 9 name prior to beginning operation. 10 13. AUDITS AND INSPECTIONS: The LICENSEE shall at any time during business 11 hours, and as often as the COUNTY may deem necessary, make available to the COUNTY for 12 examination all of its records and data with respect to the matters covered by this Agreement. 13 The LICENSEE shall, upon request by the COUNTY, allow the COUNTY to audit and inspect 14 all of such records and data necessary to ensure LICENSEE'S compliance with the terms of 15 this Agreement. 16 14. LITTER AND CLEANUP: LICENSEE shall provide adequate trash disposal units 17 adjacent to the area being utilized and shall be responsible for trash removal and area cleanup, 18 including raking or wet mopping on an as needed basis, but no less often than daily. 19 LICENSEE shall, at the end of each day, inspect the park for litter derived from the sales of his 20 or her Services and remove such litter. LICENSEE shall prevent staining of any grass, cement 21 walkway or asphalt parking area by ensuring that no residue from the unit or food preparation 22 will drip on the grass, concrete or asphalt. Trash containers are to be removed nightly. 23 15. SPECIFICATIONS: LICENSEE shall only sell products or services from mobile 24 unit(s). No general merchandise shall be sold other than those items specifically approved by 25 COUNTY as listed in Exhibit C. No products with glass containers will be allowed to be sold. 26 LICENSEE shall comply with all of the following: 27 A. The California Retail Food Code (Part 7 of Division 104 of the California Health 28 and Safety Code, commencing with Section 113700, hereinafter "CRFC") and regulations COUNTY OF FRESNO Fresno,California 5 1 promulgated thereunder, including but not limited to any future laws and regulations 2 enacted/promulgated to replace or supplement CRFC; and, 3 B. All County of Fresno Ordinances, including all regulations, policies and 4 requirements of the County of Fresno's Department of Community Health; and, 5 C. All health guidance and regulations issued by the State of California and the 6 Fresno County Department of Public Health; and, 7 D. Any other laws, regulations or ordinances as they relate to mobile/portable food 8 concession units. 9 16. UTILITIES AND DISPOSAL: All mobile units operated by the LICENSEE must be 10 self-contained. Electrical power, potable water and sewage disposal is not available. 11 17. DAYS OF OPERATION: LICENSEE may provide Service seven (7)days per 12 week during standard park operational hours, except on days when the PREMISES are closed 13 by the COUNTY or are rented by the COUNTY, in their entirety and on an exclusive basis, to 14 another person or entity for the purpose of hosting or conducting a private or special event. 15 18. GOVERNING LAW: Venue for any action arising out of or relating to this 16 Agreement shall only be in Fresno County, California. The rights and obligations of the Parties 17 and all interpretation and performance of this Agreement shall be governed in all respects by 18 the laws of the State of California. 19 19. POSSESSORY INTEREST TAX: The Parties acknowledge that California 20 Revenue & Taxation Code § 107.6 provides, in relevant part, the following: "(a) The state or 21 any local public entity of government, when entering into a written contract with a private party 22 whereby a possessory interest subject to property taxation may be created, shall include, or 23 cause to be included, in that contract, a statement that the property interest may be subject to 24 property taxation if created, and that the party in whom the possessory interest is vested may 25 be subject to the payment of property taxes levied on the interest." Accordingly, although the 26 COUNTY does not grant a possessory interest under this License, the Parties agree that the 27 COUNTY is a 'local public entity of government', and that LICENSEE is a "private party", 28 respectively, within the meaning of California Revenue & Taxation Code §107.6(a), and that COUNTY OF FRESNO Fresno,California 6 I this License (to the extent that it may be necessary under California Revenue & Taxation Code 2 §107.6(a) for the Parties to acknowledge and agree herein with respect to this License) is a 3 "contract,"which may create a possessory interest that may be subject to property taxation 4 pursuant to California Revenue & Taxation Code §107.6(a). In this regard, under this License, 5 LICENSEE acknowledges and agrees that (i) the property interest that may be created by this 6 License may be subject to property taxation, and (ii) LICENSEE (i.e., the party in whom the 7 possessory interest, if any, is vested) shall, at its sole cost and expense, be subject to the 8 direct payment of property taxes levied on such interest, and shall directly pay any and all 9 property taxes levied on such interest, and any interest, penalties, or charges thereon for 10 LICENSEE'S late payment of, or failure to pay such amounts when they are due and payable. 11 20. NOTICES: Any and all notices between either party under the terms of this 12 Agreement or by law shall be in writing and shall be deemed to be duly given if served when 13 personally delivered or deposited into the United States mail, with postage prepaid, registered, 14 and addressed to the respective addresses stated as follows: 15 COUNTY LICENSEE County of Fresno El Pillin 16 Steven E. White, Director Ana Centeno Dept. of Public Works and Planning Owner 17 Resources Division Manager 2220 Tulare Street, 61h Floor 1115 N 8th St 18 Fresno, CA 93721-2120 Fresno,CA 93702 (559) 600-4078 559-824-5655 19 parks@fresnocountyca.gov ramireza65@ymail.com 20 21 21. ELECTRONIC SIGNATURES: The Parties agree that this Agreement may be 22 executed by electronic signature as provided in this section. 23 (A) An "electronic signature" means any symbol or process intended by an individual 24 signing this Agreement to represent their signature, including but not limited to (1) a digital 25 signature; (2) a faxed version of an original handwritten signature; or(3) an electronically 26 scanned and transmitted (for example by PDF document) of a handwritten signature. 27 (B) Each electronic signature affixed or attached to this Agreement (1) is deemed 28 equivalent to a valid original handwritten signature of the person signing this Agreement for all COUNTY OF FRESNO Fresno,California 7 I purposes, including but not limited to evidentiary proof in any administrative or judicial 2 proceeding, and (2) has the same force and effect as the valid original handwritten signature of 3 that person. 4 (C)The provisions of this section satisfy the requirements of Civil Code section 1633.5, 5 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 2, Title 6 2.5, beginning with section 1633.1). 7 (D) Each party using a digital signature represents that it has undertaken and satisfied 8 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)through 9 (5), and agrees that each other party may rely upon that representation. 10 (E)This Agreement is not conditioned upon the parties conducting the transactions 11 under it by electronic means and either party may sign this Agreement with an original 12 handwritten signature. 13 22. ENTIRE AGREEMENT: This Agreement constitutes the entire agreement 14 between the LICENSEE and COUNTY with respect to the subject matter hereof and 15 supersedes all previous Agreement negotiations, proposals, commitments, writings, 16 advertisements, publications, and understandings of any nature whatsoever unless expressly 17 included in this Agreement. 18 19 20 21 22 23 24 25 26 27 28 COUNTY OFFRESNO Fresno,California 8 1 IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed as of 2 the day and year first above written. 3 LICENSEE COUNTY OF FRESNO 4 Digitally signed by Steve Whit 5 I ,, f� Steve Whlt}eDatee2025.04.18 By4�C Li f }1 By 13:47:14-07'00' Title owner Steven E. White, Director 6 Department of Public Works and Planning 7 Date-. C/ �I7/ 7� APPROVED AS TO LEGAL FORM: 8 Daniel Cederborg, County Counsel Digitally signed by 9 Zachary Zachary Adams y Adams Date:2025.04.18 10 B o8:58:27-o7'oo' Deputy 11 FOR ACCOUNTING USE ONLY: 12 Budget Unit No.: 7910 Fund No.: 0001 13 Account No.: 3400 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 COUNTY OFFRESNO Fresno,California 9 L1jL'E A E Tr•mm¢r SPnngs p� Winton Park a Speed limit 15 miles per hour 25314 E Trimmer Spring Rd,Sanger,CA 93657 \ .M !1 � b F 4 y4 FF �n t c F a � z W C Q' C 4 z �c �9eR 3 ^� a 9 6 G ti n 5 4 o ca' o PO V ti w �a Exhibit B 1 Insurance Requirements 2 1. Required Policies Without limiting the County's right to obtain indemnification from the Licensee or any third 3 parties, Licensee, at its sole expense, shall maintain in full force and effect the following 4 insurance policies throughout the term of this Agreement. (A) Commercial General Liability. Commercial general liability insurance with limits of not 5 less than One Million Dollars ($1,000,000) per occurrence and an annual aggregate of 6 Two Million Dollars ($2,000,000). This policy must be issued on a per occurrence basis. Coverage must include products, completed operations, property damage, bodily injury, 7 personal injury, and advertising injury. The Licensee shall obtain an endorsement to this policy naming the County of Fresno, its officers, agents, employees, and volunteers, 8 individually and collectively, as additional insureds, but only insofar as the operations under this Agreement are concerned. Such coverage for additional insureds will apply 9 as primary insurance and any other insurance, or self-insurance, maintained by the 10 County is excess only and not contributing with insurance provided under the Licensee's policy. 11 (B) Automobile Liability. Automobile liability insurance with limits of not less than One 12 Million Dollars ($1,000,000) per occurrence for bodily injury and for property damages. Coverage must include any auto used in connection with this Agreement. 13 (C)Workers Compensation. Workers compensation insurance as required by the laws of 14 the State of California with statutory limits. 15 (D) Employer's Liability. Employer's liability insurance with limits of not less than One Million Dollars ($1,000,000) per occurrence for bodily injury and for disease. 16 2. Additional Requirements 17 (A) Verification of Coverage. Within 30 days after the Licensee signs this Agreement, and 18 at any time during the term of this Agreement as requested by the County's Risk Manager or the County Administrative Office, the Contractor shall deliver, or cause its 19 broker or producer to deliver, to the County Risk Manager, at 2220 Tulare Street, 16th Floor, Fresno, California 93721, or HRRiskManagement@fresnocountyca.gov, and by 20 mail or email to the person identified to receive notices under this Agreement, certificates of insurance and endorsements for all of the coverages required under this 21 Agreement. 22 (i) Each insurance certificate must state that: (1) the insurance coverage has been 23 obtained and is in full force; (2) the County, its officers, agents, employees, and volunteers are not responsible for any premiums on the policy; and (3) the 24 Licensee has waived its right to recover from the County, its officers, agents, employees, and volunteers any amounts paid under any insurance policy 25 required by this Agreement and that waiver does not invalidate the insurance policy. 26 (ii) The commercial general liability insurance certificate must also state, and 27 include an endorsement, that the County of Fresno, its officers, agents, employees, and volunteers, individually and collectively, are additional insureds 28 insofar as the operations under this Agreement are concerned. The commercial COUNTY OF FRESNO Fresno,California 10 Exhibit B 1 general liability insurance certificate must also state that the coverage shall apply as primary insurance and any other insurance, or self-insurance, 2 maintained by the County shall be excess only and not contributing with insurance provided under the Licensee's policy. 3 (iii) The automobile liability insurance certificate must state that the policy covers 4 any auto used in connection with this Agreement. 5 (B) Acceptability of Insurers. All insurance policies required under this Agreement must be issued by admitted insurers licensed to do business in the State of California and 6 possessing at all times during the term of this Agreement an A.M. Best, Inc. rating of no less than A: VI I. 7 (C) Notice of Cancellation or Change. For each insurance policy required under this 8 Agreement, the Licensee shall provide to the County, or ensure that the policy requires the insurer to provide to the County, written notice of any cancellation or change in the 9 policy as required in this paragraph. For cancellation of the policy for nonpayment of premium, the Licensee shall, or shall cause the insurer to, provide written notice to the 10 County not less than 10 days in advance of cancellation. For cancellation of the policy 11 for any other reason, and for any other change to the policy, the Licensee shall, or shall cause the insurer to, provide written notice to the County not less than 30 days in 12 advance of cancellation or change. The County in its sole discretion may determine that the failure of the Licensee or its insurer to timely provide a written notice required by 13 this paragraph is a breach of this Agreement. 14 (D) County's Entitlement to Greater Coverage. If the Licensee has or obtains insurance with broader coverage, higher limits, or both, than what is required under this 15 Agreement, then the County requires and is entitled to the broader coverage, higher 16 limits, or both. To that end, the Licensee shall deliver, or cause its broker or producer to deliver, to the County's Risk Manager certificates of insurance and endorsements for all 17 of the coverages that have such broader coverage, higher limits, or both, as required under this Agreement. 18 (E) Waiver of Subrogation. The Licensee waives any right to recover from the County, its 19 officers, agents, employees, and volunteers any amounts paid under the policy of worker's compensation insurance required by this Agreement. The Licensee is solely 20 responsible to obtain any policy endorsement that may be necessary to accomplish that waiver, but the Licensee's waiver of subrogation under this paragraph is effective 21 whether or not the Licensee obtains such an endorsement. 22 (F) County's Remedy for Contractor's Failure to Maintain. If the Licensee fails to keep in effect at all times any insurance coverage required under this Agreement, the County 23 may, in addition to any other remedies it may have, suspend or terminate this 24 Agreement upon the occurrence of that failure, or purchase such insurance coverage, and charge the cost of that coverage to the Licensee. The County may offset such 25 charges against any amounts owed by the County to the Licensee under this Agreement. 26 27 28 COUNTY OF FRESNO Fresno,California 11 DATE(MM/DD/YYYY) AIR" CERTIFICATE OF LIABILITY INSURANCE 01/17/2025 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 CONTACT Carla Martin _NAME: _ Central Sierra Insurance Services,Inc PHONE 9 FAX _(AX,_No Ext):_.(55)228-6400 (559)228-6405 4554 N 1st Street E-MAIL nralsierrans ADDRESS: cet i @9mail.com Fresno,CA 93726 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: United States Liability Insurance Company INSURED INSURER 6 Adrian Santillan&Ana Centeno INSURER C: DBA El Piilin INSURER D: 1115 N 8th Street INSURER E: Fresno,CA 93702 1 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR ADD L SU iR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 FIVI CLAIMS-MADE OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP(Any one person) s 5,000 A GL1278092 01/10/2025 01/10/2026 PERSONAL&ADV INJURY $ 1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG s Included OTHER: I s AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea_accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( 1 HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I IER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate Holder is listed as Additional Insured per endorsement CG 20 13 04 13(Attached). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fresno County ACCORDANCE WITH THE POLICY PROVISIONS. 2220 Tulare St Fresno,CA 93721 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD C ORATION, All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GL 1278092 COMMERCIAL GENERAL LIABILITY CG 20 13 04 13 State Or Governmental Agency Or Subdivision Or Political Subdivision Effective Date: 01/10/2025 FRESNO COUNTY 2220 TULARE ST FRESNO, CA 93721 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to However: include as an additional insured any state or governmental agency or subdivision or political 1. The insurance afforded to such additional insured subdivision shown in the Schedule, subject to the only applies to the extent permitted by law; and following additional provision: 2. If coverage provided to the additional insured is This insurance applies only with respect to the required by a contract or agreement,the insurance following hazards for which the state or governmental afforded to such additional insured will not be agency or subdivision or political subdivision has broader than that which you are required by the issued a permit or authorization in connection with contract or agreement to provide for such additional premises you own, rent or control and to which this insured. insurance applies: B. With respect to the insurance afforded to these 1. The existence, maintenance, repair, construction, additional insureds, the following is added to erection or removal of advertising signs, awnings, Section III -Limits Of Insurance: canopies, cellar entrances, coal holes, driveways, If coverage provided to the additional insured is manholes, marquees, hoist away openings, required by a contract or agreement, the most we sidewalk vaults, street banners or decorations and will pay on behalf of the additional insured is the similar exposures; or amount of insurance: 2. The construction, erection or removal of elevators; I. Required by the contract or agreement, or or 2. Available under the applicable Limits of 3. The ownership, maintenance or use of any Insurance shown in the Declarations; elevators covered by this insurance. whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 13 04 13 ©Insurance Services Office, Inc.,2012 Page 2 Of 2 AC R® CERTIFICATE OF LIABILITYINSURANCE DATE(MM/DDIYYYY) `../" 01/17/2025 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 CONTACT Carla Martin NAME: Central Sierra Insurance Services,Inc Ext)_(559)228-6400 A^�NO (559)228 6405 4554 N 1st Street E-MAIL nralsierrans ADDRESS:__cet i @gmail.com Fresno,CA 93726 _ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: United States Liability Insurance Company INSURED INSURER B: Adrian Santillan&Ana Centeno INSURER C: DBA El Pillin INSURER D: 1115 N 8th Street INSURER E: Fresno,CA 93702 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR J ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD VJVD POLICYNUMBER MM/DDIYYYY)I(MMIDDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED 100()0� PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A GL1278092 01/10/2025 01/10/2026 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECT CI LUC PRODUCTS-COMP/OPAGG $ Included OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) _ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HL-CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNE R/EXECUTIV E OFFICER/MEMBER EXCLUDED? ❑ N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is listed as Additional Insured per endorsement CG 20 13 04 13(Attached). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fresno ACCORDANCE WITH THE POLICY PROVISIONS. 2600 Fresno St AUTHORIZED REPRESENTATIVE Fresno,CA 93721 ©1988-2015 ACORD C ORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GL1278DS2 COMMERCIAL GENERAL LIABILITY C<32O13U4i% THIS ENDORSEMENT CHANGES —9 HE POLICY. PLEASE READ UTCAREFULLY. ������7�������W INSURED � ������ ""~�=°" " .~°.���~~ .""~���u^y��� �� " �� ° �� ���� u��������K������U ���������� ���� SUBDIVISION � ~~~ ^ ��~^ ° ~~GOVERN°"°"°�"" " ,~^� AGENCY~~."~* " ��"~ ���� ���U D��U���V �8 8����"��������1 ������U~~� ~�o� . ��°�� x u����u� ��������U � x^�u��u� ~ x =�uvwouu � ^� OR AUTHORIZATIONS RELATING TO PREMISES This endorsement nxodilion insurance provided under the following: COMMERCIAL GENERAL L|AB|L|TY COVERAGE PART SCHEDULE State Or Governmental Agency OrSubdivision Or Political Subdivision Effective Date: 01/102025 CITY OFFREONO 2000FRESNOST FRESN0, CA93721 A. Section U -VVho Is An Insured is amended to However include ouan additional insured any state or go«emme�a| agenoyoroubdi�oionorpo|idoa| 1� The insurance afforded to such addkiona| insured subdi�oionshown in the Schedule, subject tothe on|yapp|ieoto�heo*entpenndhydby |mw� and following additional provision: 2. |f coverage provided to the additional insured ia This insurance applies only with respect to the required bya contract or agreement,the insurance a�ordndtneuchadditiona| inouredvviUnc� be foUovvinghazards for m/hiohthe �ateorgovernmental agency or subdivision n/political subdivision has broader than that which You are required bythe issued u permit or authorization in connection with contract or agreement ho provide for such additional premises you own, rent or control and to which this insured insurance applies: B. With respect tothe insurance afforded to these 1. The existence, maintenance, repair, construction, additional insureds, the following ie added to erection or removal of advertising signs, awnings, Section III 'LimiteOf|nouranue: canopiea, cellar entrances, coal holes, driveways. If coverage provided to the additional insured is manho|eo, manqueee, hoist away npeningo, required by o contract oragreement, the most we sidewalk vaults, street banners or decorations and will pay on behalf of the additional insured iathe similar exposures; or amount ofinsurance: 2. The construction, erection or removal ofe|avabom� I. Required by the contract or agreement; or or 2. Available under the applicable Limits of 3. The ownership, maintenance mr use ofany Insurance shown in the Declarations; elevators covered by this insurance. whichever isless. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. usco1no*1n 0mxuranue Sem/ovxomne. mc.zo1z paeo 1 Of 2 Central Sierra Insurance Services, Inc. 4554 N. 1st Street Fresno, CA 93726 800-997-6585 1 559-228-6400 # 0497899 Receipt# 442694 New Application Voucher Office: CL CLIENT COPY PmtDate: 1/10/2025 4:34 PM Named Insured 1115 N 8TH ST FRESNO CA 93702 ADRIAN SANTILLAN &AND ANA CENTENO Type of Insurance GenUab New or Existing Client: New to CSI Quoting Agent CA Writing Agent: CA Language: SP Referred By 559-228-5191 ADRIAN & 559-824-5655 ANA If CSI client: Name,address,policy Insurance Co or G/A: CHARITY FIRST Policy# or Zap TBD Method of payment: Cash Hold, Deferred, Mtg billed: Hold/Deferred Due Date Amount to Company: $485.00 Hold Check Amount: $0.00 Broker Fee charged: $235.00 Deferred /Mtg Billed Amt: $0.00 MVR/ CC Fees: $0.00 Total 1st amount Collected: 2nd method 720.00 J 2nd amount X Taken By: CRISTINA Note: This receipt is for a down-payment on a new insurance policy any fees charged are fully earned. Su recibo nuestra la prima recibida al empezar una poliza nueva. Los honorarios recibidos no seran reembolzables. FS Date: '4 I Ana Centeno Owner El Pillin 1115N8thSt Fresno, CA 93702 559-824-5655 To County of Fresno Parks: I, Ana Centeno, am the owner of El Pillin, and do not use my personal vehicle for county purposes in connection with the Agreement. Should I use my personal vehicle for county purposes in connection with the Agreement, I will submit the appropriate insurance immediately. Thank you, J\�\�'- Ana Centeno Fxh L Ir,,A E� Date: Ana Centeno Owner El Pillin 1115 N 8th St Fresno, CA 93702 559-824-5655 To County of Fresno Parks: I,Ana Centeno, owner of El Pillin, am exempt from the State's Workers'Compensation requirements because I have no employees and agree to hold the County harmless from loss or liability for such. Thankyou, Avv� �4� Ana Centeno C MOBILE MENU/CALCARD 2025 BusinM Date BurAn ,Address FA Business Owner Name FOOD Business Owner Telephone Commissary Name Commissary Address 0 List complete MENU that you will be serving (do not list prices): See attached menu ❑ 6 S4 \ 1 U Ca S r)S 'k-,-e, \l k--e- �1 _h c, <_, C l cy-fMCA y, © List all EMPLOYEES and CFM/CalCard information: Name CFM or CalCard Class Provider Expiration Date Completed by: Print Name Signature Title G?EHlFood Pro9r+mVAobileaViOUNDUP2025VAobia M.—M Map aN Payment COMBO UPDATE-REVISED 2J25.d— Official Consumer Food Protection Inspection Report fr, Department of Public Health Environmental Health Division 1221 Fulton Street,P.O.Box 11867,Fresno,CA 93775,Phone(559)600-3357 http://www.fcdph.org Email: EnvironmentalHealth@fresnocountyca.gov FACILITY ID: FA10093704 RECORD ID: FOOD10093705 CT: Tract 20 EL PILLIN Time In: 03/19/2025 3:06 pm 2350 W MCKINLEY AVE Time Out: 03/19/2025 3:46 pm FRESNO CA 93728 OWNER: ADRIAN SANTILLAN Reins ection Date: FOOD Mobile Facility Routine Inspection Mobile Food Vendors- Push Cart Prepackaged Permit Expiration Date: 03/31/2026 Sticker Affixed: Yes Balance Due: $0.00 Location Found DOCUMENTS OBTAINED ❑ OP STATEMENT OBTAINED or 0 Operating: 2350 W MCKINLEY AVE _ COMM AUTH 0 DRIVERS LIC. N/A Commissary Name: Kid's Ice Cream ❑VEHICLE REG ❑ LAST SIX VIN: FSC Name: Pre-packaged only Exp. Date Agency: Linen (ppm)Cl: Linen (ppm) Qt: Utensil Sink(ppm) Cl: Utensil Sink(ppm)Qt: Hot Temperature: Cold Temperature: Violations/ Not in compliance 64a. Mobile properly identified with required information on customer side Violation: The business name or the name of the operator, city, state and ZIP code of the commissary, and the name of the permittee(if different from the business name) shall be permanently affixed and clearly visible on the customer side of the MFF or MSU. [114299(a)] Comments: . Business name, commissary city, state, zip code, and permit holder name was not provided on the customer side of the carts. -Provide the business name in 3 inch minimum lettering on the customer side. -Provide the commissary city, state, zip code in 1 inch minimum lettering on the customer side. -Provide the permit holder's name in 1 inch minimum lettering on the customer side. Remedy: Properly identify mobile with required information: business name; city, state and zip code of commissary; name of permittee(if different from business name). TEMPERATURE CONTROL: Documentation required for all facilities with potentially hazardous food. Type of Food Temp Process/Holding Location 1 Observed and in Compliance: 23. No rodents, insects, birds, or animals observed 24. Person in charge(PIC) is present and performs duties Page 1 of 2 35. Equipment approved, installed, clean, in good repair, with adequate capacity 44. Premises maintained; personal/cleaning items separate; vermin-proofing adequate; no unused equipment; mop sink meets requirements 51. No imminent health hazard 61a. Drivers license/identification provided 62. Current Commissary Authorization provided General Comments: -Routine MRU inspection for pre-packaged ice cream push cart#2 and #3 -Correct violations noted on the inspection report by the next mobile round up inspection. -Sticker issued and affixed on pre-packaged push cart #2 and #3. NOTICE: REINSPECTION FEES WILL BE CHARGED FOR REINSPECTIONS DUE TO UNCORRECTED VIOLATIONS Received By: Adrian Santillan, Owner Inspected By: Jerry Xiong FAI0093704/ FOOD10093705 03/19/2025 Page 2 of 2