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Ray White Cement; 2024-12-12; PR-MPW-24008P
Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 1 City Attorney Approved 6/5/2024 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT ALGA NORTE AQUATICS POOL DECK; CONT. NO. PR-MPW-24008P This contract is made on the ______________ day of _________________________, 20__ (“Contract”), by the City of Carlsbad, California, a municipal corporation ("City") and Ray White Cement, a California corporation whose principal place of business is 2380 Via Monserate, Fallbrook, CA 92028 ("Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, as contained in the Standard Specifications for Public Works Construction “Greenbook,” latest edition and including all errata; Part 1 General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor’s proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by Temujin Matsubara (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. PREVAILING WAGE RATES. Any construction, alteration, demolition, repair, and maintenance work, including work performed during design and preconstruction such as inspection and land surveying work, cumulatively exceeding $1,000 and performed under this Contract constitute “public works” under California Labor Code Section 1720 et seq., and are subject to state prevailing wage laws. The general prevailing rate of wages, for each craft or type of worker needed to execute the contract, shall be those as determined by the Director of Industrial Relations pursuant to the Sections 1770, 1773 and 1773.1 of the California Labor Code. Consistent with the requirement of Section 1773.2 of the California Labor code, a current copy of applicable wage rates may be obtained via the internet at: www.dir.ca.gov/dlsr/. Contractor shall not pay less than the said specified prevailing rates of wages to all such workers employed by him or her in the execution of the Contract. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which requires keeping accurate payroll records, verifying and Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF December 2412th Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 2 City Attorney Approved 6/5/2024 certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Labor Code Section 1776. DIR REGISTRATION. California Labor Code Section 1725.5 requires the Contractor and any subcontractor or subconsultant performing any public work under this Contract to be currently registered with the California Department of Industrial Relations (‘DIR’), as specified in Labor Code Section 1725.5. Labor Code Section 1771.1 provides that a contractor or subcontractor/subconsultant shall not be qualified to engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Labor Code section 1725.5. Prior to the performance of public work by any subcontractor or subconsultant under this Contract, Contractor must furnish the City with the subcontractor or subconsultant's current DIR registration number. CALIFORNIA AIR RESOURCES BOARD (CARB) ADVANCED CLEAN FLEETS REGULATION. Contractor’s vehicles with a gross vehicle weight rating greater than 8,500 lbs. and light-duty package delivery vehicles operated in California may be subject to the California Air Resources Board (CARB) Advanced Clean Fleets regulations. Such vehicles may therefore be subject to requirements to reduce emissions of air pollutants. For more information, please visit the CARB Advanced Clean Fleets webpage at https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets. CALIFORNIA AIR RESOURCES BOARD (CARB) IN-USE OFF-ROAD DIESEL FUELED FLEETS REGULATION. Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. More information about the requirements and Contractor’s required certification is provided in Exhibit D. CONSTRUCTION MANAGEMENT SOFTWARE. Procore Project Management and Collaboration System. This project may utilize the Owner’s Procore (www.procore.com) online project management and document control platform. The intent of utilizing Procore is to reduce cost and schedule risk, improve quality and safety, and maintain a healthy team dynamic by improving information flow, reducing non- productive activities, reducing rework and decreasing turnaround times. The Contractor is required to create a free web-based Procore user account(s) and utilize web-based training / tutorials (as needed) to become familiar with the system. Unless the Engineer approves otherwise, the Contractor shall process all project documents through Procore because this platform will be used to submit, track, distribute and collaborate on project. If unfamiliar or not otherwise trained with Procore, Contractor and applicable team members shall complete a free training certification course located at http://learn.procore.com/procore-certification-subcontractor. The Contractor is responsible for attaining their own Procore support, as needed, either through the online training or reaching out to the Procore support team. It will be the responsibility of the Contractor to regularly check Procore and review updated documents as they are added. There will be no cost to the Contractor for use of Procore. It is recommended that the Contractor provide mobile access for Windows, iOS located at https://apps.apple.com/us/app/procore-construction-management/id374930542 or Android devices located at https://play.google.com/store/apps/details?id=com.procore.activities with the Procore App installed to at least one on-site individual to provide real-time access to current posted drawings, specifications, RFIs, submittals, schedules, change orders, project documents, as well as any deficient observations or punch list items. Providing mobile access will improve communication, efficiency, and Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 3 City Attorney Approved 6/5/2024 productivity for all parties. The use of Procore for project management does not relieve the contractor of any other requirements as may be specified in the contract documents. FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this Contract and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ___________________________________ REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. Property damage insurance in an amount of not less than……..$2,000,000 Automobile Liability Insurance in the amount of $2,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Diane White Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 4 City Attorney Approved 6/5/2024 non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that 30 days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. Workers’ Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. INDEMNITY. Contractor agrees to defend (with counsel approved by the City), indemnify, and hold harmless the City and its officers, elected and appointed officials, employees and volunteers from and against all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys’ fees for litigation, arbitration, or other dispute resolution method. THIRD PARTY RIGHTS. Nothing in this Agreement should be construed to give any rights or benefits to any party other than the City and Contractor. JURISDICTION AND VENUE. This Agreement shall be interpreted in accordance with the laws of the State of California. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Contract is San Diego County, California. Start Work: Contractor agrees to start within fifteen (15) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within sixty (60) working days after receipt of Notice to Proceed. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 5 City Attorney Approved 6/5/2024 CONTRACTOR’S INFORMATION. Ray White Cement 2380 Via Monserate (name of Contractor) 410673 (street address) Fallbrook, CA 92028 (Contractor’s license number) C8, Aug. 31, 2025 (city/state/zip) 760-728-0170 (license class. and exp. date) 1000003603; June 30, 2025 (telephone no.) office@raywhitecement.com (DIR registration number/exp. date) (e-mail address) AUTHORITY. The individuals executing this Contract and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Contract. [signatures on following page] Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 6 City Attorney Approved 6/5/2024 CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California Ray White Cement, a California corporation By: By: (sign here) Kyle Lancaster, Parks & Recreation Department Director Diane White, President (print name/title) ATTEST: By: SHERRY FREISINGER, City Clerk N/A single signer (sign here) By: Deputy City Clerk (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Contract must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Deputy / Assistant City Attorney Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF .:'.J~ R... ~ ~ Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 7 City Attorney Approved 6/5/2024 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Type of Work to be Subcontracted Business Name and Address DIR Registration No. & Expiration Date License No., Classification & Expiration Date % of Total Contract Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Zero 0 Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 8 City Attorney Approved 6/5/2024 EXHIBIT B SCOPE OF WORK AND COST Summary: Remove and replace approximately 300 sq. ft. of concrete decking, patch worn concrete and install new valve boxes, meter boxes and electrical tombstones at various locations at Alga Norte Aquatic Center. Scope of Work: • Sawcut and replace approximately 300 sq. ft. of concrete decking at various locations. This includes the spa area, around old valve meter boxes throughout the pool deck. • Remove old valve and meter boxes and replace with new ones coated in polymer to prevent deterioration from pool chemicals. • Patch old worn concrete in various areas including slot drains on North and West sides of the Instructional Pool. • Install two concrete electrical tombstone boxes at Northeast and Southeast corners of the Competition Pool deck. Specific locations to be field verified by Mike Anderson. Each tombstone to be approximately 1’ wide x 3’ long x 2’ high with one four-way plug at each tombstone. • Dig footings and trenches for new electrical concrete boxes and for electrician’s new conduit. • Remove old caulking around coping of spa area and old expansion joints where caulking has failed (approximately 165 linear ft.). Notes: • Mike Anderson will verify locations of two new electrical tombstones, footings and trenches for conduit. • Electrical contractor to provide and install new gang boxes at tombstones, and complete electrical wiring from existing nearby tombstone gang box. • All work to be completed during time of pool closure. • All patching of deteriorated concrete locations is not guaranteed from cracking from sika product required by the city. Cost: $35,970.00* *Includes prevailing wage, labor and materials bond, taxes, fees, expenses and all other costs. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF I a_icc..\\. ·~ ~¼ l. ~('0: \ ~ •. ~-:.L i + I T : l • },-~ll .. .. -I --- I i I I . I J I I .. ! I : .. :· -r -] r ;t ,--·-:-,i -- -· . 7- J.... --1 . I :.~ - ,••.1 :-:<I :· ; .~J ··.• I .=i 1 .. --:r --;;_1 • ! i J H I I . I -I ' .1 -__ j I I ' I l· • ·I ·r --1 ----1 '-I I l I -,--=, ... -'-t . __ ...,__ .. l .. :1·_~)~-J __ :.,_ ... ;~.~ . A~: ,_;I_.. . . . .· !·_. . __ ,._ • • •• .. • • • ·1/ .~,;~ h ~~~. • --'°O'f.; / / / I' Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF THE ~INAL PREMIUM IS PREDICATED ON THE FINAL CONTRACT AMOUNT EXHIBITC LABOR AND MATERIALS BOND Bond No. 024281354 Premium: $899.00 Tracking#: WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Ray White Cement (hereinafter designated as the "Principal"), a Contract for: ALGA NORTE AQUATICS POOL DECK CONTRACT NO. PR-MPW-24008P in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the CiW Clerk of the City of Carlsbad and all of which are incorporatedherein-by this-reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the ext1;?nt h.ereinafter set forth. NOW, THEREFORE, WE, Ray White Cement, as Principal, (hereinafter designated as the ''Contractor"), and The Ohio Casualty Insurance Company as Surety, are held firmly bound unto. the City of Carlsbad in the sum of Thirty-Five Thousand Nine Hundred Seventy and 00/100 dollars ($ • ), said sum being an amount equal to: One hundred percent {100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. *35,970.00 THE CONDITION OF THIS OBLIGATION iS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code sectlon 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13010 of the Unemployment Insurance Code with respect to the work and labor, that the Swety will pay for the same, and, also, in ~ase ~uit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit broug~t upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shali affect its obligations on this bond; and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. In the event ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 9 City Attorney Approved 6/5/2024 Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Tracking#: that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. This labor .and materials bond may be-approvedasfo form by the City Attorney for the City in counterpart; and the counterpc1ri:s shall all Gonstitute a single, original instrument. SIGNED AND SEALED, this _25_t_h __ day of November ~R=a~y""""W""'h"""it'"'"e-'C~e~m-'e~n~t ______ (SEAL) The Ohio Casualty Insurance Company(SEAL} (Principal) . ~ By, ~l.@zs By,_S-ha ... u~n~n-a_R_o_ze-1-le_O_s-tr_o_m_, -(S-ig_n_a-tu_r_e_) -- Attorney-in-Fact (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY-ATTACH ATTORNEY-IN-FACT CERTiflCATE) APPROVED AS TO FORM: CINDIE K. McMAHON City Attorney By: au.Lff!, fvtd Deputy /Assistant City Attorney ALGA NORTE AQUATICS POOL DECK CONT. NO, PR-MPW-24008P PagelO City Attorney Approved 6/5/2024 Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On ----'-11.:..:../2=5=/2=0=2'-'-4 ______ before me, ___ A_d_ria_n_B_en_k_e_rt_-L_a_n__,,g'-re_l--'--1, _N_o_ta_ry,__P_u_b_lic ___ _ (insert name and title of the officer) personally appeared Shaunna Rozelle Ostrom who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand ~nd official seal. DRIAN BENKERT-LANGRELL M COMM. #2403748 M ~ Notary Public-California ~ u. ORANGE COUNTY u. (Seal) yComm.~ Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF ~Libertx \P Mutuat SURETY This Power of Attorney Hmlts the acts of those named herein, and they have no authority to bind the Company except _rn the manner and to the extent herein stated, Bond No. 024281354 Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company Cerijfica(e No: 8;?09029-969561 POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casually Insurance Company is a corporation duly organiZed under !he laws of lhe State of New Hampshire, U)al Uberiy Mutual insurance Company is a corporation duly organized under the laws of lhe Stale of Massachusetts, and West American Insurance Company is a i;orporalion duly organized under the laws of tt1e Sta!e of Indiana (herein colleclively called tile "Companies"), pursuant to and by aulhcrity herein set forth, does hereby name, constitute and appoint Arturil Ayala: Daniel Huckabay; Adnan Langrell; Chelsea Liberatore: Frank Morones: R. Nappi; Dwight Reilly; Shaunna Rozelle Ostrom: Ben Stong: Michael D. Stong; all of ihe city of Oranl!e state of CA each lndividually if lllere be more than one named. Us lrue and lawful attorney-in-fact to ma~e. execute, seal, acknowledge and deliver; for and on its bellalfas surety ar.cl as its acl anct deed, any and all unoertakings, bonds. recognizarn;~ an(l ol/ler surety obligations, in pursuaili:e or these presents and shall be as binding upon the Companies as if they ha;1e been duly signed by lhe pres!dent and altested by lhe secretary of !he Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Atlornay has been subscnt>eo by an authorized officer oi official of the Companies and the corpor<1te seals of the Companies have been affixed there10 thi, '.ll st d;;y of November , 2023 . Liberty Mutual Insur.moo Company Toe Ohio Casualty tnsurance·company West Aniencan Insurance Company .,; ~//.fe~.,.,/1 ciiE a, . ~ /. I ,.,.,;r ai o ~ By:c:-...,.,.,..,...,,---~......,,_.----------~ :§ _3 . ~ David M. Carey, Assistant Secret;iry g-gJ '6 (ti State of PENNSYLVANIA ss --:5 ~ ::, County of MONTGQMERY .§ E .!: ~ On lhis 21st . o'iiy or November . 2023 before rne personally appeared David t,t Carey, who acknowledged himself lo be Ille Assistsnt Secretary ot Liberty Mutuallnsurancfi 81ii !: iii Campany, ihe Ohio Casually Company, and West American Insurance Company, and lhat he, as s11ch, being atrthorized so to do, execute the foregoing insin.imenlfor lhe purposes !€ ,g ,2l ~ therein coiilaineo by slgniog on behalf of I/le corporations by himself as a duly authorfaed officer. ~ dim .· . .. . . a:: -. -5 IN WITNESS WHEREOF, l have hereunto subscribed my name and affixed my notarial seal al Plymou!h Meeling. Pennsylvania, on the day and year first above written. ~o.cn i:::·- m :iJ ,,;-r.1s",'-:'.\ . . ~ ,Q '-~~::.· i$'~~1',\"~ ~... COmmo,w,1!.a<lr,:cfPqr,11!-y!.-,nl.1 -Not.;rySo~ >--oJ O 1;: OJ "'<, ~-(_ Tttol dP~.\lf:']i!,t+.it.')r,Pi.!hl1C ' ,.,.___,_ d 4>'ffi 1--..c,, ,.,~ :,-\) M<ir:i901T.C1)'Coc.nr1 V/.,: .. i 1/../-.1/ EE 0~ , ..... ~ J \4'fo:.r::mlss:Qna,0-~M.1~n2a.ms By·: ~ ~ o a, : != ~?{ M,,,.,,.::::;;,::::::!:!~"'"'" Teresa Pastella, Notary Public ~ o o, gJ • 1;,,-.v v.:J, o ~ m.._. . . . . . '--N .g> ~ This Power of Allorr.ey is mad.e ilOd exec;u(ec:l pursuant to and by authority or lhe fellowing By-laws ar.d Avlhori.:aUons ot The Ohio Casually Insurance Company, Liberty Mutual ~ I"? E -!::_ Insurance Company, and West Ameri~an Insurance Ccmpany which resi;lutioos are now in full force and effect readiog as follows: (1_ P) ... 2 ARTICLE IV -OFFICERS: Section 12-Power cf Attorney. . . 5 ~ -l2 ~ Any _officer or other official of the Corporallon authorize\/ for lhat purpose in writing by t~e Chairman or the Prnsidenl. and subject to such limitation as the Ch?irman .or the =a <0 ;g i:;' President. may prescnbe, shall appoint sucn attorneys-In-fact, as may tie necessar1 to act 10 behalf of the Corporation to make, execu(e, seal, acknowledge and deliver as surery (ij = ~ ffi any and alf undertakings, bonds; rec~nizances·and.olher surety obligaiions, Such attorneys-In-fact. subjectto the llniitalioos set forth in ille_ir respective powers cf attorney, Shall "O ~ 0 l:: have full power to bind t.he Corporation by their signature and execution of any such Instruments and lo attach Ulereto lhe seal of the CorporaUon. When so executed: such § (I) z is instn.1men1s shall bG as binding as If signed by the President and atleste.d 10 by th.e S~crEllary. Any power or i!Ulhority granted to any represenialive or attorney.in-fact under the ~. ~ provisions of tn1s article may lie re,;oked at any time by 1he Board, the Chairman, the President or by ihe officer or officers granting such power or ai.rlhorily. ~ ~ ARTICLE XIII-Execution of Contracts: Section 5. Sorely Boods.and Ut.dertakings. Any officer of Ille Company authorized for that purpose in_ wriun9 by the chairman or the president, ar,d sub/eel to such_ timitalions as Ille chairman or the presideni may prescribe, shall appoint such auomeys;in-fact. as mat be necessary to act in behalf of the Company to make, execute, seal. acknowledge and· deliver as surety any-and all undertakings, t-onds, ril"'..ogr.izances and other surety obligations. Such attorneys-in-fact subject lo lhe limitations sei forth in their res"i*tiv¢ powers of attorney, shall have.run power (I) bind the Company by their signature and execution of any such insirumen1s and to attach thereto trie seal of the Company. When so execuieo_ such ir.strurr.enis .shall be as binding as if signed by the president and attested by lhe secretary. Certificate of OesignaUon -The President of the Company, acting ·pursuant to lhe Byle11s of the Company, authorizes Daiii{l M. Carey, Assistant Secretary lo appoint such artorneys-in- fact as may be necessar/ to act on behalf of lhe Company to make, e,ecule. seal, ackno1•iladge and deliver as surety any and all undartakings, bonds. recognizances and olfier surety obliga1ions. Authorization -By unanimous consent of the Ci;mpany's Board of Dir~:tors. lne Company consents lhal facsimile or mechank:ally reprojuced signature of any assistant secretary of the Company, wherever appearing upon a cer\ified copy ot any power or attorney issued by Iha Company in connection with suretYbor.ds. shall Ile valid and binding·upon the Company witii the same force and effect as thoug~ manually affixed. I, Renee C. Llewellyn. the un~ersigned, Assislant Secretary, TM Ohio Casualty Insurance CQmpany, Liberty Mutual Insurance Cpmpany, and West Amer.ican lnsuran.ce Company do hereby ceriify lh_arthe original power.or attorney of which lhe foregoing is a full. true and correct copy cf the Povier oi Allorney executed by said Companies, is In full force and effect an(! has not been te\'Oked, , • • • • • • 1 1 \); I , ,· IN TESTJMONYWlil:REOF, I nave hereunto set my hand and aVixed the $Calsof said CompanieJ (his 25th day or November , 2024 . , ' • '( l " ,-1 1 1 -----------'< \, i, .. /.J, I LMS-12873 LMIC OGIC WAlCMuttl C:002121 "'I '-I • • • • ·'?" '/' '~ } ( ' .. .,,_ t~ ,· '/_,, , ,1 i• '. (l -:-:' • ji\ ', . I ,-1-, ~, --_,·.,..rs ~ JJJ ; ry QI . - '' Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 11 City Attorney Approved 6/5/2024 EXHIBIT D In-Use Off-Road Diesel-Fueled Fleet Regulation Requirements CARB implemented amendments to the In-Use Off-Road Diesel Fueled Fleets Regulations that apply broadly to all self-propelled off-road diesel vehicles 25 horsepower or greater and other forms of equipment used in California. More information about the requirements can be found at https://ww2.arb.ca.gov/our-work/programs/use-road-diesel-fueled-fleets-regulation Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. The City is a “Public Works Awarding Body,” as that term is defined under Title 13 California Code of Regulations Section 2449(c)(46). Accordingly, the Contractor must submit, with their pre-award contract documents, valid Certificates of Reported Compliance (CRC) for the Contractor’s fleet, and for the fleets of any listed subcontractors (including any applicable leased equipment or vehicles). Failure to provide a valid CRC, will limit the city’s ability to proceed with awarding this Contract. Contractor has an on-going obligation for term of this Agreement to provide copies of Contractor’s, as well as all listed subcontractors, most recent CRC issued by CARB. Throughout the Project, and for three (3) years thereafter, Contractor shall make available for inspection and copying any and all documents or information associated with Contractor’s and subcontractors’ fleet including, without limitation, CRC, fuel/refueling records, maintenance records, emissions records, and any other information the Contractor is required to produce, keep or maintain pursuant to the Regulation upon two (2) calendar days’ notice from the City. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF Tracking #: ALGA NORTE AQUATICS POOL DECK CONT. NO. PR-MPW-24008P Page 12 City Attorney Approved 6/5/2024 EXHIBIT D (CONT.) IN-USE OFF-ROAD DIESEL-FUELED FLEET REGULATION CERTIFICATION Contractor hereby acknowledges that they have reviewed the CARB’s policies, rules and regulations and are familiar with the requirements of In-Use Off-Road Diesel-Fueled Fleet Regulation. Contractor hereby certifies, subject to the penalty of perjury, that the option checked below relating to the Contractor’s fleet, and/or that of their subcontractor(s) (“Fleet”) is true and correct: ☐ The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto. ☐ The Fleet is exempt from the Regulation under Section 2449.1(f)(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto. ☐ Contractor and/or their subcontractor is unable to procure R99 or R100 renewable diesel fuel as defined in the Regulation pursuant to Section 2449.1(f)(3). Contractor shall keep detailed records describing the normal refueling methods, their attempts to procure renewable diesel fuel and proof that shows they were not able to procure renewable diesel (i.e., third party correspondence or vendor bids). ☐ The Fleet is exempt from the requirements of the Regulation pursuant to Section 2449(i)(4) because this Project has been deemed an “emergency”, as that term is defined in Section 2449(c)(18). Contractor shall only operate the exempted vehicles in the emergency situation and records of the exempted vehicles must be maintained, pursuant to Section 2449(i)(4). ☐ The Fleet does not fall under the Regulation or are otherwise exempt and a detailed reasoning is attached to this certification. Name of Contractor: Ray White Cement Signature: Name: Title: President Date: Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF 12/6/2024 X Diane White Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF ACORD-CERTIFICATE OF LIABILITY INSURANCE I DATE [MMIDDIYYYY) L-,--·· 10/212024 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 CONSTrTUTE 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 polh;y(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the tenns and conditions of the policy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER <AJNTACT Dennis Silva NAME· Silva and Sons Insurance Services Inc. PHONE 888-745-8259 l ~Nol: 951-763-8000 40477 Murrieta Hot Springs, Suite D1-205 l&lr> IJ-C·--e\o Murrieta, CA 92563 _ME-MAI_L i&m· dsiwa@sitva-ins.com - INSUR~R!S)AFFORDING COV!eRAGE NAIC# www.Silva-lns.com Lie #OH99310 --INSURER A: Gemini Insurance Comoany 10833 INSURED ~ER a: Travelers Casual\~ Corn11an)!'. 41769 Ra~ White Cement INSURER c: Covinoton Soecialtv Insurance Como.anv 13027 23 0 Via Monserate - Fallbrook CA 92028 INSURERD: !NSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER· 82251862 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 Ar-N 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 CONDITJONS OF SUCH.POLICIES. LIMITS SHOWN MAY HAVE BEEN REDU6ED BY PAID CI;AJMS. INSR A0DL SUBR ' .-.PO,.;;;LICY, EFF l2\,A~~I LIMITS LTR TYPE OF INSURANCE ••orft ,,_,A POLICY NUMBER DIYYYYl A iL.-COMMERCIAL GENERAL LIABILITY ✓ ✓ VIGP028665 10/1/2024 10/1/2025 EACH OCCURRENCE $1 ,000 000 = CL.AIMS.MADE [71 OCCUR ~~~~~J?e~~,1.,E~--, - $ 100 000 ------MED EXP {Anyono person) $5,000 PERSONAL & />DY INJURY s 1 ooo ooo -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,ooo,ooo ~ POLICY 177 ~:g: □LOC PRODUCTS • COMP/OP AGG I $ 2 0 00 000 OTHER: Per Prolect Annreaate $2 000.000 B AUTOMOBILE LIAII IUTY BA A0879308-1 1011/2024 101112025 COMBINED SINGLE LIMIT i 1,000 000 >--(Ea accld&nt) iL.-P,,NYAUTO BODILY INJURY (Pe< person) $ OWNED -SCHEDULED BODILY INJURV (Pu acciden1) $ -AUTOS ONLY °7~~1~WNED L HIRED r~~~:~:l."nt~AMAGE $ AUTOS ONLY ~ AUTOS ONLY $ A UMBRELLALIA8 ~ OCCUR ✓ ✓ VIFX003379 10/112024 10/112025 EACH OCCURRENCE $2,000 000 r✓ EXCESS LIAII CLAJ MS-MADE AGGREGATE $2,000 000 I DED I RETENTIONS $ B 'WORKERS COMPENSATION ✓ UB-00A0606030 10/11202-1 1011/2025 ✓ I ~~: n.JTE I 10TH, AND EM PLOVERS' LIABILITY ER YIN ANYPROrRIET0RIPARTNER/E~ECIJTIVE Cr] NIA E.L EACH ACCIDENT $ 1 000 000 OFF ICERIMEMB ER EXCLUDED? E.L. DISEASE -EA EMPLOYEE1 $ 1 /\/\/\ noo_ (M.anclatory In NH) -~~Sd~it~~~ onFdc{PERA TJON ~ below E.L DISEASE -POLICY LIMIT $ 1000000 C COMMERCIAL PROPERTY VBA898126 01 1115/2024 1115/2025 LEASED/RENTED EQIUPMENT $50,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Sch1dule, may be att.chod if rnor, spaco Is requlrod) City of Carlsbsd/CMWD, All operation of the named insured for the certificate holder In regards to concrete are named additional insured as respects to the General Liability when required by written contract as per the attached form/ Waiver of Subrogation applies to General liabilny and Workers Compensation I Primary and Non-Contributory endorsement applies as respects to General Liability as par attached form./ Per Project Aggregate applies as respects lo General liabilily per attached /Umbrella is over Gl CERTIFICATE HOLDER CANCELLATION City of Carlsbad/CMWD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN c/o EXIGIS Insurance Compliance Services ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 947 Murrieta CA 92564 AU THORl2ED REPRESENTATIVE ~~ Dennis Silva © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD e225H:62 I .2',-25 GL }:S WC AU1'CI CP I Del'lJ'.iS Silv~ i 1C/2/2C-2~ 11 :C~:11 At-'! [P(l'r) I Paige 1 of i 'l'hi.$ ce.t·t.1fical:.e cane-els e.nci. ~upe.:-sed!.!S A.L.L pr~viously isst.:tE!d ce,i::tific~t~s. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF POLICY NUMBER: VIGP028665 10/01/2024 CO'\1Ml:RCIA1. (iENERAL LJABILIT'l' cu ::o :n 07 0-1 THIS ENDORSEMENT CHAN(iES THI'. POLJCY. PU;:ASE READ IT CAREFULLY. ADDlTIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This cndorsc1ncnt modifies insurunc<: pnJ\·idcd under the f,ill,lwing: COMMERCIAL (iENl:.:RAL LIAHILJTY COVERA<,E PART SCHEDULE Name Of Additional Insured Pcrson(s) Location And Description Of Completed Opera- Or Oni:anization(si: tions City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O.Box 947 Murriata CA 92564 Wh~n.: n.:4uin:<l hy writl<:n conlrnt'l /\II opcrntillllS or the Nanwd ln~un:ds. or written agrieement. lnf,,rnrntion rcquin.:cl to n1rnple1c thi~ Sd1c<lulc, i r not slwwn aho\'~'. will lio: ~hown in the Do:duration,. C(i 20 nm 0-1 Section II -Wlm Is An lnsun.:d is :.nncn<l~·d !o in~·luJ~- as an ad<litional insurc<l the pcrson(sJ or orgnnizti- tion( sJ sho,\·n in the S<..:hcduk. but only will1 respect to liability ror "bodily injury" 01· "property dm1iago:" en used. in \\"hole or in part. by "your work" at the loc:.ition desig- nated and described in the ~chedule of thi.~ enJor~e- nh·nt performed for that additional insured and indudcd in the "produ,·ts-compktcd opcrntious ha1ard" C' ISO Prnpcrtics. Inc.. 200-l-!'age l o!" I e/.2:51-€62 I 24-25 GL XS WC: A\.ITO CP I D@rrni:s S)lvc:. l 10/2/?:0/.4 11 ;04:11 AM jl'D'?') I l'c.qe 2 -::.f 7 ".fhis cert..ificale cancel.ti c>.nd supe.t.•:u~de-~ .ALL prf:!v1cu:sly ir~.s·Jed certif.icates. D Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF POLICY NUMBER: VIGP028665 10/01/2024 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locatlon(s) 01 Covered Ooerations Ra~Whlte Cement 23 Via Monserate Fallbrwk CA 92028 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 include as an additional insured the person(s) or organization{s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury'' caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service. maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 201007 04 © ISO Properties, Inc., 2004 Page 1 of 1 B22~ U?62 I 2-4.-2 5 Cl. .XS WC AT.1TO CP I Penni!;i Si lv,::i I 10/2/202 ~ E :Cti: 11 A>:! (PD'r} I Page :; of 7 This ccrt..ifica~c cancels and supcr.se:dcs A!...L previously issued certi(ic.ates. □ Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF VIGP028665 10/01/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsemenl mOdifies insurance provided under the rollowing: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Omanlzatlonlsl: If no entry appears above, this endorsement applies to all Additional Insureds covered under this oollcv. ArtJ c<Jvera.ge provided to an Additional Insured under this policy shall be excess over any other valid and coflectlble Insurance avallable to such Additional Insured whether primary, excess, conUngent or on -any oUler basis unless a written con\ract or written agreement specilicatly requires that this insurance apply on a primary and nanconlributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031US 04-10 Page 1 of 1 f!?.?.Sle-6?. I i.t-25 GL XS WC AUTO CP I D~oni.-; Si lV':!.l. I 10/.2/2C24 11 ; "·L 11 AH i PDT) I Pill:Jl3 4 or: 7 Thb~ (;ert1f1crlt.e cancel!:! A,'l<l !:HJpecsed~::c .ALL prt:!-Vic:i:sly l~.::i:~ied Gett 1ficat.1::'!.$. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VIGP028665 10/01/2024 POLICY LIMITATION-AMENDED AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS COMBINED LIABILITY POLICY SECTION Ill -LIMITS OF INSURANCE -The General Aggregate Limit applies separately to each "Project" of the Named Insured. Notwithstanding the application of the General Aggregate Limit to each "Project'' of the Named Insured, under no circumstances will we pay more than $ for all claims under this policy that are subject to the General Aggregate limit. For the purpose of this endorsement, the following definition is added: "Project" means all work done by you or on your behalf, away from premises owned or rented to you, to complete an individual bid or negotiated contract to provide services for a specified period of time. Multiple jobs, work orders, purchase orders, or work done at multiple "locations" under one contract are not separate "projects" within the meaning of this coverage. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5012US 12-03 Page 1 of 1 8.225 if 62 I 2~-2'5 GL :.Cs WC .AU'IO CI> I Denni:3 3i lva I 1 C/2/ 2n24 11 :.::4: 11 A.'1 {POT) I Pu~e .J :Jf ·1 This certificat'=! c:.inc.el.5 and supersedes AI..L previously issued certificates Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF VIGP028665 1010112024 COMMERCIAL GENERAL LIABILITY CG 24 0410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under !he following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization to which you are obligated by virtue of wrillen contract to provide insurance such as is afforded by this policy, but only with respect to (1) occurrences taking place after such written contract has been executed and (2) occurrences resulting from work performed by you during the policy period, or occurrences resulting from the conduct of your business during the policy period. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV - COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with lhat person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organizalion shown in the Schedule above. CG 24 0410 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 D 822519 62 I 2.oi-25 (;L x;; ~l: A.UTO l'.:f' I Denr.ia Silva i l C/2/:202-4 11: JtJ: 11 AM ◄f•Dl') J Pace ti :}f i This c1::rtificate ~a.nee.ls and supe~sede3 ALL prieviously issued certifi.;at.es. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF UB-OOA 0606 03 0 10/01/2024 VUORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Ray White Cement WC 040306 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT .. CALIFORNIA We have the right to ·recover our payments from anyone llab!a for an injury covered by this policy. We wm not enforce our right against the person or organization named in the Schedule. {This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement tom us.) You must main1ain P8Y,1'0II records accuraiely segregating the remuneration of your employees whOe engaged in the work described in the Schedule. The eddl11onal premium for this endorsementshall be 2 otherwise due on such remuneration. % of the California workers' compensation premium SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION -19118 bythaWmbns' C~armtlunln&11rance ~ Bureau DfCallfcm1a. All rights reserved. From the 'WCIRB's California Workers' Compensation lnsuraooe Forms Ntanual a 1999, IN5UREO COf"f 822518~2 : 2~-2':> GL :•:S WC AUTO CF J DeI".:iis Silv.:. I 1J/2i202~ 11:C'ti:ll AM iPOl) I Paqe 7 c.f 7 Ti\is ce:!"tificate cancel~ and supersedes !\LL previously issued certificate~. Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF UNANIMOUS WRITTEN CONSENT OF THE BOARD OF DIRECTORS OF RAY WIDTE CEMENT, a California corporation The undersigned, being all the directors of Ray White Cement, a California corporation ("Corporation"), by their signature below, as of October I, 2022, hereby adopt by written consent the following resolutions. RESOLVED, that any one officer of the Corporation ( either Diane K. White or Thomas M. White) are authorized and empowered to execute, on behalf of the Corporation, any business contract, agreement, and document and to do or cause to be done all such further acts or things as may be detennined to be necessary or advisab]e to carry out the business of the Corporation. RESOLVED, FURTHER, that all actions previously taken by the Corporation with respect to the foregoing reso]utions are hereby approved, ratified and confirmed in all respects. This consent may be signed in multiple counterparts, each of which will be deemed an original, and all of which together will be deemed one instrument. Signatures delivered via facsimile or electronic mail will be deemed the same as original signatures for all purposes. This consent-is executed pursuant to subdivision (b) of Section 307 of the California Corporations Code and is to be filed with the Minutes of the Director proceedings. Dated: October 4, 2022 DIRECTORS Diane K. White Docusign Envelope ID: 638263EB-167F-462C-9BEA-08F9AA9D02BF 1130124, 10:54AM ssl .arb .ca.gov/tru crs _reporti nglcert14. p, ~ ~R'\h~~s~E~ !tl~ Certificate of Reported Compliance With: Truck and Bus Regulation Issued to: Ray White Cement This certificate confirms that the fleet owner has attested under penalty of perjury that the statementsand information they provided to the California Air Resour<.es Board (CARB) are true, accurate, and complete regarding all relevant vehides in-the fleet required to show compliance. CARB hereby finds that the fleet listed has reported compliance. with California Oxle of RegulatiOJis (CCR): Title 13 CCR 2025 (Truck and Bus Regu!atioo) If CAR8 subsequently finds that the :ru1tements and information that have been provided are not true, accurate, and complete, this certifi~te shall be effectively revoked end the fleet subject to noncompliance penalties. +his c-ertificate is valid ,mtil December 31, 2024· fr .c.L. . L. Printed on 2024-01-30 TRUCRS Aeet tdel'ltification rv:a,~ 95298 k Kilowskl 2 Vehicles Ol•lf;lon ('.-k!f, lloh•IIJ Sou,ce Contrnl To •"'ifY tt... •.-»tldl1 of 1111:s certl'lciote, visit lliYi<iionC.,lfoml• J\io l½;ouoce< Board WWW,1'11>a,11<>Y/""'l)rog}om<Jlcoelttt:,bokulJ,php https://ssl. arb .ca.gov/true rs _re porting/cert14. p hp 1/1