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HomeMy WebLinkAboutLMC Production; 2025-01-24; PSA25-3645ENVPSA25-3645ENV City Attorney Approved Version 5/22/2024 Page 1 RECITALS City requires the professional services of a consultant that is experienced in Earth Month Celebration Services. Contractor has the necessary experience in providing these professional services, has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A,” attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2. TERM This Agreement will be effective for a period of one (1) year from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed during the initial Agreement term shall not exceed ten thousand dollars ($10,000). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or the Services specified in Exhibit “A.” 4. 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 AGREEMENT FOR EARTH MONTH CELEBRATION SERVICES LMC PRODUCTIONS THIS AGREEMENT is made and entered into as of the ______________ day of _________________________, 20_____, by and between the City of Carlsbad, California, a municipal corporation (“City”) and LMC Productions, a sole proprietorship (“Contractor”). Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 January 24th 25 PSA25-3645ENV City Attorney Approved Version 5/22/2024 Page 2 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 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. 5. STATUS OF CONTRACTOR Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished. 6. INDEMNIFICATION 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, damages, losses and expenses including attorney’s fees arising out of the performance of the work described herein caused by any willful misconduct or negligent act or omission of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. If Contractor’s obligation to defend, indemnify, and/or hold harmless arises out of Contractor’s performance as a “design professional” (as that term is defined under Civil Code section 2782.8), then, and only to the extent required by Civil Code Section 2782.8, which is fully incorporated herein, Contractor’s indemnification obligation shall be limited to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor, and, upon Contractor obtaining a final adjudication by a court of competent jurisdiction. Contractor’s liability for such claim, including the cost to defend, shall not exceed the Contractor’s proportionate percentage of fault. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. 7. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile liability insurance, a combined policy of workers' compensation, employers liability insurance, and professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has 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, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 PSA25-3645ENV City Attorney Approved Version 5/22/2024 Page 3 8. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name Avecita Jones Name Lori Calvert Title Senior Program Manager Title Owner Department Public Works Address 39377 De Luz Road City of Carlsbad Fallbrook, CA 92028 Address 1635 Faraday Ave Phone No. (760) 822-6230 Carlsbad, CA 92008 Email calvertolivas@yahoo.com Phone No. 442-339-2542 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 9. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests as required in the City of Carlsbad Conflict of Interest Code. Yes ☐ No ☒ If yes, list the contact information below for all individuals required to file: Name Email Phone Number 10. COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement. 11. CALIFORNIA AIR RESOURCES BOARD (CARB) ADVANCED CLEAN FLEETS REGULATIONS 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 Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 PSA25-3645ENV City Attorney Approved Version 5/22/2024 Page 4 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. 12. TERMINATION City or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance with the Agreement. 13. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 14. JURISDICTIONS AND VENUE This Agreement shall be interpreted in accordance with the laws of the State of California. Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California. 15. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City. 16. AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. 17. 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. 18. ENTIRE AGREEMENT This Agreement, together with any other written document referred to or contemplated by it, along with the purchase order for this Agreement and its provisions, embody the entire Agreement and understanding between the parties relating to the subject matter of it. In case of conflict, the terms of the Agreement supersede the purchase order. Neither this Agreement nor any of its provisions may be amended, modified, waived or discharged except in a writing signed by both parties. This Agreement may be executed in counterparts. 19. AUTHORITY The individuals executing this Agreement 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 Agreement. [signatures on following page] Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 PSA25-3645ENV City Attorney Approved Version 5/22/2024 Page 5 CONTRACTOR LMC Productions, a sole proprietorship CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager Lori Calvert, Owner (print name/title) ATTEST: By: SHERRY FREISINGER, City Clerk (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, Agreement must be signed by one corporate officer from each of the following two groups: Group A. Group B. Chairman, Secretary, President, or Assistant Secretary, Vice-President 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: _____________________________ Assistant City Attorney Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 PSA25-3645ENV City Attorney Approved Version 5/22/2024 Page 6 EXHIBIT A SCOPE OF SERVICES AND FEE See attached proposal dated October 30, 2024. Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 Prepared by: Lori Calvert October 30, 2024 C O S T Basic The contract price shall not exceed $7,000. The contract price includes all labor, materials, equipment, and transportation required to perform the work as outlined in the Scope of Work excluding in-class presentations. T I M E L I N E P R O J E C T D E S C R I P T I O N After a 10-year career in Recycling and Waste Reduction for the City of Escondido, I'm excited to focus on education. School-age children are typically a receptive audience and if you teach a child, it's possible that they, in turn, will pass that information onto their peers, siblings, parents, caregivers, and extended families. With that in mind, organizing and coordinating a sustainability-centered poster contest at two elementary campuses in Carlsbad and staging a culminating contest ceremony during the City's annual Earth Month Celebration could expand the community-wide outreach of the event. The contest ceremony will bring student artists and their families to an event that already features environmentally-friendly vendors, activities, workshops, live music, and free giveaways of compost and mulch. January 6-20, 2025 - Pre-class coordination February 2025 - In-class presentations March 3-7, 2025 - Follow-up communication March 10-21, 2025 - City staff judging March 24-28, 2025 - Finalist notification April 12, 2025 - Date of event In-Person The contract price is dependent on number of in-class presentations performed not to exceed $10,000. The price includes all labor, materials, equipment, and transportation required to perform basic services with the addition of in-class presentations. Services will be billed as services are performed. Payment will be made after services have been performed within 30 days of receipt of an invoice for those services. Earth Month CelebrationPOSTER CONTESTPROPOSAL L M C P R O D U C T I O N S PSA25-3645ENV Exhibit "A" Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 L M C P R O D U C T I O N S S C O P E O F W O R K P R E - C L A S S C O O R D I N A T I O N Draft email, create list for two schools, 56 teachers - 3 hours/$135 per hour, $405 total. Create printable flyer - 3 hours/$135 per hour, $405 total. Create two-minute video outlining contest description, rules - 7 hours/$135 per hour, $945 total. Task total - $1,755. Begin work 1/6/25, finish 1/20/25. F O L L O W - U P C O M M U N I C A T I O N Draft reminder email for teachers of approaching contest deadline and plans for City staff to collect entries - 1.5 hours/$135 per hour, $202.50 total. Coordinate collection with City staff - 3 hours/$135 per hour, $405 total. Task total - $607.50. Begin work 3/3/25, finish 3/7/25. C O N T E S T J U D G I N G Coordinate with City staff to judge entries. Find accessible location for judging; organize, label entries by grade level and school; invite prospective judges (City staff, local artists, perhaps.) - 10 hours/$135 per hour, $1,350 total. Task total - $1,350. Begin work 3/10/25, finish 3/21/25. F I N A L I S T N O T I F I C A T I O N Draft emails for finalists and participants. Twenty finalists, 10 per school, five each from the two grade-level categories, K-2 and 3-5. Email all participating teachers, call teachers of finalists to explain ceremony and parade, and secure RSVPs. Call each finalist’s home, describe ceremony and parade and secure RSVPs for finalists and their families. 8 hours/$135 per hour, $1,080 total. Task total - $1,080. Begin work 3/24/25, finish 3/28/25. PSA25-3645ENV Exhibit "A" (Cont.) Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 L M C P R O D U C T I O N S S C O P E O F W O R K I N - C L A S S P R E S E N T A T I O N S Schedule presentations with teachers. 2 hours travel/$135 per hour, $270 total. Classroom presentations, 30 minutes each/$135 per hour, $67.50. Task total depends on number of presentations requested, ability to consolidate trips. Five presentations in a single day, 2 hours travel, 2.5 hours presenting/$135 per hour, $607.50 total. 20 presentations, 5 per trip, 4 trips, 18 hours/ $135 per hour, $2,430 total. Offer presentations 2/3/25 through 2/21/25. E V E N T P R E P A R A T I O N Visit site, 2 hours travel, $135 per hour, $270 total. Parade route planning and walk-through, 2 hours/$135 per hour, $270 total. Task total, $540. Work takes place day before event, 4/11/25 E V E N T D A Y A C T I V I T I E S Travel, 2 hours/$135 per hour, $270 total. Event setup, 2 hours/$135 per hour, $270 total. Event management, 2 hours/$135 per hour, $270 total. Task total, $810. Work takes place 4/12/25. F I N A L R E P O R T Collect participation numbers, participant feedback, pictures and video of event. Create final report, 5 hours/$135 per hour, $675 total. Task total, $675. Final report due 4/30/25. PSA25-3645ENV Exhibit "A" (Cont.) Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBRWVDADDLINSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 American Family Connect Property and Casualty Insurance Company 6000 American Parkway Madison, WI 53783-0001 POLICY NUMBER: POLICY PERIOD:12:01 AM Standard Time LAPSE IN COVERAGE: 10/17/2024 - 04/17/2025 FOR CLAIMS SERVICE CALL: FOR CLIENT SERVICE CALL: RENEWAL DECLARATION CALIFORNIA BX10724175 NONE 1-888-404-5365 1-888-404-5365 Lori M Calvert Jose A Olivas BODILY INJURY LIABILITY PROPERTY DAMAGE LIABILITY UNINSURED MOTORIST BODILY INJURY MEDICAL EXPENSE - EXCESS COVERAGE UNINSURED MOTORIST PROPERTY DAMAGE COLLISION COMPREHENSIVE TOWING AND LABOR COSTS RENTAL EXPENSE TOTAL SEMIANNUAL PREMIUM PER VEHICLE TOTAL SEMIANNUAL PREMIUM ALL VEHICLES - CONSOLIDATED VEHICLE ASSESSMENT FEE COVERAGE/LIMIT CONVENIENCE FEE* - $100,000 EACH PERSON $300,000 EACH ACCIDENT $5,000 EACH PERSON $100,000 EACH ACCIDENT $100,000 EACH PERSON $300,000 EACH ACCIDENT CAR 2-WAIVER OF COLLISION DEDUCTIBLE DEDUCTIBLES CAR 2-$1000 4-$500 5-$1000 DEDUCTIBLES CAR 2-$500 4-$500 5-$500 2005 TYTA2 PRIUS 4 2013 TYTA TUNDRA CREW 5 2014 FORD FOCUS SE $122.00 $258.00 $264.00 INCL INCL INCL INCL INCL INCL $42.00 $1.00 $44.00 $14.00 INCL NONELECT $99.00 $1.00 $164.00 $54.00 INCL NONELECT $111.00 $3.00 $266.00 $27.00 INCL NONELECT $223.87 $576.87 $671.87 $1,915.48 CAR 4-WAIVER OF COLLISION DEDUCTIBLECAR 5-WAIVER OF COLLISION DEDUCTIBLE $0.87 $0.87 $0.87 $10.00 $75 PER DISABLEMENT Coverage is provided only when both a premium and limit are shown. * Convenience Fee is $5 per monthly installment if payment is made by credit/debit card or $2 per monthly installment for a preauthorized withdrawal method. adca01a (001)09/18/2024 Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 DRIVER INFORMATION LIENHOLDER INFORMATION YOUR POLICY HAS THE FOLLOWING ENDORSEMENTS: YOUR POLICY HAS THE FOLLOWING DISCOUNTS: CAR INFORMATION CARS KEPT AT LOCATION OTHER THAN RESIDENCE 1. Lori M Calvert 2. Jose A Olivas 3. Marek S Olivas 4. 5. 6. MULTI-CAR, PREMIER SAFETY, FULL COVERAGE, COSTCO 2005 TYTA - GOOD DRIVER, ANTI-THEFT DEVICE, DUAL AND SIDE AIRBAGS 2013 TYTA - GOOD DRIVER, ANTI-THEFT DEVICE, DUAL AND SIDE AIRBAGS 2014 FORD - GOOD DRIVER, ANTI-THEFT DEVICE, DUAL AND SIDE AIRBAGS 2015 TYTA - GOOD DRIVER, ANTI-THEFT DEVICE, DUAL AND SIDE AIRBAGS 2005201320142015 TYTATYTAFORDTYTA JTDKB20U9530698575TFDW5F16DX2883881FADP3F21EL254786JTDKN3DU4F0479332 AMENDATORY ENDORSEMENT SPECIAL EQUIPMENT/CUSTOMIZATION: NONE LIENHOLDER - 2013 TYTA TUNDRA CREW MAX LIENHOLDER - 2014 FORD FOCUS SECarmax Auto Finance, PO Box 3174, Milwaukee, WI 53201-3174 US BANK, PO Box 3427, Oshkosh, WI 54903-3427 cdec09 - CA Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 American Family Connect Property and Casualty Insurance Company 6000 American Parkway Madison, WI 53783-0001 POLICY NUMBER: POLICY PERIOD:12:01 AM Standard Time LAPSE IN COVERAGE: 10/17/2024 - 04/17/2025 FOR CLAIMS SERVICE CALL: FOR CLIENT SERVICE CALL: RENEWAL DECLARATION CALIFORNIA BX10724175 NONE 1-888-404-5365 1-888-404-5365 Lori M Calvert Jose A Olivas 39377 DE LUZ RD FALLBROOK, CA 92028-8547 BODILY INJURY LIABILITY PROPERTY DAMAGE LIABILITY UNINSURED MOTORIST BODILY INJURY MEDICAL EXPENSE - EXCESS COVERAGE UNINSURED MOTORIST PROPERTY DAMAGE COLLISION COMPREHENSIVE TOWING AND LABOR COSTS RENTAL EXPENSE TOTAL SEMIANNUAL PREMIUM PER VEHICLE TOTAL SEMIANNUAL PREMIUM ALL VEHICLES - CONSOLIDATED VEHICLE ASSESSMENT FEE COVERAGE/LIMIT CONVENIENCE FEE* - $100,000 EACH PERSON $300,000 EACH ACCIDENT $5,000 EACH PERSON $100,000 EACH ACCIDENT $100,000 EACH PERSON $300,000 EACH ACCIDENT DEDUCTIBLES CAR 6-$1000 DEDUCTIBLES CAR 6-$500 2015 TYTA6 PRIUS $168.00 INCL INCL $59.00 $2.00 $177.00 $26.00 INCL NONELECT $432.87 $1,915.48 CAR 6-WAIVER OF COLLISION DEDUCTIBLE $0.87 $10.00 $75 PER DISABLEMENT Coverage is provided only when both a premium and limit are shown. * Convenience Fee is $5 per monthly installment if payment is made by credit/debit card or $2 per monthly installment for a preauthorized withdrawal method. adca01a (001)09/18/2024 Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 Page 1 of POLICY CHANGES Policy Change Number POLICY NUMBER POLICY CHANGES EFFECTIVE COMPANY NAMED INSURED AUTHORIZED REPRESENTATIVE COVERAGE PARTS AFFECTED CHANGES Authorized Representative Signature Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 Page of Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: 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 that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Docusign Envelope ID: 23B2DFFD-F410-4BBB-8122-3E8E64BA24F0