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HomeMy WebLinkAboutCharles Doherty Concrete Inc; 2025-10-06; PWM26-3931TRANPWM26-3931TRAN ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 1 City Attorney Approved 6/5/24 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT ARMADA DR CONCRETE REPLACEMENT PHASE 2; CONT. NO. 6114 This contract is made on the ______________ day of _________________________, 2025 (“Contract”), by the City of Carlsbad, California, a municipal corporation ("City") and Charles Doherty Concrete Inc, a California corporation whose principal place of business is 2850 Industry Street, Oceanside, California, 92054 ("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: Matt Paxson 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, installation, 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: EB613393-3743-4DD3-8977-1BA687085A6D 6th October PWM26-3931TRAN ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 2 City Attorney Approved 6/5/24 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 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. Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D PWM26-3931 TRAN 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: Charles Doherty 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 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. ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page3 City Attorney Approved 6/5/24 PWM26-3931TRAN ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 4 City Attorney Approved 6/5/24 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 thirty (30) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within thirty (60) working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Charles Doherty Concrete Inc 2850 Industry St (name of Contractor) 707928 (street address) Oceanside, CA, 92054 (Contractor’s license number) A, C-8, C-13 10/31/2025 (city/state/zip) 760-535-9295 (license class. and exp. date) 1001072972 6/30/2026 (telephone no.) cwdoherty@cox.net (DIR registration number and exp. date) (e-mail address) Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D PWM26-3931 TRAN 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. CONTRACTOR CHARLES DOHERTY CONCR TE INC, a California corporation By: (sign here) Charles Doherty, President and CFO (print name, title) • (sign here) (print name, title) CITY OF CARLSBAD, a municipal corporation of the State of California By: PAZ GOMEZ, Deputy City Manager, Public Works, as authorized by the City Manager ATTEST: SHERRY FREISINGER, City Clerk By: Assistant City Clerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached. 1iE, corporation. Contract must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B 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: __ ft_i_l-\.\_YJ~b-1/1.,_S ___ _ Assistant City Attorney ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Pages City Attorney Approved 6/5/24 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D PWM26-3931 TRAN 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-ha If 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 Business Name and Address DIR Registration No. License No., %of to be & Expiration Date Classification Total Subcontracted & Expiration Contract Date NoN, Total % Subcontracted: 0 ------- The Contractor must perform no less than 50% of the work with its own forces. ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page6 City Attorney Approved 6/5/24 PWM26-3931TRAN ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 7 City Attorney Approved 6/5/24 EXHIBIT B ARMADA DR CONCRETE REPLACEMENT PHASE 2 Contractor shall provide all equipment, materials and labor, at prevailing wages, to demo, remove, dispose of, and replace 4,000 square feet of concrete sidewalk on Armada Drive starting at the sidewalk previously replaced and continuing approximately 325 feet to the South as shown in site images. Contractor to implement traffic control lane closure per traffic control permit from the City of Carlsbad. Contractor to root prune tree roots under removed concrete and scarify that disturbed existing subgrade to a depth of 6-8”. Root pruning includes the removal and disposal. Contractor to recompact subgrade with 5-ton roller. Contractor to pump, place, and finish 4,000 square feet of natural gray, 4” thick, 3250 PSI concrete. Contractor price includes DIR set up fees for the job for Superior Ready Mix and for 6 concrete loads. Before any work starts the contractor shall apply for a right of way permit and submit a Traffic Control Plan. The contractor is responsible for obtaining a water meter from Carlsbad Municipal Water District if any water is needed during the project. Any road cleanup from debris left after project must be cleaned up by the contractor before leaving the jobsite. All subcontractors must be added to the contract in exhibit A prior to the execution of the contract. All work shall be performed in accordance with the City of Carlsbad’s Engineering Standards, latest edition, the 2024 Standard Specifications for Public Works Construction (Greenbook), 2018 Caltrans Standard plans and Caltrans Specifications and California Manual on Uniform Traffic Control Devices. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 EA 1 Provide and implement traffic control lane closure as needed. $4,600.00 2 EA 4,000 Sawcut, demo and dispose of 4,000 SQ FT – assume existing concrete is 4-in thick $16,000.00 3 EA 4,000 Pump, place and finish 3250 PSI Natural Grey Concrete 4-in thick $46,600.00 4 EA 1 DIR setup fees Superior Ready Mix $800.00 5 EA 6 DIR Concrete Fees – 6 loads $1,200.00 6 EA 1 Prepare right-of-way permit application, provide insurance certs and endorsements and SDRSD TC $570.00 7 EA 1 Bonding $2,076.00 TOTAL* $71,846.00 *Includes taxes, fees, expenses and all other costs. Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D PWM26-3931TRAN ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 8 City Attorney Approved 6/5/24 EXIBIT B CONTINUED SITE IMAGES SI Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D PWM26-3931TRAN ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 9 City Attorney Approved 6/5/24 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D /_ -,7 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D EXHIBIT C LABOR AND MATERIALS BOND PWM 26-3931 TRAN Bond No. RCB0051207 Premium: $1,437 Premium will be adjusted based on final contract amount WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Charles Doherty Concrete Inc (hereinafter designated as the "Principal"), a Contract for: ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONTRACT NO. 6114 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 City Clerk of the City of Carlsbad and all of which are incorporated herein 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 materia Is, 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 extent hereinafter set forth. NOW, THEREFORE, WE, Charles Doherty Concrete Inc, as Principal, (hereinafter designated as the "Contractor"), and Contractors Bonding and Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of seventy-one thousand eight hundred forty-six dollars ($71,846.00}, 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. 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 section 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 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit 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 brought 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 shall 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 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. ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 10 City Attorney Approved 6/5/24 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D PWM 26-3931 TRAN This labor and materials bond may be approved as to form by the City Attorney for the City in counterpart, and the counterparts shall all constitute a single, original instrument. SIGNED AND SEALED, this _1_8t_h _____ day of September I 2025 :harles Dohe/li~i'"c SEP Z Z :O::LI '(signature) L'i a,, le s-}Jcf 1w. -r ~ O wlV--< re (Name/Title) Contractors Bonding and Insurance Company (SEAL) ,,...,;j (Surety) By:~ (Signature) Anne Wright, Attorney-in-Fact (Name/Title) (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY -ATTACH ATTORNEY-IN -FACT CERTIFICATE) APPROVED AS TO FORM: CINDIE K. McMAHON City Attorney By: Assistant City Attorney ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 11 City Attorney Approved 6/5/24 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: 800-645-2402 K11ow All Men by These Prese11ts: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make, constitute and appoint: Matthew C. Gaynor, Kim D. Vasguez, Daniel Frazee, David J. Garcia, Andrew Robe1ts, Anne Wright, Brittney Thompson, Joshua Hill, ·ointl or severall in the City of San Diego , State of California its true and lawful Agent(s) and Attorney(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( $25,000.000.00 ) for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each fu1ther certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to-wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secreta1y, any Assistant Secreta1y, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company cau~ed these presents to be executed by its respective and/or Contractors Bonding and Insurance Company, as applicable, have Sr. Vice President with its corporate seal affixed this 6th day of __ June , _2025 . State of Ohio County of Cuyahoga } ss On this __fil!L_ day of June , 2025 , before me, a Notary Public, personally appeared Eric Raudins , who being by me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntaiy act and deed of said corporation. Notary Public State or Ohio My Comm. Expires S•ptemb,r 12. 2025 Notary Public 0476/010101/2 Eric Raudins Sr. Vice President CERTIFICATE I, the undersigned officer of RLI Insurance Company and/or Contractors Bonding and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable; and furthermore, that the Resolution of the Company as set fo11h in the Power of Attorney, is now in force. In testimony whereof, I have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bonding and Insurance Company this ...1fil!:L_ day of September , 2025 . RLI Insurance Company Contractors Bonding and Insurance Company By: ~~ OJi~ Jeffrey ic Corporate Secretaiy A0058D19 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D ' . 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 San Diego on September 18, 2025 before me, Brittney Thompson, Notary Public (insert name and title of the officer) personally appeared _A_n_n_e_W_r_ig_h_t _____________________ _ 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 an (Seal) Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D CALIFORNIA ALL-PURPOSE CERTIFICATE OF 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 San Diego } personally appeared ~='"':..Jd.<~:t:..J.<:..:::...----<f.~L,C,:~~~----------- who proved to me on the basis of satisfactory ev· ence to be the person~hose i El~are subscribed to the within instrument and acknowledged to me that he/they executed the same ir@,er/their authorized capacity~ and that by er/their signature(s-t--en the instrument the perso$},-or the entity upon behalf of which the personfs}-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. Notary Public Signature (Notary Public Seal} ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached doc&nent continued) /fKAibrf C ~ cvJ (~itle or descriP.tion of ::',d document) /) 11:tJtfv~~ !zwd- Number of Pages~ Document DateSEP 2 2 CAPACITY CLAIMED BY THE SIGNER itle D Partner(s) D Attorney-in-Fact □ Trustee(s) □ Other _________ _ www.NotaryClasses.com 800-873-9865 INSTRUCTIONS FOR COMPLETING THIS FORM 11tisform complies il'ith c111re11t Cali/'omia statutes ffgarding notm:l' ll'ording and, if'needed, should be completed and attached to the document. Ack11owledg111e11/s .fi-0111 other states 111ay be co111pletedfi,r dorn111e11/s being sent to that state so long as the wording does 1101 require the Cal(t(w11ia 11otwJ1 to violate Cal{fOrnia 110101:v la11·. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signcr(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notaiy public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect f01111s (i.e. he/sheilhey;-is /f!fe) or circling the co1Tect fonns. Failure to co!Tcctly indicate this information may lead to rejection of document recording. • The notaty seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. ❖ Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a diflercnt document. ❖ Indicate title or type nl' attached document, number ol' pages and date. ❖ Indicate the capacity claimed by the signer. If the claimed capacity is a corporate ot1icer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. PWM26-3931TRAN ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 12 City Attorney Approved 6/5/24 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: EB613393-3743-4DD3-8977-1BA687085A6D Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D PWM26-3931 TRAN EXHIBIT D (CONT.) IN-USE OFF-ROAD DIESEL-FUELED FLEET REGULATION CERTIFICATION Contractor hereby acknowledges that they have reviewed the CAR B'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: 1K] The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto. D 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 RlOO 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: Charles Doherty Title: President ARMADA DR CONCRETE REPLACEMENT PHASE 2 CONT. NO. 6114 Page 13 City Attorney Approved 6/S/24 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Monthly CTC-VIS Account Summary From: noreply@cleantruckcheck.arb.ca.gov To: CWDOHERTY@COX.NET Date: Thursday, July 3, 2025 at 08:08 AM PDT Dear CHARLES DOHERTY, Below is a summary of the current status of your CHARLES DOHERTY CONCRETE INC. CTC-VIS account: 1. Vehicle Compliance Certification Status: a. 0 Vehicle Compliance Certification(s) were issued to your entity in the last month. b. In total, 1 vehicle(s) are currently compliant out of 1 registered in your entity. c. 1 of the Vehicle Compliance Certificate(s) will expire within next 90 days. 2. Compliance Fee: a. Fees Due Soon: 1 vehicle(s) are with fee(s) due within next 90 days. b. Fees Past Due: 0 vehicle(s) are with fee(s) already past due. 3. Clean Truck Check Emissions Compliance Testing: a. Vehicles with Test(s) Due: 1 vehicle(s) have entered their test submission period, and the test(s) will be due within next 90 days. b. Tests Past Due: 0 vehicle(s) are with test(s) already past due. 4. Enforcement Hold: 0 vehicle(s) are currently under hold due to outstanding GARB Enforcement actions. The status may vary from day to day, for more details and the latest status, please visit your account at httRs://cleantruckcheck.arb.ca .gov. Please review the status of your vehicles to ensure that all your vehicles are compliant with the Clean Truck Check program. If you have any questions or need assistance, please contact GARB at HDIM@arb.ca .gov. CA LI FORN I A A I h ,; 'f I l ;; "· ~-l Clean Truck Check Team California Air Resources Board hdim@arb.ca.gov Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D CHARDOH-01 CPELTZER ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 7/14/2025 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 License # 0757776 221JI~CT Casey Peltzer HUB International Insurance Services Inc. i:,g,N:o, Ext): (760) 804-0402 I Wc, No):(760) 804-0942 1525 Faraday Avenue Suite 150 iori1~ss: Casey.peltzer@hubinternational.com Carlsbad, CA 92008 INSURER/SJ AFFORDING COVERAGE NAIC# INSURER A: Scottsdale Insurance Comoanv 41297 INSURED INSURERB: Charles Doherty Concrete INSURERC: 1302 Crestridge Dr. INSURERD: Oceanside, CA 92054 INSURERE: INSURERF: 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. I~~~ TYPE OF INSURANCE ADDL ~~~ POLICY NUMBER POLICYEFF POLICY EXP LIMITS l.,c,n A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ~ □ CLAIMS-MADE 00 OCCUR DAMAGE TO RENTED 100,000 X X BCS2001698 7/15/2025 7/15/2026 PREMISFS IER occu=ncel $ X Per Project Agg. MED EXP /Anv one oersonl $ ~ PERSONAL & ADV INJURY $ 1,000,000 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Fl POLICY □ ~r8f □ LOC PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: EBL AGG OR EACH $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ /Ea accident) ANY AUTO BODILY INJURY (Per person) $ ~ OWNED ~ SCHEDULED ~ AUTOS ONLY ~ AUTOS BODILY INJURY /Per accident) $ HIRED NON-OWNED 1P~?~€ci1JiNAMAGE $ ~ AUTOS ONLY ~ AUTOS ONLY $ A UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 5,000,000 ~ XLS2004819 7/15/2025 7/15/2026 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ Aggregate $ 5,000,000 WORKERS COMPENSATION I PER I I OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ N/A E.L. EACH ACCIDENT $ ~FFICER/MEMBER EXCLUDED? Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Operations of the Named Insured during the current policy term. The City of Carlsbad/CMWD is Additional Insured with regard to the General Liability policy, when required by written contract, per the attached endorsement forms CG2010 12/19, CG2012 12/19 & CG2037 12/19. Coverage is Primary & Non -Contributory with regard to the General Liability policy, when required by written contract, per the attached endorsement form CG200112/19. Waiver of Subrogation applies to the General Liability policy, when required by written contract, per the attached endorsement form CG2404 12/19. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad/CMWD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Compliance Services P.O. Box947 Murrieta, CA 92564 AUTHORIZED REPRESENTATIVE I ~~ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Insured Name: Charles Doherty POLICY NUMBER: BCS2000736 Term: 7/15/2025 to 7/15/2026 COMMERCIAL GENERAL LIABILITY CG 20 10 1219 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 Oraanization(s) Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION WHEN ALL LOCATIONS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE OCCURRENCE TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. 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) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment 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 intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 1219 © Insurance Services Office, Inc., 2018 Page 1 of2 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of2 © Insurance Services Office, Inc., 2018 CG 20 10 1219 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Insured Name: Charles Doherty POLICY NUMBER: BCS2000736 Term: 7/15/2025 to 7/15/2026 COMMERCIAL GENERAL LIABILITY CG 20 121219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION -PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: ANY PERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE OCCURRENCE TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20121219 © Insurance Services Office, Inc., 2018 Page 1 of 2 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products-completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 121219 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Insured Name: Charles Doherty POLICY NUMBER: BCS2000736 Term: 7/15/2025 to 7/15/2026 COMMERCIAL GENERAL LIABILITY CG 20 371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Oraanization(s} Location And Description Of Completed Operations Any person or organization when All Locations required by written contract or agreement, executed prior to the occurrence to which this insurance applies, that such person or organization be added as an additional insured on vour policv 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 371219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Insured Name: Charles Doherty POLICY NUMBER: BCS2000736 Term: 7/15/2025 to 7/15/2026 COMMERCIAL GENERAL LIABILITY CG 20 011219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 011219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D Insured Name: Charles Doherty POLICY NUMBER: BCS2000736 Term: 7/15/2025 to 7/15/2026 COMMERCIAL GENERAL LIABILITY CG 24 041219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US {WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization for whom the insured has agreed to waive rights of recovery, provided such agreement is made in writing and prior to the loss 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 against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 041219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 07/21/2025 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 OFFICE MANAGER NAME: State Farm TRAVIS FOSTER INSURANCE AGENCY INC ritjgNr;0 Evtl• 530-242-1411 I fffc Nol: 530-242-1311 A ® 1007 DANA DR STE C iflJ~ss: CERTREQUEST@TRAVISFOSTERAGENCY.COM REDDING CA 96003 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED INSURERB: CHARLES DOHERTY CONCRETE INC INSURERC: 2850 INDUSTRY ST INSURER D: OCEANSIDE, CA 92054 INSURER E: 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 ADDL SUBR ,&gM%TvWr1 ,&3~~%~1 LTR TYPE OF INSURANCE •••~n o•R•n POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ ~ D CLAIMS-MADE □ OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence! $ ~ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ ~ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Fl □PRO-□LOG PRODUCTS -COMP/OP AGG $ POLICY JECT OTHER: $ AUTOMOBILE LIABILITY X 602 9657-A30-55 07/30/2025 07/30/2026 COMBINED SINGLE LIMIT $ 2,000,000 r Ea accident) ~ ANY AUTO BODILY INJURY (Per person) $ A ~ OWNED ~ SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ ~ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION I PER I I OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is listed as additional insured (6028BU) with 30 days notice of cancellation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad/CMWD ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Compliance Services AUTHORIZED REPRESENTATIVE P.O. Box 947 A/~S. Murrieta, CA 92564 I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132849.12 03-16-2016 Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D CHARDOH-01 IFATHIPOUR ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 1/3/2025 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 NAME: Paramount Exclusive Insurance Services, Inc. !l'8,N:o, Ext): (818) 986-7283 I Wc, No):(818) 986-4949 15760 Ventura Blvd. Suite 500 Encino, CA 91436 xt~~ss: service@paramountexclusiveins.com INSURER(Sl AFFORDING COVERAGE NAIC# INSURER A: Everest Premier Insurance Company 16045 INSURED INSURERB: Charles Doherty Concrete, Inc. INSURERC: 1302 Crestridge Dr. INSURERD: Oceanside, CA 92054 INSURERE: INSURERF: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER ,:~M%~ ,:3M%~ LIMITS LTR INSD WVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ I CLAIMS-MADE □ OCCUR DAMAGE TO RENTED PREMISES /Ea nrrurrencel $ ~ MED EXP (Anv one oersonl $ PERSONAL & ADV INJURY ~ $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Fl POLICY □ rr&-r DLoc PRODUCTS -COMP/OP AGG $ OTHER: $ ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ /Ea ar.r.irtent\ ANY AUTO BODILY INJURY /Per oersonl $ ~ -OWNED SCHEDULED ~ AUTOS ONLY -AUTOS BODILY INJURY /Per accident) $ HIRED ~8fo'§i%1~ 1P~?~&:~d~NAMAGE $ ~ AUTOS ONLY - $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ ~ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION XI ~ffTUTE I I OTH- AND EMPLOYERS' LIABILITY ER Y/N X 7600025036241 12/5/2024 12/5/2025 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE [Y] E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A 1,000,000 (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ ~~;t~ftf[~~ ~~~PERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All Projects Waiver of subrogation in favor of City of Carlsbad CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad/CMWD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Compliance Services P.O. Box947 Murrieta, CA 92564 AUTHORIZED REPRESENTATIVE . . I ~ f'-T'' ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: EB613393-3743-4DD3-8977-1BA687085A6D WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 0306 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will 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 from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHT FROM US PRIOR TO INJURY. JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 12/05/2024 Insured: Charles Doherty Concrete Inc Policy No. 7600025036241 Insurance Company: Everest Premier Insurance Company Endorsement No. 001 Premium $ INCL. Countersigned By: __________________________ _ -1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual -1999. 5