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S&J Builders and Restoration Services; 2025-11-17; PWM26-3994FAC
PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 1 City Attorney Approved 6/5/24 CITY OF CARLSBAD RATIFICATION MINOR PUBLIC WORKS CONTRACT SENIOR CENTER DINING HALL URGENT MOLD REMEDIATION This Ratification of Minor Public Works contract is made on the ______________ day of _________________________, 2025 (“Contract”), but effective November 17, 2025, for work that commenced on November 17, 2025, by the City of Carlsbad, California, a municipal corporation (“City”) and S&J Builders and Restoration Services, Inc., a California corporation, whose principal place of business is 10815 Wheatlands Ave. Suite J, Santee, CA 92071 (“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 Brian Bacardi (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 Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA 5th December PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 2 City Attorney Approved 6/5/24 Section 1776 of the California Labor Code, which requires keeping accurate payroll records, verifying and 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 C. 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: 9B832034-1BA5-42F5-AF96-390D76ABCEAA PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 3 City Attorney Approved 6/5/24 Gracie Wilson 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 non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 4 City Attorney Approved 6/5/24 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 started work on November 17, 2025. Completion: Contractor completed work on November 25, 2025. CONTRACTOR’S INFORMATION. S&J Builders and Restoration Services, Inc. 10815 Wheatlands Ave. Suite J (name of Contractor) 689944 (street address) Santee, CA 92071 (Contractor’s license number) B, C-36 2/28/2026 (city/state/zip) 619-449-2014 x 106 (license class. and exp. date) 1000018498 6/30/2026 (telephone no.) swilson@sandjbuild.com (DIR registration number and exp. date) (e-mail address) Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 5 City Attorney Approved 6/5/24 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 S&J BUILDERS AND RESTORATION SERVICES, INC., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Gracie Wilson, President & Secretary PAZ GOMEZ, Deputy City Manager, Public Works, as authorized by the City Manager (print name, title) By: ATTEST: SHERRY FREISINGER, City Clerk (sign here) Sean Wilson, Vice President & CFO By: (print name, title) Assistant City Clerk 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: _____________________________ Assistant City Attorney Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 6 City Attorney Approved 6/5/24 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 NONE Total % Subcontracted: 0% The Contractor must perform no less than 50% of the work with its own forces. Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 7 City Attorney Approved 6/5/24 EXHIBIT B SENIOR CENTER DINING HALL URGENT MOLD REMEDIATION Contractor has provided all materials, tools and labor required to remediate the mold in the Senior Center dining hall per the scope of work detailed in their proposal dated November 19, 2025, and is attached to this agreement as exhibit D. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Mold remediation services. $13,337.36 TOTAL* $13,337.36 *Includes taxes, fees, expenses and all other costs. Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 8 City Attorney Approved 6/5/24 EXHIBIT C 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: 9B832034-1BA5-42F5-AF96-390D76ABCEAA PWM26-3994FAC Senior Center Dining Hall Urgent Mold Remediation Page 9 City Attorney Approved 6/5/24 EXHIBIT C (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: S&J Builders and Restoration Services, Inc. Signature: Name: Gracie Wilson Title: President & Secretary Date: Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA X 12/5/2025 PWM26-3994FAC EXHIBIT D Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc I 08 I 5 Wheat lands Ave Suite J Santee, Ca 92071 619-449-2014 619-449-0887 fax Lie. 689944 Insured: Property: Claim Rep.: Estimator: Company: City of Carlsbad 799 Pine Ave Carlsbad, CA 92008 Brian Bacardi Sean Wilson S&J Builders Business: 10815 Wheatlands Ave Suite J Santee, CA 92071 Reference: Company: City of Carlsbad Contractor: Company: S&J Builders and Restorati,)n Services Inc Business: I 0815 Wheatlands Ave Suite J Santee, CA 9207 I Claim Nurnber: ****** Policy Number: '**** Date Contacted: 11/17/2025 I :00 PM Cellular: (760) 585-8076 E-mail: brian.bacardi@carlsbadca.gov Ce!Jular: (760) 585-8076 E-mail: Brian.Bacardi@carlsbadca.gov Business: (619)449-2014 x 106 E-mail: swilson@sandjbuild.com Business: (619) 449-2014 Type of Loss: Water Damage Date of Loss: 11/17/2025 12:00 PM Date Received: I I/ 17 /2025 I :00 PM Date Inspected: 11/18/2025 I :00 PM Date Entered: I 1/19/2025 7:24 AM Price List: CASD8X_NOV25 Restoration/Service/Remodel Estimate: CITYOFCARLSBAD-PINE PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 1 619-449-2014 619-449-0887 fax Lie. 689944 We would like to thank you for the opportunity to provide you with this COST PROPOSAL FOR Pine A \'e Remediation and Repairs the total cost for the repai.rs detailed iJ1 the following proposal is $13,337.36 Proposal includes prevailing wages. The attached estimate details the specific work to be completed. Additional work outside of that specified in this estimate will be through separate proposal(s) and/or change order(s) detailing the additional/changed scope of work as well as the terms and pricing of those changes. Repairs will be scheduled after a signed contract is received by S&J Builders and a PO is issued by the city. Unless noted otherwise, the customer is required to provide heat, water and electricity on-site for the duration of this project. The customer is responsible for providing continuous access to the project area during normal business hours, Monday -Friday, 7:30 am -4:00 pm. Where an item is being replaced, we will be matching the existing item's quality, color, finish. texture or material as close as possible where applicable unless noted otherwise, there is no guaranty either specified or implied on exact matches. This estimate docs not include hazardous material testing or abatement unless specifically detailed in the following estimate. This estimate is valid for 30 days from I L/19/2025. If you have any questions about this estimate, please contact Sean Wilson to discuss those questions. Respectfully, Sean Wilson CITYOFCARLSBAD-PINE 11/19/2025 Page: 2 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA Door Window Window Window Window S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 I 619-449-2014 6 I 9-449-0887 fax Lie. 689944 Dining Hall CITYOFCARLSBAD-PINE Main Level 700.44 SF Walls 1,816.61 SFWalls&Ceiling 124.02 SY Flooring 157.67 LF Ceil. Perimeter 3' X7' 4' X4' 4' X4' 4' X4' 4' X4' Su broom: Offset Right Side (2) 680.83 SF Walls 1,201.56 SF Walls & Ceiling 57.86 SY Flooring I 50.00 LF Ceil. Perimeter Missing Wall -Goes to Floor 60' 2" X 9' Door 6' X 7' Door 3' X 7' Door 3' X 7' Missing Wall -Goes to neither Floor/Ceiling S' 8" X 4' Door 3' X 7' CITYOFCARLSBAD-PINE 1,116.17 SF Ceiling 1,116.17 SF Floor Height: 12' 2" 26.92 LF Floor Perimeter Opens into Exterior Opens into Exterior Opens into Exterior Opens into Exterior Opens into Exterior 520.72 SF Ceiling 520.72 SF Floor Height: 9' 74.83 LF Floor Perimeter Opens into DINING_ HALL Opens into Exterior Opens into Exterior Opens into Exterior Opens into Exterior Opens into Exterior 11/19/2025 Page: 3 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 I 619-449-2014 6 I 9-449-0887 fax Lie. 689944 CONTINUED -Dining Hall Window -Goes to Floor Door Window -Goes to Floor Door Window -Goes to Floor Door Missing Wall -Goes to Floor Door Missing Wall -Goes to Floor Su broom: Offiset Left Side (1) 6 I 8.00 SF Walls 1,138.72 SFWalls &Ceiling 57.86 SY Flooring 150.00 LF Ceil. Perimeter 6'X7' 3' X 7' 6' X 7' 3' X 7' 6' X 7' 3' X7' 60' 4" X 9' Subroom: Entry/Foyer (3) I 10.67 SF Walls 138.78 SF Walls & Ceiling 3. I 2 SY Flooring 22.33 LF Ceil. Perimeter 6' X 7' 7' 3" X 6' 8" DESCRIPTION QTY REMOVE REPLACE I. Floor pro1cc1ion -heavy paper and 270.00 SF 0.66 0.00 rape 2. Containment Barrier/Airlock/Decon. 686.00 SF 0.00 1.61 Chamber 3. Hazardous Material Remediation 140.00 DA 0.00 1.57 (Drop Ceiling clip rental per day 4. Peel & seal zipper 1.00 EA 0.00 19.79 5. R&R Cove base molding -rubber or 173.50 LF 0.71 2.80 vinyl, 4" high 6. Containmcnl Barrier -tension pos1 40.00 DA 0.00 3.35 (per day) 7. Cont.ainment Barrier -air filter 2.00 EA 0.00 18.35 8. Tape -Contain door 2.25 EA 0.00 11.61 CITYOFCARLSBAD-PINE 520.72 SF Ceiling 520.72 SF Floor Height: 9' 62.67 LF Floor Perimeter Opens into Exterior Opens into Exterior Opens into Exterior Opens into Exterior Opens into Exterior Opens into Exterior Opens into DIJ"'IIING_HALL 28.11 SF Ceiling 28. ll SF Floor Height: 9' 9.08 LP Floor Perimeter Opens into Exterior Opens into DJNlNG_HALL TAX O&P TOTAL 1.46 35.94 215.60 9.04 222,70 J.336.20 0.00 43.96 263.76 0.97 4.16 24.92 23,13 126.42 758.54 0.00 26.80 160.80 1.35 7.62 45.67 0.45 5.32 31.89 11/19/2025 Page: 4 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA mi S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J .._,l hmrllilnStnicn,lac. Santee, Ca 9207 I 619-449-20 14 6 I 9-449-0887 fax Lie. 689944 CONTINUED -Dining Hall DESCRIPTION QTY REMOVE REPLACE TAX O&P TOTAL Passage and plumbing access 9. Negative air fan/Air scrubber (24 hr 10.00 DA 0.00 80.57 0.00 161.14 966.84 period) -No monit. I 0. Equipment setup, take down. and 4.00 HR 0.00 108.17 0.00 86.54 519.22 monitoring (hourly charge) I I. Hazardous Waste/Mold Cleaning 1.00 HR 0.00 108.17 0.00 21.64 129.81 Technician -per hour Labor to remove wall guard Yinyl cap, aluminum track mount and corner guard trim. 12. Tear out wet drywall, cleanup. bag, 19.92 LF 13.92 0.00 0.91 55.64 333.84 per LF -104° -Cat 3 13. Tear out wet drywall, cleanup. bag. 6.17 LF 10.02 0.00 0.14 12.38 74.34 per LF -to 2' -Cat 3 14. Tear out and bag affected 69.33 SF 2.23-0.00 0.32 30.98 185.91 insulation -Category 3 water 15. Apply anti-microbial agent to the 75.33 SF 0.00 0.49 0.29 7.44 44.64 surface area 16. HEPA Vacuuming-Detailed • 190.00 SF 0.00 1.35 0.00 51.30 307.80 (PER SF) Hepa vacumming contaiment floor area after drywall remo,·al 11/18125 17. HEPA Vacuuming exposed 75.33 SF 0.00 3.51 0.00 52.88 317.29 framing w/ drywall Isl HEPA Vac 18. Clean stud wal I -Heavy 75.33 SF 0.00 2.79 0.18 42.08 252.43 19. Clean Drywall back -Heavy 75.33 SF 0.00 3.49 0.18 52.62 315.70 Brian Bacardi from the City of Carlsbad requested the back side or the restroom drywall be cleaned, dried and encapsulated rather then rcmediated at this time because the city has the restrooms scheduled in the near future lo be remodeled and they would handle the remediation at that time. 20. HEPA Vacuuming exposed 75.33 SF 0.00 3.51 0.00 52.88 317.29 framing w/ drywall 2nd ,•ac 21. Dehumidifier (per 24 hr period)-2.00 EA 0.00 67.97 0.00 27.18 163.12 up to 69 ppd-No monitor. 22. Equipment decontamination charge 3.00 EA 0.00 96.86 1.56 58.44 350.58 -HVY. per piece or equip 23. Add for HEPA filter (for upright 0.50 EA 0.00 53.28 1.13 5.54 33.31 vacuums) 24. Add for HEPA filter (for negative 1.00 EA 0.00 220.14 15.20 47.06 282.40 air exhaust fan) 25. Seal restroom drywal back 75.33 SF 0.00 1.37 0.58 20.76 124.54 26. Seal stud wall 75.33 SF 0.00 2.66 9.34 41.94 251.66 27. HEPA Vacuuming -Light -(PER 265.33 SF 0.00 0.71 0.00 37.68 226.06 SF) CITYOFCARLSBAD-PINE l l/19/2025 Page: 5 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 I 619-449-2014 DESCRIPTION Final clean 6 I 9-449-0887 fax Lie. 689944 28. Clean stud wall Final clean 29. Conlamination -pre & post test - full service (By City Vcndcr) QTY 75.33 SF 2.00 EA City to handle all pre and post remediation testing. 30. Hazardous Material Remediation 1.00 EA (Additional cleaning or Demo after testing) 3 I. Ball insulation -4" -R 13 -paper / 69.33 SF foil faced 32. 5/8" -drywall per LF -up to 2' tall 6.17 LF 33. 5/8" -drywall per LF -up to 4' tall 15.75 LF 34. Comer be,id -per LF 5.00 LF 35. Tape joint for new t.o existing 29.92 LF drywall -per LF 36. Texture drywall • Orange Peel 85.00 SF 37. Drywall Installer/ Finisher. per 4.23 HR hour CONTINUED -Dining Hall REMOVE REPLACE 0.00 2.00 0.00 1.39 0.00 16.37 0.00 23.30 0.00 9.28 0.00 10.80 0.00 1.05 0.00 145.65 TAX O&P 0.12 30.16 4.94 20.26 0.85 20.38 3.98 74.20 0.37 9.36 0.93 64.80 0.33 17.92 0.00 123.22 Line items only allow for 5.77 hours for the drywall trades. Additional labor to stock sit.e, cut., hang, tape, noat and texture. 38. Seal the surface area w/latex based 85.00 SF 0.00 0.87 stain blocker -one coat 39. Paint the surface area -two coats -632.00 SF 0.00 1.73 2 colors Cut off paint at inside and outside corners 40. Painter -per hour 2.00 HR 0.00 98.00 Labor to remove the containment for painting. 41. Finish Carpenter -per hour 2.00 HR 0.00 120.84 Labor to reinstall wall guard aluminum track mount, vin)·I cap and COFner guard trim 42. Caulking -acrylic Caulk the top and bottom or wall guard 43. Final cleaning -cons1ruc1ion • Commercial Totals: Dining Hall CITYOFCARLSBAD-PINE 31.50 LF 0.00 3.73 200.00 SF 0.00 0.53 0.66 14.94 16.16 221.92 0.00 39.20 0.00 48.34 0.46 23.60 0.00 21.20 95.03 2,068.54 l l/19/2025 TOTAL 180.94 EXCLUDED EXCLUDED 121.57 122.23 445.16 56.13 388.87 107.50 739.32 89.55 1,331.44 235.20 290.02 141.56 127.20 12,410.85 Page: 6 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA DESCRIPTION S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 I 619-449-2014 6 I 9-449-0887 fax Lie. 689944 Restroom 368.00 SF Walls 492.22 SF Walls & Ceiling 13.80 SY Flooring 46.00 LF Ceil. Perimeter QTY REMOVE REPLACE 124.22 SFCeiling 124.22 SF Floor Height: 8' 46.00 LF Floor Perimeter TAX O&P TOTAL Brian Bacardi from the City of Carlsbad requested the back side of the restroom drywall be cleaned, dried and encapsulated rather then remediated at this time because the city has the restrooms scheduled in the near future to be remodeled and they would handle the remediation at that time. Totals: Restroom Total: Main Level General DESCRIPTION 44. Haul debris -per pickup truck load • including dump fees 45. Haul debris -per pickup truck load -including dump fees 46. Plastic contractor debris bag 47. Commercial Supervision/ Project Management • per hour 48. Commercial Supervision / Project Management • per hour Totals: General QTY 0.50 EA 0.50 EA 4.00 EA 2.00 HR 3.00 HR Linc Item Totals: CITYOfCARLSBAD-PINE CITYOFCARLSBAD-PINE REMOVE REPLACE 311.86 0.00 311.86 0.00 0.8:J. 0.00 0.00 91.33 0.00 91.33 0.00 0.00 0.00 95.03 2,068.54 12,410.85 TAX O&P TOTAL 0.00 3 I. 18 187.11 0.00 3 I. 18 187.1 1 0.26 0.72 4.30 0.00 36.54 219.20 0.00 54.80 328.79 0.26 154.42 926.51 95.29 2,222.96 13,337.36 11/19/2025 Page: 7 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 I 619-449-2014 6 I 9-449-0887 fax Lie. 689944 Grand Total Areas: 2,477.94 SF Walls 2.310.28 SF Floor 0.00 SF Long Wall 2,310.28 Floor Area 1,747.19 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length Coverage Remediation Repairs Total CITYOFCARLSBAD-PINE 2,310.28 SF Ceili11g 256.70 SY Flooring 0.00 SF Shon Wall 2,434.11 Total Area 214.33 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length Item Total % 9,360.73 3,976.63 13,337.36 70.18% 29.82% 100.00% 4,788.22 SF Walls and Ceiling 219.50 LF Floor Perimeter 526.00 LF Ceil. Perimeter 2,711.94 Interior Wall Area 0.00 Total Perimeter Length ACV Total 9,360.73 3,976.63 13,337.36 11/19/2025 % 70.18% 29.82% 100.00% Page: 8 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 1 619-449-2014 619-449-0887 fax Lie. 689944 Line Item Total Material Sales Tax Subtotal Overhead Profit Replacement Cost Value Net Claim Summary for Remediation Sean Wilson CITYOFCARLSBAD-PINE 11/19/2025 7,734.24 66.35 7,800.59 780.07 780.07 $9,360.73 $9,360.73 Page: 9 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 1 619-449-2014 619-449-0887 fax Lie. 689944 Line Item Total Material Sales Tax Subtotal Overhead Profit Replacement Cost Value Net Claim CITYOFCARLSBAD-PINE Sean Wilson Summary for Repairs 11/19/2025 3,284.87 28.94 3,313.81 331.41 331.41 $3,976.63 $3,976.63 Page: 10 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA Line Items Total S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 1 619-449-2014 619-449-0887 fax Lie. 689944 Recap of Taxes, Overhead and Profit O,•crbead (10%) Profit. (10%) I.II 1.48 1,111.48 1,111.48 1,111.48 CITYOFCARLSBAD-PINE Material Sales Tax (7.75%) 95.29 95.29 Storage Rental Tax (7.75%) 0.00 0.00 11/19/2025 Page: 11 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J Santee, Ca 9207 1 619-449-2014 619-449-0887 fax Lie. 689944 Estimate: CITYOFCARLSBAD-PINE Area: Main Level Dining Hall Coverage: Remediation Coverage: Repairs Area Subtotal: Main Level Coverage: Remediation Coverage: Repairs General Coverage: Remediation Coverage: Repairs Subtotal of Areas Total Coverage: Remediation Coverage: Repairs CITYOFCARLSBAD-PINE Recap by Room 72.17% = 27.83% = 72.17% = 27.83% = 43.87% = 56.13% = 70.19% = 29.81 % = 10,247.28 93.00% 7,395.65 2,85 l.63 10,247.28 93.00% 7,395.65 2,85 I.63 771.83 7.00% 338.59 433.24 ll,019.ll L00.00% 7,734.24 3,284.87 11,019.11 100.00% 11/19/2025 Page: 12 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA mi S&J Builders and Restoration Services Inc 10815 Wheallands Ave Suite J .._,lhmrllilnStnicn,lac. Santee, Ca 9207 I 619-449-2014 6 I 9-449-0887 fax Lie. 689944 Recap by Category O&P Items Total % CLEANING 106.00 0.79% Coverage: Repairs @ 100.00% = 106.00 GENERAL DEMOLITION 1,110.29 8.32% Coverage: Remediation @ 85.66% = 951.04 Coverage: Repairs @ 14.34% = 159.25 DRYWALL 1,542.87 11.57% Coverage: Remediation @ 39.93% = 616.10 Coverage: Repairs @ 60.07% = 926.77 FLOOR COVERING -VINYL 485.80 3.64% Coverage: Remediation @ 100.00% = 485.80 FINISH CARPENTRY / TRIM WORK 241.68 1.81 % Coverage: Repairs @ 100.00% = 241.68 HAZARDOUS MATERIAL REMEDIATION 5,059.12 37.93% Coverage: Remediation @ 100.00% = 5,059.12 INSULATION 96.37 0.72% Coverage: Repaiss @ 100.00% = 96.37 LABOR ONLY 456.65 3.42% Coverage: Remediation @ 40.00% = 182.66 Coverage: Repairs @ 60.00% = 273.99 MOISTURE PROTECTION 117.50 0.88% Coverage: Repairs @ 100.00% = I 17.50 PAINTING 1,666.89 12.50% Coverage: Remediation @ 18.21% = 303.58 Coverage: Repairs @ 81.79% = 1,363.31 WATER EXTRACTION & REMEDIATION 135.94 1.02% Coverage: Remediation @ 100.00% = 135.94 O&P Items Subtotal 11,019.11 82.62% Material Sales Tax 95.29 0.71% Coverage: Remediation @ 69.63% = 66.35 Coverage: Repairs @ 30.37% = 28.94 Overhead 1,111.48 8.33% Coverage: Remediation @ 70.18% = 780.07 Coverage: Repairs @ 29.82% = 331.41 Profit 1,111.48 8.33% Coverage: Remediation @ 70.18% = 780.07 Coverage: Repairs @ 29.82% = 331.41 Total 13,337.36 100.00% CITYOFCARLSBAD-PINE 11/19/2025 Page: 13 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 3 5 7 10815 Wheatlands Ave Suite J Santee, Ca 9207 I 6I9-449-2014 6 I 9-449-0887 fax Lie. 689944 CITYOFCARLSBAD-PINE 2 4 6 8 11/19/2025 Page: l4 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA 9 II 13 15 S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, Ca 9207 I 6I9-449-2014 6 I 9-449-0887 fax Lie. 689944 10 12 14 16 CITYOFCARLSBAD-PINE 11/19/2025 Page: 15 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA S&J Builders and Restoration Services Inc 17 19 10815 Wheatlands Ave Suite J Santee, Ca 9207 I 6I9-449-2014 6 I 9-449-0887 fax Lie. 689944 CITYOFCARLSBAD-PINE 18 11/19/2025 Page: 16 PWM26-3994FAC Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA Main Level 0 set Left Sid (I) Dining Hall Off Right Si . ••·o•------t CITYOrCARLSBAD-PINE 11/19/2025 Main Level Page: 17 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A(Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 11/24/2025 12203 S & J Builders And Restoration Services, Inc.10815 Wheatlands Ave. Ste. J Santee, CA 92071 20260 35076 31453 A 1,000,000 X P0000010966 10/15/2025 10/15/2026 100,000 5,000 1,000,000 2,000,000 2,000,000 1,000,000B 50004339601 3/1/2025 3/1/2026 2,000,000A 00166803-0 10/15/2025 10/15/2026 2,000,000 C X 9372480-2025 1/1/2025 1/1/2026 1,000,000Y1,000,000 1,000,000 D COL & Prof Liab D3AD12250101 10/15/2025 $4MIL/Occ/Agg 4,000,000 E Property 60497187 10/10/2025 10/10/2026 Personal Prop of OTH 29,200 Deductible for Contractors Pollution Liability is $5,000 per claim | Deductible for Professional liability is $5,000 per claim Re: All Projects with the City As respects General Liability, 'The City of Carlsbad/CMWD' is additional insured when required by written contract per attached endorsements. Cancellation Clause applies per attached policy language. Waiver of Subrogation applies with respects to Workers Compensation. City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance ServicesP.O. Box 947Murrieta, CA 92564 S&JBUIL-01 CUSTOMSERV JPL Insurance Group, Inc.3033 Fifth Ave. #325San Diego, CA 92103 Kristi Andreas-Redondo kristi@jplinsurance.com James River Insurance Infinity Select Insurance Company State Compensation Ins Fund Beazley Excess And Surplus Insurance, Inc. Financial Pacific Insurance Co X 10/15/2026 X X X X X X Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA AC:C>RD9 I ~ I -□ □ - - ~ □ □ - -- ->-- -~ -H I I I I I □ I Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA POLICY NUMBER: P0000010966 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): Location(s) Of Covered Operations Where required by written contract or written agreement All operations of the Named Insured 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. 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 2010 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 □ Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA POLICY NUMBER: P0000010966 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Where required by written contract or written All operations of the Named Insureds agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 □ Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA STATE COMPENSATION INS URANCE FUND t:NUUK~t:IVll:l"T AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE JANUARY 1, 2025 AT 12. 01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME AND EXPIRING JANUARY 1, 2026 AT 12.01 A.M. S & J BUILDERS AND RESTORATION SER 10815 WHEATLAND AVE, SUITE J SANTEE, CA 92071 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY 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 REP 04 9372480-25 NEW SD 0-44-34-80 PAGE 1 OF NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 2572 ~~-5,(, JANUARY 2, 2025 If~~ .d!-L~~~ PRESIDENT AND CEO 1 SCIF FORM 10217 (REV.4-2018) OLO DP 217 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AP2104US 10-12 Page 1 of 2 COMMON POLICY CONDITIONS All Coverage Parts in this policy are subject to the following Conditions. 1. CANCELLATION AND NON-RENEWAL A. The first Named Insured shown in the Declarations may cancel this policy by mailing or deliveringto us advance written notice of cancellation. B. We may cancel this policy by mailing or delivering to the first Named Insured written notice ofcancellation at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or (2) 30 days before the effective date of cancellation if we cancel for any other reason. C. We will mail or deliver our notice to the first Named Insured’s last mailing address known to us. D. Notice of cancellation will state the effective date of cancellation. The policy will end on that date. E. If this policy is cancelled, we will send the first Named Insured any premium refund due. If wecancel, the refund will be pro rata unless cancellation is due to non payment of premium, in whichcase the refund may be less than pro rata. If the first Named Insured cancels, the refund may beless than pro rata. The cancellation will be effective even if we have not made or offered a refund. F. If notice is mailed, proof of mailing will be sufficient proof of notice. If we elect not to renew this policy, we shall mail written notice to the First Named Insured at the address shown in the Declarations. Such written notice of non-renewal shall be mailed at least 30 days prior to the end of the policy term. 2. CHANGES This policy contains all the agreements between you and us concerning the insurance afforded. Thefirst Named Insured shown in the Declarations is authorized to make changes in the terms of thispolicy with our consent. This policy’s terms can be amended or waived only by endorsement issued by us and made a part of this policy. 3. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US If the insured has rights to recover all or part of any payment we have made under this policy, thoserights are transferred to us. The insured must do nothing after loss to impair them. At our request, theinsured will bring suit or transfer those rights to us and help us enforce them. 4. REPRESENTATIONS By accepting this policy, you agree: A. The statements in the Declarations are accurate and complete; B. Those statements are based upon representations you made to us; and C. We have issued this policy in reliance upon your representations. 5. SERVICE OF SUIT It is agreed that in the event of the failure of this Company to pay any amount claimed to be duehereunder, this Company will submit to the jurisdiction of any court of competent jurisdiction within theUnited States of America and will comply with all requirements necessary to give such Court jurisdiction and all matters arising hereunder shall be determined in accordance with the law andpractice of such Court. It is further agreed that service of process in such suit may be made upon the Company’s President,or his nominee, at the address shown on the Declarations page of this policy, and that in any suitinstituted against any one of them upon this policy, this Company will abide by the final decision of Policy#001229933Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA AP2104US 10-12 Page 2 of 2 such Court or of any Appellate Court in the event of an appeal. The above-named is authorized and directed to accept service of process on behalf of this Company in any such suit and/or upon the request of the insured to give a written undertaking to the insured that it or they will enter a general appearance upon this Company’s behalf in the event such a suit shall be instituted. Further, pursuant to any statute of any state, territory or district of the United States of America, which makes provision therefore, this Company hereby designates the Superintendent, Commissioner or Director of Insurance or other officer specified for that purpose in the statute, or his successor or successors in office, as their true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by or on behalf of the insured or any beneficiary hereunder arising out of this contract of insurance, and hereby designates the above-named as the person to whom the said officer is authorized to mail such process or a true copy thereof. 6. TERMS, CONDITIONS AND PREMIUM On each renewal, continuation, anniversary of the effective date of the policy or on an annual basis, the Company will determine the rate and premium and/or amend the terms and conditions in accordance with the rates and rules then in effect. 7. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS POLICY Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. In Witness Whereof, this Company has executed and attested these presents; but this policy shall not be valid unless signed by duly authorized representatives of this Company. VICE PRESIDENT PRESIDENT Docusign Envelope ID: 9B832034-1BA5-42F5-AF96-390D76ABCEAA