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HomeMy WebLinkAboutSouthern California Precision Concrete Inc dba Precision Concrete Cutting; 2026-03-17; PWM26-4015TRANPWM26-4015TRAN Citywide Speed Hump Slicing 36 Locations Page 1 City Attorney Approved 6/5/24 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT CITYWIDE SPEED HUMP SLICING 36 LOCATIONS This contract is made on the ______________ day of _________________________, 2026 (“Contract”), by the City of Carlsbad, California, a municipal corporation (“City”) and Southern California Precision Concrete Inc., a California corporation, dba Precision Concrete Cutting, whose principal place of business is 320 State Place, Escondido, California, 92029 (“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 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 March17th PWM26-4015TRAN Citywide Speed Hump Slicing 36 Locations 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 D. CONSTRUCTION MANAGEMENT SOFTWARE. Procore Project Management and Collaboration System. This project may utilize the Owner’s Procore (www.procore.com) online project management and document control platform. The intent of utilizing Procore is to reduce cost and schedule risk, improve quality and safety, and maintain a healthy team dynamic by improving information flow, reducing non- productive activities, reducing rework and decreasing turnaround times. The Contractor is required to create a free web-based Procore user account(s) and utilize web-based training / tutorials (as needed) to become familiar with the system. Unless the Engineer approves otherwise, the Contractor shall process all project documents through Procore because this platform will be used to submit, track, distribute and collaborate on project. If unfamiliar or not otherwise trained with Procore, Contractor and applicable team members shall complete a free training certification course located at http://learn.procore.com/procore-certification-subcontractor. The Contractor is responsible for attaining their own Procore support, as needed, either through the online training or reaching out to the Procore support team. It will be the responsibility of the Contractor to regularly check Procore and review updated documents as they are added. There will be no cost to the Contractor for use of Procore. It is recommended that the Contractor provide mobile access for Windows, iOS located at https://apps.apple.com/us/app/procore-construction-management/id374930542 or Android devices located at https://play.google.com/store/apps/details?id=com.procore.activities with the Procore App installed to at least one on-site individual to provide real-time access to current posted drawings, specifications, RFIs, submittals, schedules, change orders, project documents, as well as any deficient observations or punch list items. Providing mobile access will improve communication, efficiency, and Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 PWM26-401STRAN productivity for all partl . Th us of Pro ore for project management does not relieve the contractor of any other requirement as may b p lfl d In th contract documents. FALSE Cl.AIMS. Contractor hereby a9rees that any contract clalm submitted to the City must be asserted as part of the contract pro ess as set forth In this Contract and not In anticipation of litigation or in conjunction with litigl\tlon. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for clvil 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 ii'.:itings 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 autoH and cannot be limited in any manner. Citywide Speed Hump Slicing 36 Locations Page 3 City Attorney Approved 6/S/24 PWM26-4015TRAN Citywide Speed Hump Slicing 36 Locations 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 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. Southern California Precision Concrete Inc. dba Precision Concrete Cutting 320 State Place (name of Contractor) 925449 (street address) Escondido, CA, 92029 (Contractor’s license number) C-61/D06 - 12/31/26 (city/state/zip) 951-760-1945 (license class. and exp. date) 1000003322 - 6/30/26 (telephone no.) parker@pcctriphazardremoval.com (DIR registration number and exp. date) (e-mail address) Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 PWM26-4015TRAN 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 SOUTHERN CALIFORNIA PRECISION CONCREiE INC., a California corporation, dba Precision Concrete Cutting By: Ronald William Duma, Jr., President (print name, title) By: 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: ~b!wlrern ~ (sign here) SHERRY FREISINGER, City Clerk Neshtinscka Duma, Secretary By: (print name, title) Assistant City Clerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !f..g 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: ___ fi_i~_¼-'--tJ_tA,_S ___ _ Assistant City Attorney Citywide Speed Hump Slicing 36 Locations Page 5 City Attorney Approved 6/5/24 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 PWM26-4015TRAN 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 wlll be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if It falls 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 Business Name and Address DIR Registration No. License No., %of to be & Expiration Date Classification Total Subcontracted & Expiration Contract Date !/\_ j OJ\~ E Total% Subcontracted: ______ _ The Contractor must perform no less than 50% of the work with its own forces. Citywide Speed Hump Slicing 36 Locations City Attorney Approved 6/5/24 PWM26-4015TRAN Citywide Speed Hump Slicing 36 Locations Page 7 City Attorney Approved 6/5/24 EXHIBIT B CITYWIDE SPEED HUMP SLICING 36 LOCATIONS Contractor shall provide all equipment, labor, and materials to perform horizontal slicing repairs to 36 speed hump edges at six separate locations. Two locations on the North side of Cadencia Street, and four locations on Corinitia Street between Alga Road and El Fuerte Street. Exact locations are below in “Exhibit B Continued.” Edge slicing will consist of horizontally slicing speed humps at a 45 degree angle to achieve one foot of slope at the center of each hump. Before and after pictures shall be taken by Contractor and provided to the City Project Manager upon completion of work. Contractor shall use a HEPA dust suppression system and sweep/remove all other debris generated by repair work. Contractor shall obtain a right of way permit through the City of Carlsbad before beginning work. City will provide traffic control for the duration of the project, not to exceed 3 working days. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 EA 36 Speed Hump Edge Slices $800.00 2 EA 1 Right of Way Permit $600.00 TOTAL* $29,400.00 *Includes taxes, fees, expenses and all other costs. Site Example (Edge Slicing) Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 ' I 1· . I ' I • • • • I PWM26-4015TRAN Citywide Speed Hump Slicing 36 Locations Page 8 City Attorney Approved 6/5/24 EXHIBIT B (CONT.) SITE IMAGES CORINTIA BETWEEN ALGA AND EL FUERTE 3300 BLOCK OF CADENCIA Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 EXHIBIT C LABOR AND MATERIALS BOND Bond No. CIC1975077 PWM26-4015TRAN WHEREAS, the City Council of the City of Carlsbad, State of Californla, has awarded to Southern California Precision Concrete Inc. dba Precision Concrete Cutting (hereinafter designated as the "Principal"), a Contract for: CITYWIDE SPEED HUMP SLICING 36 LOCATIONS 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 fa il to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, Southern California Precision Concrete Inc. dba Precision Concrete Cutting, as Principal, (hereinafter designated as the "Contractor"), and Capitol Indemnity Corporation as Surety, are held firmly bound unto the City of Carlsbad in the sum of twenty-nine thousand four hundred dollars ($29,400), 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 addit ion 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. Citywide Speed Hump Slicing 36 Locations Page 9 City Attorney Approved 6/5/24 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 PWM26-4015TRAN This labor and n,aterlals 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 __ &_th ____ day of ___ M_a_r_ch ______ ...J 2026 Southern Callfornla Precision Concrete Inc. dba Precision Concrete Cutting (SEAL) Capitol Indemnity Corporation (SEAL) (Principal) By, 'I:!___, ~ ---------gnature} coo (Name/Title) By: (Surety) ,~/ ~ ~~~(4. J;,u. fin ,. -.-~-;;~, ✓-"";:; \\5EAL \'J WIiiiam Reidinger; Attorney-Ir.\,~ (Name/Title) "'~ (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY -ATTACH ATTORNEY-IN-FACT CERTIFICATE) APPROVED AS TO FORM: CINDIE K. McMAHON City Attorney By: 111\.\ V16lA,S Assistant City Attorney Citywide Speed Hump Slicing 36 Locations Page 10 A notary public or other offteer completing lh~ 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 rJ that document c•••••••••••1 • TOA,IAS ELEAZAR CORONEL ~ Moi.ry Public • Caltfoml• I 1 Rlvenkle County Commtsston • 2436185 -i My Comm. Explrft MM t, 2027 t City Attorney Approved 6/5/24 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 "urety Company Acl.-nowledgment: tate of ... ~~~.~~~,~~ ................ .. C unty of .. I.>.~!!~~~.~ ................. ss.: On this ~.th ........... day of ......... M~~S~ .. 2026 .. , before me personally appeared .... \\'.iJliM1.J.l~i~i1J1?~r. ............... , to be known, whom being by me duly sworn, did depose and say: that he/she resides at. . S~bauinhurg, JL ........................................................... , that he/she is the .. ~~<.>!11~.Y. }P. f.~~\ ....... of ... ~.~~~1 .~ 1. ~~~-~~i.1:'. ~?~.~~~t_i?.~ .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , the corporation described in and which executed the annexed instrument; that he/she knows the corporate seal of said corporation that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation; that he/she signed his/her name thereto by like order; and that the liabilities of said corporation do not exceed its assets as ascertained in the manner provided by law. Notary Public in and for the above County an tate. 03/09/2027 My commission expires .... , ........................... . Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 CAPITOl, INDtMNITV CORPORATION POWElt OF ATTORNEV c,;u,;122,wz llt>nd N""""' Kl\'UW I.I, MJ: I\' n1t.,1 Plllit.,J: "-11111 tllt CAPITOi, INDlMNlfY OIIIPOIIIA'tlON. 1 co,porltlon or the 8111, of WltcOlllln, ~inl ii, piftclf!lll oll'lffi 111,_ • ofMlddltiM, Wt~,tn, ~ mike, t'Oll1tl111te and 1ri,aln1 its 11\Jt alld 11'11-ftil A~t}.ft1-fllcl, f('I mAltc, eietvtr, !INI and clfll•'ff Aw and on Its bdlalf, u sul'fly, and II It, act and dffll. any and 111 bondt, undmalrinp •!Id-'"'~ flf' ~1hlr, ""'''ldtd that no bond or unclmllltln1 °' can111e1 or ,vretyshlp m11uttd under 1h11 IUtltority thtll «eeed in •mount Ille ,um ti( t §sl Pen4 rsxm b c,,~ I 975077 on behalf of So,fbap Cel,Cwnie Prcci'NM Coocrde loo ,t, e,utsm Coocccv C1ct1cr A l!WN llond t.'umliff Prlnclp,t Thi "'"'"' elf A~• b pwntNI and I, sllMlf Ind K'IINI by facsimile under and by the authority of the followin1 Resolution adopted by the Board or ~,c,n <ll"CAPITOL l!lo'DtMNtTV CORPORA 110N 11 • mcctln1 duly called and held on the I $th day of May, 2002. '1tESOt.V.:D, 1h11 tht !'resident. fa(CUti1-c Vice President, Vice President, Secretary or Trmurcr, 1c1in1 individually or otherwise, be and they hereby ,re ,nnh.'11 the p<'"''Cf Ind 1111horintlon 10 arpoint by • Power of Allomey '°' the purpotet only of uccutin1 and 1111Cl1in1 bond, and undertakinp, Ind other wririll(!S obhptocy In lite llllllrt thfflof, one or morc resident vice-presidents, u1i1t.,1 sccm1ries and 11t0fftey(s},in-rac1, •h appointee to hive 1hr powm and duties uul ta 500h off'tCts to the business of this ~y; the 1ilfllhirc of such offlccn .,d seal or the Company 11111y be affixed 10 any IUCh power o( 1ntwne)' or to any l'fflificate rclatinll thereto by facsimile, and .,y such power of 1t1omey or ct11ificate belrin1 Mich facsimile sipturcs or ractimile 11al hall be valid and bindmg upon thc C~y. and any such power so mcuted and ct11ified by fac1imile 1ip11tures and f1e1imile al shall be valid 111d bmclinl ~ the C011'4)111y in the llmirt with rap«t to any bond or undenakin1 or other writin1 obllptory in thc nlllllre thereof ro which i1 it ltllehed. Arr, such apromtmenl may be m'Olccd. for cause. or without cause, by any of said officcn, at any lime." In COllftl'Clion willl obliptlona in ni,w of1he Florida Dq,anmcn1 ofTransponation only, it is 1pced 1hat the power Ind authority hereby given to the Attomey- in-Fllct inchldcs any and 111 conlfflts for thc release of rtliined pcrtenrages and/or final cstirmtcs on enaincerina and construction collll'Ktl required by the Slalc of Florida Dq,anmcft1 of Trlnspor1alion. h is !lilly undcntood thar conscnrina to the S111c of Florida Dcpartmcnr ofTrwponation makina paymenc of thc fmal estimate to the Contraclor and/Of its assigntt, shall not relieve thi1 surety company of any of its obliplions wider its bond. In conn«tion wilit obligations in fal'Of of the Kentucky Dcpanmcnt ofHiahways only, ii is agreed that the power and authority hereby sivm 10 the Anomey- in-faet cannot be modified or revoked unless prior wriucn pcnonal notice of such inlcnl has been given to the Commissioner-Dcparlmcnt of Hiahway, of thc Commonwealth ofKcn111cky at least thiny (30) dayt prior to the modification or revocation. IN WITNESS WHEREOF, the CAPITOl. lNDEMNITV CORPORATION has caused these presents to be signed by its officer unclcnigned and its corpcnte seal 10 be hcn:to lflixcd duly attested, this Isl day of September, 2022. ,..... JJ T / V'-L r._ Ryan J. Byrnes Senior Vice President. Chief Financial Off'ICer and Treasurer -r~~ Todd Burri ck ClliefUndcrwriting Officer com,."JY OF DANE S.S.: CAPITOL INDEMNITY CORPORATION ~~ Adam L. Sills Chief Executive Omcer and President ST A TE OF WISCONSIN } On the I st day of Scplcmbcr, 2022 before me personally ~me Adam L. Sills, lo me known, who being by me duly sworn, did depose and say: lha1 be resides in the County of New York, State of New York; that he is Chief Executive Officer and President of CAPITOL INDEMNITY CORJ'()RATJON, tbc corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said insllumcnt i.< such cruporate seal; that it was so affixed by order of the Board of Director, of said corporation and that he signed bis name thcrdo by like order. STATE OF WISCONSIN COUNTY OF DANE } S.S.: David J. Regele Nowy Public, Dane Co., WI My Commission Is Pcnnancnt I, tbc undcniped. dilly elecied to the office stated below, now the incumbent in CAPITOL INDEMNITY CORPORATION, a Wisconsio1 C'..xpon;tion, IUlboriz.cd to make this certificate, DO HEREBY CERTIFY that the foregoing auachcd Power of Attorney remains in full f~ and bas noc been revoked; and furthermore, 1h11 the Resolution of the Board of Directors, set forth in lite Power of Attorney is now in forte. Signed and scaled II the City of Middleton, Stale of Wisconsin this 6th day of ____ ...;.;.M;.;;ar;..;;c~h _____ .. 20 ]026 ~ ~ J'I\ ~ Suzanne~i.Broad!>en! S«rclar)' TIIIS DOCUMENT IIAS 13EEN GENERATED FOR A SPECIFIC 13OND. IF YOU IIAVE ANY QUESTIONS CONCERNING TIIE AUTHENTICITY Of THIS DOCUMENT CALL 800-475-4450. CIC-cPOA (Rev. 09-l022l PWM26-4015TRAN Citywide Speed Hump Slicing 36 Locations Page 11 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: 412DFA36-7058-499C-BD1A-3B6398176856 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 PWM26-4015TRAN 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 lo-Use Off-Road D!ese!-Fue!ed Fleet RHulatlon. 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: D 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.l(f)(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto. D Contractor and/or their subcontractor is unable to procure R99 or RlOO renewable diesel fuel as defined in the Regulation pursuant to Section 2449.l(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). D The Fleet is exempt from the requirements of the Regulation pursuant to Section 2449(1)(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(1)(4). g The Fleet does not fall under the Regulation or are otherwise exempt and a detailed reasoning is attached to this certification. Name of Contractor: Southern California Precision Concrete Inc. dba Precision Concrete Cutting Signature: /, ~ ( J,:7 /1 -=-------/&4 -= Name: Ronald William Durna, Jr. Title: President Date:_b _/_,,_I /....;;..~_.::;;...ou'-'--------- Citywide Speed Hump Slicing 36 Locations Page 12 City Attorney Approved 6/5/24 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 6/17/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S}, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ~~l~CT Barbara Shepherd The Baldwin Group West, LLC r1J8NJ:o Fxtl· (714) 505-7000 I rffc Nol: (714) 573-1770 15901 Red Hill Ave, Ste 100 Tustin CA 92780 :to'J~ss: barbara.shepherd@wgbib.com INSURER/SI AFFORDING COVERAGE NAIC# INSURER A: Middlesex Insurance Company 23434 INSURED SOUTH47 INSURER B : Clear Serina Prooertv and Casu 15563 Southern California Precision Concrete, Inc. INSURERC: Oba Precision Concrete Cutting 320 State Place INSURERD: Escondido CA 92029 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: 1814984298 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 POLICYEFF POLICY EXP LIMITS LTR ···~" un,n POLICY NUMBER IMM/DD/VYVYl IMM/DD/VYVYl A X COMMERCIAL GENERAL LIABILITY y y A0253953002 6/2/2025 6/2/2026 EACH OCCURRENCE $1,000,000 ~ □ CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED PREMISES /Ea occurrence\ $500,000 X 5,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 ~ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 ~ [K]PRO-DLoc PRODUCTS -COMP/OP AGG $2,000,000 POLICY JECT OTHER: ded. $5,000 A AUTOMOBILE LIABILITY y y A0253953001 6/2/2025 6/2/2026 n:~~~~~~llNGLE LIMIT $1,000,000 ~ X ANY AUTO BODILY INJURY (Per person) $ ~ ~ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY /Per accidentl $ A X UMBRELLA LIAB MOCCUR A0253953003 6/2/2025 6/2/2026 EACH OCCURRENCE $2,000,000 ~ EXCESSLIAB CLAIMS-MADE AGGREGATE $2,000,000 DED I I RETENTION $ $ B WORKERS COMPENSATION y CSWC03008802 6/2/2025 6/2/2026 X I ~ffTUTE I I OTH-ER AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE □ N/A E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Umbrella is Excess over the General Liability, Auto Liability and Employers Liability. Certificate holder(s) is/are named as Additional Insured per the attached endorsements as required by written contract subject to the terms & conditions of the policy per attached endorsements: GL Al CG 2010 1219 GL AI/WOS/PNC Blanket CG 71 25 0622 WC WOS Blanket WC 04 03 06 AUTO Al CA 70 57 1013 See Attached ... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad/CMWD ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Compliance Services P.O. Box 947 AUTHORIZED REPRESENTATIVE Murrieta CA 92564 6~C I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 AGENCY CUSTOMER ID: SOUTH47 -------------------LO C #: -------- ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED The Baldwin Group West, LLC Southern California Precision Concrete, Inc. Dba Precision Concrete Cutting POLICY NUMBER 320 State Place Escondido CA 92029 CARRIER I NAICCODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE AUTO PNC CA 76 01 0615 AUTO WOS CA 04 44 1013 30 days notice of cancellation/ 10 days for non-payment of premium RE: All projects Additional Insured: The City of Carlsbad Page of ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC040308 (Ed. 04-84) 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 perfonn 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 2.50% of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION Any Person or Organization for which the insured has agreed by written contract executed prior to loss to furnish this waiver This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise statad. (The lnformaUon below Is rwqulred only when this endorsement Is issued subsequent to praparation of the pollcy.) Endorsement Effective 6/2/2025 12:01 AM Policy No. CS-WC-030088-G2 Insured Soulhem Callfomla Precision Concrete, Inc. Insurance Company Clear Spring Property and Casually Company Countersigned by 01998 by the Workers' Compensation Insurance Rating Bul"Nu of California. All rights ruervect. Endorsement No. O Premium Included From the WCIRB's Callfomla Workers' Compensation Insurance Fonns Manual© 1999. Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 POLICY NUMBER: A0253953002 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 Organization(s} Location(s} Of Covered Operations As required per Written Agreement All Locations and Operations or Contract 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 20101219 A0253953 © Insurance Services Office, Inc., 2018 Page 1 of 2 05/31/2024 Middlesex Insurance Company 1 00001 0000000000 24152 0 N 6577d55a-85ec-4688-a9ff-db2de49000f9 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 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 of 2 A0253953 © Insurance Services Office, Inc., 2018 CG 20101219 05/31/2024 Middlesex Insurance Company Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 POLICY NUMBER: A0253953001 COMMERCIAL AUTO CA 76 01 0615 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED -PRIMARY AND NONCONTRIBUTORY -COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: Southern California Precision Concrete, Inc. dba: Precision Concrete Cutting Endorsement Effective Date: 61212025 SCHEDULE Name Of Person(s) Or Organization(s): As required per Written Agreement or Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in: (1) Paragraph A.1. of Section II -Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2) Paragraph D.2. of Section I -Covered Autos Coverages of the Auto Dealers Coverage Form. B. Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other auto insurance issued to the person or organization in the schedule under your policy provided that: (1) The person or organization is a Named Insured under such other insurance; and (2) Prior to the "accident" 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 person or organization. CA 76 01 0615 A0253953 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 05/31/2024 Middlesex Insurance Company with its permission. 1 00001 0000000000 24152 0 N 6cdf2687-ab63-41 e0-9130-23b8934cc996 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 POLICY NUMBER: A0253953001 COMMERCIAL AUTO CA 04441013 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: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: oncre e, nc. Endorsement Effective Date: 6/2/2025 SCHEDULE Name(s) Of Person(s) Or Organization(s): As required per Written Agreement or Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04441013 A0253953 Middlesex Insurance Company 1 00001 0000000000 24152 0 N © Insurance Services Office, Inc., 2011 ac7 e 1241-6f33-47c4-88ed-80ccd262da2b Page 1 of 1 05/31/2024 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 COMMERCIAL AUTO CA 70 5710 13 SPECIAL BROAD FORM AUTO ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1. Broadened Who Is An Insured Under Section II -Covered Autos Liability Coverage, the following is added to Coverage A.1. Who Is An Insured: A. Employees As Insureds Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or personal affairs. B. Newly Acquired Organizations Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: 1. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization of the end of the policy period; whichever is earlier; and 2. Coverage does not apply to "bodily injury", "property damage" or "covered pollution cost or expense" that occurred before you acquired or formed the organization. 2. Broadened Supplementary Payments Coverage Extension 2.a. Supplementary Payments under Section II -Covered Autos Liability Coverages is amended as follows: A. Paragraph 2.a.(2) is amended to pay up to $3000 for cost of bail bonds; and B. Paragraph 2.a.(4) is amended to pay for loss of earnings up to $500 a day because of time off from work. 3. Fellow Employee Bodily Injury Extension The Fellow Employee exclusion contained in Section II -Covered Autos Liability Coverage does not apply. 4. Accidental Airbag Discharge The following is added to Exclusion B.3.a. under Section Ill -PHYSICAL DAMAGE: This exclusion does not apply to the accidental discharge of an airbag in a covered auto for a loss that Physical Damage Coverage is shown in the Declarations. CA 70 5710 13 A0200442 Middlesex Insurance Company 1 00002 0000000000 23262 0 N a73e2efd-d41 e-446d-a0dd-cc9a4cc1 ec54 5. Towing We will pay up to the limit shown in the Declarations for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. 6. Physical Damage Coverage Extensions The following replaces the Coverage Extensions under Section Ill -PHYSICAL DAMAGE: A. Transportation Expenses We will pay up to $50 per day to a maximum of $1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay up to $75 per day to a maximum of $1500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the truck or van type with a Gross Vehicle Weight of less than 10,000 pounds used as a private passenger vehicle. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". B. Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or agreement. We will pay for loss of use expense if caused by: 1. Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; 2. Specified Causes Of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto"; or Page 1 of 3 09/19/2023 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 SPECIAL BROAD FORM AUTO ENDORSEMENT -CONTINUED 3. Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $50 per day, to a maximum of $1000. 7. Rental Reimbursement A. For any covered "auto" for which Comprehensive and Collision coverages are provided, we will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No Physical Damage Coverage deductibles apply to this coverage. B. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. C. Our payment is limited to the lesser of the following amounts: (1) Necessary and actual expenses incurred; or (2) $50 per day, to a maximum of $1000. D. Our payment under this coverage extension is excess over any other rental reimbursement coverage available to you. E. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. F. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage Coverage Extension. 8. Hired Auto Physical Damage A. If you have Comprehensive or Specified Causes of Loss and Collision Coverages provided on your owned "autos" you may extend Physical Damage Coverage to any "autos" you lease, hire, rent or borrow; provided you have Liability Coverage for hired "autos". B. The hired "auto" must be of like kind and used as the "autos" owned and covered under this Coverage Form. Page 2 of 3 A02O0442 Middlesex Insurance Company C. The most we will pay for "loss" to any hired "auto" in any one "accident" is the lesser of: (1) $50,000 (2) The actual cash value of the "auto" at the time of the "loss" (3) The cost of repair or replacement with other property of like kind and quality D. The following deductible provisions apply: (1) The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage shown in the Declarations. (2) No deductible will apply to "loss" caused by fire or lightning. E. Any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" under this coverage extension. 9. Auto Loan And Lease Gap Coverage Section Ill -PHYSICAL DAMAGE is amended by the addition of the following: A. In the event of a total "loss" to a covered "auto" shown in the Declarations, we will pay any unpaid amount due on the lease or loan for a covered "auto", less: (1) The amount paid under the policy's Physical Damage Coverage; and (2) Any: (a) Overdue lease/loan payments at the time of the "loss"; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the lessor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. B. This coverage extension applies to covered autos that are loaned or leased for a period of six months or longer and which have been provided Physical Damage Coverage. The "loss" must be caused by damage for which coverage is shown in the Declarations. 10. Personal Effects The following is added to A. Coverage under Section Ill -Physical Damage Coverage: CA 70571013 09/19/2023 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 SPECIAL BROAD FORM AUTO ENDORSEMENT -CONTINUED A. We will extend Physical Damage Coverage on a covered "auto" to include personal property owned by you, a relative or an "employee" that is in the covered "auto" at the time of "loss". The "loss" must be caused by damage for which coverage is shown in the Declarations. There must be evidence of forced entry for loss caused by theft. B. The exclusion referring to tapes, records, discs or other similar audio, visual or data electronic devices designated for use with audio, visual or data electronic equipment does not apply. C. The most we will pay for any one "loss" under this coverage extension is $500. No Physical Damage Coverage deductible applies to this coverage extension. D. Coverage provided by this Personal Effects extension is excess over any other collectible insurance. E. The coverage extension does not apply to the following property: (1) Any device designed or used to detect speed-measuring equipment such as radar or laser detectors and any jamming apparatus intended to elude or disrupt speed-measurement equipment; (2) Any electronic equipment that reproduces, receives or transmits audio, visual or data signals; (3) Tools; (4) Jewelry, precious metals and loose gems; (5) Money and securities; or (6) Property specifically insured or covered under the Business Personal Property Coverage of this policy. 11.Glass Deductible Under Section Ill -PHYSICAL DAMAGE, the following is added to A.3. Glass Breakage - Hitting A Bird Or Animal -Falling Objects Or Missiles Coverage: The Comprehensive Coverage deductible shown in the Declarations does not apply to glass breakage if such glass is repaired rather than replaced. 12.Broad Knowledge Of Accident, Claim, Suit Or Loss Under Section IV -Business Auto Conditions, the following is added to Loss Conditions A.2. Duties In The Event Of Accident, Claim, Suit Or Loss: CA 70571013 A0200442 Middlesex Insurance Company 3 00002 0000000000 23262 0 N a73e2efd-d41 e-446d-a0dd-<:e9a4cc1 ec54 Knowledge of an "accident", claim, "suit" or "loss" by an agent or "employee" of an insured or receipt of any demand, notice, summons or other legal paper in connection with a claim or "suit" by any agent or "employee" of any insured shall not in itself constitute knowledge of the named insured or receipt of the named insured, unless a partner, member, manager, executive officer or director shall have such knowledge or shall have received such demand, notice, summons or legal paper. 13. Unintentional Failure To Disclose Hazards Under Section IV -Business Auto Conditions, the following is added to General Conditions B.2. Concealment, Misrepresentation Or Fraud: If in your representations to us you unintentionally failed to disclose all hazards and exposures subject to this insurance, we shall not deny all coverage under this policy because of such oversight. 14.Mental Anguish A. The definition of "bodily injury" under Section V -Definitions is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including "mental anguish" or death resulting from any of these at any time. B. The following definition is added to Section V -Definitions: "Mental anguish" means extreme pain or distress inflicted upon an individual's emotional and intellectual condition with regard to the individual's response to the environment. Page 3 of 3 09/19/2023 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 Policy Number: A0253953002 COMMERCIAL GENERAL LIABILITY CG 712506 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS BLANKET ADDITIONAL INSUREDS, PRIMARY & NONCONTRIBUTORY, WAIVER OF SUBROGATION This endorsement modifies the coverage provided under the following Coverage Form(s): COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Coverage enhancements are listed below. For details of each coverage, please read the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds -Automatic Status for 13 Additional Insured Types A. Owners, Lessees Or Contractors -Automatic Status When Required In A Written Construction Agreement With You B. Owners, Lessees Or Contractors -Automatic Status When Required In Written Construction Agreement With You (Completed Operations) C. State or Governmental Agency or Subdivision or Political Subdivision -Permits or Authorizations D. Lessor of Leased Equipment E. Owners or Other Interests From Whom Land Has Been Leased F. Manager or Lessor of Premise G. Mortgagee, Assignee, or Receiver H. Controlling Interest I. Co-owner Of Insured Premises J. Executors, Administrators, Trustees Or Beneficiaries K. State Or Governmental Agency Or Subdivision Or Political Subdivision -Permits Or Authorizations Relating To Premises L. Vendors M. Granter of Franchise 2. Primary and Noncontributory -Other Insurance Condition 3. Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. 1. Additional Insureds -Automatic Status for 13 Additional Insured Types Section II -Who Is An Insured is amended to include the following as additional insureds when you have agreed to add that person or organization as an Additional Insured on your policy in a written contract or written agreement with that person or organization, or because of a permit issued by a state or political subdivision; provided the injury or damage occurs subsequent to the execution of the contract or agreement or issuance of the permit and while the contract, agreement or permit remains in effect. A. Owners, Lessees Or Contractors Automatic Status When Required In A Written Construction Agreement With You 1) A person or organization with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. CG 712506 22 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 5 05/31/2024 A0253953 Middlesex Insurance Company with its permission. 2cdb1363-4d0c-4a9d-97 44-a2c7ffcc6887 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. 2) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. b. "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. B. Owners, Lessees Or Contractors Automatic Status When Required In Written Construction Agreement With You (Completed Operations) 1) Any person{s) or organization{s) with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed for that additional insured and included in the "products-completed operations hazard", but only when that portion of the "products-completed operations hazard" is not excluded by endorsement. 2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, 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. 2) This insurance does not apply to: Page 2 of 5 A0253953 Includes copyrighted material of Insurance Services Office, Inc., CG 712506 22 05/31/2024 Middlesex Insurance Company with its permission. 2cdb1363-4d0c-4a9d-97 44-a2c7ffcc6887 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 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". D. Lessor of Leased Equipment 1) Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). 2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. E. Owners or Other Interests From Whom Land Has Been Leased 1) Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the land leased to you by the additional insured person(s) or organization(s). 2) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. Any "occurrence" which takes place after you cease to lease that land; b. Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured person(s) or organization(s). F. Manager or Lessor of Premise Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the premises leased to you by the additional insured person(s) or organization(s), subject to the following additional exclusions: This insurance does not apply to: 1) Any "occurrence" which takes place after you cease to be a tenant in that premises. 2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. G. Mortgagee, Assignee, or Receiver Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of a premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured person(s) or organization(s). H. Controlling Interest 1) Any person(s) or organization(s) with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. 2) This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. I. Co-owner Of Insured Premises Any person(s) or organization(s) with respect to their liability as co-owner of a premises co-owned by you and covered under this insurance. J. Executors, Administrators, Trustees Or Beneficiaries Any executor, administrator, trustee or beneficiary of your estate or living trust while acting within the scope of their duties as such. CG 712506 22 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 5 05/31/2024 A0253953 Middlesex Insurance Company with its permission. 2cdb1363-4d0c-4a9d-97 44-a2c7ffcc6887 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 K. State Or Subdivision Permits Or Premises Governmental Agency Or Or Political Subdivision - Authorizations Relating To Any state or governmental agency or subdivision or political subdivision, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: 1) The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or 2) The construction, erection or removal of elevators; or 3) The ownership, maintenance or use of any elevators covered by this insurance. L. Vendors 1) Any person(s) or organization(s) (referred to throughout this endorsement as vendor), but only with respect to liability for "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However: a. The insurance afforded to such vendor only applies to the extent permitted by law; and b. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2) With respect to the insurance afforded to these vendors, the following additional exclusions apply: a. The insurance afforded the vendor does not apply to: 1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2) Any express warranty unauthorized by you; 3) Any physical or chemical change in the product made intentionally by the vendor; 4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; 5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; 6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or 8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or Page 4 of 5 A0253953 Includes copyrighted material of Insurance Services Office, Inc., CG 712506 22 05/31/2024 Middlesex Insurance Company with its permission. 2cdb1363-4d0c-4a9d-97 44-a2c7ffcc6887 Docusign Envelope ID: 412DFA36-7058-499C-BD1A-3B6398176856 (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. b. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. M. Grantor of Franchise Any person(s) or organization(s) with respect to their liability as granter of a franchise to you. However: 1. The insurance afforded to such additional insureds 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. 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. If there is any difference in coverage afforded to an additional insured in this endorsement and that provided under another additional insured endorsement attached to this policy, the broader coverage will apply to that additional insured. 2. Primary And Noncontributory Insurance The following is added to the Other Insurance Condition and supersedes any provision to the contrary: 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. 3. Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic 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 any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. CG 712506 22 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 5 05/31/2024 A0253953 Middlesex Insurance Company with its permission. 2cdb1363-4d0c-4a9d-97 44-a2c7ffcc6887