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Shade Structure Inc; 2026-04-29; PR-MPW-26001P
Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 1 City Attorney Approved 12/18/2025 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT; CONT. NO. PR-MPW-26001P This contract is made on the ______________ day of _________________________, 20__ (“Contract”), by the City of Carlsbad, California, a municipal corporation ("City") and Shade Structures, Inc, a Delaware corporation whose principal place of business is 1085 N. Main Street, Suite C, Orange, CA 92867 ("Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, as contained in the Standard Specifications for Public Works Construction “Greenbook,” latest edition and including all errata; Part 1 General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor’s proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by Temujin Matsubara (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. PREVAILING WAGE RATES. Any construction, alteration, demolition, repair, and maintenance work, including work performed during design and preconstruction such as inspection and land surveying work, cumulatively exceeding $1,000 and performed under this Contract constitute “public works” under California Labor Code Section 1720 et seq., and are subject to state prevailing wage laws. The general prevailing rate of wages, for each craft or type of worker needed to execute the contract, shall be those as determined by the Director of Industrial Relations pursuant to the Sections 1770, 1773 and 1773.1 of the California Labor Code. Consistent with the requirement of Section 1773.2 of the California Labor code, a current copy of applicable wage rates may be obtained via the internet at: www.dir.ca.gov/dlsr/. Contractor shall not pay less than the said specified prevailing rates of wages to all such workers employed by him or her in the execution of the Contract. Contractor and any subcontractors shall comply with Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 April 2629th Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 2 City Attorney Approved 12/18/2025 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: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 3 City Attorney Approved 12/18/2025 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. CONTRACTOR PERFORMANCE EVALUATION. The City will use a standardized Contractor Performance Evaluation (“Evaluation”) to assess the Contractor’s effectiveness, reliability, and overall quality of performance under this Contract. Performance will be evaluated across key categories like specifications & standards, responsiveness, cost control, communication, and safety & risk management, using a standardized rating scale described in the Evaluation form. The Evaluation will serve as a formal record of Contractor’s performance and is intended to promote accountability, transparency, and continuous improvement in the Contractor's execution of the work. The City will provide the Contractor with the current Evaluation form and full list of performance criteria at the start of the Project, typically during the pre-construction meeting or initial kickoff. Evaluations may be completed by the Engineer or other designated City representative. The Contractor may provide written comments or responses to the completed Evaluation, which the City will retain with the Evaluation record. Evaluation results may be considered in future City procurements, responsibility determinations, and Contract renewals. Corrective actions for unsatisfactory performance may include written notice, corrective action plans, withholding of payment, suspension of work, termination for cause, and other remedies permitted by this Contract or law. Evaluations may occur at substantial completion, final completion, or when performance issues arise. Nothing described in this section limits the City’s discretion to enforce Contract remedies or take any other action permitted under this Contract or applicable law. 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: ___________________________________ Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Robert Blakley Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 4 City Attorney Approved 12/18/2025 REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. Property damage insurance in an amount of not less than……..$2,000,000 Automobile Liability Insurance in the amount of $2,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that 30 days written notice shall be given to the City prior to such cancellation. 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. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 5 City Attorney Approved 12/18/2025 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 sixty (60) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within seventy (70) working days after receipt of Notice to Proceed. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 6 City Attorney Approved 12/18/2025 CONTRACTOR’S INFORMATION. Shade Structures, Inc. 1085 N. Main St., Suite C (name of Contractor) 989458 (street address) Orange, CA 92867 (Contractor’s license number) B; 12/31/2027 (city/state/zip) 619-838-4489 (license class. and exp. date) 1000003533; 6/30/2028 (telephone no.) mario.gomes@usa-shade.com (DIR registration number/exp. date) (e-mail address) AUTHORITY. The individuals executing this Contract and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Contract. [signatures on following page] Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 7 City Attorney Approved 12/18/2025 CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California Shade Structures, Inc., a Delaware corporation By: By: (sign here) Kyle Lancaster, Parks & Recreation Director Robert Blakley, Senior Vice President (print name/title) ATTEST: By: SHERRY FREISINGER, City Clerk (sign here) By: David Starr, Secretary Deputy City Clerk (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Contract must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Deputy / Assistant City Attorney Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 8 City Attorney Approved 12/18/2025 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Type of Work to be Subcontracted Business Name and Address DIR Registration No. & Expiration Date License No., Classification & Expiration Date % of Total Contract Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Installation of Shade Structure 50 50 Playsafe Construction, Inc. 1517 Franzen Ave 1517 Franzen Ave Santa Ana, CA 1019514 (expires 6/30/26) 1019514, Class B (exp Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 9 City Attorney Approved 12/18/2025 EXHIBIT B SCOPE OF WORK AND COST Project Overview The Contractor shall provide all labor, materials, equipment, tools, transportation, supervision, and incidentals necessary to remove and replace one (1) existing shade sail fabric at Poinsettia Community Park, located at 6600 Hidden Valley Road, Carlsbad, CA 92011. Work includes the safe removal and disposal of the existing fabric, installation of the new fabric and protection of surrounding park features. Location and Fabric Specifications Tot Lot Shade Structure at Poinsettia Community Park • Remove one (1) existing shade sail fabric • Install one (1) new replacement shade sail fabric • Fabric type: Colourshade FR • Color: Blue Contractor Responsibilities 1. Removal and Installation The Contractor shall: • Remove and properly dispose of existing shade sail fabric and associated hardware. • Install new fabric sails in accordance with manufacturer specifications and industry standards. • Ensure all tensioning, attachment points, and hardware are properly secured and adjusted. 2. Site Protection and Access The Contractor shall: • Protect existing turf, planters, irrigation components, and park amenities from damage during equipment use. • Place plywood or equivalent material under lifts, trucks, or other equipment to prevent rutting or surface damage. • Maintain a clean and orderly work area; remove debris daily. 3. Public Safety and Traffic Control The Contractor shall: • Establish and maintain a safe work zone using cones, barricades, caution tape, delineators, or equivalent. • Prevent public access to the work area at all times during construction activities. • Coordinate with City staff regarding work hours and site access. 4. Equipment and Utilities The Contractor shall: • Provide all necessary equipment, including lifts, tools, and rigging. • Verify clearances and ensure equipment operation does not damage existing structures. • Notify the City immediately if concealed conditions or obstructions are encountered. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 10 City Attorney Approved 12/18/2025 City Responsibilities The City shall: • Mark known irrigation mainlines, lateral lines, and other non-public utility service lines within the work area. • Provide access to the site during normal working hours. • Coordinate with Contractor regarding any park programming or public events that may affect scheduling. Exclusions The following items are not included in the Contractor’s scope unless added by fully executed Change Order: • Permit fees (not required for fabric-only replacement unless otherwise determined by the City). • Relocation, repair, or replacement of unmarked irrigation lines, lateral pipes, or low-voltage wires. • Repair of pre-existing damage or deterioration unrelated to Contractor’s work. • Work outside the defined shade sail fabric replacement. Performance Requirements • All work shall comply with applicable codes, manufacturer specifications, and City standards. • Contractor shall perform work during City-approved hours and complete the project within the mutually agreed schedule. • Contractor shall restore the site to pre-construction condition upon completion. Deliverables • One (1) fully installed replacement shade sail fabric. • Clean work area and removal of all debris and discarded materials. • Confirmation of proper tensioning and installation. Warranty Requirements The Contractor shall provide the following warranties to the City: 1. Manufacturer Warranty The Contractor shall provide and assign to the City all manufacturer warranties associated with the installed shade sail fabric. The manufacturer’s warranty shall cover defects in materials consistent with the manufacturer’s published warranty terms. The Contractor shall submit all manufacturer warranty documents to the City at project closeout. Manufacturer warranties are provided for reference only and shall not modify or supersede the terms and conditions of this Agreement. 2. Contractor Workmanship Warranty The Contractor shall warrant its installation workmanship for a minimum period of one (1) year from the date of City acceptance. The workmanship warranty shall cover defects arising from installation, including tensioning, attachment, and hardware installation. 3. Warranty Claims and Corrections During the warranty period, the Contractor shall, at no additional cost to the City: Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 11 City Attorney Approved 12/18/2025 • Correct defects in workmanship. • Coordinate with the manufacturer regarding material defects. • Remove and reinstall fabric or hardware as necessary to complete warranty repairs. 4. Exclusions Warranty obligations do not apply to: • Damage caused by vandalism, misuse, or acts of nature. • Damage caused by unmarked underground utilities not identified by the City. • Normal wear and tear. Total Cost - $5,963.26* *Includes taxes, fees, prevailing wage, expenses and all other costs. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 12 City Attorney Approved 12/18/2025 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: 22458F01-9D2E-4E5E-8F45-025693BE3197 Tracking #: POINSETTIA COMMUNITY PARK SHADE SAIL REPLACEMENT CONT. NO. PR-MPW-26001P Page 13 City Attorney Approved 12/18/2025 EXHIBIT D (CONT.) IN-USE OFF-ROAD DIESEL-FUELED FLEET REGULATION CERTIFICATION Contractor hereby acknowledges that they have reviewed the CARB’s policies, rules and regulations and are familiar with the requirements of In-Use Off-Road Diesel-Fueled Fleet Regulation. Contractor hereby certifies, subject to the penalty of perjury, that the option checked below relating to the Contractor’s fleet, and/or that of their subcontractor(s) (“Fleet”) is true and correct: ☐ The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto. ☐ The Fleet is exempt from the Regulation under Section 2449.1(f)(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto. ☐ Contractor and/or their subcontractor is unable to procure R99 or R100 renewable diesel fuel as defined in the Regulation pursuant to Section 2449.1(f)(3). Contractor shall keep detailed records describing the normal refueling methods, their attempts to procure renewable diesel fuel and proof that shows they were not able to procure renewable diesel (i.e., third party correspondence or vendor bids). ☐ The Fleet is exempt from the requirements of the Regulation pursuant to Section 2449(i)(4) because this Project has been deemed an “emergency”, as that term is defined in Section 2449(c)(18). Contractor shall only operate the exempted vehicles in the emergency situation and records of the exempted vehicles must be maintained, pursuant to Section 2449(i)(4). ☐ The Fleet does not fall under the Regulation or are otherwise exempt and a detailed reasoning is attached to this certification. Name of Contractor: Shade Structures, Inc. Signature: Name: Title: Senior Vice President Date: Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 X Robert Blakley 4/23/2026 Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 C alifornia E nvironmental Protection Agency Air Resources Board January 1, 2025 CERTIFICATE OF REPORTED COMPLIANCE OFF-ROAD DIESEL VEHICLE REGULATION is issued to SHADE STRUCTURES INC Thrs oemficate indrcates that the fleet lrsted above has reported off-road diesel vehicles to the California Arr Resources Board and has certified they are in compliance with title 13 CCR. section 2449 All applicable vehicles owned by the individual company, or agency must be reported and labeled. as specified in Section 2449, with all possible completeness, else this certificate is null and void. Certificate expires 2/28/2026 ,~ct Kifow~k• ChM;'f, ~Obi~ source control oM'\lon C;iliforl'lli Air ResOi..rCit$ Bo¥d Off-road Diesel Fleet Identification 141156 l o v«Uy the authenticity of ll'i$ ce-rutlca.t&. e11.er tin number at http:/lw1Mv.art>.ca.gov/doors/compliance_cert1.html Ho l d e r I d e n t i f i e r : 777 7 7 7 7 7 0 7 0 7 0 7 0 0 0 7 7 7 6 1 6 1 6 0 4 5 5 7 1 1 1 0 7 7 7 6 1 7 1 1 6 3 0 4 5 5 7 2 0 7 4 5 3 1 3 6 7 7 2 4 0 6 3 1 0 0 7 3 6 5 0 5 6 6 1 5 7 3 3 0 0 2 0 7 3 6 0 5 5 5 5 3 0 6 6 4 5 0 3 0 7 0 6 6 0 5 5 7 2 2 2 2 5 4 1 3 0 7 0 6 3 3 2 6 5 761 7 7 7 6 0 0 7 6 7 2 4 0 4 1 3 6 4 5 3 3 1 3 0 7 3 0 4 0 1 1 3 5 2 2 7 0 1 3 0 0 7 6 7 2 7 2 4 2 0 3 5 7 7 2 0 0 0 7 7 7 7 7 7 7 0 7 0 0 0 7 0 7 0 0 7 777 7 7 7 7 7 0 7 0 7 0 7 0 0 0 7 3 5 2 5 6 7 7 1 1 5 4 5 6 0 0 0 7 2 3 0 1 1 4 1 7 1 3 7 2 0 2 2 0 7 1 3 2 3 2 6 3 5 3 1 7 2 1 0 0 0 7 0 3 3 3 3 6 2 4 3 1 6 2 1 1 0 0 7 0 2 2 3 3 7 2 5 2 0 6 2 0 1 1 0 7 1 2 3 3 3 7 2 4 3 1 6 2 1 1 1 0 7 1 2 3 3 3 6 2 530 6 3 1 1 1 0 7 1 2 3 3 3 7 3 4 2 0 7 2 1 0 0 0 7 1 3 2 2 3 7 3 5 3 0 6 3 0 1 1 0 7 7 7 5 6 1 6 3 3 5 1 7 6 5 5 4 0 7 7 7 7 7 7 7 0 7 0 0 0 7 0 7 0 0 7 Ce r t i f i c a t e N o : 5 7 0 1 1 7 5 4 5 5 9 7 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/06/2026 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. PRODUCER Aon Risk Services Central, Inc. St. Louis MO Office4220 Duncan AvenueSuite 401St Louis MO 63110 USA PHONE(A/C. No. Ext): E-MAILADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED 12262Pennsylvania Manufacturers' Assoc Ins CoINSURER A: 19489Allied World Assurance Company (US) IncINSURER B: 12203James River Insurance CompanyINSURER C: 31127Columbia Casualty CompanyINSURER D: INSURER E: INSURER F: FAX(A/C. No.):(800) 363-0105 CONTACTNAME: Shade Structures, Inc.USA SHADE & FABRIC STRUCTURES2580 Esters Blvd., Suite 100DFW Airport, TX 75261 USA COVERAGES CERTIFICATE NUMBER:570117545597 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.Limits shown are as requested POLICY EXP (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)SUBRWVDINSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X X X GEN'L AGGREGATE LIMIT APPLIES PER: $1,000,000 $300,000 $10,000 $1,000,000 $2,000,000 $2,000,000 XCU not excl C 10/01/2025 10/01/2026Y Y 000959656 PRO-JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X BODILY INJURY (Per accident) $1,000,000A10/01/2025 10/01/2026Y Y COMBINED SINGLE LIMIT (Ea accident)152500 0652321 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $5,000,000 $5,000,000 $10,000 10/01/2025UMBRELLA LIABB 10/01/202603140086 RETENTIONX X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH-ERPER STATUTEA10/01/2025 10/01/2026 $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N / A Y N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 2025750652321 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Organizational Unit : City of Carlsbad -> Community Services -> Parks & Recreation, Agreement Name : Calavera Hills Park Shade Sail Replacement, Agreement Number : PR-MPW-25021P. The per location aggregate is subject to a policy cap of $10,000,000. The General Liability (Ongoing & Completed Operations) and Automobile Liability include a blanket Additional Insured endorsement that provides this feature only when there is a written contract with the named insured that requires such status. General Liability insurance is primary and non-contributory. The General Liability, Automobile Liability and Workers' Compensation policies include a blanket Waiver of Subrogation endorsement that provides this feature only when there is a written contract with the named insured that requires such status. Umbrella Liability policy follows form. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECity of Carlsbad/CMWD c/o EXIGIS Insurance Compliance ServicesPO Box 947Murrieta CA 92564 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 _______, I ACC,Rc:,® ~ I ,...._ =1 □ Fl □ □ ------- -H I I I I I □ AGENCY CUSTOMER ID: ADDITIONAL REMARKS SCHEDULE LOC #: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:ACORD 25 FORM TITLE:Certificate of Liability Insurance EFFECTIVE DATE: CARRIER NAIC CODE POLICY NUMBER NAMED INSUREDAGENCY See Certificate Number: See Certificate Number: 570117545597 570117545597 Aon Risk Services Central, Inc. 570000052633 ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSURER INSURER INSURER INSURER INSURER(S) AFFORDING COVERAGE Page _ of _ NAIC # Shade Structures, Inc. TYPE OF INSURANCE POLICY NUMBER LIMITS EXCESS LIABILITY D 7040440664 10/01/2025 10/01/2026 Aggregate $5,000,000 Each Occurrence $5,000,000 01 Excess $5M x $5M ADDL INSD INSR LTR SUBR WVD POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 I ADDITIONAL REMARKS SCHEDULE AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS EFFECTIVE DATE: CARRIER NAIC CODE NAMED INSUREDAGENCY See Certificate Number: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:ACORD 25 FORM TITLE:Certificate of Liability Insurance 570000052633 Aon Risk Services Central, Inc. 570117545597 570117545597 See Certificate Number: POLICY NUMBER Companies Affording coverage COMPANYLINE OF BUSINESS DESCRIPTION POLICY NUMBER NAICPOLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) PRIMARY (Y/N) FLAG PERCENTAGE OF RISK Page _ of _ Shade Structures, Inc. 000959656General Liability Coverage James River Insurance Company 12203 03140086Umbrella Liability Allied World Assurance Company (US) Inc 19489 100 152500 0652321Business Auto Coverage Pennsylvania Manufacturers' Assoc Ins Co 12262 100 2025750652321Workers Compensation Pennsylvania Manufacturers' Assoc Ins Co 12262 100 7040440664Excess Liability Coverage Columbia Casualty Company 31127 100 Y Y Y Y Y 10/1/2025 10/1/2026 10/1/2025 10/1/2025 10/1/2025 10/1/2025 10/1/2026 10/1/2026 10/1/2026 10/1/2026 100 The Subscribing insurers' obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The subscribing insurers are not responsible for the subscription of any co-subscribing insurer who for any reason does not satisfy all or part of its obligations. ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 I COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following is added to Section III – 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. POLICY NUMBER: 00095965- Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 ADDITIONAL INSURED – DESIGNATED 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): Where required by written contract or written agreement. 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1.In the performance of your ongoing operations; or 2.In connection with your premises owned by or rented to you. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following is added to Section III – 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. POLICY NUMBER: 00095965- Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 POLICY NUMBER: 00095965-COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 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. 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. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 C.With respect to the insurance afforded to these additional insureds, the following is added to Section III – 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. $3863DJHRI PRIMARY AND NON CONTRIBUTORY ENDORSEMENT 7KLVHQGRUVHPHQWPRGLILHVLQVXUDQFHSURYLGHGXQGHUWKHIROORZLQJ $//&29(5$*(3$576 Name Of Additional Insured Person(s) Or Organization(s): :KHUHUHTXLUHGE\ZULWWHQFRQWUDFWRUZULWWHQDJUHHPHQW ,IQRHQWU\DSSHDUVDERYHWKLVHQGRUVHPHQWDSSOLHVWRDOO$GGLWLRQDO,QVXUHGVFRYHUHGXQGHUWKLVSROLF\ $Q\FRYHUDJHSURYLGHGWRDQ$GGLWLRQDO,QVXUHGXQGHUWKLVSROLF\VKDOOEHH[FHVVRYHUDQ\RWKHUYDOLGDQGFROOHFWLEOHLQVXUDQFHDYDLODEOHWRVXFK$GGLWLRQDO,QVXUHGZKHWKHUSULPDU\H[FHVVFRQWLQJHQWRURQDQ\RWKHUEDVLVXQOHVVDZULWWHQFRQWUDFWRUZULWWHQDJUHHPHQWVSHFLILFDOO\UHTXLUHVWKDWWKLVLQVXUDQFHDSSO\RQDSULPDU\DQGQRQFRQWULEXWRU\EDVLV ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED POLICY NUMBER: 00095965-Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 POLICY NUMBER: 00095965-COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or written agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 □ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AP5011US 12-03 Page 1 of 1 POLICY LIMITATION – AMENDED AGGREGATE LIMITS OF INSURANCE PER LOCATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION III – LIMITS OF INSURANCE - The General Aggregate Limit applies separately to each “Location” of the Named Insured. Notwithstanding the application of the General Aggregate Limit to each “Location” of the Named Insured, under no circumstances will we pay more than $10,000,000 for all claims under this policy that are subject to the General Aggregate limit. For the purpose of this endorsement, the following definition is added: “Location” means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. POLICY NUMBER: 00095965Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AP5012US 12-03 Page 1 of 1 POLICY LIMITATION – AMENDED AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS COMBINED LIABILITY POLICY SECTION III – LIMITS OF INSURANCE - The General Aggregate Limit applies separately to each “Project” of the Named Insured. Notwithstanding the application of the General Aggregate Limit to each “Project” of the Named Insured, under no circumstances will we pay more than $10,000,000 for all claims under this policy that are subject to the General Aggregate limit. For the purpose of this endorsement, the following definition is added: “Project” means all work done by you or on your behalf, away from premises owned or rented to you, to complete an individual bid or negotiated contract to provide services for a specified period of time. Multiple jobs, work orders, purchase orders, or work done at multiple “locations” under one contract are not separate “projects” within the meaning of this coverage. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. POLICY NUMBER: 00095965- Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION 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. A.The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1.Such "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 such "insured". B.The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1.Such "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 such "insured". INSURED COPY 32/,&<180%(5 Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 AGENT POLICY NUMBER: COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 20 48 10 13 Insurance Services Office, Inc., 2011 Page 1 of 1 DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE 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 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 does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured:3/$<32:(5,1& Endorsement Effective Date: SCHEDULE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 Paragraph A.1. of Section II ---- Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I ---- Covered Autos Coverages of the Auto Dealers Coverage Form. Name Of Person(s) Or Organization(s): 152500 0652321 AS REQUIRED BY WRITTEN CONTRACT Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 © PCA 05 04 04 14 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 1 with its permission The PMA Insurance Group, 2014 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF RECOVERY RIGHTS This endorsement modifies coverage provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM We waive any right of recovery that we may have against the person or organization shown in the SCHEDULE because of payments we make for injury or damage arising out of the operation of an insured "auto", but such waiver is only effective if the Named Insured has entered into a written contract or agreement with that person or organization, if such contract or agreement is made and dated prior to the injury or loss, and if such written contract or agreement requires a waiver of recovery rights. This waiver applies only to the person or organization shown in the SCHEDULE below. SCHEDULE Name of Person or Organization: AS REQUIRED BY WRITTEN CONTRACT. COMMERCIAL AUTO PCA 05 04 04 14 INSURED COPY Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 POLICY NUMBER: ' " ' ' ' ' " '! ' % ' ' % ' ' ' '! %' " ' %' ' %' '#' ' '! ' ' ' ' ' ' & ' '' ' ! ' ' ' '%' ' ' $ ' '%!' '# '! ' '# ' ' ' ! '%!' ' ' ' ' '! ' ' ' ' ' ' %' ' %' ' ' % ' ' '' ' ! ' &6 $ 1%6 56 3 )* 6 +#,6 42- 6 !"6 .6 /6 06 6 '(6 Docusign Envelope ID: 22458F01-9D2E-4E5E-8F45-025693BE3197 POLICY NUMBER: -r