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HomeMy WebLinkAboutAnchor Construction Specialties Inc; 2019-01-29; PKRC693Tracking#: CITY OF CARLSBAD PUBLIC WORKS LETTER OF AGREEMENT BLOCK RESTROOM REPAIRS AT AVIARA COMMUNITY PARK: CONTRACT PKRC693 This letter will serve as an agreement between Anchor Construction Specialties, Inc., a corporation (Contractor) and the City of Carlsbad (City). The Contractor will provide all equipment, material and labor necessary to remove and replace two (2) existing toilet partitions in the block restroom located between the baseball field and tot-lot playground at Aviara Community Park, per the Contractor's proposal dated January 7, 2019 and City specifications, for a sum not to exceed two thousand one hundred fifty dollars ($2,150.00). This work is to be completed within 21 working days after issuance of a Purchase Order. ADDITIONAL REQUIREMENTS 1. City of Carlsbad Business License 2. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its agents, officers, officials, employees and volunteers, from 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 this Contract or work; or from any failure or alleged failure of the contractor to comply with any applicable law, rules or regulations including those relating to safety and health; except for loss or damage which was caused solely by the active negligence of the City; and from any and all claims, loss, damage, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by this Contract, unless the loss or damage was caused solely by the active negligence of the City. The expenses of defense include all costs and expenses, including attorney's fees for litigation, arbitration, or other dispute resolution method. 3. Contractor shall furnish policies of general liability insurance, automobile liability insurance and a combined policy of workers compensation and Employers' Liability in an insurable amount of not less than one million dollars ($1,000,000) each, unless a lower amount is approved by the Risk Manager or the City Manager. Said 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. Insurance is 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. Proof of all such insurance shall be given by filing certificates of insurance with contracting department prior to the signing of the contract by the City. 4. The Contractor shall be aware of and comply with all Federal, State, County and City Statues, Ordinances and Regulations, including Workers Compensation laws (Division 4, California Labor Code) and the "Immigration Reform and Control Act of 1986" (8USC, Sections 1101 through 1525), to include but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants that are included in this Contract. 5. The Contractor may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sec· ns 12650, et seq .. and Carlsbad Municipal Code Sections 3.32.025, et seq. , ....,~ init ____ init '™-,_...... 6. The Contractor hereby acknowledges th debarment by another jurisdiction is grounds fo!:ity of Carlsbad to disqualify the Contractor from participating in contract bidding .• ~ init init 7. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for re lution of any disputes between the parties arising out of this agreement is San Diego County, California. BLOCK RESTROOM REPAIRS AT AVIARA COMMUNITY PARK: CONTRACT PKRC693 --1 --City Attorney Approved 2/29/2016 Tracking#: 8. 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 Section 1770, 1773 and 1773.1 of the California Labor Code. Pursuant to Section 1773.2 of the California Labor code, a current copy of applicable wage rates is on file in the office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in the execution of the work covered by this Letter of Agreement. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. 9. City Contact: Temujin Matsubara, 760-434-2844 Contractor Contact: Scott Saling 858-452-0562 CONTRACTOR 7071 Carroll Road San Diego, CA 92121 858-452-0562 scott@anchorspecialties.com By~114~ S u,rT S A-1~1",!f~> /Pfl-E.S > DetJf (print name/title) By: 1 ~&\ <;cc~~ (print namtltle} r CITY OF CARLSBAD, a municipal corporation of the State of California By: e,(. 2.1,' Parks Dated: (Proper notarial acknowledgment of execution by Contractor must be attached. Chairman, president or vice-president and secretary, assistant secretary, CFO or assistant treasurer must sign for corporations. 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: CELIA A. BREWER, City Attorney BY: (!____p ~ Deputy City Attorney 0 BLOCK RESTROOM REPAIRS AT AVIARA COMMUNITY PARK: CONTRACT PKRC693 --2 --City Attorney Approved 2/29/2016 JOB: LOCATION: EST#: DATE: Prepared By: Aviara Park Carlsbad 13578 1/7/2019 Scott Saling www.anchorspecialties.com scott@anchorspecialties.com WE ARE PLEASED TO QUOTE ON THE FOLLOWING: PARTITIONS: Solid Plastic -Floor Mount Overhead Braced Hardware: Continuous Aluminum Brackets, Hinges and Hardware. Toilet Partitions Labor Color: Black Inc. Tax/Supply Only/Will Call Inc. Demo & Installation !Total Addenda Noted: ------- THIS QUOTATION INCLUDES THE FOLLOWING: 2 Toil et Partitions $1,250 $900 s2,1so 1 Optional labor to remove, dispose existing material & Install new partitions EXCLUSIONS: -Subrogation waivers of workers compensation claims conditions. -Overtime labor resulting from scheduling problems caused by others. -Aggregate insurance limits over $2 Million dollars and/or any non-industry standard coverage requirements. QUALIFICATIONS: -Prevailing wage rates included. We are Non-Union. -All applicable taxes are included in pricing. -Claims for defective material must be made within 48 (Forty-eight) hours of receipt of shipment. Our responsibility ceases upon acceptance of shipment by carrier. Consignee to file claim with carrier for all material damaged in transit. THANK YOU FOR THE OPPORTUNITY TO QUOTE TO YOU. 7071 Carroll Rd. San Diego, CA 92121 anchorspecialties.com Lie. No. 438185 Phone 858 452-0562 Fax 858 452-9081 ~ ANCHCON-01 DONM01 ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 1/16/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # OL48969 ~iij!~cT Carla Luger C3 Risk & Insurance Services rtg,NJo, Ext): (619) 385-4637 161 I FAX 404 Camino Del Rio S. STE 410 (AIC, No): San Diego, CA 92108 i~D'M~ss: carla@c3insurance.com INSURER(Sl AFFORDING COVERAGE NAIC# 1NsuRER A: Ohio Securitv Insurance Comoanv 24082 INSURED INSURER B: American Fire & Casualtv 24066 Anchor Construction Specialties, Inc. 1NsURER c: ZNAT Insurance Comoanv 30120 7071 Carroll Road INSURER D: San Diego, CA 92121 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. l~f[ TYPE OF INSURANCE ~..\'J>,.\-~-'!.~~ POLICY NUMBER POLICYEFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -□ CLAIMS-MADE [K] OCCUR DAMAGE TO RENTED 100,000 BKS57191145 7/7/2018 7/7/2019 PREMISES iEa occurrenr,a\ $ MED EXP (Anv one oerson\ $ 15,000 - PERSONAL & ADV INJURY $ 1,000,000 -2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Fl POLICY oo ~rBf □ LOG PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ A ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT !Ea accident\ $ 1,000,000 ANY AUTO BAS57191145 12/11/2018 7/9/2019 BODILY INJURY (Per oerson) $ -OWNED ~ SCHEDULED -AUTOS ONLY r-----AUTOS BODILY INJURY (Per accident) $ X ~URT!ffi, ONLY X ~8to~~1~ 1P~~~fc~d~t?AMAGE $ r----- $ B UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 5,000,000 -ESA57191145 7/7/2018 7/7/2019 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ / OED I X I RETENTION$ 0 $ C WORKERS COMPENSATION XI ~\%uTE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N C066159115 7/7/2018 7/7/2019 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE [Y] E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A 1,000,000 (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $ ~~S~~ritt~ ~t'6PERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 A Equipment Floater BKS57191145 7/7/2018 7/7/2019 Blanket Agg Limit 25,000 ✓ DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional insureds are included as/where required by written contract as respects to General Liability, waiver of subrogation and Primary Non-Contributory wording applies but limited to the operations of the Insured under said contract, and always subject to all the policy terms, conditions and exclusions per endorsements attached. Per project Aggregate applies to General Liaility when required by contract. Waiver of subrogation applies to the Workers Compensation but limited to the operations of the Insured under said contract, and always subject to all the policy terms, conditions and exclusions per endorsements attached. Cancellation wording applies per the terms and conditions of the attached form when required by written contract or agreement. All Operations CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF CARLSBAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PARKS & RECREATION ADMIN ATTN: JENNIFER MARINOV 799 PINE AVENUE, SUITE 200 AUTHORIZED REPRESENTATIVE Carlsbad, CA 92008 ~ I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0 POLICY NUMBER: BKS57191145 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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): Blanket Additional Insured agreed 7071 CARROLL RD SAN DIEGO, CA 92121 Location(s) Of Covered Operations Any location(s) when You have agreed in a written contract, agreement or permit that person or organization be added as an additional 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 in- jury", "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 operatons 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 permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, 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 addi- tional exclusions apply: This insurance does not apply to "bodily in- jury" or'' property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed 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 or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 0 = ------ = - 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 shown in the Declarations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 0 POLICY NUMBER: BKS57191145 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Blanket Additional Insured agreed 7071 CARROLL RD SAN DIEGO, CA 92121 Location And Description Of Completed Operations Work described in writing in the contract, agreement or permit. Location(s) at which You performed work described in written contract, agreement or permit. 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 in- jury" or "property damage" caused, in whole or in part, by "your work" at the location des- ignated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-com- pleted operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BKS57191145 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 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: As required by written contract or agreement entered into before loss. 7071 CARROLL RD SAN DIEGO, CA 92121 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 organi- ~ zation shown in the Schedule above. 0 0 0 CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 re 0 Policy#: BKS57191145 COMMERCIAL GENERAL LIABILITY CG 89 98 0412 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to provision a. Primary Insurance of Paragraph 4. Other Insurance under Section IV -Commercial General Liability Conditions: However, when an additional insured has been added to this Coverage Part by attachment of an endorsement, we will not seek contribution from the "additional insured's own insurance" provided that: (1) You have agreed in a written contract that this insurance is primary and non-contri butory; and (2) The "bodily injury" or "property damage" occurs, or the "personal and advertising injury" is committed, subsequent to the execution of such contract. B. For the purposes of this endorsement the following is added to Section V -Definitions: "Additional insured's own insurance" means other insurance for which the additional insured is designated as a Named Insured. © 2012 Liberty Mutual Agency Corporation. All rights reserved. CG 89 98 0412 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 0 ~ N 0 "' N -= -= = -= - COMMERCIAL GENERAL LIABILITY CG 88 70 12 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONSTRUCTION PROJECT(S) -GENERAL AGGREGATE LIMIT (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I -Coverage A -Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I -Coverage C Medical Payments, which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to you: 1. A separate Construction Project General Aggregate Limit applies to each construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations . 2. The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medical expenses under Cov- erage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Construction Project General Aggregate Limit for that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I -Coverage A -Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I -Coverage C Medical Payments, which cannot be attrib- uted only to ongoing operations at a single construction project away from premises owned by or rented to you: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Construction Project General Aggregate Limit. D. If the applicable construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section Ill -Limits Of Insurance not otherwise modified by this endorsement shall continue to apply. CG 88 70 12 08 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 1 0 AAIS CL 0162 01 16 Page 1 of 3 This endorsement changes the policy --PLEASE READ THIS CAREFULLY -- AMENDATORY ENDORSEMENT CALIFORNIA 1. Under Common Policy Conditions, Cancella- tion is deleted and replaced by the following: Cancellation And Nonrenewal a. "You" may cancel this policy by returning the policy to "us" or by giving "us" writ- ten notice and stating at what future date coverage is to stop. b. "We" may cancel or not renew this policy by delivering or mailing written notice to the producer of record and to "you" at "your" mailing address last known to "us". "Our" notice will state the reason for the cancellation or nonrenewal. Proof of delivery or mailing is sufficient proof of notice. c. If this policy has been in effect for 60 days or less, "we" may cancel for any reason. "We" will give "you" notice at least 10 days before the cancellation is effective. "Our" notice will state the date on which the cancellation is effective. Such notice may be delivered by electronic means if "you" have affirmatively consented to that method of delivery and have not withdrawn such consent. d. If this policy has been in effect for more than 60 days, or if it is a renewal of a policy issued by "us", "we" may cancel only for one or more of the following rea- sons: 1) nonpayment of premium; 2) there has been a judgment by a court or an administrative tribunal that "you" have violated a law of this state or the United States involving an act that materially increases a haz- ard insured against; 3) there has been a discovery of fraud or material misrepresentation com- mitted by: a) a person insured under this cov- erage or his or her representative in obtaining this insurance; or b) "you" or "your" representative in pursuing a claim under this policy; 4) there has been a discovery of willful or grossly negligent acts or omis- sions, or of violations of state laws or regulations establishing safety stan- dards by "you" or "your" representa- tive, that materially increase a hazard insured against; 5) there has been a failure by "you" or "your" representative to implement reasonable loss control requirements to which "you" agreed as a condition of the issuance of this policy, or which were required in order to qualify for a particular rate or rating plan, if the failure materially in- creases a hazard insured against; 6) the Insurance Commissioner has de- termined that loss of, or changes in, "our" reinsurance would threaten "our" financial integrity or solvency; 7) the Insurance Commissioner has de- termined that a continuation of this policy would place "us" in violation of the law or that continuation of cov- erage would threaten "our'' solven- cy; or 8) there has been a change made by "you" or "your" representative in the activities or property which has re- sulted in a materially added, in- creased, or changed hazard that is not included in the policy. Copyright, American Association of Insurance Services, Inc., 2015 0 AAIS CL 0162 01 16 Pa e 2 of 3 If "we" cancel this policy for nonpayment of premium or fraud, "we" will give "you" notice at least 10 days before the cancellation is effective. If "we" cancel this policy for any other reason, "we" will give "you" notice at least 30 days before cancellation is effective. "Our" notice will state the date on which the cancellation is effective. Such notice may be delivered by electronic means if "you" have affir- matively consented to that method of de- livery and have not withdrawn such con- sent. e. "Your" return premium, if any, will be calculated on a pro rata basis and will be refunded at the time of cancellation or within 80 business days of cancellation unless this policy is subject to audit. If this policy is subject to audit, it will be refunded to "you" within 80 business days of the date "you" provide all infor- mation needed to conduct an audit. Pay- ment or tender of the unearned premium is not a condition of cancellation. f. If we decide not to renew this policy, "we" will give "you" notice at least 60 days, but not more than 120 days, before the nonrenewal is effective. However, notice of nonrenewal is not re- quired if: 1) this policy is transferred to or re- newed by another insurer in "our" in- surance group without changing policy "terms" or the rate on which the premium is based; 2) the policy has been extended for 90 days or less after notice was given in accordance with the requirements of this condition; 3) "you" have obtained replacement coverage or have agreed in writing to obtain replacement coverage within 60 days of the termination of this policy; 4) this policy was issued for a term of 60 days or less and "you" were noti- fied when the policy was issued that it would not be renewed; 5) "you" request a change in "terms" or hazards covered within 60 days of the end of the policy period; or 6) in accordance with the requirements of this condition, "we" have made a written offer to renew the policy with changed "terms" or at a change to the rate on which the premium is based. g. If this policy covers a one-to four-family dwelling, and if in accordance with Cali- fornia law, "you" have designated an ad- ditional person to receive notice of the nonrenewal or cancellation of this policy for nonpayment of premium, "we" will give notice to such person at least 10 days before the nonrenewal or cancella- tion is effective. Such notice will be sent by first-class United States mail, postage prepaid, to the address provided by "you" within 10 days after the date on which the premium is due and unpaid. Except as provided above, no person des- ignated by "you" to receive notice of the nonrenewal or cancellation of this policy for nonpayment of premium has any rights, whether as an additional insured or otherwise, to any benefits under this policy. 2. Under Common Policy Conditions, the follow- ing condition is added: Conditional Renewal -If "we" condition the renewal of this policy upon: a. a reduction in "limits"; b. an elimination of coverage; c. an increase in deductibles; or d. a rate increase of more than 25%; Copyright, American Association of Insurance Services, Inc., 2015 = -= ---==== -= AAIS CL 0162 01 16 Pa e 3 of 3 "we" will deliver or mail written notice to the producer of record and to "you", at the mail- ing address shown in the policy, at least 60 days, but not more than 120 days, before the end of the policy period. Such notice may be delivered by electronic means if "you" have affirmatively consented to that method of de- livery and have not withdrawn such consent. Proof of delivery or mailing is sufficient proof of notice. CL 0162 01 16 Copyright, American Association of Insurance Services, Inc., 2015 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT THE ZENITH 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 any person or organization with whom you have a written contract that requires you to obtain this agreement from us. The additional premium for this endorsement shall be 2% of the California workers compensation premium otherwise due. Minimum Premium: $0 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy) Endorsement Effective 7/7/18 ZNAT INSURANCE COMPANY -30414 Insured ANCHOR CONSTRUCTION SPECIAL TIES, INC. [A CORP] Policy No. C066159115 Policy Period 7/7/18 To 7/7/19 Issued On 7/6/18 At San Diego, CA WC-99-04-25B (Ed. 10-07) Endorsement No. 1