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Ayala Engineering Inc; 2019-10-24; PWM20-915UTIL
PWM20-915UTIL CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT EL FUERTE MANHOLE REHABILITATION; CONT. NO. 5503 This agreement is made on the lL(.& day of ~~bee , 2019, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Ayala Engineering Inc., a California corporation, whose principal place of business is 8482 E. Meadowridge St, Anaheim, CA 92808 (hereinafter called "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, 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: Jesse Castaneda (City Project Manager) WAGE RATES. 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 Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the 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 execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. 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. EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 1 of 8 City Attorney Approved 1/25/2019 PWM20-915UTIL 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 agreement 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 years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or contractor fro a ·cipating in contract bidding. Signature: Print Name: REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers' Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best's Key Rating Guide of at least "A:X"; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than ........ $1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ....... $1,000,000 Property damage insurance in an amount of not less than ........ $1,000,000 Automobile Liability Insurance in the amount of $1,000,000 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 thirty (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. EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 2 of 8 City Attorney Approved 1/25/2019 PWM20-915UTIL INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, 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 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. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within fourteen (14) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within twenty (20) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. /II /II /II /II /II /II /II /II /II /II /II Ayala Engineering Inc. (name of Contractor) 959385 (Contractor's license number) A -8/31/2020 (license class. and exp. date) 1000005012 (DIR registration number) 6/30/2020 (DIR registration exp. date) EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 3 of 8 8482 E.Meadowridge St (street address) Anaheim, CA 92808 (city/state/zip) 714-823-7179 (telephone no.) 562-297-4228 (fax no.) Ricardo@Ayalaengineering.com ( e-mail address) City Attorney Approved 1/25/2019 PWM20-915UTIL AUTHORITY. The individuals executing this Agreement 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 Agreement. CONTRACTOR AYALA ENGINEERING INC, a California corporatio By: Ricardo Ayala, President & CFO (print name/title) By: (sign here) (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By: Vicki V. Quiram, Utilities Director as authorized by the City Manager If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !f.._g corporation, Agreement 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: EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 4 of 8 City Attorney Approved 1/25/2019 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On /Jc";rpJ'e-£ (Zt1IY before me, Ronald D. Smith Notary Public personally appeared ' £LL:~d> ;1/e2/4- who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws Of the State of California that the foregoing paragraph is true and correct. Signature___..___..._.,.~_~..............,w_ // Ronald D. Smith Notary Public _____________ OPTIONAL. _______________ _ Title of Document: /&.,v¢ /1#1✓£ !t,04/J ~T£4~r ~.~~~.L-,;;;;.;:;,.;;;.;;.,;;;;._~==-----=------------------- /o/qt;z o1, Name of Signer(s): __ /d.,,_. 1 -='C--"4d'---~----'-A'-"½-~_/4_4.. ________________ _ Date of Document: PWM20-915UTIL EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor 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 sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor 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 Portion of Project to Business Name and Address DIR Registration License No., % of be Subcontracted No. Classification & Total Expiration Date Contract ;,,..;/4 Total % Subcontracted: -~,,_;/ ___ _ The Contractor must perform no less than fifty percent (50%) of the work with its own forces EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 5 of 8 City Attorney Approved 1/25/2019 PWM20-915UTIL EXHIBIT B El Fuerte Manhole Rehabilitation El Fuerte sewer manhole rehabilitation at five locations. All work shall be in accordance with the City of Carlsbad Engineering Standards, 2016 Edition, the Standard Specifications for Public Works Construction, 2018 Edition and the supplements thereto as published by the "Green Book" Committee of Public Works Standards. Inclusions: • Mobilization of and Labor and Equipment • Certified Payroll/Prevailing Wages Perform Confined Space Entry All Crew Members Trained in Confined Space Entry, CPR, and First Aid • Traffic Control Plans • City of Carlsbad Business License • City of Carlsbad Right of Way Permit • Traffic Control as required per approved traffic plans • Surface prep per manufacturers recommendation Installation of false floor to prevent debris from entering collections system Removal of manhole steps Stopping of active inflow in manhole Resurfacing of manhole interior to original dimensions Installation of ArrowLock PVC Lining System • Application performed by trained applicators • Spark Testing per manufactures recommendations Ten Year Warranty on Installation Exclusions: Replacement of Frames and Covers • Third Party Inspection Warranty excludes any damage due to road adjustment or street overlay JOB QUOTATION ITEM UNIT QTY DESCRIPTION NO. Manhole rehabilitation at locations MH#31O-36, 1 5 EA MH#31D-37, MH#31D-38, MH#310-39 & MH#31D-40 TOTAL* *Includes taxes, fees, expenses and all other costs. PRICE $11,925 $59,625 EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 6 of 8 City Attorney Approved 1/25/2019 EXHIBIT C LABOR AND MATERIALS BOND PWM20-915UTIL Bond #024240938 WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Ayala Engineering Inc. (hereinafter designated as the "Principal"), a Contract for: EL FUERTE MANHOLE REHABILITATION CONTRACT NO. 5503 in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any 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, Ayala Engineering Inc., as Principal, (hereinafter designated as the "Contractor"}, and The Ohio Casualty Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of fifty-nine thousand six hundred twenty- five Dollars ($59,625), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 7 of 8 City Attorney Approved 1/25/2019 PWM20-915UTI L 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. SIGNED AND SEALED, this __ 3_0_th ____ day of ___ S_e_.p._:.te.c...m_..:.._be.c...r _______ , 20J_g__ __ A~ya_l_a_E_n ..... g_in_e_e_rin~g~ _______ (SEAL) The Ohio Casualty Insurance Company (SEAL) Principal) By: __ :;/f___;;___(S-etl--.._____y) _____ _ (Signature) Frank Morones, Attorney-in-Fact (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY -ATTACH ATTORNEY-IN-FACT CERTIFICATE) APPROVED AS TO FORM: CELIA A BREWER City Attorney By: EL FUERTE MANHOLE REHABILITATION CONT. NO. 5503 Page 8 of 8 City Attorney Approved 1/25/2019 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On {)cro;ft'~ tf;ZNf before me, Ronald D. Smith Notary Public personally appeared ' ,LJ;c 4~/41 1/y ala_ who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws Of the State of California that the foregoing paragraph is true and correct. Signature --~-~____.,..._...W_~, f/ _ Ronald D. Smith Notary Public i············f •;'c.<~ ~CNLD D. SrilTH ;,.. r.,,;,. t/~-~ Notae1 ~,-~,,:-California ~ ;.,: ~~. 1 ·.:. • ,~~ Or2ncc County ~ j 1 ~f/ C:C"~ ,,;:c = 2226823 ~ ~ f.lv CJ~,-c C:x;,res Jan 25, 2022 t -=-= = ---- ____________ OPTIONAL. _______________ _ Title of Document: L~~,R lfvd //J;1P.€'/4/r £ad' Date of Document: /o/tJt/rolf I Name of Signer(s): /3c4~ ~IA, (/) Q) ~-libertv ~ Mutual SURETY Bond No. 024240938 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8200308 -969561 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Arturo Ayala_ Daniel Huckabay, Frank Morones. Dwight Reilly. Shaunna Rozelle Ostrom all of the city of Orange state of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 16th day of January , 2019 Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company /' ;(!J74 .. By: /'4 , ,,,,---,- rJ rJ Cl C 'ii 2 c David M. Carey, Assistant Secretary .c _; ~ State of PENNSYLVANIA :, -<ll SS C ~ ::i County of MONTGOMERY « _ Ol C J a> On this ~ day of January , 2019 before me personally appeared David M Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance c 5 2 Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes = ~ v ~ therein contained by signing on behalf of the corporations by himself as a duly authorized officer. r.l U: ~m ~E !! ::i IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. ~ c ~~ oC -oo -~ ~ ~ ,,.,·_,.;,.<••·•·'· COMMONWEALTH OF PENNSYLVANIA ~ '<I -1..-1\ota:nal Se.-1 fa,,t--.__ d {k -,: Ji O ! Torosa P.u,toga, Notary Pub'1C (// ' k' -I-" O C 5 2 ' Upoer Merioo Twp. Mootgorne,y Cosirly By; Y,M.4,(.} '/l,4,,(,L · ~ ECl =_ ~ ' \l-, (;nq•r,vs,,;,n F,pues March,~. 20r Teresa Pastella, Notary Public ~ Cl l) +-J f./ernt;:;.,r hnn5/'/flrt1a.A1,.socu?!-Ofl ot Notanet:. a_ C ?~ .~c ~ w This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual £ cr ~ ~ Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: o ~ -a> ARTICLE IV-OFFICERS: Section 12. Power of Attorney. -~ i ~ "e1 Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the ;:g 1 ~ r, President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety ~ c :1l c any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall 1 ~ :'. ~ have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such -ex; ~ ~ instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the -~ ~ - 0 provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. c ex; oc ARTICLE XIII -Execution of Contracts: Section 5. Surety Bonds and Undertakings. u u: Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, ~ ~ shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation -The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in- tact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization -By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this lQ!!!__ day of September , 2019 /7--~t4t-By:~~~~~-,,----,.~~~~--------Renee C. Llewellyn, Assistant Secretary CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certiftcate verifies only the identity of the individual who signed the document to which this certificate is attached. and noi the truthfulness, accuracy, or validity of that documcnt. State of California County of ... __ oi:-ange ......................................................... ) On .. 'J/315/,;,Lct--~-before me, __ L_:. c~;;;,~;=~~:~;:~:l~:i~;f tht~ CJffi~e; personally appeared .. -...... __ Frank Morones Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the personfSf whose name~ is/are subscribed to the within instrument and acknowledged to me that heh,h@/thoy executed the sarne in his1her/their authorized capacity(:.tes), and thnt by his/hor/thoir si9nature(s) on the instrun·1ent the person(s), or the ('lntity upon behalf of which the person(-&) acted, executed the instrument. a L.CLARK -Notll'W Pullie • California ~ lH Allgeln County z Conlmill&oft • 2170352 .. JO • • • o ,Ml :0T"!' =• !'°! t';.2&221 Place Notary Seal Above I certify under ~"IENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature ... rx:~ ... Signature of Notary Public ----------------OPTIONAL _______________ , Though this section is optional, completing this information can cfeter alteration of the document or fraudulent reattac/m,ent of this form to an unintemded docwnent. Description of Attached Document Title or Type of Document ______________ Document Date: Number of Pages: ____ Signer(s) Other Than Named Above: ____ ....... _._ .... _ ......... . Capacity(ies) Claimed by Signer(s) Signer's Name: ··--·· ......... -· ... •--• Corporate Officer --Title(s): .. -······ ····-·····-· ... Pariner --Limited General Individual Trustee Attorney in Fact Guardian or Conservator Other: ---·· ........ -..... Si9ner ls Representing: ·----------- ............. • -····· .... -._-- Signer's Name: ..... Corporate Officer --Title(s): . .. __ _ Partner --· Limited General Individual Trustee Attorney in Fact Guardian or Conservator Other: _______ _ Signer Is Representing: ·--··-·--· ... -------••-,--v•-••••••-••-----------•-• •••--~•---•-•--•--•-••••--•""'-••••• @2014 National Notary Association • www.NationalNotary.org • 1 ·B00·US NOTARY (1-800•876-6827) Item #5907 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) ~ 3/13/2019 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 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 ~2~l~cT Jose L. Gurrola JL Gurrola Insurance Agency i4~~NJo c-•• l'in?\ 'JQ'>-'-'>'>'> I rti~ Nol: License No. OF70482 E-MAIL 1508 E. 5th St. #D AD_DI!ESS:_jose@ilgia.com -----------~~~~~~~:ID#: Av"I" Long Beach, CA 90802 INSURER/SI AFFORDING COVERAGE NAIC# INSURED INSURER A: Tokio Marine Specialty Insurance Company 23850 Ayala Engineering, Inc. INSURER B: State Compensation Insurance Fund of CA 35076 8482 E. Meadowridge St. INSURERC: Anaheim, CA 92808 INSURERD: INSURERE: 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. NOTVI/ITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT \I\IITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF ,~m~irvw,, LTR •••rn ... ~ POLICY NUMBER IMMIDDNYYYl A GENERAL LIABILITY -PPK1941696 2/8/2019 2/8/2020 X COMMERCIAL GENERAL LIABILITY [v r -□ CLAIMS-MADE [8J OCCUR X Ded: $2,500 - ~ GEN'L AGGREGATE LIMIT APPLIES PER: rx7 POLICY IXl j'rg: nLOC AUTOMOBILE LIABILITY - -ANY AUTO r r ALL O'M'IED AUTOS ~ SCHEDULED AUTOS ~ HIRED AUTOS f-- NON-O'M'IED AUTOS f-- UMBRELLA LIAB / x 1 occuR t-'I A 2/8/2019 2/8/2020 A f-- X EXCESS LIAB CLAIMS-MADE r r DEDUCTIBLE RETENTION $ C WORKERS COMPENSATION 900495519 2/8/2019 2/8/2020 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE □ OFFICER/MEMBER EXCLUDED? NIA r !Mandatory In NH) I yes. describe under enc~, --·-· r r R'Es~r50N OF ftPERA TIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remari<s Schedule, if more space is required) e: pera ions City of Carlsbad/CMWD is included as additional insured when required by written agreement. CERTIFICATE HOLDER City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 4668 -ECM #35050 New York NY 10163-4668 ACORD 25 (2009/09) The ACORD name and logo ar CANCELLATION LIMITS EACH OCCURRENCE $ 1 111111111111 UAMAGt: IO Ht:N I t:U PREMISES /Ea occurrence\ $ 10(1111111 MED EXP (Any one person) $ NIA PERSONAL & ADV INJURY $ 1 000 000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ ? 111111111111 $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ EACH OCCURRENCE $ 8,000,000 AGGREGATE $ 8,000,000 $ $ X I WC STATU-I TORY LIMITS IOTH-ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 E.L. DISEASE -POLICY LIMIT $ 1 111111111111 All rights reserved. ,/ POLICY NUMBER: PPK1941696 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) Location(s) Of Covered Operations Any person or organization to whom the Named Insured Where specified by fully executed written contract. has agreed by a fully executed written contract that such person or organization be added as an Additional Insured, but only with respect to operations performed by or on behalf of the Named Insured and only with respect to occurrences subsequent to the making of such fully executed written contract otherwise covered by this insurance. 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 CG20100413 © Insurance Services Office, Inc., 2012 Page 1 of 2 POLICY NUMBER: 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. 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 applicable Limits of Insurance shown in the Declarations. CG 2010 0413 © Insurance Services Office, Inc., 2012 Page 2 of 2 POLICY NUMBER: PPK1941696 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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) Location And Description Of Completed Operations Any person or organization to whom the Named Where specified by fully executed written contract. Insured has agreed by a fully executed written contract that such person or organization be added as an Additional Insured for Completed Operations Coverage, but only with respect to operations performed by or on behalf of the Named Insured and only with respect to occurrences subsequent to the making of such fully executed written contract otherwise covered by this insurance. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 STATE ENDORSEMENT AGREEMENT EXPERIENCE MODIFICATION ENDORSEMENT BROKER COPY COMPENSATION INSURANCE FUNO REP Dl 9004955-19 RENEWAL HOME OFFICE SAN FRANCISCO EFFECTIVE FEBRUARY 8, 2019 AT 12.01 A.M. NA 5-72-51-30 PAGE 1 OF ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME AYALA ENGINEERING 5753 E. SANTA ANA CANYON #G-571 ANAHEIM, CA 92807 ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT. IT IS AGREED THAT THE POLICY CONTRACT PREMIUM EARNED AT THE BASE RATE SHALL BE MODIFIED BY 073 % IN ACCORDANCE WITH THE CALIFORNIA WORKERS' COMPENSATION EXPERIENCE RATING PLAN. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~;{,~ FEBRUARY 8, 2019 d-,··-.JI~<~~ PRESIDENT AND CEO SCIF FORM 10217 (REV.7-2014) 2512A OLD DP 217 1