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Bergelectric Corp; 2018-06-25; PWM18-447GS
RECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2019-0211731 111111111111 lllll 11111111111111111111111111111111111111111111111111111 Jun 03, 2019 11 :01 AM OFFICIAL RECORDS Ernest LJ Dronen burg, Jr., SAN DIEGO COUNTY RECORDER FEES $0.00 (SB2 Atkins $0.00) PAGES 1 Space above this line for Recorder's use. PARCEL NO: NOTICE OF COMPLETION Notice is hereby given that: 167-101-35-00 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full names of the undersigned are City of Carlsbad, a municipal corporation. 3. The full address of the undersigned is 1200 Carlsbad Village Drive, Carlsbad, California 92008. 4. The nature of the title of the undersigned is: In fee. 5. A work or improvement on the property hereinafter described was completed on Feb. 5, 2019. 6. The name of the contractor for such work or improvement is Berg Electric Corporation. 7. The property on which said work or improvement was completed is in the City of Carlsbad, County of San Diego, State of California, and is described as follows: Project No. PWM18-447GS and Project Name: Calavera Hills Park Electric Meter Retrofit. 8. The street address of said property is 2997 Glasgow Dr., Carlsbad, CA 92010, in the City of Carlsbad. VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Carlsbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on Yh~ ci) K , 20il, accepted the above described work as completed and ordered that a Not e of Completion be filed. I declare under penalty of perjury that the foregoing is true and correct. Executed on .S -i9 CJ 2o_t'}, at Carlsbad, California. Q \Public Works\General Services\Agreements & Contracts\Berg Electric\Calavera Hills Park Electric Meter Retrofit -PWM18-447GS\NOC\NOC (Public and Private) -recreated 2018-12- 18.docx CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Berg Electric Corporation has completed the contract work required for PWM18-447GS - Calavera Hills Park Electric Meter Retrofit. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS Separate sports field and exterior lighting to a second electric meter. VALUE $38,433 CERTIFICATION OF COMPLETION OF IMPROVEMENTS I ( i~ . . t--...-,· \ \.,1 (\.,' John Maash Date CITY MANAGER'S ACCEPTANCE OF PUBLIC IMPROVEMENTS The construction of the above described contract is deemed complete and hereby accepted. The City Clerk is hereby authorized to record the Notice of Completion and release the bonds in accordance with State Law and City Ordinances. The City of Carlsbad is hereby directed to commence maintaining the above described improvements. Manager Date APPROVED AS TO FORM: CELIA BREWER, City Attorney By CY.~ Deputy City Attorney Q \Public Works\General Services\Agreements & Contracts\Berg Electric\Calavera Hills Park Electric Meter Retrofit -PWM18-447GSINOC\3.API -Calavera Hills Park Electric Meter Retrofit.docx Project: PWM 18-44 ?GS -Calavera Hills Park Electric Meter Retrofit Change Order No. 1 CONTRACT CHANGE ORDER NO. 01 Cct.la \/t' .a. .l-fi l \5. ~tr~ PROJECT: Stageeoaeh---Park--Electric Meter Retrofit CONTRACT NO. PWM18-447GS ACCOUNT NO. 001-5310-7550 CONTRACTOR: Bergelectric Corp. ADDRESS: 650 Opper Street Escondido, CA 92029 P.O. NO. P136128 The Contractor is directed to make the following changes as described herein. Changes shall include all labor, materials, equipment, contract time extension, and all other goods and services required to implement this change. Payment stated on this change order includes all charges, direct or indirect, arising out of this additional work including charges for field overhead, extended home office overhead, delays, disruptions, cumulative impacts, loss of efficiency, extended equipment costs and overtime premium costs and is expressly agreed between the City and the Contractor to be the complete and final costs hereof. The requirements of the specifications, where pertinent and not in conflict with this change order, shall apply to these changes. Pursuant to the Standard Specifications for Public Works Construction, perform the following: Item 1: Contractor to provide all tools, materials and labor necessary to furnish and install (1) Isolation Bracket for ATS at main electrical switchgear. Total cost not to exceed ................................................................. $1,713.00 TOTAL INCREASE TO CONTRACT COST .................................................... $1,713.00 TIME FOR COMPLETION OF ALL WORK UNDER THIS CONTRACT SHALL BE INCREASED BY FORTY-FIVE (45) WORKING DAYS AS A RESULT OF THIS CHANGE ORDER. Project: PWM18-447GS -Calavera Hills Park Electric Meter Retrofit Change Order No. 1 RECOMMENDED BY: ~UN I AL PROJECTS MAN ENGi~ !□1:C;fci DEP~RTMENT HEAD , (; 6 APPROVED AS TO FORM: CITYATTO~ ~ (DATE) DISTRIBUTION: INSPECTION FILE (ORIGINAL), PURCHASING, CONTRACTOR (DATE) 7 -3/_.,:1_! \6 . --, ;,. -\v I (DATE) CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT CALAVERA HILLS PARK ELECTRIC METER RETROFIT PWM18-447GS This agreement is made on the /J 5-th day of _-4-4-,>,,<'-'-'-'c..,,_"-------' 2018, by the City of Carlsbad, California, a municipal corporation, (hereina r called "City"), and Bergelectric Corp., a California corporation whose principal place of business is 650 Opper Street, Escondido, CA 92029 (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: Ron Haugland (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. Calavera Hills Park Electric Meter Retrofit Page 1 of 8 City Attorney Approved 9/27/16 PWM18-447GS 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 sub tra ;tor frof icipating in contract bidding. Signature: ~ J Print Name: Ron Wood, Executive Vice President 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. Calavera Hills Park Electric Meter Retrofit Page 2 of 8 City Attorney Approved 9/27/16 PWM18-447GS 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 ten (10) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within one hundred fifty (150) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. BERGELECTRIC CORP., a California corporation Ill Ill Ill Ill (name of Contractor) 85046 (Contractor's license number) C10; A;B; C7 2/28/19 (license class. and exp. date) 1000000328 (DIR registration number) 6/30/18 (DIR registration exp. date) Calavera Hills Park Electric Meter Retrofit Page 3 of 8 650 Opper Street (street address) Escondido, CA 92029 (city/state/zip) 760-746-1003 (telephone no.) 760-746-0675 (fax no.) wguillen@bergelectric.com (e-mail address) City Attorney Approved 9/27/16 PWM18-447GS 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 BERGELECTRIC CORP., :~·li2AJR ~ (sign here) ---=---- Ron Wood, Executive Vice President (print name/title) By /h !}JIJL- • (sign here) Alan J. Mashburn, CEO 1' ~e1Jii,.(l.( (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By: Elaine Lukey / Publi s Director as authorized by the City Manager If required by City, proper notarial acknowledgment of execution by Contractor must be attached. ~ 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: CELIA A. BREWER, City Attorney BY: ~ _fiL/~ eputy City Attorney Calavera Hills Park Electric Meter Retrofit Page 4 of 8 City Attorney Approved 9/27/16 ACKNOWLEDGMENT 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 San Diego On June 6, 2018 before me, Carol Ann Fisher, Notary Public (insert name and title of the officer) personally appeared _R_o_n_W_o_o_d ______________________ _ 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 PENAL 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. (Seal) ACKNOWLEDGMENT 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 San Diego On June 6, 2018 before me, Carol Ann Fisher, Notary Public (insert name and title of the officer) personally appeared _A_l_a_n_M_a_s_h_b_u_r_n ____________________ _ 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 PENAL 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 (CV~~ v-... bb,iu;,, (Seal) PWM18-447GS 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 5% Angus Asphalt Inc 1000003892 523300 5 Total% Subcontracted: 5 -'-------- The Contractor must perform no less than fifty percent (50%) of the work with its own forces Calavera Hills Park Electric Meter Retrofit Page 5 of 8 City Attorney Approved 9/27/16 PWM18-447GS EXHIBIT B Calavera Hills Park Electric Meter Retrofit Contractor will replace existing one meter switchgear with new two meter switchgear to obtain lower electrical useage rates. • Remove and replace existing 400-amp main 480/277 3-phase 4-wire 50AIC with new dual meter one for building the other for Musco lighting. • Engineering, develop and submit to City for approval prints for removal and replacement, no new loads. • Coordinate with SDG&E for the removal and replacement of the meter mains at the park as listed above. • Pay for permit fee's budget $250.00 ea. • Plan check fee's budget $750.00 ea. • Prevailing wage DIR SD-2017-2 • Reroute existing Musco feed to new meter location 20' of EMT surface mounted to building. • Coordinate with SDG&E for inspections and signoff. • Extend existing concrete pad (no new concrete pad) JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Labor, Equipment, Materials, Bonds, Insurance $35,720 2 LS 1 Allowance City Plan Permit Fee $250 3 LS 1 Allowance Plan Check Fee $750 TOTAL* $36,720 *Includes taxes, fees, expenses and all other costs. Calavera Hills Park Electric Meter Retrofit Page 6 of 8 City Attorney Approved 9/27/16 Bond No. 8245-56-24 Premium: $250.00 EXHIBIT C LABOR AND MATERIALS BOND PWM18-447GS WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to BERGELECTRIC CORP., a California corporation (hereinafter designated as the "Principal"), a Contract for: CALAVERA HILLS PARK ELECTRIC METER RETROFIT 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, BERGELECTRIC CORP., a California corporation, as Principal, (hereinafter designateq as the "Contractor"), and FEDERAL INSURANCE COMPANY as Surety, are held firmly bound unto the City of Carlsbad in the sum of THIRTY SIX THOUSAND SEVEN HUNDRED TWENTY Dollars ($36,720), 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. Calavera Hills Park Electric Meter Retrofit Page 7 of 8 City Attorney Approved 9/27/16 Bond No. 8245-56-24 PWM18-447GS 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. Executed by CONTRACTOR this __ 1_3_t_h __ _ day of ___ J_u_n_e ______ , 20~. CONTRACTOR: BERGELECTRIC CORP. By: ______ d~22-~:,02~Con~-ct _ ~ (sign here) Ron Wood (print name here) Executed by SURETY this __ 1 _2t_h ____ day of __ ..,.J..,.u=n-=e ________ , 20.JJL. SURETY: FEDERAL INSURANCE COMPANY (name of Surety) 2028 Halls Mill Rd., Whitehouse Station, NJ 08889 (address of Surety) (908) 903-3493 (telephone number of Surety) By· ~ _E_x_e_c_u_t_i_v_e_V_i_c_e_P_r_e_s_.~,_B_e_r~ge_l_e_c_t_r_1_· c_C_o_r~p. · ~ l ~ (title and organization of signatory) (signature of Attorney-in-Fact) By d1 fd<~n here) Alan J. Mashburn (print name here) CEO, Bergelectric Corp. (title and organization of signatory) Michael Destiche (printed name of Attorney-in-Fact) (attach corporate resolution showing current power of attorney) (Proper notarial acknowledgment of execution by CONTRACTOR and SURETY must be attached.) (President or vice-president and secretary or assistant secretary must sign for corporations. If only one officer signs, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering that officer to bind the corporation.) APPROVED AS TO FORM: CELIA A. BREWER City Attorney By: cZ/e~ Deputy City Attorney Calavera Hills Park Electric Meter Retrofit Page 8 of 8 City Attorney Approved 9/27/16 ACKNOWLEDGMENT 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 Los Angeles On June 12, 2018 before me, Norma A. Raygoza, Notary Public (insert name and title of the officer) personally appeared Mich ae I Destiche --------------------------------------------------------------- who proved to me on the basis of satisfactory evidence to be the person~) whose name(1) is/M2 subscribed to the within instrument and acknowledged to me that he/5b.a/~executed the same in his/hoo/t4¥Nt authorized capacity(~. and that by his/m/xR~ir signature(~ on the instrument the person(S;l, or the entity upon behalf of which the person(~ 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. WITNESS my hand and official seal. Signature h~( , ~Seal) OPTIONAL Though the information below is not required by law, it moy prove voluoble to persons relying on the document and could prevent fraudufent removal and reattachment of this form to another document. 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) ____ _ Individual Partner Limited General X Attorney in Fact Trustee Guardian or Counservator Other: ______ _ Signer is Representing:·---- Federal Insurance Company Vi ilant Insurance Com an Pacific Indemnity Company RIGHT THUM PRINT Of-SIGNER Top of thumb here Signer's Name: ___________ _ Corporate Officer · ntle(s): ____ _ Individual Partner Limited General Attorney in Fact Trustee Guardian or Conservator Other: ______ _ Signer is Representing: __ RIGHT THUM PRINT or SIGNER Top of thumb here . . Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Know All by These Presents, That FEDERAL INSURANCE COMPANY. an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Michael Destiche, Clara Do, Steven G. Grella and Norma A. Raygoza of Los Ange I es, Ca I if o rn ia ----------------------------------------------------------------------------------------------------------------------------------------------------------------- each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to amx their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof {other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof. said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and amxed their corporate seals on this 10•• day of February, 2017. 1 l:IV,11 \1 l '.hlon "· .\",.;1-.1:1111 ~C(.T('(:11')-S1qihc11 \l ll:111,_, \ ll'L' l'rc,,1de111 STATE OF NEW JERSEY County of Hunterdon ss. On this 10•• day of February, 2017 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof: that the seals amxed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that she is acquainted with Stephen M. Haney, and knows him to be Vice President of said Companies; and that the signature of Stephen M. Haney, subscribed to said Power of Attorney is in the genuine handwriting of Stephen M. Haney, and was thereto subscribed by authority of said Companies and in deponent's presence. Notarial Seal KATHERINE J. ADEL.MR NOTARY PUBLIC OF NEW JERSEY No. 2318685 Commission E,'ll,,,,. .My 16, 2019 CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016: "RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings. recognizances, contracts and other written commitments of the Company entered into in the ordinary course of business (each a "Written Commitment"): (1) Each of the Chairman. the President and the Vice Presidents of the Company 1s hereby authorized to execute any Written Commitment for and on behalf of the Company, under the seal of the Company or otherwise. (2) Each duly appointed attorney-in-facl of the Company is hereby authorized to execute any Wriuen Commitment for and on behalf of the Company, under the seal of the Company or otherwise. to the extent that such action is authorized by the gram of powers provided for in such person's written appointment as such attorney-in-fact. (3) Ea.ch of the Chairman, the President and the Vice PresidenL'i of the Company 1s hereby authorized. for and on behalf of the Company. to appoint in writing any person the attorney- in-fact of the Company with full power and authority to execute, for and on behalf of the Company, under the seal of the Company or otherwise. such Written Commitments of the Company as may he specified in such written appointment. which specification may he by general type or class of Written Commitments or hy specification of one or more particular Written Commitments. (4) Each of the Chairman. the President and the Vice Presidents of the Company is hereby authorized. for and on behalf of the Company. to delegate in writing to any other officer of the Company the authority to execute, for and on behalf of the Company. under the Company's seal or otherwise. such Written Commitments of the Company as are specified in such written delegation. which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitment,;;. (5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution. and the seal of the Company. may be afl1xed by facsimile on such Written Commitment or written appointment or delegation. FUKTHER RESOLVED. that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of otTicers. employees and other persons to act for and on hehalf of the Company. and .such Resolution shall not limit or othelViise affect the exercise of any such power or authority otherwise validly granted or vested." I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies") do hereby certify that (i) (ii) (iii) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect, the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in the U.S. Virgin Islands, and Federal is licensed in Guam, Puerto Rico, and each of the Provinces of Canada except Prince Edward Island; and the foregoing Power of Attorney is true, correct and in full force and effect. Given under my hand and seals of said Companies at Whitehouse Station, NJ, this 12th day of June 2018 -0@ 'k)C).U.)1---'f'f\. ~0~ IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER. PLEASE (ONT ACT US AT: Tele hone (908) 903-3493 Fax (908) 903-3GSG e-mail: suret •(!l•chubb.com Form 15-10-0225B-U GEN CONSENT (rev. 12-16) ACKNOWLEDGMENT 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 San Diego On June 13, 2018 before me, Carol Ann Fisher, Notary Public (insert name and title of the officer) personally appeared _R_o_n_W_oo_d _______________________ _ 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 PENAL 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 f' a/ 1.-1...{ v~ v--. ?-l.6k.c2J (Seal) ACKNOWLEDGMENT 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 San Diego On June 13, 2018 before me, Carol Ann Fisher, Notary Public (insert name and title of the officer) personally appeared _A_l_a_n_M_a_s_h_b_u_rn ____________________ _ 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 PENAL 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. (Seal) '.heck A License -License Detail Page I of Contractor's License Detail for License # 85046 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071 .17 , only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. This license is current and active. All information below should be reviewed. C10 -ELECTRICAL Business Information BERGELECTRIC CORP 650 OPPER ST ESCONDIDO, CA 92029 Business Phone Number:(442) 281-8197 Entity Corporation Issue Date 03/11/1946 Expire Date 02/28/2019 License Status Classifications A -GENERAL ENGINEERING CONTRACTOR B -GENERAL BUILDING CONTRACTOR C-7 -LOW VOLTAGE SYSTEMS Bonding Information Contractor's Bond This license filed a Contractor's Bond with FEDERAL INSURANCE COMPANY . . Bond Number: 83040723 Bond Amount: $15,000 :Effective Date: 01/01/2016 Contractor's Bond History Bond of Qualifying Individual This license filed Bond of Qualifying Individual number 82331887 for TOMMY ROLAND BADILLO in the amount of $12,500 with FEDERAL INSURANCE COMPANY. Effective Date: 02/19/2014 ! This license fried Bond of Qualifying Individual number 8232-04-43 for ROBERT JAMES MORENO in the amount of $12,500 with FEDERAL INSURANCE COMPANY. Effective Date: 12/05/2012 Workers' Compensation ttps://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum=85046 5/23/201 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) 5/31/2018 ~ 7/1/2018 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 Lockton Insurance Brokers, LLC CONTACT NAME: 725 S. Figueroa Street, 35th FL PHONE I FAX IA/C No Extl: (A/C Nol: CA License #0F15767 E-MAIL Los Angeles CA 90017 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# (213) 689-0065 INSURER A : Old Republic General Ins Cornoration 24139 INSURED Bergelectric Corp. INSURER B : General Insurance Company of America 24732 1376305 650 Opper Street INSURER c: American Fire and Casualty Company 24066 Escondido CA 92029 INSURER D : Starr Indemnity & Liability Company 38318 INSURER E: Employers Insurance Company of Wausau 21458 INSURER F : Berkley Regional Insurance Company 29580 COVERAGES BEREL0I CERTIFICATE NUMBER: 15418338 REVISION NUMBER: xxxxxxx THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYYl (MM/DD/YYYYl LIMITS A X_ COMMERCIAL GENERAL LIABILITY y y AlCG08291703 7/1/2017 7/1/2018 EACH OCCURRENCE $ 1.000 000 ~ CLAIMS-MADE [x] OCCUR DAMAGE TO RENTED PREMISES (Ea occurrencel $ 100 000 X_ Ded: $25 000 MED EXP (Any one person) $ 5.000 PERSONAL & ADV INJURY $ 1.000 000 - GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 000.000 =l [x] PRO· OLoc PRODUCTS • COMP/OP AGG $ 2 000,000 POLICY JECT OTHER: $ B AUTOMOBILE LIABILITY y y 24-CC-321834-10 bAOS -$2M) 7/1/2017 7/1/2018 COMBINED SINGLE LIMIT $ 2 000 000 (Ea accident\ C -ESA 28) 5735696 (XS AOS) 7/1/2017 7/1/2018 E _x_ ANY AUTO ASC-91-460530-027 (HI) 7/1/2017 7/1/2018 BODILY INJURY (Per person) $ xxxxxxx -OWNED SCHEDULED BODILY INJURY (Per accident) $ xxxxxxx AUTOS ONLY AUTOS --HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY /Per accident\ $ xxxxxxx -- $ xxxxxxx D UMBRELLA LIAB fi OCCUR y y 1000023798 7/1/2017 7/1/2018 EACH OCCURRENCE $ 5 000 000 >------X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5 000 000 OED I I RETENTION $ $ xxxxxxx WORKERS COMPENSATION y I PER I I OTH-A A 1 WC0829 l 703 7/1/2017 7/1/2018 X STATUTE ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE Cm N/A E.L. EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE· EA EMPLOYEE $ 1 000.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE· POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER(S) IS ADDITIONAL INSURED(S) AS PER THE ATTACHED ENDORSEMENT OR POLICY LANGUAGE. INSURANCE PROVIDED TO ADDITIONAL INSURED(S) IS PRIMARY AND NON-CONTRIBUTORY AS PER THE ATTACHED ENDORSEMENTS OR POLICY LANGUAGE. WAIVER OF SUBROGATION APPLIES AS PER THE ATTACHED ENDORSEMENTS OR POLICY LANGUAGE. WRAP UP EXCLUSIONS APPLY TO ALL PROJECTS INSURED IN ANY OCIP, CCIP OR SIMILAR INSURANCE PROGRAM. Additional Jnsured(s): City of Carlsbad, as per the attached endorsement or policy language. CERTIFICATE HOLDER 15418338 City of Carlsbad Public Works 1635 Faraday Avenue Carlsbad CA 92008 ACORD 25 (2016/03) CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: A1CG08291703 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): WHERE REQUIRED BY EXECUTED WRITTEN CONTRACT. Location(s) Of Covered Operations WHERE REQUIRED BY EXECUTED WRITTEN CONTRACT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be brocider than that which you are required by the contract or agreement to provide for such additional insured. 8. 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. 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 20 10 0413 Copyright, Insurance Services Office, Inc .. 2012 Attachment Code: D493935 Master ID: 1376860, Certificate ID: 14129084 Policy Number: A1CG08291703 COMMERCIAL GENERAL LIABILITY CG20370413 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): "WHERE REQUIRED BY EXECUTED WRITTEN CONTRACT, BUT ONLY WHEN COVERAGE FOR COMPLETED OPERATIONS IS SPECIFICALLY REQUIRED BY THAT CONTRACT." Location And Description Of Completed Operations "WHERE REQUIRED BY WRITTEN EXECUTED CONTRACT, BUT ONLY WHEN COVERAGE FOR COMPLETED OPERATIONS IS SPECIFICALLY REQUIRED BY THAT CONTRACT." Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" 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 Attachment Code: D494035 Master ID: 1376860, Certificate ID: 14129084 OLD REPUBLIC GENERAL INSURANCE CORPORATION CHANGES ADDITIONAL INSURED PRIMARY WORDING SCHEDULE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Name of Additional Insured Person(s) Or Organization( s ): Where required by written contract. Location(s) of Covered Operations Where required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other insurance of a like kind available to the person or organization shown in the schedule above unless the other insurance is provided by a contractor other than the person or organization shown in the schedule above for the same operation and job location. If so, we will share with that other insurance by the method described in paragraph 4.c. of Section IV -Commercial General Liability Conditions. All other terms and conditions remain unchanged. Named Insured Berqelectric Corp. Policy Number A 1 CG08291703 I Endorsement No. Policy Period 7/1/2017 to 7/1/2018 I Effective Date: 7/1/2017 Producer's Name OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY__,___INC. Producer Number CG EN GN 0029 09 06 Attachment Code: D493939 Master ID: 1376860, Certificate ID: 14129084 POLICY NUMBER: A1CG08291703 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: WHERE REQUIRED BY EXECUTED WRITTEN CONTRACT 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. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Attachment Code: D493937 Master ID: 1376860, Certificate ID: 14129084 Page 1 of 1 OLD REPUBLIC GENERAL INSURANCE CORPORATION WRAP-UP EXCLUSION WITH LIMITED EXCEPTIONS FOR CERTAIN ONGOING OPERATIONS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following exclusion is added to Paragraph 2.Exclusions of Section I -Coverage A -Bodily Injury and Property Damage Liability: This insurance does not apply to "bodily injury" or "property damage" arising out of any project that is or was subject to a "wrap-up insurance program" in which you are or were included as an insured. This exclusion does not apply to "bodily injury" or "property damage" arising out of your ongoing operations: A: for work being performed at any location owned by, or rented to you that is not within the project site or location as defined in the "wrap up insurance program" and is not covered by the "wrap-up insurance program" or B: for work being performed on a project covered by a "wrap-up insurance program" after such program has terminated or expired. The exceptions A. and B. above do not apply to "bodily injury" or "property damage" included in the "products- completed operations hazard" even if you are required to provide such coverage for an additional insured by a written contract or agreement. 2. The following is added to Section V-Definitions: "Wrap-up insurance program" means an owner or contractor-controlled or similar insurance program, under which some or all of the contractors and subcontractors working on a specific project or projects are required to participate in a program to obtain insurance that: a. Is issued specifically to cover damage or injury arising out of such project or projects; and b. Includes the same or similar insurance as is provided by this endorsement. All other terms and conditions of this Policy remain unchanged. Named Insured: Policy Number: Policy Period: Bergelectric Corp. A1CG08291703 7/1/2017 to 7/1/2018 Endorsement No. Endorsement Effective Date: Producer's Name: OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY, INC. Producer Number: CG EN GN 0090 02 10 Attachment Code: D493940 Master ID: 1376860, Certificate ID: 14129084 Page 1 of 1 000 7/1/2017 POLICY NUMBER: 24-CC-321834-10 (AOS -$2M) COMMERCIAL AUTO CA 7110 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. EXTENDED CANCELLATION CONDITION Paragraph 2. b. of the CANCELLATION Common Policy Condition is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE COVERAGE Under paragraph C. CERTAIN TRAILERS, MOBILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS of SECTION 1 COVERED AUTOS, the following is added: If Physical Damage coverage is provided by this Coverage Form, then you have coverage for: Any auto you do not own while used with the permission of its owner as a temporary substitute for a covered auto you own that is out of service because of its breakdown, repair, servicing, loss or destruction. BROAD FORM NAMED INSURED SECTION 11 LIABILITY COVERAGE A.1. WHO IS AN INSURED provision is amended by the addition of the following: d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. BLANKET ADDITIONAL INSURED SECTION II LIABILITY COVERAGE A.1. WHO IS AN INSURED provision is amended by the addition of the following: e. Any person or organization for whom you are required by an insured contract to provide insurance is an insured , subject to the following additional provisions: (1) The insured contract must be in effect during the policy period shown in the Declarations, and must have been executed prior to the bodily injury or property damage. (2) This person or organization is an insured only to the extent you are liable due to your ongoing operations for that insured, whether the work is performed by you or for you, and only to the extent you are held liable for an accident occurring while a covered auto is being driven by you or one of your employees. (3) There is no coverage provided to this person or organization for bodily injury to its employees, nor for property damage to its property. (4) Coverage for this person or organization shall be limited to the extent of your negligence or fault according to the applicable principles of comparative negligence or fault. (5) The defense of any claim or suit must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or "suit". Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CA71100307 Page 1 of 6 EP Attachment Code: D493950 Master ID: 1376860, Certificate ID: 14129084 (6) The coverage provided will not exceed the lesser of: PERSONAL EFFECTS COVERAGE (a) The coverage and/or limits of this policy; or A. SECTION Ill PHYSICAL DAMAGE COVERAGE, A.4. COVERAGE EXTENSIONS, is amended by adding the (b) The coverage and/or limits required by the insured following: contract. (7) A person's or organization's status as an insured under this subparagraph d ends when your operations for that insured are completed. EMPLOYEE AS INSURED Under Paragraph A. of Section II LIABILITY COVERAGE item f. is added as follows: Your employee while using his owned auto , or an auto owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that auto . This coverage is excess to any other collectible insurance coverage. FELLOW EMPLOYEE COVERAGE Exclusion 5. FELLOW EMPLOYEE of SECTION II LIABILITY COVERAGE B. EXCLUSIONS is amended by the addition of the following: However, this exclusion does not apply if the bodily injury" results from the use of a covered auto you own or hire, and provided that any coverage under this provision only applies in excess over any other collectible insurance. BLANKET WAIVER OF SUBROGATION We waive the right of recovery we may have for payments made for bodily injury or property damage on behalf of the persons or organizations added as insureds under Section II LIABILITY COVERAGE A.1.D. BROAD FORM NAMED INSURED and c. Personal Effects Coverage For any Owned auto that is involved in a covered loss , we will pay up to $500 for personal effects that are lost or damaged as a result of the covered loss , without applying a deductible. EXTRA EXPENSE BROADENED COVERAGE Paragraph A. COVERAGE of SECTION Ill PHYSICAL DAMAGE COVERAGE is amended to add: 5. We will pay for the expense of returning a stolen covered auto to you. AIRBAG COVERAGE Under paragraph B. EXCLUSIONS of SECTION Ill PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. NEW VEHICLE REPLACEMENT COST Under Paragraph C LIMIT OF INSURANCE of Section Ill PHYSICAL DAMAGE COVERAGE section 2 is amended as follows: 2. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. However, in the event of a total loss to your new vehicle to which this coverage applies, as shown in the declarations, we will pay at your option: A.1.e. BLANKET ADDITIONAL INSURED. a. The verifiable new vehicle purchase price you paid for your damaged vehicle, not including any insurance or PHYSICAL DAMAGE ADDITIONAL TRANSPORTATION warranties purchased; EXPENSE COVERAGE The first sentence of paragraph A.4. of SECTION Ill - PHYSICAL DAMAGE COVERAGE is amended as follows: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered auto of the private passenger type. CA 71 10 03 07 Attachment Code: D493950 Master ID: 1376860, Certificate ID: 14129084 b. The purchase price, as negotiated by us, of a new vehicle of the same make, model and equipment, not including any furnishings, parts or equipment not installed by the manufacturer or manufacturers dealership. If the same model is not available pay the purchase price of the most similar model available; Page 2 of 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE WHERE REQUIRED BY WRITTEN CONTRACT IN ALL STATES WHERE APPLICABLE. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (This information below is required only when this endorsement is issued subsequent to preparation of the policy.) ENDORSEMENT EFFECTIVE: 7/1/2017 POLICY NO. A1WC08291703 Insured: Bergelectric Corp. ENDORSEMENT NO. PREMIUM Insurance OLD REPUBLIC GENERAL INSURANCE CORPORATION Company: WC 00 0313 (Ed. 4-84) U3024a Attachment Code: D493945 1983 National Council on Compensation Insurance. Master ID: 1376860, Certificate ID: 14129084