Loading...
HomeMy WebLinkAboutChris R. Sperbeck Inc dba Doorworkx; 2018-05-14; PWM18-151GSCITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT STAGECOACH PARK-PD SUBSTATION DOOR PWM18-151GS This agreement is made on the //../-/lJ.. day of __ ....µ.....µ::=:i,.c._-----' 2018, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "Cit }, and Chris R Sperbeck, Inc., dba Doorworkx, a California corporation whose principal place of business is 1046 Commerce St. Suite "G", San Marcos, CA 92078 (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: Brian Bacardi (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. Stagecoach Park -PD Substation Door Page 1 of 6 City Attorney Approved 9/27/16 PWM18-151GS 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 subcontractor fr · · ating 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. Stagecoach Park -PD Substation Door Page 2 of 6 City Attorney Approved 9/27/16 PWM18-151GS 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 thirty (30) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Chris R Sperbeck, Inc., dba Doorworkx, a California corporation Ill Ill Ill Ill Ill (name of Contractor) 783544 (Contractor's license number) C-61, D-28 5/31/20 (license class. and exp. date) 1000041522 (DIR registration number) 6/30/18 (DIR registration exp. date) Stagecoach Park -PD Substation Door Page 3 of 6 1046 Commerce St. Suite "G" (street address) San Marcos, CA 92078 (city/state/zip) 760-510-1043 (telephone no.) 760-471-7710 (fax no.) doorsfixed@yahoo.com (e-mail address) City Attorney Approved 9/27/16 PWM18-151GS 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, CHRIS R SPERBECK, INC., dba DOORWORKX, a California corporation By: (sign here) OJI/&/ f/~C&r frer,d/,._,r (print name/title) By: (sign here) (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By: Elaine Lukey / P lie rks 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 ~BNER, City Attorney BY:~ Deputy City Attorney Stagecoach Park -PD Substation Door Page 4 of 6 City Attorney Approved 9/27/16 PWM18-151GS 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 Total% Subcontracted: The Contractor must perform no less than fifty percent (50%) of the work with its own forces Stagecoach Park -PD Substation Door Page 5 of 6 City Attorney Approved 9/27/16 PWM18-151GS EXHIBIT B Stagecoach Park -PD Substation Door Contractor to provide all materials, tools and labor to install one (1) 3'X7' hollow metal door at Stagecoach Park located at 3420 Camino De Los Coches, Carlsbad, CA 92009. Scope of work to consist of: ITEM NO. 1 Contractor to mark out and cut 3'x7' opening from the interior side of the wall to determine if there is a conflict with any utilities running through that portion of the wall. If any plumbing or electrical is found in the area of work, the contractor will pull off the project until all utilities are rerouted. Contractor will then cut out stucco on the exterior portion of the opening, frame in a header (4" minimum) with double king studs, and a 3'x7' hollow metal door frame. Drywall repair to be City responsibility. Contractor to furnish and install one (1) 3'x7' hollow metal door with three (3) 4-1/2" hinges, one (1) 36" door sweep, one (1) door closer, and one Schlage mortise lockset with thumb turn in the inside and key cylinder on the outside. JOB QUOTATION UNIT QTY DESCRIPTION PRICE LS 1 Install 3'X7' hollow metal door for new PD substation. $5,386.41 TOTAL* $5,386.41 *Includes taxes, fees, expenses and all other costs. Stagecoach Park -PD Substation Door Page 6 of 6 City Attorney Approved 9/27/16 A"'--C~R CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/0D/YYYY) 11/02/17 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, ANO THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the tenns and conditions of the pollcy, certain policles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAtJ~~" ROBERT R. WILEY II BOB WILEY INSURANCE AGENCY INC r!J~~ Cwt\• (760) 735-9890 I r~.Nod760) 735-2460 966 PO Box ADC>R~ss:rrw5620@aol.com Escondido, CA 92033-0966 INSURER(S) AFFOIIOING COVEIIAGI! NAICf 0626539 INSURER A: SECURITY NATIONAL INSURANCE co INSURED Chris R. Sperbeck INC. DBA: DOOWORKX INSURER B: 197 Woodland Parkway, #104 PMB471 INSURER C: SAN MARCOS, CA 92069 INSURERD: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ~ --.. l'Vl.11,, t:rr ,~5~ LIMITS LTR 1Nsn --POLICY NUMBER X COMMERCIAL GIENERAI. LIABILITY EACH OCCURRENCE s 1.000 .000 ---:] CLAIMS-MADE [!] OCCUR u"""""c I ~i"cn cu PREMISES Ea OCCUIT9lltel $ 100 000 -NA105777805 6/27/2017 6/27/2018 MED EXP (Any one person) s 5 000 -1,000,000 A X X PERSONAL & ADV INJURY s - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 =i POLICY ~ jrtr DLOC PRODUCTS -COMP/OP AGG S 2,000,000 OTHER: s ALITOMOBILE LIABILITY (Ea accldenti'""Lt: LIMII s -ANYAUTO BDDIL Y INJURY (Per person) s -OWNED ,--SCHEDULED AUTOS ONLY ALITOS BODILY INJURY (Per accident) s --HIRED NON-OWNED r nvr · ~n. I T UAIW\br= s AUTOS ONLY AUTOS ONLY /Per accident) --s UMBRELLA LIAS HOCCUR EACH OCCURRENCE s -EXCESS LIAS CLAIMS-MADE AGGREGATE s OED I I RETENTION s s WORKERS COMPENSATION I STATUTE I I ~~M- AND EMPLOYERS' LIABILITY Y/N loJ('( PROPRIETOR/PARTNER/l!XECUTl1/E D E.L EACH ACCIDENT s OFFICER/MEMBER EXCUJOEO? NIA (-o,ylnNH) E.L DISEASE -EA EMPLOYEE S grs~=~ ~"oPERATIONS below E.L DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be allached If more space is raquired) THE CITY OF CARLSBAD IS NAMED AS ADDITIONAL INSURED. JOB: FIRE STAION NO 5 CERTIFICATE HOLDER CANCELLATION CITY OF CARLSBAD/CMWD c/o EXIGIS INSURANCE COMPLIANCE SERVICES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE Will BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. BOX 4668 -ECM#35050 NEW YOURK, NY 10163-4668 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSUREDS - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Policy Number: NA105777806 Endorsement Effective: 6/27/2017 12:01 a.m. Named Insured CHRIS R SPERBECK INC, DBA: DOORWORKX SCHEDULE Name of Person or Oraanization: · Jl:ny person or orgamzaoon mat the named Insured is obligated by virtue of a written contract or agreement to provide Insurance such as Is afforded by this policy. Location: (If no entry appears above, Information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement.) A. Section II -Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that insured. B. Wlth respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions 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 site 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. The words "you• and •your" refer to the Named Insured shown in the Declarations. D. "Your work" means work or operations performed by you or on your behalf; and materials, parts or equipment furnished in connection with such work or operations. Primary Wording If required by written contract or agreement: Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self-insurance maintained by the above additional insured(s) shall be excess of the insurance afforded to the named insured and shall not contribute to it. Waiver of Subrogation If required by written contract or agreement: We waive any right of recovery we may have against an entity that Is an additional insured per the terms of this endorsement because of payments we make for injury or damage arising out of "your work" done under a contract with that person or organization. 49-0108 07 11 May Include Copyrighted Material of Insurance Services Offices, Inc. Page 1 of1 Used with permission _,...........,_ A~Rv CERTIFICATE oF LIABILITY INSURANCE I OA~m~oIF THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYANDCONFERSNO RIGHTS UPONTHECERTIACATE HOU>ER.-TltlS CERTIROOEOOES_NO......JT_MFI __ RMA_TIV_ £1.Y OR·N-·EGA--:mlEl:--Y----1 AMEND, EXTEND OR ALTER THE COYEMGE AFFORDED BY THE POUCIES IIELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREll(S), AUTHORIZED REPttESENTATlVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ~·~------·-··· --.. ___ ., _____ ----------·---------·---···--------·--------------------------·----------------- IMPORTANT:lflheartlllcattholdttlsanADDmONALINSUREO.thepollcy(les)mutthaveADDITIONALINSUREDprovblonsorbeendol'Hd.lfSUBROGATIONISWAIVED,Mlb)ecttolllelermtancl C<lfldldofl1 of the polky. cenaln polclu may rwqun an enclorsemenL Aatatement on lhb-11ficate cloea not confer rights to tllecertlliate holder in lieu of 1U<h --...enl(1). -------·-------------------------~--------- PRODUCER CONTACT JACOB VAN SLOTEN(9983376) 16776 BERNARDO CENTER DR STE 110 SAN DIEGO CA 92078 INSURED CHRIS SPERBECK INC OBA: [)()()RIJI.K)RKX 1046 COMMERCE ST STE G SAN MARCOS CA 92078 NAME: JACOB VAN SLOTEN PHONE (A/C, NO, EXT): 866-611-8742 I FAX CA/C.NO): 866-811-8742 E-MAIL ADDRESS: jvan@farmersagent.com INSURER(S)AFFOROING=.:C:..:OVERAGE..:.::.:..:.:. ______ +---NAICc,.,-_l_-1 INSURERA: Truck lnsura_nce __ Ex_cha_....:nge0 ________ 4-_2~1~T09-=-----i INSURERS: Farmers Insurance Exchange 21652 J.-.-IN..:.SU..:.R..:ER.:....:C_: _M_id_Ce_n_tury--lnsura ___ n_ce_Co_m=.pa_ny ______ -l-2c-1c-:68:-_cj- INSUIIERD: INSURERE: INSURERF: COVEMGES C£RTIF1CATEIIUM8ER: REVISION NUMBER: THIS IS TO CERTIFY TMAT THE POUOES OF INSURANCE LISTED BElOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POI.ICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TEAM 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 POUCLES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXO.USIONSANDCONDITIONS OF SUCH POLICIES. UMlTS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS. INSR Tl'1'E OF INSURANCE ADD11. SUBR POLICY NUMBER POLICYEFF POUCYEXP LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) UMITS COMMERCIAi. GENERAL UABILITT EACH OCCURRENCE $ -D ClAIMS-MADE D OCCUR DAMAGE TO RENTED s PREMISES (Ea Occu,rfflCe) -MED EXP (Any one person) $ PERSONAL & AfJV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s Fl POLICY D PROfECT Otoe PRODUCTS-COMP/OPAGG S 0'11-lER: s AUTOMOBILE UAllllJTY COMBINED SINGLE LIMIT s 1,000,000 (~accidont) ---ANYAUTO BODILY INJURY (Per person) s -~ B OWNEDAUTOS X SCHEDULED ONLY AUTOS y 606286955 07/01/2017 07/01/2018 BODILY INJURY (Per accident) $ --~ HIRED AUTOS NON-OWNED PROPERTY DAMAGE ONLY AUTOS ONLY (Per accident) $ --$ UMBRELLA UAB OCCUR EACH OCCURRENCE s ,__ 1--- EXCESSUAB CLAIMS-MADE AGGREGATE $ OED r I RET!;NTIONS s WORXERSCOMPENSATION I PER I I 0'11-lER ANO EMPLOYERS' LIABIUlY STATUTE $ ANY PROPRIETOR/PARTNER/ Y/N E L EACH ACCIDENT $ EXECUTIVE OFACER/MEMBER C N/A EXClUDED7 (-atory In NH) E.L OlSEASI: • EA EMPLOYEE ~ If yes, dacnbe under DESCRIPTION OF OPERATIONS below E.l. DISEASE • POLICY LIMIT $ DESCRIPTIONOfOPERATIONS/LOCATIONS/VEHICUS(ACORD 101,AddltloMIRemarksSchedule,maybeattacheclifmorespaaisNqUlrecl) 2012 DODGE RAM 3500 S; VIN: 3C7WDSBL2CG187942; "This policy provides 30 day notice of canceHatlon to an additional lnalnds HIiied on the policy" CERTIFICATE HOI.DER EXIGIS Insurance Compliance 5ervices P.O. Box 4868 -ECM #35050 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIU BE DEI.IVl!RED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPAESENTATIV£ ~ ACOR025(2016/03) 31-1769 I 1-15 C,1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD ACORDS CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 11/10/2017 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 NAME:" Automatic Data Processing Insurance Agency, Inc. ritJgNJo Extl: I rt~ No): E-MAIL 1 Adp Boulevard ADDRESS: Roseland, NJ 07068 INSURER($) AFFORDING COVERAGE NAIC# INSURER A: Wesco Insurance Company 25011 INSURED DOORWORKX INSURER B: 1046 Commerce St Ste G INSURERC: Vendor ID: 692626 INSURER D: San Marcos, CA 92078-INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 779041 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE IALJLJL 1:SUt,t< POLICY EFF {~~~.!iii~, LTR INSD WVD POLICY NUMBER {MM/DD/YYYYl LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ -~ CLAIMS-MADE D OCCUR UAMAGE TO r-<tcN I cu PREMISES /Ea occurrence\ $ -MED EXP (Any one person) $ PERSONAL & ADV INJURY $ -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 9 DPRO-DLOC PRODUCTS -COMP/OP AGG POLICY JECT $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ /Ea accident) -ANY AUTO BODILY INJURY (Per person) $ -ALL OWNED -SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ --NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS /Per accident) $ --$ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ -EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ WORKERS COMPENSATION X I ~ffTuTE I I lJTH-AND EMPLOYERS" LIABILITY ER Y/N 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE ~ N/A y WWC3271843 05/11/2017 05/11/2018 E.L. EACH ACCIDENT $ 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) This certificate has a blanket Waiver of Subrogation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF CARLSBAD/CMWD C/0 EXIGIS INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. COMPLIANCE SERVICES P.o Box 4668-ecm #35050 AUTHORIZED REPRESENTATIVE New York, NY 10163-4668 /l7-}11)1(...;.. I A© 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 01-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Person or Organization Any person or organization as required by written contract. Schedule Job Description $250.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Insurance Company 5/11/2017 Policy No. Chris R. Sperbeck, lnc.(A Corp.) Wesco Insurance Company WWC3271843 Endorsement No. Premium$ 0 6893 Countersigned by _______________________ _ WC 04 03 06 (Ed. 01-84)