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Commercial and Industrial Roofing Co Inc; 2019-10-21; PWM20-908GS
DOC# 2020-0085502 111111111111 lllll lllll 111111111111111 lllll 1111111111111111111111111111 RECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 Feb 20, 2020 11 :43 AM OFFICIAL RECORDS Ernest J. Dronenburg, Jr .. SAN DIEGO COUNTY RECORDER FEES. $0.00 (S82 Atkins. $0.00) PAGES 1 Space above this line for Recorder's use. PARCEL NO: NOTICE OF COMPLETION Notice is hereby given that: 203-142-04-00 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: Jan. 30, 2020. 6. The name of the contractor for such work or improvement is Commercial & Industrial Roofing Co., Inc. 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. PWM20-908GS, Project Name: Magee Park Restroom Roof Replacement. 8. The street address of said property is 258 Beech Ave., Carlsbad, CA 92008, in the City of Carlsbad. I, the undersigned, say: I am the City Clerk of the City 9f Carlsbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on te bnJ "rio ) 6 lh , 20:) 0, accepted the above described work as completed and ordered that a otice of Completion be filed. I declare under penalty of perjury that the foregoing is true and correct. Executed on feJx.;.o / ~ Jh, 20 J e, at Carlsbad, California. CITYOFCAR~ /;1 ~ ,;;;;zl-lecl« Gorn(, 21 Depvf-.1 BARBARA ENGLESON (;,f:1 City Clerk 7) Q:\Public Works\General Services\Agreements & Contracts\Commercial & Industrial Roofing Co, lnc\Magee Park Restroom Roof Replacement -PWM20- 908GS\6. Notice of Completion\2.NOC -Magee Park Restroom Roof Replacement -PWM20-908GS.docx Cler✓ CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Commercial & Industrial Roofing Co., Inc. has completed the contract work required for PWM20- 908GS -Magee Park Restroom Roof Replacement. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS Roofing replacement at Magee Park Restrooms VALUE $26,370 CERTIFICATION OF COMPLETION OF IMPROVEMENTS John Maaa~~~~er 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. Date APPROVED AS TO FORM: CELIA BREWER, City Attorney By _flt! ~ Deputy City Attorney Q:\Public Works\General Services\Agreements & Contracts\Commercial & Industrial Roofing Co, lnc\Magee Park Restroom Roof Replacement -PWM20-908GS\6. Notice of Completion\3.API (Public Works) -revised 2019-02-07.docx CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT MAGEE PARK RESTROOM ROOF REPLACEMENT PWM20-908GS '1/ b-1-IL • .1-L ~ ,. This agreement is made on the ---=oL:;;....___.. _____ day of f/C.,-WQ.U( -<' , 2019, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Commercial & Industrial Roofing Co, Inc, a California corporation whose principal place of business is 9239 Olive Drive, Spring Valley, CA 91977 (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. Magee Park Restroom Roof Replacement Page 1 of 10 City Attorney Approved 1/25/2019 PWM20-908GS FALSE Ct.AtMS. 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 disre.g_ar:d Qf th_e. truth Qr faJsJty of th.e. infQrmatiQn. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.02@, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. -Contractor -hefeby ackoowledges Utat the fifing--of a false daim may stJbtect the -Con-tractor 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 a that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor b n actor from participating in contract bidding. Signature: Print Name: REQU1RED lNSURANCE. The successful contractor shall prov,ae to the c,ty of Caf'lsoaa, 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 RriQr tQ the. start of work .. Th.e. minim.um limits_ Qf liability insurnnce. are. to be. pJae.e.d with CalifQrnia 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 tflsttraoce -Commissioners (NAtC} tatest -quaf°tefly-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 11m1t for each person on account of one acc1dent 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 coveraQe 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 giveft to the-C+ty prior to stteh canceUation-. 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• COMPENSATlON AND EMPLOYER'S LIABILfiY. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation wilt not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. · BUS1NESS UCENSE. The Contractor ana all subcontraclors are requTrea to have ana maintaTn a valid City of Carlsbad Business License for the duration of the contract. Magee Park Restroom Roof Replacement Page 2 of10 City Attorney Approved 1/25/2019 PWM20-908GS tNDEMNITY. The Contractor shatl assume the defense of, pay alt 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 allegea failure of Contractor to comply wlth 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 negJige.nc.e. Qr willful mi&.c.Qnduc.l Qf lh.e. City. The. expe.ns_e.s_ Qf deJe.n.S.e. include. all C.QS.lS. 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 resoftttioo of any -dis:ptttes between-the :parties arisfng ottt of th-is agreement -is San Diego Cottn-ty, 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 (3()) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Ill Ill Ill If/ lll Ill Ill Commercial & Industrial Roofing Co, Inc. (name of Contractor) 542724 (Contractor's license number) C39 -Roofing 9/30/2020 (license class. and exp. date) 1000001851 (DIR registration number) 6/30/2020 {DIR r-egistration -exp. date) Magee Park Restroom Roof Replacement Page 3 of 10 9239 Olive Drive (street address) Spring Valley, CA 91977 (city/state/zip) 619-465-3737 (telephone no.) 619-465-8578 (fax no.) dean@ciroofing.com {e-mail addr-ess) City Attorney Approved 1/25/2019 PWM20-908GS 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 COMMERCIAL & INDUSTRIAL ROOFING C0,1 By· (sign here) CITY OF CARLSBAD, a municipal corporation of the State of California P>ARfly 1:U~N0URJ ~rnca-1:rlwarsu~ (print name/title) Paz Go Works, ~wi~fJi~u~ utJosln{ HEB:z-1 oTI5x \J. ~-15ru.a}r(<JJ (print name itle) • .. -I If required by City, proper notarial acknowledgment of execution by Contractor must be attached . .!L§. 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: Magee Park Restroom Roof Replacement Page 4 of 10 City Attorney Approved 1/25/2019 PWM20-908GS 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 portfon, 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 Exoiration Date Contract l\\DN£ Total% Subcontracted: __ O.>IC...f~...,._ __ _ The Contractor must perform no less than fifty percent (50%) of the work with its own forces Magee Park Restroom Roof Replacement Page 5 of 10 City Attorney Approved 1/25/2019 PWM20-908GS EXHtBtTB Magee Park Restroom Roof Replacement Contractor to provide all tools, materials and labor to remove and replace existing roofing, skylights and flashings at the Magee Park Restroom building located at 258 Beech Ave., Carlsbad CA, 92008. ScQp_e_ Qf Work shall e_Qnsls.t Qf all ite.ms r:ne.ntiQne.d in the. e_Qntrae_tQr's. p.rQpQs.al da..te.d Ma..re_h 2.8., 2.Q19. a..nd in accordance with the Technical Scope of work as attached to this document in this Exhibit "B." TECHNICAL SCOPE OF WORK City of Carlsbad -Magee Park Restroom Roof Replacement 258 Beech Ave. Carlsbad, CA 92008 Technical Scope of work • Properly remove and replace existing roofing. skylights and flashings to substrate. • Inspect plywood sheeting and supporting framing and replace on a unit cost basis. New plywood shall be 15/32" 5 ply APA rated. • Wood railing to be removed and re-installed by others. • Install new high temperate peel and stick undertayment and 30 year asphalt dimensional shingles per manufacturer warranty detail requirement, color and style shall be approved by City and shall match adjclcent buildings. • Install new pre-painted edge metal on perimeter edge for shingle roof. color to be approved by City, install skirt metal as needed @ high eave to tuck under flat root perimeter clad metal. color to be approved by City. • Install 1/4" tapered polyisocyanurate roof insulation with 1/4" dexcell FA cover board, slope to perimeter edge. Mechanically fasten both layers of insulation with #1510 fasteners and 3'' plates. • Provide and install new 60 mil TPA membrane system, mechanically fasten per warranty detail requirements with #1510 fasteners and barbed membrane plates. Heat weld all laps per warranty detail requirements. • Install new curb mounted double domed, aluminum framed, venting skylights by Bristolite or equivalent, match existing size. • Install new projection I curb flashings with TPA membrane per warranty detail requirements. • Install new roofed in blocking supports for perimeter decorative rails, blocking shall be 4" x 4" x 6" long at each current rail location. • Install new perimeter TPA clad edge metal with 22 gage wind clips. • New Roof shall be UL Class A Fire Rated. • Provide City with 3 year contractor warranty for labor, 15 year manufacturer material warranty on flat roof section. and 30 year manufacturer warranty for shingle roof section. • Leave job site in a clean and workmanlike manner. Bid price is based on prevailing wage labor rates Magee Park Restroom Roof Replacement Page 6 of10 City Attorney Approved 1/25/2019 PWM20-908GS CJ ': c-0::. I "I 3 '.' !, L MS " ,; o\ c, 1 c..., ~ p ~i u t ') .J (, ~ ;; ,' J ~,. :, T I I :: t i-..1 :., I • :0 t'l ;• / ;• 4. Mnrch 28th 2019 To: City of Carlsbad Attn: Brian Bacardi Re: Magt!e Park Restroom We Arc 13idding: Per Plans & Specs: Addcndas Noted: Tax Included: Pre,•ailing Wage: Roofing Per specifications provided by Tremco No Addcndums Received Yes Y1:s Excluded: Landscape Protection. Rooftop Railings. Interior finish work, Interior protection, Overburden work, Building insulation, Asbestos or lead removal, MEI>, Permits. Testing or inspection. Included: Asphalt Shingle Rooting; Trcmco TPA single ply Roofing; Base Bid: Unit add price / allowances: Plywood replacement: $3.50 per sq. ft. x 200 ~q. ft. Framing: 2" x 8" $20.00 per In. !\. x 40 In. ft. Perimeter Fascia: RS Cedar 2" x 8" primed and painted Total l3id Price Page 1 Magee Park Restroom Roof Replacement Page 7 of 10 $19,!!53.00 $700.00 Add $800.00 Add $4.500.00 Add S25.853.00 City Attorney Approved 1/25/2019 PWM20-908GS JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Roofing Replacement Base Bid $19,853 2 S.F. 200 Plywood replacemeAt $-700 3 L.F. 40 Framing 2" x 8" $800 4 LS 1 Perimeter Fascia RS Cedar 2"x8" Framing 2" x 8" $4,500 5 LS 1 Bond $517 TOTAL* $26,370 --- -- -- *Includes taxes, fees, expenses and all other costs. Magee Park Restroom Roof Replacement Page 8 of 10 City Attorney Approved 1/25/2019 EXHIBtTO LABOR AND MATERIALS BOND PWM20-908GS Bond No. 12177362 Premium: $158.00 WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Commercial & Industrial Roofing Co., Inc., a California corporation (hereinafter designated as the "Principal"), a Contract for: MAGEE PARK RESTROOM ROOF REPLACEMENT in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Oocttments-newoofllefrt-theOffioe-of-the·CltyClel'k-ef·th&Clty-of-Carlsbad and-alt--efwhich-aretncerporated- herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing .of .a-bood, .puwicUr:1g .that.if .P-i:iRCipal-0r -any .of -Its subccmtr.aciGFS· sl:lall-.fail-lc .pay -for .aRY .mater-ials, provisions, provender or other-supplies or teams used.'in, upon or aboutthe performance ofthe work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond wilt pay the same to the extent hereinafter set forth. NOW, THEREFORE, we, c0mmere11:11 & lndusll'la1 Roofing co., me., as Prtnctpa1, '(l'le-ralflafter aes1gl'laled as the "Contractor"), and The Guarantee Company of North America USA as Surety, are held firmly bound unto the City of Carlsbad in the sum of twenty-six thousand three hundred seventy dollars ($28,370), said sum being an amount equal to: One hundred percent (100%) of the total am.QJ.IOi payJlhle. JJ.O.d.er tb.e. .terms. Qf tbe. C.QIUCa.~ Lly the. CitY. Qf C.arlma.d..,and .fQC wbj,m .p_~m~t w:efl and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or asslg_ns, lolntly and severally, firmly by these presents. THE CON0ff¼ON-OF THtS OBL-fGA T¼ON-ts SUCH that ff the Oontractor -or -l'tlslher ~ faff-to pay for any materials, provisions, provender, supplies, or teams used ln, 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 WQFk .OF -labor -per-formed -UAder ~his -Comr-act, -or .fGr .arw .amooms .r-equir.ed .to -be -deducted, -withheld', -and-pakl·overlo the Emptcymel'lt Devetopment C>epartmen·t from H,e wages otemptoyees 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 stlpulates and agrees that no change,. extension of time, alteration or addition ta the terms of ·the Contraot, or to the work to be performed hereunder or the speolfloatlons aooompanylng the eame ehall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addltiol'I' to the-terms -cf the-cemract -or to the work -or to the specifications. Magee Park -Restroom Root Replacement Page9of'10 City Attorney Approved 1/25/2019 PWM20-908GS In ttte event tMt Contfdctor is an ltidiVidUal, ir-is agreed· that ttre deant ot any such contrltetor st1a11 not exonerate the Surety from Its obligations under this bond. · SIGNED AND SEALED, this __ 8th ____ day of October Commercial & lndusbial Roofing Co., Inc. (SEAL) I !~ By:/~ (Signature) ,20_1L (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY -ATTACH ATTORNEY-IN-FACT CE-RT-IF~AT-E} APPROVED AS TO FORM;. CELIA A. BREWER City Attorney By~ Magee Park Restroom Roof Replacement Page 10 of 10 City Attorney Approved 1/25/2019 TNe GUARANTEE® The Guarantee Company of North America USA Southfield, Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and existing under the laws of the Stale of Michigan, having its principal office in Southfield, Michigan, does hereby consti1ute int appoint Kyle Ki'lg, Dale Harshaw, Tara Bacon, Jom R Quain McGriff Insurance Services, Inc. -San Diego its true and lawful attomey(s}--n-fact to exerute, seal int deliver for int on its behal as stely, any and all bonds and undeftakings, contracls of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, reguation, contract or otherwise. The execution of such inslrunent(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fuly and amply, to al intents and pl.lJ>OS8S, as if the same had been duly executed int acknowledged by its regulal1y elected officers at the principal office. The P~r of Attorney is exeruted and may be certified so, and may be revoked, ptr.;uant to and by authority of Article IX, Section 9.03 of the By-laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meet.Jg held on the 31"' day of December, 2003. The President, or any Vice President, acoog with any Secretaly or Assistant Secretary, shall have power int authority: 1. To appoint Attorney(s}-in-fact. and to aulhorize them to execute on behalf of the Company, int attach the Seal of the Company thereto, bonds and l.Wldertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time, any such Attorney-in-fact and revoke the authority given, except as provided below 3. In COi ■ IOC1ion with obligations in favor of the Florida Depar1meft of Transportation only, ii is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of mt.ailed percentages and/or mal estimates on engineering and construct.ion contracts requred by the State of Florida Depertment of Transportation. It is Uy IRierstood that consenting to the Stale of FIOfida Depar1ment of Transportation making paymeot of the final estmate to the Contractor and/or its assignee, shall not relieve this stety rompany of any of its obligations under its bond. 4. In comection with obligeoons in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney-in-Fact camot be modified or revoked unless prior written personal notice of such intent hes been given lo the Commissioner -Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modilicalion or rewcation. Fldler, this Power of Attorney is signed and sealed by facsimile iusuant to resolution of the Board of Directors of the Company adopted at a meeting d(jy called and held on the 6th dey of December 2011, of which the following is a true excerpt RESOLVED that the signalure of any adhorized officer and the seal of the Company may be affixed by facsmile to any PCMer of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signatla"e and seal when so used shall have the same force and effect as though maooally affixed. IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA hes caused ttis instrument to be signed and its corporate seal to be affixed by its authorized officer, this 1st day of March, 2018. STATE OF MICHIGAN County of Oakland THE GUARANTEE COMPANY OF NORTH AMERICA USA Stephen C. Ruschak, Chief Executive Officer Randall Musselman, Secretary On this 1st dey of March, 2018 before me came the individuals who executed the preceding inslrunent, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each 5Vl8ture were duly affixed by 0fder of the Board of Diiectors of said Company. Cynthia A. Takai Notary Public, State of Michigan County of Dale/and My Commitaion &pirn February 27, 2024 At:ti119 in Oolcland c_,,,,, IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Company of North America USA offices the day and year above written. ~~ a. -r~ I, Randal Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and conect copy of a Power of Attorney executed by THE GUARANTEE COMP ANY OF NORTH AMERICA USA, which is stil in ful force and effect IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 8th day of October 2019. Randall Musselman, SeCletary CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CML CODE§ 1189 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 October 8, 2019 before me, Maria Hallmark, Notary Public (insert name and title of the officer) personally appeared __ T_a_r_a_B_a_c_o_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. Signarure (¼h2 £tlL (Seal) All Purpose California Acknowledgement 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 } ss. On __ O~ctc...c.o....c-b~e_r _10~,~2~0~1~9-~, before me, DeEtte Key, Notary Public (Date) (Notary) personally appeared __ B_a_rry......_T_u_r_n_o_u_r ______________ _ who proved to me on the basis of satisfactory evidence to be the person(s) whose name(es) istafe subscribed to the within instrument and acknowledged to me that he/s'9stt'9oy executed the same in hist'9oF./t'9eir authorized capacity(+es), and that by hist'9sF-.'t'9sir signature(s) on the instrument the person(s), or entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PURJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ACORD® CERTIFICATE OF LIABILITY INSURANCE I DA TE (MM/00/YYYY) ~ 10/03/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kiki Velasquez NAME: Webster Insurance Agency, Inc. rJ1~N,.7n ~-"· 619 433-3801 I rie~ Nol: 619 741-1047 8315 La Mesa Blvd. E-MAIL kiki~bsterinsur.com La Mesa, CA 91942 ADDRESS: INSURER/SI AFFORDING COVERAGE NAIC# License #: OM08728 CM Vantane Sneclaltv Insurance Comnanv 15872 INSURER A: INSURED INSURERS: FIRST MERCURY INSURANCE CO. 10657 COMMERCIAL & INDUSTRIAL ROOFING CO., INC Barry Tumou1 INSURERC: CALIFORNIA INSURANCE COMPANY 38865 9239 Olive Drive INSURERO: WESTCHESTER SURPLUS LINES INS CO 10172 Spring Valley, CA 91977 INSURERE: HARTFORD FIRE INSURANCE 19682 INSURERF: COVERAGES CERTIFICATE NUMBER· 00000000-0 REVISION NUMBER· 1238 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 ~.~.?~ ~.!!.~~ ,;g)ilg~, ,;g)ilg'fvWv, I LTR POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY CMV-PLl-0008043-02 I 05/01/20191 05/01/2020 ' EACH OCCURRENCE ]$ 1000000 ~ □ CLAIMS-MADE [x] OCCUR I DAMAGE I9. RENTED [ , PREMISES Ea occurrence• $ 300 000 f--I MED EXP (Any one person) 1$ Excluded PERSONAL & ADV INJURY $ 1000000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ]$ 2,000 000 Fl POLICY [x] ff& □ LOG PRODUCTS -COMP/OP AGG $ 2 000.000 OTHER: I$ AUTOMOBILE LIABILITY fE~~~~~~~1,5iNGLE LIMIT $ ': ANY AUTO I BODILY INJURY (Per person) ;$ ~ O'M'-IED -I SCHEDULED I BODILY INJURY (Per accident)] $ d AUTOS ONLY ~ AUTOS HIRED NON-O'M'-IED I ;p~~:;c\'~t~AMAGE 1$ AUTOS ONLY ~ AUTOS ONLY ! '$ B UMBRELLA LIAB ~ OCCUR CA-EX-0000083126-01 I 05,01,2019 05/01/2020 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE ;$ 5,000,000 ✓ X OED I I RETENTION$ 0.00 $ C WORKERS COM PENSA 110N 82-882276-01-06 01/01/2019 01/01/2020 · X I ~~f TUTE I I ~~H-I AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE [iJ E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? Y N/A ] EL DISEASE· EA EMPLOYEE $ (Mandatory in NH) 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I EL DISEASE· POLICY LIMIT $ 1,000,000 D POLLU/MOLD $15,000DE G71519405 001 05/01/2019 I 05/01/2020 I EACH CLAIM/POLCY J G 2,000,000 E Equipment Floater 72MSZD5781 ; 05,01,2019 1 05101,2020 I 700,000 / DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) 30 Day Notice of Cancellation/ 10 Day Non Pay to Certificate Holder RE: CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS RESPECTS THE GENERAL LIABLITY PER THE ATTACHED FORMS Workers Comp: 0 deductible CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad/CMWD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN c/o EXIGIS Insurance Compliance Services ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4668 -ECM #35050 New York, NY 10163-4668 AU/{ REPRESENTATIVE - I , ?"\ .,,(./._~,, ., ~ (KMV) © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by KMV on October 03, 2019 at 04:26PM CMV-PLl-0008043-02 POLICY NUMBER: CMV-PLl-0008043-02 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 Oraanlzatlon{s) Locatlon(s) Of Covered 0Deratlons As required by Written Contract Information reQuired to complete this Schedule, if not shown above, will be shown In the Dedarations. A. Section II -Who Is An Insured Is amended to indude as an additional Insured the person(s) or organization(s) shown In the Schedule, but onty 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 lnsured(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 lnsured(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. CG 2010 0413 © Insurance Services Office, Inc., 2012 Page 1 of2 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. Paga 2 of2 © Insurance Services Office, Inc., 2012 CG 2010 0413 Polley Number: CMV-PLl-0008043-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT -ADDITIONAL INSURED -DESIGNATED OPERATIONS AND COMPLETED OPERATIONS WITH A WORKERS COMPENSATION EXCLUSION SCHEDULE AddltJonal lneured: AS REQUIRED BY WRITTEN CONTRACT OperatJona: A. lnformatjon to complete the Schedule, If not 1hown above, will be shown In the Declaratlons. The following ia added to the Who 11 An Insured Section of the Coverage Fonn: B. The person(•) or organizalion(s) shown In the Schedule above ii (are) an insured but only as respects cialma or ·1u1t1• for damages cauMd, In whole or in part, by: 1. Your acta or omi11lon1; or 2. The actt or oml11lon1 of those acting on your behalf. C. llle act, or omilllon1 must: 1. Occur awrJ from premiael you own or rent; and 2. Arise out of "your wor1<" described as Operations in the Schedule above, and includes am or omissions that occur after the earrier of: a. All wot1< to be petformed by or on behalf of the Additional ln1ured(1) haa been completed. <lCher than MrVlce, maintenance or repairs unles• euch wor1< 11 only comprll8d of service, maintenance or repail'I; or PU 51350618 Page 1 of2 Copyright 2018, CM Vantage Specially Insurance Company b. That portion al "your WOfk'' out of wtiich the damages arise has been put to its Intended UM by any peraon or OfVMlzlltlon other than another contractor or aubcontractor -,gaged in perfonnlng operatlona for • principal II a part of the same project. D. The lnsuran~ afforded to such Addltlonal ln.ured only applies to the extent permitted by law. E. If insurance provided to lhe Additional Insured 11 required by a contract °' agreement, the lnlurance afforded to them will not be broader than, nor the limits cl insurance greater than, that which you are required by the contract or agreement to provide for such Additional Insured. F. However, the person(s) or organlzation(a) shown In the Schedule above Is not an insured for any claim or •suit" seeking damages for Injury to your employee or a leased or temporary worker who has insurance avallable by your or your sub-contractor's workers compensation insurance. All other terms and conditions of the policy remain unchanged. PLI 51 35 06 16 Pag•2 of 2 Copyright 2016, CM Vantage Specialty Insurance Company POLICY NUMBER: CMV-PLl-0008043-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT -ADDITIONAL INSURED • PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION SCHEDULE Addltlonal lnsul'9d: AS REQUIRED BYWRlmN CONTRACT A. lnfonnatlon to complete the Schedule, if not ahown above, will be shown in the Declarations. The following is added to the Other lnaurance Condition and supersedes any provision to the contrary: Primary and Noncontributory lnauranc. As re,pects the Additional Insured shown in the Schedule abow, thia insurance Is primary to and wiH not seek contribution from any other insurance available to the Additional Insured, provided that: e. The Additional Insured i1 a Na-nee! Insured under such other in1urance: and C. You have agreed in wrltlng in a contract or agreement that this insurance would be primary and would not seek contribution rrom any other Insurance available to the additional insl.l'ec:S. All other terms and conditions of the policy remain unchanged. PU 52400618 Page 1 of 1 Copyright 2016, CM Vantage Specialty Insurance Company POLICY NUMBER: CMV-PU-0008043-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT -WAIVER OF SUBROGATION SCHEDULE Perwon or organization(•,: AS REQUIRED BY WRITTEN CONTRACT Information to complete the Schedule, if not 1hown above, wiU be ahown in the Declarations. Anything to the contrary in the policy notwithatandlng, we waive any right of recowry for payments made under this insurance (commonly known as right of subrogation) against any party designated in the Schedule to whom the Insured has given a written releaH of liability prior to a claim or .. suit", but only to the extent of such written release. All other terms and condition• of the policy remain unchanged. PEL 57 00 06 16 Page 1 of 1 Copyright 2018, CM Vantage Specialty Insurance Company POLICY NUMBER: COMMERCIAL GENERAL UABtUTY CG 2503 Olot CMV-PLl-0008043-02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endonlement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE O..lgnated Construction Pro~•): AS REQUIRED BY WRITTEN CONTRACT Information reaulred to comDlete this Schedule. If not shov,,n above will be shown in the Declarations. A. For all sums which the insured bEl<:Ol'Yla legally obligated to pay as damages caused by ''occurrences" under Section I -Coverage A, and for all medical expenaes cauied by accidents under Section I -Coverage c. which can be attributed only to ongoing operations at a single designated construction Proiect shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each detignated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Oetlgnated Construction Project General Aggregate Limit la the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily Injury" or "property damage" included in the "producta- completed operations hazard", and for medical expenses under Coverage C regardless of the number of: L lnaw-edl; b. Claims made or "suits" brought; or c. P~l"SQns or Qrianizationa making claims or bnnglng ·sutta . 3. Any payments made under Coverage A for damages or under Coverage C for medicel expenses shall reduce the Oeaignated Construction Project General Aggregate LlmH tor that designated construction project. Such payments shall not reduce the General Aggregate Limit shown In the Oeciarltionl nor shall they reduce any oth« Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. -4. The limits lhown in the Oeclarationa for Each Occurrence, Damage To PremiSN Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Lmlt shown In the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. CG2503 05 09 C Insurance Seivlcea Office, Inc., 2008 Page 1 of2 O B. For all sums which the insured becomes legally obligated to pay as damagea caused by "occurrences" under Section I -Coverage A, and for all medical expenses caused by accidents under Section I -Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown fn the Schedule above: 1. Any paymentl made under Coverage A for damages or under Coverage C for medical expenlN shall reduoe the amount available under the General Agg119gate limit or the Products-completed Operations Aggregate Limit, whichever is applicable: and 2. Such payments shall not reduce any Designated Construction Project General Aggregate limit. C. When coverage for liability arising out of the "producta-completed operations hazard" is provided, 8"f paymentl for damaget becaUM of "bodily injury" or •property damage" included In the "products-ampleled operations hazard" will reduce the Products-<:omplMed Operations Aggf9g8te Linit, and not reduce the General Aggregate Limit nor the Delignated Construction Project General Aggrwgata Umil. D. If the appicable designated construction project has been abandoned, delayed, or abandoned and then l'Ntarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specificationa or timetables, the project will still be deemed to be the same construction project. E. The proviliona of Section HI -Units Of Insurance not othetwiN modified by this endorsement shall continue to apply a, stipulated. Pao-2 of2 C Insurance SeNic:es Office, Inc., 2008 CG25030509 a WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 01 03 03 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization: (x) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: 3. Premium 2500 The premium charge for this endorsement shall be of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium 5. Advance Premium This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Endorsement Effective 01/01/19 Policy No. 82-882276-01-06 Endorsement No. 8 Insured Commercial & Industrial Roofing Co., Inc. Premium$ 2,500.00 Insurance Company California Insurance Company Countersigned by _____ +/ ... /=-__ f.S-----_________ _ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/24/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. nus CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BF.LOW. 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 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 Naomi Hayashi(96803K7) 948 Industrial Ave Palo Alto INSURED CA 94303-4911 COMMERCIAL & INDUSTRIAL ROOFING CO.,INC 9239 OLIVE DR SPRING VALLEY CA 91977 CONTACT NAME: Naomi Hayashi Insurance Agency -rEi~fci.-~~~:;~_;~37 ·--··· ..... -··]}i:. ~~1:.650-321-4;8~·-· E-MAIL ADDRESS: nhayashi@farmersagent.com ·--.. ······-··-··-··-···-·-·· .. ···-- INSURER(S) AFFORDING COVERAGE NAIC # --------+---- 1 NS URE RA: Truck Insurance Exct:ii!!:IQ,,_e ____ . _____ -1-_2_1_7_0_9_ INSURERB: Farmers Insurance Exchange 21652 INSURER c: Mid Century lnsurance __ C_o_m_,_p_a_n.,_y ________ 2_16_8_7 __ _, INSURERD: INSURERE: INSURERF: ---------------···-······-·•·-•-·---..J.-.-----COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ------·-··---------··------------ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOlWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE 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 LTR TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY ~ ~J CLAIMS.MADE [] OCCUR 1--'-----------~·-·-·····----·--·--···--··------ GEN'L AGGREGATE LIMIT APPLIES PER: OTIIER: AOOTL SUBR INSD WVD POLICY NUMBER POLICY EFF POLICYEXP (MM/OD/YYYY) (MM/OD/YYYY) ~~--1. P.OLICY [J PROJECT □ LOC I--------------+----+----l----·· -··--··-------!-- AUTOMOBILE LIABILITY ~ ANY AUTO ----- C OWNED AUTOS SCHEDULED ONLY AUTOS ··-y 606742381 05/01/2019 05/01/2020 X IIIREDAUlOS X NON-OWNED ONLY AUTOS ONLY --·--·" ........ ---1---<------+-_,_ __ ·--··-·-·-···-···•-_. __ _,_ __ _,_ ____________ ············--·-· -····· ,_ ____ _, ___ _ UMBRELLA LIAB EXCESSUAB OED --OCCUR CLAIMS-MADE I I RETENTION$ .~--~-·-·-----+----+---+------······-··------·-··--·-···-·-------------·-·-----·-··········-··········-·-- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER r-. EXCLUDED? (Mandatory In NH) I ..... _ lfye,;, describe under DESCRIPIION OF OPERATIONS below N/A .... ,. ....... ---·-·-·--·---···"" "" ......... " ...... --·--------·I·---+---+·------ C Pollution Liability 606742381 ....• .-----·-----·-·· -·'-----L-------·---•--""· 05/01/2019 05/01/2020 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Endorsement • (IF APPLICABLE.WILL BE DELIVERED WITH POLICY). 30 Day Notice of Cancellation/ 1 0 Day non Pay to Certificate Holder RE: ALL OPERATIONS ............... ·-·-··---------------····-.--- LIMITS EACH OCCURRENCE $ DAMAGE TO llCNTl::D $ PREMISES (Ea Occurrence) MED EXP (Any one person) $ --------····-. PERSONAL & ADV INJURY $ GENERAi.AGGREGATE $ PRODUCTS -COMP/OP AGG $ $ COMBINED SINGLE LIMIT $ 1,000,0 (la accident) BODILYINJURY(Perperson) $ ------··-----·---+------l BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE ...... --·•---.-~--~ PER STATUTE OTHER E.L. EACH ACCIDENT $ $ E.l. DISEASE· POLICY LIMIT $ $100,00 ~----------------------------.---·····--···------------------------------_J ACORD 25 (2016/03) 31-1769 11-15 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANC WITH THE POLICY PROVISIONS. AUTHORIZED REPR ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD I