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HomeMy WebLinkAboutCommercial Aquatic Services; 2020-09-10; PKRC20-0723Tracking #: CITY OF CARLSBAD MONROE STREET POOL UNDERWATER LIGHT REBUILD; CONT. NO. PKCR20-0723 This agreement is made on the )0ik day of Sep41)mbe( , 20,79p, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Commercial Aquatic Services whose principal place of business is 1121 N. Hawk Cir., Anaheim, CA 92807(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: Chris Gray (City Project Manager) PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. 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. MONROE STREET POOL UNDERWATER LIGHT REBUILD; CONT. NO. PKCR20-0723 Page 1 of 6 City Attorney Approved 1/22/2020 Tracking #: 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 co actor may be prevented from further bidding on public contracts for a period of up to five years and at .-ba ment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor o s act* m participating in contract bidding. Signature: Print Name: Cha 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. MONROE STREET POOL UNDERWATER LIGHT REBUILD; CONT. NO. PKCR20-0723 Page 2 of 6 City Attorney Approved 1/22/2020 Tracking #: 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 15 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 45 working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Commercial Aquatic Services (name of Contractor) 1045217 1121 N. Hawk Cir. (street address) Anaheim, CA 92807 (Contractor's license number) (city/state/zip) C53 — 10/31/2020 877-794-6227 (license class, and exp. date) (telephone no.) 1000061453 877-794-9329 (DIR registration number) (fax no.) 6/30/2021 chaser©commercialaquatic.com (DIR registration exp. date) (e-mail address) MONROE STREET POOL UNDERWATER LIGHT REBUILD; CO NT. NO. PKCR20-0723 Page 3 of 6 City Attorney Approved 1/22/2020 ATTEST: BARBARA ENGLESON City Clerk Pecial GOrn e 2/ cl Doniel Sutton, ecretary (print me/title) (sign here) CELIA A. BREWER, Cit Attorney BY: 1111100111AyirsE Tracking #: 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 (sign here) Sutton, President CITY OF CARLSBAD, a municipal corporation of the State of California By: Assi-ete ty Manager, Deputy City Manager, or Depa ent Director as Authorized by the City Manager (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, Secretary, President, or Assistant Secretary, Vice-President 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. 1eal APPROVED AS TO FORM: Deputy stant City Attosney, MONROE STREET POOL UNDERWATER LIGHT REBUILD; CONT. NO. PKCR20-0723 Page 4 of 6 City Attorney Approved 1/22/2020 (1) t-*-1 I \ (and (2) 1E2- Name of SigneEs) proved to me on the-basis of satisfactory evidence to be the persor6) who appeared before me. J. B. SWAN Ill Notary Public - California Orange County Commission 4 2250382 Expires Aug 15, 2022 --rt 01\1 ), Signature tgture of Notary Public Seal Place Notaty Seal Above OPTIONAL CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 Ne"..rt!v-Ae-l>x•-•<'-ox" See Attached Document (Notary to cross out lines 1-6 below) El See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) 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 f-,<`\ C- Subscribed and sworn to (or affirmed) before me 71 on this day of L.. , by Date Mo th Year Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: i tt acA20-0 Document Date: 617/2W2-202 Number of Pages: Signer(s) Other Than Named Above: -67- 6, 6, .1V" ©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5910 Tracking #: 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 be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract None Total % Subcontracted: 0.00% MONROE STREET POOL UNDERWATER LIGHT REBUILD; CONT. NO. PKCR20-0723 Page 5 of 6 City Attorney Approved 1/22/2020 Tracking #: EXHIBIT B SCOPE OF SERVICES Underwater Light Fixture Repair and Bulb Replacement Commercial Aquatic Services to: - Shut off pool lights from main control panel and lock out power - Have diver enter water to remove hardware and pull light fixture from their niches - Technician on deck to disassemble lights, removing lens gasket, grid gasket, and bulb - Clean housing and install new bulb, grid gasket, and lens gasket - Secure lid onto housing and have diver reinstall light fixture in the existing niche - Upon completion, exit water and restore power to test light operation Estimate to repair underwater swimming pool lights at Monroe Street Pool. Fixtures are older Hydrel lights that require various repairs. Will pull fixtures to deck and replace gaskets and bulbs as needed. Fixtures that are rusted out will be marked and left in niche due to damaged red brass conduit under the deck. Some fixtures with water will not be serviced, their cost will be removed from quote. Quote based on twenty (20) fixtures total for service. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 Underwater light fixture repair and bulb replacement prevailing wage labor. $8,748.24 TOTAL* $8,748.24 Amount not to exceed $8,748.24. *Includes taxes, fee's, expenses and all other costs. MONROE STREET POOL UNDERWATER LIGHT REBUILD; CONT. NO. PKCR20-0723 Page 6 of 6 City Attorney Approved 1/22/2020 7 0 ACCPRE) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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 Champion Risk & Insurance Services, L.P. 12250 El Camino Real, Ste 375 San Diego CA 92130 CONTACT NAME: PHONE FAX (Nc. No. Eat): 858-369-7900 (A/C, No): 760 496 2816 E-MAIL ADDRESS: certsonly@championrisk.net INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : HDI Specialty Insurance Co 16131 INSURED THEIL-1 The Illini Companies, Inc. dba: commercial aquatic serv. 1121 N. Hawk Circle Anaheim CA 92807 INSURER B: National Union Fire Ins Co PA 19445 INSURER C: Insurance Company of the West 27847 INSURER D: Westchester Surplus Lines INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1673986729 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y . GK20X001168 9/24/2019 9/24/2020 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES JEPRO- CT PER: LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ A AU _ _ _ OMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - x SCHEDULED AUTOS NON-OWNED AUTOS ONLY Y Y GK20X001168 9/24/2019 9/24/2020 COMBINEent)D SINGLE LIMIT (Ea accid $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS-MADE 6E080703734 9/24/2019 9/24/2020 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A VVSD504313601 9/6/2019 9/6/2020 X ISTATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 EL. DISEASE - EA EMPLOYEE $ 1,000,000 EL. DISEASE - POLICY LIMIT $ 1,000,000 D POLLUTION G71543353001 7/1/2019 7/1/2020 Each Occurrence AGGREGATE DEDUCTIBLE 1,000,000 2,000,000 2,500 DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED WITH RESPECTS TO LIABILITY ARISING OUT OF THE NAMED INSUREDS OPERATIONS WHERE REQUIRE BY WRITTEN CONTRACT AND OR AGREEMENT. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY. BLANKET WAIVER OF SUBROGATION APPLIES. CERTIFICATE HOLDER CANCELLATION 30 day notice. 10 day non-payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Proof Of Coverage AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GK20X001168 01 00 CA COMMERCIAL AUTO NI CA Al 2003 (05 14) (Blkt) HDI GLOBAL INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement chan es the policy effective on the inception date of the policy unless another date is indicate Endorsement effective v09/2412019 / Named Insured The Illini Companies, Inc. -- --Cou e signed by (-- , -A, 1 - --- i ... i --"4- (Authorized Representative) WHO IS AN INSURED (under Section II — Liability Coverage, Al-)-is amended to include as an "insured" the person or organization shown in the Schedule with respect to the operation, maintenance, or use of a covered "auto" you own if: 1) You are obligated to add that person or organization, as an additional insured to this policy by: a. an expressed provision of an "insured contract", or written agreement; or b. an expressed condition of a written permit issued to you by a governmental or public authority; and 2) The "bodily injury" or "property damage" is caused by an "accident" which takes place after: a. You executed the "insured contract" or written agreement; or b. The permit has been issued to you. SCHEDULE Name Address Blanket as required by an expressed provision of an "insured contract", or written agreement; or an expressed condition of a written permit issued to you by a governmental or public authority and effective during the policy period as stated on the policy declarations. NI CA AI 2003 (05 14) (Bikt) Page 1 of 1 POLICY NUMBER: GK20X001168 01 00 CA COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 (Blkt) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Blanket as required by written contract and effective Primary Insurance applies: It is agreed that such during the policy period as stated on the policy insurance as is afforded by this policy for the declarations, benefit of the additional insured shown shall be primary insurance, and any other insurance maintained by the additional insured(s) shall be excess and noncontributory as respects any claim, loss or liability allegedly arising out of the operations of the named insured or its subcontractors, provided however that this insurance will not apply to any claim loss or liability which is determined to be solely the result of the additional insured's negligence or solely the additional insured's responsibility. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. Section ll — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or ''personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 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 20 10 04 13 (Blkt) © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 (Blkt) POLICY NUMBER: GK20X001168 01 00 CA COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 (Blkt) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Blanket as required by written contract and effective Primary Insurance applies: It is agreed that such during the policy period as stated on the policy insurance as is afforded by this policy for the benefit declarations. of the additional insured shown shall be primary insurance, and any other insurance maintained by the additional insured(s) shall be excess and noncontributory as respects any claim, loss or liability allegedly arising out of the operations of the named insured or its subcontractors, provided however that this insurance will not apply to any claim loss or liability which is determined to be solely the result of the additional insured's negligence or solely the additional insured's responsibility. This insurance also does not apply to any structure intended to be occupied as a private residence, not including apartments. 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 B. 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. With respect to the insurance afforded to these additional insureds, the following is added to Section III — 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 04 13 (Blkt) @ Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: GK20X001168 01 00 CA COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 (Blkt) 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: Blanket as required by written contract and effective during the policy period as stated on the policy declarations. 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 organ- ization shown in the Schedule above. CG 24 04 05 09 (Blkt) © Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: GK20X001168 01 00 CA COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 (Away) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): This endorsement applies only to your projects away from premises owned by or rented to you. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally obli- gated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project Gen- eral Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated—Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed op- erations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for dam- ages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated con- struction project. Such payments shall not reduce the General Aggregate Limit shown in the Decla- rations nor shall they reduce any other Designat- ed Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. CG 25 03 05 09 (Away) Insurance Services Office, Inc., 2008 Page 1 of 2 B. For all sums which the insured becomes legally obli- gated to pay as damages 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 ongo- ing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A for dam- ages or under Coverage C for medical expenses shall reduce the amount available under the Gen- eral Aggregate Limit or the Products-completed Operations Aggregate Limit, whichever is appli- cable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "prod- ucts-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard" will reduce the Prod- ucts-completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Desig- nated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties de- viate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 (Away) POLICY NUMBER: GK20X001168 01 00 CA COMMERCIAL AUTO CA 04 44 10 13 (AutoBlktWaiver) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: The Illini Companies, Inc. Endorsement Effective Date: 09/24/2019 SCHEDULE Name(s) Of Person(s) Or Organization(s): Blanket where required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 (AutoBlktWaiver) © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: GK20X001168 01 00 CA COMMERCIAL AUTO NI CA Al 2003 (05 14) (B)kt) HDI GLOBAL INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement chan es the oolicv effective on the inception date of the policy unless another date is indicated below. Endorsement effective 09/24/2019 Named Insured The Illini Companies, Inc. Countersigned by (Authorized Representative) WHO IS AN INSURED (under Section ll — Liability Coverage, A.1) is amended to include as an "insured" the person or organization shown in the Schedule with respect to the operation, maintenance, or use of a covered "auto" you own if: 1) You are obligated to add that person or organization, as an additional insured to this policy by: a. an expressed provision of an 'insured contract", or written agreement; or b. an expressed condition of a written permit issued to you by a governmental or public authority; and 2) The "bodily injury" or "property damage" is caused by an "accident" which takes place after: a. You executed the "insured contract" or written agreement; or b. The permit has been issued to you. SCHEDULE Name Address Blanket as required by an expressed provision of an "insured contract", or written agreement; or an expressed condition of a written permit issued to you by a governmental or public authority and effective during the policy period as stated on the policy declarations. NI CA Al 2003 (05 14) (Blkt) Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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). The additional premium for this endorsement shall be 3 % of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization ANY PERSON/ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT Job Description ALL CA OPERATIONS 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 09/06/2019 Policy No. WSD 5 04 313 6 01 Endorsement No. Insured ILLINI COMPANIES INC (THE) Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) INSUR ED Premium $ INCL .