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HomeMy WebLinkAboutCosco Fire Protection Inc; 2018-05-07; PWM18-124GSCITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FARADAY SERVER ROOM FM200 SYSTEM PWM 18-124GS This agreement is made on the '7 fh--day of _-+....!....1-....:c..:;.~.,__ _____ , 2018, by the City of Carlsbad, California, a municipal corporation, (hereinafter call "City"), and Cosco, a California corporation whose principal place of business is 4990 Greencraig La e, San Diego, CA 92123 (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. Faraday Server Room FM200 System; Cont. No. 4723 Page 1 of 10 City Attorney Approved 9/27/16 PWM 18-124GS 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 subc~nyactor from pa~ipating in contract bidding. Signature: ~"~~/~-/.~~----------- Print Name: Alex tk.rTV1A1CL{ Z 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. Faraday Server Room FM200 System; Cont. No. 4723 Page 2 of 10 City Attorney Approved 9/27 /16 PWM 18-124GS 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 thirty (30) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within forty (40) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Ill /II Ill Ill Cosco Fire Protection, Inc., a California corporation (name of Contractor) 577621 (Contractor's license number) C-10, C-16 9/30/2019 (license class. and exp. date) 1000002305 (DIR registration number) 6/30/2018 (DIR registration exp. date) Faraday Server Room FM200 System; Cont No. 4723 Page 3 of 10 4990 Greencraig Lane (street address) San Diego, CA 92123 (city/state/zip) 858-444-2000 (telephone no.) 858-444-2056 (fax no.) mkeller@coscofire.com (e-mail address) City Attorney Approved 9/27/16 PWM18-124GS 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 COSCO FIRE PROTECTION, INC., a California corporation By: /LI!~ (sign here) tkx Ha[Y)Jy}£ ~ \f al}cs,dU)f (print nae/title) By: CITY OF CARLSBAD, a municipal corporation of the State of California By: Elaine Lukey lie Works Director as authoriz by the City Manager c;==~ f?J~'r ~ \lW,iftta~~~y:cr/SJc;cftl,Ylj 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 Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY:~ Deputy City Attorney Faraday Server Room FM200 System; Cont. No. 4723 Page 4 of 10 City Attorney Approved 9/27/16 PWM 18-124GS 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 \-.\ l.-?\...( l:;,, Total% Subcontracted: The Contractor must perform no less than fifty percent (50%) of the work with its own forces Faraday Server Room FM200 System; Cont. No. 4723 Page 5 of 10 City Attorney Approved 9/27/16 PWM18-124GS EXHIBIT B Faraday Server Room FM200 System Contractor to provide all materials, tools, equipment, design, and installation labor, to add a new Clean Agent fire suppression system in the Faraday Server Room. System will include a nozzle at existing ceiling, piping, and tank with liquid level indicator, Conventional Releasing Panel , Manual Release Pull Station and Abort Station at exit door, Key Maintenance Switch, Photo Smoke Detectors per code, inside and outside Horn/Strobes per code, and provide dry contacts for tie-in to existing Fire Alarm Detection Panel. Additionally: • All work will be performed during normal working hours as one phase. • Installation of system will be performed per NFPA requirements. • Plans, material submittals, and calculations shall be submitted to Carlsbad Fire Department. • Clean Agent system pipe shall be sch. 40 black steel pipe with threaded and grooved fittings. • One door fan test shall be performed to confirm room integrity. • Remove four existing pendant sprinklers and replace with new 286 degree, chrome, standard spray pendent with recessed chrome escutcheon and chrome expansion plate. • Plans, Submittals, Permit fees, & inspections included. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Install FM200 fire suppression system in server room. $38,400 1 LS 1 1.5% for labor & materials bond. *Includes taxes, fees, expenses and all other costs. Faraday Server Room FM200 System; Cont. No. 4723 Page 6 of 10 $576.00 TOTAL* $38,976.00 City Attorney Approved 9/27/16 •••••••• •••••••• • •• •• •• • •••••••• COSCO Fire Protection 4990 Greencraig Lane San Diego, CA, CA 92123 (858) 444-2000 fax: 444-2056 Attn: Brian Bacardi City of Carlsbad Public Works Superintendent City of Carlsbad Server Room 1635 Faraday Ave, Carlsbad, CA 92008 RE: New FM200 System Scope of Work: State License No: C-16-577621 www.coscofire.com Exhibit" B" PWM18-124GS February 23, 2018 • This proposal includes materials, tax, tools, equipment, design, and installation labor, to add a new Clean Agent fire suppression system in Server Room. System will include a nozzle at existing ceiling, piping, and tank with liquid level indicator, Conventional Releasing Panel , Manual Release Pull Station and Abort Station at exit door, Key Maintenance Switch, Photo Smoke Detectors per code, inside and outside Hom/Strobes per code, and provide dry contacts for tie-in to existing Fire Alarm Detection Panel. • All work will be performed during normal working hours as one phase. • Installation of system will be performed per NFP A requirements. • Plans, material submittals, and calculations shall be submitted to Carlsbad Fire Department. • Clean Agent system pipe shall be sch. 40 black steel pipe with threaded and grooved fittings. • One door fan test shall be performed to confirm room integrity. • Remove four existing pendant sprinklers and replace with new 286 degree, chrome, standard spray pendent with recessed chrome escutcheon and chrome expansion plate. • Plans, Submittals, Permit fees, & inspections included. Exclusions: • Working in areas with hazardous material, as defined by OSHA. • Overtime, off-hours work & working during holidays. • Any work associated with fire hose cabinets and extinguishers. • Fire watch, bond, patching walls, fire stopping, or replacing ceiling tiles. • Exhaust / Venting systems. • Reserve FM-200 tanks, dump tests for FM-200 system, or air sampling. • Customer shall provide a dedicated 120vac 20amp circuit w/Breaker Lock for all Equipment. • Plywood backboard at locations as required. • Upgrade/troubleshoot/repairs to existing Fire System. • All Mechanical & Dampers, shunt-trips, duct detectors, control wiring, or conduit to the HVAC. • FM200 protection above suspended ceilings or beneath raised floors (unless noted otherwise). • Sealing and Patching of Holes in existing walls & ceilings for room integrity test. • Installation of nozzles under existing 6" raised floor. Page 7 of 10 Exclusions continued: Exhibit "B" PWM 18-124GS • Modifications to fire sprinkler or fire alarm systems ( other than what is indicated in the scope of work). • Excludes tie-in, programming and cable run to existing building fire alarm. • Any additional equipment & devices due to change in plan design, will be considered a change order. • All Fire stopping material and fire stop penetrations excluded. • Additional requirements per FPE/ AHJ/Owner not noted under this proposal will be subject to a change order. • All raceways & building to building conduits, manholes, poles and all outdoor related work excluded. • Any access doors and installation of access doors excluded. • Cutting, Coring, Painting, Priming, Patching & additional work due to unforeseen conditions are excluded. • 1 Week notice shall be giving to Cosco to schedule a test with the fire marshal. • Bond excluded {ifrequired add 1.5% to price}. Base Bid: 1.5% for Bond: Total Base Bid: $38,400.00 $576.00 $38,976.00 Thank you for the opportunity to provide this quotation. This quote is valid for 60 days and subject to Cosco Fire Protection's Terms and Conditions. Sincerely, Accepted by: ___________ _ Print Name: -------------Mark Keller Project Manager/Sales Title: Date: ------------- Page 8 of 10 Bond No. K13536077 PWM18-124GS EXHIBIT C LABOR ANO MATERIALS BONO WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Cosco Fire Protection, Inc. ,(h ereinafter designated as the "Principal"), a Contract for: FARADAY SERVER ROOM FM200 SYSTEM CONTRACT NO. 4723 in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that If Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE., COSCO FIRE PROTECTION, INC., as Principal, (hereinafter designated as the "Contractor"), and Westchester Fire Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of THIRTY EIGHT THOUSAND NINE HUNDRED SEVENTY SIX Dollars ($38,976), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. Faraday Server Room FM200 System; Cont. No. 4723 Page 9 of 10 City Attorney Approved 9/27/16 PWM 18-124GS In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. n "2._ Yi Executed by CONTRACTOR this -~----_> __ day of -~M?o-.a..,...c_\..,__ ___ , 20 \~. CONTRACTOR: Cosco Fire Protection, Inc. By "' (nz:=:::r (sign here) (print name here) T~~urer ~Sl.C.~tun;?c (title and O ganization of signaory) Executed by SURETY this __ 1_3_th ____ day of ___ A_,p_r_il ________ ,20~. SURETY: Westchester Fire Insurance Company (name of Surety) 436 Walnut Street, PO Box 1000, Philadelphia, PA 19106 (address of Surety) (215) 640-1000 (telepha.ne m~ B Julie Denmap, Attorney-in-Fact ' ,(printed name of Attorney-in-Fact) (attach corporate resolution showing current power of attorney) (Proper notarial acknowledgment of execution by CONTRACTOR and SURETY must be attached.) (President or vice-president and secretary or assistant secretary must sign for corporations. If only one officer signs, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering that officer to bind the corporation.) APPROVED AS TO FORM: CELIA A. BREWER CityAttor~ By:~ Deputy City Attorney Faraday Server Room FM200 System; Cont. No. 4723 Page 10 of 10 City Attorney Approved 9/27/16 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL 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 ) Countyof ~n G,e()u ~. . . . On Ar~~ .;;) 3>, 'Z,ol, before me, \\l'-'\iJ\ D-\(':\~, ~~v~ ~u--6\. <:.., Date Here Insert Name and Tit of the Officer personally appeared ~Q.)<(£.~ v fu Mc::/'\.J.e..~ Name(s) of Signer(s) 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. Place Notary Sea/ Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature SC:,,~~ Y,'-- Signat~Notary Public ----------------OPTIONAL---------------- 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: ____________________________ _ Document Date: ___________________ Number of Pages: _____ _ Signer(s) Other Than Named Above: _______________________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ____________ _ Signer's Name: ____________ _ D Corporate Officer -Title(s): ______ _ D Corporate Officer -Title(s): ______ _ D Partner -D Limited D General D Partner -D Limited D General D Individual D Attorney in Fact D Individual D Attorney in Fact D Trustee D Guardian or Conservator D Trustee D Guardian or Conservator D Other: ______________ _ D Other: _____________ _ Signer Is Representing: _________ _ Signer Is Representing: _________ _ • ©2016 National Notary Association· www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate vcrifirs only the iclentity of the individuill who signed t!ie document to which t11is certificate is ilttilcl1ed. ancl not tlw truthfulness, ilccuracy, or villiclity of that docunwnt. State of California County of l9 YlaQ..~e.-::: } On (}p-7\ 1£, ctDI~ before me, \-kc,\~ G{i'«~ ~\Sn\~~ ~t:LC. Date Here Insert Name and Title of the Officer personally appeared __ ___cet.,.,,,..v....,ia,q....Jc,el2...==-.._;~,_,_,,,~~=""l-''-c-'j~1._.rn,p_._.~------------- Q ~tJme(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person~whose nam~) !§Lare subscribed to the within instrument and acknowledged to me that he/s~ti.ey executed the same in his/Wr'/t~ authorized capacity(~. and that by his/*'1"/t.J;l,e,irsignature~n the instrument the perso~or the entity upon behalf of which the person~cted, executed the instrument. Place Notary Seal and/or Stamp Above 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. OPTIONAL Completing this information con deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _____________ _,,,,'----------------- Signer's Name: o Corporate Officer -Title(s · --cJiC-----7"-'----- o Partner -D Limited D D Individual D Trustee D Other: Signer is Representing: _________ _ 2017 National Notary Association Signer's Name: o Corporate Officer -Title(s): ______ _ o Partner -D Limited o General D Individual o Attorney in Fact o Trustee o Guardian of Conservator o Other: Signer is Representing: _________ _ Ml304-09 (09/17) Powerof Attorney WESTCHESTER FIRE INSURANCE COMPANY Know all men by these presents: That WESTCHESTER FIRE INSURANCE COMPANY, a corporation of the Commonwealth of Pennsylvania pursuant to the following Resolution, adopted by the Board of Directors of the said Company on December 11, 2006, to wit: "RESOLVED, thal the following authoflzations relate 10 the execution, for and on behalf of the Company, of bonds, undertakings, recognizances, contracts and other written commitments of the Company entered into the ordinary course of business ( each a 'Written Commitment"): ( 1) Each or the Chairman, the President and the Vice Presidents of the Company is hereby authonzed to execute any Written Commitment for and on behalf of the Company, under the seal of the Company or otherwise. (2) Each duly appointed attorney-in-fact of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company, under the seal of the Company or otherwise, to the extent that such action is authorized by the grant of powers provided for in such persons written appointment as such attorney-in-fact , (3) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to appoint in writing any person the attorney-in-fact of the Company with full power and author~y to execute, for and on behalf of the Company, under the seal of the Company or otherwise, such Written Commitments of the Company as may be specified In such written appointment, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chairman, the President and Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to delegate in writing any other officer of the Company the authorit) to execute, for and on behalf of the Company, under the Company's seal or otherwise, such Written Commitments of the Company as are specified in such written delegation, which specification may be by general type or ctass of Written Commitments or by speciftcation of one or more particular Written Commitments. (5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, may be affixed by facsimile on such Written Commitment or written appointment or delegation. FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of officers, employees and other persons to act for and on behalf of the Company, and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested. Does hereby nominate, constitute and appoint BRIAN COOK, Drew Brach, Julie Denman alt of the City of GRAND RAPIDS, Michigan. each individually if there be more than one named, its true and lawful attorney-in-fact, to make, execute, seal and deliver on its behalf, and as its act and deed any and all bonds, undertakings, recognizances, contracts and other writings in the nature thereof in penalties not exceeding SEVENTY MILLION DOLLARS & ZERO CENTS ($70,000,000.00) and the execution of such writings in pursuance of these presents shall be as binding upon said Company, as fully and amply as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office, IN WITNESS WHEREOF, the said Stephen M. Haney, Vice-President, has hereunto subscribed his name and affixed the Corporate seal of the said WESTCHESTER FIRE INSURANCE COMPANY this 29 day of November 2017 COMMONWEALTH OF PENNSYLVANIA COUNTY OF PHILADELPHIA ss. WESTCHESTER FIRE INSURANCE COMPANY Stephen M. Haney , Vice President On this 29 day of November, 2017 before me, a Notary Public of the Commonwealth of Pennsylvania in and for the County of Philadelphia came Stephen M. Haney ,Vice-President of the WESTCHESTER FIRE INSURANCE COMPANY to me personally known to be the individual and officer who executed the preceding Instrument, and he acknowledged that he executed the same, and that the seal affixed to the preceding instrument is the corporate seal of said Company; that the said corporate seal and his signature were duly affixed by the authority and direction of the said corporation, and that Resolution, adopted by the Board of Directors of said Company, referred to in the preceding instrument, is now in force. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal at the Cityof Philadelphia the day and year first above written. I, the undersigned Assistant Secretary of the WESTCHESTER FIRE INSURANCE COMPANY, do hereby certify that the original POWER OF ATTORNEY, of which the foregoing is a substantially true and correct copy, is in full force and effect. (l . In witness whereof, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate seal of the Corporation, this &day of f)l'l { 20~. Dawn M Chloros. Assistant Secretary THIS POWER OF ATTORNEY MAY NOT BE USED TO EXECUTE ANY BOND WITH AN INCEPTION DATE AFTER NOVEMBER 29, 2019 . . DocuGard #04546 contains a se~urity_pantO{J_rap_0 blue background, heat-sensitive ink, coin-reactive watermark, and_microtext printing 0/l bqrd/3~- State of County of Ml Kent } ss: On April 13, 2018 , before me, a Notary Public in and for said County and State, residing therein, duly commissioned and sworn, personally appeared Julie Denman known to me to be Attorney-in-Fact of Westchester Fire Insurance Company the corporation described in and that executed the within and foregoing instrument, and known to me to be the person who executed the said instrument in behalf of the said corporation, and he duly acknowledged to me that such corporation executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and year stated in this certificate above. My Commission Expires 7/6/2024 ACORD9 CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 01/16/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pDlicy(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 NAME: MARSH USA INC. PHONE I FAX 125 OTTAWA AVENUE NW /Air "'n "•+I· IA/C Nol: SUITE 400 E-MAIL GRAND RAPIDS, Ml 49503 ADDRESS: INSURER($) AFFORDING COVERAGE NAIC# 5181-MX-GAW-18-19 INSURER A: HDI Global Insurance Company 41343 INSURED INSURER B : Old Republic General Insurance Corp, 24139 Cosco Fire Protection, Inc. 4990 Greencraig Lane INSURER C : N/A N/A San Diego, CA 92123 INSURERD: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: CHl-008586638-11 REVISION NUMBER: 9 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR 1:g)-J%~1 /~g)-J%~1 LTR TYPE OF INSURANCE ,.,-,n un,n POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY GLD1447201 01/01/2018 01/01/2019 EACH OCCURRENCE $ 2,000,000 -D CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence! $ 1,000,000 MED EXP (Any one person) $ 10,000 - PERSONAL & ADV INJURY $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Fl POLICY 0 jr& DLOC PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY A-SCA-923218-09 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT $ 1,000,000 /Ea accident! -X ANY AUTO BODILY INJURY (Per person) $ --OWNED SCHEDULED BODILY INJURY (Per accident) $ -AUTOS ONLY -AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ f--AUTOS ONLY f--AUTOS ONLY /Per accident\ $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ f--EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION A-SDW-92321810 U1/U1/,U 10 01/01/2019 X I ~~fTUTE I I OTH-ER AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE 0 EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) EL DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under EL DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: PWM18-18GS, Stagecoach Backfiow Replacement, 2430 Camino De Los Coch es, Carlsbad CA, COSCO Job No 1 0CD5779 The City of Carlsbad, its officials, employees and volunteers is/are included as additional insured where required by written contract with respect to General Liability. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject lo policy terms and conditions. Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. See attached for Notice of Cancellation endorsement. CERTIFICATE HOLDER CANCELLATION City of Carlsbad/CMWD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Atln: Contract Adminstration THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1635 Faraday Ave ACCORDANCE WITH THE POLICY PROVISIONS. Carlsbad, CA 92008 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I Scott Pell ~-i::t:::,~ © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD OLD REPUBLIC GENERAL INSURANCE CORPORATION EXTENDED NAMED INSURED SCHEDULE Cosco Fire Protection, Inc. Firetrol Protection Systems, Inc. CFP Fire Protection CFP Inc. Fire Call, Inc. Firetrol Protection Systems, Inc. dba Arizona Fire & Security Flamex, Inc. Predomont Sound & Signal, Inc. Minimax Fire Solutions, Inc. MX Holdings US, Inc. Named Insured MX HOLDINGS US, Policy Number A-SCA-923218-09 Policy Period 01/01/2018 to INC. 01/01/2019 Producer's Name: OLD REPUBLIC CONTRACTORS Producer Number: OOQQ007005 AUTHORIZED REPRESENTATIVE Endorsement No. Endorsement Effective Date: INSURANCE AGENCY, INC. DATE Page 1 of 1 000 01/01/2018 OLD REPUBLIC GENERAL INSURANCE CORPORATION EARLY NOTICE OF CANCELLATION PROVIDED BY US THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: BUSINESS AUTO COVERAGE FORM Common Policy Conditions, A. Cancellation, 2. is replaced by the following: 2. We may cancel this policy by mailing to the first Named Insured written notice of cancellation at least: a. TEN ( 10) days before the effective date of cancellation if we cancel for nonpayment of premium: or b. SIXTY (60) days before the effective date of cancellation if we cancel for any other reason. Named Insured MX HOLDINGS US, INC. Policy Number A-SCA-923218-09 Endorsement No. 000 Policy Period 01/01/2018 to 01/01/2019 Endorsement Effective Date: 01/01/2018 Producer's Name: OLD REE'UBLIC CONTRACTORS INSURANCE AGENCY, INC. Producer Number: 7005 AUTHORIZED REPRESENTATIVE DATE CA EN GN 001710 06 Policy Number GLD1447201 ENDORSEMENT HDI Global Insurance Company Named Insured MX HOLDINGS US, INC. Effective Date: 0 1-0 1-18 12:01 A.M., Standard Time Agent No. P02999892 This Endorse,,_rt Changes The Poley. Pluss Read Jt Carefully. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS-COMPLETED OPERATIONS THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF ADDITIONAL INSURED PERSON(S) OR ORGANIZATION(S): ONLY THOSE ENTITIES REQUESTING THIS FORM BY ~ITTEN CONTRACT LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS: THOSE LOCATIONS SPECIFIED IN WRITTEN CONTRACTS INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IF NOT SHOWN ABOVE, WILL BE SHOV\IN IN THE DECLAAATlONS. SECTION II -WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN ADDITIONAL INSURED THE PERSON(S) OR ORGANIZATION(S) SHOW\! IN THE SCHEDULE, BUT ONLY WITH RESPECT TO LIABILITY FOA ''BODILY INJURY" OR flPAOPERTY 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". MAN-GL(01/02) 1..o ~,. a10Y ENDORSEMENT Policy Number GLD1447201 HDI Global Insurance Company Named Insured MX HOLDINGS us, INC. Agent Name Agent No. MARSH USA INC. OF MI (GRAP) P02082030 This Endorsement Changes Ths Polley. Please Read It Carefully. Effective Date: 0 1-0 1 -1 8 12:01 A.M., Standard Time ADDITIONAL INSURED ? OWNERS, LESSEES OR CONTRACTORS? AUTOMATIC STATUS-ONGOING OPERATIONS THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II ? WHO IS AN INSURED JS AMENDED TO INCLUDE AS AN ADDITIONAL INSURED ANY PERSON OR ORGANIZATION FOR \."k!OM YOU ARE PERFORMING OPERATIONS WHEN YOU AND SUCH PERSON OR ORGANIZATION HAVE AGREED IN 'hRmNG IN A CONTRACT OR AGREEMENT THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. SUCH PERSON OR ORGANIZATION IS AN ADDITIONAL INSURED 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. A PERSON'S OR ORGANIZATION'S STATUS AS AN ADDITIONAL INSURED UNDER THIS ENDORSEMENT ENDS WI-IEN YOUR OPERATIONS FOR THAT ADDITIONAL INSURED ARE COMPLETED. B. WITH RESPECT TO THE INSURANCE AFFORDED TO THESE ADDITIONAL INSUREDS, THE FOLLOWING ADDITIONAL EXCLUSIONS APPLY: THIS INSURANCE DOES NOT APPLY TO: 1. "BODILY INJURY", "PROPERTY DAMAGE" OR ''PERSONAL AND ADVERTISING INJURY" ARISING OUT OF THE RENDERING OF, OR THE FAILURE TO RENDER, ANY PROFESSIONAL ARCHITECTURAL, ENGINEERING OR SURVEYING SERVICES, INCLUDING: A. THE PREPARING, APPROVING, OR FAILING TO PREPARE OR APPROVE, MAPS, SHOP DRAWINGS, OPINIONS, REPORTS, SURVEYS, F.IELD ORDERS, CHANGE ORDERS OR DRAWINGS AND SPECIFICATIONS; OR B. SUPERVISORY, INSPECTION, ARCHITECTURAL OR ENGINEERING ACTIVITIES. 2. "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURRING AFTER: A. ALL vVORK, 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 B. THAT PORTION OF 'YOUR WORK" OUT OF WHICH THE MAN-Gl (01/02) 1..c,\O 01 OL( ENDORSEl\JIENT Policy Number GLD1447201 HDI Global Insurance Company Named Insured MX HOLDINGS us, INC. Agent Name Agent No. MARSH USA INC. OF MI {GRAP) P02082030 This Endorserrert Changes The Policy. Please Read It Csmfully. 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. MAN-Gl. (01/02) Effective Date: O 1-o 1-1 8 12:01 A.M., Standard Time POLICY NUMBEA:GLD1447201 COMIIERCIAL GENERAL LIABILITY CG02241093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ rr CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice ___ 9 o __ (If no entry appears above, information required to complete this Schedule will be shown in the Declarations a5 applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided In paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. CG 022410 93 Copyright, Insurance Services Office, Inc., 1992 Page1of1 D ENDORSEMENT Policy Number GLD1447201 HDI Global Insurance Company Named Insured MX HOLDINGS us, INC. Agent Name Agent No. MARSH USA INC. OF MI {GRAP) ?02082030 This Endomemsrt Changes The Policy. Please Read It Carefully. NANED INSURED ENDORSEMENT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS: MX HOLDINGS US, INC. MINIMAX FIRE SOLUTIONS, INC. COSCO FIRE PROTECTION, INC. FLAMEX INC. CFP, INC. MINIMAX CHINA FIRE PROTECTION SYSTEM CO., LIMITED FIRETROL PROTECTION SYSTEMS, INC. CFP FIRE PROTECTION, INC. PIEDMONT SOUND & SIGNAL, INC. Effective Date: 01-01-18 12:01 A.M., Standard Time FlRETROL PROTECTION SYSTEMS, INC. DBA ARIZONA FIRE AND SECURITY KUSTER LLC ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME. MAN-GL (01 / 02) COMIIIERCIAL GENERAL LIABILITY CG20010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies Insurance provl~ed under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Prlnwy And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (2) You have agreed In writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other Insurance available to the additional insured. (1) The additional insured is a NaTted Insured under such other insurance; and CG2001 0413 @ Insurance Services Office, Inc., 2012 Page 1 of 1 OLD REPUBLIC GENERAL INSURANCE CORPORATION WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY CANCELLATION PROVISION THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: Part Six -Conditions, Item D. Cancellation, Number 2, is changed to read: 2. We may cancel this policy. We must mall or deliver to you not less than 60 days advance written notice stating when the cancellation Is to take effect, unless cancellation is for nonpayment of premium, in which event our obligation is mailing not less than 1 O days prior to the effective date of cancellation. Mailing notice to you at your mailing address shown in Item 1 on the Information Page will be sufficient to prove notice. Named Insured MX HOLDINGS US, INC. Policy Number A-SDW-923218-10 Endorsement No. 000 Policy Period 01/01/2018 to Endorsement Effective Date: 01/01/2018 01/01/2019 Producer's Name: OLD REPUBLIC CONTRACTORS INSURANCE AGENCY, INC. Producer Number: 0000007005 AUTHORIZED REPRESENTATIVE WC 99 03 14 (01/07) DATE OLD REPUBLIC GENERAL INSURANCE CORPORATION WORKERS COMPENSATION & EMPLOYERS LIABILITY INSURANCE POLICY EXTENSION OF INFORMATION PAGE · EXTENDED NAME SCHEDULE ACCOUNT NUMBER: CK00392 POLICY NO. A·6DW·928218·10 ENOOR 000 RENEWAL OF A-1DW.923217-0IJ NAMED INSURED AND MAILING ADDRESS AGENCY AND MAILING ADDRESS MX HOLDINGS US, INC. 163 TECHNOLOGY DRIVE SUITE 200 IRVINE, CA 92618 OLD REPUBLIC CONTRACTORS INSURANCE AGENCY, INC. 307 N. MICHIGAN AVE, SUITE 600 CHICAGO, IL 60601·0000 EXTENDED NAMED INSURED This extension includes additional named insureds. ENTITY NO. 2 SEQ. NO. 1 COSCO FIRE PROTECTION, INC. UNEMPLOYMENT NO: ENTITY NO. 3 SEQ. NO. 1 FEIN: FIRETROL PROTECTION SYSTEMS, INC. UNEMPLOYMENT NO: ENTITY NO. 3 SEQ. NO, 2 FEIN: FIRETROL PROTECTION SYSTEMS, INC. OBA ARIZONA FIRE & SECURITY UNEMPLOYMENT NO: ENTITY NO. 4 CFP INC. ENTITY NO. 5 SEQ. NO. 1 SEQ. NO. 1 CFP FIRE PROTECTION, INC. WC 99 05 32 (02/11) 01-04-18 TG FEIN: UNEMPLOYMENT NO: FEIN: UNEMPLOYMENT NO: cjimenez Page l of 2 7006 WORKERS COMPENSATION ANO EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT we oo 0313 (Ed. 4-84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shafl not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule LA $18 BLANKET WHERE REQUIRED BY AN EXECUTED WRITTEN CONTRACT IN ALL STATES WHERE APPLICABLE. This endorsement changes the policy to which it Is attached effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement is issued subsequent to preparation of the policy,) Endorsement Effective 01/01/2018 Policy No. A-SDW-923218-10 Endorsement No. 000 Insured MX HOLDINGS US, INC. Insurance Company OLD REPUBLIC GENERAL INSURANCE CORPORATION WC 000313 (Ed. 4-84} @ 198) National Council on CQmpenutlon lnsuranc11. Premium$ Countersigned by