HomeMy WebLinkAboutFireblast Global Inc; 2018-05-18; PWL18-136GSRECORDED REQUESTED BY
CITY OF CARLSBAD
AND WHEN RECORDED PLEASE
MAIL TO:
City Clerk
City of Carlsbad
1200 Carlsbad Village Drive
Carlsbad, California 92008
DOC# 2018-0497572
11111111111111111111111111111111 lllll 111111111111111111111111111111111
Dec 03, 2018 01 :48 PM
OFFICIAL RECORDS
Ernest J. Dronenburg, Jr.,
SAN DIEGO COUNTY RECORDER
FEES: $0.00 (SB2 Atkins: $0.00)
PAGES: 1
Space above this line for Recorder's use.
PARCEL NO: 209-050-26-00
NOTICE OF COMPLETION
Notice is hereby given that:
1. The undersigned is owner of the interest or estate stated below in the property hereinafter described.
2. The full name of the undersigned is the 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 June 22, 2018.
6. The name of the contractor for such work or improvement is Fire blast Global, 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. PWL18-136GS, Replacement of Gas
Detection Transmitter (Polytron) at Safety Training Center.
8. The street address of said property is Safety Training Center, 5750 Orion Street, Carlsbad, CA 92010-7201.
CITY O.F CARLSBAD
VERIFICATION OF CITY CLERK
I, the undersigned, say:
I am the City Clerk of the City of Carlsbar:500 Carlsbad Village Driv~ Carlsbad, California, 92008; the
City/Executive Manager of said City on O (), / 5 , 20})[_, accepted the above described
work as completed and ordered that a Notice of Completion be filed.
I declare under penalty of perjury that the foregoing is true and correct.
Executed on Qou' I 5 I 20 /~, at Carlsbad, California.
\'~FCARLSBAD I .
i1/Y1JCJc~ ~1Yl'"211~
~RBARA ENGLESON 0 City Clerk
\\FILES01V\Departments\Publ1c Works\General Serv,ces\Safety Training Center (STC)\2 Budget\2. Contracting\FireBlast Global-Annual Fire Prop PM Services\Contracts\NOC\NOC-
PWL 18-136GS Replace Gas Detection Transmitter (Fireblast) Kennedy.doc
CITY OF CARLSBAD
ACCEPTANCE OF PUBLIC IMPROVEMENTS
COMPLETION OF PUBLIC IMPROVEMENTS
Fireblast Global, Inc., has completed the contract work required for Project No. PWL 18-136GS,
Replacement of Gas Detection Transmitter (Polytron) at Safety Training Center. City forces
have inspected the work and found it to be satisfactory. The work consisted of:
IMPROVEMENTS
(Specify if City or CMWD)
Replacement of Gas Detection Transmitter
(Polytron) at Safety Training Center (City)
VALUE
$3,924.93
CERTIFICATION OF COMPLETION OF IMPROVEMENTS
Engineering ~J\ Date 1
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.
~ Scott Chadwi": City Manager Date
APPROVED AS TO FORM:
CELIA BREWER, City Attorney
\IFILES01V\Departments\Publ1c Works\General Serv,ces\Safety Training Center (STC)\2. Budget\2 Contracting\FireBlast Global-Annual Fire Prop PM
Serv,ces\Contracts\NOC\API PWL 18-136GS Replace Gas Detection Transmitter (Fireblast) Kennedy.doc
PWL18-136GS
CITY OF CARLSBAD
PUBLIC WORKS LETTER OF AGREEMENT
REPLACEMENT OF GAS DETECTION TRANSMITTER (POLYTRON) AT STC
This letter will serve as an agreement between Fireblast Global, Inc., a California corporation (Contractor)
and the City of Carlsbad (City). The Contractor will provide all equipment, material and labor necessary to
replace one (1) Polytron Gas Detection Transmitter at the Safety Training Center located at 5750 Orion St,
Carlsbad, CA 92010, per Exhibit "A", and City specifications, for a sum not to exceed three thousand nine
hundred twenty-four dollars ninety three cents ($3,924.93). This work is to be completed within ten (30)
working days after issuance of a Purchase Order.
ADDITIONAL REQUIREMENTS
1. City of Carlsbad Business License
2. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold
harmless the City, and its agents, ,officers, officials, employees, and volunteers 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 this Contract or work; or from any failure or alleged failure of the
contractor to comply with any applicable law, rules or regulations including those relating to safety and
health; except for loss or damage which was caused solely by the active negligence of the City; and
from any and all claims, loss, damage, injury and liability, howsoever the same may be caused, resulting
directly or indirectly from the nature of the work covered by this Contract, unless the loss or damage
was caused solely by the active negligence of the City. The expenses of defense include all costs and
expenses, including attorney's fees for litigation, arbitration, or other dispute resolution method.
3. Contractor shall furnish policies of general liability insurance, automobile liability insurance and a
combined policy of workers compensation and Employers' Liability in an insurable amount of not less
than one million dollars ($1,000,000) each, unless a lower amount is approved by the Risk Manager or
the City Manager. Said 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. Insurance is 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. Proof of all such insurance shall be given by filing certificates of
insurance with contracting department prior to the signing of the contract by the City.
4. The Contractor shall be aware of and comply with all Federal, State, County and City Statues,
Ordinances and Regulations, including Workers Compensation laws (Division 4 California Labor Code)
and the "Immigration Reform and Control Act of 1986" (8USC, Sections 1101 through 1525), to include
but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and
consultants that are included in this Contract.
5. The Contractor may be subject to civil penalties for the filing of false claims as set forth in the California
False Claims Act, Gc;iver~roent Code sections 12650, et seq., and Carlsbad Municipal Code Sections
3.32.025, et seq. ~IA/~ __ r'-L--__ init -----init
6. The Contractor hereby acknowledges that debarment by another jurisdictioJ:,g_;9unds for the City of
Carlsbad to disqualify the Contractor from participating in contract bidding. lL.~nit ___ init
7. 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.
Replacement of Gas Detection
Transmitter at STC Page 1 of 2 City Attorney Approved 9/27 /16
PWL18-136GS
8. 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 the Section 1770, 1773
and 1773.1 of the California Labor Code. Pursuant to Section 1773.2 of the California Labor code, a
current copy of 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 the
execution of the work covered by this Letter of Agreement. 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.
9. City Contact: Jason Kennedy, 760-931-2236
Contractor Contact: Vern Nash 951-277-8319
CONTRACTOR
FIREBLAST GLOBAL, INC.,
a California corporation
545 Monica Circle
Corona, CA 92880
jgonzalez@fireblast.com
By:
(sign here)
CITY OF CARLSBAD, a municipal corporation of
the State of California
By:
Elaine Lukey / Pu ~ks Director as
authorized by the City Manager
Dated:
(Proper notarial acknowledgment of execution by Contractor must be attached.
Chairman, president or vice-president and secretary, assistant secretary, CFO or assistant treasurer
must sign for corporations. 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
Replacement of Gas Detection
Transmitter at STC Page 2 of 2 City Attorney Approved 9/27 /16
EXHIBIT II A II • FIREBLAST
CLOEP,L
545 Monica Circle
Corona, CA 92880
Phone: (951) 277-8319
Bill To: C000770
Carlsbad Fire Department
Jason Kennedy
1635 Faraday Ave
Carlsba~CA 92008
Item No. Description
40-003425 GAS DETECTOR PIR 7000 PROCESS ADAPTER
SAMPLING
40-005851 GAS DETECTOR POL YTRON 8700 24VDC
Service & Service Exspenses
Terms and Conditions
1. Sales quote good for 90 Days.
Unit
EACH
EACH
EACH
Quantity
2. Excludes taxes, duties, shipping, permits, bonds and special requirements (unless listed as line items above).
PWL 18-136GS
SALES QUOTE
Quote Number:
Quote Date:
SQ001596
2/27/2018
Vern Nash Sales Person
Terms
Page:
Due on Receipt
1
Ship To:
Carlsbad Fire Department
Jason Kennedy
1635 Faraday Ave
Carlsbad, CA 92008
Unit Price
372.93
2,602.00
950.00
Subtotal:
Total:
Total Price
372.93
2,602.00
950,00
3,924.93
3,924.93
All amounts are in US Dollars
3. For fixed facilities, quote excludes thermal lining, infrastructure and electrical/fuel source to facility (unless listed as line item above).
4. Any previous sales quotes are no longer valid.
A~if CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
12/12/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATI()N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EJtTEND 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: ,Jf the certificate holder Is an ADDrTIONAL INSURED, the poUcy(les) must_ have ADDITIONAL INSURED provialons or be endorsed.
If SUBROGATION IS WAIVED, subject to the tenns and conditions of the poDcy, certain pollcles may ~Ire an endorsement A statement on
this certificate does not confer rights to the certificate holder In lleu of such enclorsement(s).
PRODUCER ~~CT Kathleen Panganiban
MIUennlum Corporate Solutlons r,tl,.QN,t <=v+>· (949)857-4500 Ir~ Nol: (949)857-4800
License fl. OL 12555 AOORESS: kpanganlban@mcslns.com
5530 Trabuco Road I AfPOROINO COVERAGE NAJCIII
Irvine CA 92620 INSURERA: Hartford Flre Insurance Company 19682
INSURED INSURERB: Ohio Security Ins Company 24082
Flrablast 451, Inc., OBA: Flf8biast Global IHSURERC: Twin City Fire Insurance Co. 29459
545 Monica Clr INSURERD: Securtty National Ins Company 19879
INSURERE: Axle Surplus Insurance Company 26620
Corona CA 92680-5447 IHSURERF:
COVERAGES CERTIFICATE NUMBER: 17-18AII Lines REVISION NUMBER:
THIS IS TO CERllFY. THAT THE POLICIES OF. INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOT'MTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 'MTH RESPECT TO 'M-IICH THIS
CERTIFlCATE MAY BE ISSUED OR MAY PERTAIN, TiiE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU. TiiE TERMS,
EXCLUSIONS AND CONDmONS OF SUCH POLICIES. LIMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~ .n -· EFF l"'Ut.Jl,;J t=.A.t-' ' TYPE OF IHSURANCE """" IIMID POLICY NUMBER IMI.IIDDIYYYYI LIMITS
X COMIIERCIALGEHERAL LIAl3U.ITY EACH 00::URRENCE s 1,000,000
I CLAIMS-MADE ~ OCCUR =~dYd:" I t:U s 300,000
,--MED EXP (Arn 008 P8™llll $ 10,000,
A 72 CES OF7179 10/01/2017 10/01/2018 PERSONAL & N:N IN.n.JRY $ 1,000,000
--;-Ni..AGGREGATE LIMrf APPLIES PER: GENERALAOOREGATE s 2,000,000
~~o~ ~LOC PROOUCTS • COMP/OP AOO $ 2,000,000
OTI-IER Employee Benefits $ 2,000,000
AUTOYOBILI! LIABlll1Y ~~;::,,r,GLE LIMIT S 1,000,000
X ANYAUTO BODILY INJURY (Per peraon) $
,--ONNED -sa-EDULEO B AUTOSON.Y AUTOS BAS55759061 10/01/2017 10/01/2018 BOO LY INJURY (Per ecadenl) $
~ HIRED ~ NON-OW-JED ~~~~DAMAGE $ AVTOSON.Y AUTOS ONLY : U ninsu rad motorist S 1,000,000
~ UMBRELLA UAB ~ 00::UR EACH 00::U~E" "• S 5,000,000
C EXCESSUAB CLAI~ 72XS ON1271 10/01/2017 10/01/2018 N3GREGATE s 5,000,000 /
DED I . I RETEN'TlON $ $
WORKERS COIIPEHSATION XI s¥rnrrE I I ~Rn-Ahl) EMPLOYERS' LIABILITY Y/N s 1,000,000 D ANY RROPRJETORIPARTNER/EXIVE D N/A S'M:1168456 11/01/2017 11/01/2018 E.L EACH ACCIDENT OFFlCERIMEMBER EXQ.LOED?
(MandatolylnNH), E.L DISEASE -EA EMPLOYEE s 1,000,000
If ya&, desafbe under S 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT
Professional Liability Aggregate Limit $2,000,000 ~ E ENN599755 10/01/2017 10/01/2018 Per Clalm $2,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEIICLES. (ACORD 101, Additional Ramarlal Schadule, may be -IT 1110111 ap11ca la required)
City of Csr18bed, The Cfty, Its offlclaJs, employees end volunteers and 1111 other entities where required by written contract are named as
additional insured with waiver of subrogation es respects General Llablnty per form H GOOO 1 0916 and WC waiver of subrogation applles per
form 'M:040306 attached. 30 days NOC except non-payment/10 days given. [Replaces cert111cate dated 12/7/17]
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF TiiE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TiiE EXPIRATION DATE THEREOF, NOTICE Will. BE DELIVERED IN
City of Car1sbad/CMWD r:Jo EXIGIS Insurance ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box4668 ALITHORIZED REPRESENTATIVE ECM#35050 ~P~~-~J New York NY 10163-4668 I -/
I
~ 1988-2015 ACORD CORPORATION. All rights raserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
The insurance afforded herein for any
subsidiary not named in this Coverage Part
as a named insured does not apply to injury
or damage with respect to which such insured
is also a named insured under another policy
or would be a named insured under such
policy but for its termination or the exhaustion
of its limits of insurance.
3. Newly Acquired Or Fonned Organization
Any organization you newly acquire or form,
other than a partnership, joint venture or limited
liability company, and over which you maintain
financial interest of more than 50% of the voting
stock, will qualify as a Named Insured if there is
no other similar insurance available to that
organization. However:
a. Coverage under this provision is afforded only
until the 180th day after you acquire or form
the organization or the end of the policy
period, whichever is earlier;
b. Coverage A does not apply to "bodily injury"
or "property damage" that occurred before
you acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury" arising out of an offense
committed before you acquired or formed the
organization.
4. Nonowned Watercraft
Wrth respect to watercraft you do not own that is
less than 51 feet long and is not being used to
carry persons for a charge, any person is an
insured while operating such watercraft with your
permission. Any other person or organization
responsible for the conduct of such person is
also an insured, but only with respect to liability
arising out of the operation of the watercraft, and
only if no other insurance of any kind is available
to that person or organization for this liability.
However, no person or organization is an insured
with respect to:
a. "Bodily injury" to a co-"employee" of the
person operating the watercraft; or
b. "Property damage" to property owned by,
rented to, in the charge of or occupied by you
or the employer of any person who is an
insured under this provision.
5. Additional Insureds When Reguired By
Written Contract, Written Agreement Or
Pennit
The following person(s) or organization(s) are an
additional insured when you have agreed, in a
written contract, written agreement or because of
a permit issued by a state or political subdivision,
that such person or organization be added as an
additional insured on your policy, provided the
injury or damage occurs subsequent to the
execution of the contract or agreement.
Page 12 of 21
A person or organization is an additional insured
under this provision only for that period of time
required by the contract or agreement.
However, no such person or organization is an
insured under this provision if such person or
organization is included as an insured by an
endorsement issued by us and made a part of
this Coverage Part.
a. Vendors
Any person(s) or organization(s) (referred to
below as vendor), but only with respect to
"bodily injury" or "property damage" arising
out of "your products" which are distributed or
sold in the regular course of the vendor's
business and only if this Coverage Part
provides coverage for "bodily injury" or
"property damage" included within the
"products-completed operations hazard".
(1) The insurance afforded the vendor is
subject to the following additional
exclusions:
This insurance does not apply to:
(a) "Bodily injury" or "property damage" for
which the vendor is obligated to pay
damages by reason of the assumption
of liability in a contract or agreement.
This exclusion does not apply to
liability for damages that the vendor
would have in the absence of the
contract or agreement;
(b) Any express warranty unauthorized by
you;
(c) Any physical or chemical change in the
product made intentionally by the
vendor;
(d) Repackaging, except when unpacked
solely for the purpose of inspection,
demonstration, testing, or the
substitution of parts under instructions
from the manufacturer, and then
repackaged in the original container;
(e) Any failure to make such inspections,
adjustments, tests or servicing as the
vendor has agreed to make or normally
undertakes to make in the usual
course of business, in connection with
the distribution or sale of the products;
(f) Demonstration, installation, servicing
or repair operations, except such
operations performed at the vendor's
premises in connection with the sale of
the product;
(g) Products which, after distribution or
sale by you, have been labeled or
relabeled or used as a container, part
or ingredient of any other thing or
substance by or for the vendor; or
HG 00 01 0916
(h) "Bodily Injury" or "property damage"
aiislng out of the sol~ negligence of the
vendor for: its own acts or omissions or
those of its employees or anyone else
acting on . its behalf. However, this
exclusion does not apply to: '
(I) The exceptions contained in Sub-
paragraphs (d) or (f); or
(II) .Such l~spectlons, adjustments,
tests or servicing as the vendor has
agreed to make or· nonnally
undertakes to ,make in the usual
course of business, In connection
with the . cHstrlbution or sale of the
products.
(2) This Insurance does not apply to any
Insured person, or organization, . from
whom you have acquired such products,
or ~my Ingredient, part or container,
entering into, accompanying or containing
Sl!ch, products.
b. Lessors Of Equipment
(1) Any person(s) or · organlzation(s) from
whom you I~ase equipment; but only with
respect to their liability for •bocfily ln).Jry",
•property damage" or •personal and
advertising Injury" caused, In whole or In
part, by your maintenance, · operation or
use .of equipment leased to you by such
person(s) or organization(s).
(2) With respect to the insurance afforded to
these addltlonal Insureds this Insurance
does not apply to any •occurrence• which
takes place· afl~r the equlpment lease
expires.
c. · Lessors Of Land Or Premises
Any persoh or organiZatlon from whom you
lease land or premises, but only with respect
to liability, arising ·qut of the ownership,
malnte·nance or use of that part of the land or
premises leas~ to you.
With respect to the insurance afforded these
additional insureds the following additional ·
exclusions apply:
This.Insurance does not apply to:
1. Any 11oc'currence" which takes place after
· you cease to lease that land; or
2. Structural alterations, new construction or
. demolition operations perfonned by or on
behalf of such person or organization.
d. Architects, Engineers Or Surveyors
Any architect, engineer, or surveyor, but only
with respect to· liability for 'bodily injury",
"property damage" or "personal · and
advertising Injury" caused, In whole or in part,
by your · acts or omissions or the acts or
HG 00 01 0916
omissions of those acting on your behalf:·
(1) In connection with your premises; or
(2) In the perfonnance of your ongoing
operations perfonned by you or on your
behalf.
With respect to the Insurance afforded these
addltlonal Insureds, the following addltlonal:
exclusion applies: '
This insurance does not apply to •bocfily
in)Jry", "property damage• or •personal and
advertising Injury" arising out of the rendering
of or the failure to render any professlonal
services by or for you, Including:
1. The preparing, approving, or faiHng to
prepare or approve, maps, shop drawings,
opinions, reports, surveys, field orders,
change orders or drawings and
specifications; or
2. Supervisory, inspection, architectural or
engineering activities.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision, hiring,
employment, training or monitoring of others
by that inl;iured, If the "occurrence" which
·caused the "bodily injury" or •property
damage•, or the offense which caused the
"personal and advertising injury", involved the
rendering , pf or the failure to render any
prof0l;isional services by or for you.
e. Permits Issued By State Or Political
Subdlvlslon·s
Any state or political subdivislon, but only with
respect to operations performed by you or on
your behalf for which the state or political
subdivision has Issued a pennlt.
With respect to ~he Insurance afforded these
additional Insureds, this Insurance does not
apply to:
(1) •socfily injury", •property damage" or
•personal and advertising injury" arising
out of operations perfonned for the state
or munlclpallty; or
(2) •soolly injury" or
Included within the
operations hazard".
f. Any Other Parfy
"property damage"
"products-completed
I
Any other person or organization who Is not
an additional Insured under Paragraphs a.
through e. above, but only with respect to
liability for •bodily ln).Jry", "property damage"
or npersonal and advertising injury'' caused, In
whole or In part, by your acts or omissions or
the acts or omissions of those acting on your
behalf:
(1) In the perfonnance of your ongoing
operations;
Page 13 of 21
(2) In connection with your premJses owned
by or rented to you; or
(3) In connectlQn with "your wor1c" and
included within the "products-completed
operations hazard", but only If
(a) The written contract or agreement
requires you to provide such coverage
to such additional insured; and
(b) This Coverage Part provides coverage
for "bodily injury" or "property damage"
Included within 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
addltlonal 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, this Insurance does
not apply to:
"Bodily ln)JI)'", •property damage" or
"personal and advertising injul)'" arising out of
the rendering of, or the failure to render, any
professional architectural, engineering or
surveying services, Including:
(1) The preparing, approving, or faffing to
prepare or approve, maps, shop drawings,
opinions, reports, surveys, field orders,
change orders or drawings and
specifications; or
(2) Supervisory, inspection, architectural or
engineering activities.
This exclusion applies even If the claims
against any Insured allege negligence or
other wrongdoing in the supervision, hiring,
employment, training or monitoring of others
by that insured, if the "occurrence" which
caused the "bodily Injury" or "property
damage", or the offense which caused the
•personal and advertising Injury", Involved the
rendering of or the failure to render any
professional services by or for you.
The limits of insurance that apply to additional
Insureds Is described in Section Ill -Limits Of
Insurance.
How this Insurance applies when other Insurance
Is available to the additional Insured is described
In the other Insurance Condition In Section IV -
Commercial General Liability Conditions.
Page 14 of 21
No person or organization Is ~n Insured with respect
to the conduct of any current or past partnership,
joint venture or limited llabllity company that is not
shown as a Named lnsu~ ln'the Declarations.
SECTION Ill -LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insurance · shown In the
Declarations and the rules below fix the most we
will pay regardless of the number of: .··
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organlµtions making claims or
bringing "suits".
2. General Aggregate Limit
The General Aggregate Limit Is the most we will
pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except
damages because of "bocmy Injury" or
"property damage" Included lff the "products-
completed operations hazard"; and
c. Damages under Coverage B.
3. Products-Completed Operations Aggregate
Limit · ·
The Products-Complet~d Operations Aggregate
Limit is the most we wlll pay under Coverage A
for damages because of "bodily Injury" and
"property damage" Included in .the "products-
cor:npleted operations hazard".
4. Personal And Advertising Injury Limit
Subject. to 2. above, the Personal and
Advertising Injury Limit is the. most we will pay
under Coverage B for the sum of all damages
because of all "personal and advertising ln).lry"
sustained by any one person or organization.
5. Each Occurrence Llmit------
Subject to 2. or 3. above, whichever applies, the
Each Occurrence Limit is the most we will pay for
the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of all ~bodily injury" and "property
damage" arising out of any.one "occurrence".
6. Damage To Premises Rented To You Limit
Subject to 6. above, the Damage To Premises
Rented To You Limit is the most we will pay
under Coverage A for damages because of
"property damage" to· any one .premises, while
rented to you, or In the case of damag'e by fire,
lightning or expk;)slon, while rented to you or
temporarily occupied by you with permission of
the owner. '
HG 00 01 0916
In the case of damage by fire, lightning or
exploslon, the Damage to Premises Rented To
You Limit applies to all damage proximately
caused by the same event, whether such
damage results from fire, lightning or explosion
or any combination of these.
7. Medical Expense Umit
Subject to 6. above, the Medical Expense Limit is
the most we will pay under Coverage C for all
medical expenses because of "bodily ln)Jry''
sustained by any one person.
8. How Limits Apply To Additional Insureds
If you· have agreed In a wrttten contract or wrttten
agre~ment that another person or organization
be added as an additional Insured on your policy,
the most we will pay on behalf 9f such additional
Insured is the lesser of:
a. The llmlts of insurance specified in the wrttten
contract or written aweement; or
b. The Limits of Insurance · shown · in , 'the
Declarations.
Such amount shall be a part of and not In
addition to Limits of Insurance. shown In the
Declarations and descrl.bed in this Section.
The Limits of Insurance ·of this Coverage Part apply
separately .to each consecutive annual period and to
any remaining period of less than 12 months,·
starting with the beginning of the policy period
shown in the Declarations, unless the policy period
is extended after Issuance for an additional period of
less than 12 months. In that case, the addltlonal
period will be deemed part of the last preceding
period for purposes of determining the Limits of
Insurance.
SECTION IV COMMERCIAL GENERAL
LIABILITY CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the insured or .of the
insured's estate will not relleve us of our
obligations under this Coverage Part.
2. Duties In The Event Of Occurrence, Offense,
Claim Or Suit
a. Notice Of Occurrence Or Offense
You or any additional insured must see to It
that we are notified as soon as practicable of
an "occurrence" or an offense which may
result In a claim. To the extent possible,
notice should Include:
(1) How, when ar:tQ where the "occurrence" or
offense took place;
(2) The· names and addresses of any Injured
persons and witnesses; and
(3) The nature and location of any injury or
-damage ·arising out of the "occurrence" or
offense.
HG 00 01 0916
b. Notice Of Claim
If a claim is made or "suit'' Is brought against
any Insured, you or any additional Insured
must:
(1) Immediately record the specifics of the
claim or "suit" and the date received; and
(2) Notify us as soon as practicable.
You or any additional insured must see to It
that we receive wrltte.n notice of the claim or
"suit" as soon as practicable.
c. As~lstance And Cooperation Of The
Insured
You and any other involved insured must:
(1) Immediately send us copjes of any
demands, nottces, summonses or legal
papers received In connection with the
claim or "suit''; ·
(2) Authorize us to obtain records and other
Information;
(3) Cooperate with us in the Investigation or
settlement of the claim or defense against
the "suit"; and
(4) Assist us, upon our request, in the
enforcement of any right against any person
or organization which may be liable to the
insured because of injury or damage to
which this Insurance may also apply.
d. Obli1;1at1ons At The Insureds Own Cost
No insured will, except at that insured's own
cost, voluntarily make a payment, assume
any obligation, or incur any expense, other
than for first aid, without our consent
e. Additional Insureds Other Insurance
If we cover a claim or "suit" under this
Coverage Part that may also be covered by
other insurance available to an additional
Insured, such addltlonal insured must submit
such claim or "suit" to the other insurer for
defense and indemnity.
However, this provision does not apply to the
extent that you have agreed in a written
contract or written agreement that this
insurance ~ primary and non-contributory
with the additional lnsured's own insurance.
f. Knowledge Of An Occurrence, Offense,
Claim Or Sult
Paragraphs a. and b. apply to you or to any
additional Insured only when such
noccurrence", offense, claim or "suit" is known
to:
(1) You or any additional Insured that Is an
individual;
(2) Any partner, if you or the additional
Insured is a partnership;
Page 15 of 21
(3) Any manager, if you or the additional
insured is a limited liability co mpany;
(4) Any "executive officer'' or insurance
manager, if you or the additional insured is
a corporation ;
(5) Any trustee, if you or the additional
insured is a trust; or
(6) Any elected or appointed official, if you or
the additional insured is a political
subdivision or public entity.
This duty applies separately to you and any
additional insured.
3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us
into a "suit" asking for damages from an
insured; or
b. To sue us on this Coverage Part unless all of
its terms have been fully complied with.
A person or organization may sue us to recover
on an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the
applicable limit of insurance. An agreed
settlement means a settlement and release of
liability signed by us, the insured and the
cla imant or the claimant's legal representative.
4. Other Insurance
If other valid and collectible insurance is
available to the insured for a loss we cover under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when b.
below applies. If other insurance is also
primary, we will share with all that other
insurance by the method described in c.
below.
b. Excess Insurance
This insurance is excess over any of the other
insurance, whether primary, excess,
contingent or on any other basis:
(1) Your Work
That is Fire, Extended Coverage, Builder's
Risk, Installation Risk or similar coverage
for "your work";
(2) Premises Rented To You
That is fire, lightning or explosion
insurance for premises rented to you or
temporarily occupied by you with
permission of the owner;
Page 16 of 21
(3) Tenant Liability
That is insurance purchased by you to
cover your liability as a tenant for
"property damage" to premises rented to
you or temporarily occupied by you with
permission of the owner;
(4) Aircraft, Auto Or Watercraft
If the loss arises out of the maintenance or
use of aircraft, "autos" or watercraft to the
extent not subject to Exclusion g. of
Section I -Coverage A -Bodily Injury And
Property Damage Liability;
(5) Property Damage To Borrowed
Equipment Or Use Of Elevators
If the loss arises out of "property damage"
to borrowed equipment or the use of
elevators to the extent not subject to
Exclusion j. of Section I -Coverage A -
Bodily Injury And Property Damage
Liability;
(6) When You Are Added As An Additional
Insured To Other Insurance
Any other insurance available to you
covering liability for damages arising out
of the premises or operations, or products
and completed operations, for which you
have been added as an additional insured
by that insurance ; or
(7) When You Add Others As An
Additional Insured To This Insurance
Any other insurance available to an
additional insured.
However, the following provisions apply to
other insurance available to any person or
organization who is an additional insured
under this coverage part.
(a) Primary Insurance When Required
By Contract
This insurance is primary if you have
agreed in a written contract or written
agreement that this insurance be
primary. If other insurance is also
primary, we will share with all that
other insurance by the method
described in c. below.
(R) Primary And Non-Contributory To
Other Insurance Wilen Required By
Contract
If you have agreed in a written
contract, written agreement, or permit
that this insurance is primary and non-
contributory with the additional
insured's own insurance, this insurance
is primary and we will not seek
contribution from that other insurance.
HG00010916
Paragraphs (a) and (b) do not apply to
other insurance to which the additional
insured has been added as an additional
insured.
When this insurance is excess, we will have
no duty under Coverages A or B to defend
the insured against any "suit" if any other
insurer has a duty to defend the insured
against that "suit". If no other insurer defends,
we will undertake to do so, but we will be
entitled to the insured's rights against all
those other insurers.
When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the
sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-insured
amounts under all that other insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess Insurance provision and was not
bought specifically to apply in excess of the
Limits of Insurance shown in the Declarations
of this Coverage Part.
c. Method Of Sharing
If all of the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach each
insurer contributes equal amounts until it has
paid its applicable limit of insurance or none
of the loss remains, whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under this method, each
insurer's share is based on the ratio of its
applicable limit of insurance to the total
applicable limits of insurance of all insurers.
5. Premium Audit
a. We will compute all premiums for this
Coverage Part in accordance with our rules
and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only.
At the close of each audit period we will
compute the earned premium for that period
and send notice to the first Named Insured.
The due date for audit and retrospective
premiums is the date shown as the due date
on the bill. If the sum of the advance and
audit premiums paid for the policy period is
greater than the earned premium, we will
return the excess to the first Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
HG 00 01 0916
computation, and send us copies at such
times as we may request.
6. Representations
a. When You Accept This Policy
By accepting this policy, you agree:
(1) The statements in the Declarations are
accurate and complete;
(2) Those statements are based upon
representations you made to us ; and
(3) We have issued this policy in reliance
upon your representations.
b. Unintentional Failure To Disclose Hazards
If unintentionally you should fail to disclose all
hazards relating to the conduct of your
business that exist at the inception date of
this Coverage Part, we shall not deny
coverage under this Coverage Part because
of such failure.
7. Separation Of Insureds
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned in
this Coverage Part to the first Named Insured,
this insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
claim is made or "suit" is brought.
8. Transfer Of Rights Of Recovery Against
Otners To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or part
of any payment, including Supplementary
Payments, we have made under this
Coverage Part, those rights are transferred to
us. The insured must do nothing after loss to
impair them. At our request, the insured will
bring "suit" or transfer those rights to us and
help us enforce them.
b. Waiver Of Rights Of Recovery (Waiver Of
Subro9!n!on)
If the insured has waived any rights of
recovery against any person or organization
for all or part of any payment, including
Supplementary Payments, we have made
under this Coverage Part, we also waive that
right, provided the insured waived their rights
of recovery against such person or
organization in a contract, agreement or
permit that was executed prior to the injury or
damage.
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we
will mail or deliver to the first Named Insured
shown in the Declarations written notice of the
Page 17 of 21
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed. 04-84)
WAIVER Of OUR RIGHT To RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA
We have the right To recover our payments from anyone liable For an injury covered by this policy. We will Not enforce our right
against the person Or organization named In the Schedule. (This agreement applies only To the extent that you perfonn work
under a written contract that requires you To obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration Of your employees 1/Vhile engaged In the work
described In the Schedule. ~
The additional premium For this endorsement shall be 5% Of the Caltfomia workers' compensation premium otherwise due on
such remuneration.
Person or. Organization
City of Baytown
Baytown, TX 77521
City of Calsbad/CMWQ rlo EXIGIS Insurance
New York, NY 10163-4668
Schedule
Job Description . ,
Sp~ific waiver per written contract
Specific ·waiver per written contract.·
\
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 pollcy.)
Endorsement Effective 11/1/2017 Policy No. SWC1168456 Endorsement No. 2
Insured Fireblast 451, Inc. (A Corp) Premium$ 76793
Insurance Company Security National Insurance Company
Countersigned bY---------------,-------
WC 0403 06
(Ed.~)