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Knorr Systems Inc; 2018-06-12; PKRC665
CITY OF CARLSBAD CONTRACT CHANGE ORDER TRANSMITTAL -C/O # 1 Project: PKRC665, Monroe Street Pool Heating System Installation Date Routed: To: Project Manager @ Parks & Recreation Director City Clerk Reasons for changes: Item 1: Technicians discovered an exhaust leak while installing a new heater at Monroe Street Pool. To complete installation , the ventilation system must be repaired . COST ACCOUNTING SUMMARY: Original contract amount $33,780.46 Total amount this C/O $3,478.33 Total amount of pre~ous C/O's $0.00 Total C/O's to date $3,478.33 New Contract Amount $37,258.79 Total C/O's as % of original contract 10.30% Contingency amount encumbered $0.00 Contingency increase I decrease $0.00 Contingency Subtotal $0.00 Total C/O's to date $3,478.33 Contingency balance -$3,478.33 Note: this CCO will be encumbered to the PO once fully executed. / Project: PKRC665, Monroe Street Pool Heating System Installation Change Order No. 1 CITY OF CARLSBAD CONTRACT CHANGE ORDER NO. 1 PROJECT: PKRC665, Monroe Street Pool Heating System Installation CONTRACT NO. PKRC665 ACCOUNT NO. 3707000-9060/47241-9083 CONTRACTOR: Knorr Systems, Inc. ADDRESS: 2221 Standard Ave., Santa Ana, CA 92707 P.O. NO. P135811 The Contractor is directed to make the following changes as described herein. Changes shall include all labor, materials, equipment, contract time extension, and all other goods and services required to implement this change. Payment stated on this change order includes all charges, direct or indirect, arising out of this additional work including charges for field overhead, extended home office overhead, delays, disruptions, cumulative impacts, loss of efficiency, extended equipment costs and overtime premium costs and is expressly agreed between the City and the Contractor to be the complete and final costs hereof. The requirements of the specifications, where pertinent and not in conflict with this change order, shall apply to these changes. Pursuant to the Standard Specifications for Public Works Construction, perform the following: Item 1: Increase to contract cost. ........................................................... $3,478.33 TOTAL INCREASE TO CONTRACT COST .............................................. $3,478.33 TIME FOR COMPLETION OF ALL WORK UNDER THIS CONTRACT SHALL BE INCREASED BY ZERO (0) WORKING DAYS BECAUSE OF THIS CHANGE ORDER. RECOMMENDED BY: APPROVED BY: Project: PKRC665, Monroe Street Pool Heating System Installation Change Order No. 1 ~ CONTRACTOR KNORR SYSTEMS, INC. 2221 Standard Ave., Santa Ana, CA 92707 * (714)754-4044 * FAX (714)754-1405 Date: To: 06/11/18 MIKE PACHECO CITY OF CARLSBAD SWIM COMPLEX 3401 MONROE STREET CARLSBAD.CA 92008 From: TIM ACKERMAN Subject: HEATER TYPE-B VENTING SECTION DESCRIPTION QUOTE NUMBER PWSVQ-1161 TOTAL Labor and INSTALL NEW 14" TYPE B VENT MATERIAL FROM NEW CPN2072 HEATER FLUE TO VERTICAL $3355.03 Materials ROOF PENENTRATION. Subtotal Sales Tax* Estimate This proposal includes labor, testing equipment, and travel to perform stated work. It does not include additional parts or labor if additional work beyond this scope is required. Additional materials and labor will be quoted as applicable. OEM PARTS: Payment Terms: Interest: Freight: Sales Tax: Notes: Terms and Conditions KSI utilizes OEM parts for required repairs/ maintenance Net 30 days from date of invoice, subject to approval of credit. 18% APR is charged on all past due invoices. FOB equipment ship point, see above for for estimated freight charges. *Subject to sales tax on materials only as noted above. Quote represents current pricing and valid until 7/11/2018 $3355.03 $123.30 $3,478.33 Please review this quote for accuracy. If acceptable, please sign and provide a purchase order number, if available, and return via fax at 714-754-1405 or by email at tima2@knorrsystems.com Print Name Date Approved By Purchase Order # Tracking#: CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT MONROE STREET POOL HEATING SYSTEM INSTALLATION; CONT. NO. PKRC665 This agreement is made on the I a ±:b day of ::(}, ,:L n Q_ , 20}"><, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Knorr s;s?ems, Inc. whose principal place of business is 2221 Standard Avenue, Santa Ana, CA 92707 (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: Mike Pacheco (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. MONROE STREET POOL HEATING SYSTEM INSTALLATION CONT. NO. PKRC665 Page 1 of 8 City Attorney Approved 9/27/2016 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 contractor may be prevented from further bidding on public contracts for a period of up to five years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from partic· ating in contract bidding. Signature: ' l C Print Name: Richard Robert 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. MONROE STREET POOL HEATING SYSTEM INSTALLATION CONT. NO. PKRC665 Page 2 of 8 City Attorney Approved 9/27/2016 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 5 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 30 working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. II II II II II II Knorr Systems, Inc. (name of Contractor) 562312 (Contractor's license number) C-61/D35 exp. 3/31/2019 (license class. and exp. date) 1000004538 (DIR registration number) 6/30/2018 (DIR registration exp. date) MONROE STREET POOL HEATING SYSTEM INSTALLATION CONT. NO. PKRC665 Page 3 of 8 2221 Standard Avenue (street address) Santa Ana, CA 92707 (city/state/zip) 714-754-4044 (telephone no.) 714-754-1405 (fax no.) tomb@knorrsystems.com (e-mail address) City Attorney Approved 9/27/2016 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 By: //~~. / (sign here) &otyr fvsac/c;, Ptes,'Je11±+ t£o ( > t name/title} By: --1 (sign here) ~~ cl1cu"l 8ue;:Jer , Cf O (print n /title) CITY OF CARLSBAD, a municipal corporation of the State of Ca ·tornia By: AJ1EST: • \..i).Lmo I, 0 ihtJ.__~ Ir-- BARBARA ENGLESON City Clerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached . .!f....E. 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: MONROE STREET POOL HEATING SYSTEM INSTALLATION CONT. NO. PKRC665 Page 4 of 8 City Attorney Approved 9/27/2016 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 Business Name and Address DIR Registration License No., % of be Subcontracted No. Classification & Total Exoiration Date Contract NONE Total % Subcontracted: ___ 0_% ___ _ The Contractor must perform no less than fifty percent (50%) of the work with its own forces. MONROE STREET POOL HEATING SYSTEM INSTALLATION CONT. NO. PKRC665 Page 5 of 8 City Attorney Approved 9/27/2016 EXHIBIT B SCOPE OF SERVICES Knorr Systems, Inc. will install a new swimming pool heating system at Monroe Street Pool. ITEM DESCRIPTION -Labor and Materials NO. 1 Lochinvar model CPN2072 natural gas swimming pool heating system (2,070,000 Btu per hour input) Includes: • CA code controls • Pump delay with maintenance timer • Pumped bypass (CPVC) and cupro nickel heat exchanger • Factory commissioning and operator training Excludes: • Type B double wall venting material or flue to atmosphere 2 Installation materials 3 Installation labor • Remove and dispose of existing heater • Place new heater in location of existing heater • Install new 2-1/2" isolation butterfly valves • Modify existing gas, electrical, and plumbing to connect with new heater • Connect existing B-vent material to new heater • Perform startup • Verify operation • Provide operator training 4 Sales tax (7.75%) 5 Freight 6 Bond TOTAL Agreement amount shall not exceed $33,780.46 MONROE STREET POOL HEATING SYSTEM INSTALLATION Tracking#: PRICE $23,640.00 $850.00 $6,060.00 $1,897.98 $833.26 $499.22 $33,780.46 CONT. NO. PKRC665 Page 6 of 8 City Attorney Approved 9/27/2016 Tracking#: Bond No. 0216759 EXHIBIT C LABOR AND MATERIALS BOND WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Knorr Systems, Inc. (hereinafter designated as the "Principal"), a Contract for: MONROE STREET POOL HEATING SYSTEM INSTALLATION CONTRACT NO. PKRC665 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, Knorr Systems, Inc., as Principal, (hereinafter designated as the "Contractor"), and Berkley Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of thirty-three thousand seven hundred eighty dollars and forty-six cents ($33,780.46), 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. MONROE STREET POOL HEATING SYSTEM INSTALLATION CONT. NO. PKRC665 Page 7 of 8 City Attorney Approved 9/27/2016 Tracking#: 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. Executed by CONTRACTOR this _..:;.d_Cf.__~ __ _ day of vt'Ja.y ( , 20J.L. CONTRACTOR: Knorr Systems, Inc. £name of Contractor) By 1¼ /~ 8v~jer R. Po .5Ct c Jc.,' (print name here) (sign here) :b'u~ic\. s.'R,u~vf (print name h t:),f. \ \ \t~ Y'i. ~ fi.(\u,\\ ~/ ~ 'x D (title and organization of signatory) Executed by SURETY this 21st day of May 20 18 ' --· SURETY: By: Berkley Insurance Company (name of Surety) 475 Steamboat Rd.; Greenwich, CT 06830 (address of Surety) (203) 542-3800 (telephone number of Surety) Sylvia M. Ogle (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 City Attorney By:~ Deputy City Attorney MONROE STREET POOL HEATING SYSTEM INSTALLATION CONT. NO. PKRC665 Page 8 of 8 City Attorney Approved 9/27/2016 POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON, DELA WARE No. Bl-477k NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. -::: KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMP ANY (the "Company"), a corporation duly ., organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted is .:L. and appointed, and does by these presents make, constitute and appoint: Gary D. Eklund,· D-Ann Kleidosty; Sylvia M. Ogle; .g =Sharon J. Potts,· or Karina Plis of Marsh USA, Inc. of Atlanta, GA its true and lawful Attorney-in-Fact, to sign its name as surety 2 ] only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of 2 ~ Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars ~ ;:; (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected ':J ~ officers of the Company at its principal office in their own proper persons. J; t ~ This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, ..; 6 without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following ., 2resolutions which were duly and validly adopted at a meeting ofthe Board of Directors of the Company held on January 25, 2010: f, ., -'• -':..J :,; ::: i:: '---s ·= ---; ; __, t: " ':..J = _, 6 C: 0.. ·= Cf, -es: "' ;:: ~ .... --::; :., ".J ;, L~ 2 EJ c.. r Cf, :-:: ::'.i ,..,. ·-'...) r- s := ·f, -::: ._, ~J .d. ·-·...; co ~ L 2 '1J ~~ r ., ;::::-~...) _,, ".f. ·;::::; I RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such attorney-in-fact and revoke any power of attorney previously granted; and further RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued. IN WITNESS WHEREOF, the Come.9ny has c used these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this a!-4-cJay of . , _2£'15( . Attest: Berk le (Seal) Executive Vice President & Secretary ~ 1 WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE "BERKLEY" SECURITY PAPER . ., ;, :::; c.. r. STATE OF CONNECTICUT) 2 ;: ) ss: ~ := -~ ~ COUNTY OF FAIRFIELD } <f-- J ~ Sworn to before me, a Notary Public in the State of Connecticut, this~ day of-.;<:J'-INt.MM:A"rt--/-"l--~~- ::? -:: and Jeffrey M. Hafter who arc sworn to me to be the Executive Vice Pre "de t § ~ respectively, of Berkley Insurance Compa~ARIAC. RUNDBAKEN NOTARY PUBLIC MY COMMISSION EXPIRES APRIL 30 2019 ..., " 'CERTIFICATE Z -~ I, the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct Z b and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and that the authority of the ;: -:.; Attorney-in-Fact set forth therein, who executed the bond or undertaking to which this Power of Attorney is attached, is in full force and effect as ~ -s of this date. £J 1 pr-~-~Wf (S"1) G;,on und« my hand and seal of tho Company, th;, 4L day of~ /(Jj....:._____ V~Forte Please verify the authenticity of the instrument attached to this Power by: Toll-Free Telephone: (800) 456-5486; or Electronic Ma ii: BSG I nq ui ry@berkleysurety.com Any written notices, inquiries, claims or demands to the Surety on the bond attached to this Power should be directed to: Berkley Surety 412 Mount Kemble Ave. Suite 310N Morristown, NJ 07960 Attention: Surety Claims Department Or Email: BSGClaim@berkleysurety.com Please include with all communications the bond number and the name of the principal on the bond. Where a claim is being asserted, please set forth generally the basis of the claim. In the case of a payment or performance bond, please also identify the project to which the bond pertains. Berkley Surety is a member company of W. R. Berkley Corporation that underwrites surety business on behalf of Berkley Insurance Company, Berkley Regional Insurance Company and Carolina Casualty Insurance Company. CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 Georgia --~----- County of _F_u_lt_o_n _______ _ On May 21, 2018 } } personally appeared Sylvia M. Ogle, Attorney-in-fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature Karina Plis Karina Pfis ,,_ I NOTARY PUBLIC ru ton Cou ty My Comm n_ • GEORGIA . Expires 03/2012020 (Notary Public Seal) INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) (Tille or description of attached document continued) Number of Pages __ Document Date ___ _ CAPACITY CLAIMED BY THE SIGNER D Individual (s) D Corporate Officer (Title) 0 Partner(s) ~ Attorney-in-Fact D Trustee(s) D Other __________ _ ,J.':: • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date ofnotarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is /ere) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. •:• Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. •:• Indicate title or type of attached document, number of pages and date. •:• Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 k1,u1e.SSce. County of U-<x111; / 4vi } } On 'i/J't @)rt before me, 5~of-/-/.fooke/', )/p/a!'Y. Pub/;~_ (Here insert name and 6tle of ihe officer) personally appeared R'?je/' faSt1ck.; 1 C t:.--0 <f-PMs/cft>"'f- who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of l~iat~~lifornia that the foregoing paragraph is true and correct. .. , .. , ? ........ f./a0',,,, ~ / ..... ··~' f I J •q't .\ \ -. .__ ~ ~ : ·:c· ~A.-} -i~\~~~~ j -~-. .. , ? •• ..-' -:.. '~ .. .. ~ ,, OA:········A. ,, ,, '" CQUl-l '-~ ,, ,,,,, ,,,, S my hand and official seal. V (Notary Public Seal) INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION This form complies with c11rrent California stallltes regarding notary wording and, DESCRIPTION OF THE A TT ACHED DOCUMENT if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law (Title or description of attached document) (Title or description of attached document continued) Number of Pages __ Document Date ___ _ CAPACITY CLAIMED BY THE SIGNER D Individual (s) D Corporate Officer (Title) D Partner(s) D Attorney-in-Fact o Trustee(s) 0 Other _________ _ • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. Jie/she/they;-is !&Fe) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk •:• Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. •:• Indicate title or type of attached document, number of pages and date. •:• Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. STATE OF CALIFORNIA DEPARTl\lIENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority NQ 07382 TIIlS IS TO CERTIFY THAT, Pursuant to the Insurance Code of the State of California, Berkley Insurance Company of law.Jo/ Wilmington, Delaware Delaware , organized unrkr the , subject ta its Article.r of Incorporation or other fundamental organizational documents, is hereby authork.edto transact wit/Jin the State, subject to all provision.f of thi:i Certificate, the following cwses of insurance: Fire, Marina, surety, Disability, Plate Glass, Liability~ Workers' Compensation, Boiler and Machinery, Burglary, Credit, Automobile, Aircraft, and Miscellaneous as such classes are now or may hereafter be defined in the Insurance Law.r of the State of California. THIS CERTIFICATE i.f expressly conditioned upon the holder hereof now and hereafter being in full compliance with all, and not in violation of an.y. of the applicable Im.vs and lawful requirement3 made under authority of the laws of the State of California as long a.r .rw:h la:.v.r or requiremenu an in effect and applicable, and. a.r such laws and. requirementr now are, or may hereaftn" be changed or amended. IN WITNEss WHEREOF. effective a.r of the---=l_.,_O t=h.,___ dayof __ _,.J,..u.._Iy.._ __ _ 2001 • I have herellllta set my hand and CDllSed my official seal ta be affixed tm.f ---=-l.:.Ot""h"'--__ day o/ __ _,J"°u""'l..,y.._ __ _ 2001 By NOTICE: Qualification with the Secretuy of Stale must be :u:compfishcd as required by thi: Califumia CllllJoralions Code promptly after issoana: of this Certificate of Authority. Fnilun: ID do so will bell violalioo of Ins1U311Ce Code Section 701 and will be grounds for revoking this. Ccrtilicalc of Authority pwmmt to thi: convenants made in the application therefor and the conditions cootnined hcxeiD.. !OIIMClr.J ~OSPOQJSl!lt ~ ® I DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 05/18/2018 ~ 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 policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Marsh USA, Inc. PHONE I FAX Two Alliance Center /All"' .... n C~•\, fA/C Nol: 3560 Lenox Road, Suite 2400 E-MAIL Atlanta, GA 30326 ADDRESS: Attn: Atlanta.CertRequest@marsh.com I Fax: 212-948-4321 INSURER/Sl AFFORDING COVERAGE NAIC# 457102-CAS.-GAUWX-17-18 INSURER A: Westchester Sumlus Lines Insurance Co 10172 INSURED INSURER B : National Union Fire Ins Co. of Pittsburah PA 19445 Knorr Systems, Inc. 25658 2221 S. Standard Ave. INSURER c : The Travelers Indemnity Comoanv Santa Ana, CA 92707 INSURER D: Travelers Property Casualty Company Of America 25674 INSURER E : Libertv Sumlus Insurance Com 10725 INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004823069-01 REVISION NUMBER: 1 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 /~~)-J%~, /~~~J%)'M.y, LTR TYPE OF INSURANCE OUQn "n,n POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY G2821800A 001 02/01/2017 08/01/2018 EACH OCCURRENCE $ 2,000,000 -D CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED f--PREMISES /Ea occurrence} $ 100,000 X SIR $50,000 Per 0cc. MED EXP (Any one person) $ EXCLUDED f-- PERSONAL & ADV INJURY $ 2,000,000 f-- GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 Fl 0PRO-DLOC PRODUCTS -COMP/OP AGG $ 4,000,000 POLICY JECT OTHER: POLICY AGGREGATE $ 10,000,000 D I AUTOMOBILE LIABILITY T J-CAP-9D897065TIL-17 08/01/2017 08/01/2018 COMBINED SINGLE LIMIT $ 1,000,000 f--fEa accident\ X ANY AUTO BODILY INJURY (Per person) $ f---OWNED SCHEDULED BODILY INJURY (Per accidenl) $ f--AUTOS ONLY -AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY lPer accident) f--~ Comp./Coll. Ded.: $1,000 $ B X UMBRELLA LIAB M OCCUR BE 027711064 08/01/2017 08/01/2018 EACH OCCURRENCE $ 25,000,000 f-- EXCESS LIAB CLAIMS-MADE AGGREGATE $ 25,000,000 ./ OED I X I RETENTION$ 10 000 $ D WORKERS COMPENSATION TC2NUB-9D90031-4-17 UO/U I/LU 17 08/01/2018 X I ~~fTUTE I I OTH- AND EMPLOYERS' LIABILITY ER C YIN TROUB-9D90032-6-17 08/01/2017 08/01/2018 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? NIA 08/01/2017 08/01/2018 (Mandatory In NH) UB-7J602089-17-14-G E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under (See Additional Page.) DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 E Excess Umbrella 1000054456-07 08/01/2017 08/01/2018 Each Occurrence 25,000,000 I Aggregate 25,000,000 / DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Monroe Street Park Pool City of Carlsbad, its officers, officials, agenls, and employees, are listed as additional insured in regards to services performed by the Insured, on a primary and non-contributory basis, on the General Liability via CG 2010 & CG 2037 and Automobile Liability via CAT 4 37 policies, when required by written contract. A Waiver of Subrogation applies in favor of the additional insureds on the Workers compensation policy, when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Carlsbad SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1635 Faraday Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Carlsbad, CA 92008 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I Manashi Mukherjee ..J'wt.o.'\A-00 ..... ~ © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: _4.:...:5:..:.7.:...:1..:.02=------------------ LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA, Inc. Knorr Systems, Inc. 2221 S. Standard Ave. POLICY NUMBER Santa Ana, CA 92707 CARRIER I NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers' Compensation (Continued): TROUB-9D90032-6-17 (AZ, FL, OR, WI) TC2NUB-9D90031-4-17 (AL CA CO GA IA IL IN KS KY MD Ml MO MT NC NE NV NY OK PA SC TN TX UT) UB-7 J602089-17-14-G (AK AZ CA CO FL ID IL IN KS MD MN MT NC NH NV NY OK OR PA TN TX WV) Page 2 of 2 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURED: RECESS HOLDINGS, INC. -KNORR SYSTEMS, INC. POLICY EFFECTIVE DATES: 02-01-2017 -08-01-2018 INSURER AFFORDING COVERAGE: Westchester Surplus Lines Insurance Co. POLICY NUMBER: G2821800A 001 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Blanket as required by written contract 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 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 0413 © 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 Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not applicable Limits of Insurance Declarations. increase the shown in the Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 INSURED: RECESS HOLDINGS, INC. -KNORR SYSTEMS, INC. INSURER AFFORDING COVERAGE: POLICY EFFECTIVE DATES: 02-01-2017 -08-01-2018 POLICY NUMBER: G2821800A 001 Westchester Surplus Lines Insurance Co. COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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 Oraanization(s) Location And Descriotion Of Comoleted Operations Blanket as required by written contract 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 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. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 ISSUED DATE: 08/09/2017 ACCOUNT NAME: RECESS HOLDINGS, INC.-KNORR SYSTEMS, INC. EFFECTIVE DATE: 08/01/2017 TO 08/01/2018 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE in the BUSINESS AUTO COVERAGE FORM and Paragraph e. in A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE in the MOTOR CARRIER COVERAGE FORM, whichever Coverage Form is part of your policy: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". CA T4 37 02 16 © 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. INSURED: KNORR SYSTEMS, INC. POLICY EFFECTIVE DATES: 08-01-2017-08-01-2018 TRAVELERs'f' ONE TOWER SQUARE HARTFORD CT 06183 INSURER AFFORDING COVERAGE: Travelers Insurance Company WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) POLICY NUMBER: 7J602089-17 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORN~ (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 1. oo % of the California workers' compensation pre- mium. Person or Organization ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Schedule Job Description This endorsement changes the policy to which it is attached and is effective on the date Issued unless otherwise stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective Insured Insurance Company DATE OF ISSUE: 08~30~17 Policy No. Endorsement No. Premium Countersigned by ___________ _ ST ASSIGN: Page 1 of 1