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HomeMy WebLinkAboutKnorr Systems Inc; 2019-10-11; PKRC715Project: PKRC715, SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER Change Order No. 1 CITY OF CARLSBAD CONTRACT CHANGE ORDER NO. 1 PROJECT: PKRC715, SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER CONTRACT NO. PKRC715 ACCOUNT NO. 0014547-7550 CONTRACTOR: Knorr Systems, Inc. ADDRESS: 2221 Standard Avenue Santa Ana, CA 92707 P.O. NO. P138007 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. ........................................................... $4,855.89 TOTAL INCREASE TO CONTRACT COST .............................................. $4855.89 TIME FOR COMPLETION OF ALL WORK UNDER THIS CONTRACT SHALL NOT BE INCREASED AS A RESULT OF THIS CHANGE ORDER. .. Project: PKRC715, SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER Change Order No. 1 RECOMMENDED BY: APPROVED BY: >l>~TE) Tracking#: CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER; CONT. NO. PKRC715 ( "\ This agreement is made on the / / Lh day of b ',' :t-~,,1.,__e 4 , 20.fi_, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Knorr Systems, Inc. whose principal place of business is 2221 Standard Ave., 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: Tracy Stayton (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. SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER CONT. NO. PKRC715 Page 1 of 6 City Attorney Approved 1/25/2019 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 participating in contract bidding. Signature: -i?7 Q> ~ Print Name: :::'2, ~ c,..~ c .. -,-_J K.c \oc.~,,.... + 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-cance!lation 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. 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 SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER CONT. NO. PKRC715 Page 2 of6 City Attorney Approved 1/25/2019 Tracking#: every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within 15 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 20 working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. II II II II II II II Knorr Systems, Inc. (name of Contractor) 562312 (Contractor's license number) C-61/D35 exp date 3/31/2021 (license class. and exp. date) 1000004538 (DIR registration number) 6/30/2022 (DIR registration exp. date) SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER CONT. NO. PKRC715 Page 3 of 6 2221 Standard Avenue (street address) Santa Ana, CA 92707 (city/state/zip) 714-7 54-4044 (telephone no.) 714-754-1405 (fax no.) tima2@knorrsystems.com (e-mail address) City Attorney Approved 1/25/2019 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: -¥,5'\ (sign here) CITY OF CARLSBAD, a municipal corporation of the State of California By: kbto.,.-t , ~J ~w ,£:8-,:..._aj (print name/title) 1 City~ By: (sign here) (print name/title) . 1TTEST: () / . . \ J? /\CY]c✓ /4 0 .i< /at .11(!<-vCAG/ l B~RBARA ENGLESON l~ityClerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !f....2 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 Attor SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER CONT NO. PKRC715 Page 4 of 6 City Attorney Approved 1/25/2019 • KNORR SYSTEMS, INC. Service Supported Distribution'" A P~YCORE" Company October 31, 2017 ELECTRONIC MAIL AND FEDERAL EXPRESS City of Carlsbad Parks & Recreation Management Analyst 799 Pine Avenue, Suite 200 Carlsbad, CA 92008 RE: COMPANY SIGNATURE AUTHORIZATION To Whom It May Concern: Effective October 3, 2016, PlayCore Wisconsin, Inc. ("PlayCore") acquired Knorr Systems, Inc. ("KSI"). PlayCore delegates signing authority up to $250,000.00 (Two Hundred Fifty Thousand Dollars and Zero Cents) to the Vice President-General Manager of the local entity. The individual below is authorized to sign for all matters relating to the City of Carlsbad deemed necessary for compliance. Rich Robert, Vice President-General Manager, Knorr Systems, Inc. We appreciate your attention to this matter. Sincero/') / ~I/ Rick Ruegger Senior Vice President and CFO PlayCore Aquatic Equipment, Mechanical Room & Water Treatment Specialists Southllrn ClllifO~ 2221 Stant!WAVln.le Santa Ana, CA 92707 PIIOne: (714) 7~ Fax: (714) 764-1406 Northern Cillirornia: TilxasiOkianoma: 2021 uaPoar.aaCotn. 811".8 4320 Sln>aft Crlve 1.SS AclcSfX>n. TX 76001 LMnnore, CA ~1 Phone: ~2) 732-0306 l'hor.e: lU26} .273-0722 Fax: (972) 732-0306 Fax: (926} 273-0726 KNORR SYSTEMS UNANIMOUS WRITTEN CONSENT IN LIEU OF MEETING OF THE BOARD OF DIRECTORS September 29, 2017 THE UNDERSIGNED, being all of the members of the board of directors (the "Board") of Knorr Systems, Inc., a California corporation (the "Company"), hereby unanimously consent in writing to the taking of the following actions and the adoption of the following resolutions without a meeting in accordance with the procedures established in Section 307 of the California Corporations Code, such actions and resolutions to have the same force and effect as though duly taken and adopted at a meeting of the Board of the Company duly called and legally held. APPOINTMENT OF NEW OFFICERS RESOLVED, that each of the following persons is elected to the office of the Company set forth opposite his name below, to serve in accordance with the bylaws of the Company and at the discretion of the Board until his removal by the Board or until a successor shall have been duly elected and shall have qualified: Roger Posacki -President RESOLVED, that after giving effect to the foregoing, the following persons are confinned as being the officers of the Company elected to the office of the Company set forth opposite his name below: Chief Executive Officer and President Chief Financial Officer and Secretar GENERAL AUTHORITY RESOLVED, that the officers of the Company be, and each of them hereby is, authorized and empowered, in the name and on behalf of the Company, to take any action (including, without limitation, the payment of expenses) and to execute (by manual or facsimile signature) and deliver all such further documents, contracts, letters, agreements, instruments, drafts, receipts or other writings that such officer or officers may in their sole discretion deem necessary, appropriate or desirable to carry out, comply with and effectuate the purposes of the foregoing resolutions and the transactions contemplated thereby and that the authority of such officers to execute and deliver any of such documents and instruments, including without limitation any modification, extension or expansion, and to take any such other action, shall be conclusively evidenced by their execution and delivery thereof or their taking thereof; and it is further 23842427.1.BUSINESS RESOLVED, that in connection with the transactions contemplated in the foregoing resolutions, the officers of the Company and counsel for the Company be, and each of them hereby is, authorized in the name and on behalf of the Company, to make any filings with any governmental agency necessary, appropriate or desirable in order to carry out fully the intent and accomplish the purposes of the foregoing resolutions, and such filings shall be conclusive evidence that the same are authorized hereby, and that any and all such filings heretofore or hereafter made by such officer or counsel for the Company within the terms of these resolutions be, and they hereby are, adopted, affirmed, approved and ratified in all respects as the official filing of the Company; and it is further RESOLVED, that all actions previously taken by any officer, employee or agent of the Company in connection with or related to the matters set forth in or reasonably contemplated or implied by the foregoing resolutions be, and each of them hereby is, adopted, ratified, confirmed and approved in all respects as the acts and deeds of the Company; and it is further RESOLVED, that in connection with the transactions contemplated by the preceding resolutions, the officers of the Company are, and each of them hereby is, authorized in the name and on behalf of the Company, to certify any more formal or detailed resolutions as such officer may deem necessary, appropriate or desirable to effectuate the intent of the foregoing resolutions; and that thereupon such resolutions shall be deemed adopted as and for the resolutions of the Board as if set forth at length herein. [Remainder of Page Left Intentionally Blank} 2 23842427.1.BUSINESS IN WITNESS WHEREOF, the undersigned have executed this Unanimous Written Consent of the Board of Directors, in one or more counterparts, as of the date first written above. Rick Ruegger Mark Burgess [Written Consent of the Board of Knorr Systems, Inc. (Appointing Officers)] IN WITNESS WHEREOF, the undersigned have executed this Unanimous Written Consent of the Board of Directors, in one or more counterpa1ts, as of the date first written above. Roger Posacki b- Rick.Jl'luegger Mark Burgess [Written Consent of the Board of Knorr Systems, Inc. {Appointing Officers)) IN WITNESS WHEREOF, the undersigned have executed this Unanimous Written Consent of the Board of Directors, in one or more counterparts, as of the date first written above. Roger Posacki Rick Ruegger [Written Consent of the Board of Knorr Systems, Inc. (Appointing Officers)] 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 be Subcontracted Total% Subcontracted: ______ _ SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER CONT. NO. PKRC715 Page 5 of6 DIR Registration No. License No., % of Classification & Total Expiration Date Contract City Attorney Approved 1/25/2019 EXHIBIT B SCOPE OF WORK Tracking#: Knorr Systems, Inc. will install a new jet booster pump and circulation pump for the spa at Alga Norte Aquatic Center. ITSM< ""II .. DESCRIPTION PRICE 11 IJ ,ii,•• NO. 1 Jet Booster Pump: $5,664.00 CMK-50, 5 hP Circulation Pump with hair and lint pot, coated cast iron foot, flanged connections: 6" suction, 4" discharge, medium head (200-208v, 3PH) 2 Circulation Pump: $5,798.00 CMK-75, 7.5 hP Circulation Pump with hair and lint pot, coated cast iron foot, flanged connections: 6" suction, 4" discharge, medium head (200-208v, 3PH) 3 Installation Materials $100.00 4 Installation: $3,640.00 • Isolate existing C-Series pumps • Remove and dispose of existing hydrotherapy spa circulation and jet booster pumps, motors, impellers and seals • Install new 7.5 horsepower jet booster pump and new 5 horsepower circulation pump in the same location as previous pumps • Reconnect existing piping with new flange gaskets • Connect existing electrical WHIPs to new motors • Startup pumps • Test and verify supply voltage and motor amperage draw 5 Sales tax (8.25%) $953.87 6 Estimated Freight $888.20 TOTAL $17,044.07 Agreement amount shall not exceed $17,044.07 SPA PUMP REPAIR AT ALGA NORTE AQUATIC CENTER CONT. NO. PKRC715 Page 6 of 6 City Attorney Approved 1/25/2019 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 08/05/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1.,vNTACT NAME: Marsh USA, Inc. I FAX --PHONE Two Alliance Cen(er IA/ro fl.In Cu4o\, IA/C Nol: 3560 Lenox Road, Suite 2400 E-MAIL Atlan(a, GA 30326 ADDRESS: ------------ Attn: Atlanta.CertRequest@marsh.com I Fax: 212-948-4321 INSURER(S) AFFORDING COVERAGE I NAIC# CN102326389-CAS.-GAUWX-19-20 INSURER A : Evanston Insurance Company 35378 INSURED INSURER B: ACE Prooertv And Casualtv Ins Co 20699 Knorr Systems, Inc. 25666 Attention: Maria Townson INSURER c: The Travelers lndemnitv Comoanv of America 2221 S. Standard Ave. INSURER D: Travelers Prooertv Casualtv Comoanv Of America 25674 Santa Ana, CA 92707 19445 INSURER E: National Union Fire Ins Co. of Pittsburqh PA INSURER F : The Charter Oak Fire Insurance Co. 25615 COVERAGES CERTIFICATE NUMBER: A TL-004733402-14 REVISION NUMBER: 3 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 ·-----~--POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ,.,en '""n POLICY NUMBER IMM/DD/YYYYI IMM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY MKL V2PBC000367 08/01/2019 08/01/2020 EACH OCCURRENCE $ 2,000,000 ~ :J CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED PREMISES !Ea occurrence) $ 100,000 X SIR $50,000 Per 0cc. MED EXP (Any one person) $ EXCLUDED ~ PERSONAL & ADV INJURY $ 2,000,000 ~ 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 AUTOMOBILE LIABILITY T J-CAP-9D897065TIL-19 08/01/2019 08/01/2020 COMBINED SINGLE LIMIT $ 1,000,000 ~ /Ea accident\ X ANY AUTO BODILY INJURY (Per person) , $ -OWNED ~ SCHEDULED -+---------·---BODILY INJURY (Per accident) i $ ·-AUTOS ONLY ~ AUTOS --------HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY /Per accident\ -~ Comp./Coll. Ded.: $1,000 $ lJ X UMBRELLA LIAB M OCCUR XOOG71549501 001 08/01/2019 08/01/2020 EACH OCCURRENCE $ 10,000,000 -EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 / OED [ X [ RETENTION$ 25 000 $ F WORKERS COMPENSATION UB-2N106953-19-51-R 08/01/2019 08/01/2020 X I ~ffruTE I I OTH- AND EMPLOYERS' LIABILITY ER C YIN UB-2N159031-19-51-K 08/01/2019 08/01/2020 ANYPROPRIETOR/PARTNERIEXECUTIVE 0 E.L EACH ACCIDENT $ 1,000,000 D OFFICER/MEMBER EXCLUDED? NIA 08/01/2019 08/01/2020 (Mandatory In NH) UB-7J602089-19-14-G E.L. DISEASE· EA EMPLOYEE $ 1,000,000 ~~;~~~tffi~ OnFdc{PERATIONS below (See Additional Page.) E.L. DISEASE· POLICY LIMIT $ 1,000,000 E Excess Umbrella BE 015899319 08/01/2019 08/01/2020 Each Occurrence 15,000,000 Aggregate 15,000,000 ✓ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached If more space Is required) RE: All Jobs City of Carlsbad is listed as additional insured in regards to services during each project performed by the Insured, on a primary and non-contributory basis via CG 2010 & CG 2037, where required by written contract. . A Waiver of Subrogation applies in favor of the additional insured on the Workers Compensalion policy where required by written contract. CERTIFICATE HOLDER CANCELLATION City of Carlsbad SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE c/o Parks & Recreation Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 6565 Alicante Road ACCORDANCE WITH THE POLICY PROVISIONS. Carlsbad, CA 92009 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I Manashi Mukherjee ..J',t.o..'V\.Oelu ~ © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD INSURED: PLAYCORE HOLDINGS, INC. EFFECTIVE DATES: 08-01-2019 -08-01-2020 POLICY NUMBER: MKLV2PBC000367 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLE~E 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 Ooerations Blanket as required by written contract As per written contract Information reauired to comolete 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 Of law; and 2. If coverage provided to the additional insura:l is required by a contract or agreement, the insurance afforded to such additional insura:l 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 Page1of2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section 111-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 appliccble Limits of Insurance shown in the Declarations. Page 2of2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 AGENCY CUSTOMER ID: _C'-N-'-1---'0_2-'-32_6_3_8_9 ___________ _ LOC #: Atlanta -~® ACORD ~ ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA, Inc. Knorr Systems, Inc. Attention: Maria Townson POLICY NUMBER 2221 S. Standard Ave. Santa Ana, CA 92707 CARRIER I NAICCODE 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): UB-2N106953-19-51-R (AZ., FL, OR, WI) UB-2N159031-19-51-K (AK AL CO GA IA IL IN KS KY MD Ml MN MO MT NC ND NE NV NY OH OK PA PR SC TN TX UT VA WA WY) UB-7J602089-19-14-G (AZ. CA CO CT FL GA ID IL IN KS MD Ml MN MO MT NC NH NM NV NY OK OR PA SC 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