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HomeMy WebLinkAboutMark Beamish Waterproofing Inc; 2017-09-11; PWM18-26GSRECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2017-0602603 111111111111 lllll 11111111111111111111111111111111111111111111111111111 Dec 21, 2017 04:27 PM OFFICIAL RECORDS Ernest J. Dronenburg, Jr., SAN DIEGO COUNTY RECORDER FEES $0.00 PAGES: 1 Space above this line for Recorder's use. PARCEL NO: -Z.\2-\ \o -cl-\ -oo 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 names of the undersigned are City of Carlsbad, a municipal corporation and Carlsbad Municipal Water District (CMWD), 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 October 27, 2017. 6. The name of the contractor for such work or improvement is Mark Beamish Waterproofing, 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. PWM18-26GS, Alga Norte Skate Park Joint Sealing. 8. The street address of said property is 6565 Alicante Road in the City of Carlsbad. VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Carlsbad, 1200 Car~d Village Drive, Carlsba'J California, 92008; the City/Executive Manager of said City on Q G 4 , 20 I , 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 f;JQ C' 1 U2 , 20.12, at Carlsbad, California. ( CJY OF CARLSBAD/CMWD ~ V1/'('{'QJ~z{/c __ zr/,¼~ L BARBARA ENGLESON U'-' 1....__ City Clerk Word\Masters\Forms\Notice of Completion (City) 3/9/98 CITY OF CARLSBAD AND CARLSBAD MUNICIPAL WATER DISTRICT ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Mark Beamish Waterproofing, Inc. has completed the contract work required for PWM18-26GS, Alga Norte Skate Park Joint Sealing. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS VALUE (City Improvements ) Alga Norte Skate Park Joint Sealing $7850 CERTIFICATION OF COMPLETION OF IMPROVEMENTS Engin 1ng Manager '- November 9, 2017 Date CITY MANAGER'S/EXECUTIVE MANAGER'S ACCEPTANCE OF PUBLIC IMPROVEMENTS The construction of the above described contract is deemed complete and hereby accepted. The City Clerk or Secretary to the Board of Directors 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 and Carlsbad Municipal Water District are hereby directed to commence maintaining the above described improvements. Kevin Cr ager I Executive Manager Date APPROVED AS TO FORM: CELIA BREWER, City Attorney By: fg~ Deputy City Attorney C:\Userslpwise\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\01XPFT8WIAPI (Public Works).doc CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT ALGA NORTE SKATE PARK JOINT SEALING PWM18-26GS This agreement is made on the I \ ....\J:l... day of~ ~)-C.sl , , 2017, by the City of Carlsbad, California, a municfpai corporation, (hereinaercalled "City"), and Mark Beamish Waterproofing, Inc., a California corporation whose principal place of business is 9364 Cabot Drive, San Diego, CA 92126 (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: Ron Haugland (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. Alga Norte Skate Park Joint Sealing; Contract No. 4733 Page 1 of 6 City Attorney Approved 9/27/16 PWM18-26GS 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 ors ntr or from participating in contract bidding. Signature: Print Name: 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. Alga Norte Skate Park Joint Sealing; Contract No. 4733 Page 2 of 6 City Attorney Approved 9/27/16 PWM18-26GS 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 Fifteen (15) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within Thirty (30) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. MARK BEAMISH WATERPROOFING, INC., a California corporation Ill Ill Ill Ill Ill Ill Ill (name of Contractor) 650346 (Contractor's license number) C33; C61; D06; D51 7/31/18 (license class. and exp. date) 1000000903 (DIR registration number) 6/30/18 (DIR registration exp. date) Alga Norte Skate Park Joint Sealing; Contract No. 4733 Page 3 of 6 9364 Cabot Drive (street address) San Diego, CA 92126 (city/state/zip) 858-603-6187 (telephone no.) 858-586-04 76 (fax no.) robg@markbeamish.com (e-mail address) City Attorney Approved 9/27/16 PWM18-26GS 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 MARK BEAMISH WATERPROOFING, INC., a California car oration --(sign here) CITY OF CARLSBAD, a municipal corporation of the State of California By: Elaine Lukey / P . bli arks Director as authorized by the City Manager (pnnt name/title) l( W. ~~) By: ~;4here) . . ;J~;lf/tc7..; ~J> : f/Jl ~r c;'frr-'4'7/eJ:;rJ· /(print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached . .!f.._g_ corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY:(/~~ Deputy City Attorney Alga Norte Skate Park Joint Sealing; Contract No. 4733 Page 4 of 6 City Attorney Approved 9/27 /16 PWM18-26GS EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to Business Name and Address DIR Registration License No., %of be Subcontracted No. Classification & Total Expiration Date Contract Total % Subcontracted: ______ _ The Contractor must perform no less than fifty percent (50%) of the work with its own forces. Alga Norte Skate Park Joint Sealing; Contract No. 4733 Page 5 of 6 City Attorney Approved 9/27 /16 PWM18-26GS EXHIBIT "B" Alga Norte Skate Park Joint Sealing Joint Sealing at Alga Norte Skate Park Contractor will provide all labor, equipment and materials necessary to remove all existing caulk, clean joints of all debris, tape joints, install polyurethane elastomeric sealant, tool flat and smooth Sikaflex 2C NS/SL Joint Compound per manufacturers recommendations, clean-up work area. Joint resealing shall occur at all highlighted areas on attached map (Exhibit "C"}, approximately 940 lineal feet. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LF 940 Remove & replace concrete paving expansion joints as $7,850 shown on the attached map (Exhibit "C") at $8.35/LF. TOTAL* $7,850 *Includes taxes, fees, expenses and all other costs. Alga Norte Skate Park Joint Sealing; Contract No. 4733 Page 6 of 6 City Attorney Approved 9/27 /16 ll!f' ......... j up 11 11 ~ !I AS-BUILT CONDITIONS SHOWN i i ~ l g I • I I -I ;p~tf t f 1-!,~ 11!1 ~ii ff r it f ,·1 t h !_ ! I m X ;:!, CT ;::;: 8i;J ~~ ~~ ri:;,.: ACORD• CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYV) ~ 6/8/2017 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 hokier is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the tenns 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 Heu of such endorsement/st PRODUCER CONTACT Veronica Martinez NAME: Alliant Insurance Services, Inc. r.'1i>N,t ~ ~·-213-443-2440 I f1\~ .,_,_ 333 South Hope Street ~~~~ ..... Suite 3750 Los Angeles CA 90071 INSURERISl AFFOROING COVERAGE NAIC# INSURER A, Old Republic Insurance Comoanv 24147 INSURED INSURER B ,Allied World Assurance Co 19489 Mark Beamish Waterproofing INSURER c ,United Specialty Insurance Co. 12537 2980 E. La Jolla St. INSURER D: Anaheim, CA 92806 INSURER E: I\ISURERF: COVERAGES CERTIFICATE NUMBER: 12300 20223 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT\IVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 'M-IICH 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 TYPE OF INSURANCE l,ue~ POUCYEFF POLICY EXP 1.IMITS I TR wvn POI.ICY NUMBER lMMIDDIYYYYI <MM/0D/YYYVI C ~ COMMERCIAL GENERAL 1.IABII.ITY y y BT01658894 913012016 9130/2017 EACH OCCURRENCE $1,000,000 :J CLAIMS-MADE GJ OCCUR DAMAGE TO Rt:N 'CLJ ·- PREMISES /Ea occurTencel $100,000 -MED EXP (Any one per11on) $Excluded PERSONAL & ADV INJURY $1 .000.000 - GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $2,000,000 ~ 0PR0-OLoc PRODUCTS -COMP/OP AGG $2,000,000 POLICY JECT OTHER $ A AUTOMOBILE LIABILITY y y A1CA06851603 9/3012016 9/30/2017 IEa awdenn""'~Lt, LIMI' S1 ,000,000 -X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED -SCHEDULED X AUTOS AUTOS BODIL y INJURY (Per accident) $ X X NON-OWNED PROPERTY DAMAGE s HIRED AUTOS AUTOS (Per accident) -$ B UMBREL.1A LIAB M OCCUR y y 3059694 9/30/2016 9/30/2017 EACH OCCURRENCE S 1,000,000 -X EXCESSLIAB CLAIMS-MADE AGGREGATE $1,000,000 / OED I I RETENTION$ $ A WORKERS COMPENSATION y A1 CW06851603 9/3012016 9/30/2017 X I ~f~TUTE I I OTH-ER AND EMPLOYERS' LIABII.ITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D NIA E L EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E L DISEASE -EA EMPLOYEE $1.000,000 If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT S1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEttlCLES (ACORD 101, Addlllonal Remarh Schedule, may be attached if mon1 ,apace is raquln,dJ Certificate Holder is included as Additional Insured as respects Liability arising out of operations (work) performed by or on behalf of the Named Insured. The insurance provided shall be primary and any other insurance maintained by the Additional Insured is excess and non-contributory. Waiver of Subrogation applies as required by contract. Thirty (30) Days Notice of Cancellation/ Non-Renewal -Ten (10) Days Notice For Non-Payment of Premium. MBW#1730602; Job Description: Alga Norte Pool Deck Sample Only for Anti Slip at 6565 Alicante Road, Carlsbad, CA 92009 (Contract #PWL 17-127GS). The City of Carlsbad, its officials, employees and volunteers are named as additional insured hereunder as respects liability See Attached ... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Carlsbad THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1635 Faraday Avenue ACCORDANCE WITH TliE POLICY PROVISIONS. Carlsbad CA 92008 AUTHORIZED REPRESENTATIVE I d~c,u..£__ © 1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ------------------LO C #: ------- ADDITIONAL REMARKS SCHEDULE Page 1 of AGENCY NAMED INSURED Alliant Insurance Services, Inc. Mark Beamish Waterproofing 2980 E. La Jolla St. POLICY NUMBER Anaheim, CA 92806 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 arising out of activities performed by or on behalf of the named insured. Coverage under this policy shall be primary insurance as respects the City, its officials, employees and volunteers. This policy will not be canceled, materially changed nor the amount of coverage reduced until (30) days after receipt of written notice of cancellation of reduction in coverage by the City Clerk of the City of Carlsbad, California ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BT01658894 / COMMERCIAL GENERAL LIABILITY CG 20 371001 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 SCHEDULE Name of Person or Organization: As Required by Written Contract Location And Description of Completed Operations: Additional Premium: (If no entry appears above, information required to complete thlS endorsement will be shown in the Dectarations as applicable to this endorsement.) Section II -Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule of this endorsement performed for that insured and induded in the ~products-completed operations haz- ard". CG 20 3710 01 © ISO Properties, Inc., 2000 Page 1 of 1 CJ l POLICY NUMBER: BT01658894 COMMERCIAL GENERAL UA8ffJTY CG 20101001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFUU. Y. 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 Person or Organization: As Required by Written Contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section n -Who Is An Insured is amended to indude as an insured the person or organization shown in the Schedule, but only with respect to f. ability arising a.rt of your ongoing operations per- formed for that insured. B. With respect to the insurance afforded to these additiOnal insureds, the following exclusion is added: 2. Exclusions 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 addi- tional insured(s) at the site of the CCJtl- ered 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 contra::tor or subcontractor engaged in perforning operations for a principal as a part of the same project. CG 201010 01 © ISO Properties, Inc., 2000 Page 1 of 1 D POLICY NUMBER: BT01658894 UNITED SPECIAL TY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VEN 051 00 (01/15) PRIMARY AND NON-CONTRIBUTING INSURANCE ENDORSEMENT This endorsement modifies the Conditions provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Any coverage provided to an Additional Insured shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless: 1) a written contract or written agreement specifically requires that this insurance apply on a primary and non-contributory basis; or 2) prior to a loss, you request in writing and we agree that this insurance shall apply on a primary and non-contributory basis. All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. VEN 051 00 (01/15) Page 1 of 1 POLICY NUMBER: BT01658894 UNITED SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VEN 064 00 (01 /15) THIRD PARTY CANCELLATION NOTICE ENDORSEMENT This endorsement modifies the Conditions provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART If we cancel this policy for any reason other than nonpayment of premium, we will mail notification to the persons or organizations shown in the schedule below (according to the number of days listed below) once the Named Insured has been notified. If we cancel this coverage for nonpayment of premium, we will mail a copy of such written notice of cancellation to the name and address below at least 10 days prior to the effective date of such cancellation. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. SCHEDULE Name and Address of Other Person/Organization As required by written contract Number of Days Notice 30 All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. VEN 064 00 (01 /15) Page 1 of 1 POLICY NUMBER: BT01658894 I COMMERCIAL GENERAL LIABILITY CG 240410 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As per written contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV-COMMER- CIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your workft done under a contract with that person or organization and ncluded in the ftproducts-oompleted operations hazardw. This waiver applies only to the person or organization shown in the Schedule above. CG 24 0410 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 a OLD REPUBLIC GENERAL INSURANCE CORPORATION ADDITIONAL INSURED • PRIMARY ANO NON-CONTRIBUTORY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ iT CA~EFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: BUSINESS AUTO COVERAGE FORM With respect 10 coverago provided by lhis endoniement, the provisions or the Coverage Fenn apply unless modified by this endorsement. This endorsement identifies person(s) or organiiation(s) who are •insureds· under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Fonn. This endorsement changes the policy effective on the Inception date of the policy unless another date Is Indicated below. SCHEDULE Name of Person(s) or Organization4•) : WHERE REQUIRED BV WRITTEN CONTRACT. {If no entry appears above, information required to compete this endorsement wil be shown in the Declarations as applicable to the endorsement} Each petSOn or organization shown in the Schedule is an ·1nsurec1· for Liability Coverage, but only to the extent that person or organization qualifies as an "insured• under the Who Is An Insured Provision contained in Section II of the Coverage Form. If the person or organization shown in the schedule qualities as an 'insured' for L/ablllty Coverage, and they have coverage as a first named insured ull<ler another policy, this policy is primary to and non.conlributory with thal other insurance. All other terms. conditions. and exclusions apply. Named Insured MARK BEAMISH WATERPROOFING Pohcy Number A 1 CA06851603 Endorsement No. 000 Policy Period 9/30/2016 -9/30/2017 Endorsement Effecwe Date: 9/30/2016 Producer's Name: OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY, INC:. PrOducer Number: 0000007000 AUTHORIZED REPRESENTATIVE DATE CA EN GN 0044 02 12 Page 1 of 1 POLICY NUMBER: A 1 CA06851603 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM \IVith respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement cflanges the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: MARK BEAMISH WATERPROOFING Endorsement Effective Date: 9'30/2016 SCHEDULE Name(s) Of Person(s) OrOrganization(s): WHERE REQUIRED BY WRITTEN CONTRACT. Information reQuired to comolete this Schedule if not shown above wlll be shown in the Declarations. The Transfer Of Rights or Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogaUon is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04441013 @ Insurance Services Office, Inc., 2011 Page 1 of 1 OLD REPUBLIC GENERAL INSURANCE CORPORATION WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: WORKERS' COMPENSATION ANO EMPLOYERS' LIABILITY INSURANCE We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule AS REQUIRED BY WRITTEN CONTRACT The premium charge for this endorsement is $0.00. Named Insured Mark Beamish Waterproofing, Inc. Policy Number: A1CW06851603 Endorsement No. 000 Policy Period: 09/30/2016 -09/30/2017 Endorsement Effective Date: 09/30/2016 Producer's Name: Old Republic General Insurance Corp. Producer Number: 0000007000 WC 99 03 15 (09/06)