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HomeMy WebLinkAboutNissho of California Inc; 2019-08-29; PKRC714Tracking#: CITY OF CARLSBAD PUBLIC WORKS LETTER OF AGREEMENT DRAINAGE IMPROVEMENTS AT LEO CARRILLO RANCH HISTORIC PARK: CONTRACT PKRC714 This letter will serve as an agreement between Nissho of California, Inc., a corporation (Contractor) and the City of Carlsbad (City). The Contractor will provide all equipment, material and labor necessary to make drainage improvements at Leo Carrillo Ranch Historic Park, per the Contractor's proposal dated August 23, 2019 and City specifications, for a sum not to exceed three thousand, three hundred seventy-seven dollars and seventy-four cents ($3,377.74). This work is to be completed within 45 working days after issuance of a Purchase Order. ADDITIONAL REQUIREMENTS 1. City of Carlsbad Business License 2. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its agents, officers, officials, employees and volunteers, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of this Contract or work; or from any failure or alleged failure of the contractor to comply with any applicable law, rules or regulations including those relating to safety and health; except for loss or damage which was caused solely by the active negligence of the City; and from any and all claims, loss, damage, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by this Contract, unless the loss or damage was caused solely by the active negligence of the City. The expenses of defense include all costs and expenses, including attorney's fees for litigation, arbitration, or other dispute resolution method. 3. Contractor shall furnish policies of general liability insurance, automobile liability insurance and a combined policy of workers compensation and Employers' Liability in an insurable amount of not less than one million dollars ($1,000,000) each, unless a lower amount is approved by the Risk Manager or the City Manager. Said policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Insurance is to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best's Key Rating Guide of at least "A:X''; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Proof of all such insurance shall be given by filing certificates of insurance with contracting department prior to the signing of the contract by the City. 4. The Contractor shall be aware of and comply with all Federal, State, County and City Statues, Ordinances and Regulations, including Workers Compensation laws (Division 4, California Labor Code) and the "Immigration Reform and Control Act of 1986" (8USC, Sections 1101 through 1525), to include but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants that are included in this Contract. 5. The Contractor may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, GoTr:zent Code sec!!9,ns 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. _ ___..., init cJat,lQit 6. The Contractor hereby acknowledges that debarment by another jurisdic~-~ounds for the City of Carlsbad to disqualify the Contractor from participating in contract bidding. · init ~it 7. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. DRAINAGE IMPROVEMENTS AT LEO CARRILLO RANCH HISTORIC PARK PKRC714 --1 --City Attorney Approved 2/29/2016 Tracking#: 8. The general prevailing rate of wages, for each craft or type of worker needed to execute the contract, shall be those as determined by the Director of Industrial Relations pursuant to the Section 1770, 1773 and 1773.1 of the California Labor Code. Pursuant to Section 1773.2 of the California Labor code, a current copy of applicable wage rates is on file in the office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in the execution of the work covered by this Letter of Agreement. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. 9. City Contact: Tim Selke/ 760-434-2857 Contractor Contact: Tom Baird/ 760-727-9719 Nissho of California, Inc. 1902 South Santa Fe Avenue Vista, CA 92083 760-727 -9719 tbaird@nisshoca.com ( (sign here) tUlVJ 2:?aud Vice. prr 5u/€n+- (print name/t tie) By: (sign here) CeC{ko .Dolf~ -Sit.rda~ (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By~✓~ ~ anager or designee Dated: (Proper notarial acknowledgment of execution by Contractor must be attached. Chairman, president or vice-president and secretary, assistant secretary, CFO or assistant treasurer must sign for corporations. Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation.) APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: DRAINAGE IMPROVEMENTS AT LEO CARRILLO RANCH HISTORIC PARK PKRC714 --2 --City Attorney Approved 2/29/2016 NISSHO OF CALIFORNIA, INC. 1902 South Santa Fe Avenue, Vista, California 92083 Phone 760.727.9719 Fax 760.727.8706 License #598372 WORK ORDER Leo Carrillo Ranch Project Name 760-434-2857 Client Phone # City of Carlsdbad/ Tim Selke Client Name Authorized by (Print) Authorized by (Sign) Date DETAILED DESCRIPTION OF WORK TO BE PERFORMED MATERIALS Ground Cover "Pickleweed" LABOR Foreman Labor GRAND TOTAL Nissho Internal Only (Maintenance Department) Tom Baird Project Manager (Print) 8/23/2019 Date Sales Rep Approval (Sign) Mgmt. Approval 60' of 4" SDR drain i e QTY PRICE TOTAL 1 $ 790.35 $ 790.35 1 $ 273.00 $ 273.00 29 $ 28.91 $ 838.39 $ $ $ $ HRS RATE TOTAL 12 $ 45.00 $ 540.00 24 $ 39.00 $ 936.00 $ $ $ 3,377.74 THESE SIGNATURES BELOW CERTIFY THAT THE AREAS HAVE BEEN THOROUGHLY INSPECTED BY THE UNDERSIGNED REPRESENTATIVE. IT HAS BEEN DETERMINED THAT THE INSTALLATION IS IN ACCORDANCE WITH THE PLANS OR THE AGREED UPON SPECIFICATIONS BY THE DEVELOPER/CLIENT AND NISSHO OF CALIFORNIA, INC. Niss ho. of California Representative Client Representative Print Print Sign Date Sign Date Client#· 436527 NISSHCALIF1 ACORD™ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) 5/28/2019 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 pollcy(les) 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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER ~A;!~CT Marsh & Mclennan Agency llC r..t,gNrfo Extl: I IAfC. Nol: Marsh & Mclennan Ins. Agency llC ittJ~ss, constructioncerts@marshmma.com PO Box85638 INSURER(S} AFFORDING COVERAGE NAIC# San Diego, CA 92186 INSURER A: Starr Indemnity & Llablllty Company 38318 INSURED INSURERS: Nissho of California, Inc. INSURERC: 1902 S. Santa Fe Avenue Vista, CA 92083 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. N01WITHSTANDING 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 TYPE OF INSURANCE ADDL SUBR 11:~'il&~ 1,:Skl&~ LIMITS LTR INSR WVD POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY X X 1000025611191 P6I01I2019 06/01/2020 EACH OCCURRENCE $1 000,000 -:J CLAIMS-MADE [!] OCCUR ~~~~~H9E~~~~~ncel s300 000 MED EXP (Any one person} s5 000 - PERSONAL & ADV INJURY s1,ooo,ooo - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 ~ [!] PR~ □LOC $2,000,000 POLICY X JECT PRODUCTS -COMP/OP AGG OTHER: $ A AUTOMOBILE LIABILITY X X -1000198575191 06/01/2019 06/01/2020 fE~~~~~trlNGLE LIMIT s1,000,000 X ANY AUTO BODILY INJURY (Per person) $ -OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ --X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY /Per accident\ -$ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ f-- EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ A WORKERS COMPENSATION X 1000003246 06/01/2019 06/01/2020 X l~ffrnTE I 1gJH• AND EMPLOYERS' LIABILITY y / N s1 000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Cm E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH} E.L. DISEASE -EA EMPLOYEE $1 000 000 If yes, describe under E.L. DISEASE -POLICY LIMIT s1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: All operations performed by the named insured on behalf of the certificate holder. The City of Carlsbad, its Officials, employees and volunteers are named as additional insured with respect to General and Auto Liability, per attached endorsements. Coverage is Primary and Non-Contributory. Waiver of Subrogation applies to General Liability, Auto Liability and Workers Compensation. CERTIFICATE HOLDER CANCELLATION City of Carlsbad SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE Will BE DELIVERED IN Pine Ave. Park Artwork Refurbishment ACCORDANCE WITH THE POLICY PROVISIONS. Cont. No. PKRC685 799 Pine Avenue, Suite 200 AUTHORIZED REPRESENTATIVE Carlsbad, CA 92008-2428 ~~~' I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S4150796/M4149599 WSJlV INSURED: Nissho of California, Inc. POLICY#: 1000198575191 POLICY PERIOD: 06to1I201s TO 0610112020 COMMERCIAL AUTO CA 04441013 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 With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date Is Indicated below. Named Insured: Nissho of California, Inc. Endorsement Effective Date: 06/01/2019 Name(s) Of Person(s) Or Organization(s): SCHEDULE WHERE REQUIRED BY 'w'RITTEN CONTRACT. Information reauired to comolete this Schedule if not shown above will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply 10 the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" undiir a contract with that person or organization. CA 04441013 © Insurance Services Office, Inc., 2011 Page 1 of1 POLICY NUMBER: 1000198575191 COMMERCIAL AUTO CA 20011013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR -ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Nlssho of California, Inc. Endorsement Effective Date: SCHEDULE Insurance Company: Policy Number: 1000198575191 I Effective Date: os,0112019 Expiration Date: 0010112020 Named Insured: Nissho of California, Inc. Address: Additional Insured (Lessor): ALL LESSORS WHERE REQUIRED BY WRITTEN CONTRACT Address: Designation Or Description Of "Leased Autos": CA 20011013 © Insurance Services Office, Inc., 2011 Page 1 of 2 Coverages Limit Of Insurance Covered Autos Llabllitv $ Each "Accident" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Comprehensive $ Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Collision $ Deductible For Each Covered "Leased Auto" Specified Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Causes Of Loss $ Deductible For Each Covered "Leased Auto" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage 1. Any "leased auto" designated or described in the Schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow. 2. For a "leased auto" designated or described in the Schedule, the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an "insured" the lessor named in the Schedule. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by: a. You; b. Any of your "employees" or agents; or c. Any person, except the lessor or any "employee" or agent of the lessor, operating a "leased auto" with the permission of any of the above. 3. The coverages provided under this endorsement apply to any "leased auto" described in the Schedule until the expiration date shown in the Schedule, or when the lessor or his or her agent takes possession of the "leased auto", whichever occurs first. B. Loss Payable Clause 1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss" to a "leased auto". 2. The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor, we will obtain his or her rights against any other party. C. Cancellation 1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2. If you cancel the policy, we will mail notice to the lessor. 3. Cancellation ends this agreement. D. The lessor is not liable for payment of your premiums. E. Additional Definition As used in this endorsement: "Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. Page 2 of 2 © Insurance Services Office, Inc., 2011 CA 20011013 INSURED: Nissho of California, Inc. POLICY#: 1000198575191 POLICY PERIOD: 0610112019 TO 0610112020 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insura,ce provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions 01 the Coverage Form apply unless modified by the endorsement. This endorsement identifies perso1(s) or organization{s) who are "insureds·• for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This e,dorsement does not alter coverage provided In the Coverage Form. SCHEDULE Narrie Of Person(s) Or Organization(s): WhHrH requirHd by wrillen ~reemanl signBd prior lo ,i loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organlzatlo n Shown In the Schedule Is an •insured" for Covered Autos LiabilityGoverage, but only to the extent that person or organization qua llfles as an "Insured" under the Who lsAn Insured provision contained in Paragraph A.1. of Section II • Covered Autos Liability Coverage in the Business Auto and MotorCarrierCoverage Forms and Paragraph D.2. of Section I • Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 4810 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 INSURED: Nissho of California, Inc. POLICY#: 1000025611191 POLICY PERIOD: 06/01/2019 TO: 06/0112020 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 Location(s) Of Covered Operations Organization(s): Where Required By Written Contract Where 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. 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 increase the applicable Limits of Insurance shown in the Declarations. CG 2010 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 INSURED:Nissho of California, Inc. POLICY#: 1000025611191 POLICY PERIOD: 06/01/2019 TO: 06/0112020 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 Organization(s) Location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named Insured contract with the Named Insured 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 INSURED: NlsshoofCalifomla, Inc. POLICY#: 100002ss111e1 POLICY PERIOD: 0610112019 TO: 0610112020 COMMERCIAL GENERAL LIABILITY CG 24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Blanket as required by written contract. Information required lo complete this Scl1edule, if nol shown above, will be shown in lhe Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us ol Section IV -Conditions: 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 work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 040509 © Insurance Services Office, Inc., 2008 Page 1 of 1 INSURED: Nissho of California, Inc. POLICY#: 1000025611191 POLICY PERIOD: 0610112019 TO 0610112020 ·~;,) Starr Indemnity & liability Company Primary and Non-Contributory Condition Coniin&rt::Tal General Lillbility Coverage Part A. SECTION IV= CONOfTIONS, condition 4, Other ln~urance i~ ~men:;ledi as foltrnt1s. 1. Tnc tollowm-g is a.ielod to paragrn.p::-1 4,;;Jj, of tho other lncuranco con.11t1or: Tt1ls ms c1raf':::e Is pr,mary msurance 8$ '<es1:>ec1s C\ir ooverape to tl1e aa~htional 1ns1..,rect. wl1ere the written; contract or VITitlCt' ilgrCC,T!C:nl IC~UtrOS tt,'.!lt !hi$ ltlSUHlJtCC bO p,lt'rlilfy" ,_;r;;j non--contni:!'l.llory. In tMt ll\tl:ltll, Vii.! wlll nDL Si!e-'.< GOnlribU!ic.m r,um i::111~· umer JtlSU{fltlG~ 1;:n:.1l1<;y dV;!illi:!lb1t! to lltl:l atldJ1or.iJI lf1!:iUl!.'d or.v.Mich tt:e aort::fional insured i~ a Named fn:sured. A.LL OTHER TERl'lS AND CONDtTJDt•,JS R:M,~lc~ UNCHAMGED OG 107 (04/11) Page 1 af 1 CC•Pl'rl!Jhl & c. v, Sti!IIT & COmpan~· ~ Sta,f IOO>i'mrntv & t.f.aDlltty CQn!il)ill!IV, .l!Jl rlal'lts f{IS.Bf \1110 lnr,lµ~c-~ ~n)JYJtghtllcl ml#!IITl'll 011$0 l'fop~rtla:~, ln~-, 1,1,;nd IMth I~-,; pl!fml-,;..inn, INSURED: Nissho of California, Inc. POLICY#: 1000025611191 POLICY PERIOD: os10112019 TO: 0610112020 f,}ffi:\ ~}Y Starr Indemnity & Uability Company Dallas, TX 1-866-519-2522 Amendment of Limits of Insurance (Per Project or Per Location Aggregate Limit) Policy Number: Effective Date: Named Insured; This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM I Your policy Is amended to include either a Per Project General Aggregate Limit, a Per Location General Aggregate Urnit or a Per Project and Per Location General Aggregate Limit Please select only one of the following: 1. 2. Per Project General Aggregate Limit Per Location General Aggregate Limit ; Per Project and Per Location General Aggregate Limit [ ] Overall Policy Aggregate Limit IF NEITHER OF THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID. IF MORE THAN ONE OF THE THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID. IL SECTION Ill -LIMITS OF INSURANCE, is amended to include the following: 1. The Limits of Insurance and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we wi II pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the produots-oompleled operations hazard"; and c. Damages under Coverage B. 3. Persons or organizations making claims or bringing "suits". 4. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury'' and "property damage" included in the "products-completed operations hazard". OG 139107-11) Page 1 of3 C0pyrighl e C. V. Starr & Company and Sl.-r Indemnity & Liability Company. All ris;,ts r..:erwd. lncll1d$s copyrighted m~arial of ISO Properties, fno., used with its permission INSURED: Nissho of California, Inc. POLICY#: 1000025611191 POLICY PERIOD: 06/01/2019 ~~ ~Starr Indemnity & l.iabifily Company Dallas, TX 1-866-519-2522 TO: 0610112020 5. Subject to 2 above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 6. Subject to 2 or 3 above, whichever applies, the Each Occurrence Limit is the most we will pay for the $Um of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all ''bodily injury'' and "property damage" arising out of any one •occurrence". 7. Subject lo 5 above. the Damage to Premises Rented to You Limit is the most we will pay under Coverage A because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission by the owner. 8. Subject lo 5 above, the Medical Expense Limit is the most we will pay under Cowrage C for all medical expenses because of ''bodily injury'' sustained by any one person. 9. Subject to 2, 4, 5, 6, and/or 7 above, the Per Project Aggregate Limit is the most we will pay under Coverages A, B, and C combined for the sum of: a. Damages under Coverage A; b. Damages under Coverage B; and c. Medical expenses under Coverage C arising out of the any single Location described above. 10. Su~ect to 2. 4, 5, 6, and/or 7 above, the Per Location Aggregate Limit is the most we will pay under Coverages A, B, and C combined for the sum of: d. Damages under Coverage A; e. Damages under Coverage B; and f. Medical expenses under Coverage C arising out of the any single Location described above. 11. The Overall Policy Aggregate is the most we will pay in any policy period regardless of number of projects or locations. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuanoe for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining lhe Limits of Insurance. Ill. The Limits of Insurance shown in the Declarations are deleted in their entirety and replaced by lhe Limits of Insurance set forth below. Limits of Insurance General Aggregate Limit $2,000,000 Each Occurrence Limit $1,000,000 Produots-Completed Operations Aggregate Limit $2,000,000 OG 139107-111 Page 2 of3 Copyright © C. V. St..-r & Company and Starr lndemnily & Liability Company. All ri~ls rasarwd. lndudes copyrighted material of ISO Properties, lni,., used \'With its pennissiot~ INSURED: Nissho of California, Inc. POLICY#: 1000025611191 POLICY PERIOD: 06/0112019 ~~~ . . .. \;~· Starr lndemmty & l1al>1hty Company Dallas, TX 1-866-519-2522 Personal & Advertising Injury Limit Damage to Premises Rented to You Medical E)(pense Limit IV. SECTION V -DEFINITIONS: is amended to include !he following: $1,000,000 $ 100,000 $ 5,000 TO: 0610112020 23. "Location" means premises irwolving the same or connecting lots, or premises whose connection is interrupted only by a street roadway, waterway. or right-of-way railroad. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. Signed for STARR INDEMNITY & LIABILITY COMPANY unset OG 139 (07-11) Page 3 of3 Copyright€> C. V. $Larr & CompZ1ny and st arr lnd&mnily & Liability Comp1111y. All riltlls resDnled. Includes GQpyrlghted material of ISO Propertlos, Inc., used with its permission. INSURED: Nissho of California, Inc. POLICY#: 1000198575191 Dallas, TX 1-S66-519-2522 POLICY PERIOD: 06/01/2019 TO: 0610112020 Additional Insured -Where Required Under Written Contract or Written Agreement Endorsement This endorsement modifies the insurance coverage fom1(s) listed below that have been purchased lly you and evidenced as such on the decl:1r:1tions page. Please read the endorsement arn:J respective policy(ies} carefully. Business Auto Coverage Form THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. It is hereby agreed that SECTION II -COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, is amended to include the following: cl. Any person or organization whom you become obligated to include as an additional insured under this policy, as a result of any written contract or written agreement you enter into which requires you to furnish insurance to that person or organizallon of tl1e type provided by this policy, but only with respect to liability arising out of use of a covered u,:mto". However, the insurance provided will not exceedthelesserot (1} Toe coverage and/or limits of this policy, or (2) The coverage andlor limits re.quired IJy said written contract or written agreement. All other terms and conditions of this Policy remain unchanged. Signed for ST ARR INDEMNITY & LIABILITY COMPANY Nehemiah E. Ginsburg, General · ounsel SIC..\.1016 (0-1/U) Pn:ge l ofl C:op~t ,s, Sl:uT I!Mlemuity & l.i:ibili~· Company. All n:hts nsen'!d.. ID eludes copjT.i:,b.ted m:wferial of ISO l'Toputies, Inc.., used mth ifs permission.. .-------------------------------------------·---··---------·- INSURED: Nissho of California, Inc. POLICY#: 1000003246 POLICY PERIOD: os10112019 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY TO: 0610112020 WC 040306 (Ed. 4-84} WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from US.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shaD be_"-% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description WHERE YOU ARE REQUIRED BY WRITTEN CONTRACT TO OBTAIN THIS AGREEMENT FROM US, PROVIDED THE CONTRACT IS SIGNED AND DATED PRIOR TO THE DATE OF LOSS TO WHICH THIS WAIVER APPLIES. IN NO INSTANCE SHALL THE PROVISIONS AFFORDED BY THIS ENDORSEMENT BENEFIT ANY COMPANY OPERATING AIRCRAFT FOR HIRE. *The premium charge for this endorsement shall be 2% of the premium developed in the State of California, but not less than $500 policy minimum premium. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement is issued subsequent to preparation of the policy.} WC040306 (Ed. 4-84) t1 . . ····:~~t---CounlersignedBy_-#-._ .. ___ . __ . ____ . __ ~ .. -- .l ©'1998 by the Wotlters' Comptns11tlon Insurance Rating Bureau ,:,f Callfomla. All right$ reserved. --------·----······--··-------------------------------------------'