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Patterson Brothers Lighting Inc; 2018-11-21; PWM19-662GS
RECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2019-0431968 1111111111111111111111111111111111111111111111111111111111111111111111 Sep 30, 2019 11 :20 AM OFFICIAL RECORDS Ernest J. Dronenburg, Jr., SAN DIEGO COUNTY RECORDER FEES $0.00 (SB2 Atkins $0 00) PAGES 1 Space above this line for Recorder's use. PARCEL NO: NOTICE OF COMPLETION Notice is hereby given that: N/A 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. 3. The full address of the undersigned is 1200 Carlsbad Village Drive, Carlsbad, California 92008. 4. The nature of the title ofthe undersigned is: In fee. 5. A work or improvement on the property hereinafter described was completed on March 13, 2019. 6. The name of the contractor for such work or improvement is Patterson Bros. Lighting, 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. PWM19-662GS, Project Name: Install New Street Light Poles at Four City Locations. 8. The street address of said property is intersections of: Aviara Drive at Mimosa Drive, Paseo del Norte at Caminita Madrigal, Dove Lane at El Camino Real and 5051 Avenida Encinas, in the City of Carlsbad. VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Carlsbad1 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on Sepfemoer lf/lh , 20-1i_, 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 onStpltf(IDt( Jq-1~, 20_1i, at Carlsbad, California. ~ BARBARA ENGLESON City Clerk Hec-lor Gd111e 2 Depv+J ci+j cJeo.f Q:\Public Works\General Services\Agreements & Contracts\Patterson Bro'sllnstall New Street Light Poles at Four City Locations -PWM19-662GSINOCl2.NOC -Install New Street Light Poles at Four City Locations -PWM19-662GS.docx CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Patterson Bros. Lighting, Inc. has completed the contract work required for PWM19-662GS - Install New Street Light Poles at Four City Locations. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS Replacement of light poles due to damage. CERTIFICATION OF COMPLETION OF IMPROVEMENTS John Maas VALUE $23,600 CITY MANAGER'S ACCEPTANCE OF PUBLIC IMPROVEMENTS The construction of the above described contract is deemed complete and hereby accepted. The City Clerk is hereby authorized to record the Notice of Completion and release the bonds in accordance with State Law and City Ordinances. The City of Carlsbad is hereby directed to commence maintaining the above described improvements. anager Date APPROVED AS TO FORM: CELIA BREWER, City Attorney By ~£_,~/ Deputyttorney Q \Public Works\General Services\Agreements & Contracts\Patterson Bro'sllnstall New Street Light Poles at Four City Locations -PWM19-B62GS\NOC\3.API -Install New Street Light Poles at Four City Locations -PWM19-B62GS.docx PWM19-662GS Install New Street Light Poles at Four City Locations Page 1 of 6 City Attorney Approved 9/27/16 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT INSTALL NEW STREET LIGHT POLES AT FOUR CITY LOCATIONS This agreement is made on the ______________ day of _________________________, 2018, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Patterson Brothers Lighting, Inc., a California corporation whose principal place of business is PO Box 2037, Lakeside, CA 92040 (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: Clayton Dobbs (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. DocuSign Envelope ID: 1587C1BB-FBDB-4CD5-AFA9-1E9BBFBDA486 November21st PWM19-662GS Install New Street Light Poles at Four City Locations Page 2 of 6 City Attorney Approved 9/27/16 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: ___________________________________ Print Name: _____Kyle Patterson__________________ 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. DocuSign Envelope ID: 1587C1BB-FBDB-4CD5-AFA9-1E9BBFBDA486 PWM19-662GS Install New Street Light Poles at Four City Locations Page 3 of 6 City Attorney Approved 9/27/16 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 thirty (30) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within ninety (90) working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Patterson Brothers Lighting, Inc. PO Box 2037 (name of Contractor) 501334 (street address) Lakeside, CA 92040 (Contractor’s license number) C-10 electrical 11/30/18 (city/state/zip) 619-390-3797 (license class. and exp. date) 1000007848 (telephone no.) 619-390-2875 (DIR registration number) 6/30/19 (fax no.) kyle@pattersonbrotherslighting.com (DIR registration exp. date) (e-mail address) /// /// /// /// /// /// /// DocuSign Envelope ID: 1587C1BB-FBDB-4CD5-AFA9-1E9BBFBDA486 PWM19-662GS Install New Street Light Poles at Four City Locations Page 4 of 6 City Attorney Approved 9/27/16 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, PATTERSON BROTHERS LIGHTING, INC., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Kyle Patterson / President, CFO Paz Gomez, Public Works Director as authorized by the City Manager (print name/title) By: (sign here) Kenneth Hall / Secretary (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President 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: ___________________________ Assistant City Attorney DocuSign Envelope ID: 1587C1BB-FBDB-4CD5-AFA9-1E9BBFBDA486 PWM19-662GS Install New Street Light Poles at Four City Locations Page 5 of 6 City Attorney Approved 9/27/16 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 be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract N/A N/A N/A N/A N/A Total % Subcontracted: _____0%__________ The Contractor must perform no less than fifty percent (50%) of the work with its own forces DocuSign Envelope ID: 1587C1BB-FBDB-4CD5-AFA9-1E9BBFBDA486 PWM19-662GS Install New Street Light Poles at Four City Locations Page 6 of 6 City Attorney Approved 9/27/16 EXHIBIT B Install New Street Light Poles at Four City Locations Contractor will provide all labor, equipment and materials (unless otherwise noted) necessary to install new street light poles, foundations and fixtures at the following intersections. 1. Aviara Drive at Mimosa Drive (City of Carlsbad Hansen Work Order 514726). 2. Paseo del Norte at Caminito Madrigal (City of Carlsbad Hansen Work Order 511500). 3. Dove Lane at El Camino Real (City of Carlsbad Hansen Work Order 515957). 4. 5051 Avenida Encinas (City of Carlsbad Hansen Work Order 495616). Work to include removal of old foundations and installation of new foundations. Installation shall include setting poles, installing mast arms, installing city provided light fixtures, foundation caps, and miscellaneous electrical work between the pull box and street light as well as pouring new concrete caps. Contractor will return all poles to complete working condition. All work shall be performed in accordance with the City of Carlsbad’s Engineering Standards, the 2018 Standard Specifications for Public Works Construction (Greenbook), 2015 Caltrans Standard plans and Caltrans Specifications. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Light Pole and arm replacement: Aviara Drive at Mimosa Drive; Install Ameron pole 2B2-26 #371 2AP8A (or equivalent) concrete street light pole and arm, with new city supplied GE 96W LED fixture, new foundation cap, and connection to power source. $4,975 2 LS 1 Light Pole, foundation and arm replacement: Paseo del Norte at Caminito Madrigal; Remove old and install new matching foundation. Install Ameron pole 2B2-26 #371 2AP8A (or equivalent) concrete street light pole and arm, with new city supplied GE 96W LED fixture, new foundation cap, and connection to power source. $4,950 3 LS 1 Light Pole and arm replacement: Dove Lane at El Camino Real; Install Ameron pole 2B2-26 #371 2AP8A (or equivalent) concrete street light pole and arm, with new city supplied GE 108W Mission Bell LED fixture, new foundation cap, and connection to power source. $4,975 4 LS 1 Light Pole and arm replacement: 5051 Avenida Encinas; Install Ameron pole 2B2-26 #371 2AP8A (or equivalent) concrete street light pole and arm, with new city supplied GE 96W LED fixture, new foundation cap, and connection to power source. $3,900 5 EA 3 New Foundation (remove and replace existing foundation if needed, 3 each at $1,600 each). $4,800 TOTAL* $23,600 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 1587C1BB-FBDB-4CD5-AFA9-1E9BBFBDA486 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSDWVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION$ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD CLARICEARENA 11/09/2018 PATTBRO-01 C 88625Y181ALI B ACP3037201492 D 913647018 A 103GL002439800 1,000,000 1,000,000 1,000,000 10,000 1,000,000 1,000,000 2,000,000 1,000,000 2,000,000 5,000 100,000 1,000,000 1,000,000 X X X X X X X X 07/01/2018 07/01/2019 07/01/2018 07/01/2019 07/01/2018 07/01/2019 07/01/2018 07/01/2019 The City of Carlsbad is an additional insured, as required by written contract with the named insured, per the attached CG2010 07 04 and CG2037 07 04 forms regards to General Liability. Waiver of Subrogation applies per the attached SCIF 10217 in regards to Workers Compensation. Blanket forms apply as required by written contract with the named insured. Should any of the required policies be cancelled before the expiration date thereof, we will mail 30 days written notice to the City of Carlsbad/CMWD per form U688A-0813. *THIS CERTIFICATE CANCELS AND SUPERSEDES THE CERTIFICATE PREVIOUSLY ISSUED ON 07/05/2018* NFP Property & Casualty Services, Inc. 6333 Greenwich Drive Suite 230 San Diego, CA 92122 (858) 869-8301(858) 869-8300 City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 4668 - ECM #35050 New York, NY 10163-4668 Patterson Brothers Lighting, Inc. P.O. Box 2037 Lakeside, CA 92040 Colony Insurance Company Nationwide Mutual Insurance Company StarStone National Insurance Company State Comp Ins Fund of CA 39993 23787 35076 25496 X Y X POLICY NUMBER: 103GL002439800 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ADDITIONAL INSURED – OWNERS, LESSEES ORCONTRACTORS – SCHEDULED PERSON ORORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations All persons or organizations as required by written contract with the Named Insured. As designated in written 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", "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) desig- nated above. B.With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equip- ment 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 in- tended use by any person or organization oth- er than another contractor or subcontractor engaged in performing operations for a princi- pal as a part of the same project. POLICY NUMBER: 103GL002439800 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ADDITIONAL INSURED – OWNERS, LESSEES ORCONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Opera- tions All persons or organizations as required by written contract with the Named Insured. As designated in written contract with the Named Insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(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 desig- nated and described in the schedule of this endorse- ment performed for that additional insured and included in the "products-completed operations hazard". JULY 1, 2018 9136470-18 JULY 1, 2019 JULY 1, 2018 & ( )* )* )233 73:5 , *' 9 /9 /' : : !" # !! $ ! %& " ' ' ()*+ '! (' #*! $ ! %& " ' ! "#$% & # %%' , - /CMWD+ . " * * '//$ 01223 456767 # % 89#%:7:25 ' ;< = ;< - *> ()! - ? , , -,/ @ 57 , ;:7 , , -, < ' ;< = ;< - *> ()! / , , ' ;< = ;< *> ()! 9 9 0 , - ,/ ' ;< = ;< *> ()! 0 , , , ,/ ' ;< = ;< - *> ()! - ,- 9 ,/ , -, / !!> * #(#( #*A> '! % #)#> #" (/ 103 GL 0024398-00ENDT. #007 EFF: 11/09/2018