Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
S and J Builders and Restoration Services Inc; 2018-03-06; PWL18-119GS
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# 2018-0460062 1111111111111111111111111111111111111111111111111111111111111111111111 Nov 02, 2018 10:37 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: 209-050-26-00 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 of the undersigned is: In fee. 5. A work or improvement on the property hereinafter described was completed on March 28, 2018. 6. The name of the contractor for such work or improvement is S&J Builders & Restoration, 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. PWL18-119GS, Project Name Installation of LED Lights in 25-Yard Firearms Range Bullet Trap. 8. The street address of said property is Safety Training Center, 5750 Orion Street, Carlsbad, CA 92010, in the City of Carlsbad. CITYOF~AD A1~ (u-' City Ma 1 nager VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City ~f6arlspad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on 't:7 ~, 62,?... , 20 }8 , 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. ,C..\ Executed on ud, ~3 , 20.JK, at Carlsbad, California. c17;0F CARLSBAD _ \Jevmc..Nr-k ·rrlc 211~ ~ BARBARA ENGLESON V -City Clerk 379 Q:\Public Works\PW Common\Agreements & Contracts\Contracts\2018 Contracts\LOA'SIS&J Builders & Restoration\6.NOC -Installation of LED Lights in 25-Yard Firearms Range Bullet Trap.1.doc CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS S&J Builders & Restoration, Inc. has completed the contract work required for PWL 18-119GS - Installation of LED Lights in 25-Yard Firearms Range Bullet Trap. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS Installation of LED Lights, 25 Yard Firearms Range Bullet Trap (City) VALUE $1,849.00 CERTIFICATION OF COMPLETION OF IMPROVEMENTS ~,J J\JlA ( I IF I/ J -fuc,ngin ~Manager\ Date ' 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 improv:a; ?':1 I ti• Zc , I e Scott Chadwi~y Manager -D-at_e ________ _ APPROVED AS TO FORM: CELIA BREWER, City Attorney Q:\Public Works\PW Common\Agreements & Contracts\Contracts\2018 Contracts\LOA'S\S&J Builders & Restoration\7.API -Installation of LED Lights in 25-Yard Firearms Range Bullet Trap.doc PWL18-119GS CITY OF CARLSBAD PUBLIC WORKS LETTER OF AGREEMENT INSTALLATION OF LED LIGHTS IN 25-YARD FIREARMS RANGE BULLET TRAP This letter will serve as an agreement between S&J Builders and Restoration Services, Inc., a California corporation (Contractor) and the City of Carlsbad (City). The Contractor will provide all equipment, material and labor necessary to install LED lights on the 25-yard firearms range bullet trap at the Safety Training Center located at 5750 Orion St, Carlsbad, CA 92010, per Exhibit "A" and City specifications, for a sum not to exceed one thousand eight hundred sixty-eight dollars and eighty cents ($1,868.80). This work is to be completed within thirty (30) 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" (BUSC, 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, G9Y"ernTT:nt Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. .'i)1 ~J.... init ~ init 6. The Contractor hereby acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor from participating in contract bidding. 9::) 6 J init ,....---init LED Light Installation 25-Yard Firearms Range Bullet Trap - 1 -City Attorney Approved 2/29/2016 PWL18-119GS 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. 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: Jason Kennedy, 760-931-2236 Contractor Contact: Sean Wilson 619-449-2014 ext. 106 CONTRACTOR S&J BUILDERS AND RESTORATION SERVICES, INC., a California corporation 10815 Wheatlands Ave., Suite J CITY OF CARLSBAD, a municipal corporation of the State of California Santee, CA 92071 P: 619-449-2014, ext. 106 swilson@sandjbuild.com By: By: A ',,)R _C_{r)( .r2 ~-----C/,1-~ <-> (sigrffi°ere) Elaine Lukey~Jic,VVorks Direct C\ . n authorized by the City Manager ~C'l"-C'~, e < l_..0 ,{xf'.iGc:::C:::,,e_\.cf\f- (print name/title) By~ Dated: -(sign here) _ __,.,>c::;..ci-=_.........:....-.l __ l.:..........;:;Ll_t .....,/J"'-«>_v_--=C.:..:....FO.....:: 1 12Ji,co (print name/title) (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:Cf/~ Deputy City Attorney LED Light Installation 25-Yard Firearms Range Bullet Trap - 2 -City Attorney Approved 2/29/2016 PWL18-119GS EXHIBIT A ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Installation of LED Lights 25-Yard Range Bullet Trap $1,868.80 *Includes taxes, fees, expenses and all other costs. **City will provide three (3) LED light fixtures. ***Contractor responsible for lead work environment precautions. LED Light Installation 25-Yard Firearms Range Bullet Trap - 3 - TOTAL* $1,868.80 City Attorney Approved 2/29/2016 -S&J Builders and Restoration Services Inc Buiklers&RestonrtionSemces,lnc. 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 Client: City of Carlsbad -Safety Training Center Property: 5750 Orion St Carlsbad , CA 92008 Operator: SWILSON Estimator: Sean Wilson Position: Senior Estimator Company: S&J Builders Business: 10815 Wheatlands Ave Suite J Santee, CA 92071 Reference: Company: City of Carlsbad Type of Estimate: Reconstruction Date Entered: Date Est. Completed: Price List: Labor Efficiency: Estimate: 2/9/2018 2/9/2018 Date Assigned: 2/5/2018 Date Job Completed: CASD8X MARI 7 SJ PVW Restoration/Service/Remodel CITYOFCARLSBAD-ST-50 Exhibit "A" Business: (760) 434-2943 Business: (619) 449-2014 x 106 E-mail: swilson@sandjbuild.com Sean Wilson from S&J Builders met with Jason Kennedy (Facility Manager) on site on February 6, 2018 and requested a bid to install 3 LED city supplied lights at the 50 yd range back stop. Thank you for the opportunity to bid your repair project. Respectfully, Sean Wilson -Builders&ReslorationServk:es,lnc. S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 CITYOFCARLSBAD-ST-50 Main Level 50 YDRange Back Stop 50' 8" 50' 50 YDRangc Back Stop Door DESCRIPTION I. Remove Fluorescent -two tube -4' - strip light 2. 110 volt commercial wiring/conduit and box -rough in only Tie into existing switch and power legs. 3. Install Light fixture -City supplied Install city supplied lights Totals: 50 YDRange Back Stop Total: Main Level General DESCRIPTION 4. Bonds, Permits & City fees 5. Commercial Supervision/ Project Management -per hour Totals: General 2,017.85 SF Walls 2,717.93 SF Walls & Ceiling 77.79 SY Flooring 128.01 LF Ceil. Perimeter 3' X3' QTY REMOVE REPLACE 11.00 EA 27.30 0.00 3.00 EA 0.00 313.28 3.00 EA 0.00 62.95 QTY REMOVE REPLACE 1.00 EA 1.00 HR 0.00 110.00 Line Item Totals: CITYOFCARLSBAD-ST-50 CITYOFCARLSBAD-ST-50 Exhibit "A" 700.08 SF Ceiling 700.08 SF Floor Height: 15' 10" 125.01 LF Floor Perimeter Opens into Exterior TAX O&P TOTAL 0.00 60.06 360.36 22.01 187.96 1,149.81 0.00 37.78 226.63 22.01 285.80 1,736.80 22.01 285.80 1,736.80 TAX O&P TOTAL AS OCCURRED 0.00 22.00 132.00 0.00 22.00 132.00 22.01 307.80 1,868.80 2/9/2018 Page: 2 S&J Builders and Restoration Services Inc -·--Inc. 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 Grand Total Areas: 2,017.85 SF Walls 700.08 SF Floor 0.00 SF Long Wall 700.08 Floor Area 2,190.75 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length CITYOFCARLSBAD-ST-50 700.08 SF Ceiling 77.79 SY Flooring 0.00 SF Short Wall 743.19 Total Area 130.68 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length Exhibit "A" 2,717.93 SF Walls and Ceiling 125.01 LF Floor Perimeter 128.01 LF Ceil. Perimeter 2,017.85 Interior Wall Area 0.00 Total Perimeter Length 2/9/2018 Page: 3 -S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 Line Item Total Overhead Profit 619-449-0887 fax Lie 689944 Material Sales Tax Replacement Cost Value Net Claim CITYOFCARLSBAD-ST-50 Sean Wilson Senior Estimator Summary Exhibit "A" 1,538.99 153.90 153.90 22.01 $1,868.80 $1,868.80 2/9/2018 Page: 4 Builden,&ReslordonSerYices,lnc. Line Items Total S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 Recap of Taxes, Overhead and Profit Overhead (10%) Profit (10%) 153.90 153.90 153.90 153.90 CITYOFCARLSBAD-ST-50 Material Sales Tax (7.75%) 22.01 22.01 Exhibit "A" Storage Rental Tax (7.75%) 0.00 0.00 2/9/2018 Page: 5 S&J Builders and Restoration Services Inc Builden&RestorationServites,lnc. 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 Estimate: CITYOFCARLSBAD-ST-50 Area: Main Level 50 YDRange Back Stop Area Subtotal: Main Level General Subtotal of Areas Total CITYOFCARLSBAD-ST-50 Recap by Room Exhibit "A" 1,428.99 92.85% 1,428.99 92.85% 110.00 7.15% 1,538.99 100.00% 1,538.99 100.00% 2/9/2018 Page: 6 S&J Builders and Restoration Services Inc O&P Items 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 GENERAL DEMOLITION ELECTRICAL LABOR ONLY LIGHT FIXTURES O&P Items Subtotal Overhead Profit Material Sales Tax Total CITYOFCARLSBAD-ST-50 Recap by Category Exhibit "A" Total % 300.30 16.07% 939.84 50.29% 110.00 5.89% 188.85 10.11% 1,538.99 82.35% 153.90 8.24% 153.90 8.24% 22.01 1.18% 1,868.80 100.00% 2/9/2018 Page: 7 -·--Inc. 3 S&J Builders and Restoration Services Inc 1081 5 Wheatlands Ave Suite J Santee, CA 92071 619-449-201 4 61 9-449-0887 fax Lie 689944 2 CfTYOFCARLSBAD-ST-50 Exhibit "A" 2/9/2018 Page: 8 Main Level Exhibit "A" >----------------------------50' 8" 50' 50 YDRange Back Stop Main Level CITYOFCARLSBAD-ST-50 2/9/2018 Page: 9 ~ S&JBU-1 OP ID: AJ ACORD' CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 01/09/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 619-220-8014 ~2~I~cT Steve Henkelman JPL Insurance Group, Inc PHONE 619-220-8014 I rffc. No): 619-220-8015 JPL Insurance Services (AIC, No, Ext): 3033 5th Avenue, Ste. 325 it1D1{~ss: Steve@Jplinsurance.com San Diego, CA 92103 Steve Henkelman INSURER/SI AFFORDING COVERAGE NAIC# INSURER A, Financial Pacific Insurance Co 31453 INSUREDS & J Builders And Restoration INSURER B , Arch Specialty Ins Co 21199 Services, Inc INSURER c: Cypress Insurance Company 10855 10815 Wheatlands Ave. Ste. J Santee, CA 92071 INSURER O: California Automobile Ins Co. 38342 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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS ITI> ,.,~n "n,n B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -D CLAIMS-MADE CR] OCCUR DAMAGE TO RENTED 100,000 y 12EMP9285805 10/15/2017 10/15/2018 PREMISES /Ea occurrence) $ X CPL 12EMP9285805 10/15/2017 -10/15/2018 MED EXP /Anv one oersonl $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 =7 CR] PRO-DLOC 2,000,000 POLICY JECT PRODUCTS -COMP/OP AGG $ OTHER: Pollution $ $1 MIL/$2MIL D ~TOMOBILE LIABILITY i§~~~~~~~llNGLE LIMIT $ 1,000,000 X ANY AUTO y BA040000032483 03/01/2017 03/01/2018 BODILY INJURY /Per nersonl $ -OWNED ~ SCHEDULED -AUTOS ONLY ~ AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED /p~?~~c~d1;,~t?AMAGE $ -AUTOS ONLY ~ AUTOS ONLY $ B X UMBRELLA LIAB M OCCUR EACH OCCURRENCE $ -12EMX0523004 10/15/2017 10/15/2018 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ C WORKERS COMPENSATION XI ~ffTUTE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N y SJWC922387 01/01/2018 01/01/2019 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A 1,000,000 (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT B Professional Liabi 12EMP9285805 10/15/2017 10/15/2018 Agg/Occ $2MIL/$1 MIL A Bailees 60497187 10/15/2017 10/15/2018 Bailees 257,500 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As respects General Liability The Ci1 of Carlsbad, its officials, employees and volunteers are additional insure , including timar}' and non- contributo~ wording. As respects auto liability, itt of Carlsbad has been added as a ditional msured1 so that all communica ion regarding non-payment of premium will be mailed direct to you, whether it is 30-day for CERTIFICATE HOLDER CANCELLATION CARLSBA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad/CMWD ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Complaince Services AUTHORIZED REPRESENTATIVE PO Box 4668-ECM #35050 ~~~ iNew York, NY 10163-4663 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTEPAD: HOLDER CODE INSURED'$ NAME CARLSBA S & J Builders And Restoration S&JBU-1 OP ID: AJ underwriting reasons or 10-day for non-payment of premium. All Forms attached and apply when required by written contract. Umbrella extends General, Professional and Pollution liabiity, and workers' compensation only. Date PAGE 2 01/09/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED/ PRIMARY COVERAGE INCLUDING COMPLETED OPERATIONS (COVERAGES A, B, D & F) This endorsement modifies insurance provided under the Environmental Multiline Policy It is agreed that Section Ill -WHO IS AN INSURED is amended to include the following: Under Coverages A,B,D and F the person or organization shown in the schedule below shall be an Additional Insured, but only to the extent liability arises out of YOUR WORK for that Additional Insured and not due to any actual or alleged independent liability of said Additional Insured. This Endorsement does not apply to BODILY INJURY or PROPERTY DAMAGE arising out of the sole negligence or willful conduct of, or for defects in design furnished by the Additional Insured. With respect to the coverage afforded to the Additional Insured, this insurance is primary and non- contributory, and our obligations are not affected by any other insurance carried by such Additional Insured whether primary, excess, contingent or on any other basis. This Endorsement does not increase the Company's limits of liability as specified in the Declarations of this policy. Additional Insured: ANY PERSON OR ORGANIZATION FOR WHOM YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE WRITTEN CONTRACT MUST BE EFFECTIVE PRIOR TO THE DATE OF THE LOSS OCCURRENCE All other terms and conditions of this Policy remain unchanged. Policy Number: 12 EMP 92858 05 Named Insured: S & J BUILDERS AND RESTORATION SERVICES, INC.; S & J BUILDERS AND RESTORATION SERVICES PARTNERSHIP This endorsement is effective on the inception date of this Policy unless otherwise stated herein: Endorsement Effective Date: 10/15/2017 00 EMP0101 00 01 14 1 of 1 COMMERCIAL AUTO CA 88 10 01 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGE INDEX SUBJECT ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT ACCIDENTAL AIRBAG DEPLOYMENT AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS AMENDED FELLOW EMPLOYEE EXCLUSION AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE BROAD FORM INSURED BODILY INJURY REDEFINED EMPLOYEES AS INSUREDS (including employee hired auto) EXTENDED CANCELLATION CONDITION EXTRA EXPENSE -BROADENED COVERAGE GLASS REPAIR -WAIVER OF DEDUCTIBLE HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) HIRED AUTO COVERAGE TERRITORY LOAN / LEASE GAP PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) PERSONAL EFFECTS COVERAGE PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE RENTAL REIMBURSEMENT SUPPLEMENTARY PAYMENTS TOWING AND LABOR TWO OR MORE DEDUCTIBLES UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION II -LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED PROVISION NUMBER 3 12 19 5 13 1 22 2 23 10 15 6 20 14 16 11 8 9 4 7 17 18 20 SECTION II -LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: CA 88 10 0113 d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow, but only for acts within the scope of their employment by you. Insurance provided by this endorsement is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II -LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, paragraphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earnings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II -LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE CA88100113 Paragraph A.4. Coverage Extensions of SECTION Ill -PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. 8. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V -DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION Ill -PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is disabled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 -20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE CA 88 10 0113 Paragraph A.4.a., Coverage Extension of SECTION Ill -PHYSICAL DAMAGE COVERAGE, is amended to provide a limit of $50 per day and a maximum limit of $1,500 © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" available for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE -BROADENED COVERAGE Under SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V -DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the following: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other coverage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE CA 88 10 01 13 SECTION Ill -PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclusions 4.c. and 4.d. is deleted and replaced with the following: © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. 14. LOAN/ LEASE GAP COVERAGE CA88100113 A. Paragraph C., LIMIT OF INSURANCE of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or abnormal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", i. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V-DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 15. GLASS REPAIR -WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. 17. TWO OR MORE DEDUCTIBLES Under SECTION Ill PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group. SECTION IV -BUSINESS AUTO CONDITIONS is amended as follows: 18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph 8.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 19. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS CA88100113 SECTION IV -BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7 To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V -DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V -DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION CA88100113 COMMON POLICY CONDITIONS, paragraph A.-CANCELLATION condition applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancellation. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 0 00 N 0 -- -- IL00 1711 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. CANCELLATION 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance writ- ten notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 1 0 days before the effective date of cancellation if we cancel for nonpay- ment of premium; or b. 30 days before the effective date of cancellation if we cancel for any oth- er reason. 3. We will mail or deliver our notice to the first Named lnsured's last mailing ad- dress known to us. 4. Notice of cancellation will state the effec- tive date of cancellation. The policy pe- riod will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium re- fund due. If we cancel, the refund will be pro rata. If the first Named Insured can- cels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be sufficient proof of notice. B. CHANGES This policy contains all the agreements be- tween you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. EXAMINATION OF YOUR BOOKS AND RECORDS We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. INSPECTIONS AND SURVEYS 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspec- tions, surveys, reports or recommenda- tions and any such actions we do under- take relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition ap- ply not only to us, but also to any rating, advisory, rate service or similar organiza- tion which makes insurance inspections, surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recommendations we may make rela- tive to certification, under state or mu- nicipal statutes, ordinances or regula- tions, of boilers, pressure vessels or elevators. E. PREMIUMS The first Named Insured shown in the Dec- larations: 1. Is responsible for the payment of all pre- miums; and 2. Will be the payee for any return premi- ums we pay. F. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS POLICY Your rights and duties under this policy may not be transferred without our written con- sent except in the case of death of an individ- ual named insured. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 2 To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS, paragraph 8.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V -DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V -DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION CA 8810 01 13 COMMON POLICY CONDITIONS, paragraph A.-CANCELLATION condition applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancellation. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04108 (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. BLANKET WAIVER Person/Organization Job Description All CA Operations SCHEDULE Blanket Waiver -Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Waiver Premium 2234.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/01/2018 Insured Insurance Company Cypress Insurance Company WC 99 04108 (Ed. 9-14) Policy No. SJWC922387 Endorsement No. Premium$ Countersigned by _______________ _