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S & J Builders and Restoration Services Inc; 2020-03-18; PWM20-1044FAC
CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FARADAY ROOM 278 RECONFIGURATION PWM20-1044FAC This agreement is made on the / BJ.:1:1. day of '-fJ1M tL , 2020, by the City of Carlsbad, California, a munidpal corporation, (hereinafter called "City"), and S&J Builders and Restoration Services, Inc., a California corporation whose principal place of business is 10815 Wheatlands Ave., Suite J, Santee, CA 92071 (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: Brian Bacardi (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. Faraday Room 278 Reconfiguration Page 1 of 9 City Attorney Approved 1/25/2019 PWM20-1044FAC 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: ~.? (£2_~ Print Name: Gracie Wilson 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. Faraday Room 278 Reconfiguration Page 2 of 9 City Attorney Approved 1/25/2019 PWM20-1044FAC INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within fifteen (15) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within sixty (60) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. S&J Builders and Restoration Services, Inc. (name of Contractor) Ill Ill Ill Ill Ill Ill Ill 689944 (Contractor's license number) Class B, C36 02/28/2022 (license class. and exp. date) 1000018498 (DIR registration number) 06/30/2020 (DIR registration exp. date) Faraday Room 278 Reconfiguration Page 3 of 9 10815 Wheatlands Ave., Suite J (street address) Santee, CA 92071 (city/state/zip) 619-449-2014 (telephone no.) 619-449-2014 (fax no.) swilson@sandjbuild.com (e-mail address) City Attorney Approved 1/25/2019 PWM20-1044FAC 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 S&J BUILDERS AND RESTORATION SERVICES, INC., a California corporation By: Gracie Wilson / President (print name/title) By: Sean Wilson / CFO (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California If required by City, proper notarial acknowledgment of execution by Contractor must be attached. 1f..J! corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney Faraday Room 278 Reconfiguration Page 4 of 9 City Attorney Approved 1/25/2019 PWM20-1044FAC EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to Business Name and Address DIR Registration License No., % of be Subcontracted No. Classification & Total Expiration Date Contract L:I < c. \-'";c.....,\ r: tor /f'\ &A..""'-Oc \l -c. <o('--. I-/f:JO0O0 6J/5' Cj s-I -z. 27-C 6 )\ ,-,,.,.,,v.,,._...., clec.+r•~' I L(,fo'1 ,.,,, 11 ,.. /If,~:.., t.--'~"'c. c. r <t;,J\-2ol..0 n..... ........ ,,-4'11-i,. IJct, (' C.e t\J~ ::S-fc it O ,el ~ ._-S c--,. 7 2 &>e; 6 3 g.J'~ / Doll M..,.v Gv<. /0000 z 8-Z~ lA.fc.'c!t.~l'-'L C4 1~oyo 3,. Z.oZ-{ f loo~•'--":) l'}-p..-c.,:c.--..., L ,·toe.A; J ooo o ~29'7~ q<:, 714" r-coo'•~ l. C/7 -z. 1S2.o U ,.._. Oltlr\,J \'C. Q~ 'I --Jb--lOZ.( ., . Total% Subcontracted: ~.0(% The Contractor must perform no less than fifty percent (50%) of the work with its own forces. Faraday Room 278 Reconfiguration Page 5 of 9 City Attorney Approved 1/25/2019 PWM20-1044FAC EXHIBIT B FARADAY ROOM 278 RECONFIGURATION Contractor to provide all tools, material and labor necessary to perform renovations to Room 278 of the Faraday Center located at 1635 Faraday Avenue, Carlsbad, CA 92008. All work to be consistent with the contractors proposal dated Dec. 10, 2019, attached to the agreement as Exhibit "D". JOB QUOTATION ITEM UNIT QTY DESCRiPTION PRICE, NO. 1 LS 1 Modify Room 278 as shown on the attached plans and $36,596.88 proposal. Price includes Labor & Materials Bond. TOTAL* $36,596.88 *Includes taxes, fees, expenses and all other costs. Faraday Room 278 Reconfiguration Page 6 of 9 City Attorney Approved 1/25/2019 PWM20-1044FAC Exhibit "B" (continued) C G> :r: -i I ~ I @ rn @ @© '"Tl m o en :r: :::0 fii~~~ rn o ► -io ~ il 2o :::0 -0 -(") z z ~ ~ p 0 rn r :::0 (/) EMO v,.Ja\\/OOOr{!j o_ 10.5' c.o - NEW DESK 0 Faraday Room 278 Reconfiguration Page 7 of 9 -j ::::0 ►n zo -~ zu C)c ::::0 -j 0 177 0 ::::0 ~ 00 NEW DESK City Attorney Approved 1/25/2019 EXHIBIT C LABOR AND MATERIALS BOND PWM20-1044FAC Bond no. 100487823 Premium $712.00 WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to S&J BUILDERS AND RESTORATION SERVICES, INC., a California corporation (hereinafter designated as the "Principal"), a Contract for: FARADAY ROOM 278 RECONFIGURATION in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, S&J BUILDERS AND RESTORATION SERVICES, INC., a California corporation as Principal, (hereinafter designated as the "Contractor"), and ___________ _ American Contractors Indemnity Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of THIRTY SIX THOUSAND FIVE HUNDRED NINETY SIX DOLLARS EIGHTY EIGHT CENTS ($36,596.88), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. Faraday Room 278 Reconfiguration Page 8 of 9 City Attorney Approved 1/25/2019 "I, PWM20-1044FAC In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. SIGNED AND SEALED, this __ 5_th _____ day of __ M_a_r_c_h __________ , 20_20 __ S&J Builders and Restoration Services, Inc. (SEAL) American Contractors Indemnity Company (SEAL) By:_,A_(Prin~~-~-- (Surety) Ariel T. Heredia, mey-ln-Fact (Signature) (Signature) (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY-ATTACH ATTORNEY-IN-FACT CERTIFICATE) APPROVED AS TO FORM: CELIA A. BREWER City Attorney By il1~k~ Faraday Room 278 Reconfiguration Page 9 of 9 City Attorney Approved 1/25/2019 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On ~J,cil() before me,···--· Ted Lee, Notary Public Date Here Insert Name and Title of the Officer personally appeared Ariel T. Heredia Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(}l) whose name(~ is/am subscribed to the within instrument and acknowledged to me that he/s;oo/t~ executed the same in his/hGt/1:took authorized capacity(~), and that by his/be(!~ signature(X) on the instrument the person(x), or the entity upon behalf of which the person(s) acted, executed the instrument. i············~ ...... TED LEE @ .. ··~·····:··.\ Notary Public -California j · ··•·,-· ·. Orange County 5'. t ·. . Commission # 2223350 f = 4 '! c:m;x:es:ov::5. :21= Place Notary Seal Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. &gn~urn __ ~--------------- Signature of Notary Public ---------------oPTIONAL--------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bond # lC:X:.)Y e.;Jc)J. 3 Document Date: _______ _ Number of Pages: ___ Signer(s) Other Than Named Above: _____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: Ariel T. Heredia Signer's Name: _____________ _ : Corporate Officer -Title(s): ____ _ 1-.1 Corporate Officer -Title(s): ' Partner - [ i Limited I I General l l Partner - I Limited L j General ) Individual Kl Attorney in Fact I ) Individual ! I Attorney in Fact 'Trustee I] Guardian or Conservator f ' Trustee I 1 Guardian or Conservator : , Other: ... -----~-----Other: ______________ _ TOKIO MARINE HCC KNOW ALL MEN BY THESE PRESENTS: POWER OF ATTORNEY That American Contractors Indemnity Company of the State of California, a California corporation, does hereby appoint, ARIEL T. HEREDIA its true and lawful Attorney-in-Fact, with full authority to execute on its behalf bond number _1_0_0_4_8_7_8_2_3 __________ _ issued in the course of its business and to bind the Company thereby, in an amount not to exceed Thirty-five thousand, five hundred ninety-six and 88/100 ------'$~3_5~5~9~6~.8~8'--__ ). This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the Board of Directors of AMERICAN CONTRACTORS INDEMNITY COMPANY at a meeting duly called and held on the 1st day of September, 2011. "Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." The Attorney-in-Fact named above may be an agent or a broker of the Company. The granting of this Power of Attorney is specific to this bond and does not indicate whether the Attorney-in-Fact is or is not an appointed agent of the Company. IN WITNESS WHEREOF, American Contractors Indemnity Company has caused its seal to be affixed hereto and executed by its President on this 1st day of June 2018 ,,""'"1111111,,, ' · ,,, ~I\CTO~ 11, $'~~'\_ ............. a 4.✓~ State of California County of Los Angeles §v~.-·· ··-.. ~ ff~/ \tl ; ~ l INCOAPORATEO l :::; ; \t. SEPT. 25. 1990 /i § ~ ;-... . ... :;..· /' -:,✓,~~,~◄i:;;;oR"'~,,,~--,,,,,,,. .,"'''\ AMERICAN CONT By: Ada A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accurac , or validit of that document. On this 1st day of June, 2018, before me, Sonia 0. Carrejo, a notary public, personally appeared Adam S. Pessin, President of American Contractors Indemnity Company, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of CALIFORNIA that the foregoing paragraph is true and correct. WITNESS my hand and official seal.. s;g,at"m ~ (seal) I, Kio Lo, Assistant Secretary of American Contractors Indemnity Company, do hereby certify that the Power of Attorney and the resolution adopted by the Board of Directors of said Company as set forth above, are true and correct transcripts thereof and that neither the said Power of Attorney nor the resolution have been revoked and they are now in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand this _§!b___ day of ___ ----'M"--=a'-'rc"'"h'----- Bond No. Agency No. 100487823 4046 \\\\\\IIIIUf/,J/ ,,,'\\'1./>.CTOt(s'',,,, $''0~ .. •···· .. ······•./...t,:.½~ ~ v.•· · .. O<",::. ~~/ \"#,~ -~--~-~ ~ f !NC•)RPORATED ! :::; ~ :: ,.; ·.. SEP1. 25, 1990 , , :: \-t-;.... . ..... ~j ... ,.. •·· ,•'* ~ ,,,,,,,;..;i.';;;oii~'':., ,," 111IIIJ111\\\\\\' visit tmhcc.cam/surety for more information 2020 HCCSZZPOAAC IC06/2018 S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 Client: Property: City of Carlsbad -Faraday 1635 Faraday Ave Carlsbad , CA 92008 Operator: SWILSON Estimator: Sean Wilson Position: Senior Estimator Company: S&J Builders Business: I 0815 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: 12/15/2019 2/21/2020 Date Assigned: 12/10/2019 Date Job Completed: CASD8X MARI 9 SJ PVW Restoration/Service/Remodel ClTYOFCARLSBADFDTCOC PWM20-1044FAC Exhibit "D" (continued) Business: (760) 434-2943 Business: (619) 449-2014 x 106 E-mail: swilson@sandjbuild.com Sean Wilson from S&J Builders met with Brian Bacardi on site and requested a proposal to remodel rooms 278. City will supply the carpet for hallway. We would like to thank you for the opportunity to provide you with this COST PROPOSAL FOR OFFICE TI. The total cost for the repairs detailed in the following proposal is $ 36,596.88 The attached estimate details the specific work to be completed. Additional work outside of that specified in this estimate will be through separate proposal(s) and/or change order(s) detailing the additional/changed scope of work as well as the terms and pricing of those changes. Repairs will be scheduled after a signed contract is received by S&J Builders and a PO is issued by the city. Unless noted otherwise, the customer is required to provide heat, water and electricity on-site for the duration of this project. The customer is responsible for providing continuous access to the project area during normal business hours, Monday -Friday, 7:30 am -4:00 pm. Where an item is being replaced, we will be matching the existing item's quality, color, finish, texture or material as close as possible where applicable unless noted otherwise, there is no guaranty either specified or implied on exact matches. This estimate does not include hazardous material testing or abatement unless specifically detailed in the following estimate. This estimate is valid for 30 days from 2/21/2020. If you have any questions about this estimate, please contact Sean Wilson to discuss those questions. Respectfully, Sean Wilson S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 CITYOFCARLSBADFDTCOC PWM20-1044FAC Exhibit "D" ( continued) 2/24/2020 Page: 2 S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 CITYOFCARLSBADFDTCOC Existing Computer Training Room 278 DESCRIPTION 1. Floor protection -self-adhesive plastic film TI 278 2. Remove 5/8" drywall -hung, taped, ready for texture [ IN LABOR ] 3. Remove Metal studding, 3 5/8" wide, 16" OC, 20 gauge [ IN LABOR ] 4. Remove Suspended ceiling tile -2' x 2' [ IN LABOR ] 5. Remove Suspended ceiling grid -2' x 2' [ IN LABOR ] 6. General Demolition -per hour Labor to cut back existing floor carpet tiles for new wall layout and demo above line items. New Office DESCRIPTION 7. Metal studding, 3 5/8" wide, 16" OC, 20 gauge 8. Rewire -average commerical -copper wiring with conduit 9. Empty conduit runs for future use I 0. 110 volt commercial wiring/conduit, box, outlet, switch 11. Ductwork system -hot and cold air (per run) -Insulated Add register for new office layout. 12. Batt insulation -4" -Rl3 -unfaced batt 13. 5/8" drywall -hung, taped, ready for texture 14. Texture drywall -smooth/ skim coat 15. (Install) Steel door frame -8' opening Reuse removed door jamb from existing Computer training room. 16. (Install) Interior door, 8' -slab only Reuse existing door slab for the original computer training room wall. 17. Door -Steel insert window for I 3/4" thick door. Cut in 18. 3/8" x 3' x7' temp clear glass 19. Seal the walls w/latex based stain blocker -one coat 20. Paint the walls -two coats 21. Acoustical Treatments (Repair at new hall tie in) 22. Cove base molding -rubber or vinyl, 4" high 23. Final cleaning -construction -Commercial New Office 2 CITYOFCARLSBADFDTCOC PWM20-1044FAC Exhibit "D" (continued) 2/24/2020 Height: 9' QTY 323.09 SF 199.50 SF 99.75 SF 161.55 SF 161.55 SF 16.00 HR Height: 9' QTY 301.67 SF 95.37 SF 2.00 LF 5.00 EA 1.00 EA 271.50 SF 270.57 SF 351.57 SF 1.00 EA 1.00 EA 1.00 EA 1.00 EA 312.38 SF 312.38 SF 1.00 EA 34.15 LF 95.37 SF Height: 9' Page: 3 -S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 DESCRIPTION 24. Metal studding, 3 5/8" wide, 16" OC, 20 gauge 25. Rewire -average commerical -copper wiring with conduit 26. Empty conduit runs for future use 27. 110 volt commercial wiring/conduit, box, outlet, switch 28. Ductwork system -hot and cold air (per run) -Insulated Add register for new office layout. 29. Batt insulation -4" -Rl3 -unfaced batt 30. 5/8" drywall -hung, taped, ready for texture 31. Texture drywall -smooth / skim coat 32. Steel door frame -8' opening 33. Interior door, 8' -slab only 34. Door -Steel insert window for 1 3/4" thick door. Cut in 35. Seal the walls w/latex based stain blocker -one coat 36. Paint the walls -two coats 37. Acoustical Treatments (Repair at new hall tie in) 38. Cove base molding -rubber or vinyl, 4" high 39. Final cleaning -construction -Commercial New Computer Training Room DESCRIPTION 40. Metal studding, 3 5/8" wide, 16" OC, 20 gauge 41. Empty conduit runs for future use 42. 110 volt commercial wiring/conduit, box, outlet, switch 43. Ductwork system -hot and cold air (per run) -Insulated Add register for new office layout. 44. 5/8" drywall -hung, taped, ready for texture 45. Texture drywall -smooth/ skim coat 46. Seal the surface area w/latex based stain blocker -one coat 47. Paint the walls -two coats 48. Acoustical Treatments (Repair at new wall) 49. Cove base molding -rubber or vinyl, 4" high 50. Final cleaning -construction -Commercial New Hall DESCRIPTION 51. Remove Glue down carpet -heavy traffic 52. Metal joist 6" wide, 16" OC, 20 gauge 53. 110 volt commercial wiring/conduit and box -rough in only 54. Recessed light fixture -LED 55. 5/8" drywall -hung, taped, ready for texture CITYOFCARLSBADFDTCOC PWM20-1044FAC Exhibit "D" ( continued) 2/24/2020 QTY 235.72 SF 122.24 SF 2.00 LF 5.00 EA 1.00 EA 190.50 SF 307.41 SF 428.16 SF 1.00 EA 1.00 EA 1.00 EA 382.94 SF 382.94 SF 1.00 EA 42.22 LF 122.24 SF Height: 9' QTY 179.25 SF 2.00 LF 3.00 EA 1.00 EA 179.25 SF 200.00 SF 179.25 SF 671.36 SF 1.00 EA 20.00 LF 368.35 SF Height: 8' 10" QTY 108.17 SF 48.00 SF 1.00 EA 2.00 EA 48.00 SF Page:4 S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 DESCRIPTION 56. Tape joint for new to existing drywall -per LF 57. Texture drywall -smooth/ skim coat CONTINUED -New Hall 58. Seal the surface area w/latex based stain blocker -one coat 59. Paint the surface area -two coats - 2 colors Paint TI area and feather paint into existing walls and ceiling of hallway 60. (Install) Floor Covering -Carpet (Labor) Carpet supplied by the city General DESCRIPTION 61. Content Manipulation [ BY CITY ] 62. Asbestos test fee -full service survey -base fee [ BY CITY ] 63. Hazardous Material Remediation (Asbestos) [EXCLUDED] 64. Commercial Supervision I Project Management -per hour 65. Haul debris -per pickup truck load -including dump fees 66. Bond Grand Total Senior Estimator CITYOFCARLSBADFDTCOC PWM20-1044FAC Exhibit "D" (continued) $36,596.88 2/24/2020 QTY 19.58 LF 23.32 SF 40.00 SF 275.00 SF 1.00 EA QTY 1.00 EA 1.00 EA 1.00 EA 8.00 HR 2.00 EA 1.00 EA Page: 5 S&J Builders and Restoration Services Inc 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 Grand Total Areas: 3,008.79 SF Walls 1,547.75 SF Floor 0.00 SF Long Wall 1,547.75 Floor Area 2,670.47 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length CITYOFCARLSBADFDTCOC 1,547.75 SF Ceiling 171.97 SY Flooring 0.00 SF Short Wall 1,653.34 Total Area 286.93 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length PWM20-1044FAC Exhibit "D" (continued) 4,556.55 SF Walls and Ceiling 332.68 LF Floor Perimeter 357.76 LF Ceil. Perimeter 3,008.79 Interior Wall Area 0.00 Total Perimeter Length 2/24/2020 Page:6 -S&J Builders and Restoration Services Inc I 08 15 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 CITYOFCARLSBADFDTCOC PWM20-1044FAC Exhibit "D" (continued) 2/24/2020 Page: 7 S&J Builders and Restoration Services Inc Image No. 10815 Wheatlands Ave Suite J Santee, CA 92071 619-449-2014 619-449-0887 fax Lie 689944 Type 18-001 CITYOFCARLSBADFDTCOC Image Detail Date Taken 10/15/2019 PWM20-1044FAC Exhibit "D" (continued) Taken By 2/24/2020 Page: 8 Tl 278 20' 7" 19'1 1" 20' 7" 19' II" New Computer Training Room ~ ~ -~ f;t 9' 10' 7" Existing Computer Training Room 27 New Office "' ; New Office 2 ; 9' -9'2" 10'9" 11'1" CITYOFCARLSBADFDTCOC 22' 32' 11" New Hall 2T 9" 27' 6" PWM20-1044FAC Exhibit "D" (continued) 2/24/2020 TI 278 Page: 9 S&JBUIL-01 ASCOTT ACORD' CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 2/20/2020 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 riahts to the certificate holder in lieu of such endorsement(s). PRODUCER ijiAAI~cT Steve Henkelman JPL Insurance Group, Inc. PHONE I FAX 3033 Fifth Ave. #325 (AIC, No, Ext): (AIC, No): San Diego, CA 92103 lito'M~ss, steve@jplinsurance.com INSURER/$) AFFORDING COVERAGE NAIC# INsuRERA ,Arch Soecialtv Ins Co 21199 INSURED INSURER B, California Automobile Ins Co. 38342 S & J Builders And Restoration INSURER c, Cvoress Insurance Comoanv 10855 10815 Wheatlands Ave. Ste. J INSURER D, Financial Pacific Insurance Co 31453 Santee, CA 92071 INSURERE: 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 I Tl> •••~n un,n A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -~ CLAIMS-MADE [K] OCCUR DAMAGE TO RENTED 100,000 X 12EMP9285807 10/15/2019 10/15/2020 PREMISES /Ea occurrence\ $ X Professional Liab MED EXP /Anv one oersonl $ 5,000 X $5K deductible -PERSONAL & ADV INJURY $ 1,000,000 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ~ POLICY [K] m?r □ LOC PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ B ~TOMOBILE LIABILITY fF~~~b~~~tf1NGLE LIMIT $ 1,000,000 X ANY AUTO X BA040000032483 3/1/2020 3/1/2021 BODILY INJURY /Per oersonl $ --OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY /Per accident\ $ --HIRED ~8.ftl"m1.~ Ft.,7~2c~d~t?AMAGE $ -AUTOS ONLY - $ A X UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 2,000,000 ~ 12EMX0523006 10/15/2019 10/15/2020 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ ✓ OED I I RETENTION$ $ C WORKERS COMPENSATION XI ~1%uTE I I OTH-AND EMPLOYERS' LIABILITY ER YIN X SJWC137364 1/1/2020 1/1/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE □ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A 1,000,000 (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under E.L. DISEASE -POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS below $ A CPL 12EMP9285807 10/15/2019 10/15/2020 per occ$1,000,000/ag 2,000,000 I D Bailees 60497187 10/10/2019 10/10/2020 Bailees 250,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As respects General Liability The City of Carlsbad, its officials, employees and volunteers are additional insured, coverage is primary & non-contributory. 30-Day Notice of Cancellation applies per attached endorsement. As respects Auto Liability City of Carlsbad is additional insured. All Forms attached and apply when required by written contract. Umbrella extends General, Professional and Pollution liabiity, and workers' compensation only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad/CMWD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Complaince Services PO Box 4668-ECM #35050 New York, NY 10163-4668 AUTHORIZED REPRESENTATIVE ~ I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: S&JBUIL-01 ASCOTT ------------------- LO C #: 1 -------- ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED ~PL Insurance Group, Inc. S & J Builders And Restoration 10815 Wheatlands Ave. Ste. J POLICY NUMBER Santee, CA 92071 SEE PAGE 1 CARRIER /: NAIC CODE SEE PAGE 1 SEEP 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Named Insured Services, Inc ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION (ISO CG 2010 0413 LANGUAGE) This endorsement modifies insurance provided under the following: ENVIRONMENTAL MULTILINE POLICY SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s} Of Covered Operations Any person or organization for whom you perform All locations where your ongoing operations are being work under a written contract that requires you to performed for the additional insured persons or obtain this agreement from us. The written contract organizations shown in this Schedule except where must be signed prior to the date of the LOSS or otherwise excluded by the Policy or endorsements OCCURRENCE. The most we will pay on behalf of thereto. the additional insured is the lesser of the amount required by the contract or what is available under the limits of insurance shown in the declarations. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section Ill -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. 8. 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: 00 EMP0123 00 04 19 Includes copyright material of Page 1 of 2 Insurance Services Office, Inc., with its permission. 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 IV -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. All other terms and conditions of this Policy remain unchanged. Endorsement Number: Policy Number: 12 EMP 92858 07 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: 10/15/19 00 EMP0123 00 04 19 Includes copyright material of Page 2 of 2 Insurance Services Office, Inc., with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS (ISO CG 20 37 04 13 LANGUAGE) This endorsement modifies insurance provided under the following: ENVIRONMENTAL MULTILINE POLICY SCHEDULE Name Of Additional Insured Person(s) Or Oraanization(s) Location And Descriotion Of Comoleted Operations Any person or organization for whom you perform work All locations where YOUR WORK was performed for under a written contract that requires you to obtain this the additional insured persons or organizations shown agreement from us. The written contract must be in this Schedule except where otherwise excluded by signed prior to the date of the LOSS or the Policy or endorsements thereto. OCCURRENCE. The most we will pay on behalf of the additional insured is the lesser of the amount required by the contract or what is available under the limits of insurance shown in the declarations. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section Ill -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 IV -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: 00 EMP0125 00 04 19 Includes copyright material of Insurance Services Office, Inc., with its permission. Page 1 of 2 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. All other terms and conditions of this Policy remain unchanged. Endorsement Number: Policy Number: 12 EMP 92858 07 Named Insured: S & J BUILDERS AND RESTORATON 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: 10/15/19 00 EMP0125 00 04 19 Includes copyright material of Insurance Services Office, Inc., with its permission. Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: ENVIRONMENTAL MULTILINE POLICY The following is added to SECTION V. COMMON CONDITIONS, Paragraph 10. Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement signed prior to any occurrence or CLAIM under this policy that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this Policy remain unchanged. Endorsement Number: Policy Number: 12 EMP 95958 07 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: 10/15/19 00 EMP0120 00 03 19 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION-SPECIFIC PERSON OR ORGANIZATION ENDORSEMENT This endorsement modifies insurance provided under the Environmental Multiline Polley In consideration of the premium charged, it is hereby agreed that SECTION V, Conditions, paragraph 13. Subrogation is amended to include the following: We agree to waive this right of subrogation against the person or organization shown in the Schedule below to the extent that you had, prior to an OCCURRENCE or CLAIM, a written agreement to waive such rights. Schedule Name of Person or Organization: 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. Endorsement Number: Policy Number: 12 EMP 92858 07 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: 10/15/2019 00 EMP0052 00 05 04 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Business Auto Broadening Endorsement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS Ill. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V. SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII. ADDITIONAL TRANSPORTATION EXPENSE VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE XI. GLASS REPAIR -DEDUCTIBLE WAIVER XII. TWO OR MORE DEDUCTIBLES XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV. WAIVER OF SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO -COVERAGE TERRITORY XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH Copyright 2013 Mercury Insurance Services, LLC. All rights reserved. MCA85101213-CA Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 1 of 6 BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY (Broad Form Named Insured) SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. Coverage does not apply to an "accident" which occurred before you acquired or formed the organization. II. EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: e. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. Ill. AUTOMATIC ADDITIONAL INSURED SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: f. Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period is an "insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. IV. EMPLOYEE HIRED AUTO LIABILITY SECTION II -LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: g. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. V. SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary Payments, Subparagraphs (2) and (4) are replaced by the following: MCA85101213-CA (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We are not obligated 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. Copyright 2013 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 2 of 6 VI. FELLOW EMPLOYEE COVERAGE: SECTION II -LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee This exclusion does not apply if you have workers' compensation insurance in-force covering all of your "employees". Coverage is excess over any other collectible insurance. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses, is replaced with the following: We will pay up to $50 per day to a maximum of $1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". If your business shown in the Declarations is other than an auto dealership, we will also pay up to $1,000 for reasonable and necessary costs incurred by you to return a stolen covered auto from the place where it is recovered to its usual garaging location. VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, the following is added: c. If hired "autos" are covered "autos" for Liability Coverage in this policy and Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this coverage form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire, subject to the following limit: (1) The most we will pay for "loss" to any hired "auto" is $50,000 or Actual Cash Value or Cost of Repair, whichever is less (2) $500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to "loss" caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION Ill -PHYSICAL DAMAGE COVERAGE, B. Exclusions, 3.a., is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. Copyright 2013 Mercury Insurance Services, LLC. All rights reserved. MCA85101213-CA Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 3 of 6 X. XI. LOAN/LEASE GAP COVERAGE SECTION Ill -PHYSICAL DAMAGE COVERAGE C. Limit of Insurance, the following is added: 4. In the event of a "total loss" to a covered "auto" shown in the schedule or declarations for which Collision and Comprehensive Coverage apply, we will pay any unpaid amount due on the lease or loan for that covered "auto," less: a. The amount paid under the Physical Damage Coverage Section of the b. policy; and Any: (1) (2) (3) (4) (5) Overdue lease/loan payments at the time of the "loss"; Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage. Security deposits not returned by the lessor; Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and Carry-over balances from previous loans or leases. GLASS REPAIR -DEDUCTIBLE WAIVER SECTION Ill -PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. XII. TWO OR MORE DEDUCTIBLES SECTION Ill -PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added: If two or more "company" policies or coverage forms apply to the same accident: 1. If the applicable Business Auto deductible is the smallest, it will be waived; or 2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible; or 3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose ofthis endorsement "company" means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit, Or Loss, a., In the event of "accident", you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. Copyright 2013 Mercury Insurance Services, LLC. All rights reserved. MCA85101213-CA Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 4 of 6 XIV. WAIVER OF SUBROGATION SECTION IV -BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS SECTION IV -BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation, or Fraud, the following is added: Any unintentional omission of or error in information given by you, or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV -BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, b. For Hired Auto Physical Damage Coverage, is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: 1. Any covered "auto" you lease, hire, rent or borrow; and 2. Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV-BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, the following is added and supersedes any provision to the contrary: MCA85101213-CA e. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Copyright 2013 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 5 of 6 XVIII. HIRED AUTO -COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period, Coverage Territory, e. Anywhere in the world if:, is replaced by the following: e. Anywhere in the world if: (1) A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V -DEFINITIONS, C. "Bodily Injury" is amended by adding the following: MCA8Sl01213-CA "Bodily injury" also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease. Copyright 2013 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 6 of 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 990410B (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 $1,724 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/01/2020 Insured Insurance Company WC99 0410B (Ed. 9-14) Cypress Insurance Company Policy No. SJWC137364 Endorsement No. Premium$ Countersigned by _______________ _