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HomeMy WebLinkAboutSpring Valley Insulation Contractors; 2020-07-21; PWL21-1174FACf RECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Ca rlsbad Village Drive Carlsbad, California 92008 DOC# 2020-0507162 I\\\\\\\\\\\ \\II\\\\\\ \\II 11\\11 \\\\\ \Ill\ \\Ill 1\\\1 II\\\ \Ill\\\\\\\\\ S 02 2020 10:46 AM ep OFFICIAL RECORDS Ernest J. Dr3~~~~c~RDER SAN DIEGO CO (SB2 Atkins $0 00) FEES $14.00 PAGES: 1 Space above this line for Recorder's use. PARCEL NO: 203-353-06-00 NOTICE OF COMPLETION Notice is hereby given that: 1. The undersigned is owner of the interest or estate stated below in the property herein after 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 Aug. 7, 2020. 6. The name of the contractor for such work or improvement is Spring Valley Insulation Contractors. 7. The property on which said work or improvement was completed is in the City of Carlsbad, County of San Diego, State of Ca lifornia, and is described as follows: Project No. PWL21-1174FAC, Project Name: Harding Community Center Insulation Installation. 8. The street address of said property is 3096 Harding Street, Carlsbad, CA 92008, in t he City of Carlsbad. I, the undersigned, say: CITY OF CARLSBAD MP C?~ Geoff Patnoe, Assistant City Manager VERIFICATION OF CITY CLERK I am the City Clerk of the City of Carlsbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on ;). $' -6:-..tJ~ . 20..Jg accepted the above described work as completed and ordered that a N ce of Completion be filed. I declare under penalty of perjury that the foregoing is t rue and correct. I Executed on) ':J, lJu tr-1..S +, 20;;)0, at Carlsbad, California. CITY OF CARLSBAD 2 , q }.}.~N~~ City Clerk Q:\Public Works\General Services\Agreements & Contracts\Spring Valley Insulation Contractors\Harding Community Center Insulation Installation -PWL21- 1174FAC\4. NOC\2.NOC -Harding Community Center Insulation Installation -PWL21-1174FAC.docx SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 7/14/2020 Alliant Insurance Services,Inc.601 South Figueroa St Ste 4480LosAngelesCA90017 Soe Juedes 310-981-0753 soe.juedes@alliant.com Gemini Insurance Company 10833 SPRIVAL-10 Travelers Property Casualty Co 25674SpringValleyInsulationContractors,Inc.3151 Bancroft DrSpringValley,CA 91977 Scottsdale Insurance Company 41297 1474731124 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X Y Y VCGP024825 8/1/2019 8/1/2020 2,000,000 Deductible 5,000 B 1,000,000 X X Y Y BA-8N967045-19-26 8/1/2019 8/1/2020 Comp/CollDeductible 500/500 C X X 4,000,000XLS01108798/1/2019 8/1/2020 4,000,000 X 0 B X Y Y UB-8N963789-19-26-G 8/1/2019 8/1/2020 1,000,000 1,000,000 1,000,000 City of Carlsbad/CMWD is named as an additional insured it relates to general liability &auto liability per the terms and conditions of the policies.Waiver applytoworkerscompensationpolicy.30 days notice of cancellation apply per the attached endorsements. City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance ServicesP.O.Box 947MurrietaCA92564 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE This endorsement broadens coverage.However,coverage for any injury,damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part,and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement.The following listing is a general cover- age description only.Limitations and exclusions may apply to these coverages.Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights,duties,and what is and is not covered. H.HIRED AUTO PHYSICAL DAMAGE LOSS OFA.BROAD FORM NAMED INSURED USE INCREASED LIMITB.BLANKET ADDITIONAL INSURED I.PHYSICAL DAMAGE TRANSPORTATIONC.EMPLOYEE HIRED AUTO EXPENSES INCREASED LIMIT D.EMPLOYEES AS INSURED J.PERSONAL PROPERTY E.SUPPLEMENTARY PAYMENTS INCREASED K.AIRBAGS LIMITS L.NOTICE AND KNOWLEDGE OF ACCIDENT OR F.HIRED AUTO LIMITED WORLDWIDE COV-LOSS ERAGE INDEMNITY BASIS M.BLANKET WAIVER OF SUBROGATION G.WAIVER OF DEDUCTIBLE GLASS N.UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS this insurance applies and only to the extent thatA.BROAD FORM NAMED INSURED person or organization qualifies as an "insured"The following is added to Paragraph A.1.,Who Is under the Who Is An Insured provision containedAnInsured,of SECTION II COVERED AUTOS in Section II.LIABILITY COVERAGE: C.EMPLOYEE HIRED AUTOAnyorganizationyounewlyacquireorformdur- 1.The following is added to Paragraph A.1.,ing the policy period over which you maintain Who Is An Insured,of SECTION II COV-50%or more ownership interest and that is not ERED AUTOS LIABILITY COVERAGE:separately insured for Business Auto Coverage. An "employee"of yours is an "insured"whileCoverageunderthisprovisionisaffordedonlyun- operating an "auto"hired or rented under atilthe180thdayafteryouacquireorformtheor- contract or agreement in an "employee's"ganization or the end of the policy period,which-name,with your permission,while performingeverisearlier.duties related to the conduct of your busi-B.BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c.in A.1.,2.The following replaces Paragraph b.in B.5., Who Is An Insured,of SECTION II COVERED Other Insurance,of SECTION IV BUSI- NESS AUTO CONDITIONS:AUTOS LIABILITY COVERAGE: b.For Hired Auto Physical Damage Cover-Any person or organization who is required under age,the following are deemed to be cov-a written contract or agreement between you and ered "autos"you own:that person or organization,that is signed and (1)Any covered "auto"you lease,hire,executed by you before the "bodily injury"or rent or borrow;and"property damage"occurs and that is in effect during the policy period,to be named as an addi-(2)Any covered "auto"hired or rented by tional insured is an "insured"for Covered Autos your "employee"under a contract in Liability Coverage,but only for damages to which an "employee's"name,with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved.Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO permission,while performing duties (a)With respect to any claim made or "suit" related to the conduct of your busi-brought outside the United States of America,the territories and possessionsness. of the United States of America,PuertoHowever,any "auto"that is leased,hired,Rico and Canada:rented or borrowed with a driver is not a covered "auto".(i)You must arrange to defend the "in- sured"against,and investigate or set-D.EMPLOYEES AS INSURED tle any such claim or "suit"and keepThefollowingisaddedtoParagraphA.1.,Who Is us advised of all proceedings and ac-An Insured,of SECTION II COVERED AUTOS tions.LIABILITY COVERAGE:(ii)Neither you nor any other involvedAny"employee"of yours is an "insured"while us-"insured"will make any settlementingacovered"auto"you don't own,hire or borrow without our consent.in your business or your personal affairs.(iii)We may,at our discretion,participateE.SUPPLEMENTARY PAYMENTS INCREASED in defending the "insured"against,orLIMITSinthesettlementof,any claim or 1.The following replaces Paragraph A.2.a.(2),"suit". of SECTION II COVERED AUTOS LIABIL-(iv)We will reimburse the "insured"forITYCOVERAGE:sums that the "insured"legally must (2)Up to $3,000 for cost of bail bonds (in-pay as damages because of "bodily cluding bonds for related traffic law viola-injury"or "property damage"to which tions)required because of an "accident"this insurance applies,that the "in- we cover.We do not have to furnish sured"pays with our consent,but only up to the limit described in Para-these bonds. graph C.,Limits Of Insurance,of2.The following replaces Paragraph A.2.a.(4),SECTION II COVERED AUTOSofSECTIONIICOVEREDAUTOSLIABIL-LIABILITY COVERAGE.ITY COVERAGE: (v)We will reimburse the "insured"for(4)All reasonable expenses incurred by the the reasonable expenses incurred"insured"at our request,including actual with our consent for your investiga-loss of earnings up to $500 a day be-tion of such claims and your defensecauseoftimeofffromwork.of the "insured"against any suchF.HIRED AUTO LIMITED WORLDWIDE COV-"suit",but only up to and includedERAGEINDEMNITYBASISwithinthelimitdescribedinPara- The following replaces Subparagraph (5)in Para-graph C.,Limits Of Insurance,of graph B.7.,Policy Period,Coverage Territory,SECTION II COVERED AUTOS of SECTION IV BUSINESS AUTO CONDI-LIABILITY COVERAGE,and not in addition to such limit.Our duty toTIONS: make such payments ends when we(5)Anywhere in the world,except any country or have used up the applicable limit ofjurisdictionwhileanytradesanction,em-insurance in payments for damages,bargo,or similar regulation imposed by the settlements or defense expenses.United States of America applies to and pro- hibits the transaction of business with or (b)This insurance is excess over any valid within such country or jurisdiction,for Cov-and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured"whether primary,excess, contingent or on any other basis."auto"that you lease,hire,rent or borrow without a driver for a period of 30 days or less (c)This insurance is not a substitute for re-and that is not an "auto"you lease,hire,rent quired or compulsory insurance in anyorborrowfromanyofyour"employees",country outside the United States,its ter-partners (if you are a partnership),members ritories and possessions,Puerto Rico and(if you are a limited liability company)or Canada.members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved.CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO (2)In or on your covered "auto".You agree to maintain all required or compulsory insurance in any such coun-This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law.Your failure to comply with No deductibles apply to this Personal Propertycompulsoryinsurancerequirementswillcoverage.not invalidate the coverage afforded by K.AIRBAGSthispolicy,but we will only be liable to the same extent we would have been liable The following is added to Paragraph B.3.,Exclu- had you complied with the compulsory in-sions,of SECTION III PHYSICAL DAMAGE surance requirements.COVERAGE: Exclusion 3.a.does not apply to "loss"to one or(d)It is understood that we are not an admit- more airbags in a covered "auto"you own that in-ted or authorized insurer outside the flate due to a cause other than a cause of "loss"United States of America,its territories set forth in Paragraphs A.1.b.and A.1.c.,butandpossessions,Puerto Rico and Can- only:ada.We assume no responsibility for the furnishing of certificates of insurance,or a.If that "auto"is a covered "auto"for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance.b.The airbags are not covered under any war- ranty;andG.WAIVER OF DEDUCTIBLE GLASS c.The airbags were not intentionally inflated.The following is added to Paragraph D.,Deducti- ble,of SECTION III PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE:one "loss". No deductible for a covered "auto"will apply to L.NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced.The following is added to Paragraph A.2.a.,of H.HIRED AUTO PHYSICAL DAMAGE LOSS OF SECTION IV BUSINESS AUTO CONDITIONS: USE INCREASED LIMIT Your duty to give us or our authorized representa- tive prompt notice of the "accident"or "loss"ap-The following replaces the last sentence of Para- plies only when the "accident"or "loss"is knowngraphA.4.b.,Loss Of Use Expenses,of SEC- to:TION III PHYSICAL DAMAGE COVERAGE: (a)You (if you are an individual);However,the most we will pay for any expenses for loss of use is $65 per day,to a maximum of (b)A partner (if you are a partnership); $750 for any one "accident".(c)A member (if you are a limited liability com- I.PHYSICAL DAMAGE TRANSPORTATION pany); EXPENSES INCREASED LIMIT (d)An executive officer,director or insurance manager (if you are a corporation or other or-The following replaces the first sentence in Para- ganization);orgraphA.4.a.,Transportation Expenses,of SECTION III PHYSICAL DAMAGE COVER-(e)Any "employee"authorized by you to give no- AGE:tice of the "accident"or "loss". We will pay up to $50 per day to a maximum of M.BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in-The following replaces Paragraph A.5.,Transfercurredbyyoubecauseofthetotaltheftofacov-Of Rights Of Recovery Against Others To Us,ered "auto"of the private passenger type.of SECTION IV BUSINESS AUTO CONDI- TIONS:J.PERSONAL PROPERTY 5.Transfer Of Rights Of Recovery AgainstThefollowingisaddedtoParagraphA.4.,Cover- Others To UsageExtensions,of SECTION III PHYSICAL DAMAGE COVERAGE:We waive any right of recovery we may have against any person or organization to the ex-Personal Property tent required of you by a written contract We will pay up to $400 for "loss"to wearing ap-signed and executed prior to any "accident" parel and other personal property which is:or "loss",provided that the "accident"or "loss" arises out of operations contemplated by(1)Owned by an "insured";and CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved.Page 3 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO such contract.The waiver applies only to the The unintentional omission of,or unintentional person or organization designated in such error in,any information given by you shall not contract.prejudice your rights under this insurance.How- N.UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- lect additional premium or exercise our right ofThefollowingisaddedtoParagraphB.2.,Con- cancellation or non-renewal.cealment,Misrepresentation,Or Fraud,of SECTION IV BUSINESS AUTO CONDITIONS: Page 4 of 4 ©2015 The Travelers Indemnity Company.All rights reserved.CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. WORKERS COMPENSATION (BLANKET WAIVER) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS AND EMPLOYERS LIABILITY POLICY ENDORSEMENT – CALIFORNIA ENDORSEMENT WC 99 03 76 ( A) - HARTFORD CT 06183ONE TOWER SQUARE 001 Schedule Job DescriptionPerson or Organization 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. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium. 2.00 ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Countersigned byInsurance Company PremiumInsured Endorsement No.Policy No.Endorsement Effective 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.) ST ASSIGN: DATE OF ISSUE: Page of10-19-18 1 1