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HomeMy WebLinkAboutSunMaster Products Inc; 2018-11-19; PWM19-649GSRECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2019-0066176 111111111111 lllll 11111111111111111111111111111111111 IIIII IIIII IIII IIII Feb 25, 2019 11 :10 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: 212-130-31-00 NOTICE OF COMPLETION Notice is hereby given that: 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 Jan. 29, 2019. 6. The name ofthe contractor for such work or improvement is Sun Master. 7. The property on which said work or improvement was completed is in the City of Carlsbad, County of San Diego, State of California, and is described as follows: Project No. PWM19-649GS and Project Name: Faraday Gazebo Shade Cloth Replacement. 8. The street address of said property is 1635 Faraday Ave., Carlsbad, CA 92008, in the City of Carlsbad. · y Manager VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Carlsbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on '---9-L b.,,...u~ / ,;S . 20-1..!L, accepted the above described work as completed and ordered that a Notice of C mpletion be filed. I declare under penalty of perjury that the foregoing is true and correct. Executed on .;)/ 1 '1 • , 20 19, at Carlsbad, California . Q·\Public Works\General Services\Agreements & Contracts\Sun Master Products\Faraday Gazebo Shade Cloth Replacement-PWM19-649GS\NOC\2.NOC -Faraday Gazebo Shade Cloth Replacement.docx CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Sun Master has completed the contract work required for PWM19-649GS -Faraday Gazebo Shade Cloth Replacement. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS VALUE Install new shade cloth on existing gazebo structure. $6,800 CERTIFICATION OF COMPLETION OF IMPROVEMENTS John 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. is hereby directed to commence maintaining the above described Date APPROVED AS TO FORM: CELIA BREWER, City Attorney By: __ ---=--_ _..............-.c.--=....,._--- Deputy City Attorney Q:\Public Works\General Services\Agreements & Contracts\Sun Master Products\Faraday Gazebo Shade Cloth Replacement -PWM19-649GSINOC\3.API -Faraday Gazebo Shade Cloth Replacement.docx CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FARADAY GAZEBO SHADE CLOTH REPLACEMENT PWM 19-649GS This agreement is made on the / qji). day of lfJ1J1Mm.J)'(__(L , 2018, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and SunMaster Products, Inc., a California corporation whose principal place of business is 276 Trade Street, San Marcos, CA 92078 (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 Gazebo Shade Cloth Replacement Page 1 of 7 City Attorney Approved 9/27/16 PWM 19-649GS 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 Cartsbad 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 eMrment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor ors b on ractor from participating in contract bidding. Signature: Print Name: REQUIRED INSURANCE. The successful contractor shall provide to the City of Cartsbad, 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 Cartsbad Business License for the duration of the contract. Faraday Gazebo Shade Cloth Replacement Page 2 of 7 City Attorney Approved 9/27/16 PWM 19-649GS 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 sixty (60) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within ten (10) working days after commencing work. CONTRACTOR'S INFORMATION. Ill Ill Ill Ill Ill Ill Ill SunMaster Products, Inc. (name of Contractor) 288419 (Contractor's license number) C-61 / D03 6/30/2019 (license class. and exp. date) 1000027178 (DIR registration number) 6/30/2019 (DIR registration exp. date) Faraday Gazebo Shade Cloth Replacement Page 3 of 7 276 Trade Street (street address) San Marcos, CA 92078 (city/state/zip) 760-7 44-3404 (telephone no.) 760-744-4974 (fax no.) sun masterinc@aol.com (e-mail address) City Attorney Approved 9/27/16 PWM 19-649GS 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 SUNMASTER PRODUCTS, INC., a California r ora ·of, By: CITY OF CARLSBAD, a municipal corporation of the State of California By: (sign here) Paz Go Li SA IA.<; \l LQAtvl A f { cJ; I du\+} ~cft W.\" (print name itle) J By: (sign here) (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !f...g_ 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: Faraday Gazebo Shade Cloth Replacement Page 4 of? City Attorney Approved 9/27/16 State of California _ 9 . Secretary of State :. 4 (6 Statement of Information ---_,,_,, .. (Domestic Stock and Agricultural Cooperative Corporations) FEES (FIiing and Disclosure): $25.00. If this is an amendment, see instructions. IMPORTANT -READ INSTRUCTIONS BEFORE COMPLETING THIS FORM 1. CORPORATE NAME SUNMASTER PRODUCTS, INC 2. CALIFORNIA CORPORATE NUMBER 2248751 muvf s 15-141246 FILED Secretary of State State of California NOV 1 8 2015 No Change Statement (Not applicable if agent address of record is a P O. Box address. See instructions.) 3. If there have been any changes to the Information contained In the last Statement of lriformation filed with the California Secretary of State, or no statement of information has been previously filed, this form must be completed In Its entirety. D If there has been no change in any of the information contained in the last Statement of Information filed with the California Secretary of State, check the box and proceed to Item 17. omplete Addresses for the Followln (Do not abbreviate the name of the city. Items 4 and 5 cannot be P.O. Boxes.) 4. STREET ADDRESS OF PRINCIPAL EXECUTIVE OFFICE CITY STATE ZIP CODE 276 TRADE STREET SAN MARCOS CA 92078 5. STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA, IF ANY SAME 6. MAILING ADDRESS OF CORPORATION, IF DIFFERENT THAN ITEM 4 SAME CITY CITY STATE CA STATE ZIP CODE ZIP CODE Names and Complete Addresses of the Following Officers (The corporation must list these three officers. A comparable title for the specific officer may be added; however, the preprinted titles on this form must not be altered.) 7. CHIEF EXECUTIVE OFFICER/ ADDRESS CITY USA SURDAM 276 TRADE STREET SAN MARCOS 8. SECRETARY LISA SURDAM 9. CHIEF FINANCIAL OFFICER/ LISA SURDAM ADDRESS 276 TRADE STREET ADDRESS 276 TRADE STREET CITY SAN MARCOS CITY SAN MARCOS STATE ZIP CODE CA 92078 STATE ZIP CODE CA 92078 STATE ZIP CODE CA 92078 Names and Complete Addresses of All Directors, lncludlng Directors Who are Also Officers (The corporation must have at least one director. Attach additional pages, if necessa .) 10. NAME ADDRESS CITY STATE ZIP CODE LISA SURDAM 276 TRADE STREET SAN MARCOS CA 92078 11. NAME ADDRESS CITY STATE ZIP CODE 12. NAME ADDRESS CITY STATE ZIP CODE 13. NUMBER OF VACANCIES ON THE BOARD OF DIRECTORS, IF ANY: Agent for Service of Process If the agent is an individual, the agent must reside in California and Item 15 must be completed with a California street address, a P.O. Box address is not acceptable. If the agent is another corporation, the agent must have on file with the California Secretary of State a certificate pursuant lo California Corporations Code section 1505 and Item 15 must be left blank. 14. NAME OF AGENT FOR SERVICE OF PROCESS LISA SURDAM 15. STREET ADDRESS OF AGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF AN INDIVIDUAL CITY 276 TRADE STREET SAN MARCOS T e of Business 16. DESCRIBE THE TYPE OF BUSINESS OF THE CORPORATION MANUFACTURING AND WHOLESALE CANVAS PRODUCTS 17. BY SUBMITTING THIS STATEMENT OF INFORMATION TO THE CALIFORNIA SECRETARY OF STATE. THE CORPOR I ONT NED HEREIN, INCLUDING ANY ATTACHMENTS, IS TRUE AND CORRECT. USA SURDAM C_._E._O ____ _ TYPE/PRINT NAME OF PERSON COMPLETING FORM TITLE 1-200 ( V 01/ 01 J) STATE ZIP CODE CA 92078 0 TE 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 SP-t-l DI G:Q;,o On l O -'UP · l ~ Date before me, --=E,'-'-"-=-6"--'11t-'----"'---.&.-(2o---"-G-~---'---'S"--------I--, -'-N_o_,_~-=-:')...__--'Pll___,,1!,={)-L~- Here Insert Name and Title of the Officer personally appeared USA. M. 5U/t.QA)A.. Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person~ whose name(~ is/ai<e subscribed to the within instrument and acknowledged to me that He/she/t~y executed the same in ~/her/t~ir authorized capacity(~), and that by h'tG/her/t~r signature(~ on the instrument the person~ or the entity upon behalf of which the person(5l acted, executed the instrument. eeeeeeeeeeeel EVETTE ROSAS t@: ~·.·,• ··.. Notary Public -Caii.!orc.ia . 2 i · · San Diego County ! z -• .~ Commission # 22 '. 921 3 My Coc,m. Ex~ires Oc 2'.. 2'~2'. Place Notary Sea/ Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ::::~:: my ~]21- Sig/,ature 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: ___________________________ _ Document Date: __________________ Number of Pages: _____ _ Signer(s) Other Than Named Above: _______________________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ___________ _ Signer's Name: ____________ _ • Corporate Officer -Title(s): ______ _ • Corporate Officer -Title(s): ______ _ • Partner -• Limited • General • Partner -• Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator •Other: ______________ _ • Other: _____________ _ Signer Is Representing: ________ _ Signer Is Representing: ________ _ • ©2016 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 PWM 19-649GS 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 ~\nf'JE: ~ &},. Total% Subcontracted: U< L~ --~-7-~- The Contractor must perform no less than fifty percent (50%) of the work with its own forces Faraday Gazebo Shade Cloth Replacement Page 5 of 7 City Attorney Approved 9/27/16 PWM 19-649GS EXHIBIT B Faraday Gazebo Shade Cloth Replacement Contractor to provide all materials tools and labor to replace the existing shade cloth (top and side} on existing gazebo structure located at the City of Carlsbad Faraday Center. Contractors proposal dated July 17, 2018 estimates the dimesions of the top fabric to be approximately 30' X 14' and the vertical backside of the structure to be approximatiely to be 30' X 5'. Fabric to be Textilene Almond Brown, and attached to the structure using stainless steel tee screws. Top fabric shall be stitched to conform to the shape of the structure. Contractor warranty shall cover all materials and installation for a period of 10 years after the date of installation. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Install new shade cloth on existing gazebo structure. $7,050 TOTAL* $7,050 *Includes taxes, fees, expenses and all other costs. Faraday Gazebo Shade Cloth Replacement Page 6 of 7 City Attorney Approved 9/27/16 ........................... ,,,w...,,..,.._ o.._... .................. .. ............... ..., ..... .,...,.. ............................... ., ...... ........................... <ell-CIWl°""#W• ---•-•-lkllaAl:11 ~- PWM 19-649GS Spec1/iu110ns • ltiCM~ ....... ..,......._ .... I •---------~ .................. ....,. ................. ,.._.~ .... .-.-.....-it _,..,.. ____ .... ____ .. __ ..,._ .. ,,..p-. .., ___ u,,..._.,.._"'"..,. .. -•~1.tt:rw••• ··"""""'--•"'·-... -~ ... ----------------=-.:.-====-~==='="..=:.:.e.:=---____ -10i1""""""-----,-~.--.. ....,_.,...._,a _____ .,...,,~Cll--_,.,,,;--- r J. J: .... ;-; ,._ 7 I: I ~~~-=---..... , __ (f .,filc1 ,m;t'ffl ~---:-~.,✓•-:-:.;.;,:~ •~ • ' • "'-• • .,.-,-• •• ... •••-""_,,_,.,.•~:-:•.,,.,.-•..,..,... ~-~~ 4' yf • n~:•r;•----:;"~••ry;•"• -;.•t.,~•~,,.--.-,,.., • •••• •--•-•r---..~•:-•,...-... J- !. , Ji!l}&chc/1. . .k. -..•• , ,. , .. .,, . , . , •/• ~.:I ......... Faraday Gazebo Shade Cloth Replacement ---TMAHCO .. llO' Page 7 of 7 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 11/14/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 Liberty Mutual Insurance CONTACT NAME: PO Box 188065 PHONE 800-962-7132 I FAX 800-845-3666 Fairfield, OH 45018 /6/t' .,n l'vt\; (A/C Nol: E-MAIL BusinessService{a)LibertvMutual.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: West American Insurance Comoanv 44393 INSURED INSURER B: Ohio Securitv Insurance Comoanv 24082 Sunmaster Products Inc. OBA Sunmaster Sales Inc INSURERC: 276 Trade St INSURER D: San Marcos CA 92078 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 45386188 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 ADDL SUBR r:~Mg~, 1~m,Jg~, LTR TYPE OF INSURANCE ···~~ ••n•~ POLICY NUMBER LIMITS A _!_ COMMERCIAL GENERAL LIABILITY ✓ BKW57430130 9/27/2018 9/27/2019 EACH OCCURRENCE $1 000 000 D CLAIMS-MADE w OCCUR DAMAliE TU RENTED PREMISES /Ea occurrence) $500,000 MED EXP (Any one person) -$15,000 ~ PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 ~ POLICY • jt& DLoc PRODUCTS -COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BAS57 430130 7/7/2018 7/7/2019 COMBINED SINGLE LIMIT s 1,000,000 /Ea accident\ ~ ANY AUTO BODILY INJURY (Per person) $ ~ -OWNED SCHEDULED AUTOS ONLY ....L AUTOS BODILY INJURY (Per accident) $ ~ HIRED NON-OWNED iROPERTY DAMAGE ...:L AUTOS ONLY J_ AUTOS ONLY Per accident) $ $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ ~ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION ✓ XWS57430130 7/17/2018 7/17/2019 I PER I I OTH- AND EMPLOYERS' LIABILITY / STATUTE ER Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE • E.L. EACH ACCIDENT $1,000 000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE s 1 nnn nnn If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services is Additional Insured if required by written contract or written agreement subject to General Liability Blanket Additional Insured Provision. 30* Day Notice of Cancellation •10 Day Notice of Cancellation for Cancellation for Non-Payment of Premium Waiver of Subrogation applies per form WC000313. CERTIFICATE HOLDER CANCELLATION The Ci~ of Carlsbad/CMWD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN c/o EXI IS Insurance Comr:,liance Services ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4668 -ECM #35050 New York NY 10163-4668 AUTHORIZED REPRESENTATIVE ~iw~~ I Christine Smith © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 45386188 I ~"/430130 I 18 19 Master Certificate I Christine Smith I 11/14/2018 12:57:44 PM (PST) I Page 1 of 12 COMMERCIAL GENERAL LIABILITY CG 80 61 0114 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replacing such Conditions is amended by the following: A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or organization shown in the Schedule below. In no event will the notice to the person or organization scheduled below exceed the notice to the first named insured. B. Our obligation to send notice to the person or organization listed in the Schedule below will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person or organization to maintain insurance coverage under a policy which requires that such person or organization be notified in the event of cancellation. 1. Name: City of Carlsbad/CMWD c/o EXIGIS Insurance Comi:,liance Services P.O. Box 4668 -ECM #35050 New York, NY 10163-4668 2. Address: P.O. Box 4668 -ECM #35050 New York NY 10163-4668 3. Number of days advance notice: 30 SCHEDULE All other terms and conditions of this policy remain unchanged. © 2014 Liberty Mutual Agency Corporation. All rights reserved. CG 80 61 0114 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 45386188 I 57430130 \ 18-19 Master Certificate I Christine Smith I 11/14/2018 12:57:44 PM (PST) I Page 2 of 12 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 8810 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SUBJECT NON-OWNED AIRCRAFT NON-OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY-ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY -ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO 15 AN INSURED - FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 8810 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 4~386188 I 57430130 I 18 19 Mas::e:::-Certificate I Christine Smith I 11/14/2018 12:57:44 ?M (PST) I Page 3 of 12 PAGE 2 2 2 2 3 3 3 5 6 6 7 7 7 7 7 8 8 Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I -Coverage A -Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury And Property Damage Liability, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV -Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I -Coverage A -Bodily Injury and Property Damage Liability: CG 8810 0413 a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section Ill -Limits of Insurance. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 45386188 I 57430130 \ 18-19 Master Certificate I Christine Smith I 11/14/2018 12: 57: 44 PM (PST) I Page 4 of 12 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Ill -Limits Of Insurance. 2. Paragraph 6. under Section Ill -Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection systems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) -Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I -Coverage C -Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES AAND B 1. Under Supplementary Payments -Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II -Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: CG 8810 0413 a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 8 45386188 I 57430130 I 18 19 Master Certificate I Christine Smith I 11/14/2018 12:57:44 PM (PST) I Page 5 of 12 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) (2) (3) This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of the operations performed for the state or political subdivision; This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". Insurance applies to premises you own, rent, or control but only with respect to the following hazards: a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. 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. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV -Commercial General Liability Conditions. © 2013 Liberty Mutual Insurance CG 8810 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 45386188 I 57430130 I 18-19 Master Certificate I Christine Smith I 11/14/2018 12:57:44 PM (PST) I Page 6 of 12 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A -Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury'', "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury'' or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement issued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. 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. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: CG 8810 0413 a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 8 45386188 I S/430130 I 18 19 Master Certificate I Christine Smith I 11/14/2018 12:5"/:44 PM (PST) I Page 7 of 12 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section Ill -Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": CG 8810 0413 (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing professional health care personnel to others, or if coverage for providing professional health care services is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 45386188 I 57430130 I 18-19 Master Cert1f1cate I Christine Smith I 11/14/2018 12:57:44 PM (PST) I Page 9 of 12 Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supeNisory capacity for you. SupeNisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supeNision of other "employees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxication by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV -Commercial General Liability Conditions, the following is added to Condition 6. Representations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV -Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, seNant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II -Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, seNant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. 0. BODILY INJURY REDEFINED Under Section V -Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. © 2013 Liberty Mutual Insurance CG 8810 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8 45386188 I 57430130 I 18-19 Master Certificate I Christine Smith I 11/14/2018 12:57:44 PM (PST) I Page 9 of 12 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV -Commercial General Liability Conditions, the following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agreement. © 2013 Liberty Mutual Insurance CG 8810 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8 45386188 I 57430130 I 18-19 Master Certificate I Christine Smith I 11/14/2018 12:57:44 PM (PST) I Page 10 of 12 '"" REPRINTED FROM THL ~ORMS LIBRARY"" XWS57430130 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC 00 0313 (4-84) 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.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. City of Carlsbad/CMWD P.O. Box 4668 -ECM #35050 New York, NY 10163-4668 Schedule Copyright 1983 National Council on Compensation Insurance, Inc. WC 00 03 13 04 84 45386188 I 57130110 I 18-19 Master Certificate ] Christine Smith j 11/14/2018 12:57:44 PM (PST) I Page 11 of 12 EP WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA WC 99 06 79 Ed. 01-13 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement is $ Person or Organization City of Carlsbad/CMWD P.O. Box 4668 -ECM #35050 New York, NY 10163-4668 Job Description Blanket Coverage -Various Locations 250.00 Schedule 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 07/17/2018 Policy Effective 07/17/2018 State California Policy No. XWS57430130 Endorsement No. 007 Premium Insured SUNMASTER PRODUCTS INC. OBA: SUNMASTER SALES INC Insurance Company Liberty Mutual Insurance Company 250.00 Countersigned by cJir~ S~ WC 99 06 79 (Ed. 01-13) © 2013 Liberty Mutual Insurance Includes copyrighted material of WCIRB, with its permission. Raef id Date Policy No. Agency Code 45386188 I 57430130 I 18 19 Master Certificate I Christine Smith I 11/14/2018 12:~7:44 PM (PST) I Page 12 of 12