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HomeMy WebLinkAboutZoubek Consulting LLC; 2018-09-19;AGREEMENT FOR SAFETY AND LOSS CONTROL CONSUL TING SERVICES ZOUBEK CONSULTING, LLC THIS AGRE MENT is made and entered into as of the / 9t6 day of ~e-::~"-:=J==-"-.f-+~.,-~---· 2018, by and between the CITY OF CARLSBAD, a municipal n, ("City" , and Zoubek Consulting, LLC, a Limited Liability Corporation, ("Contractor"). RECITALS A. City requires the professional services of a Consultant that is experienced in safety training and consulting. B. Contractor has the necessary experience in providing professional services and advice related to safety and loss control. C. Contractor has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the "Services") that are defined in attached Exhibit "A", which is incorporated by this reference in accordance with this Agreement's terms and conditions. 2. STANDARD OF PERFORMANCE While performing the Services, Contractor will exercise the reasonable professional care and skill customarily exercised by reputable members of Contractor's profession practicing in the Metropolitan Southern California Area, and will use reasonable diligence and best judgment while exercising its professional skill and expertise. 3. TERM The term of this Agreement will be effective for a period of six (6) months from the date first above written. 4. TIME IS OF THE ESSENCE Time is of the essence for each and every provision of this Agreement. 5. COMPENSATION The total fee payable for the Services to be performed during the initial Agreement term will not exceed thirty-five thousand dollars ($35,000.00). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. The City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or Services specified in Exhibit "A". Incremental payments, if applicable, should be made as outlined in attached Exhibit "A". 6. STATUS OF CONTRACTOR Contractor will perform the Services in Contractor's own way as an independent contractor and in pursuit of Contractor's independent calling, and not as an employee of City. Contractor will be under control of City only as to the result to be accomplished, but will consult with City as necessary. The persons used by Contractor to provide services under this Agreement will not be considered employees of City for any purposes. City Attorney Approved Version 6/12/18 The payment made to Contractor pursuant to the Agreement will be the full and complete compensation to which Contractor is entitled. City will not make any federal or state tax withholdings on behalf of Contractor or its agents, employees or subcontractors. City will not be required to pay any workers' compensation insurance or unemployment contributions on behalf of Contractor or its employees or subcontractors. Contractor agrees to indemnify City within thirty (30) days for any tax, retirement contribution, social security, overtime payment, unemployment payment or workers' compensation payment which City may be required to make on behalf of Contractor or any agent, employee, or subcontractor of Contractor for work done under this Agreement. At the City's election, City may deduct the indemnification amount from any balance owing to Contractor. 7. SUBCONTRACTING Contractor will not subcontract any portion of the Services without prior written approval of City. If Contractor subcontracts any of the Services, Contractor will be fully responsible to City for the acts and omissions of Contractor's subcontractor and of the persons either directly or indirectly employed by the subcontractor, as Contractor is for the acts and omissions of persons directly employed by Contractor. Nothing contained in this Agreement will create any contractual relationship between any subcontractor of Contractor and City. Contractor will be responsible for payment of subcontractors. Contractor will bind every subcontractor and every subcontractor of a subcontractor by the terms of this Agreement applicable to Contractor's work unless specifically noted to the contrary in the subcontract and approved in writing by City. 8. OTHER CONTRACTORS The City reserves the right to employ other Contractors in connection with the Services. 9. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney's fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City's self-administered workers' compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. 10. INSURANCE Contractor will obtain and maintain for the duration of the Agreement and any and all amendments, insurance against claims for injuries to persons or damage to property which may arise out of or in connection with performance of the services by Contractor or Contractor's agents, representatives, employees or subcontractors. The insurance will be obtained from an insurance carrier admitted and authorized to do business in the State of California. The insurance carrier is required to 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. 10.1 Coverage and Limits. Contractor will maintain the types of coverage and minimum limits indicated below, unless the Risk Manager or City Manager approves a lower amount. These minimum amounts of coverage City Attorney Approved Version 6/12/18 2 will not constitute any limitations or cap on Contractor's indemnification obligations under this Agreement. City, its officers, agents and employees make no representation that the limits of the insurance specified to be carried by Contractor pursuant to this Agreement are adequate to protect Contractor. If Contractor believes that any required insurance coverage is inadequate, Contractor will obtain such additional insurance coverage, as Contractor deems adequate, at Contractor's sole expense. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. 10.1.1 Commercial General Liability (CGL) Insurance. Insurance written on an "occurrence" basis, including personal & advertising injury, with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 10.1.2 Automobile Liability. (if the use of an automobile is involved for Contractor's work for City). $1,000,000 combined single-limit per accident for bodily injury and property damage. 10.1.3 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. 10.1.4 Professional Liability. Errors and omissions liability appropriate to Contractor's profession with limits of not less than $1,000,000 per claim. Coverage must be maintained for a period of five years following the date of completion of the work. 10.2 Additional Provisions. Contractor will ensure that the policies of insurance required under this Agreement contain, or are endorsed to contain, the following provisions: 10.2.1 The City will be named as an additional insured on Commercial General Liability which shall provide primary coverage to the City. 10.2.2 Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. 10.2.3 This insurance will be in force during the life of the Agreement and any extensions of it and will not be canceled without thirty (30) days prior written notice to City sent by certified mail pursuant to the Notice provisions of this Agreement. 10.3 Providing Certificates of Insurance and Endorsements. Prior to City's execution of this Agreement, Contractor will furnish certificates of insurance and endorsements to City. 10.4 Failure to Maintain Coverage. If Contractor fails to maintain any of these insurance coverages, then City will have the option to declare Contractor in breach, or may purchase replacement insurance or pay the premiums that are due on existing policies in order to maintain the required coverages. Contractor is responsible for any payments made by City to obtain or maintain insurance and City may collect these payments from Contractor or deduct the amount paid from any sums due Contractor under this Agreement. 10.5 Submission of Insurance Policies. City reserves the right to require, at any time, complete and certified copies of any or all required insurance policies and endorsements. City Attorney Approved Version 6/12/18 3 11. BUSINESS LICENSE Contractor will obtain and maintain a City of Carlsbad Business License for the term of the Agreement, as may be amended from time-to-time. 12. ACCOUNTING RECORDS Contractor will maintain complete and accurate records with respect to costs incurred under this Agreement. All records will be clearly identifiable. Contractor will allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of records and any other documents created pursuant to this Agreement. Contractor will allow inspection of all work, data, documents, proceedings, and activities related to the Agreement for a period of three (3) years from the date of final payment under this Agreement. 13. OWNERSHIP OF DOCUMENTS All work product produced by Contractor or its agents, employees, and subcontractors pursuant to this Agreement is the property of City. In the event this Agreement is terminated, all work product produced by Contractor or its agents, employees and subcontractors pursuant to this Agreement will be delivered at once to City. Contractor will have the right to make one (1) copy of the work product for Contractor's records. 14. COPYRIGHTS Contractor agrees that all copyrights that arise from the services will be vested in City and Contractor relinquishes all claims to the copyrights in favor of City. 15. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City Name Edward Garbo Title Risk Manager Finance / Risk Department Management City of Carlsbad Address 1635 Faraday Avenue Carlsbad, CA 92008 Phone No. 760-602-2471 For Contractor Name Paul A. Zoubek Title President Address 3047 University Avenue, Suite 211 San Diego, CA 92104 Phone No. 619-431-5705 Email paul@zoubekconsulting.com Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 16. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. YesD No. City Attorney Approved Version 6/12/18 4 17. GENERAL COMPLIANCE WITH LAWS Contractor will keep fully informed of federal, state and local lavvs and ordinances and regulations which in any manner affect those employed by Contractor, or in any way affect the performance of the Services by Contractor. Contractor will at all times observe and comply with these laws, ordinances, and regulations and will be responsible for the compliance of Contractor's services with all applicable laws, ordinances and regulations. Contractor will be aware of the requirements of the Immigration Reform and Control Act of 1986 and will comply with those requirements, including, but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants whose services are required by this Agreement. 18. DISCRIMINATION AND HARASSMENT PROHIBITED Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment. 19. DISPUTE RESOLUTION If a dispute should arise regarding the performance of the Services the following procedure will be used to resolve any questions of fact or interpretation not otherwise settled by agreement between the parties. Representatives of Contractor or City will reduce such questions, and their respective views, to writing. A copy of such documented dispute will be forwarded to both parties involved along with recommended methods of resolution, which would be of benefit to both parties. The representative receiving the letter will reply to the letter along with a recommended method of resolution within ten (10) business days. If the resolution thus obtained is unsatisfactory to the aggrieved party, a letter outlining the disputes will be forwarded to the City Manager. The City Manager will consider the facts and solutions recommended by each party and may then opt to direct a solution to the problem. In such cases, the action of the City Manager will be binding upon the parties involved, although nothing in this procedure will prohibit the parties from seeking remedies available to them at law. 20. TERMINATION In the event of the Contractor's failure to prosecute, deliver, or perform the Services, City may terminate this Agreement for nonperformance by notifying Contractor by certified mail of the termination. If City decides to abandon or indefinitely postpone the work or services contemplated by this Agreement, City may terminate this Agreement upon written notice to Contractor. Upon notification of termination, Contractor has five (5) business days to deliver any documents owned by City and all work in progress to City address contained in this Agreement. City will make a determination of fact based upon the work product delivered to City and of the percentage of work that Contractor has performed which is usable and of worth to City in having the Agreement completed. Based upon that finding City will determine the final payment of the Agreement. Either party upon tendering thirty (30) days written notice to the other party may terminate this Agreement. In this event and upon request of City, Contractor will assemble the work product and put it in order for proper filing and closing and deliver it to City. Contractor will be paid for work performed to the termination date; however, the total will not exceed the lump sum fee payable under this Agreement. City will make the final determination as to the portions of tasks completed and the compensation to be made. 21. COVENANTS AGAINST CONTINGENT FEES Contractor warrants that Contractor has not employed or retained any company or person, other than a bona fide employee working for Contractor, to solicit or secure this Agreement, and that Contractor has not paid or agreed to pay any company or person, other than a bona fide City Attorney Approved Version 6/12/18 5 employee, any fee, comm1ss1on, percentage, brokerage fee, gift, or any other consideration contingent upon, or resulting from, the award or making of this Agreement. For breach or violation of this warranty, City will have the right to annul this Agreement without liability, or, in its discretion, to deduct from the Agreement price or consideration, or otherwise recover, the full amount of the fee, commission, percentage, brokerage fees, gift, or contingent fee. 22. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees that any Agreement claim submitted to City must be asserted as part of the Agreement process as set forth in this Agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that if a false claim is submitted to City, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act applies to this Agreement and, 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 information. If City seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorney's fees. Contractor acknowledges that the filing of a false claim may subject Contractor to an administrative debarment proceeding as the result of which Contractor may be prevented to act as a Contractor on any public work or improvement for a period of up to five (5) years. Contractor acknowledges debarment by another jurisdiction is grounds for City to terminate this Agreement. 23. JURISDICTION AND VENUE Any action at law or in equity brought by either of the parties for the purpose of enforcing a right or rights provided for by this Agreement will be tried in a court of competent jurisdiction in the County of San Diego, State of California, and the parties waive all provisions of law providing for a change of venue in these proceedings to any other county. 24. SUCCESSORS AND ASSIGNS It is mutually understood and agreed that this Agreement will be binding upon City and Contractor and their respective successors. Neither this Agreement nor any part of it nor any monies due or to become due under it may be assigned by Contractor without the prior consent of City, which shall not be unreasonably withheld. 25. ENTIRE AGREEMENT This Agreement, together with any other written document referred to or contemplated by it, along with the purchase order for this Agreement and its provisions, embody the entire Agreement and understanding between the parties relating to the subject matter of it. In case of conflict, the terms of the Agreement supersede the purchase order. Neither this Agreement nor any of its provisions may be amended, modified, waived or discharged except in a writing signed by both parties. II II II II City Attorney Approved Version 6/12/18 6 26. 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 V (s{gn here) P.u1 ( A Z u ~1 l; c. k_ / P ~c;, J e 11.r-+ (print name/title) ' By: (sign here) (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California ATTEST: Kevin Branca Finance Director l1~R1rl-~ ~ARBARA ENGLESON lr vity Clerk If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups. Group A 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: Assistant City Attorney City Attorney Approved Version 6/12/18 7 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 9 0 t O O O O 8 8 J 6 '.lOOIJPB1lU IOO BUfJ88081: J O IJ9UC O f O B D E D E J Dt C B J O C O C C C B O [J:81 880:88088 A notary public or other officer completing this certificate verifies only the identity of the individual who signed t:ie document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of Calif~a ? 1 } County of g:)_ /) /.£1~ 0 On __ f/ ___ Vi_(_,.....,..& __ before me, Ck,eoA Oa 4Q.<±ll.{I, Al oflb-.4 p gb Ire Date 0 . {' II , ~re /ns~ame and fitle of the Offlcer • personally appeared _____ _u~~~lL-~_,.t,_/ ~<1_,.,..i _..,.c_/r_)_l_( _t_,f" __ ~(-_-___________ _ ~ Name(~ of Signer~ who proved to me on the basis of satisfactory evidenc¼o be the person~ whose name'rsii~~e subscribed to the within instrument and ackno~ed to me that~Ys~/t~y executed the same i~tteN~ir authorized capacity(~. and that b his ~th~ signature'(s.l_ on the instrument the perso~, or the entity upon behalf of which the person(s) acte , executed the instrument. @ CHERYL DAGOSTARO _ Notary Public -Cahlornia ~ San Diego County ~ 1 Commission# 2162500 ~ J+ < ~ 0 0 0Mz so:r:: Expires Aug~· 2020 ( 0 C COO O O + Place Notary Seal and/or Stamp 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. OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended documen ttached Document Title or Type of Docu Signer's Name: ----::...-'---------o Corporate Officer o Partner -1mited o ual o Attorney in Fact o Guardian of Conservator Signer is Representing: _________ _ o Trustee o Other: D General o Attorney in Fact Guardian of Conservator Signer is Representing: -------".....,:------ cot BUii• •• • )II J B O at D BD0800lJ oa:1 II 18(1 ft 10 JU 1811 11IOD0881l811218881 ID Cl I) ©2017 National Notary Association See attached "Scope of Work". EXHIBIT "A" SCOPE OF SERVICES 8 City Attorney Approved Version 6/12/18 ~oubek Consulting, LLC Workplace Safety Solutions August 14, 2018 City of Carlsbad Mr. Ed Garbo 1635 Faraday Avenue Carlsbad, CA 92008 Ed.Garbo@carlsbadca.gov 760-602-2471 RE: Safety & Loss Control Consultant Services-Cost Estimate for third trimester 2018 DearEd, , The attached cost estimate outlines work scope, hours, hourly rates performed by two levels of consultants. It allows overlap of consultants particularly during the month of September for consistency and quality purposes, as well as additional overlap for same purpose during subsequent months. Total cost through the end of the year comes approximately $4000 below what you have allocated to allow for some leeway, more overlap in early weeks or an earlier start date if you wish. Please let me know if you have any comments or questions. Sincerely, /J~ Paul A Zoubek, CIH, CSP, CESCP, SMS President Zoubek Consulting, LLC 619-677-8682 paul@zoubekconsulting.com 3047 University Ave, Suite 211 • San Diepo, CA 92104 Ph: 619-431-5705 • www.zoubekconsulting.com • info@zoubekconsulting.com Cost Estimate-3rd Trimester 2018 City of Carlsbad August 14, 2018 Ooubek Consulting, LLC Workplace Safety Solutions Page2 T bl 1 S f, a e -erv1ces per orme dd S t b 2018 urmg ep em er CONTENTS HOURS RATE TOTAL COMPLIANCE DOCUMENT REVIEW/PREPARATION/Month 1 The following work will be performed at EHS Consultant Level • Review Injury and Illness Prevention Plan (IIPP) • Review and Update City's training Matrix 72 • Tour City locations and develop priority list of (Consultant) $77.50 $5580.00 site inspections • Establish an inspection schedule 28 $67.50 $1890.00 • Provide comprehensive status report at the end of (Jr. Consultant) September to the Risk Manager TOTAL $7470.00 Table la-Proposed Work Hours (September 2018)* September 2018 S~nbci.2.01.11 Ckt:i-a,~111 .. '"" Tc "' Th ,, ,. "' M, T, ,,. Th ,, s, ' ' l l . ' ' ; ,; " ' ' T ' T . ' ,0 " '2 " " " " " ,. " ,~ F " " ,., " " " " " " " " " 21 14 " " i; " ,. ::s " ,; " " " 2q ,., " 3C SUNDAY MONDAY TUESDAY W8:JNE5DAY THURSDAY FRIDAY SAlURDAY Aug 26 27 28 29 30 31 Sep 1 2 3 4 5 6 7 8 I LABOR DAY HOI.IDAY I I S-TART &IS ConsUtant I 11' EHS Coroultant (4 I I EHS Cor'5ulant rs I I EHS Consifunt (6 I 18 Hoursl Hours! + EHS HoU's) + Jr EHS HoLr~j Coruutant 18 Hoursl CoruUtart f4 Ho1.nl 9 10 11 12 13 14 15 Jr EHS Consultant (4 I I Jr EHS Lonsultant (6 i I EHS ConsUtant (8 i Hours) Hours} Ho1Js) 16 17 18 19 20 21 22 ~ Comultant (8 -1 I EHS Consutart (S ---, EHS Conslitant (8 l Hoursl I Hoissi Hours} 23 24 25 26 27 28 29 I Jr EHS Consuhntl4-I Hours) 1lrEHS-ConsulfarifTa--7 Hours} f EFis""(onsifunf[B ~--1 HOU'S} *Hours, costs and dates subject to agreement by client. Cost Estimate-Yd Trimester 2018 City of Carlsbad August 14, 2018 Ooubek Consulting, LLC Workplace Safety SOiutions Page3 T bl 2 S a e -erv1ces per orme d O t b th co er rou~ hD b 2018 ecem er CONTENTS HOURS RATE TOTAL TRAINING & CONSULTING/Subsequent Months* The following work will be performed at EHS Consultant Level • Counsel and assist the Risk Manager in performance duties typical of an in-house safety professional. • Inspection schedule of City sites, identifying and assessing risks and executing and monitoring actions to identified risks. • Prepare written reports of all assessments conducted to include corrective action(s) and recommendations, with timely follow-ups ensuring compliance. • Provide work area safety inspections and hazard identification with all appropriate counseling and coaching on best practices. • Audit and update current safety policies, programs and protocols, ensuring compliance 184 with federal, state, and City rules, laws and (Consultant) regulations, as well as assisting in the $77.50 $14,260.00 development of new policies as needed. 76. $67.50 $5130.00 • Analyze data and recommend loss control (Jr. Consultant) measures. • Recommend and perform other safety related projects. • Administer monthly progress meeting with Risk Management. • Develop and deliver the following training presentations • Heat Illness Prevention • Emergency Action Plan • Bloodbome Pathogen & Exposure Control Plan • Fire Safety • Ladder Safety • Hazard Communication • Hazardous Materials TOTAL $19,390.00 Cost Estimate-3rd Trimester 2018 City of Carlsbad August 14, 2018 Page4 Table 2a-Proposed October 2018 SUNDAY fl.,,()NDAV TUESDAY Sep 30 Oct 1 2 I.EH5Consulant[8 I Hours) .. Jr EHS Comlltalt{4Houn;) 7 8 9 11rERsConmtant 14 I Hours) 14 15 16 I EH~~;utant {8 21 22 23 llrE:~ 5 ;mutarrt(4 28 29 30 ~utant/R I Hours) ____ Zoubek Consul Ing LLC November 2018 SUNDAY fv'ONDAY 1\JESDAV Oct 28 29 30 4 5 6 I Jr ~~; 1 ~nsuhnt 14 11 12 13 I EHSConsutant(S Hours) 18 19 20 -irE:a:~ 1 0nsutinfff-! 25 26 27 I EHSConsut.ant(B Hours] Zoubek Consultng LLC ~oubek Consulting, LLC Workplace Safety Solutions Work Hours (October-December 2018)* WEDNESDAY 3 I EHS Conn:dlart {8 Hounj I 10 1·1r EH5 Consuta~ Hou.-.l 17 I BiSCoru~rt[8 Hout51 ! 24 Jr EHS Consutart (8 I Hour<i 31 &i~~o;~~r~::S I Corl'§u~an!_(4 HourS1 I WEDNESDAY 31 7 Jr Hnur~~,onl: 1:_ _ _1 14 I.EHSCorn~rt(B _j ~~--~ 21 28 EHS Connnan: (8 I Hours) -JrEHS Co1"6utantl4HourS, " ~ ' ' ' . , ' ' " ' .. ,. " " " < . ' ii . 1Q " " " " :,) ., " ,. " " ~, ,, ,., ,. " " " " ., " ,, ,., " a .• l·i " " ,. ~; " " THURSDAY FRIDAY SAlURDAV 4 6 I EHS ConsUlant (l! Hoursl 11 12 13 ~oruLlwltiB--1 HOISS L 18 19 20 EHS CormJtant (B Ho1.1sl 25 26 27 fHS ConsUlant 18 ' Holl"S Nov 1 3 8/10/2018 S;OlPM !lcoo...,;,,.JGU . ~ , ' ' ' . . " g ' " ' ' ' " ;~ " " " " " ·o ., " ~! " " " 1~ " " " " " '" ll " " " " " ,. " ,. " " " " THURSDAY F'RJOAV SATURDAY Nov1 2 3 EHS Consutarlti6 • H0111) 8 10 .i:.n;:, ._onnltantl Ho<n 15 16 17 IEHS CormJtant:(8 H011s 22 23 24 ~TR.17fffGNl~rn<lClllAY" J 29 30 Dec 1 ~~~ 8/10/2018 5:02 PM Cost Estimate-3rd Trimester 2018 City of Carlsbad August 14, 2018 PageS December 2018 SUNDAY MONDAY TUESDAY Nov25 26 27 2 3 4 Jr EHS Consultant (4 I Hours] 9 10 11 I EHS Consullant 18 Hour5) I 16 17 18 I Jr EHS Consultant {4 Hounl I 23 24 25 CHRISTMAS HOllOAY 30 31 Jan 1, 19 Zoubek Const.lung LLC WEDNESDAY 28 5 Jr EHS ConsU.tant [6 Hour~ 12 I EHS Comultant (8 Hours) 19 I Jr EHS ConsUtant {8 Hour§! 26 2 *Hours, costs and dates subject to agreement by client ~oubek Consulting, LLC Workplace safety Solutions Du~:.xl18 fa.,,ury<'a19 ., .... 1e ','!1-11 .. ,, So '" Mo ,, w, Th " s., I 1 l l . ' 2 ' . 5 ' ' ' ' 1 • ' " 11 1..: ' " 11 " 1J " 1S 13 " IS " " " .. " 17 " " " " i.2 " " ,., n " " ,. " " " 16 " " ,. " " 29 JO " " " THURSDAY FRIDAY SATURDAY 29 30 Dec 1 6 7 8 I I EHS Connitant {6 I ! Hol6sl 13 14 15 I EHS Comutant (8 I Hal.l's) 20 21 22 I EHS ConsLJtant [8 I HDLl'Sl I 27 28 29 3 4 5 8/10/2018 5:08 PM Cost Estimate-3rd Trimester 2018 City of Carlsbad August 14, 2018 Ooubek Consulting, LLC Workplace safety Solutions Page6 Table 3-Approximate Services performed by Sr. Consultant (S t b th h D b 2018) ep em er roug ecem er CONTENTS HOURS RATE TOTAL TRAINING & CONSULTING/Subsequent Months The following work will be performed at Senior EHS Consultant Level • Develop and deliver the following training presentations • Hot work • Lockout/Tagout • Electrical Safety • Confined Spaces • Fall Protection 30 $148.00 $4440.00 • Forklift • Welding cutting & brazing • Provide quality assurance reviews for work performed by consultants. • Others as directed by client. Table 4-Total Approximate Costs (Jrd Trimester 2018) JUSTIFICATION TOTALS Services performed during September 2018 $7470.00 Services performed October through December 2018 $19,390.00 Services performed by Sr. Consultant $4440.00 APPROXIMATE GRAND TOTAL (Sept-December 2018) $31,300.00 ZOUBE-1 OPID: PJ ACORD-CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYYJ ~ 07/05/18 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 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 Phone: 520-795-8511 CONTACT NAME: THE MAHONEY GROUP -TUCSON Fax: 520-795-8542 PHONE I FAX 5330 N. La Cholla Blvd IA/C No Extl: (A/C Nol: Tucson, AZ 85741-3815 E-MAIL ADDRESS: David Perks INSURER(S) AFFORDING COVERAGE NAIC# INsuRERA: Valley Forge Ins. Company 20508 INSURED Zoubek Consulting, LLC INSURER B: Natl. Fire Ins. Co of Hartford 20478 Attn: Paul Zoubek INsuRERc: Philadelphia Indemnity Ins. Co 18058 3047 University Ave, Suite 211 San Diego, CA 92104 INSURERD: INSURERE: INSURERF: 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 ~-1POLICYEFF ·=~~Ji'l'v%, LTR TYPE OF INSURANCE ,.,c,D WVD POLICY NUMBER MM/DDNYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00(] ~ UPJW\UE , u r<cr,, cu A X COMMERCIAL GENERAL LIABILITY X X 4017910125 12/01/17 12/01/18 PREMISES /Ea occurrence) $ 300,00(] >---D CLAIMS-MADE 00 OCCUR MED EXP (Any one person) $ 10,00(] PERSONAL & ADV INJURY >---$ 1,000,00(] GENERAL AGGREGATE $ 2,000,00(] ~ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,000,000 n POLICY n P,t P-i nLOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 /Ea accident\ $ f--- A ANY AUTO 4017910125 12/01/17 12/01/18 BODILY INJURY (Per person) $ ~ ALL OWNED -SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ f---- X X NON-OWNED iP~~~~~t~AMAGE $ HIRED AUTOS AUTOS $ UMBRELLA LIAS H OCCUR EACH OCCURRENCE $ ~ EXCESS LIAS CLAIMS-MADE AGGREGATE $ OED I I RETENTION $ $ WORKERS COMPENSATION I /;!,g$T~i¥s I l0J,t AND EMPLOYERS' LIABILITY B Y/N 417959065 12/01/17 12/01/18 1,000,00(] ANY PROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A 1,000,00(] (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ 1,000,00(] C Professional PHSD1295257 12/01/17 12/01/18 Ea Claim 1,000,000 Aggregate 1,000,00(] DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Addttlonal Remarks Schedule, If more space is required) Certificate holder is additional insured Including Primary/Non-Contributory & Waiver of Subrogation per attached form #SB146932F(6-16). CERTIFICATE HOLDER CANCELLATION C---- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad ACCORDANCE WITH THE POLICY PROVISIONS. 1635 Faraday Ave AUTHORIZED REPRESENTATIVE Carlsbad, CA 92008 IQ& I © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ·---.1 ··---------------------·-·· ------- ~NA SB146932F (Ed. 6-16) BLANKET ADDITIONAL INSURED AND LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS IAEILE QE ~QNTENII -1. 1111111111 Addnlonal lnaurad Provisions A. Addltlonal 1nstnc1 -IIIIDMI ~ a. lllamllanaoua Addltlonal Insureds ~-Adllblonal Provlalo.-. ~ 1Q Addblonal 1naurec1 eo,,... l. P[lmm -Noncontrlbutorv nroviamo z. DIIIDttion gt •wrtttan mmact-• 11. 1 lablll1¥ Extwlon ~vngas A. Bodi!¥ lolurv -E1Qllnded Definition 1. &road Knowledae gt ocanence ~. Estala. Lagal BwesantativN and Snot.1111 D, Lwl I lobHb -D1mw l!l Premlw E. Paraonal and AdvertlliDII IDilU -f:2lacrlmiDlllml m: l::lt.1mU1at1on E. Peraonal and Aclvertlllml lDilD -Elroadaned E1ictlon -G. W.tvar of IYIKoaation -BIIDHI - I. EILANKEI ADDDJ()NAL INSURED PBQYISIQNS A. ADDITIONAL INSURED-BLANKET VENDORS Who Is An Insured is amended to include as an additional insured any person or organization (referred to below as vendor) with whom you agreed under a "written contract" to provide insurance, but only with respect to "bodily injury• or "property damage• arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; SB146932F (6-16) Page 1 of 7 Cop>frlght, CNA Al Rights Raeerved. •ollcy #: 4017910125 Term: 12/01/17-12/01/18 lliiiiil liilil ---= C'NA SB146932F (Ed. 6-16) •· Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, In connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribu1ion or sate by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily Injury" or "property damage" arising ou1 of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Subparagraphs d. or f.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient. part or container, entering into, accompanying or containing such products. 3. This provision 2. does not apply to any vendor included as an insured by an endorsement issued by us and made a part of this Policy. 4. This provision 2. does not apply if "bodily injury" or "property damage" included within the "products- completed operations hazard" is excluded either by the provisions of the Policy or by endorsement. B. MISCELLANEOUS ADDm0NAL INSUREDS 1. Who la An Insured is amended to include as an Insured any person or organization (called additional Insured) described in paragraphs 3.a. through 3.j. below whom you are required to add as an additional Insured on this policy under a "written contract.": 2. However, subject always to the terms and conditions of this policy, including the limits of insurance, we will not provide the additional insured with: a. A higher limit of insurance than required by such "written contract"; b. Coverage broader than required by such "written contract" and in no event greater than that described by the applicable paragraph a. through k. below; or c. Coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard.• Bu1 this paragraph c. does not apply to the extent coverage for such liability is provided by paragraph 3.f. below. Any coverage granted by this endorsement shall apply only to the extent permitted by law. 3. Only the followlng parsons or organizations can qualify as additional insureds under this endorsement: a. Controlling lnterNI Any persons or organizations with a controlling interest in you bu1 only with respect to their liability arising out of: (1) such person or organization's financial control of you; or (2) Premises such person or organization owns, maintains or controls while you lease or occupy these premises; provided that the coverage granted to such additional insureds does not apply to structural alterations, new construction or demolition operations performed by or for such additional insured. SB146932F (6-16) Page 2 of 7 Copyright, CNA All Rights Reaerved. u111,y ... ...., ''" IU 1£.;) ltfllll. IUU 111,-,uu 1110 ~-· b. Co-own. of Insured PremlNa S8146932F (Ed. 6-16) A co-owner of a premises co-owned by you and covered under this insurance but only with respect to the co-owners liability for "bodily injury", 'property damage' or "personal and advertising injury" as co-owner of such premises. c. Grantor of FranchiN Any person or organization that has granted a franchise to you, but only with respect to such person or organization's liability for "bodily injury", 'property damage", or "personal and advertising injury' as grantor of a franchise to you. d. Lesaor of Equipment Any person or organization from whom you lease equipment, but only with respect to liability for "bodily injury", "property damage" or 'personal and advertising Injury" caused in whole or In part by your maintenance, operation or use of such equipment, provided that the 'occurrence" giving rise to such 'bodily injury' or 'property damage' or the offense giving rise to such 'personal and advertising injury" takes place prior to the termination of such lease. •. Leaor of Land Any person or organization from whom you lease land, but only with respect to liability for "bodily injury", 'property damage' or "personal and advertising injury" arising out of the ownership, maintenance or use of that specific part of the land leased to you, provided that the "occurrence" giving rise to such 'bodily injury" or 'property damage' or the offense giving rise to such "personal and advertising injury•, takes place prior to the termination of such lease. The Insurance hereby afforded to the additional insured does not apply to structural alterations, new construction or demolition operations performed by, on behalf of or for such additional insured. f. LNaor of Premlaes An owner or lessor of premises leased to you, or such owner or lessor's real estate manager, but only with respect to liability for "bodily injury", "property damage• or "personal and advertising Injury• arising out of the ownership, maintenance or use of such part of the premises leased to you, and provided that the "occurrence" giving rise to such "bodily injury" or "property damage" or the offense giving rise to such "personal and advertising injury", takes place prior to the termination of such lease. The Insurance hereby afforded to the additional Insured does not apply to structural alterations, new construction or demolition operations performed by, on behalf of or for such additional Insured. g. Mortgagee, Aulgnee or Receiver A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee, or receiver's liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of the ownership, maintenance, or use of a premises by you. This Insurance does not apply to structural alterations, new construction or demolition operations performed by, on behalf of or for such additional insured. h. State or Polllical Subdlvlaiona A state or government agency or subdivision or political subdivision that has issued a permit or authorization, but only with respect to such government agency or subdivision or political subdivision's liability for "bodily injury•, "property damage" or "personal and advertising Injury" arising out of: (1) The following hazards in connection with premises you own, rent, or control and to which this Insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway 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; or S8146932F (6-16) Page 3 of 7 Copyright, CNA Al Rights Reeerved. 011cy IF: 4U11111u1.::, rerm: 1:.uu1111-1:.uu11111 I I I ---ii • C'NA SB146932F (Ed. 6-16) (2) The permitted or authorized operations performed by you or on your behalf. But the coverage granted by this paragraph does not apply to: (a) "Bodily injury", "property damage• or "personal and advertising injury• arising out of operations performed for the state or government agency or subdivision or political subdivision; or (b) •Bodily injury" or "property damage" included within the "products-completed operations hazard.• Wrth respect to this provision's requirement that additional insured status must be requested under a "written contract", we will treat as a "written contract" any governmental permit that requires you to add the governmental entity as an additional insured. I. Trade Show Event Leaor With respect to your participation in a trade show event as an exhibitor, presenter or displayer, any person or organization .whom you are required to include as an additional insured, but only with respect to such person or organization's liability for "bodily injury", "property damage", or "personal and advertising injury" cause by: a. Your acts or omissions; or b. Acts or omissions of those acting on your behalf; in the performance of your ongoing operations at the trade show premises during the trade show event. J. ~ Person or Organization Any person or organization who is not an additional insured under paragraphs a. through I. above. Such additional insured is an insured solely for "bodily Injury•, "property damage• or "personal and advertising injury" for which such additional insured is liable because of your acts or omissions. The coverage granted by this paragraph does not apply to any person or organization: (1) For "bodily injury,• "property damage,• or "personal and advertising injury" arising out of the rendering or failure to render any professional services; (2) For "bodily injury" or "property damage" included in the "products-completed operations hazard: But this provision (2) does not apply to such 'bodily injury" or "property damage" if: (a) It is entirely due to your negligence and specifically results from your work for the additional insured which is the subject to the "written contract"; and (b) The "written contract" requires you to make the person or organization an additional insured tor such "bodily injury• or "property damage"; or (3) Who is afforded additional insured coverage under another endorsement attached to this policy. C. ADDITIONAL PROVISIONS PERTINENT TO ADDITIONAL INSURED COVERAGE With respect only to additional insured coverage provided under paragraphs A. and B. above: 1. The BUSINESSOWNERS COMMON POLICY CONDITIONS are amended to add the following to the Condition entitled ~ Insurance: This insurance is excess of all other insurance available to an additional insured whether primary, excess, contingent or on any other basis. However, if a "written contract" requires that this insurance be either primary or primary and noncontributing, then this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured . 2. Under Llability and Medical Expense Definitions, the following definition is added: "Written contract' means a written contract or agreement that requires you to make a person or organization an additional insured on this policy, provided the contract or agreement: a. Is currently In effect or becomes effective during the term of this policy; and b. Was executed prior to: S8146932F (6-16) Page 4 of 7 Copyright, CNA All Rights Reserved. U'tU .. J ff' ... U I I ii IV l._<J IVIIII. IMU 1111 • IMU II IU C'NA (1) The "bodily injury• or "property damage"; or (2) The offense that caused the "personal and advertising injury"; for which the additional insured seeks coverage. II, UABIUJY EXTENSION COVERAGES SB146932F (Ed. 6-16) It Is understood and agreed that this endorsement amends the BuslnHIDWMnl Llablllly Coverage Form. If any other endorsement attached to this policy amends any provision also amended by this endorsement, then that other endorsement controls with respect to such provision, and the changes made by this endorsement to such provision do not apply. A. Bodlly Injury -Expanded Definition Under Llabillly and Medical Expenses Definitions, the definition of "Bodily Injury" is deleted and replaced by the following: "Bodily injury• means physical injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the physical injury, sickness or disease. B. Broad Knowledge of Occul'l'WICe Under Businessowners Liability Conditions, the Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended to add the following: Paragraphs a. and b. above apply to you or to any additional insured only when such "occurrence,• offense, claim or "suit" is known to: (1) You or any additional insured that is an individual; (2) Any partner, if you or an additional insured is a partnership; (3) Any manager, if you or an additional insured is a limited liability company; (4) Any "executive officer" or insurance manager, If you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (6) Any elected or appointed official, if you or an additional Insured is a political subdivision or public entity. This paragraph applies separately to you and any additional insured. C. EslatN, legal Representatives and SpousN The estates, hairs, legal representatives and spouses of any natural parson insured shall also be insured under this policy; provided, however, coverage is afforded to such estates, heirs, legal representatives and spouses only for claims arising solely out of their capacity as such and, in the case of a spouse, where such claim seeks damages from marital common property, jointly held property, or property transferred from such natural parson insured to such spouse. No coverage is provided for any act, error or omission of an estate, hair, legal representative or spouse outside the scope of such person's capacity as such, provided however that the spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership Named Insureds are insureds with respect to such spouses' acts, errors or omissions in the conduct of the Named lnsured's business. D. Legal Llablllty-Damage To Premlaea 1. Under B. Excluslona, 1. Applicable to Business Llabillly Coverage, Exclusion le. Damage To Property, is replaced by the following: le. Damage To Property "Property damage" to: 1. Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of SB146932F (6-16) Page 5 of 7 Copyright, CNA Al Rights Reserved. -unt.,J w. •u11.11u1._.., 1'D'1111. ,.,u., 1,-,.,u111u --iiiiii ii • C'NA SB146932F (Ed. 6-16) such property for any reason, including prevention of Injury to a person or damage to another's property; 2. Premises you sell, give away or abandon, if the "property damage• arises out of any part of those premises; 3. Property loaned to you; 4. Personal property in the care, custody or control of the insured; 5. That particular part of any real property on which you or any contractors or subcontractors working directly or Indirectly in your behalf are performing operations, if the "property damage• arises out of those operations; or 6. That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraph 2 of this exclusion does not apply if the premises are "your work" and were ,never occupied, rented or held for rental by you. Paragraphs 1, 3, and 4, of this exclusion do not apply to "property damage• (other than damage by fire or explosion) to premises: (1) rented to you: (2) temporarily occupied by you with the permission of the owner, or (3) to the contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section D - Liability and Medical Expenses Limits of Insurance. Paragraphs 3, 4, &, and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to "property damage• included in the 'products-completed operations hazard.• 2. Under B. Exclusions, 1. Appllcablato Buall'INII Uablllty Covsage, the following paragraph is added, and replaces the similar paragraph, if any, beneath paragraph (14) of the exclusion entitled Peraanal and Advertising ln)wy: Exclusions c, d, e, f, g, h, I, k, I, m, n, and o, do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner or to the 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 D. Liability And Medlcal ExpenNe Limits Of Insurance. 3. The first Paragraph under item 5. Damage To Pramlaes Rented To You Umit of the section entitled UllbHHy And lledlcat Expenses Limits Of lnaurance is replaced by the following: The most we will pay under Business Liability for damages because of "property damage• to any one premises, while rented to you or temporarily occupied by you with the permission of the owner, including contents of such premises rented to you for a period of 7 or fewer consecutive days, is the Damage to Premises Rented to You limit shown in the Declaration. E. Personal and Advertising ln)wy -Dlacrlmlnatlon or Humillllllon 1. Under Llabillty and Medlcal ExpenHS Definitions, the definition of "personal and advertising injury• is amended to add the following: h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is: (1) Not done intentionally by or at the direction of: (a) The insured; or SB146932F (6-16) Page 6 of 7 Copyright, CNA All Rights Reserved. Ull\,J tr. -.,u I I oil IU I.C..., IVIIII• ltfJU II 11..,1._,V II IU ~-· SB146932F (Ed. 6-16) (b) Any "executive officer,· director, stockholder, partner, member or manager (If you are a limited liability company) of the insured; and (2) Not directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person or person by any insured. 2. Under B. Exclusions, 1. Applicable to Buslneu Liability eo,,.., the exclusion entitled Personal and Advertising Injury is amended to add the following additional exclusions: (15) Discrimination Relating to Room, Dwelling or Premleea Caused by discrimination directly or indirectly related to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured. (16)Employmant Related Discrimination Discrimination or humiliation directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person by any insured. (17)FinN or Penalliee Fines or penalties levied or imposed by a governmental entity because of discrimination. 3. This provision (Penonal and Advertising ln)my -Discrimination or HI.Rlllllallon) does not apply if Personal and Advertising Injury Liability is excluded either by the provisions of the Policy or by endorsement. F. Personal and Advertising lnjwy -Broadened Eviction Under Liability and Medical Expenees Definitions, the definition of "Personal and advertising injury• is amended to delete Paragraph c. and replace it with the following: c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room dwelling or premises that a person or organization occupies committed by or on behalf of its owner, landlord or lessor. G. Waiver of Subrogation -Blanket We waive any right of recovery we may have against: a. Any person or organization with whom you have a written contract that requires such a waiver. All other terms and conditions of the Policy remain unchanged. SB 146932F (6-16) Page 7 of 7 Cop/right, CNA An Rights Reaerved.