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Western Pump Inc; 2019-08-08; PWM19-821GS
DocuSign Envelope ID: 6D42ADB1-2A54-4787-BA41-DBA5474A2335 5/27/2020 6/1/2020 CONTRACT CHANGE ORDER NO. 1 PROJECT: Fleet Maintenance Vehicle Lift Replacement CONTRACT NO. PWM19·821GS_ P.O. NO. P137788 ACCOUNT NO. 0018310-7550 CONTRACTOR: Western Pump. Inc. ADDRESS: 3235 F Street San Diego. CA 92102 The Contractor Is directed to make the following changes as described herein. Changes shall Include all labor, materials, equipment, contract time extension, and all other goods and services required to implement this change. Payment stated on this change order includes all charges, direct or Indirect, arising out of this additional work Including charges for field overhead, extended home office overhead, delays, disruptions, cumulative impacts, loss of efficiency, extended equipment costs and overtime premium costs and Is expressly agreed between the City and the Contractor to be the complete and final costs hereof. The requirements of the specifications, where pertinent and not in conflict with this change order, shall apply to these changes. Pursuant to the Standard Specifications for Public Works Construction, perform the following: Item 1 : As quoted In the contractor's quote dated 04/03/2020, Contractor to provide all labor, equipment and materials necessary to install conduit, hanger supports, electrical connectors, wiring and 30 amp disconnects from existing electrical panel to the two new post lifts being installed. Total cost not to exceed ...................................................................... $4,228.30 TOT AL INCREASE TO CONTRACT COST .......................................................... $4,228.30 TIME FOR COMPLETION OF ALL WORK UNDER THIS CONTRACT SHALL BE INCREASED BY 5 WORKING DAYS AS A RESULT OF THIS CHANGE ORDER. c,~t_~_,\~o&o (DATE) DEPARTMENT HEAD (DATE) APPROVED AS TO FORM: CITY ATTORNEY (DATE) DISTRIBUTION: INSPECTION FILE (ORIGINAL), PURCHASING, CONTRACTOR PWM 19-821GS CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FLEET MAINTENANCE VEHICLE LIFT REPLACEMENT This agreement is made on the ~ day of ___ -++-_ __,~----' 2019, by the City of Carlsbad, California, a municipal corporation, (hereinafter ca ity"}, and Western Pump, Inc., a California corporation, whose principal place of business is 3235 F Street, San Diego, CA 92102 (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: John Maashoff (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. Fleet Maintenance Vehicle Lift Replacement Page 1 of9 City Attorney Approved 1/25/2019 PWM19-821GS FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: Print Name: REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers' Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best's Key Rating Guide of at least "A:X''; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than ........ $1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ....... $1,000,000 Property damage insurance in an amount of not less than ........ $1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non- scheduled. The automobile insurance certificate must state the coverage is for "any auto" and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that thirty (30) days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. Fleet Maintenance Vehicle Lift Replacement Page 2 of 9 City Attorney Approved 1/25/2019 PWM19-821GS 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 forty-five (45) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within ninety (90) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Ill Ill Ill Ill Ill Ill Ill Western Pump, Inc. (name of Contractor) 673853 (Contractor's license number) C61/D40, A, C10, B, HAZ 7/31/2019 (license class. and exp. date) 1000006997 (DIR registration number) 6/30/2020 (DIR registration exp. date) Fleet Maintenance Vehicle Lift Replacement Page 3 of 9 3235 F Street (street address) San Diego, CA 92102 (city/state/zip) 760-931-2192 (telephone no.) 760-929-9275 (fax no.) stephaniec@westernpump.com (e-mail address) City Attorney Approved 1/25/2019 PWM19-821GS 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, WESTERN PUMP, INC. a California corporation By: (sign here) :vc,~ \<~:L,~:rD(#, <;,,;fttwy By: (sign here) . CITY OF CARLSBAD, a municipal corporation of the State of California By: ijo-ve. ~ 'R1/fln E:, Be±k-n.e_i e.cA'~de,0- (print name/title)' If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !.f.J! corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney Fleet Maintenance Vehicle Lift Replacement Page 4 of 9 City Attorney Approved 1/25/2019 ACKNOWLEDGMENT • 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 San Diego On~T~ before me. Stephanie Susanne Correia, Notary Public ------------------(insert name and title of the officer) personally appeared 'Ry·{)J\ f::,, ·~~-\--.\1:LJ(l£>.A-e[ , who proved to me on the basis of satisfactory evidence to be the person(.af whose nam~ is/are-- subscribed to the within instrument and acknowledged to me that heilshe/tl 1ey executed the same in his/1"1ei/ttTer, authorized capaci~ and that by hisfl 1ell'tl 1etI signature~n the instrument the person-'"87, or the entity upon behalf of which the perso~acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal i O O 7 °sr7P!N; si:.!E 70:E17 f _ 7 Notary Public • Ciiifornia z i · = San Di~o County f Commission If 2273-467 - My Comm. Expirts Jan 26, 2023 ACKNOWLEDGMENT -~-1 i 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 San Diego On : LJ \:, ) '.)__ .20 IC/ before me Stephanie Susanne Correia, Nata ry Pub lie r (insert name and title of the officer) personally appeared ·ueK e, \C. Ket\?:l[Y)eilf who proved to me on the basis of satisfactory evidence to be the person.~whose name(sYis/.are subscribed to the within instrument and acknowledged to me that he/s.hg/they executed the same in his/tlertth9tr authorized ca pa cit~, and that by hisftte, /ti 1eir signatur~ on the instrument the personfst, or the entity upon behalf of which the person~cted, executed the instrument I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal SignatureJl;r,/,~f:cwtp_ia.__(seal) PWM19-821GS 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 &1~ (!., I 6JN~ {1#,Alf 1,'37'7;)...3 1(31/J p _:iw3'-t/ J'crF~~ ~ f COt:JC0,1,'/8 C. -(p/ I LJ b/p I/ /:emo ~~-ff~c>-14-11A C/Ui,7.. A C.6AI 6#9 , , Total% Subcontracted: / / ------- Fleet Maintenance Vehicle Lift Replacement Page 5 of 9 City Attorney Approved 1/25/2019 PWM19-821GS EXHIBIT B Contractor will provide all labor, equipment and materials necessary to remove three (3) in-ground tow post 8,000-pound vehicle lifts (Vehicle Bay B, G and H) and replace with two (2) SPOA 10 two-post above-ground lifts (Vehicle Bay G and H). SCOPE of WORK: • Pump existing oil from Cylinders to disposal containers (to be left on site). • Remove valves, and hydraulic oil piping located aboveground. • Remove and dispose of both lift superstructures and all lift components located aboveground. • Saw cut concrete to remove cylinders and inground tank. • Breakout Demo and Haul-Off concrete debris. • Backfill with crushed rock. • Grade and compact break out areas. • Dowell into existing concrete. • Place #4 re-bar at 12" o.c.ea. way. • Pour and Finish openings with 4,000 psi concrete. • Provide and Install two (2) Rotary SPOA 10 two Post Vehicle Lifts. NOTES: 1. Above price includes all taxes, fees, and barricades for site safety 2. Above price includes disposal of all lift equipment. 3. Above price excludes all permits and permit handling fees. 4. Above price excludes all engineering drawings. 5. Above price excludes disposal of all containers filled with oil. 6. Above price excludes disposal of any/all soil from excavation (by others). 7. Above price excludes all soil sampling, testing, remediation and removal. 8. Above price excludes removal of excessive material (concrete or caliche) that may be embedded around the vehicle lift equipment. Additional labor and material will be required, and a change order will be processed. 9. Above price excludes additional gravel and concrete that may be required due to the removal of excessive material. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 EA LS Remove three (3) in-ground lifts and install two (2) $42,896.85 above-ground SPAO10 (or equivalent) above-ground lifts. TOTAL* $42,896.85 *Includes taxes, fees, expenses and all other costs. Fleet Maintenance Vehicle Lift Replacement Page 6 of 9 City Attorney Approved 1/25/2019 0 ~ ~ 0 3 CD '< )> "O "O a < CD 0.. is3 (.11 N 0 ...> CD c; t{,",~~ ...,___:,,.., f Mr' 't.YNi.M ,._m s,t.;. _.,/ ■ VEHICLE BAY B '> ■ :i'!il' -•A•U l:Jll\¥3~ oun, ·~h) ,r·A.....-~ S:J!'\lli,: VEHICLE BAY G I~~il=.:J~.'Ai c«J,;tf',MOrffl "lN!l11/11"l".f"""'7.M '.:I o' Executed in duplicate EXHIBITC LABOR AND MATERIALS BOND PWM19-821GS Bond Number: 4428443 Premium: $418.00 Premium is for contract term and subJect to adjustment based on final contract price WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Western Pump, Inc., a California corporation (hereinafter designated as the "Principal"), a Contract for: FLEET MAINTENANCE VEHICLE LIFT REPLACEMENT in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fall to pay for any materials, provisions, provender or other supplies or teams used In, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, Wl;STERti PU~P. INC., as P.ci.ncipal, (hereinafter designated as the "Contractor"), and Sure I ec Insurance t,;ompany as Surety, are held firmly bound unto the City of Carlsbad in the sum of forty two thousand eight hundred ninety six dollars and eighty five cents ($42,896.85), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, Jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due 1mder the Unemployment Insurance Code with respect to the work or labor performed under this Contraq, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to saction ·13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay fot lhe same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. Fleet Maintenance Vehicle Lift Replacement Page8of9 City Attorney Approved 1/25/2019 PWM19-821GS In the event that Contractor Is an Individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. SIGNED AND SEALED, this 24th day of ___ J_u_ly...._ ______ , 20J,g_ ___ W_e;_;s..;.te.;...r_n_P_u;...m_:.;..p:..., l_n...:.c_. __ (SEAL) SureTec Insurance CompanwsEAL) (Principal) By: --~~dkt.;,___F._~__;_;_,;;....;_·_ -q_Signature) (Surety) ~~ / Michael R. Strahan, Attorney-In-Fact (Signature) (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY -ATTACH ATTORNEY-IN-FACT CERTIFICATE) APPROVED AS TO FORM: CELIA A. BREWER :: Attorney ~ g Deputy City orney Fleet Maintenance Vehicle Lift Replacement Page9 of9 City Attorney Approved 1/2512019 ACKNOWLEDGMENT 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 San Diego On ,I;~ Jk, 2{))9 before me, __ s_te_p_h_a_n_i e_S_u_sa_n_n_e_Co_rr_e_ia_, _N_o_t_a_ry_P_u_b_l_i c __ _ (insert name and title of the officer) personally appeared R 6 ... ·11 e,~e,_r who proved to me on the basis of satisfactory evidence to be the person whose namekS') istare subscribed to the within instrument and acknowledged to me that he/sbe'they executed the same in hisiflerftl ,eir 81.Jthorized capacity.(,tesr, and that by hisffter1tl'ieir signature(~n the instrument the person_'9r. or the entity upon behalf of which the perso~ acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signatur~t£~~Seal) STEPHANIE SUSANNE CORREIA Notary Public • California San Diego County J Commission# 2273467 My Comm. Expires Jan 26, 2023 POA #: 510050 SureTec lns.urance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Michael R. Strahan its true and lawful Attorney-in-fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Fifteen Million and 00/100 Dollars ($15,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20U' of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its CEO, and its corporate seal to be hereto affixed this 15th day of May , A.D. 2018 . State of Texas ss: _, .. ,,~.~;~ ~--·· 1"5.."~ (d/~'J. "?\~t ~ I ' E wi w i~• ~\ G., /~} ij\·• •••• _.J. ~ •••• ....-7 County of Harris ""••·v PANY On this 15th day of May , A.D. 2018 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is CEO of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affix.:rl by order of the Board of Directors of said Company; and that he signed his name thereto by like order. avez, Notary Public commission expires September I I, M. Brent Beaty, Assistant Secretary ofSURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Any instrument issued in excess of the penalty stated above is totally void and without any valldlty. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:30 am and 5:00 pm CST. ACKNOWLEDGMENT 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 validitv of that document. State of California S 0. • County of an 1ego on ___ J_ul __ y _24_th_,_2_01_9 ___ before me, ___ E_._B_. S_tr_a_h_a_n_, _N_ot_a_rv_P_ub_l_ic ____ _ (insert name and title of the officer) personally appeared Michael R. Strahan , who proved to me on the basis of satisfactory evidence to be the ~rsonp,j whose name~re ~cribed to the within instrument and acknowl~d to me thadi'iiihe/they executed the same in ~er/their authorized capacity.(l,ar.' and that b~er/their signatur~n the instrument the personjlr,'or the entity upon behalf of which the personj8(acted, executed the Instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official ~--··········~ , .. o, , E. B. STRAHAN : .:~-Notary Public· California ~ :; ~:~ .-.;, j'{: San Diego County '- z <o~,:,;;' Commission # 2244484 - ·• "0•" My Comm. Expires Jun 25. 2022 (Seal) ~ WESTPUM-02 CERT:l ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 6/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer riahts to the certificate holder in lieu of such endorsement(s). PRODUCER 2l?ijI~cT Aida Uranga Wateridge Insurance Services FitJ8,~o, Ext): (858) 452-2200 I FAX 10717 Sorrento Valley Road (A/C, No):(858) 452-6004 San Diego, CA 92121 ito'M~""= auranga@wateridge.com INSURER(Sl AFFORDING COVERAGE NAIC# INSURER A: Everest lndemnitv Insurance Co 01209 INSURED 1NsuRER B: Everest National Insurance Co 10120 Western Pump, Inc. INSURER c : Insurance Co. of the West 27847 3235 F Street INSURERD: San Diego, CA 92102 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. l~f: TYPE OF INSURANCE ~.?.m· W9~ POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -□ CLAIMS-MADE [K] OCCUR DAMAGE TO RENTED 50,000 X EF4ML06288191 4/1/2019 4/1/2020 PREMISES /Fa occurrence\ $ X Contractor Pollution MED EXP (Anv one oerson\ $ 5,000 X Deductible $10,000 PERSONAL & ADV INJURY $ 1,000,000 - 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ Fl PoLlcY [K] ~l8r D Loc PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ / B AUTOMOBILE LIABILITY ~~~~6~~~llNGLE LIMIT $ 1,000,000 X ANY AUTO EF4CA00323191 4/1/2019 4/1/2020 BODILY INJURY (Per oerson\ $ ~ OWNED -SCHEDULED ~ AUTOS ONLY -AUTOS BODILY INJURY /Per accident\ $ X HIRED X ~8to~"m1.~ Ft.,9~~c~Je~t?AMAGE $ AUTOS ONLY X $1,000 comp X $1,000 coll $ A UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 5,000,000 ~ EF4CU01343191 4/1/2019 4/1/2020 5,000,000 X EXCESSLIAB CLAIMS-MADE AGGREGATE $ ./ OED I X I RETENTION $ 0 $ C WORKERS COMPENSATION XI ~ffTllTE I I OTH-AND EMPLOYERS" LIABILITY ER Y/N X WSD503615102 4/1/2019 4/1/2020 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE □ E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA 1,000,000 (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ ~~;~~ftf~~ g'f'gPERATIONS below E.L DISEASE -POLICY LIMIT $ 1,000,000 A Professional Liab EF4ML06288191 4/1/2019 4/1/2020 Claims Made 1,000,000 / A Ded: $10k Per Claim EF4ML06288191 4/1/2019 4/1/2020 Retro Date:5/10/2004 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, m~ be attached If more seace Is required& Excess Liability policy follows the General Liability, Contractors Pollution Liability, rofessional Liability, Auto Lia ility & Employers Liability. 30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of Premium in accordance with the policy provisions. RE: Agreement Number: PWM19-821GS -Fleet Maintenance Vehicle Lift Replacement City of Carlsbad/CMWD is named additional insured with respects to General Liability per the attached endorsement. Workers Compensation Waiver of Subrogation applies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad/CMWD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Compliance Services P.O. Box 4668 -ECM #35050 New York, NY 10163-4668 AUTHORIZED REPRESENTATIVE ~g I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: EF4ML06288191 EVEREST CONTRACTORS ENVIRONMENTAL PLUS ECG 24 670 0818 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION -ONGOING OPERATIONS This endorsement modifies insurance provided under the following: EVEREST CONTRACTORS ENVIRONMENTAL PLUS COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): As required by written contract or agreement provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "environmental damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. ECG 24 670 08 18 All other terms and conditions of this Policy remain unchanged. Copyright, Everest Reinsurance Company 2018 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 1 POLICY NUMBER: EF4ML06288191 EVEREST CONTRACTORS ENVIRONMENTAL PLUS ECG 24 6710818 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS-COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: EVEREST CONTRACTORS ENVIRONMENTAL PLUS COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Location And Description Of Completed Organization(s): Operations Any owner, lessee or contractor whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of the loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or a "pollution incident" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". ECG 24 671 0818 All other terms and conditions of this Policy remain unchanged. Copyright, Everest Reinsurance Company 2018 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET WC 9906 34 (Ed. 8-00) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be 3 % of the total California Workers' Compensation premium otherwise due. Person or Organization ANY PERSON/ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT Schedule Job Description ALL CA OPERATIONS 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 04/01/2019 Policy No. WSD 5036151 02 Insured WESTERN PUMP INC Insurance Company INSURANCE COMPANY OF THE WEST Endorsement No. Premium $ INCL. Countersigned By _____________ _ WC 990634 (Ed. 8-00} INSURED