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HomeMy WebLinkAboutDiamond Designs LLC; 2022-01-24; PKRC21-1013Tracking #: BALLFIELD RENOVATION PROJECT; CONT. NO. PKRC21-1013 Page 1 of 10 City Attorney Approved 1/22/2020 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT BALLFIELD RENOVATION PROJECT; CONT. NO. PKRC21-1013 This agreement is made on the ______________ day of _________________________, 20___, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Diamond Designs, LLC whose principal place of business is 11956 Bernardo Plaza Dr. #519, San Diego, CA 92128 (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 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: __Temujin Matsubara__ (City Project Manager) PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. 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. DocuSign Envelope ID: 0C6E24BB-B302-4AD8-B489-78EE38081 DAB 24th January 22 terms and conditions in the Contractor's proposal. DocuSign Envelope ID: 0C6E24BB-B302-4AD8-B489-78EE38081DAB Tracking#: 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 30 working days after receipt of Notice to Proceed . Completion: Contractor agrees to complete work within 60 working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. /II /II /II /II /II /II /II Ill Ill /II Diamond Designs, LLC (name of Contractor) 1025791 (Contractor's license number) C27 -4/30/2023 (license class. and exp. date) 1000048391 (DIR registration number) 6/30/2024 (DIR registration exp. date) BALLFIELD RENOVATION PROJECT; CONT. NO. PKRC21-1013 Page 3 of 10 11956 Bernardo Plaza Dr. #519 (street address) San Diego, CA 92128 (city/state/zip) 916-709-0299 (telephone no.) NIA (fax no.) alwinejr@gmail.com (e-mail address) City Attorney Approved 1/22/2020 DocuSign Envelope ID: 0C6E24BB-B302-4AD8-B489-78EE38081 DAB Tracking#: EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the fun name and location -of the place of business .of each sub-contractor whom the Contractor proposes to subcont~et portions of the Proj.ect in e»cess of one-hatf of one percent of the total bid., and the portion of the Project which wlll be done by each sub-contractor for each subcontract. NOTE: The Contractor understands that if itij,iflS to specify a sub.,contractor for any portion of the Preject to be performed under the contract in excess of one-half Of one per~t of the bic,t, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subco.ntract that portion of the work, e»cept In cases -of pubtie emergency or necessity, and then only -after a finding, reduoed in writing as a. public reeord of the Awarding Author[ty., setting forth the facts constituting the emergency or necessity in accordance with the provisions ef the Subletttng l!,Jnd S~bcontracting Fair Practices Act {Section 41.00 et seq .. of the California Public Contract Code). If no subcontractors are to be employed on the project, ente.r the word "NONE." SUBCONTRACTORS Portion of Project to Business Name and Address DIR Registratk>n Licem;e No., %of be Subcontracted ./ / / / / / Total % Subcontracted: 0 ------ BALLFIELD RENOVATION PROJECT; CONT. NO. PKRC21-1013 Page Sof10 / No. Classification & Total Exo(ration Date Contract -/ _/' / ./ / City Attorney Approved 11.22/2020 DocuSign Envelope ID: 0C6E24BB-B302-4AD8-B489-78EE38081DAB EXHIBIT B SCOPE OF WORK Calavera Hills Community Park; Field #1, #2 & #3 • (4) Bullpens o Refurbish using existing material o Reset home plates and pitching rubbers o Field #3 bullpen includes triple bullpen • Batter's and Catcher's Boxes o Install (50) -50 lbs. bags of DuraEdge premium packing clay o (10) bags per batter's box o (5) bags per bullpen • Reset Home Plates o (3) fields; reset home plate square to field Total: $5,100.88 Poinsettia Community Park; Field #1, #2 & #3 • Infield Mix o Field #1 install 25 tons of Angels infield mix o Field #2 & #3 install 25 tons of Angels infield mix (12.5 tons per field) • Laser Grade (3) Fields o Rototill and laser grade • Install Infield Conditioner o (45) -50Ibs. bags (DuraEdge) o (15) bags per field • Grand Arc Edging (3) Fields o Edging between the dirt infield and outfield turf grand arc o Backfill edges o Dispose and haul off debris • Warning Track Edge Re-Establishment (3) Fields Tracking#: o Re-establish and define the turf line between the outfield turf and dirt warning track • Warning Track Grading (3) Fields o Regrade dirt warning tracks o Use tractor and 1200 detail rake o Field # 1 use Angels infield mix o Field #2 & #3 use existing material • Batter's and Catcher's Boxes o Install (60) -50 lbs. bags of DuraEdge premium packing clay o (10) bags per batter's box per field o (5) bags per bullpen o (20) bags per mound on Field #1 • (2) Bullpens o Refurbish bullpens using existing material and top with clay o Reset home plates and pitching rubbers • Pitching Mound Rebuild o Rebuild to baseball league specifications • Lip Reduction o (3) fields; lip reduction around dirt infield and turf outfield arc • Reset/Flip Pitching Rubber o (3) fields; reset pitching rubber to meet grade/square to field • Reset Home Plates o (3) fields; reset home plate square to field BALLFIELD RENOVATION PROJECT; CONT. NO. PKRC21-1013 Page 6 of 10 City Attorney Approved 1/22/2020 DocuSign Envelope ID: 0C6E24BB-B302-4AD8-B489-78EE38081DAB Tracking#: • Base Anchor Installation o Reset (30) base anchors to line up with foul poles, home plate, and pitching rubber Total : $23,312.62 Aviara Community Park; Baseball Field • Infield Mix o Install 25 tons of Angels infield mix • Laser Grade o Rototill and laser grade • Install Infield Conditioner o (30) -50lbs. bags (DuraEdge) • Grand Arc Edging o Edging between the dirt infield and outfield turf grand arc o Backfill edges o Dispose and haul off debris • Warning Track Edge Re-Establishment o Re-establish and define the turf line between the outfield turf and dirt warning track • Warning Track Grading o Regrade dirt warning tracks o Use tractor and 1200 detail rake o Use existing material • Batter's and Catcher's Boxes o Install (25) -50 lbs. bags of DuraEdge premium packing clay o (10) bags per batter's box per field o (5) bags per bullpen • (1) Bullpen o Refurbish bullpens using existing material and top with clay o Reset home plates and pitching rubbers • Lip Reduction o Lip reduction around dirt infield and turf outfield arc • Reset/Flip Pitching Rubber o Reset pitching rubber to meet grade/square to field • Reset Home Plates o Reset home plate square to field • Base Anchor Installation o Reset (15) base anchors to line up with foul poles, home plate, and pitching rubber Total: $9,673.44 La Costa Meadows; Field #1 & #2 • Infield Mix o Install 25 tons of Angels infield mix per field • Laser Grade (2) Fields o Rototill and laser grade • Install Infield Conditioner o (30) -50Ibs. bags (DuraEdge) o (15) bags per field • Grand Arc Edging (2) Fields o Edging between the dirt infield and outfield turf grand arc o Backfill edges o Dispose and haul off debris • Batter's and Catcher's Boxes o Install (20) -50 lbs. bags of DuraEdge premium packing clay BALLFIELD RENOVATION PROJECT; CONT. NO. PKRC21-1013 Page 7 of 10 City Attorney Approved 1/22/2020 DocuSign Envelope ID: 0C6E24BB-B302-4AD8-8489-78EE38081DAB o (10) bags per batter's box per field • Lip Reduction o (2) fields; lip reduction around dirt infield and turf outfield arc • Reset/Flip Pitching Rubber o (2) fields; reset pitching rubber to meet grade/square to field • Reset Home Plates o (2) fields; reset home plate square to field • Base Anchor Installation Tracking#: o Reset (6) base anchors to line up with foul poles, home plate, and pitching rubber Total: $11,032.48 Alga Norte Community Park; Field #1 • Infield Mix o Install 25 tons of Angels infield mix • Laser Grade o Rototill and laser grade • Install Infield Conditioner o (30) -50Ibs. bags (DuraEdge) • Grand Arc Edging o Edging between the dirt infield and outfield turf grand arc o Backfill edges o Dispose and haul off debris • Warning Track Edge Re-Establishment o Re-establish and define the turf line between the outfield turf and dirt warning track • Warning Track Grading o Regrade dirt warning tracks o Use tractor and 1200 detail rake o Use existing material • Batter's and Catcher's Box o Install (15) -50 lbs. bags of DuraEdge premium packing clay o (10) bags per batter's box per field • Lip Reduction o Lip reduction around dirt infield and turf outfield arc • Reset/Flip Pitching Rubber o Reset pitching rubber to meet grade/square to field • Reset Home Plates o Reset home plate square to field • Base Anchor Installation o Reset (15) base anchors to line up with foul poles, home plate, and pitching rubber Total: $9,050.27 Labor & Material Bond: $1,745.10 Grand Total not to exceed: $59,914.79 Exemption: • All irrigation sprinklers, laterals, mainline, etc. will be marked out with paint/flags, removed, relocated and repaired by the landscape contractor under the direction of the city inspector. BALLFIELD RENOVATION PROJECT; CONT. NO. PKRC21-1013 Page 8 of 10 City Attorney Approved 1/22/2020 ACORD® I DATE (MM/DD/YYYY) ~ CERTIFICATE OF LIABILITY INSURANCE 1/18/2022 ~ 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME'.'" Grant Moseley Utopia Management & Insurance Services, Inc rig.~o, Extl: (858) 598-11 11 lr.vc. No): 461 7 RUFFNER ST lorrFiEss, Grant@utopiainsurance.com INSURER(S) AFFORDING COVERAGE NAIC# SAN DIEGO CA 92111 INSURER A : Sentinel Insurance Company Ltd. 11000 INSURED INSURER B: National General Insurance Co. 11044 Diamond Designs, LLC. INSURER C: 11956 BERNARDO PLAZA DR INSURER D : INSURER E : SAN DIEGO CA 92 128 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. 'Tf'R TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM1cio1YYYYJ (MM/DD/YYY,YJ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 t--~ CLAIMS-MADE [XloccuR ..,~v,,-.....,._ Vu .. , C:U PREMISES (Ea occurrence) $ 1,000,000 X General Liability MED EXP (Any one person) $ 10,000 A X 72 SBA BD9926 05/01/202 1 05/01/2022 PERSONAL & ADV INJURY $ 2,000,000 ~ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 Fl □PRO-D Loc $ 4,000,000 POLICY JECT PRODUCTS -COMP/OP AGG OTHER: $ AUTOMOBILE LIABILITY c,usGLI= LIMII $ 1,000,000 (Ea accident) -ANY AUTO BODILY INJURY (Per person) $ 1,000 -OWNED -SCHEDULED B AUTOS ONLY AUTOS X 2005023982 05 05/12/202 1 05/12/2022 BODILY INJURY (Per accident) $ 1,000 1l HIRED ,__ NON-OWNED ,\.J LI I T UANIA\.::IC $ AUTOS ONLY ,__ AUTOS ONLY (Per accident) -$ ~ UMBRELLA LIAB ~OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE X 72 SBA BD9926 05/01/202 1 05/01/2022 AGGREGATE $ 1,000,000 DED I "I RETENTION $ 10,000 $ WORKERS COMPENSATION I STATUTE I IERH-IA.ND EMPLOYERS' LIABILITY Y/N ~~y PROPRIETOR/PARTNER/EXECUTIVE □ N/A E.L. EACH ACCIDENT $ 1,000,000 A FFICER/MEMBER EXCLUDED? 72 WEC AK.9:XXW 05/01/202 1 05/01/2022 KMandatory in NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Parks & recreation Department ACCORDANCE WITH THE POLICY PROVISIONS. 799 Pine Avenue, Suite 200 AUTHORIZED REPRESENTATIVE 1 Carlsbad CA 92008 Cir-o-.A-M~ © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 001 (CONTINUED ON NEXT PAGE) 01/19/22 05/01/21 05/01/22 72 SBA BD9926 SC DIAMOND DESIGNS, LLC 11956 BERNARDO PLAZA DR 519 SAN DIEGO CA 92128 01/19/22 010 UTOPIA MGMT & INS SERVICES INC 166333 SENTINEL INSURANCE COMPANY, LIMITED ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. THIS IS NOT A BILL. ADDITIONAL PREMIUM DUE AT POLICY CHANGE EFFECTIVE DATE:$11.00 *INCLUDES ADDITIONAL TERRORISM PREMIUM OF:$1.00 LOCATION 001 BUILDING 001 IS REVISED PRO RATA FACTOR: 0.279 THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. Form SS 12 11 04 05 T Page Process Date:Policy Effective Date: Policy Expiration Date: 002 01/19/22 05/01/21 05/01/22 72 SBA BD9926 010 BUSINESS LIABILITY OPTIONAL COVERAGES ARE REVISED WAIVER OF SUBROGATION IS ADDED: FORM SS 12 15 LOCATION 001 BUILDING 001 SEE FORM IH 12 00 FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: IH12001185 ADDITIONAL INSURED - PERSON-ORGANIZATION FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE: SS 12 15 03 00 IH12001185 WAIVER OF SUBROGATION Form SS 12 11 04 05 T Page Process Date:Policy Effective Date: Policy Expiration Date: POLICY CHANGE (Continued) Policy Number: Policy Change Number: 72 SBA BD9926 ADDITIONAL INSURED - PERSON-ORGANIZATION LOCATION 001 BUILDING 001 RANCHO BERNARDO WESTWOOD CLUB 17394 W BERNARDO DR SAN DIEGO CA 92127 LOC 001 BLDG 001 FACILITIES DESIGN & CONSTRUCTION UNIVERSITY OF CALIFORNIA SAN DIEGO TRITON BALLPARK 3432 VOIGT DRIVE SAN DIEGO, CA 92037 LOCATION 001 BUILDING 001 THE CITY OF CHULA VISTA IT'S OFFICERS, OFFICALS, EMPLOYEES, AGENTS, AND VOLUNTEERS 276 FOURTH AVE BLDG C CHULA VISTA, CA 91910 LOC 001 BUILDING 001 ELITE ATHELETE SERVICES LLC 2800 OLYMPIC PARKWAY THULA VISTA, CA 91915 SUNBELT RENTALS, INC. 1275 WEST MOUND STREET COLUMBUS, OH 43223 THAT THE STATE OF CALIFORNIA, THE TRUSTEES OF THE CALIFORNIA STATE UNIVERSITY, THE CALIFORNIA STATE UNIVERSITY SAN MARCOS CORPORATION, THE CALIFORNIA STATE UNIVERSITY SAN MARCOS FOUNDATION, THE ASSOCIATED STUDENTS, INC., AND CALIFORNIA STATE UNIVERSITY SAN 003 001 (CONTINUED ON NEXT PAGE) 01/19/22 05/01/22 72 SBA BD9926 ADDITIONAL INSURED - PERSON-ORGANIZATION MARCOS (WHICH IS THE TRUSTEES OF THE CALIFORNIA STATE UNIVERSITY AND IS ONE OF 23 CAMPUSES IN THE CALIFORNIA STATE UNIVERSITY SYSTEM), AND THE EMPLOYEES, VOLUNTEERS, OFFICERS, AND AGENTS OF EACH OF THEM CALIFORNIA STATE UNIVERSITY SAN MARCOS PROCUREMENT & SUPPORT SERVICES 333 S. TWIN OAKS VALLEY ROAD SAN MARCOS, CA 92096 TOWAY UNIFIED SCHOOL DISTRICT ATTN: FACILITIES DEPT 13626 TWIN PEAKS RD POWAY, CA 92064 CITY OF LA MESA ITS OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS 5100 MEMORIAL DRIVE LA MESA, CA 91942 LOC 001 BLDG 001/002 CITY OF ENCINITAS, IT'S ELECTED OFFICIALS, OFFICERS, EMPLOYEES AND AGENTS 505 S VULCAN AVE ENCINITAS, CA 92024 LOC 001 BLDG 001/002 CITY OF POWAY / DEPARTMENT OF PUBLIC WORKS 14467 LAKE POWAY ROAD POWAY, CA 92064 LOC 001 BLDG 001/002 BYROMDAVEY INC 13220 EVENING CREEK DRIVE SOUTH , SUITE 103 SAN DIEGO, CA 92128 LOC 001 BLDG 001/002 CITY OF ESCONDIDO, ITS OFFICIALS, EMPLOYEES AND VOLUNTEERS 003 002 (CONTINUED ON NEXT PAGE) 01/19/22 05/01/22 72 SBA BD9926 ADDITIONAL INSURED - PERSON-ORGANIZATION 201 N. BROADWAY ESCONDIDI, CA 92025 BYROM-DAVEY, INC & SAN DIEGO UNIFIED SCHOOL DISTRICT 13220 EVENING CREEK DRIVE #103 SAN DIEGO, CA 92128 CITY OF POWAY PO BOX 789 13904 CIVIC CENTER DR POWAY, CA 92074 LOC 001 BLDG 001/002 STEIGERWALD-DOUGHERTY, INC. PO BOX 884 SOLANA BEACH, CA 92075 003 003 (CONTINUED ON NEXT PAGE) 01/19/22 05/01/22 72 SBA BD9926 WAIVER OF SUBROGATION LOC 001 BLDG 001 CARLSBAD UNIFIED SCHOOL DISTRICT 6225 EL CAMINO REAL CARLSBAD, CA 92009 009 001 (CONTINUED ON NEXT PAGE) 01/19/22 05/01/22 001 01/19/22 05/01/21 05/01/22 72 SBA BD9926 SC DIAMOND DESIGNS, LLC 11956 BERNARDO PLAZA DR 519 SAN DIEGO CA 92128 01/18/22 009 UTOPIA MGMT & INS SERVICES INC 166333 SENTINEL INSURANCE COMPANY, LIMITED ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. THIS IS NOT A BILL. NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: IH12001185 ADDITIONAL INSURED - MANAGER/LESSOR PRO RATA FACTOR: 0.282 THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. Form SS 12 11 04 05 T Page Process Date:Policy Effective Date: Policy Expiration Date: 72 SBA BD9926 ADDITIONAL INSURED - MANAGER/LESSOR CARLSBAD UNIFIED SCHOOL DISTRICT, ITS BOARD OF TRUSTEES, OFFICERS, EMPLOYEES & AGENTS CARLSBAD UNIFIED SCHOOL DISTRICT 6225 EL CAMINO REAL CARLSBAD, CA 92009 LOC 001 BLDG 001/002 CITY OF ENCINITAS 505 S VULCAN AVENUE ENCINITAS, CA 92024 LOC 001 BLDG 001/002 SWEETWATER UNION HIGH SCHOOL DISTRICT 1130 FIFTH AVE CHULA VISTA,, CA 91911 LOC 001 BLDG 001 CALIFORNIA STATE UNIVERSITY SAN MARCOS PROCUREMENT & SUPPORT SERVICE S 333 S. TWIN OAKS VALLEY ROAD, SAN MARCOS, CA 92096 LOC 001 BLDG 001 CALIFORNIA STATE UNIVERSITY SAN MARCOS PROCUREMENT & SUPPORT SERVICE S 333 S. TWIN OAKS VALLEY ROAD, 006 001 (CONTINUED ON NEXT PAGE) 01/19/22 05/01/22 72 SBA BD9926 ADDITIONAL INSURED - MANAGER/LESSOR SAN MARCOS , CA 92096 LOC 001 BLDG 001/002 CITY OF CARLSBAD PARKS & RECREATION DEPARTMENT 799 PINE AVENUE, SUITE 200 CARLSBAD , CA 92008 006 002 (CONTINUED ON NEXT PAGE) 01/19/22 05/01/22