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HomeMy WebLinkAboutHawthorne Machinery Co; 2022-01-27; PWL22-1755UTILCITY OF CARLSBAD PUBLIC WORKS LETTER OF AGREEMENT Home Plant Lift Station Generator Repair ADDITIONAL REQUIREMENTS OR OR Jesse Castaneda, 760-802-8200 Elizabeth Abeyta, 858-647-7000 or and or Proposal CITY OF CARLSBAD-WASTE WATER CUSTOMER NO. QUOTE NO. DATE CONTACT PHONE NO. FAX NO. EMAIL MODEL MAKE SERIAL NO. UNIT NO. HOURS WO NO. P.O. NO. Note SEGMENT: 01 Provided onsite field technician to troubleshoot generator on Thursday, January 6, 2022 due to engine not starting: SITE ADDRESS: Home Plant 2359 Carlsbad Blvd Troubleshoot Report of Voltage Regulator Issue Parts Qty Item No Description Ext Price Total Parts Labor Qty Item No Description Ext Price Total Labor Miscellaneous Qty Item No Description Ext Price Total Miscellaneous Segment 01 - Total TOTAL PROPOSAL The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE COMMERCIAL GENERAL LIABILITY UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS (Mandatory in NH) WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY INSD ADDL WVD SUBR N / A 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: GLO 2925170 12 GLO 292517013 GLO 292517014 GLO 2925170 12 GLO 292517013 GLO 292517014 GLO 2925170 12 GLO 292517013 GLO 292517014 GLO 2925170 12 02/01/2019 02/01/2020 GLO 292517013 02/01/2020 02/01/2021GLO29251701402/01/2021 02/01/2022 GLO 292517014 02/01/2021 GLO 2925170 12 02/01/2019 02/01/2020 GLO 292517013 02/01/2020 02/01/2021GLO29251701402/01/2021 02/01/2022 GLO 2925170 12 GLO 292517013 GLO 292517014 BAP 2925171 12 02/01/2019 02/01/2020BAP 292517113 02/01/2020 02/01/2021BAP29251711402/01/2021 02/01/2022 BAP 2925171 12 02/01/2019 BAP 292517113 02/01/2020 BAP 292517114 02/01/2021 BAP 2925171 12 02/01/2019 BAP 292517113 02/01/2020 BAP 292517114 02/01/2021 BAP 2925171 12 02/01/2019 02/01/2020BAP 292517113 02/01/2020 02/01/2021BAP 292517114 02/01/2021 02/01/2022 02/01/2020 WC 29251691302/01/2021 WC 292516914 Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem. INCL Other Insurance Amendment – Primary And Non- Contributory THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured Address (including ZIP Code) Commercial General Liability Coverage Part 1.IV – Commercial General Liability Conditions a. b. 2.4.b.IV – Commercial General Liability Conditions GLO292517014 02/01/2021 02/01/2022