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HomeMy WebLinkAboutVanguard Fire Protection Inc; 2022-05-31; PWM22-1841FACPWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 1 of 9 City Attorney Approved 1/20/2020 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT LAS PALMAS BUILDING FIRE BACKFLOW REPLACEMENT This agreement is made on the ______________ day of _________________________, 2022, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Vanguard Fire Protection, Inc., a California corporation whose principal place of business is 2030 Allessandro Trail, Vista, CA 92084 (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 Charles Balteria (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. DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F 31st May PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 2 of 9 City Attorney Approved 1/20/2020 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. 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: _Michael Max Hickman______ __________ 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 DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 3 of 9 City Attorney Approved 1/20/2020 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 30 days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. Workers’ Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. 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 work within 30 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 90 working days after receipt of Notice to Proceed. /// /// /// /// /// /// DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 4 of 9 City Attorney Approved 1/20/2020 CONTRACTOR’S INFORMATION Vanguard Fire Protection, Inc. P.O. Box 1300 (name of Contractor) 487475 (street address) Vista, CA 92085 (Contractor’s license number) C-16 2/29/2024 (city/state/zip) 760-727-8540 (license class. and exp. date) 1000038006 6/30/2022 (telephone no.) max@vanguardfireprotection.com (DIR registration number and exp. date) (e-mail address) /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 5 of 9 City Attorney Approved 1/20/2020 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 VANGUARD FIRE PROTECTION, INC., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Michael Max Hickman, President, Secretary Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager By: (sign here) (print name/title) 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 Group B Chairman, President, or Vice-President 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 BY: _____________________________ Assistant City Attorney DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 6 of 9 City Attorney Approved 1/20/2020 EXHIBIT A LAS PALMAS BUILDING FIRE BACKFLOW REPLACEMENT LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor 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 subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor 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 be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F N/AN/A N/A N/A 0%N/A N/A0% 0% N/A N/A PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 7 of 9 City Attorney Approved 1/20/2020 EXHIBIT B LAS PALMAS BUILDING FIRE BACKFLOW REPLACEMENT Contractor to provide all material, tools and labor necessary to replace the fire suppression system 6” backflow assembly and repair the 2’’ domestic water system backflow assembly serving the Las Palmas Building located at 2075 Las Palmas, Carlsbad, CA 92011. Contractor shall perform the following scope of work: • Remove and replace (like for like) 6” Wilkins 350DA Backflow assembly (Per Exhibit C). • Repair 2” Domestic Backflow assembly with replacement Rubber Parts Kit. • Certify 6” Backflow and 2” Backflow assemblies. • Patch concrete around CMLC Spools. • Install two (2) new tamper switches on the OS&Y valves. • Remove and dispose of replaced backflow and debris. Notes: • The installation shall conform to all requirements established in the NFPA-13, the City of Carlsbad Fire Department, and the City of Carlsbad Municipal Water District. • All labor shall be prevailing wage. • Project cost includes weekend work and all applicable taxes. • Contractor to provide a one-year warranty on parts and labor provided under this agreement. • Contractor to leave the worksite in a clean and workmanlike manner. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Las Palmas Building Fire Backflow Replacement $8,490 TOTAL* $8,490 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 8 of 9 EXHIBIT C LAS PALMAS BUILDING FIRE BACKFLOW REPLACEMENT DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F ZURll Model 350DA Double Check Detector Assembly Application Designed for installation on water lines in fire protection sys- tems to protect against both backsiphonage and backpres- sure of polluted water into the potable water supply. Model 350DA shall provide protection where a potential health haz- ard does not exist. Incorporates metered by-pass to detect leaks and unauthorized water use. Standards Compliance (Sizes 2112" -10" Horiz. & Vert.) (12" Horizontal Only) • ASSE® Listed 1048 (Sizes 2 112" thru 12") • CSA® Certified B64.5 (Sizes 2112" thru 8", & 12") • AWWACompliant C510 (Sizes 2112" thru 12"), and C550 • UL® Classified (Sizes 2 112" thru 12") • C-UL® Classified (Sizes 2 112" thru 12") • FM®Approved (Sizes21l2" thru 10") • NYC MEA 147-99-M Vol 4 (2-112" -10) • Approved by the Foundation for Cross Connection Control and Hydraulic Research at the Universrty of Southern California (Sizes 2 112" thru 12") • Meets the requirements of NSF/ANSI 61' '(0.25% MAX. WEIGHTED AVERAGE LEAD CONTENT) By-Pass Backflow Assembly 3/4" Model 950XLD Materials Ductile Iron ASTM A 536 Ductile Iron ASTM A 536 Main valve body Access covers Coatings Internals NSF Approved fusion epoxy finish Stainless steel, 300 Series NORYL™ Fasteners Elastomers Polymers Springs Stainless Steel, 300 Series EPDM (FDA approved) Buna Nitrile (FDA approved) NORYL™ Stainless Steel, 300 Series Features Sizes: 2 112", 3", 4", 6", 8", 10", 12'' Maximum working water pressure Maximum working water temperature Hydrostatic test pressure End connections (Grooved for steel) (Flanged bolt pattern) 175 PSI 140°F 350 PSI AWWAC606 ASME B16.42 Class 150 Dimensions & Weights (do not include pkg.) DIMENSION (approximate) MODEL A 8 LESS E 3500A A WITH GATE C D OS&Y SIZE BUTTERFLY VALVES VALVES OPEN m. mm ,n. mm m. mm ,n. mm ,n. mm m. mm ,n. mm 21/2 66 31 787 28 711 15 7/8 403 3 814 96 9 229 17 3/4 451 3 80 32 813 281/2 724 15 7/8 403 3 214 96 9 229 20 1/4 514 4 100 37 5/8 956 328'\l 835 19 1/2 495 4 1/2 114 9 229 22 1/2 572 6 150 44 518 1133 37 5/8 966 23 1/2 597 6 152 101/2 267 30 1/2 776 8 200 007/8 1546 53 7/8 1369 37 3/4 969 10 254 12 306 37 "40 10 250 63 7/8 1622 57 7/8 1470 37 3/4 969 10 254 12 306 45 5/8 1159 12 300 66 8/1E 1681 o/a n/a 38 965 10 254 12 306 63 1346 Zurn Industries, LLC I Wilkins LEAD FREE Options (Suffixes can be combin~ □ -with OS & Y gate valves (standar"ill) □ L less shut-off valves (flanged body connections) □ LM less water meter □ with gallon meter (standard) □ CFM with cu ft meter □ CMM with cu meter meter □ G with groove end gate valves □ FG with flanged inlet connection and grooved outlet connection □ Pl with Post Indicator Gate Valve □ GF with flanged inlet connection and grooved outlet connection □ BG with grooved end butterfly valves with integral monitor swrtches (2 112" - 1 O" Accessories □ Repair kit (rubber only) □ Thermal expansion tank (Model XT) □ OS & Y Gate valve tamper switch (OSY-40) Attention: Model 350DA (flange body) and Model 350ADA (grooved body) have different lay lengths. WEIGHT E E LESS OS&Y OS&Y BJTIEAFLY OS&Y WITH F SHUTOFF GATE GATE VALVES CLOSED BUTTEFFLY VALVES VALVES VALVES ffiOOVED VALVES FLANGED GROOVED m. mm ,n. mm ,n mm lbs. kg lbs. kg lbs. kg lbs. kg 15 3/8 391 133/4 349 3 1/2 89 68 31 178 81 160 73 140 64 17 432 133/4 349 3 1/2 89 68 31 198 9C 160 68 120 54 131/4 464 17 432 6 152 106 48 296 134 282 128 19C 86 24 1/4 616 17 1/2 445 7 178 180 82 480 218 454 206 298 135 231/2 724 1615/16 430 8 1/2 216 374 170 860 386 802 364 548 249 24 814 883 1615/16 430 8 1/2 216 404 183 1222 554 1156 524 792 359 4D 1/2 1029 n/a n/a 8 7/8 226 483 210 1623 736 n/a n/a o/a n/a Rev. M Date: 3/20 1747 Commerce Way, Paso Robles, CAU.S.A. 93446 Ph. 855-663-9876, Fax 805-238-5766 Document No. BF-350DA In Canada I Zurn Industries Limited Patent No. 5, 913, 331 7900 Goreway Drive, Unit 10, Brampton, Ontario l6T 5W6, 877-892-5216 Product No. Model 3500A www.zur-n.com Page 1 of 2 PWM22-1841FAC Las Palmas Building Fire Backflow Replacement Page 9 of 9 DocuSign Envelope ID: 3D6789ED-B2A6-444F-B0F0-7394CDE5386F Flow Characteristics ◊Rated Flow (dablished by approval agencies) MODEL 350DA 21/2", 3" & 4" (STANDARD & METRIC) FLOW RATES (1/s) r .. ~--............. ----,k _____ 1T1-6--....,.,-11,'"""'l"""==-m"",:E ___ 2.,5_.2_....,,..., .. 3-"(.,.r-m-m) ___ 3_7 ... 9-----,f----4-(-10-□-mm-,l:1 (I) Q Q LU If 0 200 400 600 800 il: FLOW RATES (GPM) u 0.0 31.5 MODEL 350DA 6" & 8" (STANDARD & METRIC) FLOW RATES (1/s) 63.1 94.6 126.2 157.7 _ r:rz~ I I I w 0 I I I 104 ~ '"-·I:: I 0 w ~ 0 500 1000 1500 FLOW RATES (GPM) MODEL 350DA 10" & 12" (STANDARD & METRIC) FLOW RATES (I/s) 2000 2500 g: 114 l 111 l' I lff ?ftffii: I I i o. 0 500 1000 1500 2000 2500 3000 3500 4000 4500 a. FLOW RATES (GPM) Typical Installation Local codes shall govern installation requirements. Unless otherwise specified, the assembly shall be mounted at a mini- mum of 12" (305mm) and a maximum of 30" (762mm) above adequate drains with sufficient side clearance for testing and maintenance. The installation shall be made so that no part of the unit can be submerged. Capacity thru Schedule 40 Pipe (GPM) Pipe size 5 ft/sec 7.5 ft/sec 10 ft/sec 15 ft/sec 2 1/2" 75 112 149 224 3" 115 173 230 346 4" 198 298 397 595 6" 450 675 900 1351 8" 780 1169 1559 2339 10" 1229 1843 2458 3687 12" 1763 2644 3525 5288 Specifications VERTICAL INSTALLATION OUTDOOR INSTALLATION The Double Check Detector Backflow Prevention Assembly shall be certified to NSF/ANSI 61, ASSE® Listed 1048, and sup- plied with full port gate valves. The main body and access cover shall be epoxy coated ductile iron (ASTM A 536), the seat ring and check valve shall be Noryl™, the stem shall be stainless steel (ASTM A 276) and the seat disc elastomers shall be EPDM. The first and second check valves shall be accessible for maintenance wrthout removing the device from the line. The Double Check Detector Backflow Prevention Assembly shall be a ZURN WILKINS Model 350DA. Zurn Industries, LLC I Wilkins 1747 Commerce Way, Paso Robles, CAU.S.A. 93446 Ph. 855-663-9876, Fax 805-238-5766 In Canada I Zurn Industries Limited 7900 Goreway Drive, Unit 10, Brampton, Ontario L6T 5W6, 877-892-5216 www.zurn.com Page 2 of 2 VANGFIR-01 SGONZALEZ ACORD. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/0D/YYYY) ~· 10/18/2021 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 License# 0757776 22~1~cT Laureen Mumford HUB International Insurance Services Inc. f,:Jg_Nfio, Ed), (858) 255-3272 I rie~. No),(951) 231-2572 9855 Scranton Road Suite 100 f~o1!~ss: cal.cpu@hubinternational.com San Diego, CA 92121 INSURER/SI AFFORDING COVERAGE NAIC# INSURER A: lronshore Snecialtv Comaanv 25445 INSURED INsuRERe :Nationwide Mutual Insurance Comoanv 23787 Vanguard Fire Protection, Inc. INSURERC : Oak River Insurance Comoanv 34630 P. 0. Box 1300 INSURERD: Vista, CA 92085-1300 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 SUBJECTTOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 11N§!{ TYPE OF INSURANCE 1".'.l?P!-1?.½!l;IJ POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 f--:J CLAIMS-MADE [Kl OCCUR X RCS00025-08 10/24/2021 10/24/2022 ~~~~~~J9E~~~~~encel $ 100,000 x PD Ded: $2,500 MED EXP /Anv one oersonl $ 5,000 ~ 1,000,000 PERSONAL &ADV INJURY $ ~ 2,000,000 ~'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ POLICY □ ~r8-f □ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Err & Omissions $ Included B AUTOMOBILE LIABILITY 9,,,(~MBINED SINGLE LIMIT $ 1,000,000 ~ accid~~" X ANY AUTO ACP BA 7814684687 10/24/2021 10/24/2022 BODILY INJURY /Per oersonl $ ~ OWNED -SCHEDULED ~ AUTOS ONLY -AUTOS BODILY INJURY (Per accidentl $ HIRED ~8ro~~l~ ITROPERTY DAMAGE $ f--AUTOS ONLY -Per acciden1 $ UMBRELLA LIAB 7 OCCUR EACH OCCLRRENCE $ f-- EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ C WORKERS COMPENSATION X I ~ffru,E I i ;?JH-AND EMPLOYERS' LIABILITY YIN X VAWC209449 9/1/2021 9/1/2022 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE [Y] E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA 1,000,000 (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.l. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: All Projects City of Carlsbad/CMWD is Additional Insured with regard to General Liability when required by written contract per the attached endorsements CG2010 04/13. Waiver of Subrogation with regard to Workers Compensation applies when required by written contract per the attached endorsement form WC990410C 01/19. Should the policies be cancelled before the expiration date, Hub International Insurance Services lnc. (Hub), independent of any rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non~payment of premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation date. 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 947 Murrieta, CA 92564 AUTHORIZED REPRESENTATIVE I ~ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: RCS00025-08 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Ornanization(s) Location(s) Of Covered Operations As required by written, and properly executed contract prior to loss, if required by your written contract or written As per written, and properly executed, contract prior agreement with such Additional Insured. The inclusion of to loss, if required by your agreement with such one or more Additional lnsured(s) under the terms of Additional Insured. · this endorsement does not increase our limits of liability. All other terms and conditions remain unchanqed. Information reauired to comolete 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 "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG20100413 © Insurance Services Office, Inc., 2012 Page 1 of 2 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for . a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not applicable Limits of Insurance Declarations. increase the shown in the Page 2 of 2 © Insurance Services Office, Inc., 2012 CG20100413 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC990410C (Ed. 01-19) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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 calculated by applying a factor of 2% to the total manual premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Blanket Waiver Person/Organization Job Description All CA Operations Schedule Blanket Waiver -Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Waiver Premium (prior to adjustments) 350.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 09/01/2021 Policy No.: VAWC209449 Endorsement No.: Insured: Insurance Company: Oak River Insurance Company WC 99 0410C (Ed. 01-19) Premium$ Countersigned by _______________ _