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HomeMy WebLinkAboutProactive Consulting Group LLC; 2022-06-28; PSA22-1870FACPSA22-1870FAC City Attorney Approved Version 6/12/18 1 AGREEMENT FOR GENERATOR PERMITTING CONSULTING SERVICES - FIRE STATION 7 - PROJECT NO. 4091 PROACTIVE CONSULTING GROUP, LLC THIS AGREEMENT is made and entered into as of the ______________ day of ___________________, 2022, by and between the City of Carlsbad, a municipal corporation, ("City"), and Proactive Consulting Group, LLC, a California limited liability company ("Contractor”). RECITALS City requires the professional services of a consultant that is experienced in permitting generators with the San Diego Air Pollution Control District. Contractor has the necessary experience in providing these professional services, has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A”, attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2. TERM This Agreement will be effective for a period of one (1) year from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed shall not exceed ten thousand dollars ($10,000). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. 4. STATUS OF CONTRACTOR Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished. 5. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E June 28th PSA22-1870FAC City Attorney Approved Version 6/12/18 2 6. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile liability insurance, a combined policy of workers' compensation, employers liability insurance, and professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has 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, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. 7. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name John Maashoff Name Patrick Tam Title Public Works Manager Title Project Manager Department Public Works Address 15235 Springdale Street City of Carlsbad Huntington Beach, CA 92649 Address 405 Oak Ave. Phone No. 714-893-7900 Carlsbad, CA 92008 Email Info@proehs.com Phone No. 442-339-2856 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 8. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. Yes No 9. COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement. x DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E □ □ PSA22-1870FAC City Attorney Approved Version 6/12/18 3 10. TERMINATION City or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance with the Agreement. 11. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 12. JURISDICTIONS AND VENUE Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California. 13. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City. 14. AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. /// /// /// /// /// /// /// /// /// /// /// /// /// DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E PSA22-1870FAC City Attorney Approved Version 6/12/18 4 15. 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, PROACTIVE CONSULTING GROUP, LLC, a California limited liability company CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Paz Gomez, Deputy City Manager, Public Works, as authorized by the City manager Patrick Luu, Senior Manager (print name/title) 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, Secretary, President, or Assistant Secretary, Vice-President 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: D7723A81-50D3-4831-A0C3-CF6B675DCE9E PSA22-1870FAC City Attorney Approved Version 6/12/18 5 EXHIBIT “A” SCOPE OF SERVICES Contractor shall provide those consulting services outlined in the attached proposal dated June 13, 2022. DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E Proposal No.: P2022.6291 Page 1 of 4 SDAPCD Air Permitting Assistance for a Stationary Diesel Emergency Generator (Proposal No. 2022.6291) Equipment Location Address 4600 Carlsbad Boulevard Carlsbad, CA 92008 Proposal for City of Carlsbad 4600 Carlsbad Boulevard Carlsbad, CA 92008 From ProActive Consulting Group, LLC. 15235 Springdale Street Huntington Beach, CA 92649 June 13, 2022 15235 Springdale Street, Huntington Beach, CA 92649 Tel: (714) 893-7900  Fax: (714) 893-7955  email: info@proehs.com PSA22-1870FAC Exhibit "A" (cont'd) DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E Proposal No.: P2022.6291 Page 2 of 3 This agreement is made between ProActive Consulting Group, LLC. (hereafter referred to as ProActive) and City of Carlsbad (hereafter referred to as “The Client”, interchangeably). ProActive and the Client agree as follows: A. San Diego Air Pollution Control District (SDAPCD) Permitting Assistance for a New Emergency Generator The San Diego Air Pollution Control District (SDAPCD) has mandated that diesel generators over 50 brake horsepower must have an Authority to Construct before installation and a Permit to Operate when commissioning. If the generator is within proximity to a K-12 school, it may need a particulate filter to comply with the more stringent emission reduction requirements. For the SDAPCD, the filter applicability will be determined on a case-by-case basis, predicated on the outcome of the project specific health risk assessment. If the generator is situated within 1,000 feet of a K-12 school, a 30-day public notification is also required by California Health & Safety Code. Based on the provided address, public notification is not anticipated since no K-12 schools appear to be within 1,000 feet of the proposed location. ProActive will assist the Client perform a regulatory review to help ensure the new generator meet the SDAPCD regulatory requirements. ProActive will then prepare the necessary application documentation and engineering calculation to help the Client secure the Authority to Construct & Permit to Operate. ProActive will serve as the primary liaison with the agency during the permit issuance process. Please note that the above assessment is based on the presently available information. A more thorough evaluation will be performed upon initiating the project. The professional services provided by ProActive include the following: Advise the Client on the most current SDAPCD regulatory development and how it may affect the acceptability of the permit application. Research emission data and other specification of the regulated equipment units as required by the SDAPCD during the permitting process. Assist the Client evaluate the compliance status of the generator set before submitting the application package. Provide an in-depth review of the relevant documents to help ensure accurate technical information is provided or available to the SDAPCD in a timely manner. Whenever it is applicable, ProActive will provide adequate computerized air modeling and health risk assessment to satisfy the New Source Review or AB2588 requirements. Serve as primary liaison with SDAPCD relating to the permitting process. PSA22-1870FAC Exhibit "A" (cont'd) DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E Proposal No.: P2022.6291 Page 3 of 3 B. Professional Fees Here’s the summary of the fee associated with this project: Description Payable to:Cost ProActive’s professional fee to develop permit application package ProActive Consulting Group $3,200.00 Permit Filing Fee San Diego APCD $6,272.00* Handling/Services Fee – 5% of Permit Filing Fee if ProActive is requested to remit filing fee on behalf of the Client to the SDAPCD ProActive Consulting Group $313.60** Total fee for this project: $9,785.60 *The SDAPCD typically increases their filing fee every July 1st. The estimated SDAPCD permit filing fee for the fiscal year 2022-2023 starting July 1 st will be $6,272.00. Please note that payment to ProActive is required upon our completing the permit application documentation for submittal to the SDAPCD. This Agreement is accepted on behalf of City of Carlsbad by: Print Name Sign Name Date This Agreement is accepted on behalf of ProActive Consulting Group, LLC., by: Patrick Tam, MS, CPP 6/13/2022 Print Name Sign Name Date PSA22-1870FAC Exhibit "A" (cont'd) DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E 06/16/2022 Cornerstone Specialty Insurance Services, Inc. 14252 Culver Drive, A299 Irvine CA 92604 Aimee Guesno (714) 731-7700 (714) 731-7750 aimee@cornerstonespecialty.com PROACTIVE CONSULTING GROUP, LLC 15235 Springdale St. Huntington Beach CA 92649 Continental Casualty Company 20443 American Cas.Co. of Reading PA 20427 A ADDT'L INSURED / P & NC BLNKT WVR OF SUBRO 2084330890 07/28/2021 07/28/2022 2,000,000 1,000,000 10,000 2,000,000 4,000,000 4,000,000 A 2084330890 07/28/2021 07/28/2022 1,000,000 B Y 4024152345 07/28/2021 07/28/2022 1,000,000 1,000,000 1,000,000 A PROFESSIONAL LIABILITY Claims Made EEH288355962 07/28/2021 07/28/2022 EACH CLAIM $2,000,000 ANNUAL AGGREGATE $2,000,000 Re: Generator Permitting Consulting Services Fire Station 7 : PSA22-1870FAC The City of Carlsbad is Additional Insured for General Liability but only if required by written contract with the Named Insured prior to an occurrence and asper attached endorsement. Coverage is subject to all policy terms and conditions. *30 days notice of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability coverage, the aggregate limit is the total insurance available for all covered claims reported within the policy period. City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta CA 92564 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCEDAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E ACORD® I ~ I X I [8] X X - ~ [8] □ - -- --X X -H I I XI I I □ SB146968C (Ed.10-19) IMPORTANT:THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE,OFFENSE,CLAIM OR SUIT.SEE PARAGRAPH C.,OF THIS ENDORSEMENT FOR THESE DUTIES. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE AND BLANKET WAIVER OF SUBROGATION Architects,Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A.Who Is An Insured is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement;but the written contract or written agreement must be: 1.Crrently in effect or becoming effective during the term of this policy;and 2.Executed prior to the: a."Bodily injury"or "property damage";or b.Offense that caused the "personal and advertising injury"; for which the additional insured seeks coverage B.The insurance provided to the additional insured is limited as follows: 1.The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage"or "personal and advertising injury"caused in whole or in part by: a.Your acts or omissions;or b.The acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the written contract or written agreement;or c."Your work"that is specified in the written contract or written agreement,but only for "bodily injury"or "property damage"included in the "products-completed operations hazard,"and only if: (1)The written contract or written agreement requires you to provide the additional insured such coverage;and (2)This Coverage Part provides such coverage. 2.The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy,whichever is less.These Limits of Insurance are inclusive of,and not in addition to,the Limits of Insurance shown in the Declarations. 3.The insurance provided to the additional insured does not apply to "bodily injury," "property damage"or "personal and advertising injury"arising out of an architect's,engineer's,or surveyor's rendering of or failure torenderanyprofessionalservicesincluding: a.The preparing,approving,or failing to prepare or approve maps,shop drawings,opinions,reports,surveys, field orders,change orders or drawings and specifications by any architect,engineer or surveyor performing services on a project of which you serve as construction manager;or b.Inspection,supervision,quality control,engineering or architectural services done by you on a project of which you serve as construction manager. 4.The insurance provided to the additional insured does not apply to "bodily injury," "property damage"or"personal and advertising injury"arising out of construction or demolition work while you are acting as a construction or demolition contractor. SB146968C (Ed.10-19)Page 1of3 Copyright,CNA All Rights Reserved.00020009020843308908618Policy Number: 2084330890 Named Insured: Proactive Consulting Group, LLC DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E iiiiiiii -!!!!!!!!!!!!!!! -- SB146968C (Ed.10-19) C.Under Businessowners Liability Conditions,the condition entitled Duties In The Event of Occurrence,Offense, Claim or Suit is amended to add the following: An additional insured under this endorsement will as soon as practicable: 1.Give written notice of an occurrence or an offense to us which may result in a claim or "suit"under this insurance; 2.Tender the defense and indemnity of any claim or "suit"to us for a loss we cover under this Coverage Part; 3.Except as provided for in paragraph D.2.below: a.Tender the defense and indemnity of any claim or "suit"to any other insurer which also has insurance for a loss we cover under this Coverage Part;and b.Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit"from the additional insured. D.With respect only to the insurance provided by this endorsement,the condition entitled Other Insurance of the BUSINESSOWNERS COMMON POLICY CONDITIONS is amended to delete paragraphs 2.and 3.and replace them with the following: 2.This insurance is excess over any other insurance available to the additional insured, whether primary,excess, contingent or on any other basis,But if required by the written contract or written agreement,this insurance will be primary and noncontributory relative to insurance on which the additional insured is a Named Insured. 3.When this insurance is excess,we will have no duty under Business Liability insurance to defend the additional insured against any "suit"ifany other insurer has a duty to defend the additional insured against that "suit"Ifno other insurer defends,we will undertake to do so,but we will be entitled to the additional insured's rights against all those other insurers. When this insurance is excess over other insurance,we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a)The total amount that all such other insurance would pay for the loss in the absence of this insurance;and (b)The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any,with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. E.Additional Insured –Extended Coverage When an additional insured is added by this or any other endorsement attached to this Coverage Part,the section entitled Who Is An Insured is amended to make the following natural persons insureds: If the additional insured is: 1.An individual,then his or her spouse is an insured; 2.A partnership or joint venture,then its partners,members and their spouses are insureds; 3.A limited liability company,then its members and managers are insureds; 4.An organization other than a partnership,joint venture or limited liability company,then its executive officers, directors and shareholders are insureds;or 5.Any type of entity,then its employees are insureds; but only with respect to locations and operations covered by the additional insured endorsement's provisions,and only with respect to their respective roles within their organizations.Furthermore,employees of additional insureds are not insureds with respect to liability arising out of: (1)"Bodily injury"or "personal and advertising injury"to any fellow employee or to any natural person listed in paragraphs 1.through 4.above; SB146968C (Ed.10-19)Page 2of3 Copyright,CNA All Rights Reserved. DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E SB146968C (Ed.10-19) (2)"Property damage"to property owned,occupied or used by their employer or by any fellow employee;or (3)Providing or failing to provide professional health care services. F.The condition entitled Transfer of Rights of Recovery Against Others to Us of the BUSINESSOWNERS COMMON POLICY CONDITIONS is amended to deleted paragraph 2.and replace it with the following: 2.We waive any right of recovery we may have against any person or organization with whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work"done under a contract with that person or organization and included within the "products-completed operations hazard." All other terms and conditions of the Policy remain unchanged. SB146968C (Ed.10-19)Page 3of3 Copyright,CNA All Rights Reserved.00020009020843308908619DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E iiiiiiii Workers Compensation And Employers Liability Insurance Policy Endorsement BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One - Workers’ Compensation Insurance G. Recovery From Others and Part Two - Employers’ Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE - Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 2%. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. WC 4 24152345 Endorsement No: 3; Page: 1 of 1 Policy Page: 33 of 48 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 Form No: G-19160-B (11-1997) Endorsement Effective Date: Policy No: Policy Effective Date: 07/28/2021Endorsement Expiration Date: © Copyright CNA All Rights Reserved. DocuSign Envelope ID: D7723A81-50D3-4831-A0C3-CF6B675DCE9E CNA II