Loading...
HomeMy WebLinkAboutHabitat Protection Inc; 2022-07-11; PSA22-1873UTILPSA22-1873UTIL General Counsel Approved Version 6/12/18 1 AGREEMENT FOR PEST CONTROL SERVICES AT MAERKLE RESERVOIR HABITAT PROTECTION, INC. THIS AGREEMENT is made and entered into as of the _____________________ day of _________________________________, 2022, by and between the Carlsbad Municipal Water District, a Public Agency organized under the Municipal Water Act of 1911, and a Subsidiary District of the City of Carlsbad, ("CMWD"), and Habitat Protection, Inc., a California corporation, ("Contractor”). RECITALS CMWD requires the professional services of a consultant that is experienced in pest control services. Contractor has the necessary experience in providing these professional services, has submitted a proposal to CMWD and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, CMWD and Contractor agree as follows: 1. SCOPE OF WORK CMWD 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 six thousand five hundred dollars ($6,500). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. CMWD reserves the right to withhold a ten percent (10%) retention until CMWD has accepted the work and/or the Services specified in Exhibit “A.” 4. PREVAILING WAGE RATES Any construction, alteration, demolition, repair, and maintenance work, including work performed during design and preconstruction such as inspection and land surveying work, cumulatively exceeding $1,000 and performed under this Agreement are subject to state prevailing wage laws. 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 the Section 1770, 1773 and 1773.1 of the California Labor Code. Pursuant to Section 1773.2 of the California Labor code, a current copy of 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 such workers employed by him or her in the execution of the Agreement. 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: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 July 11th PSA22-1873UTIL General Counsel Approved Version 6/12/18 2 5. 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 CMWD. Contractor will be under the control of CMWD only as to the results to be accomplished. 6. INDEMNIFICATION Contractor agrees to indemnify and hold harmless CMWD 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 CMWD incurs or makes to or on behalf of an injured employee under the CMWD’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. 7. 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 CMWD by certified mail. CMWD will be named as additional insured on General Liability which shall provide primary coverage to CMWD. The full limits available to the named insured shall also be available and applicable to CMWD as an additional insured. Contractor will furnish certificates of insurance to CMWD with endorsements to CMWD, prior to CMWD’s execution of this Agreement. 8. NOTICES The name of the persons who are authorized to give written notices or to receive written notice on behalf of CMWD and on behalf of Contractor under this Agreement. For CMWD For Contractor Name Andrew Wilson Name Bart Van Diepen Title Utilities Supervisor Title Project Manager Carlsbad Municipal Water District Address 751 W. 4th Avenue Address 5950 El Camino Real Escondido, CA 92025 Carlsbad, CA 92008 Phone 760-745-5460 Phone 760-802-5720 E-mail bart@habitatprotection.net DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 PSA22-1873UTIL General Counsel Approved Version 6/12/18 3 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. 9. 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 ☒ 10. 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. 11. TERMINATION CMWD or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. CMWD 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. 12. 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 CMWD to terminate this Agreement. 13. 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. 14. 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 CMWD. 15. AMENDMENTS This Agreement may be amended by mutual consent of CMWD 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: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 PSA22-1873UTIL General Counsel Approved Version 6/12/18 4 16. 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 CARLSBAD MUNICIPAL WATER DISTRICT, a Public Agency organized under the Municipal Water Act of 1911, and a Subsidiary District of the City of Carlsbad HABITAT PROTECTION, INC., a California corporation By: By: (sign here) Vicki V. Quiram, General Manager as authorized by the Executive Manager Bart Van Diepen, Vice President & Secretary (print name/title) By: (sign here) (print name/title) If required by CMWD, 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, General Counsel By: _____________________________ Assistant General Counsel DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 PSA22-1873UTIL General Counsel Approved Version 6/12/18 5 EXHIBIT “A” SCOPE OF SERVICES MONTHLY PEST AND RODENT CONTROL MAINTENANCE SERVICES AT MAERKLE RESERVOIR AS OUTLINED IN THE TABLE BELOW Task Quantity Unit Unit Price Extended Price Contractor to provide/perform the following: Continue the monthly pest control program for outside the house and garage including rodent management 12 EA $68.00 $816.00 Continue the monthly bait and pest treatment service for ants and rats at Buildings 1, 2, 3 and 4 12 EA $148.00 $1,776.00 Continue the monthly repellant spray treatment for rats at Buildings 1, 2, 3 and 4 12 EA $140.00 $1,680.00 Add the services listed below Initial interior house and garage one-time general pest control service 1 EA $250.00 $250.00 Initial interior house one-time disinfectant and pest control cleanout service 1 EA $350.00 $350.00 Provide monthly interior house and garage pest control service 12 EA $35.00 $420.00 SUBTOTAL $5,292.00 Extra Work – any pest control services needed beyond this listed scope of work REQUIRES prior approval by CMWD project manager or his designee before proceeding with the work or service. $1,208.00 TOTAL AMOUNT NOT TO EXCEED $6,500.00* *Includes taxes, fees, expenses and all other costs. • Contractor is required to contact CMWD each time access is needed to Maerkle Reservoir pest control treatment locations. DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 ~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ACORD® 03/07/2022 ~ PRODUCER THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION JOHN CHO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3520 COLLEGE BLVD., SUITE 104 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR OCEANSIDE, CA 92056 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ~ ' INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: State Farm Mutual Auto Insurance Company 251 78 25178 HABITAT PROTECTION, INC. 751 W. 4TH AVE. INSURER B: ESCONDIDO, CA 92025 INSURERC: dba Pestmaster INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE IMM/DD/YYI DATE IMM/DD/YYI LIMITS ~ERAL LIABILITY EACH OCCURRENCE $ UAM"ucc ': Yi ncco. I t:U -COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence I $ D CLAIMS MADE □ OCCUR MED EXP (Anv one person) $ PERSONAL & ADV INJURY $ - GENERAL AGGREGATE $ - GEN1.AGGREGATE Uv11T APPi.JES PER: PRODUCTS-COMP/OP AGG $ 7 nPRO-POLICY JECT nLOC ~OMOBILE LIABILITY 118-2848-Fl4-55F 11/28/2021 11/28/2022 COMBINED SINGLE LIMIT 287-5293-F05-55D 12/05/2021 12/05/2022 (Ea accident) $ 1,000,000 -ANY AUTO 287-5294-F05-55D 12/05/2021 12/05/2022 ALL OWNED AUTOS 352-5670-E23-55D 11/23/2021 11/23/2022 BODILY INJURY $ -(Per person) X SCHEDULED AUTOS 422-4780-B08-55B 02/08/2022 02/08/2023 X HIRED AUTOS 446 9697-Bl2-55 02/12/2022 02/12/2023 BODILY INJURY 451 1671-Dll-55 04/11/2021 04/11/2022 (Per accident) $ X NON-OWNED AUTOS -493 9772-Al6-55 01/16/2022 01/16/2023 PROPERTY DAMAGE -(Per accident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ ~ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ ~OCCUR □ CLAIMS MADE AGGREGATE $ $ =7 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I wc STATu-,I I OTH- EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L DISEASE -EA EMPLOYEE $ ~~~t1ii5~~bc5Jls16~s below E.L DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS 16 GMC Cl500 VIN# 1GTN1LEC5GZ904827,16 GMC Cl500 VIN#lGTNlLEC3GZ902638, 15 DODGE RAM VIN#3C6JR6AGXFG525331, 17 NISSAN FRONTIER VIN# 1N6BD0CT4HN706693, 06 FORD F350 VIN# 1FDWF35P66EC03322, 17 FORD T350HD VIN# 1FDRS6ZV0HKB53766, 2018 GMC 1GTN1LEC5JZ905399 Employee Non-Owned Coverage. CERTIFICATE HOLDER CITY OF CARLSBAD/CMWD c/o EXIGIS Insurance Compliance Services PO BOX 947 MURRIETA, CA 92564 132849 03-13-2007 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE JOHN CHO All rights reserved DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 STATE .. ,,...,vn~1.m1.1JT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS REP 04 9314019-22 NEW COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO EFFECTIVE MARCH AND EXPIRING MARCH NA 3-38-35-21 PAGE 1 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME 1, 2022 AT 12 .01 A.M. 1, 2023 AT 12.01 A.M. PESTMASTER SERVICES -SAN DIEGO CO 751 W 4TH AVE. ESCONDIDO, CA 92025 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 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: MARCH 16, 2022 2572 ~!.,q, PRESIDENT AND CEO SCIF FORM 10217 (REV.4·2018) OLD DP 217 DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 ~ ACORD® ~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) 03/08/2022 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 CONTACT NAME: Matthew Welty R.I.C. INSURANCE GENERAL AGENCY PHONE I FAX 1330 N DUTTON AVE, STE 200 (A/C, NO, EXT): 858-569-1009 (A/C, NO): 888-795-2247 SANTA ROSA, CA 95401 E-MAIL c/o MATTHEW WELTY ADDRESS: matt@weltyinsurancegroup.com INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: STATE COMPENSATION INSURANCE FUND 35076 INSURER B: HABITAT PROTECTION, INC. INSURERC: dba PESTMASTER SERVICES 751 W. 4TH AVE INSURERD: ESCONDIDO, CA 92025 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME 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 SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDTL SUBR POLICY NUMBER POLICYEFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ -□ CLAIMS-MADE □ OCCUR DAMAGE TO RENTED $ PREMISES (Ea Occurrence) MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Fl POLICY □ PROJECT □ LOC PRODUCTS· COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ~ ANY AUTO BODILY INJURY (Per person) $ ~ -OWNED AUTOS SCHEDULED BODILY INJURY (Per accident) $ ONLY AUTOS -,-- HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ ONLY AUTOS ONLY (Per accident) ~ -$ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ -- EXCESSLIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION $ $ WORKERS COMPENSATION x1~:T\JTE I I OTHER $ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/ Y/N E.L. EACH ACCIDENT $ 1,000,000 EXECUTIVE OFFICER/MEMBER ~ N/A 9314019 03/01/2022 03/01/2023 A EXCLUDED? (Mandatory in NH) E.L. DISEASE· EA EMPLOYEE 1,000,000 If yes, describe under DESCRIPTION OF E.L. DISEASE -POLICY LIMIT $ 1,000,000 OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 'A Blanket Waiver of Subrogation applies in favor of the certificate holder listed below. * 30 DAY NOTICE OF CANCELLATION/10 DAY NOTICE DUE TO NON-PAYMENT* CERTIFICATE HOLDER CANCELLATION arls a EXIGIS Insurance Complaince Services PO Box947 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 25 (2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 8ED404A3-1A4D-4780-BE0D-58E5A6E8D523 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract. 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 Insured Insurance Company WC 04 03 06 (Ed. 04-84) 7/1/2021 Policy No. WWC3538846 Habitat Protection, Inc. Wesco Insurance Company Endorsement No. Premium$ 0 15,523 Countersigned by __________________ _