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HomeMy WebLinkAboutKL Painting Inc; 2022-11-07; PWM23-1997FACDocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 November7th CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FIRE STATION NO. 5 INTERIOR PAINT PWM23-1997F AC This agreement is made on the ______ day of ___________ , 2022, by the City of Carlsbad, California, a municipal corporation, (herein after called "City"), and KL Painting, Inc., a California corporation whose principal place of business is 2440 Lorna Lane, Carlsbad, CA 92008 (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 Lauren Milliken (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. WAGE RA TES. 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. Fire Station No. 5 Interior Paint Page 1 of 10 City Attorney Approved Version 8/2/2022 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 PWM23-1997F AC 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 fa lse 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 (5) 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. /X-, ~ Signature: ~ Print Name: Kody L. Kinney 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 surplu s 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 Fire Station No. 5 Interior Paint Page 2 of 10 City Attorney Approved Version 8/2/2022 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 PWM23-1997FAC 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 in sured 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 within thirty (30) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within sixty (60) working days after receipt of Notice to Proceed. Ill Ill Ill Ill Ill Ill Fire Station No. 5 Interior Paint Page 3 of 10 City Attorney Approved Version 8/2/2022 CONTRACTOR'S INFORMATION. KL Painting, Inc. (name of Contractor) 899963 (Contractor's license number) C-33 1/31/2024 (license class. and exp. date) 1000432715 / 6/30/2023 (DIR registration number/exp. date) PWM23-1997F AC 2440 Lorna Lane (street address) Carlsbad, CA 92008 (city/state/zip) 760-613-9891 (telephone no.) klpainting@gmail.com ( e-mail address) 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 KL PAINTING, INC., a California corporation By: Kody L. Kinney, President & Secretary (print name/title) By: (sign here) (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By: Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager 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 Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation .!lli!fil 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: CINDIE K. McMAHON BY: -------------City Attorney Fire Station No. 5 Interior Paint Page 4 of 10 City Attorney Approved Version 8/2/2022 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 PWM23-1997FAC EXHIBIT A 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 fai ls 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 Type of Work to Business Name and Address DIR License No., %of be Subcontracted Registration Classification & Total No. Expiration Date Contract o~~ .-fr Total % Subcontracted: ___ fr....._.__ __ The Contractor must perform no less than 50% of the work with its own forces. Fire Station No. 5 Interior Paint Page 5 of 10 City Attorney Approved Version 8/2/2022 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 PWM23-1997F AC EXHIBITS Fire Station No. 5 Interior Paint Contractor shall provide all materials, tools and labor required to repaint the entire interior of Fire Station No. 5 located at 2540 Orion Way, Carlsbad, CA 92008. All work shall be consistent with the Contractor's proposal dated Aug. 29, 2022 and Oct. 6, 2022 and is attached to this agreement as Exhibit C. Scope: Notes: ITEM NO. 1 2 Paint all walls, hard ceilings, and soffits to match existing color after wall repa irs in all bathrooms, bedrooms, kitchen, dining room , TV room, hallways, stairwell, gym, and washroom. -Patch all holes, cracks, and water damaged ceilings and walls, re-texture patches as necessary, prime and two (2) coats finish paint. Prep and prime all chipping, peeling paint on doors, jambs, and handrails throughout building before finish paint. -Contractor shall maintain good housekeeping practices throughout the duration of the project and will leave the site in a clean and workmanlike manner. -All work must be coordinated so as not to interfere with the operations of the fire station. JOB QUOTATION UNIT QTY DESCRIPTION PRICE LS 1 Prep and paint entire interior of Fire Station No. 5 $26,000 LS 1 Labor & Materials Bond $845 TOTAL* $26,845 *Includes taxes, fees, expenses and all other costs. Fire Station No. 5 Interior Paint Page 6 of 10 City Attorney Approved Version 8/2/2022 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 KL PAINTING INC License #899963 Kody Kinney 2440 Loma Lane Carlsbad, CA 92008 Phone: 760-613-9891 Fax: 760-683-3332 Email: klpainting@gmail.com ATTN: Brian Bacardi Lauren Milliken 405 Oak Ave Carlsbad, CA 92008 Phone: (760) 434-2944 Email: Brjila B,11;:1mli@~ilcl:ibild~ gg~ Email: 1,rnren mil'' -·lsb,uir:, nnv Interior: EXHIBITC ~OB SITE Fire Station #5 ~540 Orion Way Carlsbad, CA 92010 Job Description 1. KL Painting to remove all old rubber baseboards before paint PWM23-1997F AC Estimate August 29,2022 2. Patch all holes, cracks, and water damaged ceilings and walls, re-texture patches as necessary, prime and two (2) coats finish paint 3. Paint all walls, hard ceilings, and soffits to match existing color after wall repairs in all bathrooms, bedrooms, kitchen, dining room, TV room, hallways, stairwell, gym, and wash room (No paint in shop) 4. Paint blue electrical panels in hallway to match existing color 5. Prep and prime all chipping, peeling paint on doors, Jambs, and handrails throughout building before finish paint 6. Paint all doors, jambs, and handrails to match existing blue color (painted brown door to be painted blue and NO paint on laminated door) 7. KL Painting to remove all wall decor and electrical faceplates before paint and reinstall after complete •Paint samples are an additional price '*This price is valid for 45 days from date of estimate Total Interior: $26,000.0 0 Total: $26,000.00 KL Painting, Inc Date Owner Date Fire Station No. 5 Interior Paint Page 7 of 10 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 KL PAINTING INC License #899963 Kody Kinney 2440 Lorna Lane Carlsbad, CA 92008 Phone: 760-613-9891 Fax: 760-683-3332 Email: klpainting@gmail.com ATTN: Brian Bacardi Lauren Milliken 405 Oak Ave Carlsbad, CA 92008 Phone: (760) 434-2944 Email: Bria · Email: laur v Bond: Total: KL Painting, Inc Date Fire Station No. 5 Interior Paint Total PWM23-1997F AC PM23-1997FAC -Exhibit "C" (cont'd) Fire Station #5 540 Orion Way arlsbad, CA 92010 Owner Page 8 of 10 Date Estimate October 6,2022 $845.00 $845.00 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 Bond Number: UCSX372X6092 Premium: $845.00 EXHIBITD LABOR AND MATERIALS BOND PWM23-1997F AC WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to KL Painting, Inc. (hereinafter designated as the "Principal"), a Contract for: FIRE STATION NO. 5 INTERIOR PAINT in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, KL Painting, Inc., as Principal, (hereinafter designated as the "Contractor''), and United Surety Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of twenty-six thousand eight hundred forty five dollars ($26,845), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. Fire Station No. 5 Interior Paint Page 9 of 10 City Attorney Approved 8/212022 PWM23-1997FAC In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. SIGNED AND SEALED, this 18th dayof __ o_ct_ob_e_r _________ ,2022 United Surety Insurance Company (SEAL) 14� By: ____________ _ (Signature) Kelly A. Specht, Attorney-in-Fact (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY-ATTACH ATTORNEY-IN­ FACT CERTIFICATE) APPROVED AS TO FORM: CINDIE K. McMAHON By: ----,-----,---------------City Attorney Fire Station No. 5 Interior Paint Page 10 of 10 City Attorney Approved 8/2/2022 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 KL Painting. Inc. (SEAL) (Principal) By: . (Sinature) DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 California All-Purpose Certificate of Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of __ o __ r_an__.9<.,;,e ___________ _ S.S. On October 18, 2022 before me, _______ B_e_th_a_n..c..y_M_e_r_ce_r_, _N_ot_a-'ry_P_u_b_li_c ____ _ ----------Name of Notary Public, Title personally appeared ____________ K_e~lly,_A_._S_,_p_ec_h_t __________ _ Name of Signer (1) Name of Signer (2) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the in strument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Seal ------+------>.--lf--1/ OPTIONAL INFORMATION ------------- A/th n in this t required by law, it could prevent fraudulent removal and reattachment of this to an unautl cument and may prove useful to persons relying on the attached document. containing _2_ pages, and dated ___ O_c_to_b_er_1_8~, _20_2_2 __ The signer(s) capacity or authority is/are as: D lndividual(s) IX] Attorney-in-fact □ Corporate 0fficer(s) ______________ _ □ Guardian/Conservator D Partner -Limited/General D Trustee(s) Tille(s) □ other: _________________ _ representing: __ U_n_it_ed_S_ur_e ..... ty .... l_n_su_r_a_nc_e_C_o_m_p,_a_n...._y ___ _ Name(s) of Person(s) Enlily(ies) Signer is Rcpresenltng .f:r.--. --, 1r; 'I t 1 ■a1r; • Method of Signer Identification Proved to me on the basis of satisfactory evidence: D form(s) of identification D credible witness(es) Notarial event is detailed in notary journal on: Page# __ Entry# __ Notary contact: Other D Additional Signer D Signer(s) Thumbprints(s) □ © 2009-2015 Notary Learning Center - A ll Rights Reserved You can purchase copies of this form from our web site at www.TheNotarysStore.com DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 l!I UNITED CASUALTY AND SURETY INSURANCE COMPANY US Casualty and Surety Insurance Company United Surety Insurance Company POWER OF ATTORNEY Agency No: 171372 KNOW ALL MEN BY THESE PRESENTS: That United Casualty and Surety Insurance Company, a corporation of the State of Nebraska, and US Casualty and Surety Insurance Company and United Surety Insurance Company, assumed names of United Casualty and Surety Insurance Company (collectively, the Companies), do by these presents make, constitute and appoint: Kelly A. Specht, Kandis Gregory, Richard P. Ford, Thomas C. Buckner, Bethany Mercer, William Belpedio its true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed Three MjUjon Fjve Hundred Thousand & 00/100 Dollars I $3,S00,000.00 l. This Power of Attorney shall expire without further action on December 31st, 2024. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Board of Directors of the Companies at a meeting duly called and held on the 1" day of July, 1993: Resolved that the President, Treasurer, or Secretary be and they are hereby authorized and empowered to appoint Attorneys-in-Fact of the Company, in its name and as its acts to execute and acknowledge for and on its behalf as Surety any and all bonds, recognizances, contracts of indemnity, waiversof citation and all other writings obligatory in the nature thereof, with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys-in-Fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected Officers of the Company in their own proper persons. That the signature of any officer authorized by Resolutions of this Board and the Company seal may be affixed by facsimile to any power of attorney or special power of attorney or certification of either given for the execution of any bond, undertaking, recognizance or other written obligation in the nature thereof; such signature and seal, when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereunto affixed, this 5th day of July, 2022 Corporate Seals Commonwealth of Massachusetts County of Middlesex ss: UNITED CASUALTY AND SURETY INSURANCE COMPANY US Casualty and Surety Insurance Company United Surety Insurance Company Michael T. Porsch, Treasurer On this 5th day of July, 2022 , before me, Colleen A. Cochrane, a notary public, personally appeared, Michael T. Porsch, Treasurer of United Casualty and Surety Insurance Company, US Casualty and Surety Insurance Company and United Surety Insurance Company, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person(s), or the entity on behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the Commonwealth of Massachusetts that the foregoing paragraph is true and correct. WITNESS my hand and seal. COLLEEN A. COCHRANE Notary Public, Commonwealth of Massachusetts My Commission Expires 10/27/2028 I, Robert F. Thomas, President of United Casualty and Suret Insurance Company, US Casualty and Surety Insurance Company and United Surety Insurance Company do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. ~ I have hereunto set my hand and affixed the seals of said Companies at Newton, Massachusetts this ~ /BI Corporate Seals lkn-~ Robert F. Thomas, President TO CONFIRM AUTHENTICITY OF THIS BOND OR DOCUMENT EMAIL: CONFIRMBOND@UNITEDCASUALTY.COM PDFDevice by Brainy DataCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/20/2022 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:ALL COMMERCIAL INSURANCE SERVICES, LLC.ALL COMMERCIAL INSURANCE SERVICES, LLC. 16769 Bernardo Ctr Dr. #1-843 San Diego CA 92128-2546 PHONE (A/C, No. Ext):(858) 642-0200 FAX (A/C, No):(858) 642-0205 E-MAIL ADDRESS www.2insure.biz INSURER(S) AFFORDING COVERAGE NAIC # INSURED Agency Lic#: 0C64552 INSURER A: INSURER B: INFINITY SELECT INSURANCE COMPANY NATIONWIDE MUTUAL INSURANCE CO 20260 23787 KL PAINTING INC 2440 LORNA LANE CARLSBAD CA 92008 INSURER C:NATIONAL UNION FIRE CO OF PITTSBURGH, PA 19445 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:3362122 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. INSRLTR TYPE OF INSURANCE ADDLINSRD SUBRWVD POLICY EFFDATE (MM/DD/YY)POLICY EXPDATE (MM/DD/YY) X POLICY NUMBER EACH OCCURRENCE LIMITS $1,000,000ACOMMERCIAL GENERAL LIABILITY ACP7815050387 05/27/22 05/27/23 DAMAGE TO RENTED PREMISES (Ea occurence)$100,000CLAIMS MADE X OCCUR 5,000MED EXP (Any one person)$ 1,000,000PERSONAL & ADV INJURY $ 2,000,000GEN'L AGGREGATE LIMIT APPLIES PER: PRO- JECT GENERAL AGGREGATE $ 2,000,000POLICYXLOCPRODUCTS-COMP/OP AGG $ OTHER: 504590622685001 06/27/23 COMBINED SINGLE LIMIT (Ea accident) $ B AUTOMOBILE LIABILITY 06/27/22 $1,000,000 ANY AUTO BODILY INJURY (Per person)$ OWNED AUTOS ONLY X SCHEDULED AUTOS BODILY INJURY (Per accident)$ X HIRED AUTOS ONLY X NON-OWNED AUTOS ONLY PROPERTY DAMAGE $(Per accident) $ C UMBRELLA LIAB X OCCUR EBU013781095 05/27/22 05/27/23 EACH OCCURRENCE $2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED RETENTION $$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PERSTATUTE OTH-ER ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?(Mandatory in NH) Y/N N/A E.L. EACH ACCIDENT $ E.L. DISEASE-EA EMPLOYEE $ If yes, describe underDESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $ RE: ALL PROJECTS The City of Carlsbad is included as Additional Insured with respect to general liability as per the attached endorsement. *10 Day Notice of Cancellation for Non-Payment/30 Day Notice of Cancellation for all other causes DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 4668 - ECM #35050 New York, NY 10163-4668 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Emilyn Ryan Mark RubinLic # ACORD 25 (2016/03)Certificate #3362122 © 1988-2015 ACORD CORPORATION. All right reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 ACORD"" I ~ I I □ ~ □ □ - ----~ ---- -H I I I I I □ ~~£-·~. ACP GLO 7815050387 MACH 21089 INSURED COPY 47 0007426 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 COMMERCIAL GENERAL LIABILITY CG 20 33 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such 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: 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. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. CG 20 33 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 ACP GLO 7815050387 MACH 21089 INSURED COPY 47 0007427 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 CG 20 33 0413 2. "Bodily injury" or "property damage" occurring after: a. 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 b. 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: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All terms and conditions apply unless modified by this endorsement. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 33 0413 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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 certifi cate 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 certifi cate does not confer rights to the certifi cate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE (A/C, NO, EXT): FAX (A/C, NO): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: INSURER B: INSURER C: INSURER D: 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 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDTL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS 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 $ POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ OTHER:$ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident)$ ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident)$ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $$ WORKERS COMPENSATION AND EMPLOYERS ‘ LIABILITY N/A PER STATUTE OTHER $ ANY PROPRIETOR/PARTNER/ EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD ACORD 25 (2016/03) 31-1769 11-15 WOODLAND Louis Mitchell Jr. IBSEN DENISE(9532V3E) 414 Fourth ST STE A 530-668-8818 10/19/2022 530-379-2826 dibsen@farmersagent.comCA95695 CARLSBAD K L PAINTING INC Mid Century Insurance Company 216872440 LORNA LN CA 92008-1034 C Y Y A09514719 1,000,000 1,000,000 1,000,000 The City of Carlsbad is listed as Additional insured on the named Insured's workers compensation policy for all projects with the city. Waiver of Subrogation applies in favor of the certificate holder on the workers compensation policy. City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta GA 92564 Denise Ibsen 10/01/202310/01/2022 DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 ACORb® ~ I I -□ □ - Fl □ □ --~ -~ -~ -~ I I xi I I C I DocuSign Envelope ID: D29CDF62-916E-4F64-8103-9583A0056EB1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC 00 0313 (Ed. 4-84) 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Waiver of Subrogation endorsement (WC 00 03) in favor of the City of Carlsbad 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 Insured K L Painting Inc Insurance Company Mid Century Insurance Company WC 00 0313 (Ed. 4-84) © 1983 National Council on Compensation Insurance. Effective Policy No. A09514719 Endorsement No. Premium Denise Ibsen 10/1/2022 Countersigned by ________________ _