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HomeMy WebLinkAboutCharles Doherty Concrete; 2022-12-16; PWM23-2036FACPWM23-2036FAC CMWD Water Fountain Removal Page 1 of 8 City Attorney Approved 8/2/2022 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT CMWD WATER FOUNTAIN REMOVAL This agreement is made on the ______________ day of _________________________, 2022, by the City of Carlsbad, California, a municipal corporation (hereinafter called "City") and Charles Doherty Concrete, a sole proprietorship whose principal place of business is 2850 Industry Street, Oceanside, California 92054 (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 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: EEF115E2-4B56-4655-A018-8BA0C620F817 16th December PWM23-2036FAC CMWD Water Fountain Removal Page 2 of 8 City Attorney Approved 8/2/2022 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 (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. Signature: ___________________________________ Print Name: ___________Charles Doherty___________ 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: EEF115E2-4B56-4655-A018-8BA0C620F817 PWM23-2036FAC CMWD Water Fountain Removal Page 3 of 8 City Attorney Approved 8/2/2022 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 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. /// /// /// /// /// DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 PWM23-2036FAC CMWD Water Fountain Removal Page 4 of 8 City Attorney Approved 8/2/2022 CONTRACTOR’S INFORMATION. Charles Doherty Concrete 2850 Industry Street (name of Contractor) 707928 (street address) Oceanside, CA 92054 (Contractor’s license number) C-8, A, C-13 6/30/23 (city/state/zip) 760-535-9295 (license class. and exp. date) 1000019050 6/30/23 (telephone no.) cwdoherty@cox.net (DIR registration number and exp. date) (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 CHARLES DOHERTY CONCRETE, a sole proprietorship CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Charles Doherty, Owner Paz Gomez, Deputy City Manager, Public Works, as authorized by the City 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, 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: CINDIE K. McMAHON BY: _____________________________ City Attorney DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 PWM23-2036FAC CMWD Water Fountain Removal Page 5 of 8 City Attorney Approved 8/2/2022 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 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 Type of Work 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: EEF115E2-4B56-4655-A018-8BA0C620F817 none 0nonenone 0 none PWM23-2036FAC CMWD Water Fountain Removal Page 6 of 8 City Attorney Approved 8/2/2022 EXHIBIT B CMWD Water Fountain Removal Contractor to provide all materials, tools and labor necessary for the removal and disposal of a water fountain and replace with concrete flatwork at the Carlsbad Municipal Water District located at 5950 El Camino Real, Carlsbad, California 92008. All work and materials to be consistent with the Contractor’s proposal dated November 3, 2022, and is attached to this agreement as Exhibit C.The scope of work shall consist of: •Punch additional holes in floor of water feature for drainage •Demo all curbs below grade •Install recycled gravel to establish new subgrade •Edges to be slip doweled at 32-inch centers with 3/8 rebar •Construction site must maintain good housekeeping practices with trash or debrisremoved daily JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Removal of water fountain Replace fountain footprint with concrete flatwork $12,300 TOTAL* $12,300 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 CMWD Water Fountain Removal Page 7 of 8 EXHIBIT C PWM23-2036FAC DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 ~ Charl88 Dohalty Concnl8 2850 Industry Street Oceanside, CA 92054 US 760-535-9295 cwdoherty@cox.net Estimate ADDRESS SHl'lO LAUREN MILLIKEN Project Assistant, Public Works Department WATER FOUNTAIN REMOVAL 5950 EL CAMINO REAL CARLSBAD, CA ACTIVITY City of Carlsbad 405 Oak Avenue Carlsbad, CA 92008 ~TE 11/03/2022 ·scOPE OF WORK PROVIDE MATERIALS, LABOR AT PREVAILING WAGES AND EQUIPMENT TO DEMO EXISTING WATER FEATURE BELOW EXISTING CONCRETE GRADES AND INFILL AREA WITH CONCRETE •WORK TO INCLUDE PUNCH ADDITIONAL HOLES INI FLOOR OF WATER FEATURE TO ENSURE DRAINAGE PERIMETER CURBS TO BE DEMOED BELOW GRADE OF ADJACENT FLA TWORK PROVIDE AND INSTALL RECYCLED GRAVEL TO ESTABLISH NEW SUBGRADE PUMP, PLACE AND FINISH 3250 PSI CONCRETE 318 AGGREGATE THE RAISED PORTION IS 10 Fli X 10 FT APPROXIMATELY 24 IN HIGH THE SPILLWAY IS 4 FT X 25 FT LONG, EDGES TO BE SLIP DOWELED AT 32 IN CENTERS WITH 318 REBAR WE WILL MATCH EXISTING TOOLING DETAILS AS CLOSELY AS POSSIBLE ASSUME USE OF SITE WATER, POWER AND RESTROOM -WE CAN PROVIDE A RESTROOM SERVICE IF NEEDED AT ADDITIONAL COSTS ASSUME JOB DOES NOT NEEO TO BE BONDED SINCE IT IS UNDER $25,000 DIR CHARGES (1) SET-UP AND• (1) DELIVERY FEE •PAYMENT BALANCE DUE ON COMPLETION SCHEDULING OF WORK: Doherty Concrete requires a 3 week lead time for starting new projects. Due to our constant work load we plan and organize jobs 2-3 weeks ahead of schedule for our labor, 10 order products, confirm lools required, mobilization and logistic to make sure your project is a priority 10 us. If lhis is a priority or emergency p.roject please inquire aboul an expedile fee option. So AC IIVI IY plan accordingly please. J:orw~rd all e,chcdulc roqucGt to cwdohcr1y@cox.net OTY RATE 11,400.00 900.00 0.00 QIY RAlt AMOUNli 11,400.00 900.00 0.00 AMOUNI TOTAL $12,300.00 CMWD Water Fountain Removal Page 8 of 8 EXHIBIT C (Continued) PWM23-2036FAC DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME:FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A(Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE 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 onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 11/22/2022 License # 0757776 (760) 707-5659 (760) 804-0942 24856 Charles Doherty Concrete1302 Crestridge Dr. Oceanside, CA 92054 13064 41297 A 1,000,000 XXCA000024840-07 7/15/2022 7/15/2023 300,000 Per Project Agg.5,000 1,000,000 2,000,000 2,000,000 5,000,000B XCA0000088 7/15/2022 7/15/2023 5,000,000 C Equipment Floater CPS7528133 2/10/2022 Scheduled Equipment 242,935 C Commercial Property CPS7528066 2/10/2022 2/10/2023 2 buildings each 375,000 The City of Carlsbad/CMWD is named as Additional Insured with respect to General Liability per form CG2011 1219, CG2034 1219, CG2010 1219 & CG2037 1219. The City of Carlsbad/CMWD Certificate of Insurance applies to all projects with the City of Carlsbad. Insurance is Primary and Non-contributory. SEE ATTACHED ACORD 101 City of Carlsbad/CMWD C/O EXIGIS Insurance Compiance Services PO Box 947 Murrieta, CA 92564 CHARDOH-01 JGRAESSLE HUB International Insurance Services Inc.1525 Faraday AvenueSuite 150Carlsbad, CA 92008 Julie Graessle julie.graessle@hubinternational.com Admiral Insurance Company United National Insurance Company Scottsdale Insurance Company 2/10/2023 X X X X XX DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 ACORD" I ~ I ~ D □ ~ ~ Fl □ □ ~ ~ - ~ - ~ ~ ~ H I I I I I □ I FORM NUMBER: EFFECTIVE DATE: The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE FORM TITLE: Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01) AGENCY CUSTOMER ID: LOC #: AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE © 2008 ACORD CORPORATION. All rights reserved. HUB International Insurance Services Inc. CHARDOH-01 SEE PAGE 1 1 SEE PAGE 1 ACORD 25 Certificate of Liability Insurance License # 0757776 1 SEE P 1 Charles Doherty Concrete1302 Crestridge Dr.Oceanside, CA 92054San DiegoSEE PAGE 1 JGRAESSLE 1 Description of Operations/Locations/Vehicles: Waiver of subrogation applies for General Liability. **30 day notice of cancellation/10 day notice of nonpayment of premium DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 ~ ACORD" ~ I  &$ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 Policy Number: . · AD 68 93 0117 Effective Date: TIUS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCED COVERAGE (Commercial General Liability Coverage Form) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM I. AMENDED EXCLUSIONS NON-OWNED WATERCRAFT COVERAGE -Up to 55 feet SECTION I-COVERAGES -COVERAGE A-BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclu- sion g. Aircraft, Auto or Watercraft, Paragraph (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 55 feet long; and (b) Not being used to carry persons or property for a charge; MEDICAL PAYMENTS- PRODUCTS-COMPLETED OPERATIONS HAZARD SECTION I -COVERAGES -COVERAGE C-MEDICAL PAYMENTS Exclusion f. Products-Completed Operations Hazard is deleted in its entirety. CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM EXCLUSION (LIMITED EXCEPTION FOR OPERATIONS A WAY FROM PROJECT LOCATION) The following exclusion is added to paragraph 2., Exclusions of COVERAGE A -BODILY INJURY AND PROPERTY DAMAGE LIABil.ITY (Section I -Coverages): This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or opera- tions included within the "products-completed operations hazard" at any location for which a consolidated (wrap-up) insur- ance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated (wrap-up) insurance program: (1) Provides coverage identical to that provided by this Coverage Form; (2) Has limits adequate to cover all claims; or (3) Remains in effect. However, if the consolidated (wrap-up) insurance program does not provide coverage for your operations that are perfonned away from the location of the construction project, this exclusion will not apply. AD68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2009, 2012 & 2013. Pagel of8 □ I I fl i 11 11 I I I I a DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 ll. AMENDEDCOVERAGES KNOWLEDGE OF OCCURRENCE The following paragraph is added to Section IV -Commercial General Liability Conditions Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: Notice of an "occurrence" which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the "occurrence" has been reported to you, one of your "executive officers", or any "employee" authorized by you to give or receive notice ofan "occurrence". UNINTENTIONAL ERRORS AND OMISSIONS The following paragraph is added to Section IV -Commercial General Liability Conditions Paragraph 6. Representations: However, the unintentional omission of, or unintentional enor in, any information given or provided by you shall not preju-dice yow-rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our right of cancellation or nonwrenewal. III. ADDED COVERAGES PERSONAL PROPERTY OF OTHERS IN YOUR CARE, CUSTODY OR CONTROL - LIMITED COVERAGE SCHEDULE Sub-Limits of Insurance: $10,000 Each Occurrence (Included in the Each Occurrence Limit shown in the Declarations) $10,000 Aggregate (Included in the General Aggregate Limit shown in the Declarations) The Sub-Limits of Insurance shown above are included within and not in addition to the Each Occurrence Limit and the General Aggregate Limit shown in the Declarations. Supplementary Payments will reduce the Each Occurrence and Aggregate Sub-Limits of Insurance shown above. It is agreed COMMERCIAL GENERAL LIABILITY COVERAGE FORM -SECTION I~ COVERAGE A Exclusion j. ( 4) is deleted, but only with respect to personal property of others in the care, custody or control of the Named Insured, subject to the following exclusions, conditions and limitations. 1. Exclusions This insurance does not apply to: a. "Property damage" arising out of operations performed on behalf of the Named Insured by others; b. "Property damage" arising out of an "occutTence" at premises owned, rented, leased, operated, occupied or used by you; c. "Property damage" to property while in transit; d, "Property damage" arising out of any en-or, omission or deficiency in the design, specifications, workmanship or mateiials of the personal property in the Named Insured's care, custody or control; e. "Property damage" arising out of delay, loss of market, loss of use, loss of profits, or any similar indirect or conse- quential loss of any kind; f. "Property damage" included within the "products-completed operations hazard"; or g. Damages exceeding the actual cash value of the personal prope1ty in the care, custody or control of the Named In-sured at the time of the "occurrence." 2. Conditions Our right and duty to defend ends when we have used up the applicable sub-limit of insurance in the payment of judg-ments or settlements or Supplementary Payments under the insurance provided by this endorsement. AD68930l 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2009, 2012 & 2013. Page 2 of8 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 3. Limits oflnsurance a. The amount we will pay for damages is limited as described below with respect to damages covered under this en- dorsement: (l) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages because of "property damage"; (2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of"prop- erty damage" arising out of any one "occurrence"; (3) Supplementa1y Payments will reduce the Each OccmTence and Aggregate Limits of Insurance shown in the Schedule; and (4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occur- rence Limit and the General Aggregate Limit shown in the Declarations. 4. Other Insurance This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you, either as a Named Insured or an Additional Insured, whether primary, excess, contingent or any other basis. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 01 04 13) The following is added to the Othei· Insurance Condition and supersedes any provision to the contraiy: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek con- tribution from any other insurance available to the additional insured. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Se1·vices Office Endorsement CG 24 04 05 09) SCHEDULE Name Of Person Or Organization: Any person or organization, but only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract; and (2) The injury or damage first occurs subsequent to the execution of the written contract. Info1mation required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recove1·y Against Otllers To Us of Section IV -Condi- tions: We waive any right ofrecovety we may have against the person or organization shown in the Schedule above 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 in the "products-completed operations hazard". This waiver applies only to the per- son or organization shown in the Schedule above. AD68930117 Includes copyrighted material of Insurance Services Office, Inc., with its pennission, 2009, 2012 & 2013. Page 3 of8 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 Scheduled Railroad: CONTRACTUAL LIABILITY -RAILROADS (Insurance Services Office Endorsement CG 24 l 7 10 01) SCHEDULE Designated Job Site: Any railroad, but only if the following conditions are met: a. You have expressly agreed to indemnify the railroad in a written contract entered into by you; and Any job site covered by this insurance where you are per- forming operations for or affecting a Scheduled Railroad. b. The injury or damage occurs subsequent to the execu- tion of the written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- ble to this endorsement.) With respect to operations performed for, or affecting, a Scheduled Railroad at a Designated Job Site, the definition of "in- sured contract" in the Definitions section is replaced by the following: 9. "Insured Contract" means: a. A contract for a lease of premises. However, that pmtion of the contract for a lease of premises that inde1mlifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with per- mission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a munici- pality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pe1taining to your business (including an indemnification of a munici• pality in connection with work perfo1med for a municipalily) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liabil- ity that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that parL of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, smveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primaiy cause of the injrny or dam- age; (2) Under which the insured, if an architect, engineer or surveyor, asswnes liability for an injmy or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT (WITH TOTAL AGGREGATE LIMIT FOR COVERAGES A, BAND C) SCHEDULE Designated Construction Projects: All construction projects covered by this insurance. (If no ent1y appears above, information required to complete this endorsement will be shown in the Declarations as applica• ble to this endorsement.) AD 68 93 0117 Includes copyrighted material of fnsurance Services Office, Inc., with its pennission, 2009, 2012 & 2013. Page 4 of8 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 A. For all sums which the insured becomes legally obligated to pay as damages caused by "occunences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: I. A separate Designated Construction Project General Aggregate Limit applies to each designated construction pro- ject, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. However, the most we will pay under the Designated Construction Project General Aggregate Limit for all Desig- nated Construction Projects combined is $5,000,000 . · 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of"bodily injury'' or "property damage" included in the "products- completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under COVERAGE A fol' damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such pay- ments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Des- ignated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Const:mction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can- not be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Constrnction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of"bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Desig- nated Construction Project General Aggregate Lin1it. D. If the applicable designated constrnction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Oflnsurance (SECTION III) not othetwise modified by this endorsement shall continue to ap- ply as stipulated. IV. ADDITIONAL INSUREDS ADDITIONAL INSURED -LESSOR OF LEASED EQUIPMENT- AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU (Insurance Services Office Endorsement CG 20 34 04 13) A. Section II -Who Is An Insured is amended to include as an additional insured any person(s) or organizaVon(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agree- ment that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organiza- tion(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by yolll' maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., with its pennission, 2009, 2012 & 2013. Page 5 of8 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional in-sured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agree-ment with you for such leased equipment ends. B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 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 ofinsurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ADDITIONAL INSURED -MANAGERS OR LESSORS OF PREMISES (Insurance Services Office Endorsement CG 20 11 04 13) SCHEDULE Designation Of Premises (Part Leased To You): All premises leased to you and covered by this insurance. Name Of Person(s) Or Organization(s) {Additional Insured): Any person or organization that is a manager or lessor ofreal property, but only if coverage as an additional insured is re-quired by a written contract or written agreement that is an "insured contract", and provided the "bodily iajury" or "prop-erty damage" frrst occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. Infonnation required to complete 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 arising out of the ownership, maintenance or use of that paii of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or or-ganization(s) shown in the Schedule. 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. B. 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 increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 0117 Includes copyrighted material ofinsurance Services Office, Inc., with its pennission, 2009, 2012 & 2013. Page 6 of8 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 ADDITIONAL INSURED -MORTGAGEE, ASSIGNEE OR RECEIVER (Insurance Services Office Endorsement CG 20 18 04 13) SCHEDULE Name Of Person(s) Or On!anization(s) Desi!!nation Of Premises Any person or organization that is a mortgagee, assignee or re" All premises covered by this insurance. ceiver for a premises shown in this Schedule, but only if cov-erage as an additional insured is required by a written contract or written agreement that is an "insured contract", and pro-vided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first commit-ted, subsequent to the execution of the contract or agreement. Info1mation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is Au Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the owner-ship, maintenance, or use of the premises by you and shown in the Schedule. However: I. 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, B. This insurance does not apply to structural alterations, new construction and demolition operations petformed by or for that person or organization. C. With respect to the insurance afforded to these additional insureds, the following is added to Section HI-Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay 011 behalf of the additional insured is the amount of insurance: I. Required by the contract or agreement; or 2. Available Ullder the applicable Limits ofinsurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ADDITIONAL INSURED-TRADE SHOW SPONSOR-AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU A. Section II -Who Is An Insured is amended to include as an additional insured any person or organization who is a sponsor of a trade show where you are operating a booth or displaying your product, but only: I. For iajury or damage occurring at the trade show; and 2. When you and such person or organization have agreed in writing in a contract or agreement executed prior to the beginning of the trade show 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; while attending the trade show sponsored by this additional insured. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2009, 2012 & 2013. Page 7 of8 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 A person's or organization's status as an additional insured under this endorsement ends when your attendance at the trade show ends. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injwy" or "property damage" arising out of"your work" or "your product" and included in the "products-completed operations hazard". 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 increase the applicable Limits of Insurance shown in the Declarations. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION -PERMITS OR AUTHORIZATIONS (INSURANCE SERVICES OFFICE ENDORSEMENT CG 20 12 04 13) SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or governmental agency or subdivision or political subdivision that has issued a permit or authorization for opera-tions performed by you or on your behalf. Infotmation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Wllo Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations pe1formed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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 prnvide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "pmducts-completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section III -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 increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., with its pennission, 2009, 2012 & 2013. Page 8 of 8 □ &$  DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 Policy Number: CG20111219 Effective Date: TIDS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): All premises leased to you and covered by this insurance. Name Of Person(s) Or Organization(s) (Additional Insured): Any person or organization that is a manager or lessor of real prope1ty, but only if coverage as an additional insured is re- quired by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "prop- crty damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. Additional Premium: $ Included Information required to complete 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", "propetty damage" or "personal and adve1tising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: l. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: l. 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 arc required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III-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: l, Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits ofinsurance. CG 2011 12 19 © Insurance Services Office, Inc., 2018 Pagel of 1 □ CG 20 34  © Insurance Services Office, Inc., 2012 Page 1 of 1 Policy Number: CA000024840-0CG 20 34   Effective Date: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – LESSOR OF LEASED EQUIPMENT – AUTOMATIC STATUS WHEN REQUIRED IN LEASE 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(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organi- zation(s). However, the insurance afforded to such additional in- sured: 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 ad- ditional insured. A person’s or organization’s status as an additional in- sured under this endorsement ends when their contract or agreement with you for such leased equipment ends. B.With respect to the insurance afforded to these addi- tional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. C.With respect to the insurance afforded to these addi- tional insureds, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional in- sured 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 Lim- its of Insurance shown in the Declarations. DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 Policy Number: CA000024840-07 CG20101219 Effective Date: 07/15/2022 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) Location(s) Of Covered Operations Or Organization(s) Any person or organization that is an owner, lessee or man-All locations at which the Named Insured is performing ager of real property or personal property on which you are ongoing operations. performing ongoing operations, or a contractor on whose behalf you are performing ongoing operations, but only if coverage as an additional insured is required by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or ''property damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. Information required to complete 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. 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 CG20101219 © Insurance Services Office, Inc., 2018 Page 1 of2 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 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 III -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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG20101219 © Insurance Services Office, Inc., 2018 Page2 of2 □ DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 Policy Number: CA000024840-07 CG20371219 Effective Date: 07/15/2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Or Organization(s) Completed Operations Any person or organization that is an owner, lessee or All locations except locations where "your work" is or was manager of real property or personal property for whom you related to a job or project involving single-family dwellings, work or have worked, or a contractor on whose behalf you multi-family dwellings ( other than rental apartments in an work or have worked, but only if coverage as an additional apartment building: (a) originally constructed and at all times insured extending to "bodily injury" or "property damage" used for such purpose, or (b) converted from a commercial included in the "products-completed operations hazard" is building), condominiums, townhomes, townhouses, time- required by a written contract or written agreement that is an share units, fractional-ownership units, cooperatives and/or "insured contract" and provided that the "bodily injury" or any other structure or space used or intended to be used as a "property damage" first occurs subsequent to the execution residence. of the contract or agreement. Information required to complete 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". 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. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III -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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG20 371219 © Insurance Services Office, Inc., 2018 Page 1 ofl □ 1001486 132849.12 03-16-2016 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 OCCURRENCE DAMAGE 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 11/22/2022 TRAVIS FOSTER INSURANCE AGENCY INC 1007 DANA DR STE C REDDING CA 96003 OFFICE MANAGER 530-242-1411 530-242-1311 CERTREQUEST@TRAVISFOSTERAGENCY.COM CHARLES DOHERTY DBA CHARLES DOHERTY CONCRETE 2850 INDUSTRY ST OCEANSIDE,CA 92054 25178 A Y 602 9657-A30-55 07/30/2022 07/30/2023 2,000,000 Certificate holder is listed as additional insured (6028BU) with 30 days' notice of cancellation (6771BD) CITY OF CARLSBAD/CMWD C/O EXIGIS INSURANCE COMPLIANCE SERVICES P.O. BOX 947 MURRIETA, CA 92564 State Farm Mutual Automobile Insurance Company DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817____, I ACORD® ~ State Farm I A ® ~ □ □ ~ ~ R □ □ ~ ~ ~ ~ H I I I I I □ I ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 11/25/2022 (818) 986-7283 (818) 986-4949 21075 Charles Doherty 1302 Crestridge Dr. Oceanside, CA 92054 A X FOR-WC-000000180-0 12/5/2021 12/5/2022 1,000,000 Y 1,000,000 1,000,000 All Projects Waiver of subrogation in favor of the certificate holder. City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta, CA 92564 CHARDOH-01 LBALAYAN Paramount Exclusive Insurance Services, Inc. 15760 Ventura Blvd. Suite 500 Encino, CA 91436 Transverse Insurance Company X DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817 ACORD" I ~ I ~ D □ ~ ~ ~ □ □ ~ ~ ~ ~ ~ ~ ~ ~ H I I 1 1 I □ I WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA 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 12/05/2021 Policy No.FOR-WC-000000180-0 Endorsement No.000 Insured Charles Doherty dba Charles Doherty Concrete Premium Insurance Company Countersigned by ____________________ Transverse Insurance Company WC 04 03 06 (Ed. 04-84) Page 1 of 1 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 _2.50_% of the California workers’ compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Per Contractual Obligation DocuSign Envelope ID: EEF115E2-4B56-4655-A018-8BA0C620F817