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Joe’s Paving Company Inc; 2023-02-01; PKRC22-1229
Tracking #: ORSF Trail Asphalt Repair; CONT. NO. PKRC22-1229 Page 1 of 6 City Attorney Approved 12/28/2022 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT ORSF TRAIL ASPHALT REPAIRS; CONT. NO. PKRC22-1229 This agreement is made on the ______________ day of _________________________, 20___, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Joe’s Paving Company, Inc. whose principal place of business is PO Box 99, Valley Center, CA 92082 (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: Morgan Rockdale (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. 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. DocuSign Envelope ID: A62E8DF3-40C5-44D8-9231-E32903B8B660 23February1st Tracking #: ORSF Trail Asphalt Repair; CONT. NO. PKRC22-1229 Page 2 of 6 City Attorney Approved 12/28/2022 FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ___________________________________ 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 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 thirty (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. DocuSign Envelope ID: A62E8DF3-40C5-44D8-9231-E32903B8B660 Sean R. Repko Tracking #: ORSF Trail Asphalt Repair; CONT. NO. PKRC22-1229 Page 3 of 6 City Attorney Approved 12/28/2022 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 30 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 45 working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Joe’s Paving Company, Inc. PO Box 99 (name of Contractor) 806124 (street address) Valley Center, CA 92082 (Contractor’s license number) CA LIC#A & C12, exp. 3/31/2024 (city/state/zip) 760-749-0519 (license class. and exp. date) 1000011953 (telephone no.) 760-749-6415 (DIR registration number) 6/30/2024 (fax no.) alext@pavingamerica.com (DIR registration exp. date) (e-mail address) /// /// /// /// /// /// DocuSign Envelope ID: A62E8DF3-40C5-44D8-9231-E32903B8B660 Tracking #: ORSF Trail Asphalt Repair; CONT. NO. PKRC22-1229 Page 4 of 6 City Attorney Approved 12/28/2022 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 CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Sean R. Repko. CEO Assistant City Manager, Deputy City Manager, or Department Director as Authorized by the City Manager (print name/title) By: ATTEST: (sign here) SHERRY FREISINGER Cathleen Adler, CFO City Clerk (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, City Attorney BY: _____________________________ Deputy / Assistant City Attorney DocuSign Envelope ID: A62E8DF3-40C5-44D8-9231-E32903B8B660 Tracking #: ORSF Trail Asphalt Repair; CONT. NO. PKRC22-1229 Page 5 of 6 City Attorney Approved 12/28/2022 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor 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 sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor 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: A62E8DF3-40C5-44D8-9231-E32903B8B660 10 Tracking #: ORSF Trail Asphalt Repair; CONT. NO. PKRC22-1229 Page 6 of 6 City Attorney Approved 12/28/2022 EXHIBIT B JOB QUOTATION ITEM NO. UNI T QTY DESCRIPTION PRICE 1 SF 897 Demo several areas on the trail caused by root damage. Haul of asphalt and root spoils to a dump site. Pave back areas with 3” of hot mix asphalt, roll hot mix for compaction $8,638.11 2 LF 1,891 Clean dirt out of the cracks using brooms and a blower. Apply hot rubberized crack filler over 1,891 LF of cracks. 3,176.88 TOTAL* $11,814.99 *Includes taxes, fees, expenses and all other costs per job quote dated 11/11/22. DocuSign Envelope ID: A62E8DF3-40C5-44D8-9231-E32903B8B660 DocuSign Envelope ID: A62E8DF3-40C5-44D8-9231-E32903B8B660 PRIME CONSTRUCTION CONTRACT THIS AGREEMENT IS BET\'VEEN JOE'S PAVING CO ., INC. OPI) CA LIC#A & C12 806124, SBE No. 60655, DIR No. 1000011953 Office: 760-749-0519 SINCE 1972 Fax: 760-749-6415 Bid Date: 11/11/2022 Attn: City of Carlsbad Project: 1200 Carlsbad Village Drive Cadencia Street & Esfcra Sti·cet Carlsbad CA 92008 Carlsbad CA 92008 Phone: 760-802-7942 Fax: Email: morganrockdale@msn.com I Scope of Work **See Details below** Work is contingent to one (I) move-in. Any additional move-ins or "Phasing" will be subject to additional move-ins p_er rate. Item #I Demo several areas on the trail caused by root damaged. Haul offasphall and root spoils to a dump site. Pave back areas with 3" of hot mix asphalt, roll hot mix for compaction. 897 SF @ $ 9.63 SF $ 8,638.11 ltem #2 Clean out dirt out of the cracks using brooms and a blower. Apply hot rubberized crack filler over 1,89 1 If of cracks. 1,891 LF @ $ 1.68 SF Material prices good until 12/26/2022 Terms: PAY~IENT IS DUE FOR TH_E COMPLETION or ANY LINE ITEM. Note: All Unit Prict!s will be billed out on actual fiel<l quantities and final field measurements. New Asphalt requires 30 Day Minimum cure prior to Applying Sealcoat. Asphalt-Based Scaler is a topcoating only. Cracks in older asphah will reappear. Total: Joe's Paving Company, lnc. is lJOt responsible for tracking of wet sealer by others, or tire-scut1ing of cured product. Crack tillers are for temporary maintenance only. Cracks will reappear. Some settling of crack filler is nonnal. Allow 4-6 hours cure time prior to foot traffic; 24-36 hours for vehicles. Terms and Conditions: $ 3,176.88 $ 11 ,8 14.99 I. Exclusions unless included and specified above: permits, bond, or any form of engineering (stakes, testing, inspection, etc.) vegetation trimming, water meler, prevailing wages, traffic control, subgrade prep or compaction, any agency required storm water related permits or repo11s, or placemei related structures. 2. Subgrade to be taken from + or-. IO to balance and at or below optimum moisture before Joe's Paving Company, Inc. begins work. Removal & re of wa1er-satlm1ted subgrade is additional work and will be charged on a time and materials basis. Not responsible for grades lmdcr 2% fall for aspha cause ponding. 3. Work to be done in accordance with plans, specs, and quantities specified above. Any unusual conditions encountered, such as, buried slabs, und, piping, trash deposits, etc. will be deemed cause for additional charges. 4. Class n material, if included, is J/411 recycled Class II per Caltrans Standard Specifications Section 26 unless otherwise noted. 5. The owner is responsible for identifying and giving the location to Joe1s Paving Company, Inc. of all utility lines included but not limited to: wate1 gas sewer, TV or telephone prior to commencement of work. Joe's Paving Company, Inc. is not responsible for any damage to or liability from dam, undisclosed utilities caused by perfmrnance of this work. 6. A Finance Charge of I I /2% per month or 18% per annum will be payable on any oustanding balance. In the event of a dispute arising from this c prevailing party shall be entitled to recover from the other, Attorney fees and costs in addition to other amounts awarded by the cou11. 7. Material: Because of oil & aggregate market voaltility all material pricing/ quotes are only good for 30 <lays. All material pricing is subject to chai on the project stait and/or move-in date INCLUSIONS: Move-Ins§ Additional Move-lns at your request will be an add of $2,500.00 for each. L1bor x MatenalsB EqrnpmentB · lnsuranceB \Varranty x EXCLUSIONS: weeom,§ e,;,~c,,,§ Trame Control X Engineering x Te:;ting x Inspections x Utility Adjust. x Permits x Demo Scarification x Alex Tapia, Construction Estimator Acceptance: I hav<! r,:nd the nbov<! Quotation and hereby accept the terms and i.:onditions and jointly and severally authorize the work to be 1>Crfom1<.-d as specified above. Priut Name & Siguature: '"""'§ ''""''""§ Water Supply x Sealing Curbs x Sawcutting x Export Grnbbing x lh:port X Rccompaction Striping x Cell Phone: 760-445-8624 DATE: Joe's Paving Company, Inc. PO Box 99 Valley Center, CA 92082 USA DocuSign Envelope ID: A62E8DF3-40C5-44D8-9231-E32903B8B660 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 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. $ $ $ $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 1/3/2023 Patriot Risk & Insurance Services18952 MacArthur Blvd., Suite #300 Irvine, CA 92612 9494867902 www.patrisk.com 0K07568 Greenwich Insurance Company 22322 Insurance Company of the West 27847 XL Specialty Insurance Company 37885 A 1,000,000NPC-1002163-03 11/19/2022 10/1/2023 300,000 3 10,000 3 1,000,000 3 Deductible $5,000 2,000,000 2,000,0003 A NBA-1002167-03 11/19/2022 10/1/2023 1,000,000 3 3 Comp/Collision Ded $1,000 A NEC-6005960-03 11/19/2022 10/1/2023 4,000,00033 4,000,000 3 0 B WSD 5030297 07 6/1/2022 6/1/2023 3 1,000,000Y 1,000,000 1,000,000 C Leased/Rented Equipment NIM-1002162-03 11/19/2022 10/1/2023 Limit $100,000 / Deductible $2,500 Dave Jacobson Sondra Alvarado salvarado@patrisk.com Joe's Paving Company, Inc. P.O. Box 99 Valley Center CA 92082 72283131 3 3 33 3 City of Carlsbad, its officials, employees and volunteers are named as Additional Insured as their interest may appear City of Carlsbad 1635 Faraday Avenue Carlsbad CA 92008 RE: Cadencia Street & Esfera Street Carlsbad, CA 9200 per endorsement attached where required by written contract. *30-day notice of cancellation / 10-day for non-payment of premium. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 1 of 20 f--D □ f-- f-- Fl □ □ f-- f--~ f--f-- f--f-- f--H I I I I I □ Joe's Paving Company, Inc. NPC-1002163-03 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 2 of 20 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20101219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Blanket as required by written contract Blanket as required by written contract Information reauired 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 nbodily inju~ or "property damage" occurring after: 1. All work, induding materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20101219 © Insurance Services Office, Inc., 2018 Page 1 of 2 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 3 of 20 C. With respect to the insurance afforded to these additional insureds, the following is added to Section 111-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. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20101219 Joe's Paving Company, Inc. NPC-1002163-03 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 4 of 20 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG20371219 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) Or Organization(s} Location And Description Of Completed Operations Blanket as required by written contract Blanket as required by written contract Information rewired 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 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 371219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Form XIL 436 1208 ©2008, XL America, Inc. Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ENDORSEMENT # This endorsement, effective 12:01 a.m. , forms a part of Policy No. issued to by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY XL Plus Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read this endorsement carefully to determine rights, duties, and what is and is not covered. A.Reasonable Force – Bodily Injury or Property Damage B.Damage To Premises Rented To You Extension ●●Perils of fire, lightning, explosion, smoke, aircraft or vehicles, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage ●Limit increased to $300,000 C.Aircraft Chartered with Crew D.Non-Owned Watercraft E.Personal and Advertising Injury – Assumed by Insured Contract F.Increased Supplementary Payments ●Cost for bail bonds increased to $5,000 ●Loss of earnings increased to $1,000 per day G.Broadened Named Insured H.Blanket Additional Insured – Managers or Lessors of Premises I.Blanket Additional Insured – Lessor of Leased Equipment J.Injury to Co-Employees and Co-Volunteer Workers K.Knowledge and Notice of Occurrence or Offense L.Unintentional Omission M.Liberalization N.Blanket Waiver of Subrogation O.Incidental Medical Malpractice Injury P.Extension of Coverage – Bodily Injury Q.Coverage Territory Joe's Paving Company, Inc.NPC-1002163-03 11/19/2022 Greenwich Insurance Company 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 5 of 20 Form XIL 436 1208 ©2008, XL America, Inc. Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. A. REASONABLE FORCE – BODILY INJURY OR PROPERTY DAMAGE Exclusion a.Expected Or Intended Injury of Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I – Coverages is deleted in its entirety and replaced by the following: [This insurance does not apply to:) Expected or Intended Injury or Damage “Bodily injury” or “property damage” expected or intended from the standpoint of the insured. This exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force to protect persons or property. B. DAMAGE TO PREMISES RENTED TO YOU EXTENSION 1.The last paragraph of 2.Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I - Coverages is deleted in its entirety and replaced by the following: Exclusions c.through n.do not apply to damages to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by fire, lightning, explosion, smoke, aircraft or vehicles, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage. A separate limit of insurance applies to this coverage as described in Section III- Limits of Insurance. 2.This insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a.Rupture, bursting, or operation of pressure relief devices; b.Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; or c.Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 3.Paragraph 6.of Section III-Limits of Insurance is deleted in its entirety and replaced by the following: 6.a.Subject to Paragraph 5.above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of “property damage” to any one premises while rented to you, or temporarily occupied by you with permission of the owner, caused by fire, explosion, lightning, smoke, aircraft or vehicle, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same “occurrence”, whether such damage results from fire, explosion, lightning, smoke, aircraft or vehicle or riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage or any combination of any of these. b.The Damage to Premises Rented to You Limit will be the higher of: (1)$300,000; or (2)The amount shown on the Declarations for Damage to Premises Rented to You Limit. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 6 of 20 Form XIL 436 1208 ©2008, XL America, Inc. Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 4.Paragraph 9.a.of the definition of “insured contract” under Section V-Definitions, is deleted in its entirety and replaced by the following: [“Insured contract” means:] a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, aircraft or vehicle, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage to premises while rented to you, or temporarily occupied by you with the permission of the owner is not an “insured contract”. 5.This Article B. does not apply if coverage for Damage to Premises Rented to You of Coverage A.Bodily Injury And Property Damage Liability of Section I – Coverages is excluded by endorsement. C. AIRCRAFT CHARTERED WITH CREW 1.The following is added to the exceptions contained in Exclusion g., Aircraft, Auto or Watercraft in Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage of Section I – Coverages: [This exclusion does not apply to:) Aircraft chartered with crew to any insured. 2.This Article C.does not apply if the chartered aircraft is owned by any insured. 3.The insurance provided by this Article C.shall be excess over any valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. D. NON-OWNED WATERCRAFT 1.The exception contained in Subparagraph (2)of Exclusion g.Aircraft. Auto or Watercraft in Part 2., Exclusions of Coverage A.Bodily Injury And Property Damage Liability of Section I – Coverages is deleted in its entirety and replaced by the following: (2)A watercraft you do not own that is: (a)50 feet long or less; and (b)Not being used to carry persons or property for a charge; 2.This Article D.applies to any person who, with your expressed or implied consent, either uses or is responsible for the use of the watercraft. 3.This insurance provided by this Article D.shall be excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. E. PERSONAL AND ADVERTISING INJURY – ASSUMED BY INSURED CONTRACT 1.Exclusion e.Contractual Liability in Part 2., Exclusions of Coverage B.Personal And Advertising Injury Liability of Section I – Coverages is deleted in its entirety and replaced by the following: 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 7 of 20 Form XIL 436 1208 ©2008, XL America, Inc. Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. [This insurance does not apply to:) e. Contractual Liability “Personal and Advertising Injury” for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages: 1.That the insured would have in the absence of the contract or agreement; or 2.Assumed in a written contract or agreement that is an “insured contract”; provided the “personal and advertising injury” is caused by an offense which occurs subsequent to the execution of the contract or agreement. 2.Subparagraph f.of the definition of “insured contract” Section V.-Definitions is deleted in its entirety and replaced by the following: f.That part of any other contract or agreement pertaining to your business, including an indemnification of a municipality in connection for work performed for a municipality, under which you assume the tort liability of anther party to pay for “bodily injury”, “property damage” or “personal and advertising injury” to a third party or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. 2.This Article E.does not apply if Coverage B. Personal And Advertising Injury Liability is excluded by endorsement. F. INCREASED SUPPLEMENTARY PAYMENTS Subparagraphs 1. b.and d.of Supplementary Payments – Coverages A And B of Section I - Coverages are amended as follows: 1.In Subparagraph b.,the amount we will pay for the cost of bail bonds is increased up to $5,000. 2.In Subparagraph d.,the amount we will pay for a loss of earnings is increased up to $1,000 a day. G. BROADENED NAMED INSURED 1.The Named Insured in Item 1.of the Declarations is as follows: The person or organizations named in Item 1.of the Declarations and any organization, other than a partnership or joint venture, over which you maintain ownership or majority interest on the effective date of the policy. However, coverage for any such organization will cease as of the date that you no longer maintain ownership of, or majority interest in, such organization. 2.This Article G.does not apply to any person or organization for which coverage is excluded by endorsement. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 8 of 20 Form XIL 436 1208 ©2008, XL America, Inc. Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. H. BLANKET ADDITIONAL INSURED – MANAGERS OR LESSORS OF PREMISES 1.Section II-Who Is An Insured is amended to include as an insured any person or organization with whom you have agreed in a written contract executed prior to loss (an “additional insured”), but only with respect to liability arising out of the ownership, maintenance or use of that part of any premises leased to you, subject to the following provisions: a.Limits of Insurance. The Limits of Insurance afforded to the “additional insured” shall be the limits you agreed to provide, or the limits shown on the Declarations, whichever is less. b.The insurance afforded to the “additional insured” does not apply to: (1)Any “occurrence” that takes place after you cease to be a tenant in that premises; (2)Any premises for which coverage is excluded by endorsement; or (3)Structural alterations, new construction or demolition operations performed by or on behalf of such “additional insured”. 2.The insurance afforded to the “additional insured” is excess over any valid and collectible insurance available to such “additional insured”, unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. I. BLANKET ADDITIONAL INSURED – LESSOR OF LEASED EQUIPMENT 1.Section II-Who Is An Insured is amended to include an “additional insured” (as defined in Article H. above), but only with respect to their liability arising out of maintenance, operation or use by you of equipment leased to you by such “additional insured”, subject to the following provisions: a.Limits of Insurance. The Limits of Insurance afforded to the “additional insured” shall be the limits which you agreed to provide, or the limits shown on the Declarations, whichever is less. b.The insurance afforded to the “additional insured” does not apply to: (1)Any “occurrence” that takes place after the equipment lease expires; or (2)“Bodily injury” or “property damage” arising out of the sole negligence of such additional insured. 2.The insurance provided to the “additional insured” is excess over any valid and collectible insurance available to such “additional insured”, unless you have a written contract for this insurance to apply on a primary or contributory basis. J. INJURY TO CO-EMPLOYEES AND CO-VOLUNTEER WORKERS 1.Section II- Who Is An Insured is amended to include your “employees” as insureds with respect to “bodily injury” to a co-“employee" in the course of the co-”employee’s” employment by you, or to your “volunteer workers” while performing duties related to the conduct of your business, provided that this coverage for your “employees” does not apply to acts outside the scope of their employment by you or while performing duties unrelated to the conduct of your business. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 9 of 20 Form XIL 436 1208 ©2008, XL America, Inc. Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2.Section II – Who Is An Insured is amended to include your “volunteer workers” as insureds with respect to “bodily injury” to a co-“volunteer worker” while performing duties related to the conduct of your business, or to your “employees” employment by you, provided that this coverage for your “volunteer workers” does not apply while performing duties unrelated to the conduct of your business. K. KNOWLEDGE AND NOTICE OF OCCURRENCE OR OFFENSE The following is added to Paragraph 2.,Duties In The Event of Occurrence, Offense, Claim or Suit of the Section IV -Commercial General Liability Conditions: Notice of an “occurrence” or of an offense which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the “occurrence” or offense has been reported to any insured listed under Paragraph 1.of Section II-Who Is An Insured or any “employee” (such as insurance, loss control, risk manager or administrator) designated by you to give such notice. Knowledge of any other “employee(s)” of an “occurrence” or of an offense does not imply that you also have such knowledge. Notice shall be deemed prompt if given in good faith as soon as practicable to your workers compensation insurer. This applies only if you subsequently give notice to us as soon as practicable after any insured listed under Paragraph 1.of Section II – Who Is An Insured or an “employee” (such as an insurance, loss control, or risk manager or administrator) designated by you to give such notice discovers that the “occurrence”, offense or claim may involve this policy. L. UNINTENTIONAL OMISSION The following is added to Paragraph 6.,Representations, of Section IV-Commercial General Liability Conditions: The unintentional omission of, or unintentional error in, any information provided by you shall not prejudice your rights under this insurance. However, this Article L.does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable state insurance laws or regulations. M. LIBERALIZATION The following is added to Section IV-Commercial General Liability Conditions: Liberalization After the issuance of this policy, if we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part of this policy without a premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 10 of 20 Form XIL 436 1208 ©2008, XL America, Inc. Page 7 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. N. BLANKET WAIVER OF SUBROGATION The following is added to Section IV-Commercial General Liability Conditions: Waiver of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a contract with that person or organization; “your work”; or “your products”. We waive this right where you have agreed to do so as part of a written contract, executed by you prior to loss. O. INCIDENTAL MEDICAL MALPRACTICE INJURY 1.For insurance applicable to this Article O, the definition of “bodily injury” in Section V - Definitions is amended to include, “Incidental Medical Malpractice Injury”. 2.The following definition is added to Section V- Definitions: “Incidental medical malpractice injury” means “bodily injury”, mental anguish, sickness or disease sustained by a person, including death resulting from any of these at any time, arising out of the rendering of, or failure to render, the following services: a.Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; b.The furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances; c.First aid; or d.“Good Samaritan Services”. As used in this Article O., “Good Samaritan Services” are those medical services rendered or provided in an emergency and for which no remuneration is demanded or received. 3.Paragraph 2.a.(1)(d)of Section II -Who Is An Insured does not apply to any registered nurse, licensed practical nurse, emergency medical technician or paramedic employed by you, but only while performing the services described in Paragraph 2.above and while acting within the scope of their employment by you. Any “employees” rendering “Good Samaritan Services” will be deemed to be acting within the scope of their employment by you. 4.The following exclusion is added to Paragraph 2.Exclusions of Coverage A.– Bodily Injury And Property Damage Liability of Section I–Coverages: [This insurance does not apply to:) Willful Violation of Penal Statute Liability arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals by or with the knowledge or consent of the insured. 5.For the purposes of determining the applicable Limits of Insurance, any act or omission, together with all related acts or omissions in the furnishing of services described in Paragraph 2.a.through 2.d.above to any one person, will be considered one “occurrence”. 6.This Article O.does not apply if you are in the business or occupation of providing any of the services described in Paragraph 2.above. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 11 of 20 Form XIL 436 1208 ©2008, XL America, Inc. Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 7.The insurance provided by this Article O.shall be excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. P. EXTENSION OF COVERAGE – BODILY INJURY The definition of “bodily injury” Section V- Definitions is deleted in its entirety and replaced by the following: 3.“Bodily injury” means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. Q. COVERAGE TERRITORY The definition of “coverage territory” Section V- Definitions is deleted in its entirety and replaced by the following: 4.“Coverage territory” means anywhere in the world. This insurance does not apply to: a.“bodily injury” or “property damage” that takes place; or b.“personal and advertising injury” caused by an offense committed outside the United States of America (including its possessions and territories), Canada and Puerto Rico, unless a “suit” on the merits (to determine the insured’s responsibility to pay damages to which this insurance applies) is brought in the United States of America (including its possessions and territories), Canada or Puerto Rico. This insurance does not apply to damage, loss, cost or expenses in connection with any “suit” brought outside the United States of America (including its possessions and territories), Canada or Puerto Rico. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 12 of 20 Joe's Paving Company, Inc. NPC-1002163-03 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 13 of 20 COMMERCIAL GENERAL LIABILITY CG 20 011219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: 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 contribution from any other insurance available to the additional insured. CG 20 011219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Joe's Paving Company, Inc. NBA-1002167-03 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 14 of 20 POLICY NUMBER: XIC 4211013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XL PLUS BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COVERAGE DESCRIPTION A. Temporary Substitute Auto Physical Damage B. Who Is An Insured 1. Broad Form Insured 2. Employees As Insureds 3. Additional Insured By Contract, Agreement or Permit 4. Employee Hired Autos C. Supplementary Payments D. Amended Fellow Employee Exclusion E. Physical Damage Coverage 1. Rental Reimbursement 2. Extra Expense -Broadened Coverage 3. Personal Effects Coverage 4. Lease Gap 5. Glass Repair-Waiver Of Deductible F. Physical Damage Coverage Extensions 1. Additional Transportation Expense 2. Hired Auto Physical Damage G. Business Auto Conditions 1. Notice Of Occurrence 2. Waiver Of Subrogation 3. Unintentional Failure To Disclose Hazards 4. Primary Insurance H. Bodily Injury Redefined I. Extended Cancellation Condition XIC 4211013 © 2013 X.L. America, Inc. All Rights Reserved. Page 1 of 6 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 15 of 20 A. Temporary Substitute Auto Physical Damage B. SECTION I -COVERED AUTOS, C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos is changed by adding the following: If Physical Damage coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Physical Damage coverage: 1. Any "auto· you do not own while used with the permission of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or e. Destruction. Who Is An Insured SECTION II -COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is changed by adding the following: 1. Broad Form Insured For any covered "auto·, any subsidiary, affiliate or organization, other than a partnership or joint venture, as may now exist or hereafter be constituted over which you assume active management or maintain ownership or majority interest, provided that you notify us within ninety (90) days from the date that any such subsidiary or affiliate is acquired or formed and that there is no similar insurance available to that organization. However, coverage does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. Employees As Insureds Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow, in your business or your personal affairs. 3. Additional Insured By Contract, Agreement Or Permit Any person or organization with whom you have agreed in writing in a contract, agreement or permit, to provide insurance such as is provided under this policy, provided that the "bodily injury" or "property damage" occurs subsequent to the execution of the written contract, agreement or permit 4. Employee Hired Autos An "employee" of yours is an "Insured· while operating an "auto· hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. XIC 421 1013 © 2013 X.L. America, Inc. All Rights Reserved. Page 2 of 6 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 16 of 20 SECTION IV -BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, b. is replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". C. Supplementary Payments SECTION II -COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary Payments is changed as follows: Item (2) is deleted and replaced by the following: (2) Up to $3,500 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident'' we cover. We do not have to furnish these bonds. Item (4) is deleted and replaced by the following: (4) All reasonable expenses Incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. D. Amended Fellow Employee Exclusion SECTION II -COVERED AUTOS LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee does not apply. The insurance provided under this Provision D. is excess over any other collectible insurance. E. Physical Damage Coverage SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. Coverage is changed by adding the following: 1. Rental Reimbursement XIC 4211013 a. We will pay for rental reimbursement expenses incurred by you for the rental of an ·auto" because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. b. We will pay only for those expenses incurred during the policy period beginning twenty-four (24) hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: © 2013 X. L. America, Inc. All Rights Reserved. Page 3 of 6 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 17 of 20 (1) The number of days reasonably required to repair or replace the covered ·auto·. If "loss• is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. (2) Thirty {30) days. c. Our payment is limited to the lesser of the following amounts: (1) Necessary and actual expenses incurred. (2) $50 any one day per private passenger "auto"; $100 any one day per truck; $1,500 any one period per private passenger "auto"; $3,000 any one period per truck; or Higher limits if shown elsewhere in this policy. d. This coverage does not apply while there are spare or reserve "autos• available to you for your operations. e. If "loss" results from the total theft of a covered "auto• of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage Coverage Extension. 2. Extra Expense -Broadened Coverage We will pay for the expense of returning a stolen covered "auto· to you. 3. Personal Effects Coverage If you have purchased Comprehensive Coverage on this policy for an "auto• you own and that "auto· is stolen, we will pay, without application of a deductible, up to $500 for "personal effects· stolen from the ·auto". As used in this endorsement, "personal effects· means tangible property that is worn or carried by an "insured". "Personal effects• does not include tools, jewelry, money or securities. 4. Lease Gap XIC 421 1013 In the event of a total "loss· to a covered "auto• shown in the Declarations, we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease/loan payments at the time of the "loss•: (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchases with the loan or lease: and (5) Carry-over balances from previous loans or leases. @ 2013 X.L. America, Inc. All Rights Reserved. Page 4 of 6 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 18 of 20 5. Glass Repair -Waiver Of Deductible No deductible applies to glass damage if the glass is repaired rather than replaced. F. Physical Damage Coverage Extensions SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by the following: 1. Additional Transportation Expense Sections a. and b. are amended to provide a limit of $50 per day and a maximum limit of $1,000. 2. Hired Auto Physical Damage The following section is added: Any "auto" you lease, hire, rent or borrow is deemed to be a covered "auto• for physical damage coverage. The most we will pay for each covered "auto" is the lesser of: (1) the actual cash value; (2) the cost for repair or replacement; or (3) $50,000, or higher limit if shown on the Declarations for Hired Auto Physical Damage Coverage. For each covered "auto· a deductible of $100 for Comprehensive Coverage and $1,000 for Collision Coverage will apply. G. Business Auto Conditions SECTION IV -BUSINESS AUTO CONDITIONS, A. Loss Conditions is changed by the following: 1. Notice Of Occurrence Section 2. -Duties In The Event Of Accident, Claim, Suit Or, Loss, a. is changed by adding the following: If you report an injury to an "employee" to your workers' compensation carrier and if it is subsequently determined that the injury is one to which this insurance may apply, any failure to comply with this condition will be waived if you provide us with the required notice as soon thereafter as practicable after you know or reasonably should have known that this insurance may apply. 2. Waiver Of Subrogation XIC4211013 Section 5. Transfer Of Rights Of Recovery Against Others To Us is changed by adding the following: However, this Condition does not apply to any person(s) or organization(s) with whom you have a written contract, but only to the extent that subrogation is waived prior to the "accidenr or the "loss" under such contract with that person or organization. © 2013 X.L. America, Inc. All Rights Reserved. Page 5 of 6 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 19 of 20 SECTION IV -BUSINESS AUTO CONDITIONS, B. General Conditions is changed by the following: 3. Unintentional Failure To Disclose Hazards The following condition is added: Your unintentional failure to disclose all hazards as of the inception date of the policy shall not prejudice any insured with respect to the coverage afforded by this policy. 4. Primary Insurance Condition 5. Other Insurance is changed by adding the following: For any covered "auto" this insurance shall apply as primary and not contribute with any other insurance where such requirement is agreed in a written contract executed prior to a "loss·. H. Bodily Injury Redefined SECTION V -DEFINITIONS, C. "Bodily injury" is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. I. Extended Cancellation Condition COMMON POLICY CONDITIONS (Form IL 00 17), A. Cancellation, 2.b. is replaced by the following: The greater of sixty (60) days or the time required by any applicable state amendatory endorsement before the effective date of cancellation if we cancel for any other reason. All other terms and conditions of this policy remain unchanged. XIC 4211013 © 2013 X.L. America, Inc. All Rights Reserved. Page 6 of 6 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 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 Endorsement No. Insured Premium $ Insurance Company Countersigned By Policy No. INSURANCE COMPANY OF THE WEST INCL. WC 99 06 34 (Ed. 8-00) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be % of the total California Workers’ Compensation premium otherwise due. Schedule Person or Organization Job Description 2 ANY PERSON OR CALIFORNIA ORGANIZATION FOR OPERATIONS ONLY. WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER. Joe's Paving Company, Inc. WSD 5030297 0706/01/2022 72283131 | 22/23 GL/AU/UMB/IM/WC | Sondra Alvarado | 1/3/2023 8:17:21 AM (PST) | Page 20 of 20 ~r~~