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HomeMy WebLinkAboutCAI Safety Systems Inc dba CAI Fall Protection Systems; 2023-02-27; PSA23-2119UTILPSA23-2119UTIL City Attorney Approved Version 12/28/2022 1 AGREEMENT FOR DAVIT ARM(S) EVALUATION AND INSPECTION SERVICES CAI SAFETY SYSTEMS, INC. DBA CAI FALL PROTECTION SYSTEMS THIS AGREEMENT is made and entered into as of the ______________ day of ___________________, 2023, by and between the City of Carlsbad, California, a municipal corporation ("City") and CAI Safety Systems, Inc., a California corporation, d.b.a. CAI Fall Protection Systems ("Contractor”). RECITALS City requires the professional services of a consultant that is experienced in fall protection evaluation services. Contractor has the necessary experience in providing these professional services, has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A and B,” attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2. TERM This Agreement will be effective for a period of one (1) year from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed will be nine thousand six hundred dollars ($9,600). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or the Services specified in Exhibit “A.” 4. STATUS OF CONTRACTOR Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished. 5. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 February 27th PSA23-2119UTIL City Attorney Approved Version 12/28/2022 2 6. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile liability insurance, a combined policy of workers' compensation, employers liability insurance, and professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non- admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims- made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. 7. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all four categories. 8. COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement. 9. TERMINATION City or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance with the Agreement. 10. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 11. JURISDICTIONS AND VENUE Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California. 12. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City. 13. AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 PSA23-2119UTIL City Attorney Approved Version 12/28/2022 3 be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. 14. 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 CAI SAFETY SYSTEMS, INC., a California corporation d.b.a. CAI FALL PROTECTION SYSTEMS CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Vicki V. Quiram, Utilities Director as authorized by the City Manager Prajesh Naranbhai Kavia, President & CFO (print name/title) By: (sign here) (print name/title) If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A. Group B. Chairman, Secretary, President, or Assistant Secretary, Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney By: City Attorney DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 PSA23-2119UTIL City Attorney Approved Version 12/28/2022 4 EXHIBIT “A” SCOPE OF SERVICES DAVIT ARM(S) EVALUATION AND INSPECTION SERVICES ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Contractor will evaluate existing Davit systems and review locations for additional Davits as these sites: Homeplant, Poinsettia, Chinquapin, Cannon and “B” Reservoir. Contractor to provide PE stamped drawings and calculations for the system, visit sites to document condition of existing system, and will provide inspection report once evaluation is complete. $9,600 TOTAL NOT-TO-EXCEED *$9,600 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 1609 S. Grove Avenue Suite 104 Ontario, CA 91761 Phone: 951-465-7386 ext. 303 Fax: 951-405-2796 E-mail: pkavia@caisafety.com February 22, 2023 City of Carlsbad 1635 Faraday Ave. Carlsbad, CA 92008 ATTN: Mr. Don Wasko RE: Inspection and Qualified Person Services for Davit Arms Used for Fall Protection Dear Mr. Wasko: It is our pleasure to submit the following proposal to repair your fall protection system. Our proposal is based on the following assumptions: 1. Project Objective: The City of Carlsbad would like to have an engineering review of existing davit arm bases and add additional bases. The review will result in an evaluation to provide engineering back up to confirm or provide design to achieve compliance with OSHA and manufacturers recommendation pertaining to fall protection davit arm system. 2. Existing Conditions a. No existing fall protection engineered system drawings or structural documents, or vault specs exist. b. The following will be included in the engineering and design scope of work: i. Homeplant 1. 1 existing bracket mount 2. 1 in ground 3. Add 1 additional bracket at the overflow basin. ii. Poinsettia 1. 1 existing bracket mount 2. Add 1 additional bracket. iii. Chinquapin 1. 1 existing bracket 2. Add 1 additional bracket. PSA23-2119UTIL Exhibit "B" DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 CUSTO/lf E#G/#EEREO FALL PROTECT/0# SYSTE/lfS 2/21/23 FP-5370-4 - Copy 2 iv.Cannon 1.1 existing in ground v.B Site 1.Add 1 additional bracket. c.Information on Existing Davit Arm and Confined Space Winch i.Davit Arm: DBI SALA, Serial #: 14920, MFRD: Mar 2010, Model #: 8518002 ii.Confined Space Wrench: DBI Sala, Serial #: 133076, MFRD: July 2013, Model #: 8518006 3.Scope of Work Proposed a.Produce PE stamped drawings and calculations for the system. b.Visit site to document condition of existing system. If necessary, we will provide proposal to repair or replace any additional items not included in this proposal. c.Once system has been evaluated, we will provide an inspection report along with PE stamped drawings and calculations for the system. Our proposal to perform the above services will be $9,600 including travel costs. No material or install has been included. We have included the cost to assess and provide drawings and PE stamped calculations. 1.0 Notes and Clarifications 1.1 Make PO out to CAI Safety Systems, Inc. 1.2 Prices do not include replacing or repairing any parts if required. 1.3 Client will provide lift to access the entire fall protection systems during the initial inspection and the installation. 1.4 We have budgeted to be onsite for one-day. Delays caused by others will be billed as an extra. 1.5 All site work will be done over one mobilization. 1.6 Site work will be done Monday-Friday between 7AM to 5PM not including holidays. 1.7 Provide 5 days’ notice to schedule work. PSA23-2119UTIL Exhibit "B" (cont'd) DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 2/21/23 FP-5370-4 - Copy 3 Mr. Wasko, thank you for giving CAI Safety the opportunity to quote on this project. Please let us know if you have any questions or comments. Sincerely yours Peter Kavia PSA23-2119UTIL Exhibit "B"(cont'd)DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 CUSTCIN EIIGHIEERED FALL PRDTECTIOI 5rSTEHS Acceptance of Proposal -The above proposal and conditions are hereby accepted in full. You are authorized to do the work as quoted. Payment will be made as outlined above. Signature off Authorized Representative ________________ _ Name and Title of Representative __________________ _ Date of Acceptance: _______________________ _ Purchase of Reference Number __________________ _ 2/23/2023 Shank & Associates 10091 Park Run Drive Suite 200 Las Vegas NV 89145 Heather Soriano (801)790-4561 (702)870-1263 heather@swartsmanning.com CAI Safety Systems, Inc. 1609 S Grove Ave Suite 104 & 105 Ontario CA 91761 Twin City Fire Ins. Co.29459 Travelers Indemnity Company of Conneticut25682 Great American E&S Insurance Co.37532 Insurance Company of the West 27847 Lloyds of London Underwriters 32727 22/23 Master A X X X Deductible 25,000 X Y 72CESOF8627 7/24/2022 7/24/2023 1,000,000 300,000 10,000 1,000,000 2,000,000 2,000,000 Employee Benefits 1,000,000 B X X $1,000 Comp Ded X $1,000 Coll Ded X Y BA-6T344921-22 7/24/2022 7/24/2023 1,000,000 C X X X 0 XSE867653 7/24/2022 7/24/2023 5,000,000 5,000,000 D Y WLV506672500 7/24/2022 7/24/2023 X 1,000,000 1,000,000 1,000,000 E Professional Liability B0621PCOM001722 7/24/2022 7/24/2023 Limit of Liability $2,000,000 Retro Date 12th May 2020 Deductible $10,000 Re: All Operations. The City of Carlsbad is named as Additional Insured with regards to the General Liability, subject to policy terms and conditions per Blanket Additional Insured form HG00010916 and form AC85430618 on the Auto Liability. Per Project applies per GL Form HS2541 0608. Blanket Waiver of Subrogation on the General Liability per form HG00010916, on the Auto Liability, and on the Workers Compensation per form WC040306 (4-84). Primary & Non-Contributory Wording applies per form HG00010916 on the General Liability and on the Auto coverage. Excess policy follows form of the above listed policies. 30 days notice of City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta, CA 92564 Tim Shank/HS Y The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L.EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE Ifyes,describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 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: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S)AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 ACORD® I ~ I -D □ -- R □ □ - -- -- -- -H I I I I I □ I b-JQL-- cancellation to the certificate holders, except for 10 days notice for non-payment of premium. COMMENTS/REMARKS COPYRIGHT 2000, AMS SERVICES INC.OFREMARK DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS F. HIRED AUTO -LIMITED WORLDWIDE COV- ERAGE -INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE -GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which I. USE -INCREASED LIMIT PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV -BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "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 an "employee's" name, with your CA T3 53 0215 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 COMMERCIAL AUTO perm1ss1on, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II -COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II -COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO -LIMITED WORLDWIDE COV- ERAGE -INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV -BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II -COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II -COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 0215 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE -GLASS The following is added to Paragraph D., Deducti- ble, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION Ill -PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION Ill -PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV -BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV -BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 0215 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV -BUSINESS AUTO CONDITIONS: The unintentional om1ss1on of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non-renewal. Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved . CA T3 53 0215 Includes copyrighted material of Insurance Services Office, Inc. with its permission. INSURED 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 Policy No. Endorsement No. Insured Premium $ Insurance Company Countersigned By WLV 5066725 00 07/24/2022 INSURANCE COMPANY OF THE WEST CAI SAFETY SYSTEMS, INC. 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 / ORG ALL CA OPERATIONS WHEN REQUIRED BY WRITTEN CONTRACT DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 POLICY NUMBER: 72 CES OF8627 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PER PROJECT-AMENDMENT OF GENERAL AGGREGATE SUBJECT TO MAXIMUM ANNUAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE LIMITS OF INSURANCE: The Limits of Insurance shown in the Declarations are amended by the following: The Limits of Insurance, subject to all the terms of this policy that apply, are: Each Occurrence Limit Personal and Advertising Injury Limit Damage to Premises Rented to You -Any One Premises Medical Expense Limit -Any One Person General Aggregate Limit Project General Aggregate Limit Maximum Annual Aggregate Limit Products-Completed Operations Aggregate Limit $ See Declarations Page -----------$ See Declarations Page -----------$ See Declarations Page $ See Declarations Page $2,000,000 $2,000,000 $5,000,000 $ See Declarations Page In return for the payment of the premium when due and subject to all the terms of the Commercial General Liability Coverage Part not expressly modified herein, we agree with you as follows: A. The LIMITS OF INSURANCE (SECTION Ill) is deleted in its entirety and replaced with the following: 1. The Most We Will Pay The Limits of Insurance shown in the above Schedule and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. Maximum Annual Aggregate The Maximum Annual Aggregate Limit is the most we will pay for the sum of: a. Damages under the General Aggregate Limit and Form HS 25 410608 b. Damages under any one or more Project General Aggregate Limit(s), as described in paragraph 4. below. 3. General Aggregate Limit Subject to 2. above, the General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B Personal and Advertising Injury Liability; and b. Damages under Coverage C Medical Payments, and Coverage A Bodily Injury and Property Damage Liability, with the following exceptions: (1) "Bodily injury" or "property damage" included in the "products-completed operations hazard"; or Page 1 of 3 © 2008, The Hartford (Includes copyrighted material of Insurance Services Office, Inc. with its permission.) DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 (2) "Bodily injury" or "property damage" attributed solely to ongoing operations at a single "project"; c. "Property damage" included as Damage to Premises Rented to You. 4. Project General Aggregate Limit Subject to 2. above: a. A separate Project General Aggregate Limit applies to each single "project", in lieu of and not in addition to, the General Aggregate. Such Project General Aggregate is the most we will pay for all damages under Coverage A Bodily Injury and Property Damage Liability, or Coverage C Medical Payments, with the following exceptions: (1) "Bodily injury" or "property damage" included in the "products-completed operations hazard"; or (2) "Property damage" included in the Damage to Premises Rented to You coverage; or (3) "Bodily injury", "property damage", or medical expenses under Coverage C, which cannot be attributed solely to the ongoing operations at a single "project". Such damages will erode the General Aggregate Limit as provided in paragraph 3. above. b. The Project General Aggregate Limit: (1) Applies only to "occurrences" attributed solely to ongoing operations at a single "project"; and (2) Does not include damages for Coverage B Personal and Advertising Injury Liability, no matter where or in how many "projects" the offense or offenses may be committed. Such damages will erode the General Aggregate Limit as provided in paragraph 3. above. c. Any payments made under this paragraph 4., for damages for "bodily injury", "property damage", or medical expenses under Coverage C, shall reduce the Maximum Annual Aggregate Limit and the Project General Aggregate for that "project". Such payments shall not reduce the General Aggregate Limit or the Products-Completed Operations Aggregate Limit nor shall they reduce any other Project General Aggregate Limit. Form HS 25 410608 5. Products-Completed Operations Aggregate Limit The Products-Completed Operations Aggregate Limit is the most we will pay for damages under Coverage A -Bodily Injury and Property Damage Liability because of "bodily injury" and "property damage" included in the "products-completed operations hazard". 6. Personal And Advertising Injury Limit Subject to 3. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B Personal and Advertising Injury Liability for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 7. Occurrence Limit Subject to 3., 4., or 5. above, whichever applies, the Each Occurrence Limit is the most we will pay for damages under Coverage A -Bodily Injury and Property Damage Liability because of "bodily injury" or "property damage" arising out of any one "occurrence". 8. Damages To Premises Rented To You Limit Subject to 7. above, the Damage to Premises Rented to You Limit is the most we will pay for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire, lightning or explosion, the Damage to Premises Rented to You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these. The Damage to Premises Rented to You Coverage is not subject to any Project General Aggregate Limit, but will erode the General Aggregate Limit. 9. Medical Expense Limit Subject to 3. or 4. above, whichever applies, the Medical Expense Any One Person Limit is the most we will pay under Coverage C Medical Payments for all medical expenses because of "bodily injury" sustained by any one person. Page 2 of3 DocuSign Envelope ID: 4DB282F6-F37B-499B-B490-D6AD5BDBE706 Such Medical Payments Coverage is subject to either the Project General Aggregate Limit or the General Aggregate Limit as provided in paragraphs 3. or 4. above. 10. How Limits Apply To Additional Insureds If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: (1) The limits of insurance specified in the written contract or written agreement; or (2) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. 11. If More Than One Limit of Insurance Applies If more than one limit of insurance under this Coverage Part and any endorsements attached thereto applies to any claim or "suit", the most we will pay under this Coverage Part and such endorsements is the single highest limit of liability of all coverages applicable to such claim or "suit". However, this paragraph 11. does not apply to the Medical Expense Limit for Coverage C. Form HS 25 410608 The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. B. For the purposes of this endorsement, the Definitions Section is amended by the addition of the following definition: "Project" means a jobsite including premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right of way of a railroad. If a "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 as the same project. Page 3 of3