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HomeMy WebLinkAboutChris R. Sperbeck Inc dba Doorworkx; 2023-06-01; PWM23-2197FACPWM23-2197FAC STC Commercial Prop Training Door Replacement Page 1 of 8 City Attorney Approved 02/14/2023 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT SAFETY TRAINING CENTER COMMERCIAL PROP TRAINING DOOR REPLACEMENT This agreement is made on the ______________ day of _________________________, 2023, by the City of Carlsbad, California, a municipal corporation (hereinafter called "City") and Chris R. Sperbeck, Inc., a California corporiation d.b.a. Doorworkx, whose principal place of business is 1046 Commerce Street Suite G, San Marcos, California 92078 (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, as contained in the Standard Specifications for Public Works Construction “Greenbook,” latest edition and including all errata; Part 1 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 Brian Bacardi (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 1st June PWM23-2197FAC STC Commercial Prop Training Door Replacement Page 2 of 8 City Attorney Approved 02/14/2023 A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ____________Chris R. Sperbeck_________ REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than……..$1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ….…$1,000,000 Property damage insurance in an amount of not less than……..$1,000,000 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 PWM23-2197FAC STC Commercial Prop Training Door Replacement Page 3 of 8 City Attorney Approved 02/14/2023 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that 30 days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. Workers’ Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys’ fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within ten (10) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within thirty (30) working days after receipt of Notice to Proceed. /// /// /// /// /// DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 PWM23-2197FAC STC Commercial Prop Training Door Replacement Page 4 of 8 City Attorney Approved 02/14/2023 CONTRACTOR’S INFORMATION Chris R. Sperbeck, Inc. d.b.a. Doorworkx 1046 Commerce Street Ste. G (name of Contractor) 783544 (street address) San Marcos, CA 92078 (Contractor’s license number) C-61 / D28 5/31/24 (city/state/zip) 760-510-1043 (license class. and exp. date) 1000041522 6/30/24 (telephone no.) doorsfixed@yahoo.com (DIR registration number and exp. date) (e-mail address) AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR CHRIS R. SPERBECK, INC., a California corporation d.b.a Doorworkx CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Chris R. Sperbeck, President & Secretary Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: (sign here) (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Deputy City Attorney DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 PWM23-2197FAC STC Commercial Prop Training Door Replacement Page 5 of 8 City Attorney Approved 02/14/2023 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Type of Work to be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 0 N/A N/A N/AN/A N/A PWM23-2197FAC STC Commercial Prop Training Door Replacement Page 6 of 8 City Attorney Approved 02/14/2023 EXHIBIT B Safety Training Center Commercial Prop Training Door Replacement Contractor to provide all materials, tools and labor necessary to remove and replace the exisitng forceable enty training door on the first floor of the Commercial Property located at 2560 Orion Way, Carlsbad, California 92010. All work to be conisitent with the contractor’s proposal dated April 3, 2023, and is attached to this agreement as Exhibit C. Note: - Contractor to leave site in a clean and workmanlike manner. - Door to be fabricated and installed like existing door. - City of Carlsbad Fire Department to test door to confirm operation prior to City acceptance of installation. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Replace existing TroxFire training door on the Commercial Property, with new like kind. $10,364.33 TOTAL* $10,364.33 *Includes taxes, fees, expenses, and all other costs. DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 Date 4/3/2023 Estimate # 2212198 Name / Address City of Carlsbad ATTN: Accounts Payable 1635 Faraday Ave Carlsbad, CA 92008 Ship To SAFETY CENTER 2560 ORION WAY CARLSBAD, CA 92008 Terms Net 30 Project Signature Total DOORWORKX 1046 Commerce Street, Suite G San Marcos, CA 92078 760-510-1043 Fax 760-471-7710 DOORSFIXED@YAHOO.COM LIC# 783544 Description Total THE FOLLOWING PRICING IS TO HAVE DOORWORKX PERFORM THE FOLLOWING- REMOVE EXISTING FIRE TRAINING MAN DOOR SYSTEM FURNISH AND INSTALL 1EA 3'X 8' HOLLOW METAL DOOR DOOR TO HAVE 1/8" STEEL FRONT AND BACK DOOR TO HAVE 1EA TROXFIRE BREAK IN DEVISE (LIKE EXISTING) NEW DOOR WOULD BE HUNG WITH 1EA 96" HEAVY DUTY ALUMINUM CONTINUOUS HINGE AFTER NEW DOOR SYSTEM IS INSTALLED ALL ADJUSTMENTS WOULD BE MADE, RAN AND TESTED FOR PROPER OPERATION TOTAL INCLUDING ALL LABOR (PREVAILING WAGE) MATERIAL AND TAXES-10,364.33 _____________________________________ $10,364.33 PWM23-2197FAC - Exhibit "C" Page 7 of 8 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 PWM23-2197FAC Exhibit "C" (cont.) STC Commercial Prop Training Door Replacement Page 8 of 8 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 I, I ' DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the 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 ri hts to the certificate holder in lieu of such endorsement s • PRODUCER BOB WILEY INSURANCE AGENCY INC POBox966 Escondido. CA 92033-0966 INSURED ·O 2 Chris R. Sperbeck INC. DBA: DoorworkX 1046 COMMERCE STREET. SUITE I SAN MARCOS. CA 92078 * CA COVERAGES CERTIFICATE NUMBER: FAX A/C No : 760 735-2460 m 1----------"IN=S=U=RE=R=S,)'-'-A"-'FF'--'O'--"RD=l=N=G-=-CO-=-VE='-'RA'--'-G=E'------+---'N=Al=C=...,#,--1 INSURER A : BERKLEY ASSURANCE COMPANY 39462 INSURERB: BERKLEYASSURANCECOMPANY 39462 INSURERC: IRIUS AMERICA S co 38776 INSURERD: INSURERE: INSURERF : REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1~:: TYPE OF INSURANCE ADDL SUBR POLICYEFF POLICY EXP LIMITS , .. an 1 .... ,n POLICY NUMBER IMM/DD/YYYYI IMMIDDNYYYl X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000.000 ~ D CLAIMS-MADE [X] OCCUR DAMAGE TO RENTED I-PREMISES (Ea occurrence l $ 100.000 ~ MED EXP (Any one person) $ 5.000 A ~ VUMA0248461 06/27/22 06/27/23 PERSONAL & ADV INJURY $ 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000.000 Fl [X] PRO-D Loc PRODUCTS -COMP/OP AGG $ 2.000.000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ IEa accidentl ~ ANY AUTO BODILY INJURY (Per person) $ ~ OWNED ~ SCHEDULED BODILY INJURY (Per accidenl) $ ~ AUTOS ONLY I-AUTOS HIRED NON-OWNED iP~~~~~t?AMAGE $ ~ AUTOS ONLY ~ AUTOS ONLY $ UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 5.000.000 ~ B X EXCESSLIAB CLAIMS-MADE VUMA0248531 06/27/22 06/27/23 AGGREGATE $ 5,000,000 OED I I RETENTION s $ WORKERS COMPENSATION X I ~fiuTE I I OTH- AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ N/A E.L. EACH ACCIDENT $ 1.000.000 C OFFICER/MEMBER EXCLUDED? WC23528 03 12/01/22 12/01/23 (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $ 1.000.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 _ flflfl flflfl DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, AddlUonal Remarks Schedule, may be attached If more space Is required) THE CITY OF CARLSBAD/CMWD IS NAMED AS ADDITIONAL INSURED. INSURANCE IS PRIMARY AND NON-CONTRIBUTORY-WAIVER OF SUBROGATION IS INCLUDED 30 DAY NOTICE OF CANCELLATION CERTIFICATE HOLDER CANCELLATION CITY OF CARLSBAD/CMWD c/o EXIGIS INSURANCE COMPLIANCE SERVICES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. BOX947 1 MURRIETA. CA 92564 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 POLICY NUMBER: VUMA0248461 COMMERCIAL GENERAL LIABILITY CG 20 10 1219 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 As required by written contract executed and signed by As designated in written contract with the Named all parties prior to the date of loss but only to the extent Insured. permitted by law. 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. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 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 20 10 1219 © Insurance Services Office, Inc., 2018 Page 1 of2 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of2 © Insurance Services Office, Inc., 2018 CG 20 10 1219 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 POLICY NUMBER: VUMA0248461 COMMERCIAL GENERAL LIABILITY CG 20 371219 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 As required by written contract executed prior to the As designated in written contract with the Named date of occurrence but only to the extent permitted by Insured. law and 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. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section 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 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 POLICY NUMBER: VUMA0248461 COMMERCIAL GENERAL LIABILITY CG 24 0412 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization to whom or to which you are obligated by virtue of a written contract to waive your right of recovery. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 041219 © Insurance Services Office, Inc., 2018 Page 1 of 1 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY WORDING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE With respect to coverage provided to an additional insured via attachment of an Additional Insured endorsement to this policy, such coverage is primary insurance and we will not seek contribution from any other insurance available to that additional insured. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED VCAS2035 11 10 Page 1 of 1 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 TIDS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT WITH A CAP This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Designated Construction Projects: Construction project sites at which you perform work for additional insureds that require you to obtain per project general aggregate limits under a written contract that was executed prior to the date of any "occurrence" covered under this policy. Maximum Aggregate Limit: $5,000,000 A For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY and for all medical expenses caused by accidents under COVERAGE C-MEDICAL PAYMENTS, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate limit applies to each designated construction project, subject to an overall maximum aggregate limit as shown in the Schedule above, is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: a. Insureds; or b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expenses continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. VCAS2036 11 12 Page 1 of 2 DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A and for all medical expenses caused by accidents under COVERAGE C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of LIMITS OF INSURANCE SECTION Ill not otherwise modified by this endorsement shall continue to apply as stipulated. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED VCAS2036 11 12 Page 2 of 2 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12-01-22 Policy No. WC23528 Endorsement No. 001 Insured Chris R. Sperbeck Inc.Premium $ Incl. Insurance Company SiriusPoint America Insurance Company Countersigned By 1998 by the Workers’ Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB’s California Workers’ Compensation Insurance Forms Manual 1999. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0% of the California workers’ compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION Any person or organization as Required by written contract within states covered under this policy. DocuSign Envelope ID: CD809408-4FB1-4EA8-B128-9D4E2528A056 © ©