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HomeMy WebLinkAboutNissho of California Inc; 2023-07-20; PSA24-2243UTILPSA24-2243UTIL General Counsel Approved Version 5/25/2023 1 AGREEMENT FOR CMWD YARD WEED CONTROL SERVICES NISSHO OF CALIFORNIA, INC. This Agreement is made and entered into as of the _____________________ day of _________________________________, 2023, but effective August 15, 2023 by and between the Carlsbad Municipal Water District, a Public Agency organized under the Municipal Water Act of 1911, and a Subsidiary District of the City of Carlsbad, California, ("CMWD"), and Nissho of California, Inc., a California corporation, ("Contractor”). RECITALS CMWD requires the services of a consultant that is experienced in landscaping and weed removal services. Contractor has the necessary experience in providing these services, has submitted a proposal to CMWD and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, CMWD and Contractor agree as follows: 1.SCOPE OF WORK CMWD retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A,” attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2.TERM The term of this Agreement will be effective for a period of one (1) year from the date first above written. The Executive Manager may amend the Agreement to extend it for three (3) additional one (1) year periods or parts thereof. Extensions will be based upon a satisfactory review of Contractor's performance, CMWD needs, and appropriation of funds by the CMWD Board of Directors. The parties will prepare a written amendment indicating the effective date and length of the extended Agreement. 3.COMPENSATION The total fee payable for the Services to be performed during the initial Agreement term will be four thousand eighty dollars ($4,080). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. If CMWD elects to extend the Agreement, the amount shall not exceed ten thousand dollars ($5,000) per Agreement year. CMWD reserves the right to withhold a ten percent (10%) retention until CMWD has accepted the work and/or Services specified in Exhibit "A." 4.PREVAILING WAGE RATES Any construction, alteration, demolition, repair, and maintenance work, including work performed during design and preconstruction such as inspection and land surveying work, cumulatively exceeding $1,000 and performed under this Agreement are subject to state prevailing wage laws. 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 the Section 1770, 1773 and 1773.1 of the California Labor Code. Pursuant to Section 1773.2 of the California Labor code, a current copy of 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 DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 20th July PSA24-2243UTIL General Counsel Approved Version 5/25/2023 2 such workers employed by him or her in the execution of the Agreement. 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. 5. 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 CMWD. Contractor will be under the control of CMWD only as to the results to be accomplished. 6. INDEMNIFICATION Contractor agrees to indemnify and hold harmless CMWD 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 CMWD incurs or makes to or on behalf of an injured employee under the CMWD’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. 7. 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 CMWD by certified mail. CMWD will be named as additional insured on General Liability which shall provide primary coverage to CMWD. The full limits available to the named insured shall also be available and applicable to CMWD as an additional insured. Contractor will furnish certificates of insurance to CMWD with endorsements to CMWD, prior to CMWD’s execution of this Agreement. 8. NOTICES The name of the persons who are authorized to give written notices or to receive written notice on behalf of CMWD and on behalf of Contractor under this Agreement. DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 PSA24-2243UTIL General Counsel Approved Version 5/25/2023 3 For CMWD For Contractor Name Jesse Castaneda Name Tom Baird Title Utilities Superintendent Title Project Manager Carlsbad Municipal Water District Address 1902 South Santa Fe Ave. Address 5950 El Camino Real Vista, CA 92083 Carlsbad, CA 92008 Phone 760-727-9719 Phone 442-339-2337 E-mail tbaird@nisshoca.com Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 9. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the CMWD Conflict of Interest Code. The Contractor shall report investments or interests as required in the CMWD Conflict of Interest Code. Yes ☐ No ☒ If yes, list the contact information below for all individuals required to file: Name Email Phone Number 10. 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. 11. TERMINATION CMWD or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. CMWD 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. 12. 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 CMWD to terminate this Agreement. DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 PSA24-2243UTIL General Counsel Approved Version 5/25/2023 4 13. 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. 14. 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 CMWD. 15. AMENDMENTS This Agreement may be amended by mutual consent of CMWD and Contractor. Any amendment will be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. [signatures on following page] DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 PSA24-2243UTIL General Counsel Approved Version 5/25/2023 5 17. 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, CARLSBAD MUNICIPAL WATER DISTRICT, a Public Agency organized under the Municipal Water Act of 1911, and a Subsidiary District of the City of Carlsbad NISSHO OF CALIFORNIA, INC., a California corporation By: By: (sign here) Vicki V. Quiram, General Manager, as authorized by the Executive Manager Nobu Jimmy Kato, President (print name/title) By: (sign here) Cecelia Gleyo Dolleton, Secretary (print name/title) If required by CMWD, 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, General Counsel By:_____________________________ Deputy General Counsel DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 PSA24-2243UTIL General Counsel Approved Version 5/25/2023 6 EXHIBIT “A” SCOPE OF SERVICES DESCRIPTION PRICE Plant trimming, weed spraying and removal services as outlined in the proposal, which is attached to this agreement as Exhibit A. TOTAL* $4,080 *Includes taxes, fees expenses and all other costs. DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 June 29, 2023 SUBMITTED BY: PROPOSAL FOR: NISSHO OF CALIFORNIA, INC. 1902 South Santa Fe AvenueVista, CA 92083 (760)727-9719Contractor's License #598372 The City of Carlsbad Water District Landscape Maintenance: •Scope of Worko1x Trimming of plant material growing through fence of propertyoWeed Spraying/Removal 1 x/month (May-October)o Weed Spraying/Removal 2x/month (November-April) o 2 Hours/Service •Total Monthly Cost Monthly Maintenance: $340.00 per month AGENT/REPRESENTATIVE: Carlsbad Water Districtc/o Jesse Castaneda 5950 S. El Camino Real Carlsbad, CA 92008 Our company representatives have inspected the project site and reviewed the bid specifications for landscape maintenance. We propose to furnish all labor and materials indicated on the attached documents for the consideration of the following amount with all of the above areas being '.�.�:� Kver at the same time. � OF CALIFORNIA, INC. FOR OWNER: To� Baird -B-y: _________ _ Vice-President Title Date RECEIPT FOR ADDENDUM TO CONTRACT Receipt of the following addendum to the contract document is acknowledged: Addendum No. "A" Addendum No. Signature Date PSA24-2243UTIL Exhibit "A" DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 LANDSCAPE MAINTENANCE CONTRACT PURPOSE OF AGREEMENT The purpose of this agreement is to state the terms and conditions under which the Contractor will provide landscaped maintenance and related services to the Owner and/or their representatives. II Contractor agrees to perform the following landscape maintenance and related services for the Owner: 1.LAWN CARE 1.1 MOWING: Contractor will mow the lawn areas once per week except during winter months or inclement weather. The lawn will, in all cases, be maintained in a presentable manner. It shall not be the Contractor's responsibility to move portable objects that would obstruct his mowing operation. 1.2 MOWING EQUIPMENT: Lawns shall be mowed with power rotary or reel type mowers. Mowing equipment shall be capable of performing a uniform trimming of the grass. All mowers will be and are equipped with grass catching devices with optional recyclable unit attachment and shall be maintained in good working condition. 1.3 MOWING HEIGHTS: The height of the lawns will be in accordance with the season and type of turf being mowed. 2.EDGING: Shall mean cutting all grass and/or weeds along concrete walks, walls, structures, paved areas, shrub plantings, trees, and posts on a weekly basis. Edges along paved areas shallbe trimmed with a vertical cutter to prevent grass or ground cover from encroaching upon the pavedareas. Care shall be taken not to damage plant or hardscape material during this operation. 3.PRUNING AND TRIMMING: Pruning shall include removing dead and broken branches, diseased or infested wood. Excessive growth will be cut back to rejuvenate shrubbery and treesand reduce encroachment onto common areas. Pruning shall be accomplished a minimum oftwice a year or as required to provide optimum growth and design. Pruning of trees under15 feetof height throughout the complex shall be performed within the scope of the contract and itsestablished man-hour provisions. Contractor shall be required to obtain the written approval of theOwner prior to removing any trees. If a tree is over 15 feet of height, a PSA24-2243UTIL Exhibit "A" DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 Special charge will be made preceded by a written estimated bid. If any unknown factors are later discovered, a new estimate is to be provided. Prior to commencing the additional work, the Owner's authorized agent shall initial the written estimate. 4.TREE STAKING AND GUYING: The Contractor shall remove all stakes and guys as soon asthey are no longer needed. Stakes and guys are to be inspected to prevent rubbing and girdlingthat causes bark wounds. All trees shall be restaked, realigned, retied or reguyed as necessary to aid and promote proper growth at Owner's cost for material only. Cinch ties or VIT braces shallbe used to prevent bruising. Where guy wires are used for support they must be covered withPVC pipe to a vertical height of six feet. 5.FERTILIZATION (General) a.Annual flowerbeds shall be fertilized N/A times per year.b.Ground cover areas shall be fertilized NIA times per year.c.Shrubs, bushes, and trees shall be fertilized N/A times per year. Responsibility of: Nissho _x__ Owner Nissho _x__ Owner Nissho _x__ Owner d.Lawns are to be fertilized a minimum of N/A times per year at the rate of 1 to 1 1/2 poundsof nitrogen/1000 square feet to maintain a neat, uniform and healthy appearance. e.Slopes are to be fertilized a minimum of NIA times per year at the rate of 1 to 1 1/2 poundsof nitrogen/1000 square feet to maintain a neat, uniform and healthy appearance. 5.1 Fertilizer shall be delivered to the work site in unbroken bags or containers, each fully labeled and bearing the trademark and warranty of the manufacturer. 5.2 Contractor shall provide other nutrients to soil as necessary at Owner's cost to break up adobe and/or to correct acidity or alkalinity problems in order to obtain optimum growth of all lawns and ground covers. 6.WEEDS: Weeds in the ground cover and slope areas within the project boundary shall beremoved as necessary to present a neat appearance to all such planted areas. 7.CHEMICALS: Chemicals required for eradication of fungus, insects or weeds will be applied incompliance with current chemical application regulations and charged to the Owner with prior written approval. Minor spraying of weeds and insects is included and may be applied on servicedays. However, others will do any extensive spraying at an additional charge. PSA24-2243UTIL Exhibit "A" DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 8.IRRIGATION SYSTEM MAINTENANCE 8.1 LAWNS: Lawns shall be irrigated as required to maintain optimum natural growth and color to encourage deep rooting. 8.2 GROUND COVERS AND SHRUBS: Ground covers and shrubs shall be irrigated as required to maintain optimum natural growth and color and to encourage deep rooting. 8.3 The automatic controllers will be adjusted seasonally and as necessary to provide adequate irrigation for the turf, planter, and slope areas. 8.4 The Contractor shall maintain all irrigation systems within the boundaries of said project. Replacement parts shall be furnished by the Contractor and will be charged to the Owner (See Landscape Maintenance Addendum "A"). 8.5 Any damage to the irrigation system caused by the Contractor's negligence shall be repaired without charge to the Owner. Repairs shall be made within 48 hours of discovery or reported to the Contractor. 8.6 Damage not due to the Contractor's negligence or operations shall be reported to the Owner, followed by an estimate of costs for repairs. Faulty electrical repairs shall be made at Owner's expense. 8.7 All irrigation systems will be checked for head coverage and breakage. Contractor will inspect the system in accordance with the following conditions: a.The on-site crew will inspect the system weekly making adjustments and repairsas necessary. 8.8 Irrigation items to be repaired or replaced shall be billed to Owner at the cost for material per rates established in Landscape Maintenance Addendum "A". Any additional work beyond the scope of this contract shall be preceded by a written estimated bid or a labor and materials cost estimate. If any unknown factors are later discovered, a new estimate is to be provided. Prior to commencing the additional work, the Owner's authorized agent shall initial the written estimate that shall display a "good through" date. 9.FLOOD AND SLOPE EROSION CONTROL: Unplanted pathways created by foot traffic shall be discouraged by planting of shrubs and ground cover cuttings and/or the installation of stepping stones. Material shall be provided at the Owner's expense and be approved in writing by Ownerprior to installation. PSA24-2243UTIL Exhibit "A" DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 10.POLICING OF GROUNDS: All common areas at the work site shall be kept free of debrissuch as bottles, cans, papers, cardboard, metallic items on the days maintenance is performed at the project. 11.CLEANING OF PAVED AREAS: Grass and weeds growing in cracks of paved areas shall beremoved once each month. If Herbicide is required due to excessive weed problem, it shall becharged as an extra upon owner's approval. 12.REMOVAL OF DEBRIS: As soon as possible after pruning, trimming, weeding, edging, or trimming of grass, ground cover, shrubs, and trees, all cuttings and debris shall be removed fromthe work site. Walks, patios, and driveways shall be removed either by vacuum or blower. Alldebris is recycled to the highest extent practical. 13.WORK NOT INCLUDED IN THIS CONTRACT: 13.1 Except as stated in 8.5, irrigation items will not be replaced or repaired without the Owner's approval. This would consist of a written estimate/agreement to purchase or repair prior to the actual work being performed. 13.2 The planting of material will not be accomplished without the Owner's written approval and agreement to purchase prior to installation. 13.3 Reseeding of lawn areas except with Owner's written approval and agreement to purchase prior to installation. 13.4 Aeration or Turf Dethatching of lawn areas except with Owner's written approval and agreement to purchase prior to performance. 13.5 Major application of Fungicide, insecticide, herbicide, rodent control, snail bait except with Owner's written approval and agreement to purchase, unless described otherwise. 13.6 Bi-annual Brush Management except with Owner's written approval. Proposals are due in April and October, 30-days prior to actual work performed. PSA24-2243UTIL Exhibit "A" DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 6/1/2023 License # 0L48969 (619) 233-8000 (619) 864-7106 23434 Nissho of California, Inc. 1902 S. SANTA FE AVE. Vista, CA 92083 10499 A 1,000,000 X X A0221035004 6/1/2023 6/1/2024 300,000 BI/PD Ded $5,000 5,000 1,000,000 2,000,000 2,000,000 1,000,000A X X A0221035001 6/1/2023 6/1/2024 2,000,000A X A0221035005 6/1/2023 6/1/2024 2,000,000 B X CPW1001452 6/1/2023 6/1/2024 1,000,000 1,000,000 1,000,000 RE: All operations performed by the named insured on behalf of the certificate holder. Additional insureds are included as/where required by written contract as respects to General Liability, Auto Liability, General waiver of subrogation, Auto waiver of subrogation, General Liability primary non-contributory wording, Auto Liability primary non-contributory wording and Workers Compensation waiver of subrogation but limited to the operations of the Insured under said contract, and always subject to all the policy terms, conditions and exclusions per endorsements attached. Commercial Umbrella or Excess Liability follows form according to the terms, conditions, and endorsements found in the policy. 30 days’ notice of cancellation applies 10 days for cancellation due to non-payment of premium. THIS CERTIFICATE CANCELS AND SUPERSEDES ANY CERTIFICATE PREVIOUSLY ISSUED SEE ATTACHED ACORD 101 City of Carlsbad/CMWD C O EXIGIS Insurance Compliance Services P.O. Box 947 Carlsbad, CA 92008-0000 NISSOFC-01 BATGL1 C3 Risk & Insurance Services 404 Camino Del Rio S. STE 410 San Diego, CA 92108 certs@c3insurance.com Middlesex Insurance Company CorePointe Insurance Company X X X X X X X X X X DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 ACORD" I ~ I ~ □ □ ~ ~ ~ □ □ ~ ~ ~ ~ ~ ~ ~ ~ H I I I I I □ _&E~ I FORM NUMBER: EFFECTIVE DATE: The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE FORM TITLE: Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01) AGENCY CUSTOMER ID: LOC #: AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE © 2008 ACORD CORPORATION. All rights reserved. C3 Risk & Insurance Services NISSOFC-01 SEE PAGE 1 1 SEE PAGE 1 ACORD 25 Certificate of Liability Insurance License # 0L48969 1 SEE P 1 Nissho of California, Inc. 1902 S. SANTA FE AVE. Vista, CA 92083 SEE PAGE 1 BATGL1 1 Description of Operations/Locations/Vehicles: The City of Carlsbad, its Officials, employees and volunteers are named as additional insured with respect to General and Auto Liability, per attached endorsements. Coverage is Primary and Non-Contributory. Waiver of Subrogation applies to General Liability, Auto Liability and Workers Compensation. Excess/Umbrella policy follows form of general liability. DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 ~ ACORD" ~ I POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, 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 des- ignated construction project, and that limit 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, ex- cept damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard", and for medi- cal expenses under Coverage C regardless of the number of: a.Insureds; b.Claims made or "suits" brought; or c.Persons or organizations making claims or bringing "suits". 3.Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Con- struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag- gregate Limit shown in the Declarations nor shall they reduce any other Designated Con- struction 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, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject to the appli- cable Designated Construction Project Gen- eral Aggregate Limit. All construction projects away from premise owned by or rented by insured A0221035004 DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 B.For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be attri- buted only to ongoing operations at a single des- ignated construction project shown in the Sche- dule 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 Desig- nated Construction Project General Aggre- gate Limit. C.When coverage for liability arising out of the "products-completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag- gregate Limit, and not reduce the General Ag- gregate 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 contract- ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction project. E.The provisions of Section III – Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 POLICY NUMBER: © Insurance Services Office, Inc., 2012 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage All locations and jobs performed that have a written contract, agreement or permit Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. A0221035004 Page 1 of 1CG 20 37 04 13 05/31/2023A0221035 Middlesex Insurance Company 00001 0000000000 23151 0 N1 cfb0e7c9-c732-4ab6-be1a-addaf72e5433cfb0e7c9-c732-4ab6-be1a-addaf72e5433 DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 Page 1 of 2CG 20 10 04 13 05/31/2023A0221035 Middlesex Insurance Company POLICY NUMBER: © Insurance Services Office, Inc., 2012 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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 Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage All locations per written contract, agreement or permit Description: All jobs performed that have a written contract, agreement or permit 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. A0221035004 00001 0000000000 23151 0 N1 b5dc4de7-9f0a-4d57-b952-5667efcb3982b5dc4de7-9f0a-4d57-b952-5667efcb3982 DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 C.With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 CG 20 10 04 13Page 2 of 2 05/31/2023A0221035 Middlesex Insurance Company DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY –OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL 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. d d a Policy Number: A0221035004 DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 POLICY NUMBER: © Insurance Services Office, Inc., 2008 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage 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 we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. A0221035004 Page 1 of 1CG 24 04 05 09 05/31/2023A0221035 Middlesex Insurance Company 00001 0000000000 23151 0 N1 31641eb5-a011-4dc2-b2c8-f7653a652c5c31641eb5-a011-4dc2-b2c8-f7653a652c5c DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 POLICY NUMBER: SCHEDULE COMMERCIAL AUTO CA 76 01 06 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured:Nissho of California Inc Endorsement Effective Date:06/01/2023 Name Of Person(s) Or Organization(s): Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in: (1)Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2)Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. B.Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other auto insurance issued to the person or organization in the schedule under your policy provided that: (1)The person or organization is a Named Insured under such other insurance; and (2)Prior to the “accident” 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 person or organization. Includes copyrighted material of Insurance Services Office, Inc., with its permission. A0221035001 Page 1 of 1CA 76 01 06 15 05/31/2023A0221035 Middlesex Insurance Company 00001 0000000000 23151 0 N1 f642bc80-f3c7-4719-a125-397f6c3e6330f642bc80-f3c7-4719-a125-397f6c3e6330 DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 Named Insured: Endorsement Effective Date: Name(s) Of Person(s) Or Organization(s): POLICY NUMBER: A0221035001 COMMERCIAL AUTO CA 04 44 10 13 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: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. SCHEDULE Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. © Insurance Services Office, Inc., 2011 Nissho of California Inc 06/01/2023 Page 1 of 1CA 04 44 10 13 05/31/2023A0221035 Middlesex Insurance Company 00001 0000000000 23151 0 N1 9598133a-b583-4228-823e-0e0a81ac30519598133a-b583-4228-823e-0e0a81ac3051 DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 Policy Number: CPW1001452DocuSign Envelope ID: 66255D0C-9633-4C58-A636-D4F171A35853 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC040306 (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 2% 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. 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 Insured Insurance Company WC 04 03 06 (Ed. 04-84) 6/1/2023 Policy No. CPW1001452 Nissho of California, Inc CorePointe Insurance Company Endorsement No. O Premium $ 783,103 Countersigned by _________________ _