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HomeMy WebLinkAboutPalomar Flooring; 2023-08-15; PWM24-2247FACPWM24-2247FAC Stagecoach Flooring Replacement Page 1 of 10 City Attorney Approved 5/25/2023 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT STAGECOACH FLOORING REPLACEMENT This agreement is made on the ______________ day of _________________________, 2023, by the City of Carlsbad, California, a municipal corporation (hereinafter called "City") and Palomar Flooring, a California corporation whose principal place of business is 6875 Nancy Ridge Drive, Suite B, San Diego, California 92121 (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 Lauren Milliken (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 15th August PWM24-2247FAC Stagecoach Flooring Replacement Page 2 of 10 City Attorney Approved 5/25/2023 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. CONSTRUCTION MANAGEMENT SOFTWARE. Procore Project Management and Collaboration System. This project may utilize the Owner’s Procore (www.procore.com) online project management and document control platform. The intent of utilizing Procore is to reduce cost and schedule risk, improve quality and safety, and maintain a healthy team dynamic by improving information flow, reducing non-productive activities, reducing rework and decreasing turnaround times. The Contractor is required to create a free web-based Procore user account(s) and utilize web-based training / tutorials (as needed) to become familiar with the system. Unless the Engineer approves otherwise, the Contractor shall process all project documents through Procore because this platform will be used to submit, track, distribute and collaborate on project. If unfamiliar or not otherwise trained with Procore, Contractor and applicable team members shall complete a free training certification course located at http://learn.procore.com/procore- certification-subcontractor. The Contractor is responsible for attaining their own Procore support, as needed, either through the online training or reaching out to the Procore support team. It will be the responsibility of the Contractor to regularly check Procore and review updated documents as they are added. There will be no cost to the Contractor for use of Procore. It is recommended that the Contractor provide mobile access for Windows, iOS located at https://apps.apple.com/us/app/procore-construction-management/id374930542 or Android devices located at https://play.google.com/store/apps/details?id=com.procore.activities with the Procore App installed to at least one on-site individual to provide real-time access to current posted drawings, specifications, RFIs, submittals, schedules, change orders, project documents, as well as any deficient observations or punch list items. Providing mobile access will improve communication, efficiency, and productivity for all parties. The use of Procore for project management does not relieve the contractor of any other requirements as may be specified in the contract documents. 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 DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 PWM24-2247FAC Stagecoach Flooring Replacement Page 3 of 10 City Attorney Approved 5/25/2023 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: ________Mark Matthew Johnson_________ REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than……..$1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ….…$1,000,000 Property damage insurance in an amount of not less than……..$1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that 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 DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 PWM24-2247FAC Stagecoach Flooring Replacement Page 4 of 10 City Attorney Approved 5/25/2023 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 forty (40) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within sixty (60) working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Palomar Flooring 6875 Nancy Ridge Dr., Suite B (name of Contractor) 984058 (street address) San Diego, CA 92121 (Contractor’s license number) C-15 6/30/2025 (city/state/zip) 858-457-1122 (license class. and exp. date) PW-LR-1001043890 6/30/2024 (telephone no.) mark@palomarfloors.com (DIR registration number and exp. date) (e-mail address) [signatures on following page] DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 PWM24-2247FAC Stagecoach Flooring Replacement Page 5 of 10 City Attorney Approved 5/25/2023 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 PALOMAR FLOORING, a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Mark Matthew Johnson, President and Chief Financial Officer Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: (sign here) Gerasimos Lougiakis, Secretary (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: 998C466B-9669-4B94-AF64-22641BF1D370 PWM24-2247FAC Stagecoach Flooring Replacement Page 6 of 10 City Attorney Approved 5/25/2023 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: 998C466B-9669-4B94-AF64-22641BF1D370 N/A N/A N/A N/AN/A N/A PWM24-2247FAC Stagecoach Flooring Replacement Page 7 of 10 City Attorney Approved 5/25/2023 EXHIBIT B Stagecoach Flooring Replacement Contractor shall provide all materials, tools and labor required to remove carpet flooring throughout and replace with Luxury Vinyl Tile (LVT) at Stagecoach located at 3420 Camino De Los Coches, Carlsbad, California. All work shall be consistent with the Contractor’s proposal dated June 30, 2023, and is attached to this agreement as Exhibit C. Scope: - Areas of work: Front entrance, lobby, front offices, hall, bathroom entrance, back entrance, back-office area and hallway. - Demo existing floors, carbide scrape all adhesive off the floor. - Remove and replace all big furniture in rooms. - Perform TH Moisture tests. -Furnish and install Avalon “Wood Series” Color Oak Taupe LVT (or equivalent) throughout (Approx 1,930 SF). - Install carpet tile at front offices (Approx 420 SF). -Furnish and install Tarkett 6” Rubber Cove Base, Black (or equivalent) throughout. Notes: -Contractor shall maintain good housekeeping practices throughout the duration of the project and will leave the site in a clean and workmanlike manner. -Work to be scheduled during business hours. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 LVT Specification Avalon Wood Series Color: Oak Taupe 6” x 48” x 5mm LVT Planks $20,667.50 TOTAL* $20,667.50 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 PWM24-2247FAC Stagecoach Flooring Replacement Page 8 of 10 EXHIBIT B (Continued) DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 ST A G E C O A C H PA R K CO M M U N I T Y CE N T E R BU I L D I N G r-- - - - - - - - , I □ □LJIL- _ _ ... J r -------- - - - -----J L - - - - - -m-,--------~ll=il! == = ; i u : ~ HI 1 1 1 Ca rpe t ti les in of f i c e I I __ . . . . - t - 1 I l ) ~ ' /v ( " \ \ '- - - ' J ~ - /1 / I \ ( ) ltm E : : i 1 J ~ l!l l l!l l PWM24-2247FAC Stagecoach Flooring Replacement Page 9 of 10 EXHIBIT C DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 Palomar Flooring 6875 Nancy Ridge Dr Suite B San Diego, CA 9212 1 Name /A<:ldreH City of Carlsbad 405 Oak Avenue Carlsbad, CA 92008 PROJECT Stage Coach Gym 3420 Camino De Los Coches Gartsbad. CA 442-252-1165 Oesoriptioo Demo and disposal of glue down carpet at lobby 710 SF Demo and disposal of vinyl plank at e-ntry, back entry, restroom entry 350 SF lockbox.: I Gate Code: I Provide and install labor for vinyt plank glue down at lobby, hall, back entry. bath entry 1050 SF Install labor for 6" oovebase 300 LF Floor prep (estimate) ""'Please, note that the prep estimate is just an estimated price. If any additional materials and labor is needed then a change order will be required''• Demo and disposal of carpet at offtces 420 SF Provide labor to install carpet at offices 420 SF Provide Catalina Avalon Series Core Select 20 miJ Color W105 Oak Taupe 1110 SF Provide adhesive for vinyt plank Provide 6," cove base 300 LF • PLEASE NOTE: Estimate Date Estimate # 6/30/2023 4602-1107-R Proj~ Qly UIM T .. al 650.00 800.00 3,400.00 750.00 800.00 300.00 400.00 3,330.00 340.00 675.00 D1te tb t>fftt.t.f of Jh.e COVJD-19 Pandon.lc, the~ Ji a llkdiehood that Ill ,,,.,111 apnu,,,.._~ rm tu1JldJ>ated ddt1J'1 ln Jhe 1'10lfufn.crurln!l an.d s.Jrlppi"R of 1'10Jerltlb; tu1d to a lt'SSU t>Xlent cost illch!tPSd; tl.f u h'.Su/1 of factil,Y do.dnRS aemn Jhe tli>IN. Plt'.t1.St! t:On.ddt>r thb Job~ our for,,,al lfOtlu of poJentlnl dt>ltlJ'S til our pe,ft>r1'1Ulftt thrt>ullh no ftJ1dJ of our O'lf'lf Olfd Jhtll art! beronJ 01tr c.tmJrol W~ wlll dllijt>lfdJ• suk Jo Milfbnlu Jo tht' bm of our ability, Jhe effttti of thdt! 4idnJ'1 Off 01tr lf'Ork. 1111!. I li'I lill i i llillil Uilil, Ill I I I r la li~II lillil ,alill U ~ .Ii I Iii !I I I I I I I I I il'ill!!! -Palomar Flooring accepls checks. Visa and MasterCard as payment of deposits and invoices. A 3% convenience. ree will apply to all payments paid wilh credit card. Phone# Fax# Web Site Total (858)467-1122 (858)457-1188 www .palomaoffice@palomarfloo .•. Enimate l'O!id far J(J days PWM24-2247FAC Stagecoach Flooring Replacement Page 10 of 10 EXHIBIT C (Continued) DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 Palomar Flooring 6875 Nancy Ridge Dr Suite B San Diego, CA 9212 1 Name / Address City of Carlsbad 405 Oak Avenue Carlsbad, CA 92008 442-252-1165 Oescciption Provide al1owance for carpet tile at off,ces product and color TBD 420 SF Demo and disposal of existing carpet glue down 550 SF Demo and disposal of existing vin)i plank glue down 300 SF Provide labor to install vinyl plank 880 SF Provide labor to install 6~ covebase 150 LF Floor prep (estimate) lockbox: I Gate Code: I •"Please note that the prep estimate is just an estimated price. If any additional materials and labor is needed then a change order will be required"'• Provide Catalina Avalon Series Core Select 20 mil Color W105 Oak Taupe 935 SF Provide adhesive for vinyt plank Provide 6" covebase 150 LF • PLEASE NOT£: Estimate Date Estimate # 6/30/2023 4602-1107-R Projeci Qly U/M T .. al 900.00 525.00 795.00 2,TT5.00 375.00 500.00 2,805.00 210.00 337.50 D1t1! tit t'f/tt.ts o/lht! COV/D-19 Pondttn.lc, the" /t a llkdlehood tha 1tt 'lf'ill o:pffl.-.ncr untmtldJHJ.ted ddtrJ-S In Jhe 1'I01tufnccur/nfl on.d s.h[pplnj of 1'10Jerlolt; tmd WO ldSU c'Xlt'.111 t.OSI illcretrSet., trS Q ll'SNII of fac,11,y do.dnflS oeron Jht! fllo/N. Plt>.trSt! t:Ons/dc'r thb JO bt! Oltr for"'"' notlt.t! of potentltrl dc'/ays til our 1w,for1'101ttt throuflh 110 fa1dJ of our o-.w and Jh.trJ Ort! berond 011, t.011Jrol Wt! lf'lll dllijl'ndy set!k to ,nlnbnlu Jo ,1,., bm of our oblllJJ', Jht! t!J/rt.n of thdt! 41.dtrJ-S on 011, lfV>lt. ... ' ·~ ef e~ I ~ 18~& el II e "'"II ~e II ~' ti • !!I ti, .Pele 5il 1g I! I I I ,. 111! -Palomar Flooring accep1S checks. Vis.a and MasterCard as paym8~t of deposits and invoices. A 3% convenience. lee will apply to all payments paid wilh credit card. Phone# Fax# Web Site Total $20,667.50 (858)457-1122 (858)457-11 88 www.palomaoffice@pal:>marfloo ••. Esdmatc' l'Dlidftw JO da)'f DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 ~RD8 CERTIFICATE OF LIABILITY INSURANCE l DAT£ (MM/ODNYYY) 6/5/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVEL. Y 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 ls an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terme and conditions of the policy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 'liXiie-;-~· Kim Tarbell Valley Center Insurance Ageucy, Inc. Wc''N'"o Ext): 160-149-0622 l,ffi Nol: 760-749-0628 27515 Valley Center Rd, Suite B Xoo7iEss, kim@vcJainc.com INSURER(S) AFFORDING COVeRAGli NAIC# Valley Ccntet· CA 92082 · IHSURER A: WEST AMBRlCAN INS CO 44393 ltlSURED INSURERS: OHIO SECURlTY INS CO 24082 Palomut Flooring IHSURERC: 687S Nancy Ridge Or Sec B INSURERD: INSURER£: San Diego CA 92121 INSURERF: COVERAGES CERTIFICATE NUMBER• 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. N01WITHSTANDING 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 CONDITTONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. c,w TfPE OF INSURANCE INBD WVD POLICY NUMBER IMMiooim'vJ I IMWDDiv'ml LIMITS ~ COMMERCIAL GENERAL UABILllY EACH OCCURRENCE s 2,000,000 ,__ :J CLAIMS-MADE [Kl OCCUR PREMisEs (&~eel s 500,000 -MED EXP (Any on• pereon) $ 15,000 A y y BKW56254145 05/26/2CID 05/26/2024 PERSOHAL & ADV INJURY $ 2,000,000 -GEN'!. AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 RPoucv Off& OLOc PRODUCTS-COMP/OP AGG s 4,000,000 OTHER: $ AUTOMOBILE LIABILITY iEa·a«iiiiiriti"·---.... $ 1,000,000 ,__ ~ ANYAUTO BOOIL y INJURY (Per porson) $ B OWNED ,..._ SCHEDULED y y BAS56154145 05/26/2023 05/26/2024 BODILY INJURY (Per accldenl) s AUTOS ONLY AUTOS ,__ HIRED ,..._ NON-OWNED AUTOS ONLY AUTOS ONLY fp~',:';~ld~nt\" ... , .. __ s ,__ ,__ • ur~eReu.A LIAB HOCCUR EACH OCCURRENCE s -EXCESSLIAB I CLAIMS-MADE AGGAEGI\TEii ~ Dl"J) I IRBTBNTION$ $ r,,ORKERS COMPENSATIOl'l ls¥Anrre 1 le'ii''" !AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE□ NIA E.L. EACH ACCIDEl•IT $ JFF!CER/MEMBER EXCLUDED? Mandatory In NH) E.L DISEASE -EA EMPLOYEE $ 6~;i~f~W~ 'b1~PERATIONS below E.L. DISEASE-POI.ICY LIMIT s DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORO 101, Addlllonal Remark• Schedule, may be ~ltached If more apnco la required) See ACORD 101 CERTIFICATE HOLDER CANC LLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights resorved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 998C466B-9669-4B94-AF64-22641BF1D370 ACORD0 CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) "---' Acct#: 2936172 5/9/2023 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 pollcies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Insurance Services, LLC r:igNJ_ c •• ,. 844-29().4908 I fffc No': 2502 N Rocky Point Drive E-MAIL Tampa, FL 33607 .. DDRESS: BBSlcerts@locktonaffinity.com INSURER(Sl AFFORDING COVERAGE NAIC# INSURER A: Ace American Insurance Co. 22667 INSURED INSURER B: Barrett Business Services, Inc. L/C/F PALOMAR FLOORING INSURER C: 6875 NANCY RIDGE DRIVE • STE B INSURER D: SAN DIEGO, CA 92121 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER· 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. INSR TYPE OF INSURANCE ".'~':'E: !':'.l!':1~ .~a11i~ .~3~6i~, LTR POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s >--D CLAIMS-MADE □ OCCUR ~~~~:siJ ';' E~~~~~~n--' $ MED EXP (Anv one person) s -PERSONAL & AfJV INJURY $ - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ~ □PRO-□ POLICY JECT LOC PRODUCTS -COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY re~~~~~~lNGLE LIMIT $ -ANY AUTO BODILY INJURY (Per person) $ --OWNED SCHEDULED BODILY INJURY (Per accident) $ -AUTOS ONLY -AUTOS HIRED NON-OWNED ip~~~~~d::;gAMAGE $ AUTOS ONLY -AUTOS ONLY -$ UMBRELLA LIAB H OCCUR EACH OCCURRENCE s -EXCESS LIAB CLAIMS-MAfJE AGGREGATE $ o,ao I l Ai;TSNTION $ $ WORKERS COMPENSATION X I ~f fTUTE I I OTH- AND EMPLOYERS' LIABILITY ER Y/N A ANY PROPRIETOR/PARTNER/EXECUTIVE □ E.L. EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? NIA C51335302 6/1/2023 6/1/2024 (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Policy State = CA 984058 Workers' compensalion coverage is provided for only the co-employees, but not subconlractors of: PALOMAR FLOORING 8525 CAMINO SANTA FE F SAN DIEGO, CA 92121 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE £' i...--<J.,..a_ ~ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD