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HomeMy WebLinkAboutWaterline Technologies Inc; 2023-10-25; PWM24-2303FACDocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 25th October PWM24-2303FAC CITY OF CARLSBAD M INOR PUBLIC WORKS CONTRACT ALGA NORTE AQUATI C ACID TANK REPLACEM ENT; CONT. NO. 4733 This agreement is made on the ______ day of . 2023, by the City of Carlsbad, California, a municipal corporation (hereinafter called "City") and Waterline Technologies, Inc., a California Corporation whose principal place of business is 620 Santiago Street, Santa Ana, CA 92701 (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"). PROVI SIONS 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: Ron Haugland (City Project Manager). PAYM ENT. 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 Labo r 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. Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 1 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 PWM24-2303FAC The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. 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 Proco re 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, RFls, 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. Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 2 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 PWM24-2303FAC 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 subje:ct 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: Thomas Berrey 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. Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 3 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 PWM24-2303FAC 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 fifteen {15) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Waterline Technologies, Inc. (name of Contractor) 263844 (Contractor's license number) C53, C-61/D35 -12/31/2024 (license class. and exp. date) 1000006327 -6/30/2024 (DIR registration number/exp. date) 620 Santiago Street (street address) Santa Ana, CA 92701 (city/state/zip) 714-564-9100 (telephone no.) jmartindale@waterlinetech.com (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. Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 [signatures on following page] Page 4 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 CONTRACTOR WATERLINE TECHNOLOGIES, INC., a California corporation By: (sign here) Thomas R Berrey, General Manager (print name/title) By: (sign here) M~Hfr VU I Ouf\l1~L,CQ2-- (print 'name/title) PWM24-2303FAC CITY OF CARLSBAD, a municipal corporation of the State of California By: Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager If required by City, proper notarial acknowledgment of execution by Contractor must be attached. ~ corporation. Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B 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: --------'~_-_IA"'-'___,_f¾i-'-'~-'-'---'--'-'-o., __ _ Deputy City Attorney Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 5 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 PWM24-2303FAC 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 Business Name and Address DIR License No., %of be Registration Classification & Total Subcontracted No. Expiration Date Contract No Subs Total% Subcontracted: _O_o/c_o ____ _ The Contractor must perform no less than 50% of the work with its own forces. Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 6 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 PWM24-2303FAC EXHIBIT B Alga Norte Aquatic Acid Tank Replacement Remove existing Acid tank and install a replacement 500 gallon acid tank. Tank installation to be completed with all required restraints, connections, and appurtenances to ensure an operable system upon completion of the work. Work shall be completed in accordance with the attached quote dated July 24, 2023 (Exhibit "D"). JOB QUOTATION ITEM NO: UNIT QTY DESCRIPTION PRICE .. ,, ' 1 Lump 1 Install 500 gal Acid Tank per attached proposal $41,474.01 Sum *Includes taxes, fees, expenses and all other costs. Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 7 TOTAL* $41,474.01 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 PWM24-2303FAC EXH IBIT C LABOR AND MATERIALS BOND WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Waterline Technologies, Inc. (hereinafter designated as the "Principal"), a Contract for: ALGA NORTE AQUATIC ACID TANK REPLACEMENT CONTRACT NO. 4733 in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, Waterline Technologies, Inc., as Principal, (hereinafter designated as the "Contractor"), and Granite Re, Inc. dba Granite Surety Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of forty-one thousand four hundred seventy-four dollars and one cent ($41,474.01), said sum being an amount equal to: One hundred percent (100%} of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 ofthe Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 8 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 PWM24-2303FAC In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. This labor and materials bond may be approved as to form by the City Attorney for the City in counterpart, and the counterparts shall all constitute a single, original instrument. SIGNED AND SEALED, this ) 0 day of Oc ,Obi::J?.. I 2023 Waterline Technologies Inc. (SEAL) (Principal) By -r~:,:;'~ 1/f0/PIA7 8~t::-Y f {;,1J (Name/Title) Granite Re, Inc. dba Granite Surety Insurance CompanY(SEAL) (Surety) By ~-~•7:':s (Signatu) Kenneth D. Whittington, Attorney-In-Fact (Name/Title) (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY-ATTACH ATTORNEY-IN-FACT CERTIFICATE) APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney By: ____ ___.bi=·IA .... A"'--'"fb....,ta.YY't.L.M>~--"4"----- Deputy City Attorney Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 9 City Attorney Approved 6/30/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 A notary public or other officer completing this cetiificate verifies only the identity of the individual who signed the document to which this certificate is attached. and not the truthfulness. accuracv. or validitv of the document. ACKNOWLEDGMENT OF PRINCIPAL State of ___ (~A~--- County of D f M .5:=_", ~ Jl)oi~'-1- On this J.-o day of Dvf . , 20 2 3 , before me 0A-f<f+ & , (_zx.._o, Pvb/,' (__, personally appeared (l_ Here insert Name and Tifle o/Ojjicer Yh'OMd ~ U e.-f I ~ , who proved to me on the basis of satisfactory evidence to be the person Name a/Signer whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. SARA E. COCO 'COMM. #23644115 z Notary Public • California g Orange County .. Comm. Ex ires Jul 6, 2025 .J I ce1iify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and cotTect. WITNESS my hand and official seal. Signature __ c,._.J~tMlA"'-"--"'-"<--\-----"'t,,c___._CYw--------'---=--------- Sign~ture of Notary Public ACKNOWLEDGMENT OF SURETY State of Oklahoma County of Oklahoma On this 14 day of September, 2023 before me personally come(s) Kenneth D. Whittington, Attorney in-Fact of Granite Re, Inc. dba Granite Surety Insurance Company with whom I am personally acquainted, and who, being by me duly sworn, says that he reside(s) in Oklahoma City, Oklahoma that he is the Attorney in Fact of Granite Re, Inc. dba Granite Surety Insurance Company, the company described in and which executed the within instrument; that he know(s) the corporate seal of such Company; and that the seal affixed to the within instrument is such corporate seal and that it was affixed by order of the Board of Directors of said company, and he signed said instrument as Attor s)-in-Fact of the said Cot any b like order. GR0392-14 \\\\\..',I JII I/ I I I I ,, ~' ·4 1., 11 ..,_, -~~ •,.,.,., b~I; ' .L.._. ·• D F' ,, •r. ; ~ 1;-:-/ ~ 0,? "••• A -;. .._ ~ ,· ~ ·.,., ,,,, :: 4:1 ,: #11003620 \ ,:. :_ \ EXJ>. 04121127 f ~ ... ·-~~-~ .,,. . . ... ,; ·• ••. OF· ~-/ ,:, ,, ~--...... . ..... ,.,.,:~i;(R'{ \,, 111If~1111\'l\\ DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY GENERAL POWER OF ATTOR NEY Know all Men by these Presents: That GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY, a corporation organized and existing under the laws of the State of MINNESOTA and having its principal office at the City of OKLAHOMA CITY in the State of OKLAHOMA does hereby constitute and appoint: KENNETH D. WHITTINGTON; KYLE MCDONALD its true and lawful Attorney-in-Fact(s) for the following purposes, to wit: To sign its name as surety to, and to execute, seal and acknowledge any and all bonds, and to respectively do and perform any and all acts and things set forth in the resolution of the Board of Directors of the said GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY a certified copy of which is hereto annexed and made a part of this Power of Attorney; and the said GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY through us, its Board of Directors, hereby ratifies and confirms all and whatsoever the said : KENNETH D. WHITTINGTON; KYLE MCDONALD may lawfully do in the premises by virtue of these presents. In Witness Whereof, the said GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY has caused this instrument to be sealed with its corporate seal, duly attested by the signatures of its President and Assistant Secretary, this 3rd day of January, 2020. STATE OF OKLAHOMA COUNTY OF OKLAHOMA SS: Kenneth 0. Whitti ton, President ~I ;1//M/l-J K.;i;P. McDonald, Assistant Secretary On this 3rd day of January, 2020, before me personally came Kenneth D. Whittington, President of the GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY and Kyle P. McDonald, Assistant Secretary of said Company, with both of whom I am personally acquainted, who being by me severally duly sworn, said, that they, the said Kenneth D. Whittington and Kyle P. McDonald were respectively the President and the Assistant Secretary of GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY, the corporation described in and which executed the foregoing Power of Attorney; that they each knew the seal of said corporation; that the seal affixed to said Power of Attorney was such corporate seal,_ that it was so fixed by order of the Board of Directors of said corporation, and that they signed their name thereto by like order as President and Assistant Secretary, respectively, of the Company. My Commission Expires: April 21, 2027 Commission#: 11003620 Notary Public GRANITE RE, IN C. Certificate THE UNDERSIGNED, being the duly elected and acting Assistant Secretary of GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY, a Minnesota Corporation, HEREBY CERTIFIES that the following resolution is a true and correct excerpt from the July 15, 1987, minutes of the meeting of the Board of Directors of GRANITE RE, INC. DBA GRANITE SURETY INSURANCE COMPANY and that said Power of Attorney has not been revoked and is now in full force and effect. "RESOLVED, that the President, any Vice President, the Assistant Secretary, and any Assistant Vice President shall each have authority to appoint individuals as attorneys-in-fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the Company in the course of its business. On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the Company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." IN WITNESS WHEREOF, the undersigned has subscribed this Certificate and affixed the corporate seal of the Corporation this I 2023 --------- Kyler: McDonald, Assistant Secretary GR-40 (CA) Ed. 04-23 I 0 WATERllNE TECHNOlOGfES, INC. . . BILL TO: 2350 CITY OF CARLSBAD 6565 Alicante Road Carlsbad, CA 92009 760..602-2424 HELEN PO NUMBER SANTA ANA BRANCH 620 SANTIAGO STRl:El SANTA ANA, CA 92701 714.564,9100 EXHIBITO CARRIER PWM24-2303FAC QUOTATION ORDF.R l\'lJMDER 1742468 OllUlROKl'I!'. I 07/24/2023 lJ:05:031 SHIP TO: 7324 ALGA NORTE AQUATIC CENTER 6565 ALICANTE RD MIKE ANDERSON 442-888-3486 CARLSBAD, CA 92010 OFF. 760-266-4783 TERMS PAGE I of7 I Tunk Rcpl11c.eme111 and Chem Pump RcloClltiun OUR TRUCK· SANTA J\NA Net30 ILINEI l 5 6 7 ITEM I ORDERED l'Rl(:i;: Of.'iCRll'TION DEUV.,R\'INSTRUCTfONS: ............. TALK TOTIM PRIOR TO FILLlNGACID. YOU CANNOT FILL THE ACID TANK TO THE TOP, THEY ADD WATER FOR A 25% �11x••·······• .. cALL Jl,IIKE ANDERSON 442-88S-34N6 L SERVICE LABOR Vendor: 1698 Pan# : SERVICE LABOR CliARGE DIR rate for 3 techs to removal of(I) 2500 gallon Acid tank und installatio11 � ( t) 500 gall OJI acid tank Propilr rcll\oval and set up or new tank includingre,training and connt'>Cl HM HAZARDOUS MATERl,\LS CHARGE Vendor: 1698 Parl # : HAZ MAT DELIVERY FEE• NON TAXA 28-0554CHEMTAJNER 500DC SERIES TANK Vendor: 1727 Part# : TC5971 DC DOUBLE WALLED • 59" X 71" HIGH FU0200MA 2" PE HALF COUPLING INST Vendor: 1727 Part# : FB0200MA CHEMTAL.>.JER 2" FIP COUPLlNG INSTALLED ON TANKS -FACTOR1 WELDED 28-0888 RADIAL RESTRAINT KITS, 3501500 GAL TANK Vcrtilor: 1698 Part II : 10" L CHANNEL BRACKE, KIT 3,300.00 2,000.00 2,539.50 3 145.76 880.00 I Exn:NDED l'IUCE 3_3()().()() 2,000.00 2,53�.50 880.00 Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 10 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 i~HlllO PO<>( ICKIIPtllNT I CHENICAIJ 437-28 �WATERllNE T£CHNOLOGIES1 INC. m SW,.IIHIIIO POOL fQ\IIPl<!NUCHIIIIC�!.I SANTA ANA BRANCH GlO SANr1AGo S1'REET SANTA ANA, CA 92701 114 .. 564,9100 l.lXF. D'EM OltDEREU 38 39 19 2() 21 22 23 DF.'.SCRIPl'ION 1/4'' TO 51'16" SS VINYL COATED CABLE-:}'" X 3" X 10'' RADIAL SS ANCHOR BRACKETS • 1/2" THICK • TEFLON GASKETS· 3/4" SS ANCHOR BOLT'S· ALL CARRIAGE BOLTS AND CABLE TIES INCLUD IN KIT -CUT TWO I 5 FOOT CABLES AND TWO 17 FOOT CABLES 12-1708 ANTIDOTE SIGN, HYDROCt-lLOIUC ACID VeM<lor: 7 I 67 Part# : 1751 VINYL SIGN, H)" X 14" DESCRlll!NG TREATMENT IN CASE OF SPILL BODY CONTACT. 12-1725 DANGER SIGN, VINYL, HYDROCJ-ILORIC ACID Vendor: 7167 Parl ti : I 752 U)" X 14" VINYL DANGER S[GN -HYDROCHLORIC ACID SIGN 28-1204 CHEM LEVEL GAUGE/500GAL TANK Veudor: 6229 Part# : PH-2-71+5 LIQUID HEIGI-IT71 IN EMPTY TO FULL·, 5 IN FULL TO Ti-IRE.AD 2!!-3696 21N MIP X 21N CAl'vt LOCK MALE . 90 DEGREE Veru:lor: 1622 Puri # : 2001'90 BANJO FrnING 200F90 2!1-3701 2lN CAP CAMLOCK, 200CAP Ventlor: 1622 Par! # : 200CAP BANJO Fl1TING 200CAP L SERVICE LABOR Vendor: 169!1 Part ti ; SERVICE LABOR CHARGE Cusl of crane and 2 teclutidaus. al DIR rate to J\.'mOW and phtce the oltl and new tanks.. T TRAVEL V.;ndor: I 698 Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 11 PWM24-2303FAC QUOTATION OIIDER NUMUF.R 1742468 ORD£RDATE I PAGE 07/24/2023 13 :05 :03 I 2of7 £XTEND£I> l'IUCf: 15.50 15.50 15.50 15.50 4Hl.97 410.97 10.37 10.37 19.24 19.24 5,250.00 5,250.00 1,710.00 1,710.00 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 I I I 3~m-• I □ rowATERUNE TECHNOlOGIES, INC. SANTA ANA BRANCH 620 SANTiAGO STREET SANTA ANA CA. 92701 714.564.9100 LINt: ITEM ORD£RF.D 25 26 27 28 29 3() 31 32 33 IJ}:.SCRll'TION ·Teclutician Travel TC2240EF CHEMTAINER 65 GALLON TANK. WIBOLTED Vendor: 1727 Part ii : TC2240EF COVER - 22" X 4(1" - FACTORY WELDED FITTINGS -I" TOP VENT PIPE CONNECTION -I" DRAIN PORT 34-4501 SCH 40 RED BUSH I X 3\4 MIP XFIP 50 IN B \',t!H[Or: 1632 Part ti : 439-131 1 XJ/4 34-1482 SCl-180 THO I" COMPACT BALL VALVE, VITON S Ventlor: 1632 Patt I/ : 2131-010 THREADED 34-1096 SCH 60 PVC FLANGE, 6 INCH V.:-ndor: I 632 Parr ii : 854-060 34-0()]2 SCH80 I IN 90 ELL IO IN BOX v.-mlor: 1632 Pll:rttl : 806aOlO 34-0092SCH 80 I MALE ADPT 20 IN BOX V.:ndor: I 632 Parl # : 836-010 34-022$ #80 IIN PVC PIPE V-,11dor, 1573 Piirt # : I" SCH 80 GREY - CPHO 34•!086 li&O JIN x CLOSE Vendor: 1632 Pat'! # : 8!!4-005 34-0015 SCHllO 2 90 ELL 25 IN BOX Veu,lor: 1632 Parr Ii : 8.06-010 Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 12 2 2 5 PWM24-2303FAC QUOTATION ORDlffi NlJMUER 1742468 ORDER DA.Tis I PAGlc 07/24/2023 13:05:031 3 of7 l'RIC:E 1,xn:NOEU l'KICE 1,539.15 1,539.15 2.64 2.64 54.46 54.46 277.60 277.60 10.22 '.l:0.44 20.09 20.09 2.5ll 4.03 4.03 17.7[ 83.55 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 E3 & $W1111!00I Pll<.l~ EGl.ilPMENT & CMENICAI.S I I • 5.1(, 0WATERllNE TECHNOLOGIES. INC. 'YAAHlll��l IG<JIPMfNfl CHIIIICAU SANTA ANA BRANCH 620 SANTIAGO STREET SANTA ANA, CA 92701 714.564.9100 LINE 11'1::M ORDF.Rl-:O Dt:SCRIPTION 34 34-0095 35 36 37 51 53 54 :S:S 56 57 SCH SO 2 MALE ADPT IO IN BOX Vi.'Jldor: I 63 2 Part II : 836..020 34-0005 SCH80 2 TEE IO IN BOX Vendor: 1632 J),!lrl' # : 80 i -020 2229-020 SPEARS 21N PVC TU BALL CHECK VALVE Vendor: 1632 Part ii : 2229,020 SOCJFPT EPDM 34-0231 SCH 1180 PIPE 2IN Vcntlor: 1573 Part# : FP-80 - 2" PIPE, PVC, SCH 80-20 FOOT LENGHT - 2 INCH DIAMETER· PRICE I.E FOOT • NON BELLED ENDS -2000 FEET PER LIFT L SERVICE LABOR Vendor: 1698 Par,# : SERVICE LABOR CHARGE DJR tam for 2 1�hnicions 10 repo..�ition chemical pruup� 11nd redo the plumbing an.tl connections T TRAVEL Vendor: 1691! 14-0()34 SCH 80 1 I /2 COUPLING 10 IN BOX Ventlor: 1631 Patt I/ : 829-015 J4-00L4 SCHMO l-1/290ELLIOlN BOX Vendor: 1632 Part# : �06-015 34-0230 SCH #80 PlPE 1 1/21N Vendor: 1573 Part# : I 1/2" SCtl80 GREY PLAIN 801-212 Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 Page 13 2 20 8 110 16 PWM24-2303FAC QUOTATION ORO.:.R NIJMUER 1742468 • ORD»:R DA'TE • I PAGE 07/24/2023 13:05:031 4of7 PRIC,£ i,;xn:NOU) I'll.ICE 48.74 97.48 63.U< 63.18 292.91 292.91 12L80 15,400.00 15,400.00 435.00 435.(J() 2056 14.<i'l 514_1.5 4.28 513.60 23.80 380.80 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 I I 6.09 164.4!1 JS � WATERLINE TECHNOlOGIES, INC. !iWU<HYIG J<X>f EQ!JIJM!MHCMENIC�S SANTA ANA BRANCH 620 SAf\.'TIAGO STRl:�T SANTA ANA, CA 92701 714.564.9100 LIN�: ITEM 58 61 63 Df�'i,CRIPTION SCH80 TEE I/ \,•� X I 1/2 X I W' FIP Veu<lor: 1632 839-166 SCH80 RED BUSHING l '/4" X ½" MIP X FIP Ve,ulor: 1632 34-2120 SCH80 1/2" TRUE UNION BALL VAL VE, VlTON Vendor: 1632 Part t. : 36.W-005 TRUE UNION 2000 STANDARD HALL VALVE - SOCKET 34-3109 UNISTRUT CLAMP I 1121N Vc,i<lor: 16911 Part# : PCR-150 34-320() UNISTRUT DEEPS.INGLE l 5/t!XI 518, VemJ.or, 1696 l'arlli : FGSl ORl)l:il.'tll 16 50 40 PER FOOT -CORROSION RESISTANT -FRP STRUT -HD PEST -SLOl 65 67 68 69 70 28-0701 ]/81N BLACK POLY TUBJ.NG, UV PROTECTED VC'11<lor: 181 I Pan# :05)5.625 PARAFLF.X PE TUBING• 150 PSI .375 onx .250 ID 34-1903 GAL 746 GRAY LOWVOC Vc-n<lor, 1764 Parr# : 13566 6PiCS ORDERED AS: J41903 34-1922 GALLON P-68 PURPLE PRIMER v�ntlor: 1764 Parl fl : 10208 34-0097 SCH 80 l121NX CLOSE NIPPLE Vcn{lor: 1632 Part # : 882-005 30•1494 Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 500 16 Page 14 PWM24-2303FAC QUOTATION ORO ER NUMllER 1742468 o,un:R OAT£ I PAGE 07/24.12023 13:05:031 5 of7 EXTF:.NUEll l'lUCE I0.27 164.32 M.72 1,035.;,2 1.35 67.50 14.62 584.80 0.72 36().()() 166.66 166.66 157.40 157.40 2Jl4 45.44 2.78 27.80 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 I I I l'lllCll. I 16 10 �WATERllNE TECHNOlOGIES,INC. ffilMMIIKI POOi. ,t;1<11,"ENI A (MINICAU SANTAANA BRANCH 620 SANTIAGO STREET SANTA ANA, CA. 92701 714.SG4.9100 . UNE rn:�f Df.SOlll'TI0N 71 72 73 74 75 76 3/4 CONDUIT l0FT, SOLD lN l0 FOOT LENGTH V.:,n<lor: 1605 Part# : 4600750!03 30-1603 ELEC PVC 3/4IN MlP Vendor: 1605 Part ti : 6006-{>075 30-1025 T\VO GANG W/FOUR 3:'41N Vi!ndor: 1722 Part Ii : TGB75-4V 30-1464 DUPLf.X RECEPTACLE Vert<lor: 7426 Parr fl. : GFWTI-W DUPLEX RECEPT 15AI20V -GFWTI-W 30-1451 2 GANG "WHILE IN USE" NEMAJR COVER Vc11dor: 1502 Part II : WP1210C HIGH IMPACT CLEAR POLYCARBONATE COVERS 30-1025 nvo GANG W/FOUR 3141N Vcndor: 1722 Parl # : TGB75-4V B0NDl ALL BONDS -BID, PERFORf\·IANCE, LABOR Vendor: 7690 Part ti : BONDING �M111 IM M111M DKMA!wn 620 SANTIAGO STREET SANTA ANA, CA 92701 714.564, 9100 LINt: ITEM lll:!1-CRll'HON TOTAL l.fNES: 46 Quote Expires On: 09/2212023 Alga Norte Aquatic Acid Tank Replacement Cont. No. 4733 ORUf.RED 4 2 4 2 ORDERED Page 15 PWM24-2303FAC QUOTATION ORDER NUMBER 1742468 ORDER DATE I PAGE 07.12412023 t3:o5:o3 I 6of7 EXTENDED l'IHC£ 0.53 2.12 16.50 39.IJ 156.52 18.83 37.66 8.25 8.25 1,182.43 1,182.43 '-.J'IUll�l1. l-,._,�•IUL1.\. 1742468 ORD£R DA'll!. I 01.124,,2023 t3:os:o3I l'IUCE SUD-TOTAL: TAX: _AMOUNT DUE: PA(;f; 7of7 �;xn:NDED l'IUCE 40,596.80 877.21 41,474.01 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 : I l'RIC:E I I DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 07/18/2023 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 HOL,DER. 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). PRODUCER ~il!,~~cT CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY rx,i~~o, Ext): 888-333-4949 I FAX HOME OFFICE: P.O. BOX 328 (A/C, No): 507-446-4664 OWATONNA, MN 55060 ti\"imhs: CLIENTCONTACTCENTERcalFEDI NS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:FEOERATED MUTUAL INSURANCE COMPANY 13935 INSURED 308-577-6 INSURER B: WATERLINE TECHNOLOGIES INC 620 N SANTIAGO ST INSURER C: SANTA ANA, CA 92701-3942 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 167 REVISION NUMBER: 0 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 QR 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. '~.fl TYPE OF INSURANCE f\.~oDcL t~~~ POLICY NUMBER POLICY EFF ,i~~~9'1N!v, LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 -=i CLAJMS·MADE 0 OCCUR -P,~f".1_~_9.~.J~c~ENTED PREMISES $100,000 MED EXP (Any one person) EXCLUDED - A y N 0623485 08/15/2023 08/15/2024 PERSONAL & ADV INJURY $1 000 000 - GEN1. AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000 ~ POLICY Ori,: □ LOC PRODUCTS & COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY fE~~~J~~~llNGLE LIMIT $1,000,000 -X ANYAUTO BODILY INJURY (Per Person) -~ A OWNED AUTOS ONLY SCHEDULED N N 0623485 08/15/2023 08/15/2024 BODILY INJURY (Per Accident) -~ AUTOS HIRED AUTOS ONLY NON-OWNED ic~<;_>i;_~~,:,'!"~AMAGE --AUTOS ONLY X UMBRELLA LIAB X --OCCUR EACH OCCURRENCE $10,000,000 A EXCESS LIAB CLAIMS-MADE N N 0623486 08/15/2023 08/15/2024 AGGREGATE $10,000,000 DED I !RETENTION WORKERS COMPENSATION I PER STATUTE I PTHER AND EMPLOYERS' LIABILITY c ANY PROPRIETOR/PARTNER/ EXECUTIVE E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE ·EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE • POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE : 3401 MONROE ST CARLSBAD CA 92008. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOUR ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 308-577-6 167 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ATTN: CONTRACT ADMINISTRATION CITY OF CARLSBAD BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1635 FARADAY AVE ACCORDANCE WITH THE POLICY PROVISIONS. CARLSBAD, CA 92008-7314 AUTHORIZED REPRESENTATIVE ))L -D_P~_ t.~ © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural , engineering or surveying services. © Insurance Services Office, Inc., 2018 Page 1 of 2 CG 20 33 12 19 Policy Number: 0623485 Transaction Effective Date: 08/15/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 2. "Bodily injury" or "property damage" occurring after: a. 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 b. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 0623485 Transaction Effective Date: 08/15/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 POLICY NUMBER: 0623485 COMMERCIAL GENERAL LIABILITY CG 20 3712 19 TH IS 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 K::ity of Carlsbad Any Coverage Provided by This Attn Contract Administration Endorsement Applies Only With Respect to 1635 Faraday Ave Named lnsured's Commercial Carlsbad, CA 92008-7314 (Non-Residential) Tank Work at: City Pool, 3401 Monroe Street, Carlsbad CA 92008 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. Insured: Waterline Technologies Inc 620 N Santiago St Santa Ana, CA 92701-3942 CG 20 3712 19 © Insurance Services Office, Inc., 2018 Policy Number: 0623485 Page 1 of 1 Transaction Effective Date: 08/15/2023 DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 09/18/2023 ~ 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($), 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). PRODUCER CONTACT Nicole Chow NAME: Newfront Insurance Services, LLC r.~~N,t ~ ..... (415) 754-3635 I FAX IA/C Nol: 450 Sansome Street ~~lJ~ss: nicole.chow@newfront.com Suite 300 INSURER/SI AFFORDING COVERAGE NAIC# San Francisco CA 94111 INSURER A: Service American Indemnity Company 39152 INSURED INSURER B : Waterline Technologies Inc. INSURER C: INSURER D: 620 N Santiago St INSURER E: Santa Ana CA 92701 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 ADDL Sl)BR ,~m-JiM~, ,~2rJi~, LTR ,.,en ,.n,n POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ -□ CLAIMS-MADE □ OCCUR DAMAGE TO RENTED PREMISES IEa occurrence\ $ -MED EXP (Any one person) $ PERSONAL & ADV INJURY $ -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Fl □PRO-DLoc POLICY JECT PRODUCTS -COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY -fg~~~~d~~i\'INGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ --OWNED SCHEDULED BODILY INJURY (Per accident) $ -AUTOS ONLY -AUTOS HIRED NON-OWNED ip~~~2c~Je~8AMAGE $ AUTOS ONLY AUTOS ONLY --$ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ -EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION XI ~ffTUTE I IOTH- AND EMPLOYERS' LIABILITY ER YIN A ANYPROPRIETOR/PARTNER/EXECUTIVE □ X SAMTWC0031503 07/01/2023 07/01/2024 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ii more space is required) Waiver of subrogation applies in favor of the City of Carlsbad/CMWD with respect to Workers Compensation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad/CMWD ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Compliance Services AUTHORIZED REPRESENTATIVE P.O. Box 947 (\ Murrieta CA 92564 lj I . ___ i;,, .... -- I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FRO M OTHERS ENDORSEMENT-CALI FORNIA 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 per- form 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 otherwise due on such remuneration. 0 . 0 2 0 % of the California workers' compensation premium Schedule Person or Organizati on Blanket waiver of subrogation as required by written Job Description 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 requi red only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Date: 0 7 / 0 1 / 2 0 2 3 Policy No. SAMTWC 0 0 315 0 3 Policy Effective Date: 07/01/2023 to O 7/01/2024 Insured: Waterline Technologies, Inc OBA: Carrier Name I Code: Service American Indemnity Company Endorsement No. Premium$ (Method) Countersigned by __ CL:::...,__-_~ __ !::;J_.+--~----- WC 04 03 06 (Ed . 4-84) Page 1 of 1 COMPANY PROFILE Company Information GRANITE RE, INC. DBA Name: GRANITE SURETY INSURANCE COMPANY 121 E PARK SQ OWATONNA, MN 55060 Old Company Names Effective Date GRANITE RE INC 05/09/2019 Agent For Service Vivian Imperial 818 WEST SEVENTH STREET SUITE 930 LOS ANGELES CA 90017 Reference Information NAIC #:26310 California Company ID #:6204-2 Date Authorized in California:05/09/2019 License Status:UNLIMITED-NORMAL Company Type:Property & Casualty State of Domicile:MINNESOTA back to top NAIC Group List NAIC Group #:0007 FEDERATED MUT GRP Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. SURETY back to top Company Profile Company Search Company Search Results CompanyInformation Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Action/Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer © 2008 California Department of Insurance DocuSign Envelope ID: E70B9CE4-A69D-45B3-A9C0-E09E4F33E6E5 1.. ' CALffORNIA ' ' DEPARH'IENT OF INSURANCE I