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HomeMy WebLinkAboutSouthern California Precision Concrete Inc dba Precision Concrete Cutting; 2024-08-16; PWM25-3499TRANPWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 1 City Attorney Approved 6/5/24 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 This contract is made on the ______________ day of _________________________, 2024 (“Contract”), by the City of Carlsbad, California, a municipal corporation (“City”) and Southern California Precision Concrete Inc., a California corporation, dba Precision Concrete Cutting, whose principal place of business is 320 State Place, Escondido, CA 92029 (“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: Eric Zielke (City Project Manager) PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. 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 Contract constitute “public works” under California Labor Code Section 1720 et seq., and 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 Sections 1770, 1773 and 1773.1 of the California Labor Code. Consistent with the requirement of Section 1773.2 of the California Labor code, a current copy of applicable wage rates may be obtained via the internet at: www.dir.ca.gov/dlsr/. Contractor shall not pay less than the said specified prevailing rates of wages to all such workers employed by him or her in the execution of the Contract. Contractor and any subcontractors shall comply with Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A 16th August PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 2 City Attorney Approved 6/5/24 Section 1776 of the California Labor Code, which requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Labor Code Section 1776. DIR REGISTRATION. California Labor Code Section 1725.5 requires the Contractor and any subcontractor or subconsultant performing any public work under this Contract to be currently registered with the California Department of Industrial Relations (‘DIR’), as specified in Labor Code Section 1725.5. Labor Code Section 1771.1 provides that a contractor or subcontractor/subconsultant shall not be qualified to engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Labor Code section 1725.5. Prior to the performance of public work by any subcontractor or subconsultant under this Contract, Contractor must furnish the City with the subcontractor or subconsultant's current DIR registration number. CALIFORNIA AIR RESOURCES BOARD (CARB) ADVANCED CLEAN FLEETS REGULATION. Contractor’s vehicles with a gross vehicle weight rating greater than 8,500 lbs. and light-duty package delivery vehicles operated in California may be subject to the California Air Resources Board (CARB) Advanced Clean Fleets regulations. Such vehicles may therefore be subject to requirements to reduce emissions of air pollutants. For more information, please visit the CARB Advanced Clean Fleets webpage at https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets. CALIFORNIA AIR RESOURCES BOARD (CARB) IN-USE OFF-ROAD DIESEL FUELED FLEETS REGULATION. Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. More information about the requirements and Contractor’s required certification is provided in Exhibit C. 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 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 3 City Attorney Approved 6/5/24 Ronald William Durna, Jr. 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 Contract and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ___________________________________ 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 written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. Property damage insurance in an amount of not less than……..$2,000,000 Automobile Liability Insurance in the amount of $2,000,000 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. Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 4 City Attorney Approved 6/5/24 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. Contractor agrees to defend (with counsel approved by the City), indemnify, and hold harmless the City and its officers, elected and appointed officials, employees and volunteers from and against 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. THIRD PARTY RIGHTS. Nothing in this Agreement should be construed to give any rights or benefits to any party other than the City and Contractor. JURISDICTION AND VENUE. This Agreement shall be interpreted in accordance with the laws of the State of California. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Contract is San Diego County, California. Start Work: Contractor agrees to start within thirty (30) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within thirty (60) working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Southern California Precision Concrete Inc. dba Precision Concrete Cutting 320 State Place (name of Contractor) 925449 (street address) Escondido, CA 92029 (Contractor’s license number) C-61/D06 - 12/31/2024 (city/state/zip) 951-760-1945 (license class. and exp. date) 1000003322 - 6/30/2026 (telephone no.) parker@pcctriphazardremoval.com (DIR registration number/exp. date) (e-mail address) Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 5 City Attorney Approved 6/5/24 AUTHORITY. The individuals executing this Contract 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 Contract. CONTRACTOR SOUTHERN CALIFORNIA PRECISION CONCRETE INC., a California corporation, dba Precision Concrete Cutting CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Ronald William Durna, Jr., President PAZ GOMEZ, Deputy City Manager, Public Works, as authorized by the City Manager (print name, title) By: ATTEST: SHERRY FREISINGER, City Clerk (sign here) Neshtinscka Durna, Secretary By: (print name, title) Deputy City Clerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Contract 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: _____________________________ Assistant City Attorney Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 6 City Attorney Approved 6/5/24 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. & Expiration Date License No., Classification & Expiration Date % of Total Contract NONE Total % Subcontracted: 0% The Contractor must perform no less than 50% of the work with its own forces. Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 7 City Attorney Approved 6/5/24 EXHIBIT B Concrete Slicing Alongside 2023 Slurry Project JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 Inch-Foot 470 Trip Hazard Removal (1/4 to 2 inches) $18,095 2 Sidewalk- Mile 10 Hazard Data Collection/Tool Setup $4,000 TOTAL* $22,095 *Includes taxes, fees, expenses and all other costs. Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 1 City Attorney Approved 6/5/24 Exhibit B Locations: Task ID Activity Locator Address Number Locator Street Concrete Grind LFT.amt Concrete Grind LFT.unit Lat Long 69613 Concrete and Asphalt Investigation & Result 7801 Paseo la Jolla 3 ft -117.2372287 33.07715255179504 69614 Concrete and Asphalt Investigation & Result 7885 Paseo Almendro 3 ft -117.2428267 33.07546978369174 69618 Concrete and Asphalt Investigation & Result 7952 Sitio Baniano 5 ft -117.2444471 33.07484626289899 69619 Concrete and Asphalt Investigation & Result 7983 Sitio Granado 5 ft -117.2482969 33.07642321320752 69621 Concrete and Asphalt Investigation & Result 2933 Segovia Way 5 ft -117.246181 33.07877991779195 69623 Concrete and Asphalt Investigation & Result 3021 Segovia Way 10 ft -117.2425091 33.07837099527962 69624 Concrete and Asphalt Investigation & Result 3133 Segovia Way 5 ft -117.2404713 33.07830255 69625 Concrete and Asphalt Investigation & Result 7823 Quebrada Cir 5 ft -117.2400737 33.07821415621316 69627 Concrete and Asphalt Investigation & Result 7823 Quebrada Cir 5 ft -117.2399963 33.0781829 69636 Concrete and Asphalt Investigation & Result 7824 Estancia St 5 ft -117.2402862 33.07837082425639 69639 Concrete and Asphalt Investigation & Result 7812 Estancia St 5 ft -117.2402264 33.07996814489544 69640 Concrete and Asphalt Investigation & Result 7813 Estancia St 5 ft -117.2403972 33.07967326821304 69655 Concrete and Asphalt Investigation & Result 3103 Serrano Dr 5 ft -117.2415147 33.07990662734165 69660 Concrete and Asphalt Investigation & Result 7821 Estancia St 5 ft -117.240624 33.078818845936816 69661 Concrete and Asphalt Investigation & Result 3012 Segovia Ct 5 ft -117.2431716 33.07845897239658 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 2 City Attorney Approved 6/5/24 69671 Concrete and Asphalt Investigation & Result 7614 Calle Madero 5 ft -117.2490616 33.083992065511204 69673 Concrete and Asphalt Investigation & Result 7610 Primavera Way 5 ft -117.2473274 33.08396064973482 69674 Concrete and Asphalt Investigation & Result 7645 Galleon Way 5 ft -117.2458678 33.083263634423915 70069 Concrete and Asphalt Investigation & Result 7500 Cadencia St 5 ft -117.2384099 33.08776473816018 70070 Concrete and Asphalt Investigation & Result 7356 Cadencia St 5 ft -117.2379639 33.08938989594045 70071 Concrete and Asphalt Investigation & Result 7356 Cadencia St 5 ft -117.2378952 33.089566350799885 70073 Concrete and Asphalt Investigation & Result 7326 Cadencia St 5 ft -117.237374 33.0908803 70074 Concrete and Asphalt Investigation & Result 7326 Cadencia St 5 ft -117.2373152 33.09103415 70075 Concrete and Asphalt Investigation & Result 7326 Cadencia St 5 ft -117.2372176 33.091302460612624 70076 Concrete and Asphalt Investigation & Result 7337 Cadencia St 5 ft -117.2377143 33.09036762299636 70077 Concrete and Asphalt Investigation & Result 3115 La Costa Ave 10 ft -117.2395763 33.086073127779116 70078 Concrete and Asphalt Investigation & Result 3012 Cadencia St 5 ft -117.2421482 33.08463353910809 70079 Concrete and Asphalt Investigation & Result 3004 Cadencia St 5 ft -117.2430852 33.08428942467544 70080 Concrete and Asphalt Investigation & Result 3005 Cadencia St 5 ft -117.2430653 33.08418000209493 70081 Concrete and Asphalt Investigation & Result 3007 Cadencia St 5 ft -117.2428662 33.084253810232866 70083 Concrete and Asphalt Investigation & Result 3015 Cadencia St 5 ft -117.2420033 33.08456329772019 70084 Concrete and Asphalt Investigation & Result 3102 Azahar St 5 ft -117.24134 33.086009487613524 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 3 City Attorney Approved 6/5/24 70085 Concrete and Asphalt Investigation & Result 3010 Azahar St 5 ft -117.2423953 33.085654832754834 70086 Concrete and Asphalt Investigation & Result 3000 Azahar St 5 ft -117.2440872 33.08507178472061 70096 Concrete and Asphalt Investigation & Result 7714 Romeria St 5 ft -117.2435066 33.08141812151843 70097 Concrete and Asphalt Investigation & Result 7708 Romeria St 5 ft -117.2435099 33.08213770865845 70098 Concrete and Asphalt Investigation & Result 7706 Romeria St 5 ft -117.2435192 33.082203481449675 70099 Concrete and Asphalt Investigation & Result 7660 Romeria St 5 ft -117.243518 33.0834296 70100 Concrete and Asphalt Investigation & Result 3003 Azahar St 5 ft -117.2436811 33.08508868861545 70102 Concrete and Asphalt Investigation & Result 3026 Cadencia St 5 ft -117.2402819 33.08570587411421 70103 Concrete and Asphalt Investigation & Result 3205 Azahar Pl 5 ft -117.239782 33.08485561792275 70104 Concrete and Asphalt Investigation & Result 3217 Azahar Pl 5 ft -117.2394938 33.08382988893238 70108 Concrete and Asphalt Investigation & Result 3018 Garboso St 5 ft -117.2412414 33.08301617873953 70115 Concrete and Asphalt Investigation & Result 3027 Garboso St 5 ft -117.2395056 33.08342995640403 70116 Concrete and Asphalt Investigation & Result 3027 Garboso St 5 ft -117.2394261 33.083451580679714 70117 Concrete and Asphalt Investigation & Result 3210 Azahar Pl 5 ft -117.2396352 33.0847638 70118 Concrete and Asphalt Investigation & Result 3208 Azahar Pl 5 ft -117.239715 33.08497711073461 70130 Concrete and Asphalt Investigation & Result 7515 Quinta St 5 ft -117.2430564 33.08733279414826 70142 Concrete and Asphalt Investigation & Result 3008 Rana Ct 5 ft -117.2436677 33.08907279665237 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 4 City Attorney Approved 6/5/24 70146 Concrete and Asphalt Investigation & Result 7503 Solano St 5 ft -117.2437592 33.08812687081453 70147 Concrete and Asphalt Investigation & Result 3101 Madera Ct 5 ft -117.2419945 33.087422981503245 70148 Concrete and Asphalt Investigation & Result 3105 Del Rey Ave 5 ft -117.2412401 33.087977335910004 70149 Concrete and Asphalt Investigation & Result 3105 Del Rey Ave 5 ft -117.2410602 33.08796552581057 70150 Concrete and Asphalt Investigation & Result 7407 Brava St 5 ft -117.2396518 33.08933466210318 70158 Concrete and Asphalt Investigation & Result 3115 Hataca Rd 5 ft -117.2408094 33.088630557066885 70159 Concrete and Asphalt Investigation & Result 3119 Hataca Rd 5 ft -117.240605 33.08843501 70160 Concrete and Asphalt Investigation & Result 3125 Del Rey Ave 5 ft -117.2400198 33.087797530926984 70161 Concrete and Asphalt Investigation & Result 3127 Del Rey Ave 5 ft -117.2397655 33.087755461753616 70162 Concrete and Asphalt Investigation & Result 5 ft 70163 Concrete and Asphalt Investigation & Result 3133 Del Rey Ave 5 ft -117.2392704 33.08763159571668 70164 Concrete and Asphalt Investigation & Result 3139 Del Rey Ave 5 ft -117.2386791 33.08750887461285 70513 Concrete and Asphalt Investigation & Result 2042 Cumbre Ct 5 ft -117.2631508 33.08080365552316 70514 Concrete and Asphalt Investigation & Result 2032 Cumbre Ct 5 ft -117.2632893 33.08075805883949 70515 Concrete and Asphalt Investigation & Result 2061 Cima Ct 5 ft -117.262768 33.081692200956574 70516 Concrete and Asphalt Investigation & Result 2062 Ladera Ct 5 ft -117.2632017 33.08253954469977 70517 Concrete and Asphalt Investigation & Result 2022 Ladera Ct 5 ft -117.2642404 33.082256602490006 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 5 City Attorney Approved 6/5/24 70518 Concrete and Asphalt Investigation & Result 2122 Pintoresco Ct 5 ft -117.2626465 33.08489269064436 70520 Concrete and Asphalt Investigation & Result 2121 Pintoresco Ct 5 ft -117.2627931 33.084618847637906 70521 Concrete and Asphalt Investigation & Result 2020 Subida Ter 5 ft -117.263458 33.08558725015313 70524 Concrete and Asphalt Investigation & Result 2012 Subida Ter 5 ft -117.2641832 33.085151090199204 70525 Concrete and Asphalt Investigation & Result 2006 Subida Ter 5 ft -117.2648831 33.08479912169844 70526 Concrete and Asphalt Investigation & Result 7625 Rustico Dr 5 ft -117.2653288 33.08428324492014 70527 Concrete and Asphalt Investigation & Result 2101 Escenico Ter 5 ft -117.2629079 33.083259306144825 70528 Concrete and Asphalt Investigation & Result 2101 Placido Ct 5 ft -117.2623725 33.08242199124538 70529 Concrete and Asphalt Investigation & Result 7727 Palacio Dr 5 ft -117.2616839 33.08252642780648 70535 Concrete and Asphalt Investigation & Result 2390 Botella Pl 5 ft -117.2565239 33.08346824799554 70536 Concrete and Asphalt Investigation & Result 7710 Rocio St 5 ft -117.2567741 33.083341884857184 70537 Concrete and Asphalt Investigation & Result 2266 Plazuela St 5 ft -117.2596097 33.08360057000898 70538 Concrete and Asphalt Investigation & Result 2220 Boca St 5 ft -117.2600407 33.08194407717691 70539 Concrete and Asphalt Investigation & Result 7752 Quitasol St 5 ft -117.2604996 33.08250804215326 70540 Concrete and Asphalt Investigation & Result 2236 Plazuela St 5 ft -117.2601465 33.08355536268273 70541 Concrete and Asphalt Investigation & Result 2257 Plazuela St 5 ft -117.2595463 33.08349806873409 70543 Concrete and Asphalt Investigation & Result 2267 Plazuela St 5 ft -117.2590561 33.08333729268651 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 6 City Attorney Approved 6/5/24 70544 Concrete and Asphalt Investigation & Result 2287 Plazuela St 5 ft -117.2585686 33.083140322820825 70545 Concrete and Asphalt Investigation & Result 7789 Palenque St 5 ft -117.2587527 33.080789510514315 70546 Concrete and Asphalt Investigation & Result 2377 Marca Pl 10 ft -117.2576548 33.08147734409126 70548 Concrete and Asphalt Investigation & Result 2332 Marca Pl 5 ft -117.2577608 33.08147801369423 70550 Concrete and Asphalt Investigation & Result 7751 Rocio St 5 ft -117.2565971 33.08226823765284 70558 Concrete and Asphalt Investigation & Result 2716 Bressi Ranch Way 5 ft -117.2533109 33.12476735064338 70560 Concrete and Asphalt Investigation & Result 2758 Bressi Ranch Way 5 ft -117.2516153 33.12588267973615 70561 Concrete and Asphalt Investigation & Result 5925 El Fuerte St 5 ft -117.2551398 33.13576192005653 70562 Concrete and Asphalt Investigation & Result 5990 El Fuerte St 5 ft -117.2535149 33.134119594966805 70563 Concrete and Asphalt Investigation & Result 6095 El Fuerte St 5 ft -117.252736 33.13111849651951 70564 Concrete and Asphalt Investigation & Result 5810 El Camino Real 5 ft -117.2724524 33.13698527 70565 Concrete and Asphalt Investigation & Result 2494 Faraday Ave 5 ft -117.2681653 33.13658617171115 70566 Concrete and Asphalt Investigation & Result 2454 Faraday Ave 5 ft -117.2714457 33.13716792201015 70571 Concrete and Asphalt Investigation & Result 2140 Vuelta Ct 5 ft -117.2613847 33.08102401293581 70572 Concrete and Asphalt Investigation & Result 2133 Vuelta Ct 5 ft -117.2614417 33.080894442589624 70573 Concrete and Asphalt Investigation & Result 7750 Palacio Dr 5 ft -117.2605322 33.08055997780069 70574 Concrete and Asphalt Investigation & Result 7748 Palacio Dr 5 ft -117.2605815 33.08065646594917 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 7 City Attorney Approved 6/5/24 70576 Concrete and Asphalt Investigation & Result 2207 Recodo Ct 5 ft -117.2600905 33.081196386488976 70577 Concrete and Asphalt Investigation & Result 2207 Recodo Ct 5 ft -117.2598103 33.08105430318529 70578 Concrete and Asphalt Investigation & Result 7701 Rocio St 5 ft -117.2575312 33.08321556134962 70579 Concrete and Asphalt Investigation & Result 7711 Rocio St 5 ft -117.2571473 33.08320938 70580 Concrete and Asphalt Investigation & Result 7733 Palacio Dr 5 ft -117.2613196 33.081797659758095 70797 Concrete and Asphalt Investigation & Result 3924 Rockfield Ct 10 ft -117.288149 33.17277600526173 70798 Concrete and Asphalt Investigation & Result 3698 Strata Dr 5 ft -117.2916147 33.170095675920344 70803 Concrete and Asphalt Investigation & Result 722 Seaworthy Way 5 ft -117.3079522 33.102804896398176 70805 Concrete and Asphalt Investigation & Result 7019 Lavender Way 5 ft -117.307785 33.10272144322338 70846 Concrete and Asphalt Investigation & Result 2707 Jacaranda Ave 5 ft -117.2523183 33.067711797212645 70847 Concrete and Asphalt Investigation & Result 2706 Jacaranda Ave 5 ft -117.2525418 33.06781660429819 70848 Concrete and Asphalt Investigation & Result 2614 Jacaranda Ave 5 ft -117.2535974 33.067794872025914 70849 Concrete and Asphalt Investigation & Result 2603 Jacaranda Ave 5 ft -117.2546215 33.06760111941198 70850 Concrete and Asphalt Investigation & Result 2508 Jacaranda Ave 5 ft -117.2553656 33.06768041963068 70851 Concrete and Asphalt Investigation & Result 7944 Represa Cir 15 ft -117.2545746 33.07100606 70852 Concrete and Asphalt Investigation & Result 7932 Represa Cir 5 ft -117.2535644 33.07076179613248 70853 Concrete and Asphalt Investigation & Result 7931 Represa Cir 5 ft -117.2533913 33.07079891524505 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 8 City Attorney Approved 6/5/24 70854 Concrete and Asphalt Investigation & Result 7941 Represa Cir 5 ft -117.2543335 33.07117303052229 70855 Concrete and Asphalt Investigation & Result 7953 Represa Cir 5 ft -117.2552581 33.07065519733844 70856 Concrete and Asphalt Investigation & Result 7959 Represa Cir 5 ft -117.2553503 33.07012924118802 70857 Concrete and Asphalt Investigation & Result 7967 Represa Cir 5 ft -117.2549534 33.06950818050545 70858 Concrete and Asphalt Investigation & Result 7915 Rocoso Ln 5 ft -117.2537074 33.07230523809453 70859 Concrete and Asphalt Investigation & Result 7913 El Astillero Pl 5 ft -117.2527025 33.07207247500834 70860 Concrete and Asphalt Investigation & Result 7914 El Astillero Pl 5 ft -117.2525231 33.07230125275265 70861 Concrete and Asphalt Investigation & Result 7912 El Astillero Pl 5 ft -117.2525196 33.072492626093954 70862 Concrete and Asphalt Investigation & Result 7917 Roble Pl 5 ft -117.2516419 33.07210575974238 70863 Concrete and Asphalt Investigation & Result 7916 Roble Pl 5 ft -117.2513868 33.072170822370566 70864 Concrete and Asphalt Investigation & Result 7927 Las Mientes Ln 5 ft -117.2506112 33.07161288684115 70865 Concrete and Asphalt Investigation & Result 7931 Las Mientes Ln 5 ft -117.2511788 33.071304245046576 70867 Concrete and Asphalt Investigation & Result 7944 Las Mientes Ln 5 ft -117.2514454 33.07111816577755 70868 Concrete and Asphalt Investigation & Result 7920 La Capela Ln 5 ft -117.2504529 33.07246600774693 70869 Concrete and Asphalt Investigation & Result 7949 La Selva Way 5 ft -117.2521277 33.070669280868906 70870 Concrete and Asphalt Investigation & Result 7964 Camino Gato 5 ft -117.2476573 33.06996484075762 70871 Concrete and Asphalt Investigation & Result 7964 Camino Alvaro 5 ft -117.2474336 33.06958097437519 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A OLIVENHAIN RD E L CO C H E S DE LOS AC E R V O BARCE LONA IO D R CALLE TIMITEO PALOM A RAIRPO RT RD L A COSTAAV P O I N S E T T I A L N M E L R O S E D R C A R L S B A D B L C A R LS B A D V IL LAGEDR R A N CHOSANTAFERD AVIARAPY C O L L E G E BL ALGA RD CANNONRD XA N A W Y MICA RD PAL A C PA S E O D E L N O R T E RE A L LA G O L O N D R I N A S T AVENIDACIRUELA LEVANTE ST GALI C I A W Y CALLE E L F U E R T E S T EL F U E R T E S T CAD E N C I A S T TAM A R A C K A V BATIQUITOS DR FARADAY AV H A R D I N G S T CALLE TH E C R O S S I N G S D R CAMINO SEGOVIA WY BRESSI R A N C H W Y EL C A M I N O COLIBRI LN C A M I N O R E A L P A S E O D E L N O R T E RANC H O S A N T A F E R D LOCATION MAP PROJECT NAME PROJECTNUMBER EXHIBIT1Sidewalk Created By: Andy Chang 6/24/2024 Z:\Eddie_Wills\Sidewalk_Project\from2023Slurry\LocationMap_Slurry2023_Revised_04-08-24.mxd $!Å NOT TOSCALE Exhibit 1 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A / J ~ \ J r' \ PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 1 City Attorney Approved 6/5/24 EXHIBIT C In-Use Off-Road Diesel-Fueled Fleet Regulation Requirements CARB implemented amendments to the In-Use Off-Road Diesel Fueled Fleets Regulations that apply broadly to all self-propelled off-road diesel vehicles 25 horsepower or greater and other forms of equipment used in California. More information about the requirements can be found at https://ww2.arb.ca.gov/our-work/programs/use-road-diesel-fueled-fleets-regulation Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. The City is a “Public Works Awarding Body,” as that term is defined under Title 13 California Code of Regulations Section 2449(c)(46). Accordingly, the Contractor must submit, with their pre-award contract documents, valid Certificates of Reported Compliance (CRC) for the Contractor’s fleet, and for the fleets of any listed subcontractors (including any applicable leased equipment or vehicles). Failure to provide a valid CRC, will limit the city’s ability to proceed with awarding this Contract. Contractor has an on-going obligation for term of this Agreement to provide copies of Contractor’s, as well as all listed subcontractors, most recent CRC issued by CARB. Throughout the Project, and for three (3) years thereafter, Contractor shall make available for inspection and copying any and all documents or information associated with Contractor’s and subcontractors’ fleet including, without limitation, CRC, fuel/refueling records, maintenance records, emissions records, and any other information the Contractor is required to produce, keep or maintain pursuant to the Regulation upon two (2) calendar days’ notice from the City. Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A PWM25-3499TRAN CONCRETE SLICING ALONGSIDE 2023 SLURRY PROJECT; CONT. NO. 6013 Page 2 City Attorney Approved 6/5/24 EXHIBIT C (CONT.) IN-USE OFF-ROAD DIESEL-FUELED FLEET REGULATION CERTIFICATION Contractor hereby acknowledges that they have reviewed the CARB’s policies, rules and regulations and are familiar with the requirements of In-Use Off-Road Diesel-Fueled Fleet Regulation. Contractor hereby certifies, subject to the penalty of perjury, that the option checked below relating to the Contractor’s fleet, and/or that of their subcontractor(s) (“Fleet”) is true and correct: ☐ The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto. ☐ The Fleet is exempt from the Regulation under Section 2449.1(f)(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto. ☐ Contractor and/or their subcontractor is unable to procure R99 or R100 renewable diesel fuel as defined in the Regulation pursuant to Section 2449.1(f)(3). Contractor shall keep detailed records describing the normal refueling methods, their attempts to procure renewable diesel fuel and proof that shows they were not able to procure renewable diesel (i.e., third party correspondence or vendor bids). ☐ The Fleet is exempt from the requirements of the Regulation pursuant to Section 2449(i)(4) because this Project has been deemed an “emergency”, as that term is defined in Section 2449(c)(18). Contractor shall only operate the exempted vehicles in the emergency situation and records of the exempted vehicles must be maintained, pursuant to Section 2449(i)(4). ☐ The Fleet does not fall under the Regulation or are otherwise exempt and a detailed reasoning is attached to this certification. Name of Contractor: Precision Concrete Cutting Signature: Name: Ronald William Durna, Jr. Title: President Date: Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 8/7/2024 Burnham WGB Insurance SolutionsCA Insurance License 0F6977115901 Red Hill AvenueTustin CA 92780 Barbara Shepherd 714-202-9122 714-573-1770 barbara.shepherd@wgbib.com Middlesex Insurance Company 23434 SOUTH47 Clear Spring Property and Casu 15563Southern California Precision Concrete, Inc.Dba Precision Concrete Cutting32428 Campo DriveTemecula CA 92592 1056788782 A X 1,000,000 X 500,000 X 5,000 5,000 1,000,000 3,000,000 X Y Y A0253953002 6/2/2024 6/2/2025 2,000,000 ded.5,000 A 1,000,000 X X X Y Y A0253953001 6/2/2024 6/2/2025 A X X 2,000,000A02539530036/2/2024 6/2/2025 2,000,000 $0 B XYCSWC030088016/2/2024 6/2/2025 1,000,000 1,000,000 1,000,000 Umbrella is Excess over the General Liability, Auto Liability and Employers Liability. Certificate holder(s) is/are named as Additional Insured per the attached endorsements as required by written contract subject to the terms & conditions of thepolicy per attached endorsements:GL AI CG 20101219GL AI/WOS/PNC Blanket CG71250622WC WOS WC 040306AUTO AI CA76010615See Attached... City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance ServicesP.O. Box 947Murrieta CA 92564 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A ACORD® I ~ I ~ □ □ ~ ~ Fl □ □ ~ ~ ~ ~ ~ ~ ~ ~ H I I I I I □ I 6~ ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: SOUTH47 1 1 Burnham WGB Insurance Solutions Southern California Precision Concrete, Inc.Dba Precision Concrete Cutting32428 Campo DriveTemecula CA 92592 25 CERTIFICATE OF LIABILITY INSURANCE AUTO WOS CA04441013RE: All projectsThe City of Carlsbad is named as additional insured on the General Liability per attached CG 2010 1219 and CG2037 1219 as required by written contractsubject to the terms and conditions of the policy. Primary and Non-Contributory applies on the General Liability per the attached CAS5003 0717Waiver of Subrogation applies to the General Liability per attached CG 24 04 05 09Waiver of Subrogation applies to the Workers' Compensation per attached WC 04 03 0630 days notice of cancellation / 10 days for non-payment of premium Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A I 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 FORMMOTOR 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: Endorsement Effective Date: Name Of Person(s) Or Organization(s): 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.Page 1 of 1CA 76 01 06 15 05/31/2024A0253953Middlesex Insurance Company 00001 0000000000 24152 0 N1 6cdf2687-ab63-41e0-9130-23b8934cc9966cdf2687-ab63-41e0-9130-23b8934cc996 A0253953001 Southern California Precision Concrete, Inc. dba: Precision Concrete Cutting 6/2/2024 As required per Written Agreement or Contract Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A Named Insured: Endorsement Effective Date: Name(s) Of Person(s) Or Organization(s): POLICY NUMBER: 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 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 Page 1 of 1CA 04 44 10 13 05/31/2024A0253953Middlesex Insurance Company 00001 0000000000 24152 0 N1 ac7e1241-6f33-47c4-88ed-80ccd262da2bac7e1241-6f33-47c4-88ed-80ccd262da2b A0253953001 6/2/2024 Southern California Precision Concrete, Inc. dba: Precision Concrete Cutting As required per Written Agreement or Contract Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A Page 1 of 2CG 20 10 12 19 05/31/2024A0253953Middlesex Insurance Company © Insurance Services Office, Inc., 2018 POLICY NUMBER:COMMERCIAL GENERAL LIABILITY 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 CG 20 10 12 19 Name Of Additional Insured Person(s)Or Organization(s)Location(s) Of Covered Operations 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. 00001 0000000000 24152 0 N1 6577d55a-85ec-4688-a9ff-db2de49000f96577d55a-85ec-4688-a9ff-db2de49000f9 A0253953002 All Locations and OperationsAs required per Written Agreement or Contract Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A C.With respect to the insurance afforded to these additional insureds, the following is added toSection 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. © Insurance Services Office, Inc., 2018 CG 20 10 12 19Page 2 of 2 05/31/2024A0253953Middlesex Insurance Company Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A A0253953 Middlesex Insurance Company 05/31/2024 2cdb1363-4d0c-4a9d-9744-a2c7ffcc6887 COMMERCIAL GENERAL LIABILITY CG 71 25 06 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS BLANKET ADDITIONAL INSUREDS, PRIMARY & NONCONTRIBUTORY, WAIVER OF SUBROGATION This endorsement modifies the coverage provided under the following Coverage Form(s): COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1.Additional Insureds - Automatic Status for 13 Additional Insured Types Section II - Who Is An Insured is amended to include the following as additional insureds when you have agreed to add that person or organization as an Additional Insured on your policy in a written contract or written agreement with that person or organization, or because of a permit issued by a state or political subdivision; provided the injury or damage occurs subsequent to the execution of the contract or agreement or issuance of the permit and while the contract, agreement or permit remains in effect. A.Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You 1)A person or organization with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a.Your acts or omissions; or b.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Coverage enhancements are listed below. For details of each coverage, please read the corresponding policy provisions in the body of this endorsement. 1.Additional Insureds - Automatic Status for 13 Additional Insured Types A.Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You B.Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) C.State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations D.Lessor of Leased Equipment E.Owners or Other Interests From Whom Land Has Been Leased F.Manager or Lessor of Premise G.Mortgagee, Assignee, or Receiver H.Controlling Interest I.Co-owner Of Insured Premises J.Executors, Administrators, Trustees Or Beneficiaries K.State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises L.Vendors M.Grantor of Franchise 2.Primary and Noncontributory - Other Insurance Condition 3.Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5CG 71 25 06 22 Policy Number: A0253953002 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A A0253953 Middlesex Insurance Company 05/31/2024 2cdb1363-4d0c-4a9d-9744-a2c7ffcc6887 A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. 2)With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a."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: 1.The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2.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. b."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. B.Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) 1)Any person(s) or organization(s) with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed for that additional insured and included in the "products-completed operations hazard", but only when that portion of the “products-completed operations hazard” is not excluded by endorsement. 2)With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury" or "property damage" 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" involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C.State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, subject to the following provisions: 1)This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. 2)This insurance does not apply to: Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 71 25 06 22Page 2 of 5 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A A0253953 Middlesex Insurance Company 05/31/2024 2cdb1363-4d0c-4a9d-9744-a2c7ffcc6887 a."Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b."Bodily injury" or "property damage" included within the "products-completed operations hazard". D.Lessor of Leased Equipment 1)Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). 2)With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. E.Owners or Other Interests From Whom Land Has Been Leased 1)Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the land leased to you by the additional insured person(s) or organization(s). 2)With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a.Any "occurrence" which takes place after you cease to lease that land; b.Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured person(s) or organization(s). F.Manager or Lessor of Premise Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the premises leased to you by the additional insured person(s) or organization(s), subject to the following additional exclusions: This insurance does not apply to: 1)Any "occurrence" which takes place after you cease to be a tenant in that premises. 2)Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. G.Mortgagee, Assignee, or Receiver Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of a premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured person(s) or organization(s). H.Controlling Interest 1)Any person(s) or organization(s) with respect to their liability arising out of: a.Their financial control of you; or b.Premises they own, maintain or control while you lease or occupy these premises. 2)This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. I.Co-owner Of Insured Premises Any person(s) or organization(s) with respect to their liability as co-owner of a premises co-owned by you and covered under this insurance. J.Executors, Administrators, Trustees Or Beneficiaries Any executor, administrator, trustee or beneficiary of your estate or living trust while acting within the scope of their duties as such. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 5CG 71 25 06 22 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A A0253953 Middlesex Insurance Company 05/31/2024 2cdb1363-4d0c-4a9d-9744-a2c7ffcc6887 K.State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises Any state or governmental agency or subdivision or political subdivision, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: 1)The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or 2)The construction, erection or removal of elevators; or 3)The ownership, maintenance or use of any elevators covered by this insurance. L.Vendors 1)Any person(s) or organization(s) (referred to throughout this endorsement as vendor), but only with respect to liability for "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However: a.The insurance afforded to such vendor only applies to the extent permitted by law; and b.If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2)With respect to the insurance afforded to these vendors, the following additional exclusions apply: a.The insurance afforded the vendor does not apply to: 1)"Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2)Any express warranty unauthorized by you; 3)Any physical or chemical change in the product made intentionally by the vendor; 4)Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; 5)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; 6)Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 7)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or 8)"Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1)The exceptions contained in Subparagraphs d. or f.; or Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 71 25 06 22Page 4 of 5 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A A0253953 Middlesex Insurance Company 05/31/2024 2cdb1363-4d0c-4a9d-9744-a2c7ffcc6887 (2)Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. b.This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. M.Grantor of Franchise Any person(s) or organization(s) with respect to their liability as grantor of a franchise to you. However: 1.The insurance afforded to such additional insureds 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. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. If there is any difference in coverage afforded to an additional insured in this endorsement and that provided under another additional insured endorsement attached to this policy, the broader coverage will apply to that additional insured. 2.Primary And Noncontributory Insurance The following is added to the Other Insurance Condition and supersedes any provision to the contrary: 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. 3.Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 5CG 71 25 06 22 Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A Docusign Envelope ID: B50B0A7C-EF2A-40E9-AAB9-2AF1E46EED1A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.50% of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION Any Person or Organization for which the insured has agreed by written contract executed prior to loss to furnish this waiver 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 6/2/202412:01 AM Policy No. CS-WC-030088-01 Insured Southern California Precision Concrete, Inc. Insurance Company Clear Spring Property and Casualty Company Countersigned by ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Endorsement No. 0 Premium Included From the WCIRB's California Workers' Compensation Insurance Forms Manual© 1999.