HomeMy WebLinkAboutAyala Engineering; 2018-09-12; PWM19-615UTILRECORDED REQUESTED BY
CITY OF CARLSBAD
AND WHEN RECORDED PLEASE
MAIL TO:
City Clerk
City of Carlsbad
1200 Carlsbad Village Drive
Carlsbad, California 92008
DOC# 2018-0528523
11111111111111111111111111 llllll 111111111111111 IIIII IIIII IIIII IIII IIII
Dec 26, 2018 04:39 PM
OFFICIAL RECORDS
Ernest ,I Dronen burg, Jr.,
SAN DIEGO COUNTY RECORDER
FEES $0 00 (SB2 Atkins $0 00)
PAGES 1
Space above this line for Recorder's use.
PARCEL NO:
NOTICE OF COMPLETION
Notice is hereby given that:
1. The undersigned is owner of the interest or estate stated below in the property hereinafter described.
2. The full name of the undersigned is City of Carlsbad, a municipal corporation.
3. The full address of the undersigned is 1200 Carlsbad Village Drive, Carlsbad, California 92008.
4. The nature of the title of the undersigned is: In fee.
5. A work or improvement on the property hereinafter described was completed on Oct. 31, 2018.
6. The name of the contractor for such work or improvement is Ayala Engineering.
7. The property on which said work or improvement was completed is in the City of Carlsbad, County of San
Diego, State of California, and is described as follows: Project No. 39491 (PWM19-615UTIL), Vista-Carlsbad
Interceptor Sewer Manhole No. 34B-1 Rehabilitation.
8. The street address of said property is at the intersection of Palomar Airport Road and Avenida Encinas, in the
City of Carlsbad.
CITY OF CARLSBAD
/;41/et) -o/ City Manager
VERIFICATION OF CITY CLERK
I, the undersigned, say:
I am the City Clerk of the City o~lsbad, 1200 Carlsbad Vill~ge Drive, Carlsbad, California, 92008; the
City Manager of said City on · Q..c_1 / / , 20.JK, accepted the above described work as
completed and ordered that a Notice of Completion be filed.
I declare under penalty of perjury that the foregoing is true and correct.
Executed on f>g c,_, l 9 , 20.N_, at Carlsbad, California.
CITY OF CARLSBAD
~1&NV1~K>n1(__~
krt~ARBARA ENGLESON u-Dty Clerk
Q:\Public Works\PW Common\CAPITAL-ACTIVEIPWM19-615UTIL Manhole 348-1 Rehabilitation\NOC (Public and Private) -revised 2018-11-14.doc
CITY OF CARLSBAD
ACCEPTANCE OF PUBLIC IMPROVEMENTS
COMPLETION OF PUBLIC IMPROVEMENTS
Ayala Engineering has completed the contract work required for Project No. 39491 (PWWM19-
615UTIL}, Vista-Carlsbad Interceptor Sewer Manhole No. 34B-1 Rehabilitation. City forces have
inspected the work and found it to be satisfactory. The work consisted of:
IMPROVEMENTS VALUE
Manhole rehabilitation $19,860
CERTIFICATION OF COMPLETION OF IMPROVEMENTS
~~ Engineering ~
CITY MANAGER'S ACCEPTANCE OF PUBLIC IMPROVEMENTS
The construction of the above described contract is deemed complete and hereby accepted.
The City Clerk is hereby authorized to record the Notice of Completion and release the bonds in
accordance with State Law and City Ordinances.
is hereby directed to commence maintaining the above described
Ity Manager Date
APPROVED AS TO FORM:
CELIA BREWER, City Attorney
By~R~ Depty City orney
Q \Public Works\PW Common\CAPITAL-ACTIVEIPWM19-615UTIL Manhole 34B-1 Rehabilitation\API (Public Works) -revised 2018-08-01.doc
PWM19-615UTIL
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION
CONT. NO. 39491 Page 1 of 6 City Attorney Approved 9/27/16
CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION CONT. NO. 39491
This agreement is made on the ______________ day of _________________________, 2018, by the CITY
OF CARLSBAD, California, a municipal corporation, (hereinafter called "City"), and AYALA ENGINEERING, a California corporation, whose principal place of business is 8682 E. Meadowidge St.,
Anaheim, CA 92808 (hereinafter called "Contractor").
City and Contractor agree as follows:
DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project").
PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools,
equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract.
CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract,
Contractor's Proposal, the Plans and Specifications, the General Provisions, 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:
Jesse Castaneda (City Project Manager)
WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute
the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the
applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract.
Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code
and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5.
The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the
Contract for work.
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.
DocuSign Envelope ID: 452FA3F6-3768-41FB-976A-80D530979942
12th September
PWM19-615UTIL
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION
CONT. NO. 39491 Page 2 of 6 City Attorney Approved 9/27/16
FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in
conjunction with litigation.
Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These
provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information.
The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining
to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an
administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five 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: _Ricardo Ayala_______________________
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 thirty (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.
DocuSign Envelope ID: 452FA3F6-3768-41FB-976A-80D530979942
PWM19-615UTIL
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION
CONT. NO. 39491 Page 3 of 6 City Attorney Approved 9/27/16
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 seven (7) working days after receipt of Notice to Proceed.
Completion: Contractor agrees to complete work within seven (7) working days after receipt of Notice to
Proceed.
CONTRACTOR’S INFORMATION.
Ayala Engineering, a California corporation 8682 E. Meadowidge St.
(name of Contractor)
959385
(street address)
Anaheim, CA 92808
(Contractor’s license number) A-General Engineering Contractor 8/31/20
(city/state/zip) 714-823-7179
(license class. and exp. date)
1000005012
(telephone no.)
562-297-4228
(DIR registration number)
6/30/19
(fax no.)
ricardo@ayalaengineering.com
(DIR registration exp. date) (e-mail address)
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DocuSign Envelope ID: 452FA3F6-3768-41FB-976A-80D530979942
PWM19-615UTIL
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION
CONT. NO. 39491 Page 4 of 6 City Attorney Approved 9/27/16
AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind
Contractor to the terms and conditions of this Agreement.
CONTRACTOR AYALA ENGINEERING,
a Sole proprietorship
CITY OF CARLSBAD, a municipal corporation of the State of California
By: By:
(sign here) Terry Smith, Interim Utilities Director as authorized by the City Manager
(print name/title)
By:
(sign here)
(print name/title)
If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups:
Group A Group B Chairman,
President, or Vice-President
Secretary,
Assistant Secretary, CFO or Assistant Treasurer
Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation.
APPROVED AS TO FORM:
CELIA A. BREWER, City Attorney
BY: _____________________________
Deputy City Attorney
DocuSign Envelope ID: 452FA3F6-3768-41FB-976A-80D530979942
Ricardo Ayala
Ricardo Ayala
PWM19-615UTIL
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION
CONT. NO. 39491 Page 5 of 6 City Attorney Approved 9/27/16
EXHIBIT A
LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR
Set forth below is the full name and location of the place of business of each sub-contractor 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 sub-contractor for each subcontract.
NOTE: The Contractor understands that if it fails to specify a sub-contractor 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
Portion of Project to
be Subcontracted
Business Name and Address DIR Registration
No.
License No.,
Classification & Expiration Date
% of
Total Contract
Total % Subcontracted: _______________
The Contractor must perform no less than fifty percent (50%) of the work with its own forces
DocuSign Envelope ID: 452FA3F6-3768-41FB-976A-80D530979942
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PWM19-615UTIL
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION
CONT. NO. 39491 Page 6 of 6 City Attorney Approved 9/27/16
EXHIBIT B
VISTA-CARLSBAD INTERCEPTOR SEWER MANHOLE NO. 34B-1 REHABILITATION
JOB QUOTATION
ITEM NO. UNIT QTY DESCRIPTION PRICE
1 Job EA The following inclusions by Contractor:
Triplex cured in place manhole liner for sewer manhole no. 34B-1.
Prevailing wage/DIR reporting/certified payroll.
Mobilization of all labor and equipment.
Confined space entry procedure.
All employees trained in confined space, CPR and first aid.
Surface preparation per manufacturer’s
recommendations. Resurface manhole interior to original dimensions.
Bench reconstruction. Installation of false floor to
prevent debris from entering collection system.
Internal measurements taken of manhole interior. Liner manufacturing and shipping.
Installation of 6800 series cured in place manhole liner per manufacturer’s recommendations. Ayala is a McNeil
Technologies certified installer of the Triplex lining system.
Surface preparation and Triplex installation to be
performed prior to change of elevation of shaft. Epoxy seal of lower termination of flowline.
After manhole is raised to grade, perform entry to seal
Triplex joint only to new shaft. 20 Year warranty on liner.
2 Job Work to be performed in two phases:
1 Perform surface prep, measure and order liner.
2
Install manhole liner (allow minimum two weeks lead
time based on backlog of manufacturing).
TOTAL* $19,860
*Includes taxes, fees, expenses and all other costs.
DocuSign Envelope ID: 452FA3F6-3768-41FB-976A-80D530979942
aDAE (MM/DDIYYYY)AC~RDCERTIFICATE OF LIABILITY INSURANCE 7 2/20/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 CONTACTNAME:Dealey, Renton & Associates PHON Ex:74478FAX
P. 0.Box 0550 A Ex) 71-4276810A/C, No:714-427-6818P. 0.Box 0550E-MAILSanta Ana CA 92711-0550 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC It
INSURER A: Wesco Insurance Company
INSURED AYALAENGI INSURER B: Landmark American Insurance Company
Aya a Engineering, Inc.
5753 E. Santa Ana Canyon #G-57 INSURER C: State Compensation Ins. Fund of CA 35076
Anaheim CA 92807 INSURER D : Tokio Marine Specialty Insurance
INSURER E:
___________________________________________________________INSURER F:.______
COVERAGES CERTIFICATE NUMBER: 119345084 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 ADDL SUBR POLICY EFF POLICY EXP
LTR -TYPE OF INSURANCE -INSD WVD POLICY NUMBER (M/DYY (M[D[YY LIMITS
B X COMMERCIAL GENERAL LIABILITY Y Y LHA1 39860 218/2018 2/8/2019 EACH OCCURRENCE $ 1, 000,000W DAMAGE TO RENTEDCLAIMS-MADE LJ OCCUR PREMISES IEs occurrence) $ 50,000
__________________________MED EXP (Any one person) $5,000
______________________PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY PRO JECT LOC PRODUCTS -COMP/OP AGG $2,000,000
OTHER: Fx ET$
A AUTOMOBILE LIABILITY V Y WPP14083402 217/2018 2/8/2019 (COMBNE SINGLE LIMIT $ 0
ANY AUTO BODILY INJURY (Per person) $
X ALL OWNED SCHEDULED BDL NUY(e cietAUTOS AUTOS BDL NUY(e ciet
HIX NON-OWNED PROPERZTDAMAGE $HRED AUTOS -AUTOS (Per cIden$
D X UMBRELLA LIAB X OCCUR PUB617403 2/8/2018 2/8/2019 EACH OCCURRENCE $8,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 8,000,000
OttO RETENTION $ $
C WORKERS COMPENSATION Y 900495518 2/8/2018 2/8/2019 X PERUT ETHAND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNEREXECUTIVE F1E.L. EACH ACCIDENT $ 1,000,000OFFICER/MEMBER EXCLUDED? [jJ] N/A
(Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,000
If ye , dscribe underDESRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS/ILOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Agreement Number # PWM 17-84UTIL -Rehabilitate three sewer manholes.City of Carlsbad is named as Additional Insured as respects General Liability as required per written contract or agreement. Insurance coverage includes waiver
of subrogation per the attached.
CERTIFICATE HOLDER CANCELLATION 30 Days notice/ 10 Days Nonpay
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Carlsbad/CMWD ACCORDANCE WITH THE POLICY PROVISIONS.
C/o EXIGIS Insurance Compliance Services
P.O. Box 4668 AUTHORIZED REPRESENTATIVEECM #35050
New York NY 10163-4668
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: WPP1406834 02 COMMERCIAL AUTO
CA990187 0715
This Endorsement Changes The Policy. Please Read It Carefully
BUSINESS AUTO COVERAGE EXPANSION
ENDORSEMENT
This endorsement modifies insurance provided by the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the COVERAGE FORM apply
unless modified by the endorsement.
A. Newly Acquired or Formed e. An "employee" of yours is an "insured"
Organizations, Employee Hired Car while operating an "auto" hired or rented
Liability and Blanket Additional Insured under a contract or agreement in that
Status for Certain Entities. "employee's" name, with your
Item 1. Who, is an Insured of Paragraph A. permission, while performing duties
Coverage under SECTION I I-COVERED related to the conduct of your business.
AUTOS LIABILITY COVERAGE is f. Any person or organization you are
amended to add: required by written contract or
d. Any organization you newly acquire or agreement to name as an additional
form, other than a partnership, joint "insured", but only with respect to
venture or limited liability company, and liability created in whole or in part by
over which you maintain ownership of a such agreement.
majority interest (greater than 50%), will B. Increase Of Loss Earnings Payment
qualify as a Named Insured; however, Subpart (4) of a. Supplementary Payments
(1) coverage under this provision is of Item 2. Coverage Extensions of
afforded only until the 1801 day Paragraph A. Coverage under SECTION 11
after you acquire or form the -COVERED AUTOS LIABILITY
organization or the end of the policy COVERAGE is amended to read:
period, whichever is earlier; (4) We will pay reasonable expenses
(1) coverage does not apply to "bodily incurred by the "insured" at our
injury", "property damage" or request, including actual loss of"covered pollution cost or expense" earnings up to $1,000 per day
that results from an "accident" which because of time off from work.
occurred before you acquired or C. Fellow Employee Injured By Covered
formed the organization; and Auto You Own Or Hire
(3) coverage does not apply if there is Item 5. Fellow Employee of Paragraph B.
other similar insurance available to Exclusions under SECTION IlI- COVEREDthat organization, or if similar AUTOS LIABILITY COVERAGE isinsurance would have been amended to add:
available but for its termination or
the exhaustion of its limits of This exclusion does not apply if the "bodily
insurance, injury" results from the use of a covered
Thisinsuancedoe notappl if"auto" you own or hire. Such coverage as
Thisinsuancedoe notappl ifis afforded by this provision is excess overcoverage .for the newly acquired or ayohrcletbeisrne
formed organization is excluded either ayohrcletbeisrne
-by the provisions of this coverage form
or by endorsement.
CA990187 0715 Includes, Copyrighted Material of Insurance Services Offices, Inc. Page 1 of 5
Used with permission
D. Limited Automatic Towing Coverage G. "Personal Effects" Coverage
Item 2. Towing, of Paragraph A. Coverage, Item 4. Coverage Extensions of Paragraph
underSECTION Ill-PHYSICAL DAMAGE A. Coverage, under SECTION Ill-
COVERAGE is amended to read: PHYSICAL DAMAGE COVERAGE is
amended to add:2. Towing "Personal Effects" Coverage
We will pay for towing and labor costsWewlpaaculasvlefo"os"t
each time that a covered "auto" is Wperwllpao tal csthe valsued for lss todisabled. All labor must be performed at "pcoern aufets" ofbe the "isrd whxileui
the place of disablement of the coveredacoed"ut"sbctoamxim
.,auto". limit of $2,500 per "loss", for that covered"auto" caused by the same "accident". Noa. The limit for towing and labor for deductible will apply to this coverage.
each disablement is $500; H. "Downtime Loss" Coverage
b. No deductible applies to this cover-Itm4CoeaeEenisf
age. Paragraph A. Coverage, under SECTION
E. Item 3. Glass Breakage -Hitting ABird Ill. PHYSICAL DAMAGE COVERAGE, is
OrAnimal -Falling Objects or Missiles of amended to add:
Paragraph A. Coverage under SECTION Ill"onimIosICvrg
-PHYSICAL DAMAGE COVERAGE, is "onieLs"Cvrg
amended to add: We will pay any resulting "downtime loss"
Glass Repair Coverage expenses you sustain as a result of a
We wll wivethe ompehenivecovered physical damage "loss" to a
We wll wivethe ompehenivecovered "auto" up to a maximum of $100
deductible for Glass, if one is indicated on per day, for a maximum of 30 days for the
your covered "auto", for glass repairs. We same physical damage "loss", subject to
will repair at no cost to you, any glass that the following conditions:
can be repaired without replacement,
provided the "loss" arises from a covered a. We will provide "downtime loss" beginning
Comprehensive "loss" to your "auto". on the 51h day after we have given you
F. Icrese f TansprtaionExpnseour agreement to pay for repairs to a
F. oInraseOg rnpranEpne covered "auto" and you have given the
Coveragerepair facility your authorization to make
Subpart a. Transportation Expenses of repairs;
Item 4. Coverage Extensions of Paragraph b. Coverage for "downtime loss" expenses
A. Coverage under SECTION Ill- will end when any of the following occur:
PHYSICAL DAMAGE COVERAGE is
amended to read: (1) You have a spare or reserve "auto"
a. TansortaionExpesesavailable to you to continue youra. TansortaionExpesesoperations.
We will pay up to $50 per day to a (2) You purchase a replacement "auto".
maximum of $1,000 for temporary(3Reartoyucvrd"uo"he
transportation expense incurred by you(3Reartoyucvrd"uo"he
because of the total theft of a covered been completed by the repair facility
"auto" of the private passenger type. and they determine the covered
We will pay only for those covered "auto" is road-worthy.
"autos" for which you carry either (4) You reach the 30 day maximum
Comprehensive or Specified Causes of coverage.
Loss Coverage or Theft Coverage. We
will pay for temporary transportation
expenses incurred during the period
beginning 48 hours after the theft and
ending, regardless of the policy's
expiration, when the covered "auto" is
returned to use or we pay for its "loss".
CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 2 of 5
Used with permission
1Item 4. Coverage Extensions, of d. Contraband or propefty in the course
Paragraph A. Coverage, under SECTION of illegal transportation or trade.
Ill. PHYSICAL DAMAGE COVERAGE, is e. "Loss" caused by theft, unless there isamended to add: evidence of forced entry into the
We will pay any resulting rental covered "auto" and a police report is
reimbursement expenses incurred by you for filed.
a rental of an "auto" because of "loss" to a K. Accidental Airbag Discharge Coverage
covered "auto" up to a maximum of $100 per Ie ..o aarp .Ecuin ne
day, for a maximum of 30 days for the same Ie ..o aarp .Ecuin ne
physical damage "loss", subject to the SECTION Ill-PHYSICAL DAMAGE
following conditions: COVERAGE is amended to read:
a. We will provide rental reimbursement a. Wear and tear, freezing, mechanical
incurred during the policy period or electrical breakdown. The
beginning 24 hours after the "loss" and exclusion relating to mechanical
ending, regardless of the policy break-down does not apply to the
expiration, with the number of days accidental discharge of an air bag.
reasonably required to repair or replace L. Loan or Lease Gap Coverage
the covered "auto". If the "loss" is Paragraph C. Limit Of Insurance undercaused by iheft, this number of days is SECTION Ill-PHYSICAL DAMAGE
the number of days it takes to locate the COVERAGE is amended to add:
covered "auto" and return it to you or the
number of days it takes for the claim to If a covered "auto" is owned or leased and
be settled, whichever comes first. if we provide Physical Damage Coverage
b. Or pymet islimtedto ncesaryandon it, we will pay, in the event of a covered
bacOul payensis limited. eesr n total "loss", any unpaid amount due on the
actul epenes icuredlease or loan for a covered "auto", less:
c. This coverage does not apply while a. The amount paid under the Physical
there are spare or reserve "autos" Damage Coverage Section of theavailable to you for your operations, policy; and
d. If a "loss" results from the total theft of a b. Any:covered "auto" of the private passenger()Ovrulesoroa
type, we will pay under this coverage(1Ovrulesoroa
only that amount of your rental payments including penalties,
reimbursement expenses which is not interest or other charges
already provided for under the Physical resulting from overdue
Damage Coverage Extension. payments at the time of the
J. "Personal Effects" Exclusion"ls;
Paragraph B. Exclusions under SECTION(2Fiaclpeltsimod111-HYSIAL DMAG COVRAGE isunder a lease for excessive use,
Ill-P YSICA DA AG CO ER GE:i abnormal wear and tear or high
amendd toadd:mileage;
"Personal Effects" Exclusion (3) Costs for extended warranties,
We will not pay for "loss" to "personal Credit Life Insurance, Health,
effects" of any of the following: Accident or Disability Insurance
a. Accounts, bills, currency, deeds, purchased with the loan or
evidence of debt, money, notes, lease;
securities or commercial paper or (4) Security deposits not refunded
other documents of value. by the lessor; and
b. Bullion, gold, silver, platinum, or other (5) Carry-over balances from
precious alloys or metals; furs or fur previous loans or leases
garments; jewelry; watches; precious
or semi-precious stones.
c. Paintings, statuary and other works of
art.
CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 3 of 5
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M. Aggregate Deductible (3) An "executive officer" or director, if
Paragraph D. Deductible underSECTION' you are a corporation;
II- PHYSICAL DAMAGE COVERAGE is (4) A manager or member, if you are a
amended to add: limited liability company;
Regardless of the number of covered (5) Your insurance manager; or
"autos" involved in the same "loss", only ()Yu ea ersnaieone deductible will apply to that "loss". If ()Yu ea ersnaie
the deductible amounts vary by "autos", P. Waiver Of Subrogation For Auto Liability
then only the highest applicable deductible Losses Assumed Under Insured Contract
will apply to that "loss". Item 5. Transfer Of Rights Of Recovery
N. Diminishing Deductible Against Others To Us of Paragraph A.
Loss Conditions under SECTION IV -Paragraph D. Deductible underSECTION BUSINESS AUTO CONDITIONS is
II- PHYSICAL DAMAGE COVERAGE is amended to read:
amended to add:
Any deductible will be reduced by the5.TaseofRgtofecvr
percentage indicated below on the first Against Others To Us
"loss" reported during the corresponding If any person or organization to or for
policy period: whom we make payments under this
Coverage Form has rights to recover
damages from another, those rights are
Loss Free Policy Periods Deductible transferred to us. That person or
With the Expansion Reduction on the organization must do everything
Endorsement first "loss" necessary to secure our rights and must
1 0% do nothing after an "accident" or "loss"
2 25% to impair them. However, if the insured
has waived those rights to recover
3___________ 50% through a written contract, we will waive
4 75% any right to recovery we may have
5 100% under this Coverage Form.
If we pay a Physical Damage "loss" during Q. Insurance is Primary and
the policy period under any BUSINESS Noncontributory
AUTO COVERAGE FORM you have with Subpart a.oflItem 5.Other Insurance of
us, your deductible stated in the Paragraph B. General Conditions under
Declarations page of each such SECTION FV-BUSINESS AUTO
COVERAGE FORM will not be reduced on CONDITIONS is amended to read:
any subsequent claims during the remainder a hsisrnei rmr nof your policy period and your deductible noncontributory, as respects any otherreduction will revert back to 0% for each insurance, if required in a written
such COVERAGE FORM if coverage is contract with you.renewed.
1 .nowldge f Los an Notce T UsR. Other Insurance -Hired Auto Physical
1 -Knolede o Los ad Ntic ToUsDamage
Subsection a. of Item 2. Duties In the Event Subpart b. of Item 5..Other Insurance ofof Accident, Claim, Suit or Loss of Paragraph B. General Conditions underParagraph A. Loss Conditions under SECTION IV-BUSINESS AUTO
SECTION I -- BUSINESS AUTO CONDITIONS is amended to read:CONDITIONS is amended to add:
Howeerpropt otie ofthe"acidet",b. For Hired Auto Physical Damage
claim, "suit" or "loss" to us or our Cvrgtefloigaedee
authorized representative only applies to be covered "autos" you own:
after the "accident", claim, "suit" or "loss" is (1) Any covered "auto" you lease,
known to: hire, rent or borrow; and
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 4 of 5
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(2) Any covered "auto" hired or rented
by your "employee" under a
contract in that individual"employee's" name, with your
permission, while performing
duties related to the conduct of
your business.
However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto".
S. Unintentional Failure To Disclose
Hazards
Paragraph B. General Conditions under
SECTION IV- BUSINESS AUTO CONDI-
TIONS is amended to add:
9. Your failure to disclose all hazards
existing as of the inception date of this
policy shall not prejudice the coverage
afforded by this policy, provided that
such failure to disclose all hazards is not
intentional. However, you must report
such previously undisclosed hazards to
us as soon as practicable after its
discovery.
T. Additional Definition
SECTION V -DEFINITIONS isamendedto
add:
"Personal effects" means personal
property owned by the "insured".
"Downtime loss!' means actual loss of
"business income" for the period of time
that a covered "auto":
1. Is out of service for repair or
replacement as a result of a covered
physical damage "loss" and
2. Is in the custody of a repair facility if
not a total "loss".
"Business Income" means:
1. Net Income (Net Profit or Loss
before income taxes) that would
have been earned or incurred; and
2. Continuing normal operating
expenses incurred, including payroll.
In this endorsement, Headings and
iles.....are inserted solely for the
convenience and ease of reference. They
do not affect the coverage provided by
this endorsement, nor do they constitute
any part of the terms and conditions of
this endorsement. All other policy
wording not specifically changed,
modified, or replaced by this
endorsement wordina remains in effect. I
CA990187 0715. Includes Copyrighted Material of Insurance Services Offices, Inc. Page 5 of 5
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LANDMARK AMERICAN INSURANCE COMPANY
This Endorsement Changes The Policy. Please Read It Carefully.
ADDITIONAL INSURED
BLANKET- PRIMARYAND YOU RWORK
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
Name of Person or Organization: Any person or organization to whom or to which you are obligated by virtue
of a written contract or by the issuance or existence of a written permit, to
provide insurance such as is afforded by this policy.
A. SECTION 11 -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; and/or "your work" defined for the additional insured(s)
designated above included in the "prod ucts-completed operations hazard".
B. If you are required by a written contract to provide primary insurance, this policy shall be primary and
SECTION IV- COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance does not apply, but
only with respect to coverage provided by this policy.
This endorsement effective 2/8/2018 forms
part of Policy Number LHA139260
issued to AYALA ENGINEERING
by Landmark American Insurance Company
RSG 15017 1207 Includes copyrighted material of Insurance Services Office, Inc. 1984
(1185) with its permission
LANDMARK AMERICAN INSURANCE COMPANY
This Endorsement Changes The Policy. Please Read It Carefully.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST
OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE FORM
SCHEDULE
Name of Person or Organization:
Any Person or Organization As Required By Written Contract
The following is added to SECTION IV -CONDITIONS, 8. TRANSFER OF RIGHTS OF RECOVERY AGAINST
OTHERS TO US:
We waive any right of recovery we may have against the person or organization shown in the SCHEDULE above
because of payment we make for injury or damage arising out of your ongoing operations, "your product" or "your
work" done under a written contract with that person or organization and included in the "prod uct-completed
operations hazard". This waiver applies only to the person or organization shown in the SCHEDULE above.
This endorsement effective 2/8/2018 forms
part of Policy Number LHA139260 issued
to AYALA ENGINEERING
by Landmark American Insurance Company
RSG 14048 1008 Includes copyrighted material of Insurance-Services Office, Inc. 1992
with its permission.-
ENDORSEMENT AGREEMENT
WAIVER OF SUBROGATION REP DI
BLANKET BASIS 9004955-18
RENEA
NA EA
HOME OFFICE 5-72-51-30
SAN FRANCISCO EFFECTIVE FEBRUARY 8, 2018 AT 12.01 A.M. PAGE 1 OF 1AND EXPIRING FEBRUARY 8, 2019 AT 12.01 A.M.ALL EFFECTIVE DATES AREAT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
AYALA ENGINEERING
5753 E. SANTA ANA CANYON #G-571
ANAHEIM, CA 92807
WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE
LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL
NOT ENFORCE O1UR 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.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE
2.00t OF THE TOTAL POLICY PREMIUM.
SCHEDULE
PERSON OR ORGANIZATION JOB DESCRIPTION
ANY PERSON OR ORGANIZATION BLANKET WAIVER OF
FOR WHOM THE NAMED INSURED SUBROGATION
HAS AGREED B3Y WRITTEN
CONTRACT TO FURNISH THIS
WAIVER
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BEHELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT. -
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO.: ERAY1,21
AUTHORIZED RErPRESENT] IVE PRESIDENT AND CEO 2572SCIF FORM 10217 (REV.7-2014 OLD DP 217