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Cen-Pac Engineering Inc; 2019-01-30; PWM19-696TRAN
RECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2019-026297 4 111111111111 lllll 111111111111111 lllll lllll 1111111111111111111111111111 Jul 02, 2019 04:34 PM OFFICIAL RECORDS Ernest J. Dronenburg, Jr, SAN DIEGO COUNTY RECORDER FEES $0.00 (SB2 Atkins $0.00) PAGES: 1 Space above this line for Recorder's use. PARCEL NO: n/a 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 names of the undersigned are 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 May 29, 2019. 6. The name of the contractor for such work or improvement is Cen-Pac Engineering, Inc. 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. 6070 (PWM19-696TRAN), Cassia Road Signing and Striping Modifications. 8. The street address of said property is along Cassia Road in the City of Carlsbad. VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Carlsbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on J.1ne 0 I , 20-1.!L_, 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 Tune ol8 , 20Jj_, at Carlsbad, California. CITY OF CARLSBAD ~..,,), ~pu~ C;N C/ttJ./ ~"' BARBARA ENGLESON V City Clerk Q:\Public Works\PW Common\CAPITAL-ACTIVE\6070 Cassia Rd Signing and Striping Modifications\NOC.doc CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Cen-Pac Engineering, Inc. has completed the contract work required for Project No. 6070 (PWM19-696TRAN), Cassia Road Signing and Striping Modifications. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS VALUE Signing and striping $34,879 CERTIFICATION OF COMPLETION OF IMPROVEMENTS 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. The City of Carlsbad is hereby directed to commence maintaining the above described improvements. /4 ift) rl, ~) 7 /J ~ Scott Chad~: City Manager Date APPROVED AS TO FORM: CELIA BREWER, City Attorney By: C L f? . Deputy City Attorni.Y . / Q.\Public Works\PW Common\CAPITAL-ACTIVE\6070 Cassia Rd Signing and Striping Modifications\APl.doc PWM19-696TRAN CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT CASSIA ROAD SIGNING AND STRIPING MODIFICATIONS; CONT. NO. 6070 ..-::2.0-r.t This agreement is made on the v day of-+-+i-LX--=->o=.:::....,:::....;;;_-¥-----' 2019, by the City of Carlsbad, California, a municipal corporation, (hereinaft r alled "City"), a Cen-Pac Engineering, Inc., a California corporation whose principal place of business is Ave, Fresno, CA 93711 (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: John Kim (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. Cassia Road Signing and Striping Modifications; Cont. No. 6070 Page 1 of 9 City Attorney Approved 9/27/16 PWM19-696TRAN 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 subcontracto from participating in contract bidding. Signature: Print Name: SU f,{lo clecKSot] 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. Cassia Road Signing and Striping Modifications; Cont. No. 6070 Page 2 of 9 City Attorney Approved 9/27/16 PWM19-696TRAN 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 thirty (30) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Cen-Pac Engineering, Inc. (name of Contractor) 1040742 (Contractor's license number) A-General Engineering Contractor 6/30/2020 (license class. and exp. date) Ill Ill Ill Ill Ill Ill Ill 1000058668 (DIR registration number) 6/30/2019 (DIR registration exp. date) Cassia Road Signing and Striping Modifications; Cont. No. 6070 Page 3 of 9 1467 W. Shaw Ave (street address) Fresno, CA 93711 (city/state/zip) 805-984-3421 (telephone no.) 805-985-2834 (fax no.) stephen.cenpac@gmail.com (e-mail address) City Attorney Approved 9/27/16 PWM19-696TRAN 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, CEN-PAC ENGINEERING, INC., a California corporation By: -;L~ Cj(~ ~ (signh~<..:........ Vicki K Madsen / Secretary (print name/title) By: Stephen Jackson, Vice President/ R.M.O. (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !f...g corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney Cassia Road Signing and Striping Modifications; Cont. No. 6070 Page 4 of9 City Attorney Approved 9/27/16 PWM19-696TRAN 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 Business Name and Address DIR Registration License No., % of be Subcontracted No. Classification & Total Expiration Date Contract ST'{JJ[W!O't_ 51f?.1Pi5, Jf)tJ, f.O. fpY, 600710 7 ~8).86 · c-3,i___ s,~n,m r sri,fm, SAn j);~cio r,ll 9J..J60 II J -, r J p,:!,L-/ f.:x.f. ! ). ·3 I· 2 h)-D b1. C. I V Total% Subcontracted: _..!o8:...:•:..;C;;..... __ _ The Contractor must perform no less than fifty percent (50%) of the work with its own forces Cassia Road Signing and Striping Modifications; Cont. No. 6070 Page 5 of9 City Attorney Approved 9/27/16 PWM19-696TRAN EXHIBITS Cassia Road Signing and Striping Modifications Radar Speedback Signs and Thermoplastic Pavement Legends Contractor to furnish all labor, equipment and material to install two (2) City approved IDC Speedcheck-15 solar powered radar feedback signs on Cassia Road, as well as thermoplastic striping and removals. Radar Feedback systems to include (Exhibit "D"): (2) Foundations 30" x 6' per latest Caltrans (2) IDC Speedcheck-15 Solar Radar Feedback Signs (2) Poles Type 1A-15' (2) Solar Packages, including Batteries and Cabinet Striping package includes (Exhibit "D"): (180 sqft) Removal by water or grinding (4) Thermoplastic "STOP" pavement legend (1) Thermoplastic "KEEP CLEAR" pavement legend (85 ft) Install new Thermoplastic 12" Limit line * Striping package to be performed by Statewide Stripes, Inc. JOB QUOTATION ITEM UNIT DESCRIPTION NO. 1 LS Install two (2) Radar Speedback Signs (IDC Speedcheck 15) Install four (4) "STOP" and one (1) "KEEP CLEAR" thermoplastic pavement legends Install 85 feet of thermoplastic 12" limit line Remove conflicting striping or pavement legend as needed Labor and Material bond is included Traffic Control for all operations is included TOTAL* *Includes taxes, fees, expenses and all other costs. PRICE $34,879 $34,879 Cassia Road Signing and Striping Modifications; Cont. No. 6070 Page 6 of9 City Attorney Approved 9/27/16 EXHIBITC LABOR AND MATERIALS BONO Bond#: 54-213443 Premium: $436.00 PWM19-696TRAN WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to. Cen-Pac Engineering, Inc,, a California corporation (hereinafter designated as the "Prlnolpal"), a Contract for: CASSIA ROAD SIGNING AND STRIPING MODIFICATIONS CONTRACT NO·, 6070 In the City of Carlsbad, In strict conformity with the drawings and specifications, and other Contract Documents now on file In the Offloe of the City Clerk of the City of Carlsbad and all ofwhloh are Incorporated herein by this reference, WHEREAS, Principal has executed or Is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that If Prlnolpal or any of Its subcontractors shall fall to pay for any materials, provisions, provender or other supplies or teams used In, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, CEN•PAC ENGINEERING, INC., a California corporation, as Principal, (hereinafter designated as the "Contractor"), and United Fire and Casualty Company as Surety, are held firmly bound unto the City of Carlsbad In the sum of thlrty-,four thousand eight hundred seventy-nine Dollars ($34,879), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, Jointly and severally, firmly by these. presents, THE CONDITION OF THIS OBLIGATION IS SUCH that If the Contractor or his/her subcontractors fllllf to pay for any materials, provisions, provender, supplies, or teams used In, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Coda section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to tl~e Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, In case suit Is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with Callfornla Civil Code section 9554. This bond shall Inure to the benefit of any of the persons named In California Civil Code section 9100, so as to give a right of action to those persons or their assigns In any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Conlraot, or to the work to be performed hereunder or the specifications accompanying the same shall affect Its obligations on this bond, and It does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications, Cassia Road Signing and Striping Modifications; Cont. No, 6070 Page 7 of 9 City Attorney Approved 9/27/16 CALIFORNIA ALL~ PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other offic~r completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of V..enh V c,.___, On 1jCY'.] IS, l L1 } } 1············f ··~ ·~ "UBY MOFFA : ~... · .. · N1tary l"utlic -California z i O /· V~tura County ~ · . C1mmissi1n # 2219~93 - My C1mm. Exo,res Nov 23. 2021 personally appeared st e \? h,-t.,h-'~ wL_~e:.Yl who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies ), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. · l certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. i············f "UIYMOm, :@· Netary ". ultlic -Cal1f1m,a z 1lj . Ventura Ceunty ~ · . · C1mm,ssi1n # 221'8!3 - My C,mm. Ext<res Nov 23. 2t21 · (Notary Public Seal) . . INSTRUCTIONS FOR COivlPLETING THIS FORM ADD I Tl O NAL Q PTI Q NAL INF Q RMA Tl Q N This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded, should be completed and attached to the document. Acknowledgments · from other states may be completed for documents being sent to that state so long as the wording does not require the California nota,y to violate California notary law. (Title or description of attached document) (Title or description of attached document continued) Number of Pages __ Document Date ___ _ CAPACITY CLAIMED BY THE SIGNER □ Individual (s) □ Corporate Officer (Title) □ Partner(s) □ Attorney-in-Fact □ Trustee(s) □ Other _________ _ 2015 Version www.NotaryClasses.com 800-873-9865 • State and County information inust be the State and County where the document signer( s) per~onaJly appeared before the notary public for acknowledgment. • Date of notarization must be the date that the.signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name a~ it appears within his or her commission followed by a co=a and then your title (notary public). • Print th,e name(s) ·of document signer(s) who personally appear at the time of notarization. 0 Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is /Me) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different aclmowledgment form. • Signature of the notary public must match the ·signature on file with the office of the county clerk. ❖ Additional information is not required but could help to ensure this aclmowledgment is not misused or attached to a different document. ❖ Indicate title or type of attached docUJilent, number of pages and date. ❖ Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. PWM 19-696TRAN In the event that Contractor is an Individual, It Is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond, Executed by CONTRACTOR this ____ _ day of _________ ,, 20_. CONTRACTOR: Cen-Pac Engineering, Inc. By: _____ ~..,._ _____ _ (s' n here) meivi d11ol<S(J(y (print name here) v• CJ< , (print name hare) 'S' e ct~., .+R..--'I (lltle and organization of signatory) Executed by SURETY this _9_th ____ day of _ ....... Ja_n_u.;;;.;ar .. y ______ ,, 20.12._. SURETY: United Fire and Casualty Company (name of Surety) 3880 Atherton Road, Rocklin, CA 95765 (address of Surety) By: Justin Smi name of Attorney-in-Fact) (attach corpora e resolution showing current power of attorney) (Proper notarial acknowledgment of execution by CONTRACTOR and SURETY must be attached,) (President or vice-president and secretary or assistant secretary must sign for corporations. If only one officer signs, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering that offloer to bind the corporation,) APPROVED AS TO FORM: CELIA A. BREWER City Attorney ~ By: ~Af Deputy City Attorney Cassia Road Signing and Striping Modlflcatlons: Cont. No. 6070 Page 8 of 9 City Attorney Approved 9127116 CALIFORNIA NOTARY ACKNOWLEDGMENT For An Individual Acting In His/Her Own Right: A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. # State of California ) ) ss. County of h'-c".SY10 ) On C \ \ \ ct \ 2-D 19 before me, Eve,\~11 Jcmd A \I/ cW E -Z Notary Public, personally appeared \/ 1 CV--.\ V,c,\\r\ \tt'.Y'\ M ac~-sf i1 ---------------------' who proved to me on the basis of satisfactory evidence to be the person,(s) whose name{sj is/are subscribed to the within instrument and acknowledged to me that .hefshe/they executed the same in his/her/their authorized capacity(iest and that by his/her/their signature{s} on the instrument the person(sr, or the entity upon behalf of which the personfs) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal ~/ [NOT ARIAL SEAL] ~ve\~n Joy1t1 Ahct'ff'1-- Print Name ~111111111111111111111111111111111111• • r.•L • : .$!:'";;;;.>~~ EVELYN JANET ALVAREZ : 0:: ;',t;~• COMM. #2248330 Z (J) a,,.;;., NOTARY PUBLIC· CALIFORNIA j ; -~~;l~Q~",►. FRESNOCOI.MY • : My Commlalon ExplnleCJ&l30.'2022 : ~111111111111111111111111111111111111• My commission expires: D\,,, / 3 0 / 10 22 I I HEL6850CA (1/15) ACKNOWLEDGMENT A notary public or other officer completing t11is certificate verifies only the identitl' of the individual who signed the document to which this ce1iificate is attached. and not the truthfulness, accuracy, or validity of that document. State of California County of Fresno on / / 'i }; CJ befoi-e me, Roberta Voss, Notary Public -------'-+,--~,_L_~----- (insert name and title of the officer) pe1-sonally appeared _J_u_s_t_in_S_n_7i_t ______________________ _ who proved to me on the basis of satisf3ctory evidence to be the person(ii;) whose name(lli) is/~'.£ subscribed to the within instr-ument and acknowledged to me that he/zm;<xre,y< executed the same in his/~:?X/Uoo:ix autho1-ized capacity(~) ancl that by his/~X:.<r/x':.iX>i~ signature~) on the instrument the person(~). or the entity upon behalf of which the person~) acted. executed the instrument. I certify under PE~IAL TY OF PERJURY uncler the laws of the State of California that the for·egoing paragraph is true and co1-rect. WITNESS my hand and official seal Sigoature L//du~ (Seal) '·Ym\11 UNITED FIRE &CASUALTY COMPANY, CEDAR RAPIDS, IA UNITED FIRE & fNDEMNITY COMPANY, WEBSTER, TX FINANCIAL PACIFIC INSURANCE COMPANY, ROCKLIN, CA CERTIFIED COPY OF POWER OF ATTORNEY ( original on file at Home Office of Company -See Certification) Inquiries: Surety Department 118 Second Ave SE Cedar Rapids, IA 52401 KNOW ALL PERSONS BY THESE PRESENTS, That United Fire & Casualty Company, a corporation duly organized and existing under the laws of the State of Iowa; United Fire & Indemnity Company, a corporation duly organized and existing under the laws of the State of Texas; and Financial Pacific Insurance Company, a corporation duly organized and existing under the laws of the State of California (herein collectively called the Companies), and having their corporate headquarters in Cedar Rapids, State of Iowa, does make, constitute and appoint JUSTIN SMIT, ROBERTA VOSS, CHRIS GUTILLA, EACH INDIVIDUALLY their true and lawful Attomey(s)-in-Fact with power and authority hereby conferred to sign, seal and execute in its behalf ali lawful bonds, undertakings and other oblig~tory instruments of similar naMe provided that no single obligation shall exceed _ $25,000,000. 00 and to bind the Companies thereby as fully .and to the same extent as if such instruments were signed by the duly authorized officers of the Companies and all of the acts of said Attorney, pursuant to the authority hereby given and hereby ratified and confirmed. The Authority hereby granted shall expire the 13th day of March, 2020 unless sooner revoked by United Fire & Casualty Company, United Fire & Indemnity Company, and Financial Pacific Insurance Company. This Power of Attorney is made and executed pursuant to and by authority of the following bylaw duly adopted on May 15, 2013, by the Bpardsof Directors of United Fire & Casualty Company, United Fire & Indemnity Company, and Financial Pacific Insurance Company. "Article YI -Surety Bonds and llndertakings" Section 2, Appointment of Attorney-in-Fact. "The President or any Vice President, or any other officer of the Companies may, from time to time, appoint by written certificates attorneys-in-fact to act in behalf of the Companies in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any power of attorney or special power of attorney or certification of either authorized hereby; such signature and seal, when so used, being adopted by the Companies as the original signature of such officer and the original _seal of the Companies, to be valid and binding upon the Companies with the same force and effect as though manually affixed. Such attorneys-in-fact, subject to the limitatiom set of forth in their respective certificates of authority shall have full power to bind the Companies by their signature and execution of any such instruments and to attach lhe seal the Companies thereto. The President or any Vice President, the Board of Directors or any other officer of the Companies may at any time revoke all power and authority previously given to any attorney-in-fact. State of Iowa, County of Linn, ss: IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be signed by its vice president and its corporate seal to be hereto affixed this 13th day of March, 2018 UNITED FIRE & CASUALTY COMPANY UNITED FIRE & INDEMNITY COMPANY FINANCIAL PACIFIC INSURANCE COMPANY By: 9-~tf.~ Vice President On 13th day of March, 2018, before me personally came Dennis J. Richmann to me known, who being by me duly sworn, did depose and say; that he resides in Cedar Rapids, State of Iowa; that he is a Vice President of United Fire & Casualty Company, a Vice President of United Fire & Indemnity Company, and a Vice President of Financial Pacific Insurance Company the corporations described in and which executed the above ll}strument; that he knows the seal of said corporations; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporations and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporations. ~'!Jo•l._ PattiWaddell ~ ~• .. f~~ ~~~ ~~-• r Commission nu~r 713274 ~ Notary Public ~ My Commission Expires 10126/2019 · M ·_ · _ · l0/26/?0!9 . y COIDffilSS!Oll expires: . . - I, Mary A. Bertsch, Assistant Secretary of United Fire & Casualty Company and Assistant Secretary of United Fire & Indemnity Company, and Assistant Secretary of Financial Pacific Insurance Company, do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Section of the bylaws and resolutions of said Corporations as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID CORPORATIONS, and that the same are correct trdllsaips thereof, and of the whole of the said originals, and that 1he said Power of Attorney has not been revoked and is now in full force and effe-::t. In testimo_ ?hereof I have her~a.to subscribed• y name and aff.iJ<ed thr c0rpor:.t.e seal of the said Corporations this 'f ~ day of 4-n--V .ic~ ___ , 20...J_J_. BPOA0045 122017 By:~A~ Assistant Secretary, UF&C & UF&I & FPIC This paper has a colored background and void pantograph. Cassia Road Signing and Striping Modifications; Cont. No. 6070 EXHIBIT "D" Page 9of9 PWM19-696TRAN L 24" [~}-LE RJ-2cf RKrlfJD} MOll0'£M.E SJGNING WORK TO BE DONE: OJ = = s: ~~ Nil lll17AA POSt REPMI 0 IIEU()\( ElilSIN, SUI l<S IDCATID. l'llS1N; l'05T Nil '91Aih11G SIGIIS1111'BI.IMll1'UIIL (D NSfMI. 1£11 SUI l<S IDCAl!D ~ ElllS1ING 1'05T. El ~ ~ ~ ~ ~ ~ Pa.E PIJl Coll.llWIS SlRIPING WORK TO BE DONE: ® 1191)\[ £11S111c: r -oan ® IIIMOIEOISIK<UflHICIM, flDll£~llll.lO!OiS. @ RSIO\E £lilS1K aHIJC!Nl SliFINC CR PA\OEIIT L££OII _flY - @ PAIIT HEW 6' HIE II([ I.Ill£ IJ£ Pill Coll.llWIS DETAI. 39. €5) PAIIT ID Ii" IIQllll lKlE II([ I.Ill£ ti£ Pfll CALll<ANS DETAI. JIA. @ 1191)\[ 1111) P.IIIIT 8Y GlllllM:. @ IISIMI. ID °SW PA\flEIT 1BOO (llEllltflAS11C)- @ NSfMl. ID 12" 11n: lllT LIE (HJ!IIJUSne~ g Cl:: ti :s :::e _, ~ 0 20 0 I --,· • 20' RE\1S10N~ON 20 40 I GRAPHIC SCAl.E PRO.CCT HO. 6070 DRAWING NO. 513-2 I' I i ~I ' t 20 0 20 40 ----1· • 2<:f L SIGNING WORK TO BE DONE: [D :r: 3: =,e 11CJ lllflPAA l'OSI. llfPMt [I) IIDIO\f: DIS1IIC SQI AS NICl.l!D. DIS1IIC POST Nil -9CNS ro 1llWt N l'Ul:f. 0 l<STMI. IO 9Qt AS NICI.D <JI D1S111C POST. [D ~~~.=,~~Pa.[ Pl!! CM.TRNiS STRIPING WORK TO BE DONE: © IIIJIO',{OOSKr-OCll:S. ® lilJIO',£ DIIS1Nl CIW>-OOII\ f\.DII£ BASE OII.KAllltS. @ IIDIM DISK allflJC1Nl SIRl'IS at PAIOEIT L!1l!ill BY- @ PAIIT ID .. IK1E III LIi£ LI£ Pl!! CM.lRAIIS Drul. lO. s PAIIT JO r IIAallll llf1E a<E LN£ LI£ Pl!! C1t.1RN1S COAL JOA. @ IIDIMJE>PAIITBTCHIDIG. @ IIIStlU. IO 'm' PAIOEIT lROI> ~ @ 111St1U. JO IT 1K1E LIii LI£ (HRIDUs1lc~ @ IGIMI. JO 'llUP Q£Nt" PA\fl1111 lllDID {HJllaPIAsnc). r±-7,, ~ 2 RM ""!ED" Nil 1!1-:d' t;: i DIST. 112--1 (35) L.:i I -::;;;~:::::_:::::_:::::_:::::_:::::_=_:::::_:::::_=_:_:_:_:_=:_:_:_:_:_:_:=_~~!__~~~-~=-~r-~~~=:1:.=:.~=~~c'5--~:;=-::~":--i¥=-~ -~-?:-?:lt2'~~~-+I ~Ii -=--l!!!t• --~----~ I ,!; Q;) CASSIA ROAD l§f{<;A.N!IIIP) NOf lD SCM.£ ==,;;====,"s=:/===j ~ ------''='------! (/j i..; -....--.:,.----=-------t ~. ::c ~ ~ I-illU{CA.l«llflll) ::C I W'l°'lW"ACalll.E ~ r--------------''--------'..------+------~ ~ --------0. ~I===============~==============, ~ q .21' (/j r----------------------:::--:-::c=-:--:::-=;-.,-------..:~ i..; q CASSIA ROAD ~~----------~---------------------- --- ::er---------------------------------f:2 ~ I/J//IJ/ 20 0 20 40 ----,. -Zif t==j===+=======================t==~===+==~~==l ~' SH:::4:::m~l l::::::~~~1TY~o~~==c::=~::=R=~=s-=BAD==~l l=SH=~=· =,II ~===~==~========================~~==:t===+===r===1, .. -~D S1RfPlj() PUN ftXl: l1 CASSIA ROAD . I l-1-==t==t===================1~==1~==1===1===1 ~===~:;;;:;;=======;::::;·11 I-IIAGWJ. L PUlllZ I ' I 1--1-==t::==t::===================1~==1~==1===1===1 ~ /(. 1-t,f-, ,)l{I, ' f-::::.=1t-::::-=ti=-:::::::::::::::::::::::::::::::::::::::::::::::!;::::~::::::t::::::t ::::~ lRAIISPQm!IQt IRC10! 7--il<t 4mO IJP. J/Jiffe D,\1[' .. DVIN BY: ,I( PRo.£CT NO. II DRAMNC NO.: 1· 1-c-.. ::,.+....._=+----Rt\llSIQI--DESQUP--110H----1r= .... ¥,.:--:1-:....._~f;:f°~ .. t•fl::--~".'=i~ ~ :; EE 6070 . _ s13-2 . £JlmrUJt r, .,.. na ,,,,tc,flt. arr """"""- L ..----------------------~---------------------------1,0 NOr TC SCAI.E CITY OF OCEANSIDE PACIFlC OCEAN IMPROVEMENT PLANS FOR CASSIA ROAD SIGNING AND STRIPING MODIFICATIONS PROJECT NO. 6070 . CITY Of VISTA l-·-··1 .. r .,..J CITY OF CARLSBAD CARLSBAD, CALIFORNIA CITY COUNCIL MA TT HALL -MAYOR KETIH BLACKBURN -MAYOR PRO-TEM MARK PACKARD -COUNCIL MEMBER CORI SCHUMACHER -COUNCIL MEMBER MICHAEL SCHUMACHER -COUNCIL MEMBER SCOTT CHADWICK -CITY MANAGER GENERAL NOTES 1. 11£ C0N1RACTl)R IS ~ fOR AU. SIGNIIO AHO STRIPING. 2. same, S1RIPHl »cm PA\OIEHT IIARKIICS SHAU CXfft>lll TO lHE c.<U'ORIIA MANUAL OH lJl,FCfUI l1WFlC 0£\11CES (LATEST \9!SION) ANO THE CAI.TRANS Sf>J«JARO SPEaFICAllOHS (lAlEST \'£RSION) AND THESC Pl.ANS. 3. AU. 5IGNIIG ANO 51IW'INC IS ~ TO THE APA!OYAI. Of 11£ TRAHSPORTAllOH OIRECTal OR IIS REn£5ENTATl'IE PIIIOft TO l<SfAU.AT1011. 4-ANY 0£\11A 1lOII fRQ,I 1HES£ SlCNINO NIil ~ PUNS SHAU BE APf>R<MJl BY 11£ 1RAHSPORTA 11CII D<IIECTOR PIIIOft TO Nff OIAN<£ I< THE FIElJ). 5. AU. Slct.'INC AND STRJPINC SHAU. BE REfl.ECTI\IE PER CAI.TRANS SPECIFICATIONS. STl!IPJNG SHALi. BE REPAINTED TWO YED<S -'"ER HTIM. PAl<TIHG. a. AU. 5IGNACE SHAU BE REfl.ECTM: PER AS1M 0£SICHA11CII D495e N10 SHAU US( TIP£ IV PRISMATIC Rm£Cll\lE SHEE11NC (l..:H am:NSITY PAISMAllC OR EQUAi.) UNlLSS OTH!RWISE SPECFED. R1-1 "STOP", R1-2 °ml)". R2-1 "SPEED Lllllr ANO STREIT IWol: SlGNS SHAU USE rtPE IX PRISMATIC OJBE--cORNER REfl.ECll\lE SNE[T1NC (OWIOHD CRADE VP OR EQUJ,IJ. 7. PIIIOR TO flHAI. ACaPTAHCE OF S"TREET IMPROIOIDITS. AU. STREIT STRIPINC A>Cl lolARKl<CS WMN A 500' PfJtlME1ER OF THE CONSTRUCllCII PRO.ECT 01! OTHERWISE SPEClf1EI) IIIU. BE ~!D TO A "LJl<E NEW" CON011l011. I< A MANNER llfETlNG Tl£ N'PROVJ.L. OF Tl£ QTY INSl'ECTOR. a. EXACT L0CA 110H Of S,-,.C AH0 UWIT UNES SHAU BE APf>RCMD SY 11£ TRANSPOIITA 110N OIRD:TOR OR IIS REPRESOITATl'IE P1IIOR TO IIISTAU.ATK»t. II. CONTRACTOR SHAU ROIO\'E AU. CONFUCTINC PAINTED LINE$. IIARDIGS AND PA>tMDIT LEc:o«>S BY -Q. DEBRIS SHAU BE PROIIPTL Y MMCMD BT 11£ CCNTRACTIR 10. AU. PA-.olEHT l,£l;OIDS SHAU. BE Tl£ IA TEST \'ERSOH Of THE CAL TRANS METRIC STENa.S. 11. UIIT UNES NIIJ CROSSWAU<S SHAU BE f1ElD LOCAlm. CROSSWAU<S SHAU HA\IE 10' IISIDE Dl4DISIOH IK£SS OTHER'MSE SP£CF1ED. 12. AU. CROSSWAU<S, UMIT LINES, S1tf> BARS. PA\IEMEHT ARRO\\S AND PAIIEMENT LEC£NDS SHAU BE THERMOPl-'S11C UNLESS OTHERWISE SPECFIED. 13. Sl2E OF SGNS SHAU CORRESP0ND TO Tl£ SIGN Sl2E fOR CON\IEN110NJ.L. ROM>S AS 5NOOII IN 11£ FHWA STNIOARD HIGHWAY SlGNS (IATEST \IERSlON) UH1LSS DTH!R'MSE SP£CF1ED, 14. Sl<lN POSTS SHAU BE SQUARE PIJlfORATED STEEL TUIIIIG WITH BREAl(AWAY BASE PER SAN DECO RmONAI. SUNDARD ORAWIIG - 1!5. WHEN A SIGN IS ATTACHED TO A POU:. IT SiiAU. BE MOUNTED USING A STANDARll QTY =TINc 8RAQ([T 'M1H STRAPS. IS. ElOSTING SGNS THAT /,11£. RD.t(MI) SiiAU. 8EC(lME Tl£ PllOPERTY OF 11£ CXllfTRACTOR. 17. AU. SIGHS SHO"" OH lHCiE Pl.AH$ SHAU. 8E HEW SIGHS f'ROWlED SY AND l<STAU£1) BY TIC camtAC1tlR EXCE'T THOSE SIQIS Sl'£Clf1CAU.T -AS DISTINC TO BE REl.OCAT[I) OR lO RGIAIH, 1a. SP£ID FEIDBAO< SIGHS SHAU. 8E <W.NQ£Ml.E WESSM)[ S<lHS lllAT lllSPlAT TO APPROACHNG DRIVERS "THf: SP£ID AT WHICH Tl£T AA£ 1RA\IELINC. THE SP£ID FmlBAO< SlCN 5NALL BE 50lAR-POl\£RED NIO FEAl\JRE 15" AIIIIER CIGITS VTH TH£ AIIIUTY TO DISPIAY TIC WESSA0E "SI.CW OOMI". THE SlQI FACE Of 11£ SPEED flED8AQ( SIGN SHAU. BE fWORESa>IT "IW.0W <iREEN NIIJ IIA\IE 11£ 1llCT "YOUR SPEED" I< II.ACK MJOVE. Tl£ lllSPlAY. AN R2-1 (35) SPEED UIIT SCN SHAU. BE INSTAU.ED ,,__ THE fEEil8AQ( SlGN. THE SPEED ftIDBAO< SlGN SHAU. BE SPEEDQ£Q( SC-15 OR APPROVED EQUAL EXACT LOCATIOHS SHAU. BE APPRO\IED BY THE TRANSPORTATIOH DIRECTOII OR lfS REPR£SDITAT1\IE PRIOR TO l<STJ.L.IAllON. , I I ' VICINITY MAP ELAINE LUKEY -PUBLIC WORKS DIRECTOR ~I-=--=::-!-==--=:::+-==--==--==--==--==--==--==--==--==--==--==--=::t--==--i:::=--==-+i=--=~:~=--I=: ITJ I ~ ~~1&~~ I~ t=t==t============t=:!=t:~1--S-,0 -nllt I 1---+--+-----------+--+--+--t---t CASSIA ROAD t==t==t:===========~~==1==1~,·-ll#tlllMJ.LIUNlZ , 1• t==t:=j==================~~=j==:t==:t=::j '1>W,JJJI/ "· ltlh ,1,p, ~--1--+------------+---+--+---l~--t 1ii.iiisPoltuili1RC11R7,itt allO OP. 3/Jl/211 IIAJ!: 1-_~ .. =,.-+cc:"""=------RNSIQj--DESCRl'--1lOll----~...,.§ .. ~"'1-~1-~~t-:c:.~-=-:=-:4_r-="= .... = ... :::il~~ ~ II ~~0 ~ 11 ~:t I I L I _______ _;,___ _____________________________ ___,' n ~ I r--;z:: 0 Dl5t. IH W1~1P(15) -----------------~ -Q: u ~ ~ .... ~ ElOSl. 112-1(l5) 1'20/bl CASSIA ROAD ~. AUING 4 W& NCPflPI ll>TlOSCAI! r:it:t ~ Bl-:?JtOPUP> IIOT 10 SC,U: / ~ 0 20 ~ ,. -20' GRAPHIC SCAl£ ~ .s SIGNING WORK TO BE DONE: ~ [j] IDOi£ EllS1IC Sia! ;s IIOCAIED NIJ llWP/11 l'OS!. RIJ>M! ~ AffM.T UF/4 ;s IEESSIR'(, ~ IT) lfWI( EllS1IC Sia! ;s IIOCA& EllSK POST Nil IIDl.ltlNG r £' 91>1S10RDI.Ollltl'Ua. : i C, [j INSTNJ. ID SOI ;s HllCAllD 011 E»S1IIG POST. : ! f ' t I STRIPING WORK IO BE DONE: 1 1 I! © -lllS1II; t' a:RAIIC _,. ® IDO\£DOS11C llJID-IIOl\fUX8.! IWEll!IKAla!S. ® llll!M: lllSlltC IXNUCH S1ll'ltC al PAIEIEII lmJI) BY IINlllC. ® PMIT ID r IH1E Ill<( 1M IJE l'lll CM.'IIWIS DET.11. JO. 8 PMIT ID J' Rl<BI WflE E l,IIE UiC 1!R CM.'R.IHS lflM. ltA. @ IIIIIOYEllllP-BY.-.C. @ INSTIii. ID 's1tP" PA\IIEIT lmll) (Hllal,lm:). © IISTALI. ID 12' 1111[ 111T 1K ~ '11':4 C f ~ . Ii < ,~ "!,, i.j ·--..~ CASSIA ROAD "!,, .. ::i:: f:2 1IWH'IIWnCcaa.E ~ lOIBIIM ~ ~ 20 20 "' ~-~ I SHEET 11 CITY OF CARLSBAD I'~ 2 PU8UC ~S 0£PARNENT ~ ,--.--2Jf -= 1--~~~ I CASSIA ROAD ,t,W,IJQ/,( "· s[,h 1-MAl9WL ~ ~ I -.-r,n iiiii.1/?-,... •mo E»'. 3/Jii'io J! ID">N 11'1\ ,I( II ~~ ~ II MAMHO N~ I .,.,. ,,_ RE\ISION DESCRIPllOH Do\lE ...,.._ .. ,. ....._ ~ ~ EE 6070 613-2 flD'C!1' r, ._ ona •~~ cm" Jll'MtNN.. ii --1· ~-..... - CEN-ENG-01 SSLATER ACORD' CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 12/05/2018 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer ri!::ihts to the certificate holder in lieu of such endorsement(s). PRODUCER License# OE02096 CONTACT NAME: DiBuduo & DeFendis Insurance Brokers, LLC rt8.Nr;o, Ext): (559) 432-0222 I rie~. No):(559) 431-7941 P.O. Box 5479 E-MAIL Fresno, CA 93755-5479 ADDRESS: INSURERISI AFFORDING COVERAGE NAIC# INSURER A : Llovds of London INSURED Cen-Pac Engineering, Inc. INSURER B: Nationwide Mutual Insurance Comoanv 23787 Cen-Pac Engineering, Inc. INSURER c: Endurance Risk Solutions Assurance Company C/0 Vicki Madsen INSURER D: Insurance Companv of the West 27847 1467 W. Shaw Avenue INSURER E: Westchester Surolus Lines Ins. Co. Fresno, CA 93711 INSURER F: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER .f.~LICY EFF POLICY EXP LIMITS I TR •••en >An,n A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ~ D CLAIMS-MADE [K] OCCUR X X GLL1062700 11/29/2018 11/29/2019 DAMAGE TO RENTED 100,000 PREMISE'-IEa occurrence\ $ MED EXP (Anv one oerson) $ 5,000 ~ PERSONAL & ADV INJURY $ 1,000,000 ~ ~'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY □ m~T □ LOC PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 /Ea accident\ $ X ANY AUTO X X ACP3008876980 06/26/2018 06/26/2019 BODILY INJURY (Per person) $ ~ OWNED ~ SCHEDULED ~ AUTOS ONLY ~ AUTOS BODILY INJURY (Per accident\ $ HIRED ~Sfo~"mt~ /P~?~tc~dii1?AMAGE $ ~ AUTOS ONLY ~ $ C X UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE X X EXC30000870000 11/29/2018 11/29/2019 AGGREGATE $ / OED I I RETENTION$ $ 5,000,000 D WORKERS COMPENSATION XI t\%1JTE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N X WSA504468600 11/29/2018 11/29/2019 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE [Y] E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA 1,000,000 (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ B Commercial Auto ACP3008876980 06/26/2018 06/26/2019 Rented&Leased Equip 100,000 E Pollution Liability G7146684A001 12/03/2018 12/03/2019 Per Occurence 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Where required under written contract or agreement Certificate Holder is named Additional Insured with respect to General Liability per blanket policy form CG20380413, with respect to Auto Liability per attached blanket policy form AC70040316 and with respect to Pollution Liability per attached blanket policy form ENV31000804. Primary & Non-Contributory Wording applies with regard to Auto Liability per attached blanket policy form AC70040316, General Liability per blanket policy form CG20010413, Excess Liability per blanket policy form EXL 13510817 and with respect to Pollution Liability per attached blanket policy form ENV31010804. SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad/CMWD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. c/o EXIGIS Insurance Compliance Services P.O. Box 4668 -ECM #35050 New York, NY 10163-4668 AUTHORIZED REPRESENTATIVE ~ I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CEN-ENG-01 SSLATER -------------------LO C #: 1 -------- ADDITIONAL REMARKS SCHEDULE AGENCY License # 0E02096 DiBuduo & DeFendis Insurance Brokers, LLC POLICY NUMBER SEE PAGE 1 CARRIER I NAIC CODE SEE PAGE 1 SEEP 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: NAMED INSURED Gen-Pac Engineering, Inc. Gen-Pac Engineering, Inc. C/O Vicki Madsen 1467 W. Shaw Avenue Fresno, CA 93711 EFFECTIVE DATE: SEE PAGE 1 Page 1 of 1 Waiver of Subrogation applies with respect to Auto Liability per attached blanket policy form AC70040316, with respect to General Liability per blanket policy form CG24040509, with respect to Excess Liability per blanket policy form EXL60920813, with respect to Employers Liability per attached blanket policy form WC9906340800 and with respect to Pollution Liability per attached blanket policy form ENV31430305. 30-day advanced Notice of Cancellation applies to General Liability policy form to follow, to Auto Liability policy form IL7002, to Pollution Liability policy form to follow. DiBuduo & DeFendis agrees to provide 30 day advanced Notice of Cancellation in regards to the Employers Liability policy. (DiBuduo & Defendis also agrees to E-mail all 30 day notices to: support@exigis.com). {This certificate cancels and supersedes previous certificate issued 12/03/18} ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO AC 70 04 0316 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO PROTECTION -PLUS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A. Effect of This Endorsement B. Temporary Substitute Autos-Physical Damage Coverage C. Employees as Insureds-Nonowned Autos D. Additional Insured by Contract, Permit or Agreement E. Prejudgment Interest Coverage F. Personal Effects and Property of Others Extension G. Expanded Towing Coverage H. Expanded Transortation Expense I. Extra Expense -Stolen Autos J. Emergency Lockout K. Transfer Of Rights Of Recovery Against Others To Us L. Section IV -Business Auto Conditions -Notice of Knowledge of Occurrence AC 70 04 0316 ACP BA 30-0-8876980 Includes copyrighted material of Insurance Services Office, Inc. with its permission L570 18177 INSURED COPY AC7004031600 0001 Page 1 of 3 47 0008723 AC 70 04 0316 A. EFFECT OF THIS ENDORSEMENT Coverage provided under this policy is modified by the provisions of this endorsement. If there is any conflict between the provisions of this endorsement and the provision(s) of any state- specific endorsement also attached to this poli- cy, then the provision(s) of the state-specific endorsement shall apply instead of the provi- sions of this endorsement that are in conflict, but only to the extent of the conflict, and only to the extent necessary to bring such provisions into conformance with the state requirement(s) contained in the provision(s) of the state-specific endorsement. 8. TEMPORARY SUBSTITUTE AUTOS PHYSICAL DAMAGE COVERAGE The following is added to paragraph C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos of the -COVERED AUTOS SECTION: If Physical Damage Coverage is provided by this Coverage Form, the following types of vehicles are also covered "autos" for Physi- cal Damage Coverage: Any "auto" you do not own while used with the permission of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repair; c. Servicing; d. "Loss"; or e. Destruction The coverage that applies is the same as the coverage provided for the vehicle being replaced. C. EMPLOYEES AS INSUREDS -NONOWNED AUTOS The following is added to paragraph A.1. Who Is An Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE: d. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your per- sonal affairs. D. ADDITIONAL INSURED BY CONTRACT, PERMIT OR AGREEMENT The following is added to A.1. Who Is An Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any person or organization that you are required to name as an additional insured in a written contract or agreement that is executed or signed by you prior to a "bodily injury" or "property damage" occurrence is an "insured" for Covered Autos Liability Coverage. However, with respect to covered "autos", such person or organization is an insured only to the extent that person or organization qualifies as an "insured" under A.1. Who is an Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE. If specifically required by the written contract or agreement referenced in the paragraph above, any coverage provided by this en- dorsement to an additional insured shall be primary and any other valid and collectible insurance available to the additional insured shall be non-contributory with this insurance. If the written contract does not require this cov- erage to be primary and the additional in- sured's coverage to be non-contributory, then this insurance will be excess over any other val- id and collectible insurance available to the ad- ditional insured. E. PREJUDGMENT INTEREST COVERAGE The following paragraph is added to SECTION II -COVERED AUTOS LIABILITY COVERAGE, Supplementary Payments under item: (7) Prejudgment interest awarded against the "insured" on that part of the judgment we pay. If we make an offer to pay the appli- cable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. F. PERSONAL EFFECTS AND PROPERTY OF OTHERS EXTENSION 1. The. Care, Custody or Control Exclusion of the SECTION II -COVERED AUTOS LIABILITY COVERAGE, does not apply to "property damage" to property, other than your property, up to an amount not exceed- ing $250 in any one "accident". Coverage is excess over any other valid and collectible insurance. 2. The following paragraph is added to. Cover- age Extensions of SECTION Ill - PHYSICAL DAMAGE COVERAGE: c. We will pay up to $500 for your property that is lost or damaged as a result of a covered "loss", without applying a de- ductible. Coverage is excess over any other valid and collectible insurance. G. EXPANDED TOWING COVERAGE 1. We will pay up to: a. $100 for a covered "auto" you own of the private passenger type, or Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc. AC 70 04 0316 with its permission ACP BA 30-0-8876980 L570 18177 INSURED COPY AC7004031600 0001 47 0008724 b. $250 for a covered "auto" you own that is not of the private passenger type, for towing and labor costs incurred each time the covered "auto" is disabled. However, the labor must be performed at the place of disablement. 2. This coverage applies only for an "auto" covered on this policy for Comprehensive or Specified Causes of Loss Coverage and Collision Coverages. 3. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". H. EXPANDED TRANSPORTATION EXPENSE Paragraph A.4.a. of SECTION Ill -PHYSICAL DAMAGE COVERAGE SECTION is replaced by the following: We will pay up to $50 per day to a maximum of $1000 for temporary transportation expense in- curred by you because of the total theft of a covered "auto" of the private passenger type. We will only pay for those covered "autos" for which you carry Comprehensive or Specified Causes of Loss Coverage. We will pay for tem- porary 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" I. EXTRA EXPENSE -STOLEN AUTOS The following paragraph is added to Coverage Extensions. of SECTION Ill -PHYSICAL DAMAGE COVERAGE: c. We will pay for up to $5,000 for the expense of returning a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Spec- ified Causes of Loss Coverage J. EMERGENCY LOCKOUT PRIVATE PASSENGER VEHICLES We will reimburse you up to $75 for reasonable expense incurred for the services of a locksmith to gain entry into your covered "auto" of the pri- vate passenger type subject to these provisions: 1. Your door key or key entry pad has been lost, stolen or locked in your covered "auto" and you are unable to enter such "auto" , or 2. Your key or key entry pad has been lost AC 70 04 0316 or stolen and you have changed the lock to prevent an unauthorized entry; and 3. Original copies of receipts for services of a locksmith must be provided before reimbursement is payable. K. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: We waive any right of recovery we may have against any person or organization to the extent required of you by a written con- tract executed prior to any "accident" be- cause of payments we make for damages under this coverage form. L. NOTICE OF AND KNOWLEDGE OF OCCURRENCE SECTION IV BUSINESS AUTO CONDITIONS, Paragraph A is amended as follows: 6. NOTICE OF AND KNOWLEDGE OF OCCURRENCE a. Your obligation in the Duties in the Event of Accident, Claim, Suit or Loss Condi- tion relative to notification require- ments applies only when the "accident" or "loss" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company;or (4) An executive officer or insurance manager, if you are a corporation. b. Your obligation in the. Duties in the Event of Accident, Claim, Suit or Loss Condition relative to providing us with documents concerning a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. AC 70 04 0316 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 3 of 3 ACP BA 30-0-8876980 L570 18177 INSURED COPY AC7004031600 0001 47 0008725 Policy #GLL 1062700 COMMERCIAL GENERAL LIABILITY CG 20 38 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS-AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 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. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 38 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 38 0413 Policy # GLL 1062700 COMMERCIAL GENERAL LIABILITY CG 20 34 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. ADDITIONAL INSURED -LESSOR OF LEASED EQUIPMENT-AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only 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). However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. B. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc. Policy # GLL 1062700 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc. POLICY NUMBER: GLL 1062700 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 □ Policy #EXC30000870000 THIS ENUORSl<:ME'.'IT CHANGES THE POLICY, PLEASE REAU IT CAREFULLY. PRIMARY NON-CONTRIBUTORY ENDORSEMENT The Other Insurance Condition is amended to include the following additional provision: When required by written contract or agreement, the insurance provided by this policy is pnmary insurance and we will not seek contribution from any other insurance available to the person or organization covered as additional insured hereunder unless the other insurance is provided by a contractor, other than you, for the same operations and job location. This endorsement does not change any other provision of the policy. Endurance American Insurance Company Page I of I EXL 1351 0817 Policy #EXC30000870000 WAIVER OF SUBROGATION THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. We agree to waive our right of subrogation against any person or organization to whom or to which you are obligated, prior to any loss, by an "insured contract" to provide such a waiver, but only with respect to "your work", "your product" or facilities owned or used by you. This endorsement does not change any other provision of the policy. Endurance American Insurance Company Page I of I EXL 6092 0813 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET WC 990634 (Ed. 8-00) 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). The additional premium for this endorsement shall be 3 % of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization ANY PERSON/ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT Job Description ALL CALIFORNIA OPERATIONS 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 11/29/2018 Policy No. WSA 5 0 4 4 6 8 6 0 0 Insured CEN-PAC ENGINEERING INC Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 990634 (Ed. 8-00) INSURED Endorsement No. Premium $ INCL. -------------- Named Insured Endorsement Number Cen-Pac Engineering, Inc Policy Symbol I Policy Number I Policy Period Effective Date of Endorsement CPW G7146684A 001 12/03/2018 to 12/03/2019 12/03/2018 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II -WHO IS AN INSURED is amended to include as an insured the person or organizat[on shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions 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 site 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. ENV-3100 (08-04) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 Named Insured Endorsement Number Cen-Pac Engineering, Inc Policy Symbol I Policy Number I Policy Period Effective Date of Endorsement CPW G7146684A 001 12/03/2018 to 12/03/2019 12/03/2018 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT-OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NON-CONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION II -WHO IS AN INSURED is amended to include: A. SECTION II -WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions 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 site 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. C. The coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. ENV-3101 (08-04) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 Named Insured Endorsement Number Cen-Pac Engineering, Inc Policy Symbol I Policy Number I Policy Period Effective Date of Endorsement CPW G7146684A 001 12/03/2018 to 12/03/2019 12/03/2018 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. 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 PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. ENV-3143 (03-05) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 Lloyd's -Company Profile -Best's Credit Rating Center Lloyd's A.M. Best #: 085202 Domiciliary Address One Lime Street London EC3M 7HA, United Kingdom Web: www.lloyds.com Phone: 44-207-327-1000 Fax: 44-207-327-5211 AIIN #: AA1122000 Best's Credit Ratings Financial Strength Rating View Definition Rating: A (Excellent) Financial Size Category: XV ($2 Bi llion or greater) Outlook: Stable Action: Effective Date: Initial Rating Date: Affirmed July 12, 2018 October 01, 1997 Long-Term Issuer Credit Rating View Definition Long-Term: Outlook: Action: Effective Date: a+ Stable Affirmed July 12, 2018 Page I of 5 Fi....ciaj ......... !feting ~ A E!lrcallllnt Assigned to insurance companies that have, in our opinion, an excellent ability to meet their ongoing insurance obligations. View additional news, reports and products for this company. http://ratings.ambest.com/CompanyProfile.aspx?ambnum=85202&URatingld=2503 l I 2&b... 12/5/20 18 Lloyd's -Company Profile -Best's Credit Rating Center Initial Rating Date: August 12, 2004 u Denotes Under Review Best's Rating AMB Rating Unit Note: This data record represents an AMB Rating Unit and the following Best's Credit Ratings are based on the consolidated financials assigned to this record. Page 2 of 5 AMB# 078649 095926 Company Name Best's FSR Best's ICR Lloyd's Insurance Company (China) Ltd Lloyd's Insurance Company S.A. Best's Credit Rating Analyst Rating Issued by: AM. Best Europe -Rating Services Ltd. Director-Analytics: Mathilde Jakobsen Senior Director-Analytics: Catherine Thomas Disclosure Information Disclosure Information Form View AM. Best's Rating Disclosure Form Press Release A A a+ a+ AM. Best Assigns Credit Ratings to Lloyd's Insurance Company S.A.; Affirms Credit Ratings of Lloyd's July 12, 2018 Rating History AM. Best has provided ratings & analysis on this company since 1997. Financial Strength Rating http://ratings.ambest.com/CompanyProfile.aspx?ambnum=85202&URatingld=2503 l l 2&b... 12/5/2018 Lloyd's -Company Profile -Best's Credit Rating Center Effective DateRating 7/12/2018 A 7/20/2017 A 7/21/2016 A 7/22/2015 A 7/24/2014 A 7/19/2013 A Long-Term Issuer Credit Rating Effective DateRating 7/12/2018 a+ 7/20/2017 a+ 7/21/2016 a+ 7/22/2015 a+ 7/24/2014 a+ 7/19/2013 a+ Related Financial and Analytical Data The following links provide access to related data records that A.M. Best utilizes to provide financial and analytical data on a consolidated or branch basis. AMB # Company Name Company Description 087100 Lloyds Underwriters Represents the Property/Casualty financials for the Canada CAB Branch of this legal entity. Best's Credit Reports Page 3 of 5 ,;I.;;:;;.. Best's Credit Report -Where applicable, includes Best's Financial Strength Rating and \ ' ' r rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 8/3/2018 (represents the latest significant change). 1l.;;:;;.. Historical Reports are available in Best's Credit Report Archive. \ t" http://ratings.ambest.com/CompanyProfile.aspx?ambnum=85202&URatingid=2503 l l 2&b... 12/5/2018 Lloyd's -Company Profile -Best's Credit Rating Center View additional news, reports and products for this company. Press Releases A.M. Best Revises Outlooks to Negative for Labuan Reinsurance (L) Ltd A.M. Best Assigns Credit Ratings to Folgate Insurance Company Limited A.M. Best Affirms Credit Ratings of Ascot Reinsurance Company Limited A.M. Best Affirms Credit Ratings of Armour Secure Insurance S.A. de C.V. A.M. Best Affirms Credit Ratings of Members of ProSight Specialty Group A.M. Best Affirms Credit Ratings of Lloyd's Syndicate 2010 A.M. Best Affirms Credit Ratings of Lloyd's Syndicate 33 A.M. Best Affirms Credit Ratings of Lloyd's Syndicate SlO Page 4 of 5 Nov 29, 2018 Nov 21, 2018 Nov 09, 2018 Nov 02, 2018 Nov 01, 2018 Sep 21, 2018 Sep 21, 2018 Sep 21, 2018 Sep 14, 2018 A.M. Best Comments on Credit Ratings of The Hanover Insurance Group, Inc. Following Announced Sale of Certain lnt'I Subs. Sep 07, 2018 A.M. Best Affirms Credit Ratings of Lloyd's Syndicate 2001 1 2 3 4 5 6 7 8 9 10 ... Page size: 10 Find a Best's Credit Rating Enter a Company Name Advanced Search European Union Disclosures How to Get a Best's Credit Rating Best's Credit Ratings @ Mobile App 175 items in 18 pages A.M. Best -Europe Rating Services Limited (AMBERS), a subsidiary of A.M. Best Rating Services, Inc., is an External Credit Assessment Institution (ECAI) in the European Union (EU). Therefore, Credit Ratings issued and endorsed by AMBERS may be used for regulatory purposes in the EU as per Directive 2006/48/EC. A.M. Best (EU) Rating Services B.V. (AMB-EU), a subsidiary of A.M. Best Rating Services, Inc., is an External Credit Assessment (ECAI) in the EU. Therefore, credit ratings issued and endorsed by AMB-EU may be used for regulatory purposes in the EU as per Directive 2006/48/EC. http://ratings.ambest.com/CompanyProfile.aspx?ambnum=85202&URatingld=2503 l l 2&b... 12/5/2018 Lloyd's -Company Profile -Best's Credit Rating Center Page 5 of 5 Australian Disclosures A.M. Best Asia-Pacific Limited (AMBAP), Australian Registered Body Number (ARBN No.150375287), is a limited liability company incorporated and domiciled in Hong Kong. AMBAP is a wholesale Australian Financial Services (AFS) Licence holder (AFS No. 411055) under the Corporations Act 2001. Credit ratings emanating from AMBAP are not intended for and must not be distributed to any person in Australia other than a wholesale client as defined in Chapter 7 of the Corporations Act. AMBAP does not authorize its Credit Ratings to be disseminated by a third-party in a manner that could reasonably be regarded as being intended to influence a retail client in making a decision in relation to a particular product or class of financial product. AMBAP Credit Ratings are intended for wholesale clients only, as defined. Credit Ratings determined and disseminated by AMBAP are the opinion of AMBAP only and not any specific credit analyst. AMBAP Credit Ratings are statements of opinion and not statements of fact. They are not recommendations to buy, hold or sell any securities or any other form of financial product, including insurance policies and are not a recommendation to be used to make investment /purchasing decisions. Important Notice: A.M. Best's Credit Ratings are independent and objective opinions, not statements of fact. A.M. Best is not an Investment Advisor, does not offer investment advice of any kind, nor does the company or its Ratings Analysts offer any form of structuring or financial advice. A.M. Best's credit opinions are not recommendations to buy, sell or hold securities, or to make any other investment decisions. For additional information regarding the use and limitations of credit rating opinions, as well as the rating process, information requirements and other rating related terms and definitions, please view Understanding Best's Credit Ratings. About Us I Site Map I Customer Service I My Account I Contact I Careers I Terms of Use I Privacy Policy I Security I Legal & Licensing Regulatory Affairs -Form NRSRO -Code of Conduct-Rating Methodology -Historical Performance Data Copyright© 2018 A.M. Best Company, Inc. and/or its affiliates ALL RIGHTS RESERVED. http://ratings.ambest.com/CompanyProfile.aspx?ambnum=85202&URatingld=2503112&b... 12/5/2018 Policy ACP3008876980 IL 70 02 0911 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADVANCE NOTICE OF CANCELLATION, NONRENEWAL OR COVERAGE REDUCTION OR RESTRICTION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL CRIME COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY POLICY FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MERCANTILE UMBRELLA LIABILITY POLICY Person(s) or Organization(s) City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services . 30 Number of Days Notice ___ _ SCHEDULE Address P.O. Box 4668 -ECM #35050 New York, NY 10163-4668 If this policy is cancelled (other than nonpayment of premium) or nonrenewed or if the coverage provided by this policy is reduced or restricted (except for any reduction in the Limits of Insurance due to claims payments), we will provide written notice to the person(s) or organization(s) listed in the Schedule. We will provide this notice by mail 30 days in advance of any policy cancellation, nonrenewal or coverage reduc- tion or restriction or as indicated in the Number of Days Notice in the Schedule. All terms and conditions of this policy apply unless modified by this endorsement. IL 70 02 0911 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1