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Home My WebLink AboutNational Electric Works Inc; 2018-05-10; PWL18-134UTILTracking#: PWM18-143UTIL CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 This agreement is made on the l~ day of tJ~ , 2018, by the City of Carlsbad, California, a municipal corporation, (hereinafter calkar City"), and National Electric Works, Inc., a California corporation whose principal place of business is 4440 Rainier Ave., #101, San l;)iego, CA 92120 (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 excep~ed 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. ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 1 of 8 City Attorney Approved 9/27/16 Tracking#: PWM18-143UTIL 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: ~~ fnvisJ~ n 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. ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 2 of 8 City Attorney Approved 9/27/16 Tracking#: PWM18-143UTIL INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of · every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within ten (10) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within ten (10) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. Ill Ill Ill Ill Ill Ill Ill Ill Ill Ill National Electric Works, Inc. (name of Contractor) 591191 (Contractor's license number) C10 -Electrical 3131120 (license class. and exp. date) 1000003595 (DIR registration number) 6/30/18 (DIR registration exp. date) ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 3 of 8 4440 Rainier Ave. #101 (street address) San Diego, CA 92120 (city/state/zip) 619-787-0602 (telephone no.) 619-528-2898 (fax no.) rdaniels@nationalelectricworks.com (e-mail address) City Attorney Approved 9127116 Tracking#: PWM18-143UTIL 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 NATIONAL ELECTRIC WORKS, INC., a California corporation By:~~- ~/'~ Travis J. Morgan/ Vice President (sign here) Clint Morgan/ Secretary (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By: Wendy C ers/Utilities Director as autho · ed by the City Manager If required by City, proper notarial acknowledgment of execution by Contractor must be attached. ~ corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CEL~, City Attorney BY:~ Deputy City Attorney ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 4 of 8 City Attorney Approved 9/27 /16 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 oo:o:o:~co:~:o:o:o:o:o:o:o:o:o:o:o:o:o:~:0:o:o:o:o:o:o:o:o:o:o:oco:o:o:o:o:ooo:o:0:001 11 a a 11 ~fl 100:0000:0:00:0:00:oo:o 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 County of $f\-t4 n, Et., D } On AP(Z \ L :L'o I Q,D lf:, Date Here Insert Name and Title of the 0 personally appeared __ :t___.__,_Q..A,___,,_.,_V-""-\.._~......,._____,.j=·_,_µ\-'---"-oR,.-....C..C...._!'"""'.'11c"'""'iAL->-LJ.3'<...... ________ _ Name(s) of Signer(s) M o {Z_~AJ-.1 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 ~they executed the same ill hii£Rer,/their authorized capacity(ies), and that by ~their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Place Notary Seal and/or Stamp Above I 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. OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Signer(s) Other Than Named Above: ___ ::::::::..-...::,----------------------- Capacity(ies) Claimed by Signer(s) Signer's Name: D Corporate Officer -Title(s): ______ _ D Partner - D Limited o General D Individual o Attorney in Fact D Trustee o Guardian of Conservator o Other: Signer is Representing: __________ _ Signer's Name: D Corporate Officer - o Partner - D Limited o Individual o Trustee D Other: Signer is Representing: __________ _ :80:ooc11 a a a a a a a a c1 c1 10:0:0:0:0:001 a a a 11 a a 1:0:8:0:oco:o:01 m a a a a a 1:1 a m s:11:0:000:1 1:1 1:1 a a a a 111 a a a co:o:oo:H:0:000 a a a a a 1 ©2017 National Notary Association Tracking#: PWM18-143UTIL 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 douf: Total % Subcontracted: ___ .6 __ _ ( The Contractor must perform no less than fifty percent (50%) of the work with its own forces ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 5 of 8 City Attorney Approved 9/27/16 ITEM NO. 1 2 3 4 5 6 Tracking#: PWM18-143UTIL EXHIBIT B ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION JOB QUOTATION UNIT QTY DESCRIPTION PRICE Job Demo existing across-the-line wirina in existing starters Provide and install (3) new Allen Bradley SMC-Flex solid state controllers with pump control features, 135A, 25- Job 100HP, 480V, 120V control, terminal lug kits included Install (3) new Allen Bradley 150-F84L protective modules 108-1250A current rating for solid state Job controller Install new power and control wiring, control relays, Job terminal blocks as required Program and provide startup on (3) new SMC-Flex solid Job state controllers National Electric Works will provide and install (3) new remote human interface modules (HIM) with bezel kits for HIM's on exterior of starter bucket doors for operator convenience, safety, programming and monitoring Job access. Bezel cables included. Bid total for installing (3) AB SMC-Flex SS 100HP, HIM LCD kevoads, bezel kits & bezel cables $26,814 Bond $193 TOT AL NOT TO EXCEED* $27,007 *Includes taxes, fees, expenses and all other costs. ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 6 of 8 City Attorney Approved 9/27/16 Tracking#: PWM18-143UTIL EXHIBIT C LABOR AND MATERIALS BOND WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to National Electric Works, Inc. (hereinafter designated as the "Principal"), a Contract for: ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONTRACT NO. 38401 in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, National Electric Works, Inc., as Principal, (hereinafter designated as the "Contractor"), and Western Surety Company, as Surety, are held firmly bound unto the City of Carlsbad in the sum of twenty-seven thousand seven dollars ($27,007), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 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 California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 7 of 8 City Attorney Approved 9/27/16 Tracking#: PWM18-143UTIL 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. '?: t'"c\ Executed by CONTRACTOR this ___._._.,! ____ _ day of (y\ ~ , 20Jb. CONTRACTOR: National Electric Works, Inc. JDame of Contractor) By: ~AA ./;Jrf; -~<s¥n~ By: (print name here) (~~;,i~~jof signatory) Executed by SURETY this _19_t_h ____ day of __ A_p._r_i_l _______ , 20_.l_!L_. SURETY: Western Surety Company (name of Surety) 2020 Main Street, Suite 750, Irvine, CA 92614 (address of Surety) (printed name of Attorney-in-Fact) (attach corporate 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 officer to bind the corporation.) APPROVED AS TO FORM: CELIA A. BREWER City Atto:Z: By:(;~ Deputy City Attorney ELECTRICAL UPGRADES FOR THE PUMPS AT BATIQUITOS SEWER LIFT STATION CONT. NO. 38401 Page 8 of 8 City Attorney Approved 9/27/16 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 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 County A~R of a~~o,a On __________ before me, Frances Lefler Date Here Insert Name and Title of the Officer personally appeared James William Johnson, II Name(s) of Signer(s) 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. Place Notary Seal Above I 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. ---------------OPTIONAL--------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _____________ Document Date: _______ _ Number of Pages: ___ Signer(s) Other Than Named Above: ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ____________ _ Signer's Name: ____________ _ Corporate Officer -ntle(s): ______ _ Corporate Officer -Title(s): ______ _ Partner -··· i Limited ,-General Partner -Limited General _ Individual c.., Attorney in Fact Individual ,_ Attorney in Fact Trustee ; Guardian or Conservator Trustee · 1 Guardian or Conservator :.~Other: ______________ _ -Other: ______________ _ Signer Is Representing: _________ _ Signer Is Representing: _________ _ ~~'Q<..~~'Q<..~~~~~~'g,~~~~~~'Q(.~-g,_~'g<.~~'g;.~"g;.'< ©2014 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint James William Johnson II, Frances Elaine Lefler, Jennifer Caroline Anaya, Ellen Michele Bell, Erik Johansson, Melissa Lopez, Individually of Tustin, CA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature -In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 3rd day of October, 2017. State of South Dakota County of Minnehaha WESTERN SURETY COMPANY ~~fla<, VicePre,ideo< On this 3rd day of October, 2017, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; 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 corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires June 23, 2021 J. Mohr, Notary Public CERTIFICATE I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By-Law of the corporation printed on the reverse h1'1'Jf s,11 g1 f1frl8'° testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this ______ day of ___________ , ____ .. WESTERN SURETY COMPANY Form F4280-7-2012 Authorizing By-Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 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 } County of ~l-<29:)0 On fr) ,<MA '2:21 JD l 'cJ before me, ~~~l..L~~~U.,....---C)il..ll~~LI...::~~.J..-. LJ Date Here Insert Name and Title of the 0 personally appeared _T----'___._Y::_,o.....,_,\..,_J-\-~5......,_____,'-,,.._~,>,-c;.==----..,__M=-=-..,.,oft ........ ea~,,..a..L-L6---\,~---------- Name(s) of Signer(s) C11 t-Jt Mt)£C?ifrN who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s~are subscribed to the within instrument and acknowledged to me that l'le/!'!helthey executed the same in ~their authorized capacity(ies), and that by 1-iis,'l'loi;.Aheir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. J000000000 " 00 f . JENNIFER RAE BAKER : fj· .... ~ . Notary Pu.blic -California ;g < / _: · San Diego County ! J --:· Commission# 2219276 My Comm. Expires Oct 21, 2021 Place Notary Seal and/or Stamp Above I 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. OPTIONAL Completing this information can deter alt tion of the document or fraudulent reattachment of this form to an unintended document. of Attached Document Title or Type of Oc'l:t:ttlFQ.e,Qtt_: _-------------------------- Signer(s) Other Than Named Above:------=-....:::------------------ Capacity(ies) Claimed by Signer(s) Signer's Name: _____________ _ Signer's Name:_..=.....,_ __________ _ o Corporate Officer -Title(s): ______ _ o Corporate Officer - o Partner -o Limited o General o Partner -o Limited o Individual o Attorney in Fact o Individual o Trustee o Guardian of Conservator o Trustee o Other: o Other: Signer is Representing: _________ _ Signer is Representing: __________ _ ©2017 National Notary Association ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 11/1/2017 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 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 endorsementlsl. PRODUCER CONTACT NAME: Wood Gutmann & Bogart r.~~N.t c .... 714-505-7000 I ft,~ .. n,-114-573-1??0 15901 Red Hill Ave., Suite 100 E-MAIL Tustin CA 92780 AnnDC<><>· INSURER{Sl AFFORDING COVERAGE NAIC# 1NSURERA ,Travelers Indemnity Co of CT INSURED NATI013 INSURER B: Travelers Property Casualty National Electric Works, Inc. INSURER c : Columbia Casualty Company National Security Works INSURERD: National IT Works 4440 Rainier Ave., Suite 101 INSURER E: San Diego CA 92120-3319 INSURER F: COVERAGES CERTIFICATE NUMBER· 1460652671 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 WlTH 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 POLICYEFF 1~~~61>~, LIMITS LTR INSD WVD POLICY NUMBER IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY y y DT22C09J758608TCT17 10/1/2017 10/1/2018 EACH OCCURRENCE $1,000,000 ~ D CLAIMS-MADE Ci] OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 ~ MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY f--$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 R 0PRO-DLOC PRODUCTS -COMP/OP AGG $2,000,000 POLICY JECT OTHER: $ B AUTOMOBILE LIABILITY y DT8109J756074TIL 17 f-- 10/1/2017 10/1/2018 l,UMt,INtcUt~INGLE LIMII (Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ f--ALL OWNED ~ SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ f--f--NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per accident) $ --$ B UMBRELLA LIAB M OCCUR CUP9J7971971726 10/1/2017 10/1/2018 EACH OCCURRENCE $5,000,000 - X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 J OED I I RETENTION$ $ B WORKERS COMPENSATION y UB9J76258A1726G 10/1/2017 10/1/2018 I PER I I OTH-X STATUTE ER AND EMPLOYERS" LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 C Professional Liab CE0591901410 10/1/2017 10/1/2018 Each claim limit 2,000,000 includes Pollution Aggregate limit 3,000,000 ./ Per claim deductible 5,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) Blanket Additional Insured (Contractors) applies per form CGD2460805 (ongoing & completed ops) GL Primary & Non-Contributory Form applies per attached CGD2460805 GL Waiver of Subrogation Form applies per attached CGD3161111 GL Per Project Aggregate Form applies per attached GD2110104 WC 30 Day Notice of Cancellation per attached WC9906R300 WC Waiver of Subrogation Form applies per attached WC990376A See Attached ... 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 c/o EXIGIS Insurance Compliance Services ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4668 -ECM #35050 New York NY 10163 I ~~ESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: NATlO13 ------------------LO C #: ------- ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Wood Gutmann & Bogart National Electric Works, Inc. POLICY NUMBER National Security Works National IT Works 4440 Rainier Ave., Suite 101 CARRIER I NAICCODE San Diego CA 92120-3319 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Auto 30 Day Notice of Cancellation per attached IL T4050311 Auto Additional Insured and Waiver of subrogation applies per attached CAT35302015 Auto Additional Insured -Primary & Non-Contributory applies per attached CAT4740216 Umbrella Policy follows form. CERTIFICATE HOLDER VESTING: City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services Page 1 of ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: DT22CO9J758608TCT17 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED -(Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of •your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section Ill-Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: I. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and II. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products-completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to ·other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D2 4608 05 © 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence" or offense took place; II. The names and addresses of any injured persons and witnesses; and Ill. The nature and location of any Injury or damage arising out of the "occurrence· or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: I. Immediately record the specifics of the claim or "suit" and the date received; and II. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or 0 suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. -DEFINITIONS: "Written contract requiring Insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement Is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2005 The St. Paul Travelers Companies, Inc. CG 02 4608 05 Policy Number: DT22CO9J758608TCT17 / COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured -Newly Acquired Or Formed Organizations F. Who Is An Insured -Broadened Named Insured -Unnamed Subsidiaries G. Blanket Additional Insured -Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I -COVERAGES -COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I -COVERAGES - COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. 2. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I - COVERAGES -COVERAGE A. BODILY H. Blanket Additional Insured -Lessors Of Leased Equipment I. Blanket Additional Insured -States Or Political Subdivisions -Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definition N. Contractual Liability -Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section 1-Coverage A -Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion -All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. A separate limit of insurance applies to "premises damage" as described in Para- graph 6. of SECTION Ill -LIMITS OF IN- SURANCE. CGD3161111 © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- TION Ill -LIIVITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract"; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. 6. The following replaces Paragraph 4.b.(1 )(b) of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1 )(c) of SECTION IV - COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted. C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS -COVER- AGES A AND B of SECTION I -COVER- AGE: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS -COVER- AGES A AND B of SECTION I -COVER- AGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION II -WHO IS AN INSURED: Paragraph (1 )(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your busi- ness. Page 2 of 6 10 2011 The Travelers Indemnity Company. All rights reserved. CG 03161111 3. The following is added to Paragraph 5. of SECTION Ill -LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or ''Good Samaritan services" to any one per- son will be deemed to be one "occurrence". 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I -COV- ERAGES -COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV -COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury'' that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II -Who Is An Insured. -· WHO IS AN INSURED -NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II -WHO IS AN INSURED: COMMERCIAL GENERAL LIABILITY 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named Insured until the end of the policy period; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. F. WHO IS AN INSURED -BROADENED NAMED INSURED -UNNAMED SUBSIDIARIES The following is added to SECTION II -WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, joint venture or limited liability company, that is not shown as a Named Insured in the Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury'' or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. CGD3161111 © 2011 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED -OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION II -WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. H. BLANKET ADDITIONAL INSURED -LESSORS OF LEASED EQUIPMENT The following is added to SECTION II -WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any ''bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other in- surance. I. BLANKET ADDITIONAL INSURED -STATES OR POLITICAL SUBDIVISIONS -PERMITS The following is added to SECTION II -WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required Page 4of 6 (f.l 2011 The Travelers Indemnity Company. All rights reserved. CGD3161111 by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury'', "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury'' or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury'' or "property damage" in- cluded in the "products-completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV -COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II -Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: (a) Any individual who is: (I) A partner or member of any part- nership or joint venture; COMMERCIAL GENERAL LIABILITY (ii) A manager of any limited liability company; or (iii) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. (3) Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 8., Repre- sentations, of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV -COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CGD3161111 © 2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY -RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. Page 6 of 6 (g 2011 The Travelers Indemnity Company. All rights reserved. CG 03161111 POLICY NUMBER: DT22-CO-9J758608-TCT-17 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 10-06-17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project{s): EACH •pROJEC'P FOR WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT; PROVIDED THAT, THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE •BODILY INJURY• OR •PROPERTY DAMAGE• OCCURS. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION I}, and for all medical expenses caused by accidents un- der COVERAGE C (SECTION I), which can be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, unless separate Designated Project General Aggregate(s) are sched- uled above. 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A., except damages because of "bodily injury" or "prop- erty damage" induded in the "products- completed operations hazard", and for medi- cal expenses under COVERAGE C, regard- less of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Designated Project General Aggregate(s): GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS. 3. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the Desig- nated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they re- duce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Ag- gregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION I), and for all medical expenses caused by accidents un- der COVERAGE C. (SECTION I), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: CG 0211 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of2 COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Ag- gregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. C. Part 2. of SECTION Ill -LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION I) and for all medical expenses caused by accidents under COVERAGE C (SECTION I) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. D. When coverage for liability arising out of the "products-completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". F. The provisions of SECTION Ill -LIMITS OF INSURANCE not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D211 01 04 TRAVfLERs't WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: UB9J76258A 1726G NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX -CONDITIONS: Notice Of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mall or deliver such notice to each person or organization at Its listed address at least the number of days shown for that person or organiza- tion before the cancellation is to take effect. You are responsible for providing us with the information necessary to acwrately complete the Schedule below. If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such deslgnated person or organization of the cancellation. SCHEDULE Name and Address of Designated Persons or Organizations: City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services PO Box 4668 -ECM #35050 New York, NY 10163-4668 DATE OF ISSUE: 11/01/17 ST ASSIGN: C 2013 The Travelers Indemnity Company. All rights reserved. Number of Days Notice 30 ~ TRAVELERS] · ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) POLICY NUMBER: UB-9J76258A-17-26-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2. oo % of the California workers' compensation pre- mium. Person or Organization ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Schedule Job Description ELECTRICAL CONTRACTORS AND 0TH 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 Insured Insurance Company DATE OF ISSUE: 10-10-17 Policy No. Endorsement No. Premium Countersigned by ___________ _ ST ASSIGN: Page 1 of 1 POLICY NUMBER: DT8109J756074TIL 17 ISSUE DATE: 11/01/17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY -NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CANCELLATION: PERSON OR ORGANIZATION: City of Carlsbad/CMWD SCHEDULE Number of Days Notice of Cancellation: 30 ADDRESS: c/o EXIGIS Insurance Compliance Services PO Box 4668 -ECM #35050 New York, NY 10163-4668 PROVISIONS: If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, and a number of days is shown for cancellation in the schedule above, we will mail notice of cancellation to the person or organization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. IL T4 05 0311 © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Policy Number: DT8109J756074TIL 17 COMMERCIAL ALJTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS ALJTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS F. HIRED AUTO -LIMITED WORLDWIDE COV- ERAGE -INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE -GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form duI:. ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is affo1ded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured. of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or o,ganization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy pe1iod, to be named as an addi- tiona I insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES-INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of youis is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV -BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire. rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 0215 © 2015 The Travelers lndemnty Company. All rights reserved. Page 1 of4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO peImIssIon, while pe1forming duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or bonuwed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or bonuw in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II -COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II -COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO -LIMITED WORLDWIDE COV- ERAGE -INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7 ., Policy Period, Coverage Territory, of SECTION IV -BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pIu- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a d1iver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partner.; (if you are a partnership), members (if you are a limited liability company) or member.; of their households. (a) With respect to any claim made or "suit" brought outside the United States of AmeIica, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimbu.-se the "insured" for sums that the "insured" legally must pay as damages because of "bodily injuIy" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II -COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II -COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulso1y insurance in any countiy outside the United States, Its te,,. ritories and possessions, Puerto Rico and Canada. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 0215 Includes copyrighted material of Insurance Services Office, Inc. with its permission. You agree to maintain all required or compulsory insurance in any such coun- t1y up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy. but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its tenitories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE -GLASS The following is added to Paragraph 0., Deducti- ble. of SECTION Ill -PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses. of SEC- TION 111-PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT The following replaces the filSt sentence in Para- graph A.4.a., Transportation Expenses, of SECTION Ill -PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and COMMERCIAL AVTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Prope1ty coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth In Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV -BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individua0; (b) A pa,tner (if you are a pa1tne1ship); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV -BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any pe,son or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 0215 © 2015 The Travelers lndemnky Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the pe1son or oiganization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV -BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non-renewal. Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T353 0215 Includes copyrighted material of Insurance Services Office. Inc. with its permission. POLICY NO: DT8109J756074TIL 17 COMMERCIAL AUTO ll-11S ENDORSEMENT CHANGES ll-lE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement rnocifies insurance provided under the follo.ving: BUSINESS AUTO COVERAGE FORM PROVISIO~ 1. The foll<mng is added to Paragraph A.1.c., Who Is An Insured, Of SECTION II -COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a \Witten contrad or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" cx;curs and that is in effect during the policy period, to name as an additional insured for Cowred Autos Liaolity coverage, but only for damages to which this insurance applies and only to the extent or that person's or organization's liability for the oonduct of another "insured''. 2. The foll<mng is added to Paragraph 8.5., Other Insurance or SECTION rv -BUSlrESS AUTO CONDITIO~: Regardless of the provisions or pa-agraph a. and pa-agraph d. of this part 5. Other Insurance, this insurance is prima-y to and non-contributory with applicable other insurance under which an additional insured person or organizatioo is the first namoo insured when the ootten contrad or agreement between you and that person or organization, that is signed by you before the "bodily injury' or "property damage" cx;curs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CAT4 740216 u 2016 Toe Travelers Indemnity Company. AH rights reserved. Page 1 of 1 look.Ides copyrighted material of Insurance Services Office, Inc. with Its permission.