Loading...
HomeMy WebLinkAboutPlanes Boats and Automobiles LTD dba PBA LTD; 2019-12-16; PWM20-974TRANSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBRWVDADDLINSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION$ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCEDAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 12/05/2019 E360 INSURANCE SERVICES 16542 Ventura Blvd #300 Encino CA 91436 Sharon Toki (888) 862-6750 (888) 256-0809 Sharon@e360insurance.com P.B.A. LTD. (Planes, Boats, and Autos) 2029 E. Mission Ave Escondido CA 92027 BENCHMARK INSURANCE COMPANY 41394 NATIONAL GENERAL 29742 NAUTILUS INSURANCE COMPANY 17370 STATE FUND 35076 A Y Y BIC5020353 10/12/2019 10/12/2020 1,000,000 50,000 5,000 1,000,000 2,000,000 2,000,000 B Y 2006201912 03/07/2019 03/07/2020 1,000,000 C Y AN075317 10/12/2019 10/12/2020 1,000,000 1,000,000 D Y Y 9219205-19 09/30/2019 09/30/2020 1,000,000 1,000,000 1,000,000 City of Carlsbad/CMWD is Included as Additional Insured In Respects to the Commercial General Liability Policy. Waiver of Subrogation in Respects to the Workers Compensation Policy. 10 Days Notice of Cancellation for Non-Payment of Premium, 30 Days for all other Cancellation. City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services PO BOX 4668 -ECM #35050 New York NY 10163-4668 ENDORSEMENT ENDT. NO. G0103 (ed 09/24/09) PRIMARY BLANKET ADDITIONAL INSURED IT IS AGREED COVERAGE IS PROVIDED TO THE ADDITIONAL INSURED(S) AS FOLLOWS: 1. SECTION II OF THE POLICY (WHO IS AN INSURED) IS AMENDED TO INCLUDE ANY PERSON OR ORGANIZATION THAT THE NAMED INSURED HAS AGREED IN AN INSURED CONTRACT TO NAME AS AN ADDITIONAL INSURED PROVIDED THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT AND THE BODILY INJURY OR PROPERTY DAMAGE ARISES FROM YOUR WORK PERFORMED DURING THE POLICY TERM. 2. PARAGRAPH 6.D. IS HEREBY ADDED TO SECTION IV, COMMERCIAL GENERAL LIABILITY CONDITIONS, OF THE POLICY, AS FOLLOWS: D. NOTWITHSTANDING ANYTHING TO THE CONTRARY IN PARAGRAPHS 6.A., 6.B., OR 6.C. HEREOF, THE INDEMNITY PROVIDED BY THIS INSURANCE IS PRIMARY AND NONCONTRIBUTORY FOR ANY PERSON OR ORGANIZATION THAT IS AN ADDITIONAL INSURED UNDER THIS POLICY AND THAT YOU HAVE AGREED, IN AN INSURED CONTRACT, TO PROVIDE PRIMARY ADDITIONAL INSURED COVERAGE. 3 THE APPLICABLE LIMIT OF THE COMPANY'S LIABILITY SHALL NOT BE INCREASED BY THE INCLUSION OF ANY NUMBER OF ADDITIONAL INSUREDS. 4 OTHER THAN AS EXPRESSLY MODIFIED HEREIN, COVERAGE FOR THE ADDITIONAL INSURED IS GOVERNED BY THE TERMS AND CONDITIONS OF THIS POLICY, INCLUDING THE INSURING AGREEMENTS. 5 THE COVERAGE PROVIDED FOR THE ADDITIONAL INSURED IS ONLY TO THE EXTENT OF DAMAGES FROM BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE NEGLIGENCE OR STRICT LIABILITY OF THE NAMED INSURED. NO COVERAGE IS PROVIDED FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF ACTS, ERRORS OR OMISSIONS OF THE ADDITIONAL INSURED. 6. NO COVERAGE IS PROVIDED TO AN ADDITIONAL INSURED FOR DAMAGES BECAUSE OF BODILY INJURY TO AN EMPLOYEE OF THE NAMED INSURED, WHETHER SUIT IS BROUGHT OR CLAIM IS MADE BY THE EMPLOYEE OR THE PARENT, SPOUSE, CHILD OR SIBLING OF SUCH EMPLOYEE, OR ANY ENTITY SEEKING DAMAGES BECAUSE OF INJURY TO SUCH EMPLOYEE. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Policy Number Insured Effective BENCHMARK INSURANCE COMPANY Countersignature of Authorized Representative © 2009 WESTCAP 6 BIC5020353 Planes Boats and Automobiles LTD 10/12/2019 ENDORSEMENT ENDT. NO. G0905 (ed 09/24/09) WAIVER OF SUBROGATION - BLANKET IT IS AGREED, FOR AN ADDITIONAL PREMIUM OF $__________ , THAT THE TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS) IS AMENDED AS FOLLOWS: WE WAIVE ANY RIGHT OF RECOVERY WE MAY HAVE AGAINST ANY PERSON OR ORGANIZATION THAT QUALIFIES AS AN ADDITIONAL INSURED PURSUANT TO THE TERMS OF ENDORSEMENT NUMBER ______ BECAUSE OF PAYMENTS WE MAKE FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF (i) YOUR WORK PERFORMED DURING THE POLICY PERIOD UNDER AN INSURED CONTRACT WITH THAT PERSON OR ORGANIZATION, PROVIDED THAT THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT, OR (ii) YOUR PRODUCT MANUFACTURED OR SOLD DURING THE POLICY PERIOD UNDER AN INSURED CONTRACT WITH THAT PERSON OR ORGANIZATION, PROVIDED THAT THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Policy Number Insured Effective Countersignature of Authorized Representative BENCHMARK INSURANCE COMPANY © 2009 WESTCAP 7 6 InclnM&D BIC5020353 Planes Boats and Automobiles LTD 10/12/2019 ATTACHMENT A CONTRACTOR'S PROPOSAL TO: FROM: Clayton Dobbs Kevin Doherty COMPANY: DATE: City of Carlsbad DECEMBER 4, 2019 TOTAL NO. OF PAGES INCLUDING COVER: Emergency Repair storm channel 2 PHONE NUMBER: RE: (760) 801-5238 4868 Kelly Dr NOTES/COMMENTS: Emergency Repair to Kelly Storm channel behind residence at 4868 Kelly Dr. Scope: Set Two coffer dams down stream of repair with gravel bags & Filter fabric. Dewater repair area (at least 3-2in Pumps)- install #5 Epoxy coated rebar, 24” oc both directions. Dowelled into sides of existing concrete at the holes. Pump 4000 PSI concrete under beam & trapezoid side. Broom finish on repair surface <approximate 55 yards of concrete> Right of way permit – no fee from City All other permits by City of Carlsbad. All Prevailing wage All DIR filings Approximate 5 days <Can’t start until at least 4 days after a storm and water level drops to where we can control it. Demo/Remove all gravel bags & silt build up. Total labor, Equipment and materials, $59,950.00 Thank you, Kevin Doherty PBA, Ltd (760) 801-5238 PROPOSAL 2029 E. MISSION AVE, ESCONDIDO CA 92027 PH: 760/801 -5238 LICENSE # 816826 ATTACHMENT B REPAIR PLAN 11 ATTACHMENT C TIER 1 SWPPP 4868 KELLY DR 4870 KELLY DR 4885 KELLY DR 2015AURA CIR 4906 PARK DR 4875 KELLY DR 4912 PARK CT 4869 KELLY DR 4871 KELLY DR 4908 PARK DR 4910 PARK CT 4866 KELLY DR 4862 KELLY DR 4916 PARK CT 2019AURACIR 4914 PARK CT HI L L SIDE KELLYAVI LAT RIES TE REGENT GLASGOWPARK CANNONKELLYSEVILLANEBLINATAMARACKALOND RAE S S E X VIA MARTAROBERTSONREFUGI OLA PAZHIGH RIDGE LOMAAURAMILANOBIRCHWOOD WEST RANCHHILLSIDEPALISADES WELLSPRINGEL CAMINO REAL VIA HINTONEAST POINTE PARKEL CAMINO REAL KELLYTAMARACK P A R K P A R K REFUGIONEBLINATIER 1 SWPPP ±0 50 10025Feet 2019 KELLY CHANNEL EMERGENCY REPAIR LEGEND SYMBOL DWG DESCRIPTION EC-7 GEOTEXTILE & MAT (PLASTIC COVER) SE-4/6 CHECK DAM (GRAVEL BAGS) SE-10 STORM DRAIN INLET PROTECTION TR-1 STABILIZED INGRESS/EGRESS TR-2 STABILIZED ROADWAY WM-1 MATERIAL DELIVERY (SHOTCRETE) WM-2 MATERIAL USE AREA (SHOTCRETE) WM-4 SPILL PREVENTION AND CONTROL WM-8 CONCRETE WASTE MANAGEMENT SWPPP NOTES 5 1 USE EXISTING ACCESS GATE FOR INGRESS/EGRESSTO FAILURE AREA AND TO RUN PUMP LINE UP CHANNEL TO POUR SHOTCRETE DIRECTLY INTOFORMS2LAY PLASTIC WRAP WITHIN WORK AREA PER CASQAEC-7 TO PROVIDE A PROTECTIVE BARRIER OVER THE NATURAL CHANNEL BED. REMOVE PLASTICAND COLLECTED DEBRIS AT END OF REPAIR 3 DEWATER PONDED WATER FROM SITE 4 DISCHARGE PUMPED WATER DIRECTLY ONTO CONCRETE LINED PORTION OF THE CHANNEL TOPREVENT EROSION FROM DEWATERING. USEPLASTIC WRAP AND GRAVEL BERMS PER SWPPP. 5 FOOT TRAFFIC INGRESS/EGRESS ONLY 4 3 2 1