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HomeMy WebLinkAboutDeans Certified Welding Inc; 2021-04-01; PWL21-1422FAC PWL21-1422FAC Police & Fire Headquarters / EOC Materials Testing – Welding - 1 - City Attorney Approved 2/29/2016 CITY OF CARLSBAD PUBLIC WORKS LETTER OF AGREEMENT Police and Fire Headquarters / EOC Materials Testing - Welding: Contract 4719 This letter will serve as an agreement between Dean's Certified Welding, Inc., a California corporation (Contractor) and the City of Carlsbad (City). The Contractor will provide all equipment, material and labor necessary to Cut and replace select framing sections, per Exhibit A and City specifications, for a sum not to exceed one thousand eight hundred forty dollars ($1,840). This work is to be completed within ninety (90) working days after issuance of a Purchase Order. ADDITIONAL REQUIREMENTS 1. City of Carlsbad Business License 2. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its agents, officers, officials, employees, and volunteers 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 this Contract or work; or from any failure or alleged failure of the contractor to comply with any applicable law, rules or regulations including those relating to safety and health; except for loss or damage which was caused solely by the active negligence of the City; and from any and all claims, loss, damage, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by this Contract, unless the loss or damage was caused solely by the active negligence of the City. The expenses of defense include all costs and expenses, including attorney’s fees for litigation, arbitration, or other dispute resolution method. 3. Contractor shall furnish policies of general liability insurance, automobile liability insurance and a combined policy of workers compensation and Employers’ Liability in an insurable amount of not less than one million dollars ($1,000,000) each, unless a lower amount is approved by the Risk Manager or the City Manager. Said 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. Insurance is 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. Proof of all such insurance shall be given by filing certificates of insurance with contracting department prior to the signing of the contract by the City. 4. The Contractor shall be aware of and comply with all Federal, State, County and City Statues, Ordinances and Regulations, including Workers Compensation laws (Division 4 California Labor Code) and the “Immigration Reform and Control Act of 1986” (8USC, Sections 1101 through 1525), to include but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants that are included in this Contract. 5. The Contractor may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. __________ init __________ init 6. The Contractor hereby acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor from participating in contract bidding. _______ init _______ init 7. 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. DocuSign Envelope ID: FC2930A4-11B4-48E5-8437-0670689F58A9 PWL21-1422FAC Police & Fire Headquarters / EOC Materials Testing – Welding - 2 - City Attorney Approved 2/29/2016 8. The general prevailing rate of wages, for each craft or type of worker needed to execute the contract, shall be those as determined by the Director of Industrial Relations pursuant to the Section 1770, 1773 and 1773.1 of the California Labor Code. Pursuant to Section 1773.2 of the California Labor code, a current copy of 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 the execution of the work covered by this Letter of Agreement. 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. 9. City Contact: Steven Stewart, 760-602-7543 Contractor Contact: Bill Nadi, 951-704-8198 CONTRACTOR Dean's Certified Welding, Inc., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California 27645 Commerce Center Dr. Temecula, CA 92590 P: (951) 676-0242 F: N/A Bill@deanswelding.com By: By: (sign here) Zachary Gilbert, Secretary Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: Dated: (sign here) Michael Dean, President (print name/title) (Proper notarial acknowledgment of execution by Contractor must be attached. Chairman, president or vice-president and secretary, assistant secretary, CFO or assistant treasurer must sign for corporations. Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation.) APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: Assistant City Attorney DocuSign Envelope ID: FC2930A4-11B4-48E5-8437-0670689F58A9 April 1, 2021 PWL21-1422FAC Police & Fire Headquarters / EOC Materials Testing – Welding - 3 - City Attorney Approved 2/29/2016 EXHIBIT A Police & Fire Headquarters Center Materials Testing - Welding SCOPE OF WORK AND FEE Contractor shall perform select as-needed welding services at locations specified by the city’s project manager. Contractor shall provide 1’x2’ ASTM A500 Grade B HSS 6”x6”x3/16” and additional plates as agreed to by the contractor and city’s project manager, plates shall be field welded as directed by the project manager. Compensation for all work shall be made on a time and materials basis, estimates included in the table below. ITEM NO. UNIT Unit Rate QTY DESCRIPTION PRICE 1 hour $140 8 Prevailing Wage Journeyman time allowance Estimated 8 hours @$140/hour $1,120 2 hour $120 1 Travel Time allowance, 1 hour $120 3 lot 1 1 New building material allowance (Actual material costs +15% markup) $200 4 hour $100 4 Shop fabrication time, 4 hours Estimated 4 hours @$100/hour $400 TOTAL* (not to exceed, billed as cost incurred) $1,840 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: FC2930A4-11B4-48E5-8437-0670689F58A9 INSR ADDLSUBRLTRINSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person) $ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS AUTOS ONLYHIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE Admiral Insurance Company Endurance American Specialty Ins Co Zurich American Insurance Company 3/23/2021 Marsh & McLennan Agency LLC Marsh & McLennan Ins. Agency LLC PO Box 85638 San Diego, CA 92186 Blanche Martin 858 587 7517 858 909 9735 blanche.martin@MarshMMA.com Dean's Certified Welding, Inc. 27645 Commerce Center Drive Temecula, CA 92590 CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2  CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION THAT IS AN OWNER OR MANAGER OF REAL PROPERTY OR PERSONAL PROPERTY ON WHICH YOU ARE PERFORMING ONGOING OPERATIONS, OR A CONTRACTOR ON WHOSE BEHALF YOU ARE PERFORMING ONGOING OPERATIONS, BUT ONLY IF COVERAGE AS AN ADDITIONAL IN-SURED IS REQUIRED BY A WRITTEN CON-TRACT OR WRITTEN AGREEMENT THAT IS AN “INSURED CONTRACT”, AND PROVIDED THE “BODILY INJURY” OR “PROPERTY DAMAGE” FIRST OCCURS, OR THE “PERSONAL AND AD-VERTISING INJURY” OFFENSE IS FIRST COM-MITTED, SUBSEQUENT TO THE EXECUTION OF THE CONTRACT OR AGREEMENT. ALL LOCATIONS AT WHICH THE NAMED IN-SURED IS PERFORMING ONGOING OPERA- TIONS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(s) shown in the Schedule, but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; INSURED: POLICY#: POLICY PERIOD: TO: Dean's Certified Welding, Inc. CA00003610702 10/01/2020 10/01/2021 CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2  in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance af- forded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions ap- ply: This insurance does not apply to “bodily injury” or “property damage” occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of “your work” out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing oper- ations 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 III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2011 Page 1 of 2  CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION THAT IS AN OWNER OR MANAGER OF REAL PROPERTY OR PERSONAL PROPERTY FOR WHOM YOU WORK OR HAVE WORKED, OR A CONTRACTOR ON WHOSE BEHALF YOU WORK OR HAVE WORKED, BUT ONLY IF COVERAGE AS AN ADDITIONAL INSURED EXTENDING TO "BODILY INJURY" OR "PROPERTY DAMAGE" INCLUDED IN THE "PRODUCTS-COMPLETED OPERATIONS HAZARD" IS REQUIRED BY A WRITTEN CONTRACT OR WRITTEN AGREEMENT THAT IS AN "INSURED CONTRACT" AND PROVIDED THAT THE "BODILY INJURY" OR "PROPERTY DAMAGE" FIRST OCCURS SUBSEQUENT TO THE EXECUTION OF THE CONTRACT OR AGREEMENT. ALL LOCATIONS EXCEPT LOCATIONS WHERE "YOUR WORK" IS OR WAS RELATED TO A JOB OR PROJECT INVOLVING SINGLE-FAMILY DWELLINGS, MULTI- FAMILY DWELLINGS (OTHER THAN RENTAL APARTMENTS IN AN APARTMENT BUILDING: (A) ORIGINALLY CONSTRUCTED AND AT ALL TIMES USED FOR SUCH PURPOSE, OR (B) CONVERTED FROM A COMMERCIAL BUILDING), CONDOMINIUMS, TOWNHOMES, TOWNHOUSES, TIME-SHARE UNITS, FRACTIONAL-OWNERSHIP UNITS, COOPERATIVES AND/OR ANY OTHER STRUCTURE OR SPACE USED OR INTENDED TO BE USED AS A RESIDENCE. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(s) shown in the Schedule, but only with respect to liability for “bodily injury” or “property damage” caused, in whole or in part, by “your work” at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the “products-completed operations hazard”. INSURED: POLICY#: POLICY PERIOD: TO: Dean's Certified Welding, Inc. CA00003610702 10/01/2020 10/01/2021 CG 20 37 04 13 © Insurance Services Office, Inc., 2011 Page 2 of 2  However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance af- forded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2009, 2012 & 2013. Page 1 of 1  PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 01 04 13) 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 con- tribution from any other insurance available to the additional insured. INSURED: POLICY#: POLICY PERIOD: TO: Dean's Certified Welding, Inc. CA00003610702 10/01/2020 10/01/2021 AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2009, 2012 & 2013. Page 1 of 1  WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Services Office Endorsement CG 24 04 05 09) SCHEDULE Name Of Person Or Organization: Any person or organization, but only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract; and (2) The injury or damage first occurs subsequent to the execution of the written contract. 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 – Con- ditions: 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. INSURED: POLICY#: POLICY PERIOD: TO: Dean's Certified Welding, Inc. CA00003610702 10/01/2020 10/01/2021 AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2009, 2012 & 2013. Page 1 of 2  DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT (WITH TOTAL AGGREGATE LIMIT FOR COVERAGES A, B AND C) SCHEDULE Designated Construction Projects: All construction projects covered by this insurance. (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by “occurrences” under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated con- struction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Dec- larations. However, the most we will pay under the Designated Construction Project General Aggregate Limit for all Desig- nated Construction Projects combined is $5,000,000 . 2. The Designated Construction 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 “property damage” included in the “products-completed operations hazard”, and for medical 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”. 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other desig- nated construction project shown in the Schedule above. INSURED: POLICY#: POLICY PERIOD: TO: Dean's Certified Welding, Inc. CA00003610702 10/01/2020 10/01/2021 AD 68 93 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2009, 2012 & 2013. Page 2 of 2  4. The limits shown in the Declarations for Each Occurrence, Fire Damage 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 Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by “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 ongoing operations at a single designated construction project shown in the Schedule above: 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 Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the “products-completed operations hazard” is provided, any pay- ments for damages because of “bodily injury” or “property damage” included in the “products-completed operations hazard” will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then re- started, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall con- tinue to apply as stipulated. POLICY NUMBER: COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II – Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I – Covered Autos Coverages of the Auto Dealers Coverage Form. WHERE REQUIRED BY AN EXECUTED WRITTEN CONTRACT. INSURED: POLICY#: POLICY PERIOD: TO: Dean's Certified Welding, Inc. BAP380493401 10/01/2020 10/01/2021 POLICY NUMBER: COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. WHERE REQUIRED BY AN EXECUTED WRITTEN CONTRACT. INSURED: POLICY#: POLICY PERIOD: TO: Dean's Certified Welding, Inc. BAP380493401 10/01/2020 10/01/2021 INSURED: POLICY #: POLICY PERIOD: TO: Dean's Certified Welding, Inc. C380493301 10/01/2020 10/01/2021 INSURED: POLICY #: POLICY PERIOD: TO: Dean's Certified Welding, Inc. BAP380493401 10/01/2020 10/01/2021