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HomeMy WebLinkAboutSouthwest Millworks Inc; 2022-05-02; PWM22-1812FACPWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 1 of 9 City Attorney Approved 1/20/2020 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT CITY HALL COUNCIL CHAMBERS PONY WALL INSTALLATION; CONT. NO. 4718 This agreement is made on the ______________ day of _________________________, 2022, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Southwest Millworks, Inc., a California corporation whose principal place of business is 7925 Dunbrook Rd, Suite A, San Diego, CA 92126 (hereinafter called "Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor’s proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by Brian Bacardi (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. 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. DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 2nd May PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 2 of 9 City Attorney Approved 1/20/2020 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. 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 (5) 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: ________Christopher Hogan____________ 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 DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 3 of 9 City Attorney Approved 1/20/2020 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 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. 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 10 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 90 working days after receipt of Notice to Proceed. /// /// /// /// /// /// DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 4 of 9 City Attorney Approved 1/20/2020 CONTRACTOR’S INFORMATION. Southwest Millworks, Inc. 7925 Dunbrook Rd, Suite A (Name of Contractor) 791023 (Street address) San Diego, CA 92126 (Contractor’s license number) B & C-6 2/28/2023 (city/state/zip) 858-578-4640 (License class. and exp. date) 1000006569 6/30/2022 (Telephone no.) mike@southwestmillworks.com (DIR registration number and exp. date) (e-mail address) 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 SOUTHWEST MILLWORKS, INC., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Christopher Hogan, President & CFO Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: (sign here) (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: _____________________________ Assistant City Attorney DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 5 of 9 City Attorney Approved 1/20/2020 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor 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 su-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 NONENONE 0.00 NONENONENONE PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 6 of 9 City Attorney Approved 1/20/2020 EXHIBIT B City Hall Council Chambers Pony Wall Installation Contractor to provide all materials tools and labor necessary to design, fabricate and install approximately 37’ of pony wall in the City of Carlsbad Council Chambers located at 1200 Carlsbad Village Drive, Carlsbad, CA 92008. All work to be be consistant with Option 1 from the Contractor’s proposal (dated Feb. 3, 2022) and Option 1 from their drawing (dated Jan. 22, 2022) which are attached to this agreement as Exhibit C. Notes: - Installation of the pony wall shall take place during August 1-14, 2022. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Fabricate pony wall per agreed shop drawings. $10,400 2 LS 1 Install pony wall. $4,320 TOTAL* $14,720 *Includes taxes, fees, expenses and all other costs. /// /// /// /// /// /// /// /// /// /// /// /// DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 7 of 9 EXHIBIT C DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 SWMI Southwest Millworks, Inc. Contractor Specializing in Casework BID PROPOSAL February 3, 2022 Brian Bacardi City of Carlsbad Public Works 405 Oak A venue Carlsbad, CA 92008-309 Project Name: Carlsbad Council Chambers Thank you for the opportunity of providing you with our bid proposal for the above referenced project. Please read our Scope of Work and Notes & Clarifications closely as they are an integral part of this bid proposal. Scope of Work: Plastic laminate-clad barrier walls with swing / pocket gates as noted in Southwest Millworks submittal drawings dated 1/22/22. Option l Fabrication= $10,400.00 Option I Installation = $4,320.00 Total Option 1 ................................................................ $14,720.00 Option 2 Fabrication = $5,720.00 Option 2 Installation= $2,376.00 Total Option 2 .................................................................. $8,096.00 Page 1 of2 7925 Dunbrook Road Suite A San Diego, CA 92126 Ph: 858.578.4640 Fax: 858.578.4661 Email: mikec_swmi@sbcglobal.net Website: www.southwestmillworksinc.com CA license 791023 AZ License ROC239296 PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 8 of 9 DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 SWMI Southwest Millworks, Inc. Contractor Specializing in Casework Notes & Clarifications: 1. Southwest Mill works, Inc. is registered with the State of California as a Small Business. Supplier #1270460. 2. Southwest Millworks, Inc. is recognized by Woodwork Institute (aka Woodwork Institute of California) as an Accredited Mill work Company. 3. Excludes LEED and FSC Certification. 4. Excludes electrical work. 5. Barrier walls to be fastened to floor through bottom plate of wall and over existing floor covering (if left in p lace). 6. Includes prevailing wage installation. 7. Plastic laminate quoted as standard colors from Wilsonart, Fonnica or Nevamar. Premium laminates will be subjected to additional charges. 8. All work to be performed during normal business hours. 9. Price does not include bid or performance bonds. I O.Southwest Millworks, Inc. will not be held responsible for failure to perfonn obligations under this proposal, including but not limited to, material availability and unexpected price increases caused by an event of force majeure. 11.Some buy-out items in this proposal may require deposits to begin production. Southwest Millwork will request approval of an advance billing to cover the deposit amount. Billing will be submitted in a timely manner so that payment will be received prior to placing material order. 12.In the event this proposal is accepted; a mutually agreeable schedule of billings and payments is to be negotiated and included in the content of the subcontract language. Payment terms not to exceed 45 days. Thank you, fv1~Cor~ Michael Cornish Southwest Millworks, Inc. Page 2 of2 7925 Dunbrook Road Suite A San Diego, CA 92126 Ph: 858.578.4640 Fax: 858.578.4661 Email: mikec_swmi@sbcglobal.net Website: www.southwestmillworksinc.com CA license 791023 AZ License ROC239296 PWM22-1812FAC City Hall Council Chambers Pony Wall Installation -Cont. No. 4718 Page 9 of 9 DocuSign Envelope ID: 5539B2AF-4750-4389-8062-A6F0DCE88270 en 0 0 ::0 :,: ~ )> C>~ m "'07rri m --i rZ !; ~ .. 0 z .:., ;:: "' zo :z G) ~ _,., )> Z "-' Gl en ::;; ~ 0 "' z 0 JOB: ~ i5 z Gl CITY OF CARLSBAD CITY COUNCIL CHAMBER ~ i5 z Gl g 0 ::0 SOUTHWEST MILL WORKS, INC. 1200 CARLSBAD VILLAGE DRIVE SAN DIEGO, CA 92008 CENT~ OF DESK ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 03/02/2022 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 riahts to the certificate holder in lieu of such endorsementCs). PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER PHONE I FAX HOME OFFICE: P.O. BOX 328 IA/C No Extl: 888-333-4949 IA/C Nol: 507-446-4664 OWATONNA, MN 55060 t~D~~ss: CLI ENTCONTACTCENTER@FEDI NS.COM INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 352-359-4 INSURER B: SOUTHWEST MILLWORKS, INC. INSURER C: 7925 DUNBROOK RD STE A SAN DIEGO, CA 92126-6306 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 213 REVISION NUMBER: 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD IMM/DD/YYYYI IMM/DD/YYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 f--:=J CLAIMS-MADE 0 OCCUR ~~rr:iii:?E:~~!u~~encel $100,000 MED EXP (Any one person) $5,000 -A y N 9841343 06/08/2021 06/08/2022 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 FlPOLICY □ ~:g,: □ LOC PRODUCTS -COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 f--IEa accident) X ANY AUTO BODILY INJURY (Per person) --SCHEDULED A OWNED AUTOS ONLY AUTOS N N 9841343 06/08/2021 06/08/2022 BODILY INJURY (Per accident) --NON-OWNED rp~~~~~J:nfAMAGE HIRED AUTOS ONLY AUTOS ONLY f--- X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 f--f-- A EXCESS LIAB CLAIMS-MADE N N 9841344 06/08/2021 06/08/2022 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION IPER STATUTE I I OTH- AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE If yes, describe under E.L DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, 30 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. CERTIFICATE HOLDER CANCELLATION 352-359-4 213 0 CITY OF CARLSBAD/CMWD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE C/O EXIGIS INSURANCE COMPLIANCE SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 947 ACCORDANCE WITH THE POLICY PROVISIONS. MURRIETA, CA 92564-0947 AUTHORIZED REPRESENTATIVE . ~ 6 )ltv-, © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD © Insurance Services Office, Inc., 2012 Policy Number: Transaction Effective Date: 9841343 06-08-2021 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury","property damage"or "personal and advertising injury" caused, in whole or in part, by: Your acts or omissions; or The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However,the insurance afforded to such additional insured: Only applies to the extent permitted by law;and Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: "Bodily injury","property damage"or "personal and advertising injury"arising out of the rendering of,or the failure to render, any professional architectural,engineering or surveying services, including: The preparing,approving,or failing to prepare or approve, maps, shop drawings, opinions,reports,surveys,field orders, change orders or drawings and specifications; or Supervisory,inspection,architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision,hiring, employment,training or monitoring of others by that insured,if the "occurrence"which caused the "bodily injury"or "property damage",or the offense which caused the "personal and advertising injury",involved the rendering of or the failure to render any professional architectural, engineering or surveying services. Page 1 of 2 CG 20 33 04 13 COMMERCIAL GENERAL LIABILITYCG 20 33 04 13 A.Section II -Who Is An Insured 1. 2. 1. 2. B. 1. a. b. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHENREQUIRED IN CONSTRUCTION AGREEMENT WITH YOU THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. © Insurance Services Office, Inc., 2012 Policy Number: Transaction Effective Date: 9841343 06-08-2021 "Bodily injury"or "property damage"occurring after: 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 That portion of "your work"out of whichtheinjuryordamageariseshasbeenputtoitsintendedusebyanypersonororganizationotherthananothercontractororsubcontractorengagedinperformingoperationsforaprincipalasapartofthesame project. With respect to the insurance afforded to theseadditionalinsureds,the following is added to The most we will pay on behalf of the additional insured is the amount of insurance: Required by the contract or agreement you have entered into with the additional insured; or Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 CG 20 33 04 13 2. a. b. C. Section III - Limits Of Insurance: 1. 2. ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSD WVD 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) 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 EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY 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 LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) 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 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.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 2/18/2022 License # 0C32169 (619) 937-0164 (619) 937-0168 27847 Southwest Millworks Inc 7925 Dunbrook Road Ste A San Diego, CA 92126 A X WSD5035534-05 1/1/2022 1/1/2023 1,000,000 Y 1,000,000 1,000,000 RE: OPERATIONS OF THE NAMED INSURED AS CERTIFICATE HOLDERS INTEREST MAY APPEAR. WAIVER OF SUBROGATION APPLIES WITH REGARDS TO THE WORKERS COMPENSATION PER THE ATTACHED FORM. CITY OF CARLSBAD/CMWD c/o EXIGIS INSURANCE COMPIANCE SERVICES P.O. BOX 947 MURRIETA, CA 92564 SOUTMIL-01 CERTT4 Rancho Mesa Insurance Services, Inc. 250 Riverview Parkway Santee, CA 92071 Insurance Company of the West 1 X ACORD" I ~ I ~ □ □ ~ ~ ~ □ □ ~ ~ ~ ~ ~ ~ ~ ~ H I I I I I □ I INSURED 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 01/01/2022 Policy No.Endorsement No. Insured Premium $ Insurance Company Countersigned By WSD 5035534-05 INSURANCE COMPANY OF THE WEST Southwest Millworks Inc.INCL. WC 99 06 34 (Ed. 8-00) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be % of the total California Workers’ Compensation premium otherwise due. Schedule Person or Organization Job Description 2 ANY ALL CALIFORNIA PERSON/ORGANIZATION OPERATIONS WHEN REQUIRED BY WRITTEN CONTRACT