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National Electric Works Inc; 2023-03-28; PWM23-2147UTIL
PWM23-2147UTIL Electrical Connection of Surge Tank Compressor at Carlsbad Water Reclamation Facility Page 1 of 6 General Counsel Approved 02/14/2023 CARLSBAD MUNICIPAL WATER DISTRICT MINOR PUBLIC WORKS CONTRACT ELECTRICAL CONNECTION OF SURGE TANK COMPRESSOR AT CARLSBAD WATER RECLAMATION FACILITY CONT. NO. 5203 This agreement is made on the ______________ day of _________________________, 2023, by the Carlsbad Municipal Water District, a Public Agency organized under the Municipal Water Act of 1911, and a Subsidiary District of the City of Carlsbad, California, hereinafter referred to as “CMWD”, and National Electric Works, Inc., a California corporation, whose principal place of business is 4440 Rainier Ave., Suite 101, San Diego, CA 92120 (hereinafter called "Contractor"). CMWD 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, as contained in the Standard Specifications for Public Works Construction “Greenbook,” latest edition and including all errata; Part 1 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 Ray Martinez (CMWD 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 CMWD’s "duly authorized officer" for the purposes of section 4107 and 4107.5. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 March28th PWM23-2147UTIL Electrical Connection of Surge Tank Compressor at Carlsbad Water Reclamation Facility Page 2 of 6 General Counsel Approved 02/14/2023 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. FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to CMWD 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 CMWD to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ____________Clint Morgan_____________ REQUIRED INSURANCE. The successful contractor shall provide to CMWD, 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 CMWD 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 DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 PWM23-2147UTIL Electrical Connection of Surge Tank Compressor at Carlsbad Water Reclamation Facility Page 3 of 6 General Counsel Approved 02/14/2023 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 30 days written notice shall be given to CMWD prior to such cancellation. The policies shall name CMWD as additional insured. The full limits available to the named insured shall also be available and applicable to CMWD as an additional insured. WORKERS COMPENSATION AND EMPLOYER’S LIABILITY. Worker’s 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 CMWD and the City of Carlsbad, and its 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 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 CMWD or City of Carlsbad. The expenses of defense include all costs and expenses including attorneys’ fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within seven (7) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within thirty (30) working days after receipt of Notice to Proceed. /// /// /// DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 PWM23-2147UTIL Electrical Connection of Surge Tank Compressor at Carlsbad Water Reclamation Facility Page 4 of 6 General Counsel Approved 02/14/2023 CONTRACTOR’S INFORMATION. National Electric Works, Inc. 4440 Rainier Ave., Suite 101 (name of Contractor) 591191 (street address) San Diego, CA 92120 (Contractor’s license number) C10-Electrical 3/31/24 (city/state/zip) 619-520-2972 (license class. and exp. date) 1000003595 6/30/23 (telephone no.) wurtnowski@nationalelectricworks.com (DIR registration number & 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 NATIONAL ELECTRIC WORKS, INC., a California corporation CARLSBAD MUNICIPAL WATER DISTRICT, a Public Agency organized under the Municipal Water Act of 1911, and a Subsidiary District of the City of Carlsbad By: By: (sign here) Clint Morgan, President & Treasurer Vicki V. Quiram, General Manager as authorized by the Executive Manager (print name/title) By: (sign here) Travis Morgan, Vice President & Secretary (print name/title) If required by CMWD, 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: CINDIE K. McMAHON, General Counsel BY: _____________________________ General Counsel DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 PWM23-2147UTIL Electrical Connection of Surge Tank Compressor at Carlsbad Water Reclamation Facility Page 5 of 6 General Counsel Approved 02/14/2023 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 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: 61987736-8EDB-490B-8E32-ABE4E27F6E69 none none none nonenone none none nonenone none none PWM23-2147UTIL Electrical Connection of Surge Tank Compressor at Carlsbad Water Reclamation Facility Page 6 of 6 General Counsel Approved 02/14/2023 EXHIBIT B Electrical Connection of Surge Tank Compressor at Carlsbad Water Reclamation Facility (CWRF) Electrical Scope: The Compressor is to be swapped out for a surge tank at the CWRF location. The new compressor is not identical to the existing one. There is no disconnect within the new compressor control panel, and the new panel is mounted at a higher height than the existing (presenting possibility control wires will not reach new termination locations). The existing system is sourced with a 70A breaker, with 8awg feeders. The new panel is rated for 25A. NEW to switch existing 70A breaker to a 40A and provide a heavy duty 3- Pole NEMA 4 (matching new control panel rating) to be mounted at the compressor. This work includes pulling new wires. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 EA 1 Electrical materials $3,851.88 2 EA 1 Labor $2,838.20 SUBTOTAL $6,690.08 3 EA 1 Adder materials $975.81 4 EA 1 Labor $2,300.00 SUBTOTAL $3,275.81 TOTAL* $9,965.89 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 4440 Rainer Ave Suite 101 San Diego, CA 92120 619.528.2880 Tel 619.528.2898 Fax www.nationalelectricworks.com Page 1 of 3 LIC# 591191 C10 / DIR#1000003595 Monday, March 13, 2023 Bid ID: 23-3-1002 City of Carlsbad – Potable Water 1635 Faraday Avenue Carlsbad, CA 92008 Attention: Ray Martinez Re: Carlsbad CWRF Surge Tank Compressor Ray, Thank you for this opportunity to bid on this scope of work, and we appreciate you selecting NEW Inc. to support your electrical and Low Voltage needs. We propose to furnish labor, material, and equipment to perform the Electrical and/or Low Voltage work on the above referenced project for the amount(s) shown below. This proposal is based on the scope of work identified on the job walk between Eric Deckard and Ray Martinez, the following clarifications/exclusions listed below. The price is based on prevailing wage. Base Electrical Scope: The Compressor is to be swapped out for a surge tank at the CWRF location. The new compressor is not identical to the existing one. There is no disconnect within the new compressor control panel, and the new panel is mounted at a higher height than the existing (presenting possibility control wires will not reach new termination locations). The existing system is sourced with a 70A breaker, with 8awg feeders. The new panel is rated for 25A. NEW to switch existing 70A breaker to a 40A and provide a heavy duty 3- Pole NEMA 4 (matching new control panel rating) to be mounted at the compressor. Adder if Applicable If the control wires does not reach, we will need to pull new wires (no splicing per Ray Martinez). Electrical Sheets: Not Applicable to work Specification Sections: Not applicable to work General Clarifications: 1. This proposal is contingent upon contract terms and conditions being acceptable to NEW Inc. 2. This bid is based on the use of approved industry standard materials and methods. 3. NEW Inc.’s bond rate is not included in the above pricing. 4. Pricing is based on lay-down for tools, equipment and material being in the immediate area. 5. This bid assumes that there is sufficient parking for our crew. 6. Work changes shall be negotiated promptly. Added work is calculated per RS MEANS or other electrical industry standard and shall include all contracted labor force burden. 7. Payments to NEW shall not be dependent on payments by the owner or others. 8. This bid assumes that we will have access to the work during normal business hours. 9. This bid assumes that the building facilities personnel will put the critical building systems into bypass/test mode as needed for this scope of work and handle any systems that may need to be addressed during this time. PWM23-2147UTIL Exhibit "C"DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 4440 Rainer Ave Suite 101 San Diego, CA 92120 619.528.2880 Tel 619.528.2898 Fax www.nationalelectricworks.com Page 2 of 3 LIC# 591191 C10 / DIR#1000003595 10. This bid assumes that the staff facilities will be available during this time to assist access to the site, and during the commissioning process. 11. Duty for NEW to find or report any design errors/omissions. Liability for NEW not finding and reporting any design errors/omissions. 12.Liability/allowances/retesting costs due to design errors/omissions, or designs not complying with codes, requirements, or goals. 13. This bid includes a 1-year warranty on all work from NEW Inc. Schedule Clarification: 1. The proposal is based upon a concurrent construction schedule with no delays. 2. Standard lead-times apply; no expediting of manufacturing or delivery has been included in this proposal. Design/Scope Clarifications: 1. This bid is based on NEW Inc. doing all the testing, and no 3rd party testing is included. 2. Pricing is based on NEW Inc. having control of design as it relates to maintaining the pricing above. 3. Pricing is based on providing safe-off only for electrical devices and equipment to be removed under the demolition scope of work. Removal, salvage, or storage of any equipment/materials is by others. 4. This bid assumes that due to this project’s size that BIM modeling and detailing is minimal for the electrical scope. The electrical project manager will attend meetings and supply submittals as needed for the BIM MEP coordination efforts done by others (adder can be requested if needed). 5. It is presumed that the existing electrical service/equipment can accept any/all the added electrical equipment/demand, and that all existing equipment is in good working condition to accept the alterations per the above scope of work. 6. This bid assumes that we may utilize the existing materials (conduits, wire, and racks) for the temporary/permanent power feeds after a more in-depth review and upon implementation of this scope of work. Exclusions: 1. Unforeseen conditions. 2. Temp Power and Lighting (Adder can be given at your request). 3. Premium portion of overtime. 4. All mechanical controls (regardless of voltage), wiring and equipment. 5. BIM, 3-D modeling. 6. Liquidated damages. 7. Owner certified insurance programs. 8. Payment and performance bond. 9. Field cutting, coring, patching, painting, and coatings for all exterior surfaces. 10. Access panels. 11. Job site security. 12. Design and engineering fees. 13. Electrical Permits (OSHPD & HCAI). PWM23-2147UTIL Exhibit "C" (cont'd)DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 4440 Rainer Ave Suite 101 San Diego, CA 92120 619.528.2880 Tel 619.528.2898 Fax www.nationalelectricworks.com Page 3 of 3 LIC# 591191 C10 / DIR#1000003595 14. Re-supporting of all non-code compliant wiring or conduits not associated with scope noted above. 15. City and regulatory permits and fees. 16. Seismic Bracing to existing conduits. 17. Seismic Engineering to existing conduits. 18. Demolition (we will safe-off only). 19. Offsite spoils removal (spoils will be stockpiled on site next to trenches). 20. Working in energized electrical gear, or on energized electrical devices. 21. Commissioning. 22. Any work other than what is specifically mentioned in the plans noted above. 23. Mounting of inline instruments. 24. PLC programming, SCADA programming, radio programming and configuring, software, hardware, programming cables, licensing, radio’s, fees. Materials – $3,851.88 & Labor – $2,838.20 Base Bid based on Prevailing Wage $6,690.08 Adder Materials - $975.81 & Labor - $2,300.00 If Adder (For Pulling New Wire) if required $3,275.81 + Base Bid equaling $9,965.89 This proposal is contingent upon: Payment for the below services will be due in full upon completion of the work. If the duration of the project extends past one-month, NEW Inc. will submit an invoice for the work accomplished in that month. All invoices are due and payable within fifteen (15) days of receipt or 2% interest per month may be added at the sole discretion of our firm. In the event it shall become necessary for NEW Inc. to institute legal proceedings to collect the cost of the charge as set forth herein, then and in that event the unsuccessful party shall pay to the successful party reasonable attorney fees. This proposal is based upon not participating in an OCIP or Wrap Insurance Program. In the event this is a requirement of the project, NEW Inc. will need to be notified of the content and requirements of the program at time of project award, an insurance credit, if applicable, will be provided by NEW Inc. and NEW Inc. will require a $ 1,500.00 administration fee to be added to the contract for the management and administrative effort required to participate within the OCIP, CCIP or Wrap Program. Please call me at (619-520-2972) if there are any questions regarding this proposal. This quotation is valid for (30) Thirty days from the date of proposal, and any modifications or amendments to this document must be in writing. Sincerely, Walter Urtnowski Project Manager NEW Inc. Phone (619) 528-2880 Ext. (252) Fax: (619) 528-2898 Cell (619) 520-2972 $6,690.08$6,690.08 TOTAL $9,965.89 PWM23-2147UTIL Exhibit "C" (cont'd)DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 PWM23-2147UTIL Exhibit "C" (cont'd) DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 ' .. , ' .. , ' .. .. 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415"1J 250 The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTEDEACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 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: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10/3/2022 Burnham WGB Insurance SolutionsCA Insurance License 0F6977115901 Red Hill AvenueTustin CA 92780 Maryssa Mace 714-505-7000 714-573-1770 Maryssa.mace@wgbib.com Travelers Property Casualty 25674 NATIO13 Travelers Indemnity Co of CT 25682National Electric Works, Inc.National Security Works, Inc.National IT Works4440 Rainier Avenue, Suite 101San Diego CA 92120-3319 TRAVELERS CAS INS CO OF AMER 19046 COLUMBIA CAS CO 31127 Travelers Cas Ins. Co. of Amer 574732151 B X 1,000,000 X 300,000 5,000 1,000,000 2,000,000 X DT22CO6S340648TCT22 10/1/2022 10/1/2023 2,000,000 BI/PD PER OCC DED 5,000 C 1,000,000 X 8106S2696922226G 10/1/2022 10/1/2023 COMP/COLL DED 1,000/$1,000 C X 5,000,000 X $0 CUP6S3464562226 5,000,000 10/1/2022 10/1/2023 E Y UB6S3429182226G 10/1/2022 10/1/2023 X 1,000,000 1,000,000 1,000,000 AD Professional LiabIncludes PollutionLeased/Rented equipment 6603P901223TIL22CEO591901410 10/1/202210/1/2022 10/1/202310/1/2023 Each claim limitAggregate LimitMax Limit Per Item 3,000,0003,000,000130,000/ 1000 Ded. Certificate holder is named as additional insured on the General Liability per attached endorsements listed below, as required by written contract subject to theterms and conditions of the policy: Additional Insured applies per form CG D2 46 04 19Additional Insured applies per form CG D3 16 02 19GL Primary & Non-Contributory Form applies per attached CG T1 00 02 19GL Waiver of Subrogation Form applies per attached CG D3 16 02 19GL Per Project Aggregate Form applies per attached CG D2 11 01 04See Attached... City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance ServicesP.O. Box 4668 - ECM #35050New York NY 10163 DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 ACORD® I ~ I f--□ □ f-- f-- Fl □ □ f-- f--~ f--f-- f--f-- f--H I I I I I □ I ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: NATIO13 1 1 Burnham WGB Insurance Solutions National Electric Works, Inc.National Security Works, Inc.National IT Works4440 Rainier Avenue, Suite 101San Diego CA 92120-3319 25 CERTIFICATE OF LIABILITY INSURANCE WC Waiver of Subrogation Form applies per attached WC 99 03 76Auto Additional Insured applies per attached CA T3 53 02 15Auto Primary & Non-Contributory applies per attached CA T4 99 02 16Auto Waiver of Subrogation applies per attached CA T3 53 02 15 RE: Agreement Name : Wastewater System Electrical, Instrumentation and Controls Services / Agreement Number : PSA20-873UTIL CERTIFICATE HOLDERVESTING: City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 I COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products-Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS (1)Any "bodily injury", "property damage" or "personal injury" arising out of the providing,The following is added to SECTION II – WHO IS AN or failure to provide, any professionalINSURED:architectural, engineering or surveyingAny person or organization that you agree in a services, including:written contract or agreement to include as an additional insured on this Coverage Part is an (a)The preparing, approving, or failing to insured, but only:prepare or approve, maps, shop drawings, opinions, reports, surveys,a.With respect to liability for "bodily injury" or field orders or change orders, or the"property damage" that occurs, or for "personal preparing, approving, or failing toinjury" caused by an offense that is committed, prepare or approve, drawings andsubsequent to the signing of that contract or agreement and while that part of the contract or specifications; and agreement is in effect; and (b)Supervisory, inspection, architectural orb.If, and only to the extent that, such injury or engineering activities.damage is caused by acts or omissions of you or (2)Any "bodily injury" or "property damage"your subcontractor in the performance of "your caused by "your work" and included in thework" to which the written contract or agreement "products-completed operations hazard"applies. Such person or organization does not unless the written contract or agreementqualify as an additional insured with respect to the independent acts or omissions of such specifically requires you to provide such person or organization.coverage for that additional insured during the policy period.The insurance provided to such additional insured is subject to the following provisions:c.The additional insured must comply with the a.If the Limits of Insurance of this Coverage Part following duties: shown in the Declarations exceed the minimum (1)Give us written notice as soon as practicablelimits required by the written contract or of an "occurrence" or an offense which mayagreement, the insurance provided to the result in a claim. To the extent possible, suchadditional insured will be limited to such notice should include:minimum required limits. For the purposes of determining whether this limitation applies, the (a)How, when and where the "occurrence"minimum limits required by the written contract or or offense took place;agreement will be considered to include the (b)The names and addresses of any injuredminimum limits of any Umbrella or Excess persons and witnesses; andliability coverage required for the additional insured by that written contract or agreement.(c)The nature and location of any injury orThis provision will not increase the limits of damage arising out of the "occurrence"insurance described in Section III – Limits Of or offense.Insurance. (2)If a claim is made or "suit" is brought againstb.The insurance provided to such additional the additional insured:insured does not apply to: CG D2 46 04 19 ú 2018 The Travelers Indemnity Company. All rights reserved.Page 1 of 2 Policy Number: DT22CO6S340648TCT22DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL GENERAL LIABILITY (a)Immediately record the specifics of the (4)Tender the defense and indemnity of any claim or "suit" and the date received; and claim or "suit" to any provider of other insurance which would cover such additional(b)Notify us as soon as practicable and see insured for a loss we cover. However, thisto it that we receive written notice of the condition does not affect whether theclaim or "suit" as soon as practicable.insurance provided to such additional(3)Immediately send us copies of all legal insured is primary to other insurancepapers received in connection with the claim available to such additional insured whichor "suit", cooperate with us in the covers that person or organization as ainvestigation or settlement of the claim or named insured as described in Paragraph 4.,defense against the "suit", and otherwise Other Insurance, of Section IV – Commercialcomply with all policy conditions.General Liability Conditions. Page 2 of 2 ú 2018 The Travelers Indemnity Company. All rights reserved.CG D2 46 04 19 DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO 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. H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF USE – INCREASED LIMIT A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED I. PHYSICAL DAMAGE – TRANSPORTATION EXPENSES – INCREASED LIMIT C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS – INCREASED LIMITS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSSF. HIRED AUTO – LIMITED WORLDWIDE COV- ERAGE – INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE – GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED 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. The following is added to Paragraph A.1.,Who Is An Insured, of SECTION II – COVERED AUTOS LIABILITY COVERAGE: C. EMPLOYEE HIRED AUTOAny organization you newly acquire or form dur- 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 afforded 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. 1.The following is added to Paragraph A.1., Who Is An Insured, of SECTION II – COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours 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.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: 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: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which (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 02 15 ú 2015 The Travelers Indemnity Company. All rights reserved.Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number: 8106S2696922226G DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. (a)With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada:However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".(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. D. EMPLOYEES AS INSURED The following is added to Paragraph A.1.,Who Is An Insured, of SECTION II – COVERED AUTOS LIABILITY COVERAGE:(ii)Neither you nor any other involved "insured" will make any settlement without our consent. Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs.(iii)We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". E. SUPPLEMENTARY PAYMENTS – INCREASED LIMITS 1.The following replaces Paragraph A.2.a.(2), of SECTION II – COVERED AUTOS LIABIL- ITY COVERAGE:(iv)We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" 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. (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: (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. (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 pro- 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 driver 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", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. (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 compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. Page 2 of 4 ú 2015 The Travelers Indemnity Company. All rights reserved.CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL AUTO (2)In or on your covered "auto".You agree to maintain all required or compulsory insurance in any such coun- try 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. This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3.,Exclu- sions, of SECTION III – 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: (d)It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories 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. 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; andG. WAIVER OF DEDUCTIBLE – GLASS c.The airbags were not intentionally inflated.The following is added to Paragraph D.,Deducti- ble, of SECTION III – PHYSICAL DAMAGE COVERAGE:We will pay up to a maximum of $1,000 for any one "loss". No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV – BUSINESS AUTO CONDITIONS:H. HIRED AUTO PHYSICAL DAMAGE – LOSS OF USE – INCREASED LIMIT 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: The following replaces the last sentence of Para- graph A.4.b.,Loss Of Use Expenses, of SEC- TION III – PHYSICAL DAMAGE COVERAGE: (a)You (if you are an individual);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". (b)A partner (if you are a partnership); (c)A member (if you are a limited liability com- pany);I. PHYSICAL DAMAGE – TRANSPORTATION EXPENSES – INCREASED LIMIT (d)An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or The following replaces the first sentence in Para- graph A.4.a.,Transportation Expenses, of SECTION III – PHYSICAL DAMAGE COVER- AGE: (e)Any "employee" authorized by you to give no- tice of the "accident" or "loss". 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. 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:J. PERSONAL PROPERTY 5. Transfer Of Rights Of Recovery Against Others To Us The following is added to Paragraph A.4.,Cover- age Extensions, of SECTION III – PHYSICAL DAMAGE COVERAGE:We waive any right of recovery we may have against any person 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 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 CA T3 53 02 15 ú 2015 The Travelers Indemnity Company. All rights reserved.Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. 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. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2.,Con- cealment, Misrepresentation, Or Fraud, of SECTION IV – BUSINESS AUTO CONDITIONS: Page 4 of 4 ú 2015 The Travelers Indemnity Company. All rights reserved.CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL GENERAL LIABILITY c.Method Of Sharing If all of the other insurance permits contributionby equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicablelimit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contributeby limits. Under this methcx:1, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits ofinsurance of all insurers. d.Primary And Non-Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and noncontributory basis, this insurance is primary to other insurance that is available to such insuredwhich covers such insured as a named insured,and we will not share with that other insurance, provided that: (1)The "bodily injury'' or "property damage" for which coverage is sought occurs; and (2)The "personal and advertising injury" forwhich coverage is sought is caused by anoffense that is committed; subsequent to the signing of that contract or agreement by you. 5.Premium Audit a.We will compute all premiums for this Coverage Part in accordance with our rules and rates. b.Premium shown in this Coverage Part asadvance premium is a deposit premium only. At the close of each audit pericx:I we will computethe earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum ofthe advance and audit premiums paid for the policy period is greater than the earnedpremium, we will return the excess to the firstNamed Insured. c.The first Named Insured must keep records of the information we need for premiumcomputation, and send us copies at such times as we may request. 6.Representations By accepting this policy, you agree: a.The statements in the Declarations are accurate and complete; b.Those statements are based upon representations you made to us; and c.We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice 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. 7.Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, thisinsurance applies: a.As if each Named Insured were the only Named Insured; and b.Separately to each insured against whom claimis made or "suit" is brought. 8.Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured mustdo nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9.When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown inthe Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V -DEFINITIONS 1."Advertisement" means a notice that is broadcast or published to the general public or specific marketsegments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a.Notices that are published include material placed on the Internet or on similar electronic means of communication; and b.Regarding websites, only that part of a website that is about your goods, prcx:lucts or services for the purposes of attracting customers orsupporters is considered an advertisement. Page 16 of 21 © 2017 The Travelers Indemnity Company. All rights reserved. CGT1000219 Includes copyrighted material of Insurance Services Office. Inc. with its permission. Policy Number: DT22CO6S340648TCT22DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS 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 coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A.Who Is An Insured – Unnamed Subsidiaries C.Incidental Medical Malpractice B.Blanket Additional Insured – Governmental D.Blanket Waiver Of Subrogation Entities – Permits Or Authorizations Relating To E.Contractual Liability – RailroadsOperationsF.Damage To Premises Rented To You PROVISIONS a.An organization other than a partnership, joint venture or limited liability company; orA. WHO IS AN INSURED – UNNAMED b.A trust;SUBSIDIARIES The following is added to SECTION II – WHO IS as indicated in its name or the documents that AN INSURED:govern its structure. Any of your subsidiaries, other than a partnership,B. BLANKET ADDITIONAL INSURED –joint venture or limited liability company, that is GOVERNMENTAL ENTITIES – PERMITS ORnot shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONSDeclarations is a Named Insured if:The following is added to SECTION II – WHO ISa.You are the sole owner of, or maintain an AN INSURED:ownership interest of more than 50% in, such Any governmental entity that has issued a permitsubsidiary on the first day of the policy period; or authorization with respect to operationsand performed by you or on your behalf and that youb.Such subsidiary is not an insured under are required by any ordinance, law, building codesimilar other insurance.or written contract or agreement to include as an No such subsidiary is an insured for "bodily injury"additional insured on this Coverage Part is an or "property damage" that occurred, or "personal insured, but only with respect to liability for "bodily injury", "property damage" or "personal andand advertising injury" caused by an offense advertising injury" arising out of such operations.committed: The insurance provided to such governmentala.Before you maintained an ownership interest entity does not apply to:of more than 50% in such subsidiary; or a.Any "bodily injury", "property damage" orb.After the date, if any, during the policy period "personal and advertising injury" arising out ofthat you no longer maintain an ownership operations performed for the governmentalinterest of more than 50% in such subsidiary.entity; orFor purposes of Paragraph 1.of Section II – Who b.Any "bodily injury" or "property damage"Is An Insured, each such subsidiary will be included in the "products-completeddeemed to be designated in the Declarations as:operations hazard". CG D3 16 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved.Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Policy Number: DT22CO6S340648TCT22DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE pharmaceuticals committed by, or with the knowledge or consent of, the insured.1.The following replaces Paragraph b.of the definition of "occurrence" in the 5.The following is added to the DEFINITIONS DEFINITIONS Section:Section: b.An act or omission committed in providing "Incidental medical services" means:or failing to provide "incidental medical a.Medical, surgical, dental, laboratory, x-rayservices", first aid or "Good Samaritan or nursing service or treatment, advice orservices" to a person, unless you are in instruction, or the related furnishing ofthe business or occupation of providing food or beverages; orprofessional health care services. b.The furnishing or dispensing of drugs or2.The following replaces the last paragraph of medical, dental, or surgical supplies orParagraph2.a.(1)of SECTION II – WHO IS appliances.AN INSURED: 6.The following is added to Paragraph 4.b.,Unless you are in the business or occupation Excess Insurance, of SECTION IV –of providing professional health care services, Paragraphs (1)(a),(b),(c)and (d)above do COMMERCIAL GENERAL LIABILITY not apply to "bodily injury" arising out of CONDITIONS: providing or failing to provide:This insurance is excess over any valid and (a)"Incidental medical services" by any of collectible other insurance, whether primary,your "employees" who is a nurse, nurse excess, contingent or on any other basis, thatassistant, emergency medical technician is available to any of your "employees" foror paramedic; or "bodily injury" that arises out of providing or failing to provide "incidental medical services"(b)First aid or "Good Samaritan services" by to any person to the extent not subject toany of your "employees" or "volunteer workers", other than an employed or Paragraph 2.a.(1)of Section II – Who Is An volunteer doctor. Any such "employees"Insured. or "volunteer workers" providing or failing D. BLANKET WAIVER OF SUBROGATIONto provide first aid or "Good Samaritan The following is added to Paragraph 8.,Transferservices" during their work hours for you Of Rights Of Recovery Against Others To Us,will be deemed to be acting within the of SECTION IV – COMMERCIAL GENERALscope of their employment by you or performing duties related to the conduct LIABILITY CONDITIONS: of your business.If the insured has agreed in a contract or 3.The following replaces the last sentence of agreement to waive that insured's right of Paragraph 5.of SECTION III – LIMITS OF recovery against any person or organization, we INSURANCE:waive our right of recovery against such person or organization, but only for payments we makeFor the purposes of determining the because of:applicable Each Occurrence Limit, all related acts or omissions committed in providing or a."Bodily injury" or "property damage" thatfailing to provide "incidental medical occurs; orservices", first aid or "Good Samaritan b."Personal and advertising injury" caused byservices" to any one person will be deemed to an offense that is committed;be one "occurrence". 4.The following exclusion is added to subsequent to the execution of the contract or Paragraph 2.,Exclusions, of SECTION I –agreement. COVERAGES – COVERAGE A – BODILY E. CONTRACTUAL LIABILITY – RAILROADSINJURY AND PROPERTY DAMAGE LIABILITY:1.The following replaces Paragraph c.of the definition of "insured contract" in theSale Of Pharmaceuticals DEFINITIONS Section:"Bodily injury" or "property damage" arising out of the violation of a penal statute or c.Any easement or license agreement; ordinance relating to the sale of Page 2 of 3 ú 2017 The Travelers Indemnity Company. All rights reserved.CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERCIAL GENERAL LIABILITY 2.Paragraph f.(1)of the definition of "insured a.Any premises while rented to you or contract" in the DEFINITIONS Section is temporarily occupied by you with permission deleted.of the owner; or F. DAMAGE TO PREMISES RENTED TO YOU b.The contents of any premises while such premises is rented to you, if you rent suchThe following replaces the definition of "premises premises for a period of seven or fewerdamage" in the DEFINITIONS Section:consecutive days."Premises damage" means "property damage" to: CG D3 16 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved.Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERC GENERAL L ITYIALIABIL POLICY NUMBER: DT22CO6S340648TCT22 THIS ENDORSEMENT CHA OLICY. PLEASE READ I EFULLYNGES THE P T CAR DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement i ies insurance pro ided under t folmod f v he lowing: COMMERC GENERAL L ITY VERA AIALIABIL CO GE P RT SCHEDULE Designated jectPro Designated Pro General Aggregate(s):ject(s): A.3.COVERAGE A.For al sums which the insured becomes legal Any payments made underlly obligated to pay as damages caused by "occur-for da or under formagesCOVERAGE C. rences" under , and med e shall reduce the DesiCOVERAGE A. (SECT IION )ical xpenses g- for al med e s caused by accidents un-nated Projec General Aggregate L m forl ical xpense t i it der , which can be that designated "project". Such paymentsCOVERAGE C (SEC I I)T ON attr only to operations at a single desig-shall not reduce the General Aggregate Limibutedit nated "project shown in the Schedule abo e:"v shown in the Declarat nor shall they re-ions duce any other Designated Pro Generalject1.A separate Designated Project General Ag-Aggregate Li it fo any other designatedm rgregate Li it app designated "pro-m lies to each "project" n in the dule abo e.show Sche vject" and that l m is equal to the amount of, i it the General Aggregate Li t shown in the The l m shown in the Declarations formii its4.Each Declarat unless separateions,Designated Occurrence, Damage T Premises Reonted Project General Ag T Yo and Me Expegregate(s)o u dical nseare sche continue tod- uled abo .ve apply. Howe instead o be subject tover, f ing the General Aggregate Li t shown in themi2.The Designated Project General Aggregate Declarat such li its will be subject to theions, mLi it is the most we will pay for the sum o almf l applicab Designated Project General Ag-ledamages under , exceptCOVERAGE A.gregate Li itm .damages because of "bodil in " or "prop-y jury erty damage inc in the "products- For al sums which the insured becomes legal" luded l lyB. comp operations hazard , and for med obligated to pay as damages caused by "occur-leted "i- cal expenses under , regar rences" under , andCOVERAGE C COVERAGE A. (SECT Id-ION ) less of the onumber f:for al med e s caused by accidents un-l ical xpense der , which cannotCOVERAGE C. (SEC ON I)TIa.Insureds;be attribu only to operations at a sing desitedle g-b.Clai made or "suits" brought; orms nated "project shown in the Schedule abo e:"v c.Persons or organizations m ing cla msak i or bringing "suits". CG D2 11 01 04 Copyright, Tra elers Inde ity mpany, 2004 Page 1 oThe v mn Co f 2 GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS.EACH "PROJECT" FOR WHICH YOU HAVE AGREED IN A WRITTEN CONTRACT THAT IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 COMMERC GENERAL L ITYIALIABIL 1.COVERAGE A.Any payments made under v ded,any pa ments for da because ofiymages for da or under for "bodily injury or "property damage"inc inmages"ludedCOVERAGEC. med e shall reduce the amount the "products-comp o erat hazard"willicalxpensesletedpions a ilab under the General Aggregate Lim reduce the Products Comp Operat Ag-va le it -leted ions or the Products Completed Operat Ag-gregate Li t,and not reduce the General Aggre--ions mi gregate Li it ver is applic bm,whiche a le;and gate Li it nor the Designated Pro Generalmject Aggregate Li itm.2.Such payments shall not reduce any Desig- nated Projec General Aggregate L m .t i it E.Defi i-For the purposes of this endorsement the n tio Sectionsn is amended by the addit of theionC.2.SEC ION I LI T OFPartofTIIMIS INSURANCE fo lowing def itlinion:is deleted and rep folacedbythellowing: "Projec "means an area away fro pre isestmm2.The General Aggregate Li i is the most wemt owned by or rented to you at which you are per-will for o :pay the sum f for ing oper t pursuant to a contract ormaionsa.Coverage BDamagesunder;and agreement.For the purposes of deter ing themin b.Damages f m "occurrences"under applicab aggregate li t o insurance,eachrolemif COVERAGE A (SECT I)ION and for al "project"that includes prem in l i thelisesvovng med e caused by accidents same or connecting lots,or prem whose con-ical xpenses ises under which nection is interrupted only by a street,roadway,COVERAGE C (T I)SEC ION cannot be attr buted only to operat at waterway or right of way of a railroad shall beiions-- considered a single "projec ".tasingledesignated"project"shown in the SCHEDULE abo e.v F.SEC ION I LIM T OFTheproonsofvisiTIIIS D.INSURANCEWcoerageforliabliarisingoutothe not otherwise modi ied by this en-hen v i ty f f dorsement shall to applycontinue as stipulated."products-comple operations hazard is pro-ted " Page 2 o Copyright,Tra elers Inde ity mpany,2004f2ThevmnCo CG D2 11 01 04 DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 - - WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) 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 %of the California workers'compensation pre- mium. Schedule Person or Organization Job Description 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.) Policy No. UB6S3429182226G Endorsement No. Premium Countersigned by ST ASSIGN:Page 1 of 1 ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69 ~ TRAVELERSJ COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED – PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE – CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2.The following is added to Paragraph B.5.,Other Insurance of SECTION IV – BUSINESS AUTO1.The following is added to Paragraph c.in A.1.,CONDITIONS:Who Is An Insured, of SECTION Il – COVERED AUTOS LIABILITY COVERAGE:Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, thisThis includes any person or organization who you insurance is primary to and non-contributory withare required under a written contract or applicable other insurance under which anagreement, that is signed by you before the additional insured person or organization is a"bodily injury" or "property damage" occurs and named insured when a written contract orthat is in effect during the policy period, to name agreement with you, that is signed by you beforeas an additional insured for Covered Autos the "bodily injury" or "property damage" occursLiability Coverage, but only for damages to which and that is in effect during the policy period,this insurance applies and only to the extent of requires this insurance to be primary and non-that person's or organization's liability for the contributory.conduct of another "insured". CA T4 99 02 16 ú 2016 The Travelers Indemnity Company. All rights reserved.Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number: 8106S2696922226GDocuSign Envelope ID: 61987736-8EDB-490B-8E32-ABE4E27F6E69