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Home My WebLink About2023-03-29 Dempton, Lisa1 Gloria Sanchez From:Glen Raphael <GRaphael@carlwarren.com> Sent:Monday, April 24, 2023 5:14 PM To:Gloria Sanchez Cc:Andrea Staehle; Amber Molina Subject:RE: 20230419 Dempton Palm Desert NOTIFICATION LETTER 3045632 Hello, Thank you for the agreement and COI, I will tender the claim to the contractor and issue a notice to the claimant. Glen Raphael | Claims Examiner GRaphael@carlwarren.com Tel: (657) 622-4315 | Fax: (866) 254-4423 Carl Warren & Company, LLC | A Venbrook Company CA Entity License No: 2607296 PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. From: Tim Varon <TVaron@carlwarren.com> Sent: Wednesday, April 19, 2023 5:21 PM To: Gloria Sanchez (gsanchez@palmdesert.gov) <gsanchez@palmdesert.gov> Cc: Glen Raphael <GRaphael@carlwarren.com>; Andrea Staehle - City of Palm Desert (astaehle@cityofpalmdesert.org) <astaehle@cityofpalmdesert.org>; Amber Molina Nunez (amolinanunez@cityofpalmdesert.org) 2 <amolinanunez@cityofpalmdesert.org> Subject: 20230419 Dempton Palm Desert NOTIFICATION LETTER 3045632 Hi Gloria, Please find attached a copy of our Notification Letter for your records. Have a great evening! Tim Tim Varon | Claims Supervisor TVaron@carlwarren.com Tel: (657) 622-4287 | Fax: (866) 254-4423 Carl Warren & Company, LLC | A Venbrook Company CA Entity License No: 2607296 PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. 1 Gloria Sanchez From:Tim Varon <TVaron@carlwarren.com> Sent:Wednesday, April 19, 2023 5:21 PM To:Gloria Sanchez Cc:Glen Raphael; Andrea Staehle; Amber Molina Subject:20230419 Dempton Palm Desert NOTIFICATION LETTER 3045632 Attachments:We sent you safe versions of your files; 20230419 Dempton Palm Desert NOTIFICATION LETTER 3045632.pdf; FW: 3045632 CJPIA Palm Desert FW: Claim Against the City No. 894 - Dempton, Lisa Mimecast Attachment Protection has deemed this file to be safe, but always exercise caution when opening files. Hi Gloria, Please find attached a copy of our Notification Letter for your records. Have a great evening! Tim Tim Varon | Claims Supervisor TVaron@carlwarren.com Tel: (657) 622-4287 | Fax: (866) 254-4423 Carl Warren & Company, LLC | A Venbrook Company CA Entity License No: 2607296 PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or 2 facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. PO Box 2411, Tustin, CA 92781 T: 657-622-4200 | F: 866-254-4423 | www.carlwarren.com CA License #2607296 April 19, 2023 Lisa Dempton 71438 Halgar Rd. Rancho Mirage, CA 92270 RE: Claimant : Lisa Dempton Date of Loss : 12/13/22 Claim Filing Date : 3/29/23 Our File Number : 3045632 GRV Carl Warren & Company is the claims management company for the City of Palm Desert. The above-captioned claim has been assigned to Glen Raphael for handling. Mr. Raphael may be reached at 657-622-4315. When our investigation is complete, we will advise you as to whether or not we can recommend settlement. Very Truly Y ours, CARL WARREN & CO. Timothy M. Varon Timothy M. Varon Claims Supervisor cc: Member Agency: City of Palm Desert, attn:Gloria Sanchez 1 Gloria Sanchez From:Gloria Sanchez Sent:Wednesday, March 29, 2023 4:55 PM To:Carl Warren & Co. (publicentityclaims@carlwarren.com); Todd Hileman; Robert Hargreaves Cc:Chris Escobedo; Randy Chavez; Andrea Staehle; Anthony Mejia; Tim Varon Subject:Claim Against the City No. 894 - Dempton, Lisa Attachments:894 - 2023-03-29 Dempton Lisa - Claim.pdf; IMG_6040.pdf; IMG_6046.pdf; IMG_ 6053.pdf; IMG_3721.pdf; IMG_3722.pdf; IMG_3723.pdf; IMG_3725.pdf; View recent photos.png; C37040A - Executed Agreement.pdf; C37040A - COI Approval.pdf Good morning, Attached for your review and/or appropriate action is CLAIM AGAINST THE CITY NO. 894 – Lisa Dempton. Please feel free to contact me should you have any questions or require additional information. Thank you and have a nice day. TO: COPY: FROM: DATE: CJPIA (c/o CARL WARREN & CO.), CITY MANAGER, CITY ATTORNEY, ASSISTANT CITY MANAGER, HUMAN RESOURCES MANAGER, AND CITY CLERK. M. GLORIA SANCHEZ, RECORDS COORDINATOR MARCH 29, 2023 SUBJECT: CLAIM NO. – 894 LISA DEMPTON The attached Claim No. 894 is being transmitted to you for the following: Information only. or X Please review and provide any recommendation you may have to the Risk Manager, concerning any action required by the City of Palm Desert. We would appreciate your report, if requested, by May 3, 2023, for timely response to the Claimant. Note: At your earliest convenience, please let me know if you have any information related to the incident giving rise to this Claim so that I may forward it to the City’s thirdparty Claims Adjusters, Carl Warren & Company. _______________________ M. GLORIA SANCHEZ RECORDS COORDINATOR Attachment (as noted) C I T Y O F P A L M D E S E R T 73 - 510 F RED W ARING D RIVE P ALM D ESERT , C ALIFORNIA 92260-2578 T EL : 760 346-0611 I NFO @ PALM - DESERT . ORG CITY Of PALM DESERT April 2, 2021 H & H General Contractors, Inc. 7919 Palm Avenue Highland, California 92346 Dear Sir or Madam: 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346- 0611 info@;cityofpalmdesert.org Subject: Contract No. C37040A - President's Plaza Parking Lot Improvements (Project No. 758-14) At its regular meeting of March 11, 2021, the Palm Desert City Council, by Minute Motion: 1) Authorized award to H & & General Contractors, Inc., Highland, California, for President's Plaza East and West Improvements in the total amount of $7,123,393; 2) authorized the City Manager or designee to review and approve written requests for the use of the contingency for unforeseen conditions up to the contingency amounts; 3) authorized the Mayor to execute the agreement. Enclosed is a fully executed Agreement for your records. If you have questions or require additional information, please do not hesitate to contact us. Sincerely, L GRACE L. ROCHA, CMC ACTING CITY CLERK GLR/mgs Enclosure ( as noted) cc/enc: Andy Firestine, Assistant City Manager Finance Department 0 PRINTED ON RECYCLED PAPER Contract No. C37040A CONTRACT FOR CONSTRUCTION This Contract for Construction ("Contract"), No. C37040A, is made and entered into this 11th day of March, 2021, by and between City of Palm Desert, a Charter City and municipal corporation, organized under the laws of the State of California, with its principal place of business at 73-510 Fred Waring Drive, Palm Desert, California 92260, sometimes hereinafter called the "City" and H H General Contractors, Inc., sometimes hereinafter called "Contractor." WITNESSETH: That the parties hereto have mutually covenanted and agreed, and by these presents do covenant and agree with each other as follows: ARTICLE 1. SCOPE OF WORK. The Contractor shall perform all Work within the time stipulated in the Contract, and shall provide all labor, materials, equipment, tools, utility services, and transportation to complete all of the Work required in strict compliance with the Contract Documents as specified in Article 5, below, for the following Project: President's Plaza Parking Lot Improvements Project No. 758-14 Contract No. C37040A Contractor is an independent contractor and not an agent of the City. The Contractor and its surety shall be liable to the City for any damages arising as a result of the Contractor's failure to comply with this obligation. ARTICLE 2. TIME FOR COMPLETION. Time is of the essence in the performance of the Work. The Work shall be commenced on the date stated in the City's Notice to Proceed. The Contractor shall complete all Work required by the Contract Documents within 165 Working Days from the construction commencement date stated in the Notice to Proceed. By its signature hereunder, Contractor agrees the time for completion set forth above is adequate and reasonable to complete the Work. Additionally, an interim completion milestone of 125 Working Days is hereby established to achieve Early Access and Beneficial Use of the Facilities (as defined herein). The Contractor shall complete all work required by the Contract Documents for Early Access and Beneficial Use of the Facilities within 125 Working Days from the construction commencement date stated in the Notice to Proceed. Early Access and Beneficial Use of the Facilities shall mean when all work required to provide continuous access and full use of a minimum of 300 of the newly complete constructed parking stalls per lot, including, but not limited to, finished paved surface and striping, at any given time, with full access for the businesses and their patrons, is complete in accordance with the Contract Documents. The liquidated damages requirements of the Contract Documents, including the amounts in Article 4 of the Contract, shall apply to each and every calendar day of delay beyond the time prescribed in this Article to provide Early Access and Beneficial Use of the Facilities. PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 1- CONTRACT FOR CONSTRUCTION Contract No. C37040A ARTICLE 3. INCENTIVE FOR EARLY COMPLETION OF BENEFICIAL USE OF FACILITIES. In order to encourage the Contractor to provide Early Access and Beneficial Use of the Facilities prior to the established milestone date, the City shall pay the Contractor an incentive ("Incentive Bonus") to provide Early Access and Beneficial Use of the Facilities prior to the time for completion set forth in Article 2 of the Contract. The Incentive Bonus shall be in the amount of Thirty -Five Hundred Dollars ($3,500.00) for each and every Working Day in which Early Access and Beneficial Use of the Facilities is completed prior to the time for completion set forth in Article 2 of the Contract but shall under no circumstances exceed One Hundred Thousand Dollars 100,000.00). ARTICLE 4. CONTRACT PRICE. The City shall pay to the Contractor as full compensation for the performance of the Contract, subject to any additions or deductions as provided in the Contract Documents, and including all applicable taxes and costs, the sum of Seven Million One Hundred Twenty Three Thousand Three Hundred Ninety Three and 00/100 Dollars ($7,123,393.00). Payment shall be made as set forth in the General Conditions. The City will pay to Contractor compensation based upon the prices set forth in the Bid Schedule. ARTICLE 5. LIQUIDATED DAMAGES. Contractor acknowledges that the City will sustain actual damages for each and every Day completion of the Project is delayed beyond the Contract Time. Because of the nature of the Project, it would be impracticable or extremely difficult to determine the City's actual damages. Accordingly, in accordance with Government Code section 53069.85, it is agreed that the Contractor will pay the City the sum of $3,500 for each and every calendar day of delay beyond the time prescribed in the Contract Documents for finishing the Work, as Liquidated Damages and not as a penalty or forfeiture. In the event this is not paid, the Contractor agrees the City may deduct that amount from any money due or that may become due the Contractor under the Contract. This Section does not exclude recovery of other damages specified in the Contract Documents. Liquidated damages may be deducted from progress payments due Contractor, Project retention or may be collected directly from Contractor, or from Contractor's surety. These provisions for liquidated damages shall not prevent the City, in case of Contractor's default, from terminating the Contractor. ARTICLE 6. COMPONENT PARTS OF THE CONTRACT. The "Contract Documents" include the following: Notice Inviting Bids Instructions to Bidders Bid Forms Bid Acknowledgement Bid Schedule Bid Guarantee Designation of Subcontractors Information Required of Bidders Non -Collusion Declaration Form Iran Contracting Act Certification Public Works Contractor DIR Registration Certification PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 2- CONTRACT FOR CONSTRUCTION Contract No. C37040A Performance Bond Payment (Labor and Materials) Bond Contract for Construction General Conditions Special Conditions Specifications Addenda Construction Plans and Drawings Standard Specifications for Public Works Construction "Greenbook", latest edition, Except Sections 1-9 Standard Plans of the City of Palm Desert, latest edition Standard Plans for Public Works Construction, latest edition Caltrans Standard Specifications, latest edition, Except Division 1 Caltrans Standard Plans, latest edition California Manual on Traffic Control Devices for Streets and Highways (CAMUTCD), latest edition Work Area Traffic Control Handbook, latest edition Reference Specifications Approved and fully executed Change Orders Permits Any other documents contained in or incorporated into the Contract The Contractor shall complete the Work in strict accordance with all of the Contract Documents. All of the Contract Documents are intended to be complementary. Work required by one of the Contract Documents and not by others shall be done as if required by all. In the event of conflict, the various Contract Documents will be given effect in the order set forth in the General Conditions. This Contract shall supersede any prior agreement of the parties. ARTICLE 7. PROVISIONS REQUIRED BY LAW AND CONTRACTOR COMPLIANCE. Each and every provision of law required to be included in these Contract Documents shall be deemed to be included in these Contract Documents. The Contractor shall comply with all requirements of applicable federal, state and local laws, rules and regulations, including, but not limited to, the provisions of the California Labor Code and California Public Contract Code which are applicable to this Work. ARTICLE 8. INDEMNIFICATION AND INSURANCE A. Indemnification 1. To the fullest extent permitted by law, Contractor shall immediately defend (with counsel of the City's choosing), indemnify and hold harmless the City, its officials, officers, agents, employees, and representatives, and each of them from and against: a) Any and all claims, demands, causes of action, costs, expenses, injuries, losses or liabilities, in law or in equity, of every kind or nature whatsoever, but not limited to, injury to or death, including wrongful death, of any person, and damages to or destruction of property of any person, arising out of, related to, or in any manner directly or indirectly connected with the Work or this Contract, PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 3- CONTRACT FOR CONSTRUCTION Contract No. C37040A including claims made by subcontractors for nonpayment, including without limitation the payment of all consequential damages and attorney's fees and other related costs and expenses, however caused, regardless of whether the allegations are false, fraudulent, or groundless, and regardless of any negligence of the City or its officers, employees, or authorized volunteers including passive negligence), except the sole negligence or willful misconduct or active negligence of the City or its officials, officers, employees, or authorized volunteers; b) Contractor's defense and indemnity obligation herein includes, but is not limited to damages, fines, penalties, attorney's fees and costs arising from claims under the Americans with Disabilities Act (ADA) or other federal or state disability access or discrimination laws arising from Contractor's Work during the course of construction of the improvements or after the Work is complete, as the result of defects or negligence in Contractor's construction of the improvements; c) Any and all actions, proceedings, damages, costs, expenses, fines, penalties or liabilities, in law or equity, of every kind or nature whatsoever, arising out of, resulting from, or on account of the violation of any governmental law or regulation, compliance with which is the responsibility of Contractor; d) Any and all losses, expenses, damages (including damages to the Work itself), attorney's fees, and other costs, including all costs of defense which any of them may incur with respect to the failure, neglect, or refusal of Contractor to faithfully perform the Work and all of Contractor's obligations under Contract. Such costs, expenses, and damages shall include all costs, including attorney's fees, incurred by the indemnified parties in any lawsuit to which they are a party. 2. Contractor shall immediately defend, at Contractor's own cost, expense and risk, with the counsel of the City choosing, any and all such aforesaid suits, actions or other legal proceedings of every kind that may be brought or instituted against the City, its officials, officers, agents, employees and representatives. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against the City, its officials, officers, employees, agents, employees and representatives, in any such suit, action or other legal proceeding. Contractor shall reimburse the City, its officials, officers, agents, employees and representatives for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. The only limitations on this provision shall be those imposed by Civil Code section 2782. 3. The provisions of this Article shall survive the termination of this Contract howsoever caused, and no payment, partial payment, or acceptance of occupancy in whole or part of the Work shall waive or release any of the provisions of this Article. B. Insurance 1. Without limiting Contractor's indemnification of City, and prior to commencement of Work, Contractor shall obtain, provide and maintain at its own expense during PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 4- CONTRACT FOR CONSTRUCTION Contract No. C37040A the term of this Contract, policies of insurance of the type and amounts described below and in a form that is satisfactory to City. 2. General Liability Insurance. Contractor shall maintain commercial general liability insurance with coverage at least as broad as Insurance Services Office form CG 00 01, in an amount not less than $2,000,000 per occurrence, $4,000,000 general aggregate, for bodily injury, personal injury, and property damage, and a 4,000,000 completed operations aggregate. The policy must include contractual liability that has not been amended. Any endorsement restricting standard ISO insured contract" language will not be accepted. 3. Automobile Liability Insurance. Contractor shall maintain automobile insurance at least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with Work to be performed under this Contract, including coverage for any owned, hired, non -owned or rented vehicles, in an amount not less than 1,000,000 combined single limit for each accident. 4. Umbrella or Excess Liability Insurance. Contractor may opt to utilize umbrella or excess liability insurance in meeting insurance requirements. In such circumstances, Contractor may obtain and maintain an umbrella or excess liability insurance policy with limits that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automotive liability and employer's liability. Such policy or policies shall include the following terms and conditions: 5. A drop down feature requiring the policy to respond in the event that any primary insurance that would otherwise have applied proves to be uncollectible in whole or in part for any reason; a) Pay on behalf of wording as opposed to reimbursement; and b) Concurrency of effective dates with primary policies; and c) Policies shall "follow form" to the underlying primary policies; and d) Insureds under primary policies shall also be insureds under the umbrella or excess policies. 6. Workers' Compensation Insurance. Contractor may maintain Workers' Compensation Insurance (Statutory Limits) and Employer's Liability Insurance with limits of at least $1,000,000) for Contractor's employees in accordance with the laws of the State of California, Section 3700 of the Labor Code. In addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance and Employer's Liability Insurance in accordance with the laws of the State of California, Section 3700 for all of the subcontractor's employees. Contractor shall submit to City, along with the certificate of insurance, a Waiver of Subrogation endorsement in favor of the City, its officers, agents, employees and volunteers. PRESIDENTS PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 5- CONTRACT FOR CONSTRUCTION Contract No. C37040A 7. Pollution Liability Insurance. Reserved. 8. Builder's Risk Insurance. Reserved. 9. The named insureds shall be Contractor and City, including its officers, officials, employees, and agents. All subcontractors (excluding those solely responsible for design Work) of any tier and suppliers shall be included as additional insureds as their interests may appear. Contractor shall not be required to maintain property insurance for any portion of the Project following transfer of control thereof to City. The policy shall contain a provision that all proceeds from the builder's risk policy shall be made payable to the City of Palm Desert. The City will act as a fiduciary for all other interests in the Project. 10. Policy shall be provided for replacement value on an "all risk" basis for the completed value of the project. There shall be no coinsurance penalty or provisional limit provision in any such policy. Policy must include: (1) coverage for any ensuing loss from faulty workmanship, Nonconforming Work, omission or deficiency in design or specifications; (2) coverage against machinery accidents and operational testing; (3) coverage for removal of debris, and insuring the buildings, structures, machinery, equipment, materials, facilities, fixtures and all other properties constituting a part of the Project; (4) Ordinance or law coverage for contingent rebuilding, demolition, and increased costs of construction; (5) transit coverage (unless insured by the supplier or receiving contractor), with sub - limits sufficient to insure the full replacement value of any key equipment item; (6) Ocean marine cargo coverage insuring any Project materials or supplies, if applicable; (7) coverage with sub -limits sufficient to insure the full replacement value of any property or equipment stored either on or off the Site or any staging area. Such insurance shall be on a form acceptable to City to ensure adequacy of terms and sublimits and shall be submitted to the City prior to commencement of construction. C. Other Provisions or Requirements 1. Proof of Insurance. Contractor shall provide certificates of insurance to City as evidence of the insurance coverage required herein, along with a waiver of subrogation endorsement for workers' compensation. Insurance certificates and endorsements must be approved by City's Risk Manager prior to commencement of performance. Current certification of insurance shall be kept on file with City at all times during the term of this contract. City reserves the right to require complete, certified copies of all required insurance policies, at any time. 2. Duration of Coverage. Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property, which may arise from or in connection with the performance of the Work hereunder by Contractor, its agents, representatives, employees or subcontractors. Contractor must maintain general liability and umbrella or excess liability insurance for as long as there is a statutory exposure to completed operations claims. The City and its officers, officials, employees, and agents shall continue as additional insureds under such policies. PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 6- CONTRACT FOR CONSTRUCTION Contract No. C37040A 3. Primary/Non-Contributing. Coverage provided by Contractor shall be primary and any insurance or self-insurance procured or maintained by City shall not be required to contribute with it. The limits of insurance required herein may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of City before the City's own insurance or self-insurance shall be called upon to protect it as a named insured. 4. Products/Completed Operations Coverage. Products/completed operations coverage shall extend a minimum of three (3) years after project completion. Coverage shall be included on behalf of the insured for covered claims arising out of the actions of independent contractors. If the insured is using subcontractors, the Policy must include work performed "by or on behalf" of the insured. Policy shall contain no language that would invalidate or remove the insurer's duty to defend or indemnify for claims or suits expressly excluded from coverage. Policy shall specifically provide for a duty to defend on the part of the insurer. The City, its officials, officers, agents, and employees, shall be included as additional insureds under the Products and Completed Operations coverage. 5. City's Rights of Enforcement. In the event any policy of insurance required under this Contract does not comply with these requirements, or is canceled and not replaced, City has the right, but not the duty, to obtain the insurance it deems necessary and any premium paid by City will be promptly reimbursed by Contractor, or City will withhold amounts sufficient to pay premium from Contractor payments. In the alternative, City may cancel this Contract. 6. Acceptable Insurers. All insurance policies shall be issued by an insurance company currently authorized by the Insurance Commissioner to transact business of insurance or is on the List of Approved Surplus Line Insurers in the State of California, with an assigned policyholders' Rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide, unless otherwise approved by the City's Risk Manager. 7. Waiver of Subrogation. All insurance coverage maintained or procured pursuant to this agreement shall be endorsed to waive subrogation against the City, its elected or appointed officers, agents, officials, employees and volunteers, or shall specifically allow Contractor or others providing insurance evidence in compliance with these specifications to waive their right of recovery prior to a loss. Contractor hereby waives its own right of recovery against the City, its elected or appointed officers, agents, officials, employees and volunteers and shall require similar written express waivers and insurance clauses from each of its subcontractors. 8. Enforcement of Contract Provisions (non estoppel). Contractor acknowledges and agrees that any actual or alleged failure on the part of the City to inform Contractor of non-compliance with any requirement imposes no additional obligations on the City nor does it waive any rights hereunder. 9. Requirements Not Limiting. Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 7- CONTRACT FOR CONSTRUCTION Contract No. C37040A other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. If the Contractor maintains higher limits than the minimums shown above, the City requires and shall be entitled to coverage for the higher limits maintained by the Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. 10. Notice of Cancellation. Contractor agrees to oblige its insurance agent or broker and insurers to provide to City with a thirty (30) day notice of cancellation (except for nonpayment for which a ten (10) day notice is required) or nonrenewal of coverage for each required coverage. 11. Additional Insured Status. General liability, automobile liability, and if applicable, pollution liability policies shall provide or be endorsed to provide that the City and its officers, officials, employees, agents, and volunteers shall be additional insureds under such policies. This provision shall also apply to any excess/umbrella liability policies. Coverage shall be at least as broad as coverage provided by ISO's Owners, Lessees, or Contractors Additional Insured Endorsement for the ongoing (i.e. ISO Form CG 20 10 07 04) and completed operations (i.e. ISO Form CG 20 37 07 04) of Contractor. 12. Prohibition of Undisclosed Coverage Limitations. None of the coverages required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved of in writing. 13. Separation of Insureds. A severability of interests provision must apply for all additional insureds ensuring that Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the insurer's limits of liability. The policy(ies) shall not contain any cross -liability exclusions. 14. Pass Through Clause. Contractor agrees to ensure that its sub -consultants, sub- contractors, and any other party involved with the Project who is brought onto or involved in the project by Contractor, provide the same minimum insurance coverage and endorsements required of Contractor. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Contractor agrees that upon request, all agreements with consultants, subcontractors, and others engaged in the Project will be submitted to City for review. 15. Citv's Right to Revise Requirements. The City or its Risk Manager reserves the right at any time during the term of the contract to change the amounts and types of insurance required by giving the Contractor ninety (90) Days advance written notice of such change. If such change results in substantial additional cost to the Contractor, the City and Contractor may renegotiate Contractor's compensation. If the City reduces the insurance requirements, the change shall go into effect immediately and require no advanced written notice. PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 8- CONTRACT FOR CONSTRUCTION Contract No. C37040A 16. Self -Insured Retentions. Any self -insured retentions must be declared to and approved by City. City reserves the right to require that self -insured retentions be eliminated, lowered, or replaced by a deductible. Self-insurance will not be considered to comply with these specifications unless approved by City. 17. Timely Notice of Claims. Contractor shall give City prompt and timely notice of claims made or suits instituted that arise out of or result from Contractor's performance under this Contract, and that involve or may involve coverage under any of the required liability policies. 18. Additional Insurance. Contractor shall also procure and maintain, at its own cost and expense, any additional kinds of insurance, which in its own judgment may be necessary for its proper protection and prosecution of the Work. 19. Safety. Contractor shall execute and maintain its work so as to avoid injury or damage to any person or property. In carrying out its Services, the Contractor shall at all times be in compliance with all applicable local, state and federal laws, rules and regulations, and shall exercise all necessary precautions for the safety of employees appropriate to the nature of the work and the conditions under which the work is to be performed. Safety precautions, where applicable, shall include, but shall not be limited to: (A) adequate life protection and lifesaving equipment and procedures; (B) instructions in accident prevention for all employees and subcontractors, such as safe walkways, scaffolds, fall protection ladders, bridges, gang planks, confined space procedures, trenching and shoring, equipment and other safety devices, equipment and wearing apparel as are necessary or lawfully required to prevent accidents or injuries; and (C) adequate facilities for the proper inspection and maintenance of all safety measures. ARTICLE 9. PREVAILING WAGES. Contractor shall be required to pay the prevailing rate of wages in accordance with the Labor Code which such rates shall be made available at the City's Office or may be obtained online at http://www.dir.ca.gov and which must be posted at the job site. ARTICLE 10. FALSE CLAIMS. Contractor acknowledges that if a false claim is submitted to the City, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that the False Claims Act, California Government Code sections 12650, et seq., provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include within their scope false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. In the event the City seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorneys' fees. Contractor hereby acknowledges that the filing of a false claim may the Contractor to an administrative debarment proceeding wherein Contractor may be prevented from further bidding on public contracts for a period of up to five (5) years. REMAINDER OF PAGE LEFT INTENTIONALLY BLANK] PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 9- CONTRACT FOR CONSTRUCTION Contract No. C37040A IN WITNESS WHEREOF, this Contract has been duly executed by the above -named parties, on the day and year above written. CITY OF PALM DESERT KATHL KELL Mayor ATTEST: By: /./iaP - Graae L. Rocha, Acting City Clerk APPROV D AS T Be— :r__,-• ity Attorney REVIEWED BY: By: Andy Firestine Assistant City MT.ETier H & H GENERAL CONTRACTORS, INC. If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary R Treasurer REQUIRED] Its: F2 c.5 1 (>c,;'/r Printed Name: JV1'V Its: SCCR, Tom/ Printed Name: J jjn/ r. O[ E24 77YSS) Contractor's License Number and Classification 00000 Y O rg DIR Registration Number CONTRACTOR'S SIGNATURE MUST BE NOTARIZED AND CORPORATE SEAL AFFIXED, IF APPLICABLE) END OF CONTRACT PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 10- CONTRACT FOR CONSTRUCTION Contract No. C37040A Notary Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF` n r1 // 21a nv On nyaffll /9 . 20w/, before me, 4%'/2il 4/ 21 --Z , Notary Public, personally appeared CS/,/4/7 77 , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. YVONNE GUTIERREZ Notary Public - California San Bernard!no County > Commission # 2212183 [ My Comm. Expires Sep 23, 2021 i WITNESS my ha ! and official seal. Sign —ate orNotQry OPT ONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. CAPACITY CLAIMED BY SIGNER Individual Corporate Officer Title(s) Partner(s) Attorney -In -Fact Trustee(s) Guardian/Conservator Other: Signer is representing: Name Of Person(s) Or Entity(ies) Limited General DESCRIPTION OF ATTACHED DOCUMENT Title or Type of Document Number of Pages Date of Document Signer(s) Other Than Named Above PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 11- CONTRACT FOR CONSTRUCTION Contract No. C37040A Executed in Duplicate BOND FORMS Performance Bond KNOW ALL PERSONS BY THESE PRESENTS: Bond Number: 72BCSII4431 Premium: $55,626.00 Premium is for the contract term and is subject to adjustment based on the final contract price. THAT WHEREAS, the City of Palm Desert, a Charter City and municipal corporation, organized under the laws of the State of California, with its principal place of business at 73-510 Fred Waring Drive, Palm Desert, California 92260, (hereinafter referred to as the "City") has awarded to H & H General Contractors, Inc., (hereinafter referred to as the "Contractor") an agreement for Contract No. C37040A, (hereinafter referred to as the "Project"). WHEREAS, the work to be performed by the Contractor is more particularly set forth in the Contract Documents for the Project dated January 28, 2021, (hereinafter referred to as "Contract Documents"), the terms and conditions of which are expressly incorporated herein by reference; and WHEREAS, the Contractor is required by said Contract Documents to perform the terms thereof and to furnish a bond for the faithful performance of said Contract Documents. NOW, THEREFORE, we,H & H General Contractors, Inc, the undersigned Contractor and I lartford Fire Insurance Company as Surety, a corporation organized and duly authorized to transact business under the laws of the State of California, are held and firmly bound unto the City in the sum of Seven Million One Hundred Twenty Three Thousand Three Hundred Ninety Three and 00/100 Dollars ($7,123,393.00), said sum being not less than one hundred percent (100%) of the total amount of the Contract, for which amount well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that, if the Contractor, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the Contract Documents and any alteration thereof made as therein provided, on its part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their intent and meaning; and shall faithfully fulfill all obligations including the one (1) year guarantee of all materials and workmanship; and shall indemnify and save harmless the City, its officials, officers, employees, and authorized volunteers, as stipulated in said Contract Documents, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. As a part of the obligation secured hereby and in addition to the face amount specified therefore, there shall be included costs and reasonable expenses and fees including reasonable attorney's fees, incurred by the City in enforcing such obligation. As a condition precedent to the satisfactory completion of the Contract Documents, unless otherwise provided for in the Contract Documents, the above obligation shall hold good for a period of one (1) year after the acceptance of the work by the City, during which time if Contractor shall fail to make full, complete, and satisfactory repair and replacements and totally protect the City from loss or damage resulting from or caused by defective materials or faulty workmanship. The obligations of Surety hereunder shall continue so long as any obligation of Contractor remains. Nothing herein shall limit the City's rights or the Contractor or Surety's obligations under PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 12- BOND FORMS Contract No. C37040A the Contract, law or equity, including, but not limited to, California Code of Civil Procedure Section 337.15. Whenever Contractor shall be, and is declared by the City to be, in default under the Contract Documents, the Surety shall remedy the default pursuant to the Contract Documents, or shall promptly, at the City's option: i. Take over and complete the Project in accordance with all terms and conditions in the Contract Documents; or ii. Obtain a bid or bids for completing the Project in accordance with all terms and conditions in the Contract Documents and upon determination by Surety of the lowest responsive and responsible bidder, arrange for a Contract between such bidder, the Surety and the City, and make available as work progresses sufficient funds to pay the cost of completion of the Project, less the balance of the contract price, including other costs and damages for which Surety may be liable. The term balance of the contract price" as used in this paragraph shall mean the total amount payable to Contractor by the City under the Contract and any modification thereto, less any amount previously paid by the City to the Contractor and any other set offs pursuant to the Contract Documents. iii. Permit the City to complete the Project in any manner consistent with California law and make available as work progresses sufficient funds to pay the cost of completion of the Project, less the balance of the contract price, including other costs and damages for which Surety may be liable. The term "balance of the contract price" as used in this paragraph shall mean the total amount payable to Contractor by the City under the Contract and any modification thereto, less any amount previously paid by the City to the Contractor and any other set offs pursuant to the Contract Documents. Surety expressly agrees that the City may reject any contractor or subcontractor which may be proposed by Surety in fulfillment of its obligations in the event of default by the Contractor. Surety shall not utilize Contractor in completing the Project nor shall Surety accept a bid from Contractor for completion of the Project if the City, when declaring the Contractor in default, notifies Surety of the City's objection to Contractor's further participation in the completion of the Project. The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract Documents or to the Project to be performed thereunder shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract Documents or to the Project. REMAINDER OF PAGE LEFT INTENTIONALLY BLANK] PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 13- BOND FORMS Contract No. C37040A IN WITNESS WHEREOF, we have hereunto set our hands and seals this 15th day of March , 2021 Corporate Seal) Corporate Seal) Attach Attorney -in -Fact Certificate) H General Contractors Inc. ractor/ Principal Title P2t=5iOL: 2afI11--)/ e,F•.NSg 1: :CAS pp, tie • ...... • s0., ,r Title Cynthia J. Young, Attorney -In -Fact ''y:.p;,; A' First $2. 5 million @ $8.84 next $2.5 million @ $7.55 and the remaining $2,123,393 The rate of premium on this bond is @ $6.90 charges is $ 55,626.00 The above must be filled in by corporate attorney.) THIS IS A REQUIRED FORM Any claims under this bond may be addressed to: Name and Address of Surety) Name and Address of Agent or Representative for service of process in California, if different from above) Telephone number of Surety and Agent or Representative for service of process in California) PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 Hartford Fire Insurance Company Sure By Attorn • -i act per thousand. The total amount of premium Hartford Fire Insurance Company One Pointe Drive. #770 Brea, CA 928'71 Alliant Insurance Services Tnc. 685 East CarneVe Drive. Suite ?AS San Bernardino, CA 92408 Surety: 714-672-1481 Alliant: 909-886-9861 14- BOND FORMS n Contract No. C37040A Notary Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document_ On /%?7 J /9 rYI appeared 3'hi i /2z? i2//,/iin , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature( s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. STATE OF CALIFORNIA COUNTY OF ^in % //V jdna 44/ 4.41-7? 2021, before me, (i /D/%/' 7 , Notary Public, personally YVONNE GUTIERREZ Notary Public - California San Bernardino County a Commission z 2212183 i MyComm. Expires Sep 23, 2021 WITNESS my hind and official seal. Slg ure of Ndtary P" lic' - OPTIONAL Though the information below is not required by law, it may prove valuable to persor,,, me document and could prevent fraudulent removal and reattachment of this form to another document. CAPACITY CLAIMED BY SIGNER Individual O Corporate Officer Partner( s) Title( s) Limited General Attorney - In -Fact Trustee( s) O Guardian/Conservator L Other: Signer is representing: Name Of Person(s) Or Entity(ies) DESCRIPTION OF ATTACHED DOCUMENT Title or Type of Document Number of Pages Date of Document Signer( s) Other Than Named Above NOTE: This acknowledgment is to be completed for Contractor/Principal. PRESIDENTS PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 15- BOND FORMS Contract No. C37040A Notary Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the Idocumenttowhichthiscertificateisattached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF On . 20, before me, /,Notary Public, personally appeared , who proved to m - • n the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the with' instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized c.•acity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf •f which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the St. of California that the foregoing paragraph is true and correct. WITNES my hand and official seal. Sig ' ature of Notary Public 0 ' TIONAL Though the information below is not required b law, it may prove valuable to persons relying on the document and could prevent fraudulent remo =1 and reattachment of this form to another document. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT Individual Corporate Officer Partner(s) Title(s) Limite Gen: al Attorney -In -Fact Trustee(s) Guardian/Conservator Other: Signer is representing: Name Of Person(s) Or Entity(ies) Title or Type of Document Number of Pages Date of Document Signers) Other Than Named Above NOTE: This acknowledgment is to be completed for the Attorney -in -Fact. The Power -of Attorney to local representatives of the bonding company must also be attached. PRESIDENTS PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 END OF PERFORMANCE BOND 16- BOND FORMS CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino On MAR a. personally appeared ss. before me, Rebecca Elizabeth Adcock COMMISSION # 2327252 z NOTARY PUBLIC - CALIFORNIA SAN BERNARDINO COUNTY My Comm. Expires: 3-May-2024 Rebecca Elizabeth Adcock. Notary Public Name and Title of Officer (e.g., 'Jane Doe, Notary Public') Cynthia J. Young Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my han nd officigl seal. 4P)r ignature of Notaryi'ublic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: O Individual O Corporate Officer Title O Partner -- 0 Limited 0 General O Attorney -in -Fact O Trustee O Guardian or Conservator Other: Signer is Representing: Number of Pages: OF SIGNER_ Top of thumb here 1 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 i STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANQSCO CertificateofAuthority. NQ 67266 Tins IS TO CERTIFY THAT, Pursuant to the Insurance Code ofthe State of California. Hartford Fire Insurance Company of Hartford, Connecticut , ordaniiedouter du law, of Connecticut , ,,object to iuArtkles ofhtcorporation or other fundamental organizational documents. is hereby authorized to transact within the State, subject to allpmvisions of this Certificate, the following class s;of insatmnce: Fire, Marine, Surety, Disability, Plate Glass, Liability, Workers' Compensation, Common Carrier Liability, Boiler and Machinery, Surglary,.Credit, Sprinkler, Team and Vehicle, Automobile, Aircraft, Legal, and Miscellaneous as such classes Om now or may hereafter be defined in the insurance Laws of the State of Cal brnia_ THIS CERTIFICATE Is expressly conditioned upon the holder hereof now and hereafter being in full compliarrce,with all, and not in violation of any, of thea, pplkablelaws and lawful requirements made under authority of the laws of the State of California as long as such laws or requirements an in effect and applicable, and as such laws and requirements now are. or may hereafter be changed or amended. IN WITNESS WIIEiEOF, effective as of the Stb day of OFt,gber , 2000 . I have hereunto set my hand and caused my official seal to be crawl this 5th dayof OotobeK 'non By N I CE: i neaten with the Secretary of State mustbe accomplished as required by the California Corpondow Code after issuanceofthisCertificateofAuthority. Failure to do so win. be a violation of Inauaode Section 701 and will b nw Cogrbuadrforrevoking this Certificate of Authority pursuant to the convenants made in tho application therefor and the conditions cotteincd herein. GIP 00 err• Direct Inquiries/Claims to: THE HARTFORD POWER OF ATIORI\TEY BOtford 2 One Hartford Plaza Hartford, Connecticut 06155 Bond. Claims(ai)thehartford.com call: 888-2663488 or fax: 860-757-5835 Agency Name: ALLIANT INSURANCE SERVICES INC Agency Code: 7 2 -1866 9 3 Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies") do hereby make, constitute and appoint, up to the amount of Unlimited Laurie B. Druck, Jay P. Freeman, Christina Mountz, Cynthia Jean Russell, Melissa Schwartz, Cynthia J. Young of SAN BERNARDINO, California KNOW ALL PERSONS BY THESE PRESENTS THAT: their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by 0, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6, 2015 the Companies have caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. John Gray, Assistant Secretary STATE OF CONNECTICUT ss. COUNTY OF HARTFORD On this 5th day of January, 2018, before me personally came M. Ross Fisher, to me known, who being by me duly swom, did depose and say: that he resides in the County of Hartford, State of Connecticut; that he is the Senior Vice President of the Companies, the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. Hartford M. Ross Fisher, Senior Vice President CERTIFICATE Kathleen T Maynard Notary Public My Commission Expires July 31, 2021 I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is still in full force effective as of March 15, 2021 Signed and sealed at the City of Hartford. Kevin Heckman, Assistant Vice President MANM Executed in Duplicate Contract No. C37040A Payment Bond (Labor and Materials). KNOW ALL MEN BY THESE PRESENTS That Bond Number: 72BCSII4431 Premium included in charge for Performance bond WHEREAS, the City of Palm Desert, a Charter City and municipal corporation organized and operating under the laws of the State of California (hereinafter designated as the "City"), by action taken or a resolution passed March 11, 2021, has awarded to H & H General Contractors, Inc., hereinafter designated as the "Principal," a contract for the work described as follows: Contract No. C37040A (the "Project"); and WHEREAS, the work to be performed by the Contractor is more particularly set forth in the Contract Documents for the Project dated January 28, 2021, (hereinafter referred to as "Contract Documents"), the terms and conditions of which are expressly incorporated herein by reference; and WHEREAS, said Principal is required to furnish a bond in connection with said contract; providing that if said Principal or any of its Subcontractors shall fail to pay for any materials, provisions, provender, equipment, or other supplies used in, upon, for or about the performance of the work contracted to be done, or for any work or labor done thereon of any kind, or for amounts due under the Unemployment Insurance Code or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of said Principal and its Subcontractors with respect to such work or labor the Surety on this bond will pay for the same to the extent hereinafter set forth. NOW THEREFORE, we, the Principal and I Iartford Fire Insurance Company as Surety, are held and firmly bound unto the City in the penal sum of Seven Million One Hundred Twenty Three Thousand Three Hundred Ninety Three and 00/100 Dollars ($7,123,393.00) lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if said Principal, his or its subcontractors, heirs, executors, administrators, successors or assigns, shall fail to pay any of the persons named in Civil Code Section 9100, fail to pay for any materials, provisions or other supplies, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor thereon of any kind, or amounts due under the Unemployment Insurance Code with respect to work or labor performed under the contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department or Franchise Tax Board from the wages of employees of the contractor and his subcontractors pursuant to Revenue and Taxation Code Section 18663, with respect to such work and labor the Surety or Sureties will pay for the same, in an amount not exceeding the sum herein above specified, and also, in case suit is brought upon this bond, all litigation expenses incurred by the City in such suit, including reasonable attorneys' fees, court costs, expert witness fees and investigation expenses. This bond shall inure to the benefit of any of the persons named in Civil Code Section 9100 so as to give a right of action to such persons or their assigns in any suit brought upon this bond. It is further stipulated and agreed that the Surety on this bond shall not be exonerated or released from the obligation of this bond by any change, extension of time for performance, addition, alteration or modification in, to, or of any contract, plans, specifications, or agreement pertaining or relating to any scheme or work of improvement herein above described, or pertaining or relating PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 17 BOND FORMS Contract No. C37040A to the furnishing of labor, materials, or equipment therefore, nor by any change or modification of any terms of payment or extension of the time for any payment pertaining or relating to any scheme or work of improvement herein above described, nor by any rescission or attempted rescission or attempted rescission of the contract, agreement or bond, nor by any conditions precedent or subsequent in the bond attempting to limit the right of recovery of claimants otherwise entitled to recover under any such contract or agreement or under the bond, nor by any fraud practiced by any person other than the claimant seeking to recover on the bond and that this bond be construed most strongly against the Surety and in favor of all persons for whose benefit such bond is given, and under no circumstances shall Surety be released from liability to those for whose benefit such bond has been given, by reason of any breach of contract between the owner or the City and original contractor or on the part of any obligee named in such bond, but the sole conditions of recovery shall be that claimant is a person described in Civil Code Section 9100, and has not been paid the full amount of his claim. The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract to be performed thereunder, shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of Contract, including but not limited to, the provisions of Sections 2819 and 2845 of the California Civil Code. IN WITNESS WHEREOF, we have hereuset our hands and seals this 15th day of March , 2021. Corporate Seal) Corporate Seal) INeI,' I. as 0..-• I( ys 9yitos u_ ' 0- Suret,1+1 mry• •' o By in. n `- Attach Attorney -in -Fact Certificate) PRESIDENTS PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 18 General Contractors Inc. Cif . or/ Principal By 4t/ M; Title PR r5 , d GwT Hartford Fire Insurance Company Attorney - in{ acts Title Cynthia I. Young, Attorney -In -Pact 0' BOND FORMS Contract No. C37040A Notary Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNI COUNTY OFF /7 u-,/ 7/1/2U On /720/4 /9 . 202/, before me, /'i/O/Mte ir 7/Y1& , Notary Public, personally appeared C7Gl'/2 Olve/ , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. YVONNE GUTIERREZ Notary Public - California San Bernardino County n Commission # 2212183 iMyComm. Expires Sep 23, 2021 WITNESS my ha •,and official seal. e of 'Notary Public t OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. CAPACITY CLAIMED BY SIGNER Individual Corporate Officer Partner(s) Title(s) Limited LJ General Attorney -In -Fact Trustee(s) Guardian/Conservator Other: Signer is representing: Name Of Person(s) Or Entity(ies) DESCRIPTION OF ATTACHED DOCUMENT Title or Type of Document Number of Pages Date of Document Signer(s) Other Than Named Above NOTE: This acknowledgment is to be completed for Contractor/Principal. PRESIDENTS PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 19 BOND FORMS CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino On MAR 1 5 202 personally appeared ss. before me, ce\AdRebeccaElizabeth cock COMMISSION # 2327252 pl NOTARY PUBLIC- CALIFORNIA SAN BERNARDINO COUNTY 1MyComm. Eviree: 3-May-2024 Rebecca Elizabeth Adcock, Notary Public Name and Title of Officer (e.g., 'Jane Doe, Notary Public') Cynthia J. Young Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ig ture of otary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: O Individual O Corporate Officer Title O Partner -- O Limited O General O Attorney -in -Fact O Trustee O Guardian or Conservator Other: Signer is Representing: Number of Pages: OF SIGNER_ Top of thumb here IkbIfLI LJ... I .. 1•0 . P4114 b. 414 blbfM b LYlkb kYt Y, 1. 111 J 3 1 rnyrrrrerer-rrerrer—rr per-e rsarr—ee—wr—r—r—rr—s—weer--rr-e-—r-— r—rr ver—r—rr—rxMrrr— —+errs Contract No. C37040A Notary Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF On . 20_, before me, , Notary Public, personally appeared , who proved to - e on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the hin instrument and acknowledged to me that he/she/they executed the same in his/her/their authorize • capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon be - alf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of th is true and correct. tate of California that the foregoing paragraph WIT ESS my hand and official seal. Signature of Notary Public OPTIONAL Though the information below is not req ' ed by law, it may prove valuable to persons relying on the document and could prevent fraudulent emoval and reattachment of this form to another document. CAPACITY CLAIMED BY SIGNE DESCRIPTION OF ATTACHED DOCUMENT Individual Corporate Officer Partner(s) Attorney -In -Fact Trustee(s) Guardian/Conservator Other: Signer is representing: Name Of Person(s) Or Entity(i Tide(s) Li ited eneral Title or Type of Document Number of Pages Date of Document Signer(s) Other Than Named Above NOTE: This acknowledgment is to be completed for the Attomey-in-Fact. The Power -of -Attorney to local representatives of the bonding company must also be attached. PRESIDENT'S PLAZA PARKING LOT IMPROVEMENTS PROJECT NO. 758-14 END OF PAYMENT BOND 20 BOND FORMS STATE OF CALIFORNIA. DEPARTMENT OF INSURANCE N4 07268 SAN FRANCISCO Certificate ofAuthority. THIS IS TO CERTIFY THAT, Pursuant to the Insurance Code of the State of California Hartford Fire Insurance Company of Hartford, Connecticut . organized under the laws of Connecticut , subject to its Articles ofIncorporation or otherfunda,nentdl organiaatiomai documents, is hereby authorized to transact within the State, subject to all provisions ale* Certificate, the following classesmof insurance: Fire, Marine, Surety, Disability, Plate Glass, Liability, Workers' Compensation, Common Carrier Li ility, Boiler and Machinery, Burglary,. Credit, Sprinkler, Team and Vehicle, Automobile, Aircraft, Legal, and Miscellaneous as such classes ant now or may hereafter be defined in the Insurance Laws of the State of California. THIS CucriVICATB tr expressly conditioned upon the holder hereof now and hereafter being in full compiiarce with all, and not in violation of wr» of this applk stblelaw and lawful requirements made under authorkty of the laws of the State of California as long as such laws or requiremens are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended IN WP' fNI3SS WHEREOF, effective as of the Sth I October 2000 , I have hereunto set my hand and caused my official seal to be gifts:al this Sth day of October nn By N CE: fixation with the Secretary of Slum must be accomplished as requited by the California Corporations Code promptly a issuance of this Certificate of Authority. Failure tq do so will be a violation of h umance Code Section 701 and will be ands for revoking this Certificate of Authority puissant to the wave eats made in the application therefor and the renditions cottaincd herein. mnMca.r ilia owuo nor KNOW ALL PERSONS BY THESE PRESENTS THAT: Direct Inquiries/Claims to: THE HARTFORD POWER OF ATTORNEY BONG, tic One Hartford Plaza Hartford, Connecticut 06155 Bond.Claimstr7t thehartford.com call: 888-266-3488 or fax: 860- 757-5835 Agency Name: ALLIANT INSURANCE SERVICES INC Agency Code: 72-186693 Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida having their home office inHartford, Connecticut, (hereinafter collectively referred to as the "Companies") do hereby make, constitute and appoint, up to the amount of Unlimited : Laurie B. Druck, Jay P. Freeman, Christina Mountz, Cynthia Jean Russell, Melissa Schwartz, Cynthia J. Young of SAN BERNARDINO, California their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by El, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6, 2015 the Companies have caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attomey. John Gray, Assistant Secretary STATE OF CONNECTICUT SS. COUNTY OF HARTFORD On this 5th day of January, 2018, before me personally came M. Ross Fisher, to me known, who being by me duly swom, did depose and say: that he resides in the County of Hartford, State of Connecticut; that he is the Senior Vice President of the Companies, the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. Hartford M. Ross Fisher, Senior Vice President CERTIFICATE QctiL T . Shia r•aA Kathleen T Maynard Notary Public My Commission Expires July 31, 2021 I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is still in full force effective as of March 15, 2021 Signed and sealed at the City of Hartford. Kevin Heckman, Assistant Vice President POA 2018 Company Profile Page 1 of 2 CALIFORNIA DEPARTMENT OF INSURANCE Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Action/Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information Old Company Names Agent For Service Vivian Imperial 818 WEST SEVENTH STREET SUITE 930 LOS ANGELES CA 90017 Reference Information NAIC California Company ID =. Date Authorized in California: License Status: Company Type: State of Domicile: back to top NAIC Group List NAIC Group =: Lines Of Business HARTFORD FIRE INSURANCE COMPANY ONE HARTFORD PLAZA HARTFORD, CT 06115 Effective Date 19682 0085-1 01/07/1870 UNLIMITED -NORMAL Property & Casualty CONNECTICUT 0091 HARTFORD FIRE & CAS GRP The company is authorized to transact business within these Imes of insurance. For an explanation of any of these terms, please refer to the glossary. AIRCRAFT AUTOMOBILE BOILER AND MACHINERY BURGLARY COMMON CARRIER LIABILITY CREDIT DISABILITY FIRE LEGAL INSURANCE LIABILITY MARINE MISCELLANEOUS PLATE GLASS https://interactive.web.insurance.ca.gov/companyprofile/companyprofile?event=companyP... 3/23/2021 Company Profile Page 2 of 2 SPRINKLER SURETY TEAM AND VEHICLE WORKERS' COMPENSATION back to top 2008 California Department of Insurance https://interactive. web. insurance. ca.gov/companyprofile/companyprofile?event=companyP... 3/23/2021 CONTRACT NO. C3 i 0 0A CONTRACTOR'S BID City of Palm Desert President's Plaza Parking Lot Improvements (21-08), bidding on 03/ 02/2021 2 00 PM (F.`"• Page 1 of 4 Panted 0, r, 7021 Bid Results Bidder Details Vendor Name Address Respondee Respondee Title Phone Email Vendor Type License # CADIR Bid Detail Bid Format Submitted Delivery Method Bid Responsive Bid Status Confirmation # Ranking H&H GENERAL CONTRACTORS, INC, 7919 PALM AVENUE Highland, Califomia 92346 United States JUAN OLVERA PRESIDENT 909-425-3907 monica©hhgdnc.com CADIR 774552 1000004088 Electronic 03/02/ 2021 1:52 PM (PST) Submitted 244262 0 Respondee Comment Buyer Comment Bond eBond Contract ID Attachments File Title File Name HH GEN CON BID DOCUMENTS.pdf HH GEN CON BID DOCUMENTS.pdf File Type General Attachments PlanetBids. Inc City of Palm Desert Page 3 of 4 President's Plaza Parking Lot Improvements (21-08), bidding on 03/02/2021 2 00 PM (PST) Printed 03/ 02/2021 42 42 Base Bid 43 Base Bid 44 Base Bid 45 Base Bid 48 Base Bid 47 Base Bid IA Race 011 46 47 ea INSTALL 60 FEET OF CONDUIT AND INTERCEPT PULLBOX FOR CHARTER EXCAVATE AND EXPOSE ALL CONDUIT 1 STRUCTURES AS DIRECTED BY CHARTER DELETED' EXCAVATE AND EXPOSE ALL CONDUIT / STRUCTURES AS DIRECTED BY FRONTIER PROVIDE A NEW PAD FOR THE NEW CROSS CONNECT BOX FOR FRONTIER PROVIDE 4' CONDUIT FOR FRONTIER PRrIVIr1F T r flNn111T PIP FRnNTIFR EA LS EA LS EA LF 1000 IF 1Mn 5,234.00 $5.234.00 Yes 530300.00 836,300.00 Yes 14 50.00 $0.00 Yes 58,800.00 S8,800.00 Yes 2,200.00 82,200.00 Yes 815.40 $15,400.00 Yes 11711 !1'1 WWI M Vac PlanetBids. Inc CITYOF PDLMD[S[RT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL:760 346- 0611 infoo cityofpalmdcscrtorg March 12, 2021 H & H General Contractors, Inc. 7919 Palm Avenue Highland, California 92346 Dear Sir or Madam: Subject: Contract No. C37040A - President's Plaza Parkina Lot Improvements (Proiect No. 758-14) At its regular meeting of March 11, 2021, the Palm Desert City Council, by Minute Motion: 1) Authorized award to H & & General Contractors, Inc., Highland, California, for President's Plaza East and West Improvements in the total amount of $7,123,393; 2) authorized the City Manager or designee to review and approve written requests for the use of the contingency for unforeseen conditions up to the contingency amounts; 3) authorized the Mayor to execute the agreements. Enclosed are two original Contract for Construction. Please sign where indicated, have notarized (California All - Purpose Acknowledgment) and return them to us at your earliest convenience. We will then forward to you a fully executed Agreement for your records. Be advised that additional information is required from the bonding company. Pursuant to Section 995. 660 of the Code of Civil Procedure, we request the following additional information: 1. The original, or a certified copy, of the unrevoked appointment, power of attorney, bylaws, or other instrument entitling or authorizing the person who executed the bond to do so, within ten (10) calendar days of the insurer's receipt of a request to submit the instrument. 2. A copy of the certificate of authority of the insurer issued by the Insurance Commissioner, within then ( 10) calendar days of the insurer's receipt of a request to submit the copy. OR iJ 4. 110OxP; r+uicr.ri. H & H General Contractors, Inc. Page 2 of 2 March 12, 2021 3. A certificate from the clerk of the county in which the court or officer is located that the certificate of authority of the insurer has not been surrendered, revoked, canceled, annulled, or suspended; or, in the event that it has, that renewed authority has been granted, within ten (10) calendar days of the insurer's receipt of a request to submit the instrument. Additionally, we call your attention to the insurance requirements that were contained within the specification package for this project. We ask you submit your insurance information through the City of Palm Desert PlanetBids Vendor Insurance portal as soon as possible to expedite processing of the document and commencement of the project. If you have questions or require additional information, please do not hesitate to contact us. Sincerely, c-d GRACE L. ROCHA, CMC ACTING CITY CLERK GLR/mgs Enclosures (as noted) cc/enc: Andy Firestine, Assistant City Manager CITY Of PRIM DESERT CO IUNIID ON AHYttID 1IIt1 CERTIFICATES OF INSURANCE APPROVAL FORM COMPANY/VENDOR NAME:______________________________________________ ____ DEPARTMENT/VENDOR REP:_________________________________________________ PROJECT SPECIFIC:_________ if YES; Project/Contract:______________________ APPROVER :____________________________ DATE OF APPROVAL:_______________ GENERAL LIABILITY POLICY POLICY DATES/COMMENTS Occurence Limit Met _____________________________________ Aggregate Limit Met _____________________________________ Primary Non-Contributing End. _____________________________________ Additional Insured End. AUTOMOBILE LIABILITY POLICY Limits Met _____________________________________ Additional Insured End. WORKERS COMPENSATION POLICY Coverage Indicated (per Statute) _____________________________________ Waiver of Subrogation End. _____________________________________ Employer Liability Limits _____________________________________ Declaration Form (if uninsured) A.M. BEST RATING MET General Liability Policy _____________________________________ Auto Liability Policy _____________________________________ Workers Compensation Policy _____________________________________ Other: CERTIFICATE OF INSURANCE (COI) Certificate Holder Correct _____________________________________ Insured Correct _____________________________________ Date Current _____________________________________ Signed COI OTHER INSURANCE (AS REQUIRED) Professional Liability (E&O) _____________________________________ Pollution/Environmental _____________________________________ Builder’s Risk _____________________________________ Comments:_____________________________________________________________________________________ 4/1I2021 PbSYSTEM City of Palm Desert F7 oi 8 C Back to Insurance Certificate Search PB System - Insurance Cert Detail Insurance for H&H GENERAL CONTRACTORS, INC. (ID 78399) i s oPe i Status Created On March 12, 2021 Last Modified by Agency March 25, 2021 Last Modified by Vendor March 25, 2021 Close Out Date 2/28 2 22 Insured siai s Approved me:s;rs ory Vendor Name H&H GENERAL CONTRACTORS, INC. Doing Business As H&H GENERAL CONTRACTORS, INC. FEI/TaxID 330882569 Owner's Name JUAN OLVERA Contact Name JUAN OLVERA Address 7919 PALM AVENUE Highland, California 92346 United States Phone 909-425-3907 Email monica@hhgcinc.com Contracts o, ;; President's Plaza Improvements Done Copyright : 2021 https://p bsystem. pla netbids. co m/h u b/icm/icm-detai I/78399 Privacy Policy Terms and Conditions 7/7 4/1/2021 PbSYSTEI"1 City of Palm Desert t-'UfCflaSe VfQefS w y L c PB System - Insurance Cert Detail No purchase orders have been added Agency Documents Document Library File - Sample Certificate of Insurance Sample GL Waiver of Subrogation Sample WC Waiver of Subrogation Sample G.L. Additional Insured Endorsement Sample Auto Additional Insured Endorsement Sample Minimum Insurance Specifications Sample Primary Non-Contributing Endorsement Contract Documents Vendor pocuments Certificate - City of Palm Desert.pdf 1.6 mb) 03/ 25/2021 Notes to Vendor Nntes Copyright O 2021 https:/Ipbsystem. planetbids.com/hub/icm/ icm-detail/78399 tir, ,_ , ;,s:: Done Privacy Policy Terms and Conditions zn 4/1/2021 PI75YSTEMv., _, .;_, i IOI s I n 88a C PB System - Insurance Cert Detail City of Palm Desert uabmty and Huro uabiuty poucies. VVorKer's c;ompensation is requirea to meet statutory limits with Employers Liability Limits of $1,000,000 and include a waiver of subrogation in favor the City of Palm Desert, its officers, agents, empioyees, and volunteers. Blanket additional insured and waiver of subrogation endorsements are accepted, but specific wording should follow Ianguage in the contract if used. Primary/noncontributing endorsement is also requested for General Liability Pollcy. Producer Name' INLAND EMPIRE-ALLIANT INSURANCE SERVICE Address 685 CARNEGIE DRIVE SUITE 265 Gnntacf Name CHRISTINA MOUNTZ Phone' 909-886-9861 Ext Fax 909- 886-2013 Email CMOUNTZ@ALLIANT.COM Insurers Name• ASSOCIATED INDUSTRIES INSURANCE COMPANY INC. NAICS nn Done Copyright : 2021 Privacy Policy Terms and Conditions https://pbsystem. pl anetb ids. com/h u b/icm/icm-deta i I/78399 3l7 4 2 2 PB System - Insurance Cert Detail F]bSYSTEM City of Palm Desert GENERAL CASUALTY CO OF WI (QBE) Nnics 24414 w Rating A (XV) Get Ra[ing Name' BENCHMARKINSURANCECOMPANY Q NAICS 41394 Rating A (VIII) 9! Coverages 88 C'd Coverage for General Liability s alus Approved Insurer ` SSOCIATED INDUSTRIES Poucy u • AES 119416001 Each Occurrence h-r 2,000, 000.00 na,a - 6,000,000.00 Aggregate EffecGva ` 03/15!2021 Expires' 03/15/2022 Done Copyrigh[ OO 2021 Privacy Policy Terms and Conditions https://pbsystem. pia n etbi d s. comlh ublicm/icm-detail/78399 an 4/1I2021 PB System - Insurance Cert Detail bSYSTEM City of Palm Desert Contractor meets insurance limit requirements through an umbrella policy. w cc Coverage for Auto Liability status Approved Insurer " GENERAL CASUALTY CO c - Po icy # ` BCA0004933-01 Each Occurrence Min ' 0. Adu tl ' 1,000,000.00 Aggregate nn 88 $1,000.000.00 a Actual ` 2,,. C Other Details Effective ` 03l15/2021 Ezpires' 03/15/2022 Coverage for Workers Compensation (Statutory Limits) sta!us Approved Insurer' ERer,tive ` BENCHMARK INSURANCE 01l01/2021 Policy # ` Expires' CST5020730 01 /01 /2022 Copyright OO 2021 https://pbsyslem. pla netbids. com/h ublicm/ic m-deta i I/78399 LL JJ L Done Privacy Policy Terms and Conditions 5/7 4/1/2021 PbSYSTEM City oi Palm Desert i w J ul Aggregate ra n 1,000,000.00 n<<i 1,000, 000.00 Other Details PB System - Insurance Cert Detail Coverage for Umbrella Policy status Approved Insurer' ASSOCIATED INDUSTRIES Policy t!' EXA119550602 Each Occurrence Min ` 88 $Z,,0. Artual' 5.000, 000.00 C Aggregate ha 2,000,000.00 nciva ' 5.000.000.00 Effective ' 03/15/2021 Expires' 03/ 15/2022 Other Details I.-....-....I C h..+ AI..F....+...-. 1 :.. Copyright OO 2021 https://pbsystem. pla n etbids. com/h ub/icm/icm-detail/78399 Done Privacy Policy Terms and Conditions 6/7 4/1/2021 PbSYSTEM i w i c City of Palm Desert Copyrighl OO 2021 PB System - Insurance Cert Detail Done Privacy Policy Terms and Condltlons https://pbsystem.planetbids.com/hub/icmlicm-detail/78399 7l7 From:Aryan, Stephen To:Bowman, Randy; Sanchez, Gloria Subject:FW: Revised Certificate for H & H General Contractors Inc - City of Palm Desert Date:Wednesday, April 7, 2021 6:58:43 PM Attachments:Certificate - City of Palm Desert.pdf image001.png image002.png Please update your files, if needed, for H&H General Contracting with the attached insurance documents. This lists the City as the correct certificate holder. They uploaded it on the same day as interim approval, so you may have it already. I would just check that the City is listed on the first page under certificate holder, for the document you already have, and update if needed. Thank you! Stephen Stephen Y. Aryan Risk Manager Ph: 760.346.0611 Direct: 760.776.6326 saryan@cityofpalmdesert.org www.cityofpalmdesert.org Install the Palm Desert In Touch app to stay in touch with your community Android Apple Mobile Web H&HGENE-01 TWANG aCoi2o CERTIFICATE OF LIABILITY INSURANCE OATE(MMI00/YVYY) 3/26/ 2021 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 BYTHEPOLICIES 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 endorsement1 s. PRODUCER License # OC36861 I coNrncr Christlna M MountzNAME: Inland Empire•Alliant Insurance Services, Inc. I q C No, Ezt (909 886-9867 Fax 685 Carnegie Dr Ste 265 l ) ) (aic, rvo:(909) 886-2013 San Bernardino, CA 92408 I E-ma' cmountz@alliant.comADDRESS: INSIIRER(SI AFFOR ING COVERAGE iNsuaeRn:Associated Industries Insurance Company Inc INSURED H 8 H General Contrectors Inc PO Box 536 Highland, CA 92346 COVERAGES CERTIFICATE NUMBER: I iNsuaeae:Generol Casualtv Co of WI (QBE) I wsuaeac:Benchmark Msurance Companv NAIC # 23140 24414 41394 i iNsurserco: I INSURER E : I INSURER i : THIS IS TO CERTIFY THAT THE POLICIES OF WSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICV PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREINISSUBJECTTOALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS. INSR rypE OF INSURANCE ADDLSUBR pOLICV NUMBER POLICY EFF POLICY EXP LIMITSLTRIN50WVDIMMIOIYYYYIIMMIDDIYYYYI A X GOMMERdALGENERALLIABILITY EACHOCCURRENCE g OOO OOO CLAIMS-MADE OCCUR X ( AES119416001 $$ZQZ 3$ZO22 I DAMAGETORENTED QQ,p plPRFMIFFRIFanrnurenral $ X$2,500 BI/PD Ded/Occ I n eo exP (nnv one oerson) S 5,OOOI I PERSONAL&ADVINJURV $ OOO OOOI GEN'L AGGREGATE LIMIT APPLIES PER' GENERAI AGGREGATE $ Z,OOO,OOO POLICY JECT LOC I PROOUCTS-COMPIOPAGG $ Z OOO OOOI OTHER; $ B AUTOM081LE LIA9ILITY COMBMED SINGLE LIMIT 'I,OOO,OOOIIFaacndenl $ nNvnuro X X BCA0004933-01 3I15/2021 3/15/2022 I goo v NduRv(Peroerson7 8 I OWNED SCHEOULED AUTOSONLY AUTOS I BO ILVINJURV/!Peracciden0 $ I X HIRED X NON-OWNE PROPERTVOAMAGE AUTOS ONLV AUTOS ONLY fPer accitlentl $ X`$500 Comp Detl X 550 Coll Detl I G A UMBRELLA LIAB I X I OCCUR X EXCE55 LIAB I CLAIMS-MADE I DE I% I RETENTION$ below Y/N NIA EXA119550602 X CST5020730 3I15/2021 3/15/2022 EACHOCCURRENCE 5,000,000 S,OOO,OOOI 1,000,OOOI 1,000,000 r 0 00 REVISION NUMBER: AGGREGATE $ Over GLIAL/EL $ X I STATl1TF I I F RH i/ i/YOYi i i YOYP I ELEACHACCIDENT ELOISEASE-EAEMPLOYEE $ ELOISEASE-POLICVLIMIT $ OESCRIPTION OF OPERATIONS I LOCATIONS NEHICLE$ (ACORO 101, Atltlitional Remarks ScM1etlule, may be a tacM1etl If more space is requiretl) Re: Project #758-14, Contract MC37040A, Presideofs Plaza Parking Lot Improvements Con[ractor and Ci[y of Palm Desert, including tis officers, officials employees and agen[s are additional insureds, primary and non-con[ribu[ory, waiver of subrogation as respects to general liability per endorsements attached; additional insureds, waiver of subrogation as respects to auto liability per endorsement a[tached; waiver of subrogation as respects to workers' compensation per endorsement. CERTIFICATE HOLDER City of Palm Desert 73-510 Fred Waring Drive Palm Desert, CA 92660-2578 CANCELLATION SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE REPRESENTATIVE P . ACORD 25 (2016/03) OO '1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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 yo to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2_0 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Orqanization Job Descri tion Any person or organization as required by written contract 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 Date: 1/1/2021 Policy No. CST5020730 Endorsement No. Policy Effective Dates: 01/ 01/2021 - 01/01/2022 Premium $ Insured: Carrier Name / Code: Benchmark Insurance CompanyA W C 04 03 06 P Ed. 4-84) Countersigned by Page 1 of 1 POLICY NLJMBER: BCA0004933-01 COMMERCIAL AUTO AH CA 85 90 09 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHANGES IN COMMERCIAL AUTO COVERAGE FORM This endorsement modifies insurance pro ded under the following: BUSINESS AUTO COVERAGE FORM A. BROADENED WHO IS AN INSURED Paragraph A.1. Who Is an Insured of SECTION II LIABILITY COVERAGE is amended to include the following: d. Any "employee" of yours is an "insured" while using a co,ered "auto" you don't own, hire or borrow in your business or your personal affairs. e. Any "employee" of yours is an "insured" while using an "auto" hired or rented under a contract or agreement in that "employ- ee's" name, with your permission, while performing duties related to the conduct of yourbusiness. f. Each person or Organization to whom you are required by a written contract or agreement to pro de additional insured status is an "insured" under Liability Cov- erage, but only to the extent that person or organization qualifes as an "insured" un- der the Who is an Insured Provision con- tained in Section II of the co 2rage form. The written contract or agreement must be in effect during the policy period shown in the Declarations and must ha 2 been exe- cuted prior to the "bodily injury" or "proper- ty damage." B. LIABILITY COVERAGE EXTENSIONS SUPPLE- MENTARY PAYMENTS Paragraphs A.2.a. (2) and A.2.a. ( 4) Coverage Extensions — Supplementary Payments of SECTION II — LIABILITY COVERAGE are deleted and replaced with the following: 2) Up to $5,000 for the cost of bail bonds including bonds for related traffic law violations) required because of an "ac- cidenY' we cover. We do not have to furnish these bonds. 4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $ 500 a day because of time off from work. C. FELLOW EMPLOYEE COVERAGE Paragraph B.S. Fellow Employee Exclusion con- tained in SECTION II — LIABILITY COVERAGE does not apply if the "bodily injury" results from the use of a co,ered "auto" you own or hire that is not a bus, motorcycle or van used to transport em- ployees. This Fellow Employee Co rage is excess o,er any other collectible insurance. D. POLLUTION LIABILITY — BROADENED COV- ERAGE FOR COVERED AUTOS 1. Liability Coverage is changed as follows: a. Paragraph B.11.a. of the Pollution Exclu- sion in SECTION II — LIABILITY COV- ERAGE applies only to liability assumed under a contract or agreement. b. With respect to the co erage afforded by Paragraph 1.a. Above, Exclusion B.6. Care, Custody or Control of SECTION II LIABILITY does not apply. 2. Changes in Definitions For the purposes of this endorsement, Para- graph D. of SECTION V— DEFINITIONS is replaced by the following: D. "Co red pollution cost or expense" means any cost or expense arising out of: 1. Any request, demand, order or statuto- ry or regulatory requirement that any insured" or others test for, monitor, clean up, remo, contain, treat, de- toxiiy or neutralize, or in any way re- spond to, or assess the effects of "pol- lutants": or Includes copyrighted material of Insurance Sen,ices Offce, Inc., AH CA 85 90 09 17 with its permission. Page 1 of 6 2. Any claim or "suiY' by or on behalf of a go rnmental authority for damages be- cause of testing for, monitoring, cleaning up, removing, containing, treating, detoxiTy- ing or neutralizing, or in any way respond- ing to or assessing the effects of "pollu- tants". Co,ered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dis- persal, seepage, migration, release or escape of "pollutants": a. Before the "pollutants" or any property in which the "pollutants" are contained are mo ed from the place where they are accepted by the "insured" for mo,ement into or onto the co red auto"; or b. After the "pollutants" or any property in which the "pollutants" are contained are mo,ed from the co red "auto" to the place where they are finally deliv- ered, disposed of or abandoned by the insured". Paragraphs a. and b. abo do not apply to "accidents" that occur away from prem- ises owned by or rented to an "insured" with respect to "pollutants" not in or upon a co red "auto" if: 1) The "pollutants" or any property in which the "pollutants" are con- tained are upset, oeerturned or damaged as a result of the maintenance or use of a co red auto' ; and 2) The discharge, dispersal, seep- age, migration, release or escape of the "pollutants" is caused di- rectly by such upset, o erturn or damage. This Pollution Liability Co rage is subject to an Annual Aggregate Limit of Liability of $100,000. E. NEWLY ACQUIRED OR FORMED ORGANIZATI ONS Throughout this policy, the words you and your al- so refer to any organization you newly acquire or form, other than a partnership, joint nWre or lim- ited liability company, and oeer which you maintain ownership or majority interest, but only if there is no similar insurance available to that organization. Howe,er: 2. Unless you notify us to add co rage to your policy, the co rage under this pro sion is af- forded only until: a. The 120th day after you acquire or form the organization, or b. The end of the policy period, whiche,er is earlier. f i U7 j[Y 9I[7 Paragraph A.2. Towing of SECTION III — PHYS- ICAL DAMAGE COVERAGE is deleted and re- placed with the following: We will pay for towing and labor costs each time a co red "auto" is disabled. All labor must be per- formed at the place of disablement. If the "auto" is of the private passenger type, there will be no de- ductible. If the "auto" is other than a pri rate pas- senger type, a$100 deductible will apply. The most we will pay under this EXTENDED TOW- ING co erage is $750 per occurrence. G. PHYSICAL DAMAGE COVERAGE EXTENSIONS Paragraph A.4. — Coverage Extensions of SEC- TION III — PHYSICAL DAMAGE COVERAGE is amended as follows: a. Transportation Expenses The amount we will pay for temporary transportation expense is increased to $50 per day to a maximum of $3,000. b. Loss of Use Expenses The amount we will pay for loss of use is increased to $75 per day and to a maxi- mum limit of $1,000. H. RENTAL REIMBURSEMENT 1. This co erage applies only to a co red "auto" described or designated in the Schedule or in the Declarations as carrying physical damage co rage. 2. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" be- cause of "loss" to a co red "auto". Payment applies in addition to the othervvise applicable amount of co erage you ha on each co red auto". 3. We will pay only for those expenses incurred during the policy period beginning 24 hours af- ter the "loss" and ending, regardless of the pol- icy's expiration, with the lesser of the following number of days: 1. The co rage does not apply to an "accidenY' which occurred before you acquired or formed the organization. Includes copyrighted material of Insurance Sen,ices Offce, Inc., Page 2 of 6 with its permission. AH CA 85 90 09 17 a. The number of days reasonably required to repair or replace the co ered "auto". If loss" is caused by theft, this number of days is added to the number of days it takes to locate the coeered "auto" and re- turn it to you; or b. 30 days. 4. Our payment is limited to the lesser of the fol- lowing amounts: a. Necessary and actual expenses incurred; or b. $50 per day 5. This co,erage does not apply while there are spare or resen2 "autos" available to you for your operations. 6. If "loss" results from the total theft of a co 2red auto" of the private passenger type, we will pay under this co,erage only that amount of your rental reimbursement expenses which is not already pro ided for under the paragraph A.4. Coverage Extensions in SECTION III — PHYSICAL DAMAGE COVERAGE. No Deductible applies to this coeerage. I. AIRBAG COVERAGE Exclusion B.3. in SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add: This exclusion does not apply to the accidental discharge of an airbag. J. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT 1. Coverage a. We will pay with respect to a co red "au- to" described in the Schedule for "loss" to any electronic equipment that recei s or transmits audio, tisual or data signals and that is not designed solely for the repro- duction of sound. This co rage applies only if the equipment is permanently in- stalled in the co,ered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the co red "auto" at the time of the "loss", and such equipment is de- signed to be solely operated by use of the power from the "auto's" electrical system, in or upon the co red "auto". b. We will pay with respect to a covered "au- to" described in the Schedule for "loss" to any accessories used with the electronic equipment described in Paragraph 1.a. abo. Howe,er, this does not include tapes, records or discs. 2. Exclusions The exclusions that apply to SECTION III — PHYSICAL DAMAGE, except for the exclusion relating to Audio, Visual and Data Electronic Equipment, also apply to co,erage pro ided by this endorsement. In addition, the following ex- clusions apply: We will not pay, under this endorsement, for either any electronic equipment or accessories used with such electronic equipment that is: a. Necessary for the normal operation of the co red "auto" or the monitoring of the co ered "auto's" operating system; or b. Bath: 1). An integral part of the same unit hous- ing any sound reproducing equipment designed solely for the reproduction of sound if the sound reproducing equip- ment is permanently installed in the co,ered "auto": and 2). Permanently installed in the opening of the dash or console normally used by the manufacturer for the installation of a radio. 3. Limit Of Insurance With respect to co rage under this endorse- ment, the Limit Of Insurance provision of SECTION III — PHYSICAL DAMAGE COV- ERAGE is replaced by the following: a. The most we will pay for all "loss" to audio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of: 1). The actual cash value of the damaged or stolen property as of the time of the loss"; 2). The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or 3). $1,500. b. An adjustment for depreciation and physi- cal condition will be made in determining actual cash value at the time of the "loss". c. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. 4. Deductible No deductible applies to this co 2rage. The insurance pro ided by this extension is excess o r any other collectible insurance. Includes copyrighted material of Insurance Sen,ices Offce, Inc., AH CA 85 90 09 17 with its permission. Page 3 of 6 K. TAPES, RECORDS AND DISCS COVERAGE Exclusion B.4.a. of SECTION III — PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: a. Tapes, records, discs or other similar au- dio, visual or data electronic devices de- signed for use with audio, visual or data electronic equipment except when the tapes, records, discs or other similar au- dio, sual or data electronic devices: 1) Are your property or that of a family member, and 2) Are in a co,ered "auto" at the time of loss". a). The most we will pay for "loss" is 200. No Physical Damage Cov- erage deductible applies to this co rage. This extension provides co rage only to a coeered auto". L. PHYSICAL DAMAGE DEDUCTIBLE — SINGLE DEDUCTIBLE AND GLASS REPAIR Paragraph D. Deductible in SECTION III — PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: D. Deductible For each co red "auto," our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable de- ductible shown in the Declarations. Any Com- prehensi Co rage deductible shown in the Declarations does not apply to "loss" caused by fre or lightning. When two or more co red "autos" sustain loss" in the same occurrence, the total of all the "loss" for all the inwl d co red "autos" will be reduced by a single deductible, which will be the largest of all the deductibles apply- ing to all such co 2red "autos." No deductible applies to glass damage if the glass is repaired rather than replaced. M. PERSONAL EFFECTS COVERAGE 1. If you purchase Comprehensi e Coverage on this policy for a stolen owned "auto", we will pay up to $600 for "personal effects" stolen with the "auto". 2. "Personal effects" as used in this extension means tangible property that is worn or carried by the "insured". "Personal effects" does not include tools, jewelry, money, securities, radar or laser detectors, or tapes, records, discs or similar audio, visual or data electronic equip- ment. No Deductible applies to this extension. The insurance provided by this extension is excess o r any other collectible insurance. N. LOAN/LEASE PAYOFF COVERAGE The SECTION III — PHYSICAL DAMAGE COV- ERAGE is amended by the addition of the follow- ing: In the event of a total "loss" to a covered "auto" shown in the Declarations, we will pay any unpaid amount due on the lease or loan for a co red "au- to", less: 1. The amount paid under the Physical Damage Coeerage Section of the policy; and 2. Any: a. O rdue lease/loan payments at the time of the "loss" b. Financial penalties imposed under a lease for excessi e use, abnormal wear and tear or high mileage. c. Security deposits not returned by the les- sor; d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and e. Carry-o r balances from previous loans or leases. O. CUSTOM SIGNS AND DECORATIONS In the e 2nt of a total loss to a ehicle insured for auto physical damage co rage on this policy, in addition to the ACV of the hicle, we will pay the actual cost to repair or replace signage or custom paint details up to $5,000. P. HIRED AUTO PHYSICAL DAMAGE If hired "autos" are covered "autos" for Liability Co erage and if Physical Damage Co.erage of Comprehensiee, Specified Causes of Loss, or Col- lision are pro ded under this Co rage Form for any "auto" you own, then the Physical Damage Co erage's provided are extended to "autos" you hire of like kind and use subject to the following limit: The most we will pay for any one loss is the lesser of the following: 1. $50,OOOperaccident, Includes copyrighted material of Insurance Sen,ices Offce, Inc., Page 4 of 6 with its permission. AH CA 85 90 09 17 2. Actual Cash Value, or 3. The cost of repair. The deductible will be equal to the largest deducti- ble applicable to any owned "auto" for that co er- age. No deductible applies to "loss" caused by fre or lightning. This Hired Auto Physical Damage cov- erage is excess o r any other collectible insur- ance. Subject to the above limit, deductible and excess provisions, we will provide co rage equal to the broadest coeerage applicable to any co red auto" you own. Q. DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Subparagraphs A.2.a. of SECTION IV — BUSI- NESS AUTO CONDITIONS is deleted and re- placed by: a. In the e 2nt of "accidenY', claim, "suiY' or loss", you, your insurance manager or any other person you designate must gi,e us or our authorized representati prompt notice of such "accidenY' or "loss". Include: 1) How, when and where the "accident" or loss" occurred; 2) The "insured's" name and address; and 3) To the extent possible, the names and ad- dresses of any injured persons and wit- nesses. Knowledge of an "accident" or "loss" by your agent, servant or "employee" shall not be consid- ered knowledge by you unless you, your insurance manager or any other person you designate has recei d notice of the "accidenY' or "loss" from your agent, servant, or "employee." R. WAIVER OF SUBROGATION SECTION IV — BUSINESS AUTO CONDI- TIONS— A. 5. Transfer of Rights of Recovery Against Othersto Us is amended as follows: This condition does not apply to any person or or- ganization to which you wai.ed this condition by written contract or agreement, but only to the ex- tent that subrogation is wai d prior to the "acci- denY' or "loss" under a contract with that person or organization. S. UNINTENTIONAL FAILURE TO DISCLOSE HAZ- ARDS Paragraph B.2. Concealment, Misrepresentation Or Fraud in SECTION IV — BUSINESS AUTO CONDITIONS is amended by adding the following: Any unintentional failure to disclose all exposures or hazards existing as ofthe effecti e date ofthe Business Auto Co 2rage Form or at any time dur- ing the policy period will not invalidate or ad rsely affect the co rage for such exposure or hazard. Howe r, you must report the undisclosed expo- sure or hazard to us as soon as reasonably possi- ble after its disco ry. T. EXTENDED EMPLOYEE HIRED AUTO PHYSICAL DAMAGE Paragraph B.5.b. Other Insurance of SECTION IV BUSINESS AUTO CONDITIONS is deleted and replaced by the following: b. For Hired Auto Physical Damage Co,er- age, the following are deemed to be cov- ered "autos" you own: 1. Any co red "auto" you lease, hire, rent or borrow: and 2. Any coeered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your perrnission, while performing du- ties related to the conduct of your business. Howe r, any "auto" that is leased, hired, rented or borrowed with a dri 2r is not a co.ered "auto". U. POLICY PERIOD, COVERAGE TERRITORY Paragraph B.7. Policy Period, Coverage Territo- ry of SECTION IV — BUSINESS AUTO CONDI- TIONS is deleted and replaced by: 7. Policy Period, Coverage Territory Under this Coverage Form, we co r "acci- dents" and "losses" occurring: a. During the policy period shown in the Dec- larations; and b. Within the co rage territory. The co 2rage territory is: a. The United States of America; b. The territories and possessions of the United States of America; c. Puerto Rico; d. Canada; and e. Anywhere in the world if: 1) A co red "auto" is leased, hired, rented or borrowed for a period of 30 days or less; and Includes copyrighted material of Insurance Sen,ices Offce, Inc., AH CA 85 90 09 17 with its permission. Page 5 of 6 2) The "insured's" responsibility to pay damages is determined in a"suit" on the merits, in the United States of America, the territories and posses- sions of the United States of America, Puerto Rico, or Canada or in a settle- ment we agree to. We also co er "loss" to, or "accidents" inwlving, a co red "auto" while being transported between any of these places. V. DEFINITION OF BODILY INJURY AMENDED Paragraph C. of SECTION V— DEFINITIONS is amended to include: Bodily Injury" includes mental anguish or other mental injury resulting from "bodily injury." Howev- er, no co rage is provided for mental anguish or mental injury absent physical injury. None of the extensions provided under this co er- age endorsement apply if co,erage is more specif- cally identifed elsewhere in the policy or endorse- ments, for which a premium charge is made or a higher limit is identifed. Under no circumstances is any limit provided under this extension to be com- bined with a limit provided elsewhere in the policy or endorsements. Includes copyrighted material of Insurance Sen,ices Offce, Inc., Page 6 of 6 with its permission. AH CA 85 90 09 17 POLICY NUMBER: AE5119416001 COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are pertorming opera- tions 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 re- spect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an addition- al insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the ren- dering of, or the failure to render, any profes- sional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcon- tractor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 OO ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: AES119416001 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): All persons or organizations where written contract with the Named insured requires completed Operations coverage. This form does not apply to your work on "residential property" Location And Description Of Completed Opera- tions Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard". CG 20 37 07 04 O ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: AES119416001 COMMERCIAL GENERAL LIABILITY NX GL 009 08 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTING INSURANCE THIRD-PARTY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Third Party: All persons or organizations where required by written contract with the Named Insured Absence of a specifically named Third Party above means that the provisions of this endorsement apply as required by written contractual agreement with any Third Party for whom you are performing work.) Paragraph 4. of SECTION IV: COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance: With respect to the Third Party shown above, this insurance is primary and non-contributing. Any and all other valid and collectable insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for loss covered by this policy, shall in no instance be considered as primary, co-insurance, or contributing insurance. Rather, any such other insurance shall be considered excess over and above the insurance provided by this policy. NX GL 009 08 09 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission POLICY NUMBER: AES119416001 COMMERCIAL GENERAL LIABILITY CG 24 04 OS 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations where required by written contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 OO Insurance Services Office, Inc., 2008 Page 1 of 1