HomeMy WebLinkAboutJ&S Striping - 2021-05-12 SERVICE AGREEMENT 13ETWEEN
THE CITY OF HUNTINGTON I3EACII
AND
.I&S STRIPING
FOR
ON-CALL MAINTENANCE RE TRAFFIC
SIGNAGE AND STRIPING CITYWIDE
THIS AGREE1vlEN'I' ('`Agreement") is made and entered into by and bctNycen the City of
Huntington Beach a municipal corporation of the State of California, hereinafter called "Cite." and
J&S Striping, hereinafter retcrred to as "Contractor."
Recitals
A. The City- desires to retain a Contractor having special skill and knowledge in the field of
maintenance re traffic signage and striping. and as needed pressure washer cleaning
services.
B. Contractor represents that Contractor is able and willing to provide such services to the
City.
C. In undertaking the performance of this Agreement. Contractor represents that it is
knowledgeable in its field and that any services performed by Contractor under this
Agreement will be performed in compliance with such standards as may reasonable be
expected from a comparable company or firm in the field.
Contractor has been selected to perform these services pursuant to Huntington Beach
Iunicipal Code Chapter 3.02,
NOW. THEREFORE. it is agreed by City and Contractor as follows:
I. Scope of Services
Contractor shall provide all services as described in Exhibit "A" which is attached hereto
and incorporated into this Agreement by this retcrence. Thcsc services shall sometimes hereinafter
be referred to as the "Project/Service."
Contractor hereby designates Robert Aragon who shall represent it and be its sole contact
and agent in all consultations with City during the performance ofthis Agreement.
2. City Staff Assistance
City shall assign a stal't coordinator to work directly with Contractor in the performance ol'
this Agreement.
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3. Compensation
a. City agrees to pay. and Contractor agrees to accept as total payment for its
services, the rates and charges identitied in Exhibit "B." The total sum to be expended
under this Agreement. shall not exceed Twenty Nine Thousand Nine Hundred Dollars
(529.900).
b. Payment by City shall be made within thirty (30) days l'ollowinc receipt of proper
invoice evidencing work perfornied, subject to City accounting procedures. Payment need
not be made for work which fails to meet the standards of performance set forth in the
Recitals which may reasonably be expected by City.
C. Contractor shall be paid pursuant to the terms of Exhibit "B."
9. Term
-time is of the essence regarding the Project/Service and execution of this Agreement. The
services of Contractor are to commence May 112021 or as soon as practicable after the execution
of this Agreement by City (the '`Commencement Date") and terminate November 11. 2021. unless
terminated earlier in accordance with the provisions of this Agreement. Contract may be extended
for two (2) additional one year periods if' mutually agreed to in writing by both parties. All tasks
specified in Exhibit "A" shall be completed at the frequency time and schedule indicated in
Exhibit "A". -fhe time for performance of the tasks identified in Exhibit "A" are generally to be
shown in Exhibit "A." This schedule and Term may be amended to benefit the Project if mutually
agreed to in writing by Cite and Contractor.
In the event the Commencement Date precedes the Effective Date, Contractor shall be
bound by all terms and conditions as provided herein.
5. Extra Work
In the event City requires additional services not included in Exhibit "A" or changes in the
scope of services described in Exhibit "A," Contractor will undertake such work only after
receiving written authorization from City. Additional compensation for such extra work shall be
allowed only if the prior written approval ol'Cih is obtained.
6. Disposition of Plans Estimates and Other Documents
Contractor agrees that title to all materials prepared hereunder, including. without limitation,
all original drawings, designs, reports, both field and office notices. calculations, computer code
language, data or programs. maps, memoranda. letters and other documents. shall belong to City.
and Contractor shall turn these materials over to City upon expiration or termination of this
Agreement or upon Project completion, whichever shall occur first. These materials may be used by
Croy as it sees fit.
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7. Hold Harmless
Contractor hereby agrees to protect, defend, indemnify and hold harmless Cite, its officers,
elected or appointed officials, employees, agents, and volunteers from and against any and all,
claims, damages, losses, expenses, judgments. demands and defense costs. and consequential
damage or liability of any kind or nature, however caused. including those resulting from death or
injury to Contractor's employees and damage to Contractor's property, arising directly or indirectly
out of the obligations or operations herein undertaken by Contractor, caused in whole or in part by
any negligent act or omission of' the Contractor, any subcontractors, anyone directly or indirectly
employed by any of them or anyone for whose acts may be liable, including but not limited to
concurrent active or passive negligence, except where caused by the active negligence, sole
negligence, or willful misconduct of the City. Contractor will conduct all defense at its sole cost
and expense and City shall approve selection of Contractor's counsel. This indemnity shall apply to
all claims and liability regardless of whether any insurance policies are applicable. The policy
limits do not act as a limitation upon the amount of indemnification to be provided by Contractor.
8. Workers Compensation Insurance
Pursuant to California Labor Code Section 1861, Contractor acknowledges awareness of
Section 3700 et seq. of this Code. which requires every_ employer to be insured against liability for
workers' compensation: Contractor covenants that it will comply with such provisions prior to
commencing performance of the work hereunder.
Contractor shall obtain and furnish to City workers' compensation and employer's liability
insurance in an amount of not less than the State statutory limits.
Contractor shall require all subcontractors to provide such workers' compensation and
employer's liability insurance for all of the subcontractors' emplovees. Contractor shall furnish to
Cite a certificate of' waiver of subrogation under the terms of' the workers' compensation and
employer's liability insurance and Contractor shall similarly require all subcontractors to waive
subrogation.
9. General Liabilitv Insurance
In addition to the workers' compensation and employer's liability insurance and Contractor's
covenant to defend. hold harmless and indemnify City. Contractor shall obtain and furnish to City, a
policy of general public liability insurance, including motor vehicle coverage covering the
Project/Service. This policy shall indemnify Contractor, its officers. emplovees and agents while
acting within the scope of their duties, against any and all claims arising out or in connection with
the Project/Service, and shall provide coverage in not less than the following amount: combined
single limit bodily injury and property damage, including products/completed operations liability
and blanket contractual liability, of One Million Dollars (51,000,000) per occurrence. If coverage is
provided under a form which includes a designated general aggregate limit, the aggregate limit must
be no less than One Million Dollars ($1.000.000) for this Project/Service. This policy shall name
Citv. its officers, elected or appointed officials, employees, agents, and volunteers as Additional
Insureds. and shall specifically provide that any other insurance coverage which may be applicable
to the Project/Service shall be deemed excess coverage and that Contractor's insurance shall be
primary.
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Under no circumstances shall said above-mentioned insurance contain a self-insured
retention, or a "deductible" or any other similar form of'limitation on the required coverage.
10. Automobile Liability Insurance
Contractor shall obtain and furnish to City an automotive liability insurance policy covering
the work performed by it hereunder. This policy shall provide coverage for Contractor's automotive
liability in an amount not less than One Iyfillion Dollars ($1.000,000.00) per occurrence and a
separate "Additional Insured Endorsement" page listing both the policy number and naming the
"City of Huntington Beach, its officers, elected and/or appointed ofJiciols, eml)Ioyees, agents crud
volunteers" as additional insured on the endorsement. The above-mentioned insurance shall not
contain a self-insured retention. "deductible" or any other similar form of limitation on the required
coverage except with the express written consent of City.
11. Certificate of Insurance
Prior to commencing performance of the work hereunder. Contractor shall furnish to City a
certificate of' insurance subject to approval of the City Attorney evidencing the foregoing insurance
coverage as required by this Agreement; the certificate shall:
a. provide the name and police number of each carrier and policy;
b. state that the policy is currently in force; and
c. promise that such policy shall not be suspended, voided or canceled by either party,
reduced in coverage or in limits except after thirty (30) days' prior written notice;
however, ten (10) days' prior written notice in the event of cancellation for nonpayment
of premium.
Contractor shall maintain the foregoing insurance coverage in force until the work under this
Agreement is hilly completed and accepted by City.
The requirement for carrying the Ioregoing insurance coverage shall not derogate from
Contractor's defense, hold harmless and indemnification obligations as set forth in this Agreement.
City or its representative shall at all times have the right to demand the original or a copy of the
policy of insurance. Contractor shall pay, in a prompt and tinnelq manner, the premiums on the
insurance hereinabove required.
12. Independent Contractor
Contractor is, and shall be, acting at all times in the performance of this Agreement as an
independent contractor herein and not as an employee of City. Contractor shall secure at its own
cost and expense, and be responsible for any and all payment of' all taxes. social security, state
disability insurance compensation, unemployment compensation and other payroll deductions for
Contractor and its officers, a,,ents and employees and all business licenses. if any. in connection
with the Project and/or the services to be performed hereunder.
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13. Conflict of Interest
Contractor covenants that it presently has no interests and shall not have interests. direct or
indirect. which would conflict in any manner with performance of services specified under this
Agreement.
14. Termination
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event. Contractor shall be entitled to receive and the City shall pay Contractor
compensation for all services performed by Contractor prior to receipt of such notice of termination,
subject to the lollowing conditions:
a. As a condition of such payment, the Director may require Contractor to deliver to the
City all work product completed as of such date, and in such case such work product shall be the
property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such
purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of perfomlance
specified in the Recitals of this Agreement.
15. Exclusivity and Amendment
This Agreement represents the complete and exclusive statement between the City and
Contractor. and supersedes any and all other agreements, oral or written, between the parties. In the
event of' a conflict between the terms of this Agreement and any attachments hereto, the terms of
this Agreement shall prevail. This Agreement may not be modified except by written instrument
signed by the City and by an authorized representative of Contractor. The parties agree that any
terms or conditions of any purchase order or other instrument that are inconsistent with. or in
addition to. the terms and conditions hereof, shall not bind or obligate Contractor or the City. Each
party to this Agreement acknowledges that no representations, inducements, promises or
agreements, orally or otherwise, have been made by any party. or anyone acting on behalf of any
party, which are not embodied herein.
16. Assignment
Inasmuch as this Agreement is intended to secure the specialized services of Contractor.
Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment. transfer, delegation or subcontract without the
City's prior written consent shall be considered null and void. Nothing in this Agreement shall be
construed to limit the City's ability to have any of the services which are the subject to this
Agreement performed by City personnel or by other Contractors retained by City.
17. City Employees and Officials
Contractor shall employ no City official nor any regular City employee in the work
performed pursuant to this Agreement. No officer or employee of City shall have any financial
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interest in this Agreement in violation of' the applicable provisions of the California Government
Code,
18. Notices
Any notices, certificates, or other communications hereunder shall be Liven either by
personal delivery to Contractor's agent (as designated in Section 1 hereinabove) or to City as the
situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and
depositing the same in the United States Postal Service, to the addresses below. City and Contractor
may designate different addresses to which subsequent notices, certificates or other communications
will be sent by notifying the other party via personal delivery, a reputable overnight carrier or U.S.
certified mail-return receipt requested:
To City: To Contractor:
City of Huntington Beach J&S Striping
Attn: John NLuven Attn: Robert Aragon
2000 (Main Street 1544 S. Vinyard Avenue
Huntington Beach, CA 92648 Ontario, CA 91716
19. Consent
When City's consent/approval is required under this Agreement, its consent/approval for
one transaction or event shall not be deemed to be a consent/approval to any subsequent occurrence
of the same or anv other transactions or event.
21). Modification
No waiver or modification of any language in this Agreement shall be valid unless in writing
and duly executed by both parties.
21. Section Fleadinps
The titles, captions, section, paragraph and subject headings, and descriptive phrases at the
beginning of the various sections in this Agreement are merely descriptive and are included solely
for convenience of reference only and are not representative of matters included or excluded from
such provisions. and do not interpret, define, limit or describe, or construe the intent of the parties or
affect the construction or interpretation of any provision of this Agreement.
22. Interpretation of this Agreement
The language of' all parts of' this Agreement shall in all cases be construed as a whole,
according to its fair meaning, and not strictly for or against an of the parties. If any provision of
this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void,
illegal or invalid. such holding shall not invalidate or affect the remaining covenants and provisions
of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so
expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or
plural number shall be deemed to include the other whenever the context so indicates or requires.
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21-97001254679
Nothing contained herein shall be construed so as to require the commission of any act contrary to
law, and wherever there is any conflict between any provision contained herein and any present or
future statute, law, ordinance or regulation contrary to which the parties have no right to contract,
then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be
curtailed and limited only to the extent necessary to bring it within the requirements of the law.
23. Duplicate Original
The original of this Agreement and one or more copies hereto have been prepared and
signed in counterparts as duplicate originals, each of which so executed shall. irrespective of the
date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed
an original instrument as against any party who has signed it.
24. Immigration
Contractor shall be responsible for full compliance with the immigration and naturalization
laws ol'the United States and shall. in particular, comply with the provisions of'the United States
Code regarding employment verification.
25. Legal Services Subcontracting Prohibited
Contractor and City agree that City is not liable for payment of any subcontractor work
involving legal services, and that such legal services are expressly outside the scope of services
contemplated hereunder. Contractor understands that pursuant to Huntington Beach City Charter
Section 309, the City Attorney is the exclusive legal counsel for City: and City shall not be liable
for payment of any legal services expenses incurred by Contractor.
26. Confidentiality,
Contractor recognizes that in the performance of its duties under this Agreement. it must
conduct its activities in a manner designed to protect information of a sensitive nature from
improper use or disclosure. Contractor warrants that it will use reasonable efforts consistent with
practices customary in the facilities management industry in recruiting, training and supervising
employees and in otherwise performing its duties hereunder in order to achieve this result. in the
furtherance of this. Contractor agrees, at the request of the City. to require its employees to execute
written undertakings to comply with the foregoing confidentiality provision.
27. Discrimination
Contractor shall not discriminate because of race, color, creed, religion, sex, marital status.
sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by
applicable law, in the recruitment, selection. training, utilization. promotion. termination or other
employment related activities. Contractor affirms that it is an equal opportunity employer and shall
comply with all applicable federal, state and local laws and regulations.
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28. Jurisdiction - Venue
This Agreement and all questions relating to its validity, interpretation, performance. and
enforcement shall be governed and construed in accordance with the laws of the State of California.
]'his .Agreement has been executed and delivered in the State of California and the validity,
interpretation, performance, and enforcement of any of the clauses of this Agreement shall be
determined and governed by the laws of the State of California. Both parties further agree that
Orange County. California, shall be the venue for any action or proceeding that may be brought or
arise out of. in connection with or by reason of this Agreement.
29. Professional Licenses
Contractor shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers. and exemptions necessary for the provision of the services hereunder
and required by the laws and regulations of the United States, the State of California, the City of
Huntington Beach and all other governmental agencies. Contractor shall notify the City
immediately and in writing of their inability to obtain or maintain such permits, licenses, approvals,
waivers, and exemptions. Said inability shall be cause for termination of this Agreement.
30. AttorneN's Fees
In the event suit is brought by either party to construe. interpret and/or enforce the terms
and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its
own attorney's fees. such that the prevailing party shall not be entitled to recover its attornev's fees
from the nonprevailina party.
31. Survival
Terms and conditions of this Agreement. which by their sense and context survive the
expiration or termination of this Agreement. shall so survive.
32. Coverninp, Law
This Agreement shall be governed and construed in accordance with the laws of the State of
California.
33. Signatories
Each undersigned represents and warrants that its signature hereinbelow has the power.
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
indemnify City fully for any injuries or damages to City in the event that such authority or power is
not, in fact. held by the signatory or is withdrawn.
34. Entirety
(a) The parties acknowledge and agree that they are entering into this Agreement
freely and voluntarily following extensive arm's length negotiation, and that each has had the
opportunity to consult with legal counsel prior to executing this Agreement. The parties also
acknowledge and agree that no representations, inducements, promises, agreements or warranties.
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21 97001254079
oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are
not embodied in this Agreement, and that that party has not executed this Agreement in reliance on
any representation, inducement, promise, agreement warranty, fact or circumstance not expressly
set forth in this Agreement.
(b) All Exhibits referenced herein and attached hereto shall be incorporated as if
fully set forth in the body of this Agreement.
35. Effective Date
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by
and through their authorized officers. This Agreement shall be effective on the date of its approval
by the City Manaeer. This Agreement shall expire when terminated as provided herein.
CONTRACTOR: CITY OF HUNTINGTON BEACH, a
municipal corporation of the State of
J&S STRIPING California
INITIATED AND APPROVED:
print name
IT'S: (circle one) Chairma iden ice President Director of Public Works
AND
APPROVED AS TOFORM:
By:
4City Attorney
print name
ITS: (circle one) SecretaryNice-President/Chief
Financial Officer/Asst. Secretary-Treasurer
REVIEWED AND APPROVED:
City Manager
RECEIVED:
�.�rwrrri"ART
City Clerk
9
21-9700/254679
oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are
not embodied in this Agreement, and that that party has not executed this Agreement in reliance on
any representation, inducement, promise, agreement warranty, fact or circumstance not expressly
set forth in this Agreement.
(b) All Exhibits referenced herein and attached hereto shall be incorporated as if
fully set forth in the body of this Agreement.
35. Effective Date
IN WITNESS WHEREOF,the parties hereto have caused this Agreement to be executed by
and through their authorized officers. This Agreement shall be effective on the date of its approval
by the City Manager. This Agreement shall expire when terminated as provided herein.
CONTRACTOR: CITY OF HUNTINGTON BEACH, a
municipal corporation of the State of
1&S STRIPING California
INITIATED AND APPRO
By:
n r 3/('V
am print ne
I"I S: (clydeone)Chairm reside
a nt! ice President Director of Public Works
AND
APPROVED AS TO FORM:
By.
4City Attomoey
prim name
ITS: ( ircle one)SecretaryNice-President/Chief
Financial Officer/Asst.Secretary -Treasurer
RE I 'WED A APPROVED:
City Manager
RECEIVED:
COUNTERPART
City Clerk
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21-971101254679
Exhibit A
00
1544 S.Vineyard Ave Ontario, California 91761
(909)947-8073 FAX: (909) 947.9489
'- ) Lic. No. 538211
CUSTOMER: Proposal & Contract
Proposal: 13290
HUNTING'1'ON BEACH CITY OF Date: 5/3/2021
2000 MAIN ST
HUNTINGTON BEACH,CA 92648 Phone: (71 75-)
FAX: (7 N)375-5001001
Attention: JOHN NGUYFN
Uwe hereby agree to furnish all labor,material and equipment for the completion,In a good workman like manner,of the work described below:
Job Address: HUNTING'rON BEACH -ON CALL STRIPING
Item No. Description Quantity U/M UnitPrice Total Price
Schodule 1
1 ON CALL SERVICES FOR SIGNAGE AND STRIPING NOT TO 1.0 LS 29,900.000 29,900.00
EXCEED THE AMOUNT OF$29,900.00 BASED ON UNIT
COST SERVICE ITEMS ----
Total: $29,900.00
Total Proposal Price: $29,900.00
Special Conditions:
ACCEPTANCE
(By Owner,Agent.or General Contractor)
Itwe accept the within proposal. You are authorized to perform the work comprehended hereunder and I/we agree to pay the said amount in
accordance with the terms set forth.All of the terms on the reverse side are incorporated herein and made a part hereof.
J R S Striping
HUNTINGTON BEACH CITY OF Robert Aragon
Date:
Accepted By.
1 1/2%SERVICE CHARGE PER MONTH APPLIED TO ALL PAST DUE BALANCES. ALL QUOTES GOOD FOR 90 DAYS.
Page 1 of 1
Exhibit B
PAINT STRIPING 4'
2021 THRU 2022
ITEM # Date U/M PRICE Quantity Total
1 DETAIL 1 LF 1 0.0700 0.00
2 DETAIL 24 jLF0.1000 0.00
3 DETAIL 8 0.0800 0.00
4 DETAIL 15 0.1200 0.00
5 DETAIL 21 0.1700 0.00
6 DETAIL 276 0,0800 0.00
7 DETAIL 28 LF 0.1700 0.00
8 DETAIL 31 LF 0.1700 0.00
9 DETAIL 37b LF 0.1000 0.00
10 DETAIL 38A LF 0.1000 0.00
11 DETAIL 39 LF 0.1000 0.00
12 DETAIL 39A LF 0.0900 0.00
13 DETAIL 40 LF 0.0800 0.00
14 12" LIMIT LINE OR X-WALK SF 1.1000 0.00
15 24"RR LIMIT LINE SF 1.9500 o.0a
16 MARKINGS SF 1.1500 0.00
17 6" CURB LF 0.4500 0.00
18 8" CURB LF 0.5000 0.00
19 12" CURB LF 0.7200 o.ao
20 REMOVE LANE STRIPE LF 3.7500 0.00
21 REMOVE 12"LIMIT LINE OR X-WALK SF 4.0000 0.00
22 REMOVE THERMO PAINT MARKINGS SF 4.0000 1 0.00
23 REMOVE CURB LF 2.1000 0.00
24 DETAIL 10 LF 0.2000 0.00
25 DETAIL 23 LF 0.3000 0.00
26 DETAIL 26 LF 0.0400 0.00
27 DETAIL 30 LF 0.3000 0.00
28 DETAIL 37C LF 0.2000 0.00
29 DETAIL 38C LF 0.2000 0.00
30 DETAIL 40A LF 0.1500 0.00
31 DETAIL 41A LF 0.1500 0.00
32 TYPE C EA 2.2000 0.00
33 TYPE D EA 2.2000 0.00
34 TYPE G EA 2.2000 o.oa
35 TYPE H EA 2,2000 0.00
36 TYPE A 8 AY EA 1.7500 0.00
37 8" CERMIC EA 30.0000 0.00
38 PARKING STALLS EA 7.5000 0.00
39 4"X-HATCH AREA LF 1.4500 0.00
40 HANDICAP LEGEND EA 53.0000 0.00
38 12" LETTERS t: 1.3500 0.00
36 2" BLACK LF 0,0600 0.00
38 LAYOUT LF 0.1600 0.00
Grand Total 0.00
PAINT STRIPING 6"STRIPING
2021 THRU 2022
ITEM # Date U/M PRICE
1 DETAIL 1 IYELLOW SKIP LF 0.8000
2 DETAIL 24 YELLOW SOLID LF 0.1000
3 DETAIL 8 1WHITE SKIP LF 0.1800
4 DETAIL 15 YELLOW SOLID / SKIP LF 0.1200
5 DETAIL 21 IDOUBLE YELLOW LF 0.1800
6 DETAIL 27B SOLID WHITE LF 0.1000
7 DETAIL 28 DBL/DBL YELLOW LF 0.1800
8 1 DETAIL 31 TWO WAY LEFT LF 0.1800
9 DETAIL 37b LF 0.1000
10 DETAIL 38A LF 0.1000
11 DETAIL 39 LF 0.1000
12 DETAIL 39A LF 0.0900
13 DETAIL 40 WHITE SKIP LF 0.0900
14 12" LIMIT LINE OR X-WALK SF 1.1000
15 24" RR LIMIT LINE SF 1.9500
16 MARKINGS SF 1.1500
17 6" CURB LF 0.4500
18 8" CURB LF 0.5000
19 12" CURB LF 0.7200
20 REMOVE LANE STRIPE LF 3.7500
21 REMOVE 12" LIMIT LINE OR X-WALK SF 4.0000
22 REMOVE THERMO PAINT MARKINGS SF 4.0000
23 REMOVE CURB LF 2.1000
24 DETAIL 10 LF 0.2000
25 DETAIL 23 LF 0.3000
26 DETAIL 26 LF 0.0400
27 DETAIL 30 LF 0.3000
28 DETAIL 37C LF 0.2000
29 DETAIL 38C LF 0.2000
30 DETAIL 40A LF 0.1500
31 DETAIL 41A LF 0.1500
32 TYPE C EA 2.2000
33 TYPE D EA 2.2000
34 TYPE G EAJ 2.2000
35 TYPE H EA 2.2000
36 TYPE A & AY EA 1.7500
37 8" CERMIC EA 30.0000
38 PARKING STALLS EA 7.5000
39 4" X-HATCH AREA LF 1.4500
40 HANDICAP LEGEND EA Fj3.0000
38 12" LETTERS EA 1.3500
38 2" BLACK LF 0.0800
38 ILAYOUT LF 0.1600
2021-2022
THERMOPLASTIC
ITEM# Date UIM PRICE ouantity Total
1 DETAIL 1 LF 0.7700 0.00
2 DETAIL 8 LF 0.7700 0.00
3 DETAIL 15 LF 1.5500 0.00
4 DETAIL 21 LF 1.1000 0.00
5 DETAIL 27B LF 0.7000 0.00
6 DETAIL 28 LF 2.1000 0.00
7 DETAIL 31 LF 1.7000 0.00
8 DETAIL 37BA LF 1.0000 o.oa
9 DETAIL 38A LF 1.0700 0.00
10 DETAIL 39 LF 0.8600 0.00
11 DETAIL 39A LF 0.3500 0.00
12 DETAIL 40 LF 0.4500 0.00
13 12" LIMIT LINE OR X-WALK SF 2.1000 0.00
14 24" THERMO SF 3.7500 0.00
15 MARKINGS SF 6.7500 0.00
16 REMOVE LANE STRIPE LF 3.7500 0.00
17 REMOVE 12"LIMIT LINE OR X-WALK SF 4.0000 0.00
18 REMOVE THERMO MARKINGS I SF 4.0000 0.00
19 REMOVE CURB I LF 4.5000 0.00
20 LAYOUT STRIPE & MARKINGS LF 0.1600 0.00
21 TYPE C EA 2.2000 0.00
22 TYPED EA 2.2000 0.00
23 TYPE G EA 2.2000 0.00
24 TYPE H EA 2.2000 0.00
25 TYPE DB EA 15.0000 0.00
26 2" BLACK LF 0.0800 0.00
0.00
27
0.00
2s
0.00
29
0.00
30
0.00
31
Grand Total 0.00
2021-2022
THERMOPLASTIC
ITEM# Date U/M PRICE Quantity Total
1 DETAIL 1 6" LF 0.8100 0.00
2 DETAIL 8 6" LF 0.8100 0.00
3 DETAIL 15 6" LF 1.7000 0.00
4 DETAIL 21 6" LF 1.3600 0.00
5 DETAIL 27B 6" LF 0.8600 0.00
6 DETAIL 28 6" LF 2.6200 0.00
7 DETAIL 31 6" LF 1.9600 0.00
8 DETAIL 37BA LF 1.0000 0.00
9 DETAIL 38A LF 1.0700 0.00
10 DETAIL39 LF 0.8600 0.00
11 DETAIL 39A LF 0.3500 0.00
12 DETAIL 40 6" LF 0.6200 0.00
13 12" LIMIT LINE OR X-WALK SF 2.1000 o.ao
14 24"THERMO SF 3.7500 0.00
15 MARKINGS SF 6.7500 0.00
16 REMOVE LANE STRIPE LF 3.1500 0.00
17 REMOVE 12"LIMIT LINE OR X-WALK SF 4.0000 0.00
18 REMOVE THERMO MARKINGS SF 4.0000 o.ao
19 REMOVE CURB I LF 4.5000 0.00
20 LAYOUT STRIPE & MARKINGS LF 0.1600 0.00
21 TYPE C EA 2.2000 0.00
22 TYPE D EA 2.2000 0.00
23 TYPE G EA 2.2000 0.00
24 TYPE H EA 2.2000 0.00
25 TYPE DB EA 15.0000 0.00
26 2" BLACK LF 0.0800 0.00
27 0.00
28 0.00
29 0.00
30 0.00
31 0.00
Grand Total 0.00
HUNTINGTON BEACH
Dete: Unit Price Quantity Total
1 REMOVE SIGN 8 POST EA 98.000 0.00
2 REMOVE SIGN AND POST REPAIR SIDEWALK EA 1 125.000 0.00
3 FURNISH AND INSTALL SIGN EA 185.000 0.00
4 FURNISH AND INSTALL SIGN IN TOP SOIL EA 265.000 0.00
6 FURNISH AND INSTALL SIGN IN CONCRETE(CDR EA 350.000 0.00
6 DRAINS TO OCEAN STENCILING(PAINT) EA 18.500 D.00
7 0.00
8I IC.DD
9 D.00
10 0.00
t 1 0.00
12 0.00
13 0.00
14 0.00
15 D.Co
16 o.ao
17 0.00
18 0.00
19 0.00
20 0.00
21 0.00
22 0.00
23 0.00
coo
F28
0.00
0.00
0.00
a.00
0.00
e.co
o.00
0.00
0.00
33
34 0.00
35 0.00
Grand total 0.00
ALA vR CERTIFICATE OF LIABILITY INSURANCE °ATS4n°
21
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(los)must have ADDITIONAL INSURED provisions or be endorsed.
if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may requlro an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lieu of such endoraomunt(s).
QUINTACT
Wl°°ucFR Patriot Risk&Insurance Services NAME: Annette Romero
AX
2415 Cam us Drive, Suite#200 O NTAEaO' 948-486-7904 [.EFMX vim:
Irvine, CA 92612 _e L
o aromaro al(lsk.com
WSURERIS)AFFORDING COVERAGE NAILS
w .palrisk.com OK07568 INSURER A: Zurich Americanlnsuranco Company 18535
INSuaeo INSURER S: Navigators Insurance Compalry 42307
J &S Striping, Inc.
1544 S.Vineyyard Avenue INSURER C:
Ontario CA 91761 INSURER°:
INSUflER E
INSURER f:
COVERAGES CERTIFICATE NUMBER: 615347 5 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN OR TYPE OP INSURANCE . aX POLICY NUMBER POLIO I PM O PIP UMR9
A COMMERCIAL GENERAL LIABILITY / V G1.0027665504 3129/2021 3/29/2022 EACH OCCURRENCE S1 OD0000
UAMAUE IV CIAIALSAAOE �OCCU0. 6 E�� $500000
_ �5000 Uetluclide NED EXP M em W. $10000
PE RSONAL a ADV INJURY $1000000
GENT.AGGREGATE LIMIT APR"PER: GENERAL AGGREGATE s2,000,000
PCIICy�JECj 0 LOC PROUXTS-COSWNW AGO S2,000,000
O HER: Ann $
A AUTOMOBILELIABIUTY 7 7 8A 02 5 I 2912021 3(292022 I LRAIT IT 000000
ANYAUTO n BODILY WAIRY IN, ii.) $
OWMED SCHEDULED ![Y EMILY WARY(Pe,dean) S
_ Auros ONLY AUToa HA E. DATES $
HIRED
ONLY �OS ONLY CITY ATTORNEY Ppar E
Uninsured mote isl com $1 000.000
B UMBRELLA LIAR t/ OCCUR SE21EXCZ04UGVC 329/2021 3129/2022 EACH OCCURRENCE 54,000000
EXCESS LAB CLAIMS-uAOE AGGREGATE 14 0110,000
DEB RETENTION O 1
A WCRNEASCOMPENSATION WCO27665704 3r292021 32W022 / 0,CAB2,EERH
ANo EMPLOYERS'LAmLITY
MYPROPRIETOPJPARTHENEXECUTIVE YIN E.L.EACHALODENT S1000ODO
UFFICERAIEMBERFXCLIAE01I NIA
IMa.ft.,M NMI El.DISEASE-EA EMPLOYEE 11,000.000
e ll''n.d.MT ix.
OESCMPION°F OPERATIONS bsP E.L.DISFASE-PUNICYUMIT $1000000
DgnMPnO OFOPERATWNSILOCATgHSIVEHICLE9 (ACORO TeI.AddeleRd Mnvb BdudNP,IeryGWlrtEcd Bmon cDEcr N,Kulnd)
R°: On-Coll Slripprig-Hunfington Beach,CA/JSJN 4417-5
the City of Huntington Beach its officers,elected or appointed officials,employees,agents and volunteers
are named as additional Insureds in res�acis to the General Liability and Auto Liability,Includes Primary and Non-contributory
rr the attached endorsements as required by written contract.Waiver of subrogaVon applies to GL.Auto and WC
Days notice of cancellmion, 10 days for non-payment of premium.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Huntington Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
2000 Main Street ACCOROANCE WITH THE POLICY PROVISIONS.
Huntington Beach CA 92648
AUTHORIZED REPRESENTATNE
Dove Jacobson U
01988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORO
1X53.19s 111/]l DL/AU/Utla/4C - ITY er IWmin9ton Beach I Mnette Kf CO 1 5/4/M] ],Ll,u IM IPpr: I P.ee L of 10
mi. ce rt if ScA t. ca co . S.G Dupere.dea ALL prevl.u.ly i...ed CeMLffc.te..
i
Additional Insured — Owners, Lessees Or Contractors — ZURICH'
Scheduled Person Or Organization
i
PoOcy No. Eff. Dato of Poi. Exp. Date of Pol. Eff.Date of End. Producer No. Addl.Prom Return Prom.
GL0027665504 0=912021 03129/2022
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. .I
i
Named Insured: d a S st%ng,Inc.
1544 S.V•ineyand Avenue
Address(Including ZIP Code): Ontario CA 91761
This endorsement modifies Insurance provided under the:
Commercial General Liability Coverage Part
SCHEDULE
Name Of Additional Insured Person(s) Location And Description Of Covered Operations
Or Organization(s) .
The City of Huntington Beach,Its ol6cere,olocled or appointed On-Call Striping
to ee 11u l ton oach CA
17
A. Section II —Who Is An Insured is amended to Include as an additional Insured the person or organization shown in
the Schedule above, whom you are required to add as an additional insured on this policy under a written contract or
written agreement. Such person or organization is an additional Insured only with respect to liability for"bodily Injury",
"property damage"or"personal and advertising Injury"caused,in whole or In part, by:
1. Your acts or omissions;or
2. The acts or omissions of those acting on your behalf,
In the performance of your ongoing operations or "your work" as included in the "products-completed operations
hazard', which Is the subject of the written contract or written agreement at the Location designated and described in
the Schedule above.
However,the Insurance afforded to such additional insured:
1. Only applies to the extent permitted by law;and
2. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured.
B. With respect to the Insurance afforded to these additional insureds,the following additional exclusion applies:
This insurance does not apply to:
I
I
I
U-GL-1177-F Cw(04/13)
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This cartif Cate canes is and supersedes ALL previously issued cart[ lcates.
"Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to
render any professional architectural, engineering or surveying services including:
a. The preparing, approving or falling to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
b. Supervisory, Inspection, architectural or engineering activities.
This exclusion applies even if the claims against any Insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or monitoring of others by that insured, If the"occurrence' which caused the
"bodily Injury" or "property damage', or the offense which caused the "personal and advertising injury", Involved, the
rendering of or the failure to render any professional architectural, engineering or surveying services.
C. The following is added to Paragraph 2, Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV -
Commerclal General Liability Conditions:
The additional insured must see to it that:
1. We are notified as soon as practicable of an"occurrence'or offense that may result in a claim;
2. We receive written notice of a claim or"suit'as soon as practicable;and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy Issued by
another Insurer under which the additional insured may be an insured in any capacity. This provision does not
apply to Insurance on which the additional Insured Is a Named Insured, if the written contract or written agreement
requires that this coverage be primary and non-contributory.
D. For the purpose of the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition-of Section IV - Commercial General Liability
Conditions:
Primary and Noncontributory Insurance '
This Insurance is primary to and will not seek contribution from any other Insurance available to an additional
Insured provided that:
a. The additional insured is a Named Insured under such other Insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other Insurance available to the additional Insured.
2. The following paragraph is added to Paragraph 4.1b.of the Other Insurance Condition of Section IV-Commercial
General Liability Conditions:
This insurance is excess over:
Any of the other Insurance, whether primary, excess, contingent or on any other basis, available to an additional
Insured, in which the additional insured on our policy is also covered as an additional insured on another policy
providing coverage for the same "occurrence", offense,claim or"suit"- This provision does not apply to any policy
in which the additional insured Is a Named Insured on such other policy and where our policy is required by
written contract or written agreement to provide coverage to the additional insured on a primary and non-
contributory basis.
E. With respect to the Insurance afforded to the additional insureds under this endorsement, the following is added to
Section III-Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement referenced in Paragraph A.of this endorsement; or
2. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This endorsement shall not Increase the applicable Limits of Insurance shown In the Declarations.
All other terms and conditions of this policy remain unchanged.
U-GL-1177-F CW l04/17)
Page 2 of 2
Includes copyrighted material of Insurance Services Olaco,Inc.,Win Its pennisslon-
4l5)tl9S e1/1] OL/AU/MRP W - CITY OF Nmt LptM Y"ech I a^^etto N ro 15/Nl0]I l,)6,U 1. iPDTI 1 11." ) O[ 10
nis ter it ceto carwe o and suporaedes ALL previously tooued Corti lceto..
J & S Striping, Inc.
POLICY NUMBER:GL0027665504 COMMERCIAL GENERAL LIABILITY
CG 24 04 05 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:
The Chy or Huntington Beach Its
officers,elected or appointed ofgclals,
employees,agents and volunteers
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 ®Insurance Services Office, Inc., 2008 Page 1 of 1 ❑
61534 lls 1 }l/ra aUau/wm/xc - u" or xunc b,gcon aeecn I Am,etta rom ro I sHtell )HHu oe (rm) 1 r.y. . oa ra
Yhta certificate cancelo and •uperaedea ALL previwuly loaned certi4cetee.
Coverage Extension Endorsement ZURICH
Policy No. Elf. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer No. Merl.Prem Return Prem.
BAP027665804 3t2912021 3/29/2022 5/412021
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies Insurance provided under the:
Business Auto Coverage Form
Motor Carrier Coverage Form
A. Amended Who Is An Insured
1. The following is added to the Who Is An Insured Provision In Section II—Liability Coverage:
The following are also"insureds":
a. Any "employee" of yours is an "Insured" while using a covered "auto" you don't own, hire or borrow for acts
performed within the scope of employment by you.
b. Anyone volunteering services to you is an "Insured" while using a covered "auto" you don't own, hire or
borrow to transport your clients or other persons in activities necessary to your business.
c. Anyone also who furnishes an'auto" referenced in Paragraphs a. and b. above.
d. Any person(s) or organization(s) where required by written contract or written agreement executed prior to
any"accident" provided the"accident"arises out of operations contemplated by such contract or agreement.
2. The following is added to the Other Insurance Provision in the Conditions Section:
Coverage for any person(s) or organization(s) where required by written contract or written agreement executed
prior to any'accident'will apply on a primary basis and any Insurance maintained by the additional "insured" will
apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the
coverage form.
B. Amendment—Supplementary Payments
Paragraphs a.(2)and a.(4) of the Coverage Extensions Provision In Section II— Liability Coverage are replaced by
the following:
(2) Up to$5,000 for the cost of bail bonds(including bonds for related traffic law violations)required because of an
"accident"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 eamings up to$500 a
day because of time off from work.
C. Fellow Employee Coverage
The Fellow Employee Exclusion contained in Section Il—Liability Coverage does not apply.
D. Driver Safety Program Liability and Physical Damage Coverage
1. The following Is added to the Racing Exclusion In Section II—Liability Coverage:
This exclusion does not apply to covered "autos' participating In a driver safety program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations.
U-CA-424-E CW(04-11)
Page 1 of 5
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Th1a cae[lt teat* canca. a and anpercedaa ALL peavi Waly laaued carLlrtcareo.
i
2, The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the
Business Auto Coverage Form and Paragraph 2.b, in the Exclusions of Section IV — Physical Damage
Coverage of the Motor Carrier Coverage Form:
i
This exclusion does not apply to covered 'autos" participating in a driver safely program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations. l
E. Lease or Loan Gap Coverage
The following Is added to the Coverage Provision of the Physical Damage Coverage Section:
Lease Or Loan Gap Coverage
In the event of a total"loss"to a covered"auto",we will pay any unpaid amount due on the lease or loan for a covered i
'auto", less:
a. Any amount paid under the Physical Damage Coverage Section of the coverage form; and
b. Any:
(1) Overdue lease or loan payments at the time of the "loss';
(2) Financial penalties Imposed under a lease for excessive use,abnormal wear and tear or high mileage;
(3) Security deposits not returned by the lessor;
(4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the
loan or lease;and
(5) Carry-over balances from previous leases or loans.
F. Towing and Labor
The following is added to Paragraph A.2. of the Physical Damage Coverage Section:
We will pay up to$75 for towing and labor costs incurred each time a covered "auto'of the private passenger type is
disabled. However, the labor must be performed at the place of disablement.
G. Extended Glass Coverage
The following is added to Paragraph A.3.a.of the Physical Damage Coverage Section:
If glass must be replaced, the deductible will be $100 or the deductible shown in the Declarations, whichever Is less.
If glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the
option of having the glass repaired rather than replaced,
H. Hired Auto Physical Damage—Increased Loss of Use Expenses
The Loss Of Use Expenses Provision of the Physical Damage Coverage Section Is replaced by the following:
Loss Of Use Expenses
For Hired Auto Physical Damage,we will pay expenses for which an "insured' becomes legally responsible to pay for
loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We
will pay for loss of use expenses if caused by:
(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered
"auto";
(2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided
for any covered "auto'; or
(3) Collision only If the Declarations Indicate that Collision Coverage is provided for any covered"auto'.
However, the most we will pay for any expenses for loss of use Is$100 per day, to a maximum of$3000.
I. Personal Effects Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Personal Effects Coverage
a. We will pay up to$750 for"loss"to personal effects which are:
(1) Personal property owned by an"insured"and
u-CA-424-E CW(04-11)
Page 2 of 5
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R is car tif(n m.care cancels and vupersedoe ALL previwaly /naued certificates.
I
I
(2) In or on a covered 'auto".
i
b. Subject to Paragraph a. above, the amount to be paid for"loss"to personal effects will be based on the lesser of:
(1) The reasonable cost to replace;or
(2) The actual cash value.
c. The coverage provided In Paragraphs a. and b. above, only applies in the event of a total theft of a covered
'auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of
the following:
(1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other
documents of value.
(2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches,
precious or semi-preclous stones.
(3) Paintings, statuary and other works of art.
(4) Contraband or property in the course of Illegal transportation or trade.
(5) Tapes, records, discs or other similar devices used with audio,visual or data electronic equipment.
Any coverage provided by this Provision is excess over any other Insurance coverage available for the same"loss".
J. Tapes, Records and Discs Coverage
1. The Exclusion In Paragraph B.4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage
Form and the Exclusion in Paragraph B.2.c. of Section IV — Physical Damage Coverage in the Motor Carrier
Coverage Form do not apply.
2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the
Physical Damage Coverage Section:
We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual of data electronic
equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices:
(a) Are the property of an"insured'; and
(b) Are in a covered "auto"at the time of"loss".
The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical
Damage Coverage Deductible Provision does not apply to such *loss'.
K. Alrbag Coverage
The Exclusion In Paragraph B.3.a. of Section III—Physical Damage Coverage In the Business Auto Coverage Form
and the Excluslon In Paragraph B.4.a. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage
Form do not apply to the accidental discharge of an airbag.
L. Two or More Deductibles
The following is added to the Deductible Provision of the Physical Damage Coverage Section:
If an accident is covered both by this policy or coverage form and by another policy or coverage form Issued to you by
us,the following applies for each covered"auto'on a per vehicle basis:
1. If the deductible on this policy or coverage form is the smaller(or smallest)deductible, it will be waived; or
2. If the deductible on this policy or coverage form is not the smaller (or smallest) deductible, it will be reduced by
the amount of the smaller(or smallest)deductible.
M. Physical Damage—Comprehensive Coverage—Deductible
The following Is added to the Deductible Provision of the Physical Damage Coverage Section:
Regardless of the number of covered"autos"damaged or stolen, the maximum deductible that will be applied to
Comprehensive Coverage for all"loss"from any one cause Is $5,000.
U-CA424-ECW(04.11)
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i
N. Temporary Substitute Autos—Physical Damage
1. The following Is added to Section I—Covered Autos:
Temporary Substitute Autos—Physical Damage
If Physical Damage Coverage is provided by this coverage form on your owned covered "autos", the following
types of vehicles are also covered 'autos"for Physical Damage Coverage: j
Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered
'auto"you do own but Is out of service because of its:
1. Breakdown;
i
2. Repair;
3. Servicing;
4. "Loss'; or
5. Destruction.
2. The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Temporary Substitute Autos—Physical Damage
We will pay the owner for"loss"to the temporary substitute "auto" unless the "loss"results from fraudulent ads or
omissions on your part. If we make any payment to the owner,we will obtain the owner's rights against any other
party.
The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it
replaces.
O. Amended Duties In The Event Of Accident, Claim, Suit Or Loss
Paragraph a.of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following:
a. In the event of"accident",claim,"suit"or"loss', you must give us or our authorized representative prompt notice
of the"accident", claim, "suit"or"loss". However, these duties only apply when the"accident', claim,"suit"or
"loss"is known to you(if you are an individual), a partner(if you are a partnership), a member(if you are a limited
liability company)or an executive officer or Insurance manager(if you are a corporation). The failure of any
agent, servant or employee of the "Insured"to notify us of any"accident",claim, "suit"or"loss" shall not Invalidate
the Insurance afforded by this policy.
Include, as soon as practicable:
(1) How, when and where the"accident"or"loss"occurred and if a claim is made or"suit"is brought, written
notice of the claim or"suit" Including, but not limited to, the date and details of such claim or"suit'
(2) The"insured's'name and address;and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
If you report an"accident", claim, "suit"or"loss"to another insurer when you should have reported to us,your
failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon
as practicable after the fact of the delay becomes known to you.
P. Waiver of Transfer Of Rights Of Recovery Against Others To Us
The following Is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:
This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or
"loss", provided that the "accident'or"loss"arises out of operations contemplated by such contract. This waiver only
applies to the person or organization designated in the contract.
Q. Employee Hired Autos— Physical Damage
Paragraph b. of the Other Insurance Condition In the Business Auto Coverage Form and Paragraph I. of the Other
Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced
by the following:
For Hired Auto Physical Damage Coverage,the following are deemed to be covered "autos" you own:
U-CA-424-E CW(04.11)
Page 4 of 5
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i
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(1) Any covered "auto"you lease,hire, rent or borrow; and
(2) Any covered 'auto" hired or rented under a written contract or written agreement entered Into by an"employee" or
elected or appointed official with your permission while being operated within the course and scope of that
"employee's"employment by you or that elected or appointed official's duties as respect their obligations to you.
However,any"auto"that Is leased, hired, rented or borrowed with a driver Is not a covered "auto".
R. Unintentional Failure to Disclose Hazards
The following is added to the Concealment, Misrepresentation Or Fraud Condition:
However,we will not deny coverage under this coverage form if you unintentionally:
(1) Fail to disclose any hazards existing at the Inception date of this coverage form;or
(2) Make an error, omission, Improper description of"autos"or other misstatement of information.
You must notify us as soon as possible after the discovery of any hazards or any other Information that was not
provided to us prior to the acceptance of this policy.
S. Hired Auto—World Wide Coverage
Paragraph(5)(a)of the Policy Period,Coverage Territory Condition is replaced by the following:
(a) A covered "auto'is leased, hired, rented or borrowed for a period of 60 days or less; and
T. Bodily Injury Redefined
The definition of"bodily injury"In the Definitions Section is replaced by the following:
"Bodily injury" means bodily Injury, sickness or disease, sustained by a person including death or mental anguish,
resulting from any of these at any time. Mental anguish means any type of mental or emotional Illness or disease.
All other terms and conditions of this policy remain unchanged.
U-CA-424 E CW(04-11)
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LI SIf]f5 21(22 OL/AU/M%(WC - C1tY 01(I111n11aCCr1-6dlLiC')'xA18�(lr1FEdY[U",USIi/�a]ta]'i RA YYlr1l P1�j1A 1OV5sIon,
This cer Llf cote canoe a and supersedes ALL previously issued certi(ica[ea.
I
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 you 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 % of the California workers'compensation premium
otherwise due on such remuneration.
Schedule
Person or Oraanlzadon Job Description
WHERE REQUIRED BY WRITTEN CONTRACT WHERE REQUIRED BY WRITTEN CONTRACT
This endorsement Is executed by the
Premium$
Effective Date 3/29/2021 Expiration Dale 3/29/2022
For attachment to Policy No, WCO27665704
WC 04 03 06 Page 1 of 1
ED:4/1984
61514795 I 21 }] OLJAVJUIm WC - CITY Of NOnLINLen OOLC6 I e OtL6 PMeiO 15J6/3901 11161i1 Mt ICVII I Ci90 10 O: 19
Thla cortir(cute ounce la aad euperaedca ALL prevloualy teaUed Certif Kates.