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HomeMy WebLinkAboutJLE Painting - 2023-08-01 (2) SERVICE AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND JLE PAINTING FOR PAINTING SERVICES THIS AGREEMENT ("Agreement") is made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter called"City," and JLE Painting, hereinafter referred to as "Contractor." Recitals A. The City desires to retain a Contractor having special skill and knowledge in the field of painting. 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 reasonably be expected from a comparable company or firm in the field. Contractor has been selected to perform these services pursuant to Huntington Beach Municipal Code Chapter 3.02. NOW, THEREFORE, it is agreed by City and Contractor as follows: 1. Scope of Services Contractor shall provide all services as described in Exhibit"A,"which is attached hereto and incorporated into this Agreement by this reference. These services shall sometimes hereinafter be referred to as the "Project." Contractor hereby designates Jose Luis Espinoza, Jr., who shall represent it and be its sole contact and agent in all consultations with City during the performance of this Agreement. 2. City Staff Assistance City shall assign a staff coordinator to work directly with Contractor in the performance of this Agreement. 23-12783/308350 1 3. Compensation a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit"B." The total sum to be expended under this Agreement, shall not exceed Three Hundred Fifty Thousand Dollars ($350,000.00) during the term of this Agreement. Additional services required by other divisions and/or departments shall not count towards the Public Works not to exceed. b. Payment by City shall be made within thirty(30) days following receipt of proper invoice evidencing work performed, 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." 4. Term Time is of the essence of this Agreement. The services of Contractor are to commence 2 3or as soon as practicable after the execution of this Agreement by City (the"Commencement Date") and terminate three (3) years from Commencement Date, unless terminated earlier in accordance with the provisions of this Agreement. Contract may be extended for 2 additional one-year periods if mutually agreed to in writing by both parties. The 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 City 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 of City 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, date 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 City as it sees fit. 23-12783/308350 2 7. Hold Harmless Contractor hereby agrees to protect, defend, indemnify and hold harmless City, 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 any of them 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' employees. Contractor shall furnish to City 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 Liability 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, employees and agents while acting within the scope of their duties, against any and all claims arising out of 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 ($1,000,000) per occurrence. If 23-12783/308350 3 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) 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 City, 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. 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 Million 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 or appointed officials, employees, agents and volunteers" as additional insured on the endorsement. The above-mentioned insurance shall not contain a self-insured retention, "deductible" or any 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 policy 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 (3Q) 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 fully completed and accepted by City. This requirement for carrying the foregoing 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 23-12783/308350 4 original or a copy of the policy of insurance. Contractor shall pay, in a prompt and timely 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, agents and employees and all business licenses, if any, in connection with the Project and/or the services to be performed hereunder. 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 following 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 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 performance 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. 23-12783/308350 5 16. Assignment Inasmuch as to 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 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 given 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 U.S. certified mail-return receipt requested: To City: Contractor: City of Huntington Beach JLE Painting Attn: Director of Public Works Attn: Jose Luis Espinoza, Jr. 2000 Main Street 904 E. Mountain View Terrace Huntington Beach, CA 92648 Alhambra, CA 91801 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 any other transactions or event. 20. Modification 23-12783/308350 6 No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties. 21. Section Headings 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 any 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. 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 of the United States and shall, in particular, comply with the provisions of the United States Code regarding employment verification. 25. Legal Services Subcontracting Prohibited 23-12783/308350 7 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. 28. Jurisdiction—Venue This Agreement and all questions relating to its validity, interpretation, performance, and enforcement shall be government and construed in accordance with the laws of the State of California. This 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, through 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 her inability to obtain or 23-12783/308350 8 maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 30. Attorney'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 attorney's fees from the non-prevailing 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. Governing 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, oral or otherwise, have been made by that party or anyone acting on that patty'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. 23-12783/308350 9 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 Mayor. This Agreement shall expire when terminated as provided herein. CONTRACTOR CITY OF HUNTINGTON BEACH, a JLE PAINTING municipal corporation of the State of California By: !( 4.1 _.wa":,3 Mayor SSr LkU 'C5pi Ai614 , �� Print name Z1k'ut..ht ) - ITS: (circle one)Chairm resident/ 444141./ Vice President Ci er 8f i le -�— AND o By: v '3' L LAA C C6)91 015-1,161 , I D A PROVED: Print name ITS: (circle on•.f�/Chief Financial Officer/Asst. Secret. - reasurer Dir tor f Public Works APPROVED AS T ORM: City Attorney 41u/ REVIEW 0 AND AP' 'O ED: Libh.h. City Mang: ' 23-12783/308350 I0 EXHIBIT "A" A. STATEMENT OF WORK: (Narrative of work to be performed) Commercial painting of both interior and exterior buildings including minor wood, stucco and drywall repairs. B. CONSULTANT'S DUTIES AND RESPONSIBILITIES: C. CITY'S DUTIES AND RESPONSIBILITIES: D. WORK PROGRAM/PROJECT SCHEDULE: 23-12783/308350 11 EXHIBIT "B" Payment Schedule (Hourly Payment) A. Hourly Rate CONSULTANT'S fees for such services shall be based upon the following hourly rate and cost schedule: "SEE ATTACHED EXHIBIT B" B. Travel Charges for time during travel are not reimbursable. C. Billing 1. All billing shall be done monthly in fifteen (15) minute increments and matched to an appropriate breakdown of the time that was taken to perform that work and who performed it. 2. Each month's bill should include a total to date. That total should provide,at a glance, the total fees and costs incurred to date for the project. 3. A copy of memoranda, letters, reports, calculations and other documentation prepared by CONSULTANT may be required to be submitted to CITY to demonstrate progress toward completion of tasks. In the event CITY rejects or has comments on any such product, CITY shall identify specific requirements for satisfactory completion. 4. CONSULTANT shall submit to CITY an invoice for each monthly payment due. Such invoice shall: A) Reference this Agreement; B) Describe the services performed; C) Show the total amount of the payment due; D) Include a certification by a principal member of CONSULTANT's firm that the work has been performed in accordance with the provisions of this Agreement; and E) For all payments include an estimate of the percentage of work completed. Upon submission of any such invoice, if CITY is satisfied that CONSULTANT is making satisfactory progress toward completion of tasks in accordance with this Agreement, CITY shall approve the invoice, in which event payment shall be made within thirty(30) days of receipt of the invoice by CITY. Such approval shall not be unreasonably withheld. If CITY does not approve an invoice, CITY shall notify CONSULTANT in writing of the reasons for non-approval and the schedule of performance set forth in Exhibit "A" may at the option of CITY be suspended until the parties agree that past performance by CONSULTANT is in, or has been brought into compliance, or until this Agreement has expired or is terminated as provided herein. 5. Any billings for extra work or additional services authorized in advance and in writing by CITY shall be invoiced separately to CITY. Such invoice shall contain all of the information required above, and in addition shall list the hours expended and hourly rate charged for such time. Such invoices shall be approved by CITY if the work performed is in accordance with the extra work or additional services requested, and if CITY is satisfied that the statement of hours worked and costs incurred is accurate. Such approval shall not be unreasonably withheld. Any dispute between the parties concerning payment of such an invoice shall be treated as separate and apart from the ongoing performance of the remainder of this Agreement. EXHIBIT B GENERAL CONTRACTING/PAINTING I ELECTRICAL AND MECHANICAL MAINT. SERVICES • BID SHEETS PAINTING-COMMERCIAL(BUILDING INTERIOR AND EXTERIOR INCLUDING MINOR WOOD,STUCCO AND DRYWALL REPAIRS Contractor Name:. L !i t r C J Date: % Z 01. instructions for completing Bid Sheet: i I. Complete Bid Sheet and enter pricing for ONLY those services your firm can provide. 2. Attach and include in your submittal only those bid sheets you are quoting. 3.Attach a current rate sheet/fee schedule and include with your submittal. 4. Pill in the company name above and the boxes below,circle$or%sign for markup. ITEM NORMAL BBUSINESS HOURS �Laboi hour) rate 7�•�� Materials markup $ me _-- • • 6 i • ::v fiti PAiNTNi I . ' LASORRATESHEET j ROLE DESCRIPTION !MINIMUM NORMAL HOURS'OVERTIME HOLIDAY/W1; EMERGENCY, I I HOURS , EEKENDS ! i , • ;Supervisor/Foreman 4 j $ 82.00 •$ 97.75-1$ 122.75 ; $ 122.75 '. ' ;Journeyman 4 ' $ 77.25 ; $ 97.50 1$ 119.75 1 $ 119.75 '. • 'Apprentice 8 $ 59.75 $ 76.75 ; $ 93.75 ' $ 93,75 I i • _�__—_ 1 • 'Helper 8 ':$ 59.75 `: $ 76.75 1$ 93.75 $ 93.75 -__ 41 - ? jj __�• _._ i 5%°=Materials Markup to cover order submission,processing,handling,coordinatiori _ I 2.5%of total bid.=Fee to cover cost of Payment&Performance bonding,if required,on projects/work _ __ I • _ 5%i=Annual percentage increase on labor hourly rates to cover increases to prevailing wages,payroll taxes,workers comp insurance,etc. • lice* Printed on 9/29/2022 at 9:22 PM hops://jlepainting-mysharepointcom/personal/joseluisilepainting_com/Documents/Documents/Estimates-RFP/20220929_City of Huntington Seach_Painting Main Services/20220929_Rate Sheet JLE Painting DDNYY A D® CERTIFICATE OF LIABILITY INSURANCE DATE(MW 023 Y) THIS CERTIFICATE iS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Angelina Lopez Allison Commercial Insurance Agency Inc. PHONE FAX 2775 N.Ventura Rd, Ste.209 (A/c.No.Bet):805-644-4740 (A/C.No):805-278-0748 Oxnard CA 93036 ADDRILEss: Angelina®coastgeneralinsurance.com INSURER(S)AFFORDING COVERAGE NAIC 11 Llcense{l:OF60642 INSURER A:Evanston Insurance CO, 35378 INSURED JLEPAIN.01 INSURER B: JLE Painting 904 E Mountain View Terrace INSURER C: Alhambra CA 91801 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:310721262 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. [NOR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DD/YYYY) IMM10D/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 3AA617789 11/15/2022 11116/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE ES0RENTED PREMISES(Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PROT LOC PRODUCTS-COMP/OP AGO $2,000,000 JEC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accIdent) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ CEO RETENTION$ $ WORKERS COMPENSATION MO EMPLOYERS'LIABILITY Y/N ST OTH- ATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ( N/A EL.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? i (Mandatory In NH) EL,DISEASE-EA EMPLOYEE $ Ii yes,describe under DESCRIPTION OF OPERATIONS below E.L,DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORb 101,Additional Remarks Schedule,may he attached It more space Is required) City of Huntington Beach,its officers,elected or appointed officials,employees,agents and volunteers are named as additional insured,per the attached policy endorsement and only when required by contract.Waiver of subrogation is included. AP ROVED AS TO t=pt3jUq AEL��GATE CERTIFICATE HOLDER CANCELLATION CITY o )HUMTi�G7Oy REACii SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Huntington Beach 2000 Main Street AUTHORIZED REPRESENTATIVE Huntington Beach CA 92648 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016iO3) The ACORD name and logo are registered marks of ACORD CI CW A021011 CERTIFICATE OF INSURANCE This certificate Is issued for informational purposes only.It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to any party nor can it be used,in any way, to modify coverage provided by such policies.Alteration of this certificate does not change the terms,exclusions or conditions of such policies.Coverage is subject to the provisions of the policies,including any exclusions or conditions, regardless of the provisions of any other contract, such as between the certificate holder and the Named Insured.The limits shown below are the limits provided at the policy inception.Subsequent paid claims may reduce these limits. Certificate Holder. Named Insured: CITY OF HUNTINGTON BEACH ITS JLE PAINTING OFFICERS, ELECTED OR APPOINTED 904 E MOUNTAIN VIEW TER OFFICIALS, EMPLOYEES AGENTS AND OR ALHAMBRA CA 91801-4136 VOLUNTEERS 2000 MAIN ST HUNTINGTON BEACH, CA USA 926482702 Automobile Liability Insurer Name:Allstate Insurance Company Polio/Number: 648872175 1-Any Auto 2-Owned Autos Only 3-Owned Priv.Pass.Autos Only 4-Owned Autos Other Than Priv. 5-Owned Autos Subject to 6-Owned Autos Subject to a Compulsory UM Law Pass.Autos Only No Fault x 7-Specifically Described Autos X 8-Hired Autos Only X ,9-Nonowned Autos Only Policy Effective Date: 12-02-2022 Policy Expiration Date: 12-02-2023 Limits of $1,000,000 Combined Single Limit(each accident) Insurance: BI Per Person 81 Per Accident PD Per Accident Description of Operations/Locations/VehlcleslEndorsementsiSpedal Provisions Interested Party Type: Additional Insured - All Other THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED,THE POLICY(IES)MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOL DER WITH ADDITIONAL INSURED STATUS.THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer: COMMERCIAL CONTACT CENTER Authorized Representative: Date:03-22-23 Includes copyrighted material of Insurance Services Office,Inc.,with its permission CI CW A021011 Allstate Insurance Company Page 1 of 1 Insured Full Copy CERTHOLDER COPY sc STATE COMPENSATION P.O. BOX 8192, PLEASANTON, CA 94588 INSURANCE• FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 03-21-2023 GROUP: POLICY NUMBER: ' 9253550-•2022 CERTIFICATE ID: 32 CERTIFICATE EXPIRES: 11-18-2023 11-18-2022/11-18-2023 CITY OF HUNTINGTON BEACH SC 2000 MAIN ST HUNTINGTON BEACH CA 92648-2702 This is to certify that we have issued a valid Workers' Compensation insurance policy In a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to Its normal expiration. This certificate of insurance is not an Insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein, Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. ees^-ver/—"er..-/ Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2023-03-21 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: CITY OF HUNTINGTON BEACH ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2023-03-21 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF HUNTINGTON BEACH EMPLOYER dLE PAINTING SC 904 E MOUNTAIN VIEW TER ALHAMBRA CA 91801 [FYA,CN) PRINTED : 03-21-2023 (R E V.7-2014) • POLICY NUMBER: 3AA617789 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION , This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART • SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s)Of Covered Operations The City of Huntington Beach, its officers,elected or Various appointed officials, employees,agents and volunteers,2000 Main Street, Huntington Beach, CA 92648 Information required to complete this Schedule, if not shown above,will be shown In the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the Insurance afforded to these Include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising Injury" "property damage"occurring after: caused, In whole or In part, by: 1. All work, including materials, parts or 1. Your acts or omissions;or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional Insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above, completed;or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the C. With respect to the insurance afforded to these • insurance afforded to such additional insured additional insureds, the following is added to will not be broader than that which you are Section III—Limits Of Insurance: required by the contract or agreement to provide for such additional insured. CG 20 10 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 2 If coverage provided to the additional insured is 2. Available under the applicable Limits of required by a contract or agreement, the most we Insurance shown in the Declarations; will pay on behalf of the additional Insured is the amount of Insurance: whichever is less. 1. Required by the contract or agreement;or This endorsement shall not increase the applicable Limits ,of Insurance shown In the Declarations. • Page 2 of 2 ©Insurance Services Office, Inc.,2012 CG 2010 0413 • POLICY NUMBER: 3AA617789 COMMERCIAL GENERAL LIABILITY CO 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations The City of Huntington Beach, its officers,elected All Commercial and/or Residential - or appointed officials,employees, agents and Remodel/Repair work as required by written volunteers contract with the Insured. information required to complete this Schedule, if not shown above,will be shown In the Declarations. A. Section II — Who Is An Insured Is amended to B. With respect to the insurance afforded to these include as an additional Insured the person(s) or additional insureds, the following is added to organizations) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described In the Schedule of this endorsement amount of insurance: performed for that additional insured and included In the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law;and Limits of Insurance shown in the Declarations. 2. if coverage provided to the additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 ©Insurance Services Office, Inc.,2012 Page 1 of 1 • Policy#:3AA617789 COMMERCIAL GENERAL LIABILITY CG20010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY- OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contractor Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 ©Insurance Services Office, Inc., 2012 Page 1 of'I COMMERCIAL GENERAL LIABILITY CG20331219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN 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 B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract or agreement that such person or organization be 1. "Bodily injury", "property damage" or "personal added as an additional insured on your policy. Such and advertising injury" arising out of the person or organization is an additional insured only rendering of, or the failure to render, any with respect to liability for"bodily injury", "property professional architectural, engineering or damage" or "personal and advertising injury" surveying services, including: caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports, surveys, field orders, behalf; change orders or drawings and specifications; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such additional This exclusion applies even if the claims against insured: any insured allege negligence or other 1. Only applies to the extent permitted by law; and wrongdoing' in the supervision, hiring, 2. Will not be broader than that which you are employment, training or monitoring of others by required by the contract or agreement to provide that insured, if the "occurrence" which caused for such additional insured. the "bodily injury" or"property damage", or the offense which caused the "personal and A person's or organization's status as an additional advertising injury", involved the rendering of or insured under this endorsement ends when your the failure to render any professional operations for that additional insured are architectural,engineering or surveying services. completed. CG 20 33 12 19 ©Insurance Services Office, Inc.,2018 Page 1 of 2 2. "Bodily injury" or "property damage" occurring C. With respect to the insurance afforded to these after: additional insureds, the following is added to a. All work, including materials, parts or Section III —Limits Of Insurance: equipment furnished in connection with such The most we will pay on behalf of the additional work, on the project (other than service, insured is the amount of insurance: maintenance or repairs)to be performed by 1. Required by the contract or agreement you have or on behalf of the additional insured(s) at entered into with the additional insured;or the location of the covered operations has been completed; or 2. Available under the applicable limits of b. That portion of"your work" out of which the insurance; injury or damage arises has been put to its whichever Is less. intended use by any person or organization This endorsement shall not increase the applicable other than another contractor or limits of insurance. subcontractor engaged in performing operations for a principal as a part of the same project. Page 2 of 2 ©Insurance Services Office, Inc., 2018 CG 20 33 1219 COMMERCIAL GENERAL LIABILITY CG 24 53 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART • UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS 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 against any person or organization, because of any payment we make under this Coverage Part,to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. • CG 24 53 12 19 ©Insurance Services Office, Inc.,2018 Page 1 of 1 POLICY NUMBER: 648872175 COMMERCIAL AUTO CA 2048 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement Identifies person(s) or organization(s)who are'Insureds"for Covered Autos Liability Coverage under the Who is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date Is indicated below. Named Insured: JLE PAINTING Endorsement Effective Date: 03-22--2023 • SCHEDULE Name Of Person(s) Or Organization(s): CITY OF HUNTINGTON BEACH ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES AGENTS AND OR VOLUNTEERS 2000 MAIN ST HUNTINGTON BEACH, CA USA 926482702 Information required to complete this Schedule,if not shown above,will be shown In the Declarations. Each person or organization shown in the Schedule is an'Insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an 'Insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II— Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D,2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ©Insurance Services Office, Inc.,2011 Page 1 of 1 Insured Full Copy POLICY NUMBER: 648872175 COMMERCIAL AUTO AA CW 40 10 71 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF THE TRANSFER OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Designated Person or Organization: Contract Number: Description of Project: Location of Project: The following is added to the Transfer of Rights of Recovery Against Others To Us Condition: We waive any right of recovery we may have against the person or organization designated In the above Schedule because of payments we make for injury or damage arising out of work you perform under a contract with the above designated person or organization. The waiver applies only to the above designated person or organization and the work you perform must be under the contract, and for the project and location designated in the above Schedule. AA CW 401011 Allstate Insurance Company Page 1 of 1 Insured Full Copy POLICY NUMBER: 648872175 COMMERCIAL AUTO AACW401011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF THE TRANSFER OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Designated Person or Organization: CITY OF HUNTINGTON BEACH ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES AGENTS AND OR VOLUNTEERS Contract Number: N/A Description of Project: N/A Location of Project: N/A The following is added to the Transfer of Rights of Recovery Against Others To Us Condition: We waive any right of recovery we may have against the person or organization designated in the above Schedule because of payments we make for injury or damage arising out of work you perform under a contract with the above designated person or organization. The waiver applies only to the above designated person or organization and the work you perform must be under the contract, and for the project and location designated in the above Schedule. AA CW 401011 Allstate Insurance Company Page 1 of 1 Insured Full Copy Policy Number 648872175 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMON POLICY CHANGE ENDORSEMENT Endorsement No. 0 05 Allstate Insurance Company Named Insured JLE PAINTING Effective Date: 03-22-23 12:01 A.M.,Standard Time Agent Name COMMERCIAL CONTACT CENTER This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or conditions of coverage unless at the sole request of the insured. COVERAGE PART INFORMATION—Coverage parts affected by this change as Indicated by x[]below. Commercial Property Commercial General Liability Commercial Crime Commercial Inland Marine X COMMERCIAL AUTOMOBILE NO CHARGE The following item(s): Insured's Name Insured's Mailing Address Policy Number Company • Effective/Expiration Date Insured's Legal Status/Business of Insured Payment Plan Premium Determination Additional Interested Parties Coverage Forms and Endorsements 'Limits/Exposures Deductibles Covered Property/Location Description Classification/Class Codes Rates o Underlying Exposure/insurance is(are)changed to read {See Additional Page(s)) SEE NEXT PAGE The above amendments result in a change in the premium as follows: This premium does not Include taxes and surcharges. X No Changes To be Adjusted at Audit Additional NO CHARGE Return NO CHARGE Tax and Surcharge Changes Additional Return Countersigned By: COMMERCIAL CONTACT CENTER AUTHORIZED AGENT DM CW 30 01 10 Allstate Insurance Company Insured Full Copy You ro k i ood hands. Cinstat CWA021011 CERTIFIC, ',TE OF INSURANCE This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued to the Named insured. It does not grant any rights to any party nor can it be used,in any way, to modify coverage provided by such policies. Alteration of this certificate does not change the terms,exclusions or conditions of such policies.Coverage is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at the policy inception. Subsequent paid claims may reduce these limits. Certificate Holder. Named insured: CITY OF HUNTINGTON BEACH ITS JLE PAINTING OFFICERS, ELECTED OR APPOINTED 904 E MOUNTAIN VIEW TER OFFICIALS, EMPLOYEES AGENTS AND OR ALHAMBRA CA 91801-4136 VOLUNTEERS 2000 MAIN ST HUNTINGTON BEACH, CA USA 926482702 Automobile Liability Insurer Name:Allstate Insurance Company Policy Number: 648872175 1 --Any Auto 2-Owned Autos Only 3-Owned Priv.Pass.Autos Only 4--Owned Autos Other Than Priv. 5-Owned Autos Subject to 6-Owned Autos Subject to a Compulsory UM Law Pass.Autos Only No Fault X 7-•Specifically Described Autos X 8-Hired Autos Only ,X 9-Nonowned Autos Only Policy Effective Date: 12-0 2-2 0 2 2 Policy Expiration Date: 12-0 2-2 0 2 3 Limits of $1,000,000 Combined Single Limit(each accident) Insurance: BI Per Person BI Per Accident PD Per Accident Description of Operations/Locations/Vehicles/Endorsements/Special Provisions Interested PartyType: Additional Insured - All Other THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER, IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES)MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WiTH ADDITIONAL INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT, Producer: COMMERCIAL CONTACT CENTER Authorized Representative: Date: 03-22-23 I :,,}.j �tt4"'li ii''(�"i'.I:i1,{i�.'.{.•t;�: Sv�Y�ri Includes copyrighted material of Insurance Services Office, Inc., with its permission uuu :; CI CW A02 10 11 Allstate insurance Company Page 1 of 1 ,tv` Alist te. Yot,m In good hinds. POLICY NUMBER:648872175 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LiILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "Insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is Indicated below. Named Insured: JLE PAINTING Endorsement Effective Date: 0 3-2 2-2 0 2 3 SCHEDULE Name Of Person(s) Or Organization(s): CITY OF HUNTINGTON BEACH ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES AGENTS AND OR VOLUNTEERS 2000 MAIN ST HUNTINGTON BEACH, CA USA 926482702 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. -y r CA 20 48 10 13 ©Insurance Services Office, Inc.,2011 Page 1 of 1