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HomeMy WebLinkAboutVerne's Plumbing, Inc. - 2024-11-01 (2) SERVICE AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND VERNE'S PLUMBING,INC. FOR PLUMBING INSTALLATION,REPAIR AND EMERGENCY CALL-OUT 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 Verne's Plumbing, Inc,, a California Corporation,hereinafter referred to as"Contractor." Recitals A. The City desires to retain a Contractor having special skill and knowledge in the ,field of plumbing installation, repair and emergency call-out services. B. Contractor represents that C ontractor 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. Scone 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 Lawrence J. Verne, 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. 23-12563/305117 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 One Hundred Ninety Five Thousand Dollars ($195,000.00)during the term of this Agreement. 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 1! or 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 maybe 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 cod; 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. 23-12563/305117 - 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 Iimited 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 coverage is provided under a form which includes a designated general aggregate limit, 23-12563/305117 3 .. 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(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 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 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, 23-12563/305117 4 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. 23-12563/305117 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 Verne's Plumbing,-Inc. Attn: Director of Public Works Attn: Lawrence J. Verne 2000 Main Street 8561 Whitaker Street 1-luntington Beach, CA 92648 Buena Park, CA 90621 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 No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties. 23-12563/305117 6 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 fairimeaning, 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 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; 23-12563/305117 7 and City shall not be liable for payment of any legal services expenses incunxed 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 maintain such permits, licenses, approvals,waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 8 23-12563/305117 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 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. 23-12563/305117 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 VERNE'S PLU G, INC. municipal corporation of the State of a California C rporation Califor Tem ��► By: L�i&*rJ Al 4 ayor Print name ITS: circle one) Chairman/President/ ice Presider � eliu4 A‘ ity Clerk 0/120 AND �,^ By: d\ 1_,LuG etcUltwi,1 - 3 ` � INITIATED AND APPROVED: Pri ITS: (circle one Secretar hief Financial Officer/Asst. Secretary-Treasurer irector of Public Works APPROVED AS RM: c2e City Attorney qv EVIEWED AND APPROVED: /fl City Manager 23-12563/305117 10 EXHIBIT "A" A. STATEMENT OF WORK: (Narrative of work to be performed) Plumbing installations, repair,maintenance and emergency call-out services. B. CONSULTANT'S DUTIES AND RESPONSIBILITIES: C. CITY'S DUTIES AND RESPONSIBILITIES: D. WORK PROGRAM/PROJECT SCHEDULE: • 23-12563/305117 Il 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 firth 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 23-12563/305117 12 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. 23-1.2563/305117 • 13 EXHIBIT B GENERAL CONTRACTING I PAINTING I ELECTRICAL AND MECHANICAL,iMAINT,SERVICES • BID SHEETS PLUMBING INSTALLATION,REPAIR AND EMERGENCY CALL.OUT SERVICES Contractor Name:, Verne's Plumbing. Inc. Date: 09-29-2022 Instructions for completing Bid Sheet: 1.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 cumin 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. 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' • � 1 ®ACCPR CERTIFICATE OF LIABILITY INSURANCE DATE(Mh11DDIYYYY) 9/17/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME; IMA, Inc. PHONE FAX 3475 E.Foothill Blvd., Suite 100 _0110.110.-EXO' (626)799-7000 (Arc,No): (626)583-2117 Pasadena, CA 91107 At DRESS; INSURER(S)AFFORDING COVERAGE NAIC II www.boltonco.com OH64724 INSURER A: Zurich American Insurance Company 16535 INSURED INSURER B: Verne's Plumbing Inc 8561 Whitaker Street INSURER C: Buena Park CA 90621 INSURERD: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 81943890 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP DI LIMITS LTRINSD WVO POLICY NUMBER (MMIDYYYY( (MMIDDIYYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO RENTED S CLAIMS-MADE I I OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE S POLICY I I PROT LOC PRODUCTS-COMP/OP AGG $ JEC OTHER: S 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) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION $ A WORKERS COMPENSATION WC380497003 10/1l2024 10/1/2025 ✓ STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRE TORIPA THE EXECUTIVE Y� N/A E.L.EACH ACCIDENT S 1,000,000 OFFICER/M(Mandatory In NH) I I E.L.DISEASE-EA EMPLOYEE 51.000.000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT- S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) • Re:Permits Issued by The City of Huntington Beach. APPROVED AS TO FORM MICHAEL E,GATES CITY ATTORNEY. CITY OF HUNTINGTON BEACH 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 St. ACCORDANCE WITH THE POLICY PROVISIONS. Huntington Beach, CA 92648 AUTHORIZED REPRESENTATIVE Avery Boles ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 81943890 1 VERNPLU-Cl 124-25 MC Master I Sara Powell 19/17/2024 12:37:20 PM (PDT) 1 Page 1 of 1 off.t . ACCPRO DATE(MMIDO/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/16/2024 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 COVERAOE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an;ADDITIONAL INSURED,the poilcy(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 endorcement(s). PRODUCER NAIaEI CT CLIENT CONTACT:CENTER FEDERATED MUTUAL INSURANCE COMPANY x HOME OFFICE:P.O.BOX 328 IA/C No.EOU:888-333-4949 RA,HON 507.446-4664 OWATONNA,MN 55060 E.AODREss:CLIENTCONTACTCENTER(SIFEDINS.COM INSURERS AFFORDINO COVERAGE URIC U IHSUurn A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 310.790.1 INSURER D: VERNES PLUMBING INC INSURER C: 8561 WHITAKER ST BUENA PARK;CA 00621.3129 IHBunil 0: INSURER Et INSURER FI COVERAGES CERTIFICATE NUMBER:66 REVISION NUMBER:8 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 NESUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. II7R TYPE OF INSURANCE gO BR POLICY HIUTAaER IMMtDD[vYYY1 hA1A/hOIYVYYh UNITS • X COMMERCIAL OEHERILUA5ILITV EACH OCCURRENCE $1,000,000 CLANMS•MADE EOCCUR PE/,MADE TO,(IENrso parmIsEO $100 000 ,aenarenn MCOEXP Wry ON penal $5,000 A Y N 9024889 05/17/2024 05/17/2025 PERSONAL a ADV INJURY S1.000.000 OENL AOOREOATE UNIT APPL ES PCR: GENERAL AOOREOATE $2,000.000 roue CT Li' LOC PRODUCTS 8 COMP/OP A00 $2,000,000 OTHER: C� pp • AUTOMOBILE UABIUTY f OMSI(EE%SINoLE UNIT $1,000,000 2LANYAUTO BODILY INJURY(Per Pusa4 A OWNED AUTOS CNL?_ '--+uIEo Y N 9024869 05/17/2024 05/17/2025 Roomy INJURY(Pic Aoadwt _HMO AUTOS ONLY _mem wed1 X UMBRELLALIAS XoccuR EACH OCCURRENCE $10,000,000 A ^EXCESSUPS a.assss4AADe N N 9024070 05/17/2024 05/17/2025 AOORSOATE S10,000,000 DEO I IRETENTION WORKERS COMPENSATION IPER STATUTE I SOTHER AND EMPLOYERS'LIABILITY WI1 MY PROPRIETOR/PARTNER/EXECUTIVE L E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED/ N/A (Mindaloty NH) E.L DISEASE EA EMPLOYEE II yyees,dHUIbp tndei DEECRIPnOILOF OPERATIONS.Oobw E.L DISEASE•POLICY UNIT POLLUTION UABIUTY N N 9024875 05/17/2024 05/17/2025 FAPOLL INCIDENT $1,000,000 AGGREGATE $1,000,000 A DESCRIPTION OF OPERATIONS I LOOATIONS I VEHICLES WORD 101.AidlSo'.d R,m,,t,8dl,dub,mF bo ethd,d II men sp,aid rgyind THE CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS ARE ADDITIONAL INSURED FOR ONGOING AND COMPLETED OPERATIONS ON THE GENERAL LIABILITY COVERAGE FOR ALL JOBS PERFORMED BY THE NAMED INSURED. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. CERTIFICATE HOLDER CANCELLATION CITY OFiHUNTINGTON BEACH se 8 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 2000 MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DEUVERED IN HUNTINGTON BEACH,CA 92648.2702 ACCORDANCE WITH THE POLICY PROVISIONS.(y AUTHORIEEO REPRESENTATIVE :;:,441 0 1988.2016 ACORD CORPORATION.All rights reserved, ACORD 26(2018/03) The ACORD name and logo are registered marks of ACORD APPROVED M1CjaAEI.AS E.GATE FOS CITY ATTOBN TO CITY Or I-tUNTINGTON BEACH ," r ® DATE(MMIOD/YYY1't A y D CERTIFICATE OF LIABILITY INSURANCE 9/15/2023 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 1NSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(tes)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 Bolton Insurance Services LLC PHONE FAX 3475 E.Foothill Blvd.,Suite 100 (c No.Est): (626)799-7000 (NC,Ro); (626)583-2117 AIL (p Pasadena,CA 91107 A ADDRESS; INSURER(S)AFFORDING COVERAGE NAIC N www.boitonco.com 6004772 INSURER A: Zurich American insurance Company 16535 INSURED INSURERS: Verne's Plumbing, Inc INSURERC: 8561 Whitaker Street Buena Park CA 90621 INSURERD: INSURER E: _ INSURER F: COVERAGES CERTIFICATE NUMBER: 76281026 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. I POLICY EXP ' LTIR TYPE OF INSURANCE INSD SWVD POLICY NUMBER IMMIODIYYYV) (MM1DO(YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ AGE TO RENTE CLAIMS-MADE I I OCCUR PREMISES SES Ea occurrence) S MED EXP(Any one person) S _ PERSONAL&AOV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 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) S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LtAB CLAIMS-MADE AGGREGATE $ DED RETENTION S S A WORKERS COMPENSATION WC380497002 10/1/2023 10/1/2024 v srn UTE ER OTH AND EMPLOYERS'LIABILITY YI N AM/PROPRIETOR/PARTNER/EXECUTIVE I I N f A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL.DISEASE-GA EMPLOYEE $1.000000 U yyes desuibe under E.L.DISEASE•POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) Re:Permits Issued by The City of Huntington Beach. • 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 St. ACCORDANCE WITH THE POLICY PROVISIONS. Huntington Beach, CA 92648 :::::::: REN1 EPESTATVE 7' I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 76281026 I VERtIPLU-C1 123-24 4:C Raster 1 Jonathan Alvarado 1 9/15/2023 1:58:22 PR IPSTI 1 Page 1 of 1 POLICY NUMBER:9024869 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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 City of Huntington Beach All Projects or Work Done by the Named 2000 Main St Insured for the Additional Insured Person(S) Huntington Beach,CA 92648-2702 or Organization(S).Additional Insureds Also Include:the City of Huntington Beach, its Officers,Elected or Appointed Officials, Employees,Agents.and Volunteers. 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", This insurance does not apply to"bodily injury"or "property damage" or "personal and advertising "property damage"occurring after: injury"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 addifiol insured(s) at the location(s) location of the covered operations has been completed;or designated above. However: 2. That portion of "your workI� 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 principal as a part of the same project. 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. © Insurance Services Office, Inc.,2018 Page 1 of 2 CG 20 10 12 19 Policy Number:9024869 Transaction Effective Date:05/17/2024 C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III-Limits Of insurance: whichever is less. If coverage provided to the additional insured Is This endorsement shall not increase the required by a contract or agreement,the most we applicable limits of insurance. will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contract or agreement;or Insured: Vernes Plumbing Inc 8561 Whitaker St Buena Park,CA 90621-3129 Page 2 of 2 © Insurance Services Office,Inc.,2018 CG 20 10 12 19 Policy Number:9024869 Transaction Effective Date:05/17/2024 POLICY NUMBER: 9024869 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 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 Organizations) Location And Description Of Completed Operations City of Huntington Beach All Projects or Work Done by the Named 2000 Main St Insured for the Additional Insured Huntington Beach,CA 92648-2702 Person(S)or Organization(S).Additional Insureds Also Include:the City of Huntington:Beach, its Officers,Elected. or Appointed Officials,Employees, Agents and Volunteers. 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 organization(s) 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 1. Required by the contract or agreement;or In the"products-completed operations hazard". However 2. Available under the applicable limits of insurance; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted by law;and This endorsement shall not increase the applicable 2. If coverage provided to the additional Insured is limits of insurance. 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. Insured: Vernes Plumbing Inc 8561 Whitaker St Buena Park,CA 90621-3129 ti © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 3712 19 Policy Number:9024869 Transaction Effective Date:05/17/2024 4 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 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 LIQUOR 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 contract Condition and supersedes any provision to the or agreement that this Insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other Insurance available to the This insurance is primary to and will not seek additional insured. 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 • ©Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 01 12 19 Policy Number:?9024869 Transaction Effective Date:05/17/2024 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for"bodily injury"and "property damage" liability is amended to Include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily Injury or property damage "auto" liability Insurance arising out of operation of a covered "auto"with your permission.However.this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered"auto"is a"trailer"connected to a covered"auto"you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing,parking or storing"autos"unless that business is yours. (4) Anyone other than your"employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered"auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a covered"auto"owned by him or her or a member of his or her household. B. The coverage extended to any additional Insured by this endorsement is limited to, and subject to all terms, conditions,and exclusions of the Coverage Part to which this endorsement Is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured,or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties,or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To"loss"which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an Insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented"auto"or the policy period ends,whichever occurs first. Includes copyrighted material of Insurance Services Office,Inc.with its permission. CA-F-127(03-03) Policy Number:9024869 Transaction Effective Date:05/17/2024 1 ® DATE(h1A1/DDlYYYY) A o CERTIFICATE OF LIABILITY INSURANCE s(MM/ 024 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 poiicy(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; IMA, Inc. PHONE FAX 3475 E.Foothill Blvd., Suite 100 leMAIL Fxt1'E. (626)799-7000 INC.Not: (626)583-2117 Pasadena, CA 91107 ADDRESS: INSURER(,AFFORDING COVERAGE NAIC f/ www.boitonco.com 0H64724 INSURER A: Zurich American Insurance Company 16535 INSURED INSURER B Verne's Plumbing Inc 8561 Whitaker Street INSURER C: Buena Park CA 90621 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 81943890 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF. POLICY EXP LIMITS LTR INSD VND POLICY NUMBER (MM/DDIYYYY) (MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) S MED EXP(Any one person) $ PERSONAL BADVINJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I I.PRO-ECT LOC PRODUCTS-COMP/OP AOG S J OTIIER: - S. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident)' ANY AUTO BODILY INJURY(Par person) $ . u OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTIONS $ A WORKERS COMPENSATION WC380497003 10/1/2024 10/1/2025 ,/ STA UTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE YIN EL.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? f Y I N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 5.1.000.000 If yes,describe under DESCRIPTION OF OPERATIONS below -E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) Re:Permits Issued by The City of Huntington Beach. APPROVED AS TO FORM By: MICHAEL E.GATES CITY ATTORNEY CITY OF-HUNTINGTON BEACH 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 St. ACCORDANCE WITH THE POLICY PROVISIONS. Huntington Beach, CA 92648 AUTHORIZED REPRESENTATIVE Avery Boles ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 81943890 I VERUPLU-C1 124-25 WIC Master I Sara Powell 19/17/2024 12;37:20 PM (PDT) I Page 1. of 1