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HomeMy WebLinkAboutOne Corp Striping Service, LLC - 2026-04-08 SERVICE AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND ONE CORP STRIPING SERVICE,LLC FOR ON-CALL STRIPING AND SIGNAGE MAINTENANCE 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 One Corp Striping Service,LLC hereinafter referred to as "Contractor." Recitals A. The City desires to retain a Contractor having special skill and knowledge in the field of striping and signage maintenance. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. Contractor entered into a Professional Services Agreement with the City of Garden Grove on or about December 9, 2025,referred to as the"Professional Services Agreement". City desires to "piggyback"on the City of Garden Groves' Contract pursuant to HBMC Section 3.02.190(C)(2), and unless otherwise noted, contained in this Agreement, or in conflict with this Agreement,the Parties wish to be bound by the same terms and conditions as the City of Garden Grove. D. 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 Ron Wilcox,who shall represent it and be its sole contact and agent in all'consultations with City during the performance of this Agreement. 26-17615/401680 1 2. City Staff Assistance City shall assign a staff coordinator to work directly with Contractor in the performance of this Agreement. 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 Million One Hundred Fifteen Thousand Dollars ($1,115,000.00) 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 4/4.7r24 , or as soon as practicable after the execution of this Agreement by City (the "Commencement Date") and 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 26-17615/401680 2 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. 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 26-17615/401680 3 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, 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 26-17615/401680 4 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. 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, 26-17615/401680 5 orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 16. Assignment Inasmuch as 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 One Corp Striping Service, LLC Attn: Director of Public Works Attn: Ron Wilcox 2000 Main Street 183 N. Pixley Street Huntington Beach, CA 92648 Orange, CA 92868 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. 26-17615/401680 6 20. Modification No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties. 21. Section 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. 26-17615/401680 7 25. Legal Services Subcontracting Prohibited Contractor and City agree that City is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. Contractor understands that pursuant to Huntington Beach City Charter Section 309,the City Attorney is the exclusive legal counsel for City; and City shall not be liable for payment of any legal services expenses incurred by Contractor. 26. Confidentiality Contractor recognizes that in the performance of its duties under this Agreement, it must conduct its activities in a manner designed to protect information of a sensitive nature from improper use or disclosure. Contractor warrants that it will use reasonable efforts consistent with practices customary in the facilities management industry in recruiting, training and supervising employees and in otherwise performing its duties hereunder in order to achieve this result. In the furtherance of this, Contractor agrees, at the request of the City, to require its employees to execute written undertakings to comply with the foregoing confidentiality provision. 27. Discrimination Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 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. 26-17615/401680 8 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. 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. 26-17615/401680 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 ONE CORP STRIPING SERVICE, LLC municipal corporation of the State of California By: .c,. 1sti.,-4✓_ Mayor Print name ITS: ( .'rd e o e) Chairman/President/ ice President City Clerk AND By: — INITIATED AND APPROVED: Print name ITS: (circle ortreAss_ glief Financial Officer/Asst. Secretary-Treasurer Director of P lie Works APPROVED AS TO FORM: 1*. City Attorney REVIEWED AND APPROVED: City Manager COUNTERPART 26-17615/401680 1O 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 ONE CORP STRIPING SERVICE, LLC municipal corporation of the State of California By: Mayor Print name ITS: (circle one) Chairman/President/ Vice President ity Clerk AND By: INITIATED AND APPROVED: Print name ITS: (circle one) Secretary/Chief Financial Officer/Asst. Secretary-Treasurer Director of P lic Works APPROVED AS TO FORM: City Attorney REVIEWED AND APPROVED: City Manager COUNTERPART 26-17615/401680 10 EXHIBIT "A" A. STATEMENT OF WORK: (Narrative of work to be performed) Provide On-Call Street striping and Sign Installation for the City of Huntington Beach B. CONSULTANT'S DUTIES AND RESPONSIBILITIES: C. CITY'S DUTIES AND RESPONSIBILITIES: D. WORK PROGRAM/PROJECT SCHEDULE: 26-17615/401680 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 26-17615/401680 12 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. 26-17615/401680 13 EXHIBIT B COST PROPOSAL FORM ON-CALL STREET STRIPING AND SIGN INSTALLATION Item *Item Description Unit Measure Unit Price 1. 4" Broken Lane Line PER LF $ • 2. 4" Solid Lane Line PER LF $ • 1 S' 3, 4" Double Solid Line with 3"Solid Black Line PER LF $ . ag 4" Solid Lane Line with 3"Solid Black Line with 4. 4" Broken Lane Line (Continuous left-turn PER LF $ pocket) 5, 8" Solid White Line PER LF $ . 3 6. 8"Skip White Line PER LF $ 7. 6"Solid White Line PER LF ' $ , ao 8. 6"Skip Lane Line PER LF $ , } $' 9. 6" Skip White Line PER LF $ g 10. 6" Double Yellow Line PER LF $ , 3� 11, 6"Solid Lane Line PER.LF $ , aQ 12. 12" Crosswalk & Limit Bar Lines PER SF $ a 2- s- 13. 3-foot Yield Line (shark teeth) PER SF $ , as 14. R X R Marking PER EA $ 1 7, 5'° 15, Arrow Legend (Type I/IV/VII/VIII) PER SF $ ' (c,0 16. 8' Letter Legend PER SF $ 3 . 651 17. 12"-18" Letter Legend PER EA $ 0 0 *Assume paint, unless otherwise noted Item *Item Description Unit Measure Unit Price 18 Curb Painting (Red, Green, Yellow, White, Blue PER LF $ or Grey) a J 2 C 19. Parking "T" PER EA 20. 4" Parking Lot Line with Layout PER LF $ , Lv 21. 4" Parking Lot Line With No Layout PER LF $ 1 , OD 22. Paint Blackout PER SF $ v o (>0 _ 23 International Symbol of Accessibility (ISA) PER EA $ . MarkingS 7 . To 24. Yellow or White Non-reflective Pavement PER EA $ Marker - Ceramic , OD 25. Yellow or White Reflectorized markers PER EA $ . 5-C-> 26. Blue Reflectorized Hydrant Pavement Markers PER EA $ ! 5-. 0 Removal of Painted Lines, legends, or symbols by grinding. Square footage of legends shall be 27 determined by using California State Division of PER SF $ Highways calculations for standard pavement stencils. Contractor shall be responsible for 7 0) cleanup. Miscellaneous Sandblasting for Paint Removal. 28' Contractor shall be responsible for cleanup. PER HR $ � �� 29. Removal of any raised pavement markers PER EA $ v CC 30. "BIKE LANE"w/ arrow legend — PER EA $ 63 n S'O 31. Bike Symbol w/ Arrow Legend PER EA $ , ) &4c. 32. Shared Lane Marking Legend PER EA $ 57 r 3(D 33. Replace Divots with Hot Melt Bituminous PER EA Material $ �.' 34. 12"Thermoplastic Bar PER LF $ 3 o S C 35. Thermoplastic 4" Broken Lane Line PER LF $ o 675 *Assume paint, unless otherwise noted Item *Item Description Unit Measure Unit Price 36. Thermoplastic 4" Solid Lane Line PER LF $ ,70 37 Thermoplastic 4" Double Solid Line with 3"Solid PER LF $ Black Line j '025- Thermoplastic 4"Solid Lane Line with 3"Solid 38. Black Line with 4" Broken Lane Line PER LF $ (Continuous left-turn pocket) I .2C 39. Thermoplastic 8" Solid White Line PER LF $ I , 40. Thermoplastic 8" Skip White Line PER LF $ 1 > )� 41. Thermoplastic 6"Solid White Line PER LF $ . 95' 42. Thermoplastic 6"Skip Lane Line PER LF $ , 43. Thermoplastic 6"Skip White Line PER LF $ 7g 44. Thermoplastic 6" Double Yellow Line PER LF $ / 45. Thermoplastic 6"Solid Lane Line PER LF $ ,95 46. Thermoplastic 12" Crosswalk & Limit Bar Lines PER SF $ 3 >5—c) 47. Thermoplastic 3-foot Yield Line (shark teeth) PER SF $ 3 , St 48. Thermoplastic R X R Marking PER EA $ L �� Di✓ 49. Thermoplastic Arrow Legend PER SF $ L/ 50. Thermoplastic 8' Letter Legend PER SF $ , sc 51. Thermoplastic"BIKE LANE"w/ arrow legend PER.EA $ ( 7 o57 52. Thermoplastic Bike Symbol w/Arrow Legend PER EA $ 41 8',9s- 53. Thermoplastic Shared Lane Marking Legend PER EA $ J o 60 54, Layout PER LF $ " 55. Weeding PER HR $ aas'D0 *Assume paint, unless otherwise noted STREET SIGN ][NSTALLATXON Item **Item Description Unit Measure Unit Price Remove or Install Road Signs on existing 1 unistrut post (Sign provided by the City; PER EA labor, tools and related to be supplied by $ I 9 C, C) the Contractor) / ti ' Remove or replace Road Signs on existing round post/pole or light standard 2. (Sign provided by the City; labor, tools PER EA and related to be supplied by the $ � l O6) Contractor) 3. Core drilling sidewalk for sign post PER EA $ i 0 e C)C) Furnish and install 10' unistrut post, sleeve and anchor (Sign provided by 4, City; sign post/anchor/sleeve, labor, PER EA $ tools and related to be supplied by the re) C3 Contractor) Furnish and install 12' unistrut post, sleeve and anchor (Sign provided by 5. City; sign post/anchor/sleeve, labor, PER EA $ tools and related to be supplied by the o. Contractor) Furnish and install 14' unistrut post, sleeve and anchor (Sign provided by 6. City; sign post/anchor/sleeve, labor, PER EA $ tools and related to be supplied by the 97 Contractor) c.� Sign, post, anchor and sleeve removal 7' through sidewalk PER EA $ S ° Sign, post, anchor and sleeve removal $ 7 ° g' through soil PER EA Remove or Install a Set of Street Name 9 Signs on existing post (City to supply PER EA $ µ signs; labor, tools, hardware and related to be supplied by the Contractor) • **Unistrut post installation is assumed to be on soil, otherwise add line Item 3 Item **Item Description Unit Measure Unit Price Remove or Install a Set of Street Name Signs on existing light standard (City to 10. supply signs; labor, tools, hardware and PER EA $ ` o C) related to be supplied by the Contractor) t G Remove or Install a Set of Street Name Signs on existing light standard (Double 11' sided signs, labor, tools, hardware and PER EA $ � related to be supplied by the Contractor) Remove or Install a Set of Street Name Signs on existing post (Double sided PER EA / 0' 12' signs, labor, tools, hardware and related $ `�(� to be supplied by the Contractor) Relocate existing sign post to new 13. location (labor tools, hardware and PER EA $ 1 '' O related to be supplied by the Contractor) ! Furnish and Install Metal Beam Guardrail } � 14. (all material, hardware, labor tools and PER LF $ 1 L..) I related to be supplied by the Contractor) Furnish and install Type Q (CA) object marker, epoxy glue down version and shall be a vertical tubular marker with a height of 18-inches and minimum cross- 15. sectional dimension of 2.25 inches. PER EA $ Yellow retroreflective material shall ' \ / ° S3 consist of three (3) bands, each 3-inch in height and spaced 0.75-inches.at the top and between bands Paint Median nose, curb face and top with highly reflective premixed white traffic paint with glass beads and install 16. yellow reflective pavement markers on PER EA $ top surface of median curb nose 2-feet %. 0 center-center spacing (minimum 5 markers) 17. Furnish 12"x 18" sign PER EA 3 18. Furnish 12" x 24" sign PER EA $ S a 1'CD 19. Furnish 18" x 24" sign PER EA **Unistrut post installation is assumed to be on soil, otherwise add line Item 3 Item **Item Description Unit Measure Unit Price 20. Furnish 24" x 18"sign PER EA $ I'g. Li 21. Furnish 24"x 24" sign PER EA $ 6 // , 66 22. Furnish 24" x 30" sign PER EA $ g g 1 23. ' Furnish 24"x 48"sign PER EA $ I i, . 7 24. Furnish 30"x 12" sign PER EA $ /Q 4 `1 0 25. Furnish 30" x 18" sign PER EA $ 60 , 62/ 26. Furnish 30" x 24"sign PER EA $ a 27. Furnish 30" x 30" sign PER EA $ 1 D 1 , (32. 28. Furnish 30" x 36" "sign PER EA $ j 1 29. Furnish 30"x 42" sign PER EA $ )-_` ..�� a.; 30. Furnish 36"x 18" sign PER EA $ j Q j 73 31. Furnish 36" x 30" sign PER EA $ 1 ' l , erla 32. Furnish 36"x 36"sign PER EA $ 1 Li 5.; 41(a 33., Furnish 36"x 48" sign PER EA $ , c S .9 34. Furnish 36"x 72" sign PER EA $ .9(). 9 3 35. Furnish 48" x 48" sign PER EA $ 36. Furnish 48"x 60" sign PER EA $ 3 j , 2.k-.) **Unistrut post installation is assumed to be on soil, otherwise add line Item 3 surf city INSURANCE AND INDEMNIFICATION WAIVER Ht3MODIFICATION REQUEST 1. Requested: Public Works 2. Date: March 27, 2026 3. Name of contractor/permittee: One Corp Striping Service, LLC 4. Description of work to be performed: On call striping & signage maintenance 5. Value and length of contract: $300,000 per year, (3) years 6. Waiver/modification request: $75,000 deductible for General Liability 7. Reason for request and why it should be granted: The City only allows up to a $5,000 deductible for General Liability. One Corp Striping Service, has provided a financial statement to prove they are in good standing. 8. Identify the risks to the City in approving this waiver/modification:Low Department Head Signature ate: APPROVALS Approvals must be obtained in the order listed on this form. Two approvals are required for a request to be granted. Approval from the City Administrator's Office is only required if Risk Management and the City Attorney's Office disagree. 1. Risk Management El Approved ❑ Denied 1614-40.--- 3-3e-.34 Signature Date 2. City Attorney's Office ❑ Approved ❑ Denied — 4 f, j?.4; Signa ure Date 3. City Manager's Office 0 Approved ❑ Denied Signature Date If approved, the completed waiver/modification request is to be submitted to the City Attorney's Office along with the contract for approval. Once the contract has been approved, this form is to be filed with the Risk Management Division of Human Resources Waiver Form 3/27/2026 11:51:00 AM COMPANY-01 NICK ACORN CERTIFICATE OF LIABILITY INSURANCE DATE 3/2/2 pIYYYY) `-� /2/2026 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 License#0M70471 CONTACT Nicole Ick NAME; Orion Risk Management Insurance Services,An Alera Group Insurance PHONE FAX Agency,LLC (Alo,No,Ext):(949)284-6044 (Alc,No):(949)263-8860 18575 Jamboree Rd,Suite 500 tax,„;nick@orionrisk.com Irvine,CA 92612 INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:General Security Indemnity Company of Arizona 20559 INSURED INSURER B:Starr Indemnity&Liability Company 38318 One Corp Striping Service,LLC INSURER c:Great American Insurance Company 16691 16525 Celadon Court INSURER o:Homeland Ins Co of NY 34452 Chino Hills,CA 91709 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ITR INSD SW POLICY NUMBER rf B,p POLICY EFF POLICY EXP L TYPE OF INSURANCE (MM/DpIYYYY) (MMfDDYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE y 1,000,000 CLAIMS-MADE X OCCUR GSA463911765305 3/1/2026 3/1/2027 DAMAGE TO RENTED 100,000 X X PREIdISES(Ea mrurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X JEOT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 X OTHER.Ded:$75k B1/$75K PD B AUTOMOBILE LIABILITY COMBINEDt)SINGLE LIMIT 2,000,000 X ANY AUTO X X 1000198615261 3/1/2026 3/1/2027 BODILY INJURY(Per person) $ OWNED ^SCHEDULED AUTOS��� ONLY AUTOS BODILYBpj� INJURY(Per accident) S AUTOS ONLY AUUTOOS ONLY (Per accide Ip)AMAGE S S C UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5,000,000 X EXCESS LIAB — CLAIMS-MADE TUE246585309 3/1/2026 3/1/2027 AGGREGATE y 5,000,000 DED X RETENTIONS 0 S B WORKERS COMPENSATION X STATUTE OFR AND EMPLOYERS'LIABILITY Y/N X 1000003558 3/1/2026 3/1/2027 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ QEFICERR,IF)M$ER EXCLUDED? Y N/A (Mandatory n H) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Pollution Liability 7930019400012 3/1/2026 3/1/2027 Aggregate Limit 2,000,000 D Pollution Liability 7930019400012 3/1/2026 3/1/2027 Each Poll Condition 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached[(more space Is required) City of Huntington Beach Is included as Additional Insured per the terms of the attached endorsements. Primary and non-contributory wording applies per the terms of the attached endorsements. Waiver of Subrogation applies in favor of Additional Insureds per the terms of the attached endorsements. 30 Days'Notice of Cancellation;10 Days'Notice for Non-Payment(non-reporting if applicable)apply per policy provisions. • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE • THE EXPIRATION THEREOF,City of Huntington Beach ACCORDANCE WITH TTHE ATE POLICY PROVISIONS. WILL BE DELIVERED IN 2000 Main Street Huntington Beach,CA 92648 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GSA4639117653-05 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 City of Huntington Beach, its officers, elected or 'Location: Various locations throughout HB appointed officials, employees, agents and Job Description: On Call Striping & Signage volunteers Maintenance 2000 Main St., 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 exclusions organization(s) shown in the Schedule, but only with apply: respect to liability for"bodily injury", "property damage" This insurance does not apply to"bodily injury"or or"personal and advertising injury" caused, in whole or "property damage" occurring after: in part, by: 1 All work, including materials, parts or 1 Your acts or omissions; or equipment furnished in connection with such work, 2 The acts or omissions of those acting on your on the project(other than service, maintenance or behalf; repairs) to be performed by or on behalf of the in the performance of your ongoing operations for additional insured(s) at the location of the covered the additional insured(s) at the location(s) operations has been completed; or designated above. 2 That portion of"your work"out of which the However: injury or damage arises has been put to its intended use by any person or organization other 1 The insurance afforded to such additional than another contractor or subcontractor engaged insured only applies to the extent permitted by law; and in performing operations for a principal as a part of 2 If coverage provided to the additional insured is the same project. 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 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds,the following is added to Section III Insurance shown in the Declarations; —Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the most we Limits of Insurance shown in the Declarations. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 ©Insurance Services Office, Inc.,2012 CG 2010 0413 POLICY NUMBER: GSA4639117653-05 COMMERCIAL GENERAL LIABILITY CG20370413 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 City of Huntington Beach, its officers elected or Location: Various locations throughout HB appointed officials, employees, agents and volunteers Job Description: On Call Striping & Signage 2000 Main St., Huntington Beach, CA 92648 Maintenance 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 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 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: GSA463911765305 General Security Indemnity Company of Arizona THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VEN 051 00 (02/20) PRIMARY AND NON-CONTRIBUTING INSURANCE ENDORSEMENT This endorsement modifies the Conditions provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS of the COMMERCIAL GENERAL LIABILITY COVERAGE PART,and supersedes any provision to the contrary: Primary and Non-Contributory Insurance Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless: a. (1) The Additional Insured is a Named Insured under such other insurance; and (2) A fully written contract fully executed prior to the Named Insured's commencement of work for such Additional Insured for the specific project that is the subject of the claim, "suit," or"occurrence" expressly requires that this insurance: (i) apply on a primary and non-contributory basis; and (ii) would not seek contribution from any other insurance available to the additional insured. or b. Prior to a loss, you request in writing and we agree in writing that this insurance shall apply on a primary and non-contributory basis. Name Of Person(s) Or Organization(s) As Required By Written Contract, Fully Executed Prior To The Named Insured's Work. All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. VEN 051 00(02/20) Page 1 of 1 POLICY NUMBER: GSA463911765305 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As Required By Written Contract, Fully Executed Prior To The Named Insured's Work Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ COMMERCIAL AUTO SICA-1016 06 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL.INSURED - AUTOMATIC STATUS AMENDATORY ENDORSEMENT Policy Number: 1000198615261 Effective Date: 3/1/2026 Named Insured:One Corp Striping Service, LLC This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies)carefully. AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM It is hereby agreed that SECTION 11—COVERED AUTOS LIABILITY COVERAGE,A.COVERAGE,1.Who Is An Insured of the Business Auto Coverage Form and Motor Carrier Coverage Form, and SECTION I —COVERED AUTOS COVERAGES, D. Covered Autos Liability Coverage, 2. Who Is An Insured of the Auto Dealers Coverage Form are amended to include the following: Any person or organization whom you become obligated to include as an additional insured under this policy, as a result of any written contract or written agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability for "bodily injury"or"property damage"caused,in whole or in part,by your use of a covered"auto". However,the insurance afforded only applies to the extent permitted by law, and will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by such written contract or written agreement. All other terms and conditions of this Policy remain unchanged. SICA-1016 06 21 Copyright©Starr Indemnity&Liability Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. • >y' COMMERCIAL AUTO t k. SICA-1017 (0919) F Starr Indemnity & Liability Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS AMENDATORY ENDORSMENT Policy Number: 1000198615261 Effective Date: 3/1/2026 Named Insured: One Corp Striping Service, LLC This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) carefully. BUSINESS AUTO COVERAGE FORM SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, c., is amended by the addition of the following: The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions of this Policy remain unchanged. SICA-1017 (0919) Copyright©Starr Indemnity&Liability Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. POLICY NUMBER: 1000198615261 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured:One Corp Striping Service, LLC Endorsement Effective Date:3/1/2026 SCHEDULE Name(s)Of Person(s)Or Organization(s): As Required By Written Contract,Fully Executed Prior To The Named Insured's Work Information required to complete this Schedule,if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the"accident"or the"loss"under a contract with that person or organization. CA 04 441013 Co Insurance Services Office, Inc.,2011 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an Injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule.(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees white engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.0 %of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description As Required By Written Contract,Fully Executed Prior To The Named Insured's Work This endorsement changes the policy to which it Is attached and Is effective on the date Issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective:3/01/2028 Policy No.:1000003558 Endorsement No.: insured:One Corp Striping Service,LLC Premium: Insurance Company: (�`L J�4`'_�1J14j3l� Countersigned by: WC 04 03 06 (ED.04-84) Page l of 1