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HomeMy WebLinkAboutEncroachment AgreementFEE: $490.00 MONITORING WELL ENCROACHMENT PERMIT AND AGREEMENT The City of National City hereby grants an Encroachment Permit to the undersigned, Frank Motors, Inc. (hereinafter referred to as "PERMi imE") in accordance with and pursuant to the terms and conditions set forth in Chapter 13.12 of the National City Municipal Code to install monitoring wells. The term "PERMITTEE" includes all successors in interest and assigns of the PPR MITTPP The PERMITTEE, in consideration of this grant of permission by the City of National City (hereinafter referred to as "CITY") to install and maintain MONITORING WELLS (all hereafter designated from time to time as an "encroachment") within or upon a CITY easement, property, or right-of-way for the use and benefit of PERMITTEE'S property and adjacent lands, now covenants and agrees as follows: The site of installation and any description of PERMITTEE'S encroachment are described in EXHIBIT A, attached. The terms and conditions under which the encroachment is to be installed and maintained are as follows: 1. This Encroachment Permit and Agreement (collectively hereafter, AGREEMENT) is made for the direct benefit of PERMITTEE and PERMITTEE's property described above, and the covenants herein contained shall be binding on the PERMITTEE and its assigns and successors. This AGREEMENT is issued pursuant to Chapter 13.12 of the National City Municipal Code, the terms of which PERMITTEE hereby specifically acknowledges, accepts. and agrees to. PERMITTEE also acknowledges that those terms and conditions include, without limitation, the CITY's right to require the removal, relocation, or undergrounding of the encroachment when deemed necessary and feasible by and in the sole discretion of the City Engineer, at PERMITTEE's expense. The terms and conditions of Chapter 13.12 shall govern the interpretation and application of this Encroachment Permit, the maintenance of the encroachment, and the PERMITTEE'S duties and obligations. In the event of litigation to enforce any of the terms and conditions of this permit, the CITY shall be entitled to its attorney's fees and costs of enforcement. A copy of this Encroachment Agreement may be recorded against the PERM! I T tE's real property that may be benefited by the installation and maintenance oldie encroachment. Upon request by CITY, FERMI ITEE shall record this Encroachment Agreement with the County of San Diego , County Recorder's Office, and upon recordation shall return the original to the CITY. 2. The encroachment shall be maintained in a safe and sanitary condition at all times at the sole cost, risk, and responsibility of PERMITTEE and all successors in interest, so long as the encroachment exists. 3. Upon notification in writing by CITY's City Engineer, the above described encroachment shall be abandoned, removed, or relocated by PERMITTEEE at the PERMITTEE's sole expense. If PERMITTEE fails to remove or relocate the encroachment herein permitted within thirty (30) days after notice of removal or relocation from the CITY, CITY Y may cause such removal or relocation -to be done at PERMITTEE's sole cast and expense, which cost shall be a lien upon the land benefited by the encroachment and the personal liability of the PERMITTEE. 4. PERMITTEE shall furnish the CITY with a faithful performance bond as security for the prompt completion of the installation, removal, abandonment, and all appurtenant operations, including any necessary subsequent street resurfacing or restriping required for installing or maintaining the encroachment, which bond shall be maintained so long as the encroachment exists. -1- 5. CITY shall not at any time be liable for injury or damage occurring to any person or property from any cause whatsoever arising out of PERMITTEE's construction, installation, maintenance, repair, use, operation, condition, or dismantling of the monitoring wells or the encroachment except to the extent caused by CITY's sole negligence or willful misconduct. 6. PERMITTEE shall indemnify, defend, and hold harmless CITY and its officers, agents, and employees from all liability, loss, costs, claims, demands, suits, and defense costs, including attorneys' fees, arising out of PERMITTEE's entry upon and use of CITY's easement or right-of-way for the installation, maintenance, removal, and use of the PERMITTEE's encroachment. PERMITTEE shall indemnify, defend, and hold harmless CITY and its officers, agents, and employees from all liability, loss, costs, claims, demands, suits, clean-up costs, and defense costs, including attorneys' fees and expert witness fees, arising out of or related to PERMITTEE's monitoring wells subject to this Agreement, except for those claims which arise out of the sole negligence or willful misconduct of the CITY. 7. Insurance. PERM1TTEE shall take out and maintain, during the time the encroachment remains on CITY's easement or right-of-way, commercial general liability insurance with minimum limits of Two Million Dollars ($2,000,000.00) per occurrence, and Four Million Dollars ($4,000,000) aggregate, covering all claims of bodily injury, including death, and property damage arising out of this Agreement. PERMITTEE shall take out and maintain, during the time the encroachment remains on CITY's easement or right-of-way, pollution liability coverage with minimum limits of Three Million Dollars ($3,000,000) per occurrence covering all claims of bodily injury, including death, and property damage arising out of this Agreement. PERMITTEE shall take out and maintain workers' compensation insurance covering all of PERMITTEE's employees, with limits sufficient to satisfy California statutory requirements. In addition, PERMITTEE shall take out and maintain employer's liability coverage with limits of not less. then One Million Dollars ($1,000,000) per occurrence. The policy shall be endorsed with a waiver of subrogation as to the CITY. All policies required by this Agreement shall be written by insurers licensed to do business in the State of California, which are rated at least "A, III" by the current A.M Best Ratings Guide and otherwise approved by CITY's Risk Manager. Coverage written by non -admitted, surplus lines carriers may be acceptable provided the insurer is included in the most recent California List of Eligible Surplus Lines Carriers (LESLI list) and otherwise meets CITY insurance requirements. Coverage shall be written on occurrence forms; in the event coverage is written on a claims made form, the retro date must be on or before commencement of this Agreement, and coverage must be maintained for a period of at least three (3) years following the termination of this Agreement. All deductibles and/or self -insured retentions must be disclosed on the certificate of insurance. These policies shall name CITY and its officers, agents, and employees as additional insureds, and shall constitute primary insurance as to CITY and its officers, agents, and employees, so that any other policies held by CITY shall not contribute to any loss under said insurance. Said policies shall provide for thirty (30) days prior written notice to CITY of cancellation or material change. Prior to commencement of this Agreement, PERMIFI hE shall furnish CITY a certificate of insurance with all required endorsements evidencing the coverage required by this section. Should PERMI I-1 E fail to do so, CITY may elect to obtain such coverage at PERMITTEE'S expense or immediately terminate this Agreement, and require removal of the encroachment. S. PERMITTEE is further responsible for obtaining any required construction, excavation, or building permits; for notification to Underground Service Alert, when applicable; and for the safe installation and maintenance of the encroachment at all times. 2 Encroachment Permit and Agreement Monitoring Well -2- 9. This Encroachment Permit shall not be valid nor confer any rights to install and maintain an encroachment until it is approved by the CITY, and accepted and acknowledged by the PERMITTEE, and if determined necessary by the CITY, recorded. 10. PERMITTEE shall within 48 hours upon written notification by the CITY adjust, or cause to adjust the top of the well on , if and when such adjustment will become necessary as a result of CITY's street resurfacing, or other construction operations. 11. PERMITTEE shall provide and maintain adequate traffic control at the sole cost, risk and responsibility of PERMITTEE and successor in interest, during the course of the construction of the well, and the monitoring and sampling periods or any other operation within the CITY right-of-way. PERMITTEE shall hold CITY harmless with respect thereto. 12. PERMITTEE shall notify the CITY in writing of any proposed change in the location of the well prior to installation. PERMITTEE shall obtain additional permits for any such changes from the CITY prior to the commencement of work. 13. PERMITTEE shall apply to the City Engineer for a construction permit prior to the installation of the well on . and for subsequent adjustments. 14. All operations conducted by the PERMI'r1'EE on the CITY premises, including monitoring and sampling of the well and running of equipment shall be limited to the hours set by the City Engineer, and there shall no deviations from these hours. 15. PERMITTEE shall notify all adjacent residential and commercial developments as to the intended construction, and shall post notices indicating the type and the hours of construction and all other subsequent work. The PERMITTEE shall diligently proceed to complete all work with a minimum of inconvenience to the public. 16. At least 48 hours prior to start of construction, PERMITTEE shall contact Underground Service Alert for all underground utility mark -out. It shall be the responsibility of the PERMITTEE to locate all substructures and protect them from damage. The expense or repair or replacement of said substructures shall be solely borne by the PERMITTEE, and the CITY shall be held harmless with respect thereto. 17. The PERMITTEE shall be responsible for the prevention of damage to the adjacent property. No person shall excavate on land so close to the property line as to endanger any adjoining public street, sidewalk, alley, or any other public or private property without supporting and protecting such property from settling, cracking, erosion, silting, scour, or the damage which might result from the PERMITTEE's operations. 18. The PERMITTEE shall design, construct, and maintain aii safety devices, including shoring, and shall be Solely responsible for conforming to all local, state, and federal safety and health standards, laws, and regulations. 19. The proposed well may exist in the public right-of-way for a maximum of two years. The PERMITTEE shall inform the CITY if additional time will be required for groundwater monitoring, and shall obtain the CIT.Y's written approval for any time extension. 20. PERMITTEE shall notify the CITY in writing at least 48 hours prior of any intended monitoring of the well to be conducted during the length of this encroachment. Such notification shall contain the time and date of the intended sampling, and shall be subject to the approval of the CITY. 3 Encroachment Permit and Agreement Monitoring Well -3- 21. PERMITTEE shall deposit a sum equal to $2,000.00 in the CITY's account, to be used only for emergency purposes, prior to the approval of this Encroachment Agreement. 22. The well cap installed under this permit shall have information printed giving the name and phone number of the responsible entity in charge of the installation and maintenance of the well. 23. The PERMITTEE shall provide the CITY with a copy of the site assessment and remediation report; a copy of the Department of Health Services, County of San Diego response; and the site remediation completion report. The report shall show the extent of ground water and/or soil contamination, if any. Dated: CITY OF NATIONAL CITY PERMITTEE: Frank Motors, Inc. Ron Morrison, Mayor En . /Comp Signa e s o Fib ame & Title s[tracc T ATTACH NOTARY CERTIFICATION FOR THE NAME OF PERMITTEE SHOWN ABOVE. USE CALIFORNIA ALL PURPOSE ACKNOWLEDGEMENT NOTARY ONLY. PERMITTEE/APPLICANT INFORMATION: Chris Crosby Person in Responsible Charge 619-920-1107 24/7 Phone Number SCS Engineers Firm Name Mailing Address: Frank Motors Atten: Jerry Drewett 3150 National City Blvd. National City, CA 91950 PLAT SHOWING LOCATION OF WELL HEADS OR OTHER STRUCTURES, EASEMENT, OR RIGHT-OF- WAY, AND SEWER AND/OR. DRAINAGE FACILITIES: SEE EXHIBIT "A", ATTACHED 4 Encroachment Permit and Agreement Monitoring Well -4- CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Date On Tail -C d 13 before m personally appeared Place Notary Seal Above Hoii AsAenL "-' VLlilV-) Signature: OPTIONAL DEC 262013 SCS ENGINEERS CIVIL CODA ! 1189 £QjLameandp1\Title of the Officer a71�nIIrfI in I amA e(s) of slgner(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are— subscribed to the within instrument and acknowledged to me that he/she/II y executed the same in his/bber,&J.ieir• authorized capacity(ies), and that by his/bex/tbeh- signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my -nd and o.'cial seal. a►.t.. • : Though the information below is not required by law, it may prove val able to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signers) Signer's Name: Corporate Officer — Title(s): ❑ Individual Partner — ❑ Limited ❑ General ❑ Attorney in Fact O Trustee Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Individual 0 Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee 0 Guardian or Conservator ❑ Other: Signer Is Representing: © 2010 National Notary Association • NationalNotary.org • 1-1300-US NOTARY (1-800-876-6827) Top of thumb here Item #5907 -5- MONITORING WELL INSTALLATION QUESTIONS 1) What is the time of completion of the drilling and well construction? Approximately 3-4 weeks from receiving the approved encroachment permit 2) What is the time required to install each well? Approximately 2 days for all 3 wells 3) How long will the wells remain in the street? Until the County of San Diego DEH grants site closure and authorizes the destruction of the wells. 4) How long will the abandonment of the wells be? (time frame) 2 days for 3 wells 5) How often will the wells be monitored and sampled? Quarterly 6) How long will it take to purge and sample each well? Approximately 2 hours per well 7) Who will be responsible for removing the wells from the public right-of- way and restoring the street? Frank Motors, Inc. is responsible for such and all work will be performed by SCS Engineers under contract with Frank Motors, Inc. 8) Who will be responsible for top of well head adjustments? Frank Motors, Inc. is responsible for such and all work will be performed by SCS Engineers under contract with Frank Motors, Inc. -6- Parana 'Kg‘ ` Ih'llti(i (tiger-- (<4 MINI5 w.. 11�ds+ ` n• (5) 1 , -41:•fiwi —how 0801 Creedal; Merdeant.nds....d.l..e...bd Nana.. Pm.. MN Md. M.M.....1 iJ.A.f...1keb Mt.. New Mu.Rae.. leeml.e MWIA M Or..r e qAr°'d sow. Crr a Mee M a• MTtE . A. RAW7 areal, Model. ad E... Sew,erar afMm sable bred and A.. NMa.....tee.:.s Iw1Qreg. Md.eY _debledamex MWi WYMI.M Medea al' Geerm a.....e b.a......a..bw.d ever b.f. MW4 Warr Lap' MaeMartw CMd Lakral bee..Fal D.aeralee WME error.. e.d M.rd.. 1.f4 reeler mem MWS We. Lawl M.ledg air Upgrade.. Mid Weer MU od elemeareuyereato Peed. M.fiord, M.Jodq� Se.peg 1WM le.a, ,..beer .e.ei. bell aedibA w..m.r.b. nand .rr I 4 ._, ow. MW7 WM. L.wIM.brlg orgy UpgreneelWed ..> elele QC seereake MA MWIS WWriael Mentarlw Cry i.ml lWbQ O.wednp CcC awwde. aerate MWc WadMeed Name arCate 'Um...NM bd.•Mcl adeemed. 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Al.sidr. abed ew.rwr am appratmelk 4. • • .V�.16 Tan Moynslmi 7adng Car Dealership cl r J iso• ,nnlraton contours of MTEE reputed •n micrograms per 19er (pg/L) in February 2011. Dashed where estimated, queried a t / where inknown. a. jPertY Beanie nr v Interpreted extent of former underground storage tank (UST) excavation o• /�- - based an the Corrrerse Environmental West (CEW) report dated B113/92. EXPLANATION MonIrrii'ng WeNearn h. tlon Indicated In proposed to be omitted Cron futum groan , Proposed He Well Lo aMdoreonlforing Reported concentrations of methyl tertiary butyl ether (MTBE) reported in mirrograms per !ter (pglL) in February 2011. c = not reported above laboratory reporting limit for given analyte. Interpre ed groundwater gradient dkectfon with estimated magnitude shown. Interpreted Febuery 2011 groundwater gradent direction with estimated magrdhle shown. CDC - Constituents of Concern Vacant Lot LjSGS monitoring Sloped \Embankment' Caltrans Easement (sloped) rAIZERINIE Vacant lot EglainelenTS Environmental Consonants 8799 t3stboo Avenue, Suite 280 San Dike. California 92123 a 4a so 120 Approximate Graphic Scale In Feet PROPOSED MONITORING WELL LOCATIONS Frank Motors 3150 National City Boulevard National City. Califc.mia EXHIBIT.A Project No.: 11991787.08 Figure 3 Date tufted: 113f14 EXHIBIT "A" MONITORING WELL CONSTRUCTION DETAILS FLUSH MOUNT WELL $C 8799 Balboa Avenue. Suite 290 San Diego, California 92123 PROJECT NUMBER: 11991767.08 BORING/WELL NUMBER: MW18 SITE: 3150 National City Blvd., National City, CA CLIENT: Frank Motors COUNTY & PERMIT #:TBD DRILLER: TBD DATE OF INSTALLATION: TBD PREPARED BY: Chris Crosby A CONSTRUCTION DETAILS Surface Elevation Top of Casing Elevation TBD TBD A. Total Depth 30 ft B. Boring Diameter 8 in C. Casing Length 30 ft Casing Material PVC D. Casing Diameter E. Depth to Top of Screen F. Screen Length Screen (slot) Size G. Depth to top of Filter Pack Filter Pack Material H. Depth to top of Seal Seal Material 2 in 15 ft 15ft 0.020 in 13ft #3 Sand aft Bentonite Chips E. Depth to Top of Fill Material 3 ft Annular Fill Material Bentonite Chips J. Surface Seal Dimensions Radial or Square or Other Surface Seal Material 3 ft Diameter Radial Concrete K. Type and Size of Protective Casing: 12 in Traffic Box Notes: Prepared by: Chris Crosby Date: 1/2/2014 Reviewed by: Date: F:1Projects19911750 to 1800199E1767 (Frank Motors Group)111991767.08 3150 Nat'l City\Additional Site Assessment (2013)1PermittinglWeilCompletton MW18.xls -8- EXRIBIT "A" MONITORING WELL CONSTRUCTION DETAILS FLUSH MOUNT WELL NGINEERS 8799 Balboa Avenue, Suite 290 San Diego, Calitomia 92123 PROJECT NUMBER: 11991767.08 BORING/WELL NUMBER: MW19 SITE: 3150 National City Blvd., National City, CA CLIENT: Frank Motors II COUNTY & PERMIT #: TOD DATE OF INSTALLATION: TBD DRILLER: TBD PREPARED BY: Chris Crosby �+ r A a L•.� iLLJLLt SL: }S!}L!}L'� tP. . CONSTRUCTION DETAILS Surface Elevation Top of Casing Elevation TBD TBD A. Total Depth 30 ft B. Boring Diameter 8 in C. Casing Length 30 ft Casing Material PVC D. Casing Diameter E. Depth to Top of Screen F. Screen Length Screen (slot) Size G. Depth to top of Filter Pack Filter Pack Material H. Depth to top of Seal Seal Material 2 in 15ft 15ft 0.020 in 13ft #3 Sand aft Bentonite Chips I. Depth to Top of Fill Material 3 ft Annular Fill Material Bentonite Chips J. Surface Seal Dimensions 5 ft x 5 ft Radial or Square or Other Square Surface Seal Material Concrete K. Type and Size of Protective Casing: 12 in Traffic Box Notes: Prepared by: Chris Crosby Date: 1(2J2014 Reviewed by: Date: F:1Projects19911750 to 1800199E1757 (Frank Motors Group)111991767.08 3150 Nat'l City1Addttional Stte Assessment (2013)1Permitting1WellCompletion MW19.xls -9- EXHIBIT "A" MONITORING WELL CONSTRUCTION DETAILS FLUSH MOUNT WELL SZSAENGINEE1 8799 Balboa Avenue, Suite 290 San Diego. California 92123 PROJECT NUMBER: 11991767.08 BORING/WELL NUMBER: MW20 SITE: 3150 National City Blvd., National City, CA CLIENT: Frank Motors COUNTY & PERMIT #: TBD DRILLER: TBD DATE OF INSTALLATION: TBD PREPARED BY: Chris Crosby A D CONSTRUCTION DETAILS Surface Elevation Top of Casing Elevation A. Total Depth TBD TBD 30 ft B. Boring Diameter 8 in C. Casing Length 30 ft Casing Material PVC D. Casing Diameter E. Depth to Top of Screen F. Screen Length Screen (slot) Size G. Depth to top of Filter Pack Filter Pack Material H. Depth to top of Seal Seal Material 2 in 15 ft 15 ft 0.020 in 13 ft #3 Sand 3ft Bentonite Chips i. Depth to Top of Fill Material 3 ft Annular Fill Material Bentonite Chips J. Surface Seal Dimensions Radial or Square or Other Surface Seal Material 2.5 ft x 2.5 ft Square Concrete K. Type and Size of Protective Casing: 8 in Traffic Box Notes: Prepared by: Chris Crosby Date: 1 /2/2014 Reviewed by: Date: F:IProjects19911750 to 1800199E1767 (Frank Motors Group)111991767.08 3150 Nat'l City1Additional Site Assessment (2013)1Permitting\WellCompletion MW20.xls -10- 'zbe CERTIFICATE OF LIABILITY INSURANCE DAT12/052013YYYj 17J06@019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 Ileu of such endorscmcnt(a). PRODUCER Rah Risk Insurance Services West, Inc. Los Angeles CA Office 707 Wilshire Boulevard Suite 2600 , Los Angeles CA 90017-0460 USA COACT PHONE AJC,-ND.E„t1: (866) 283-T122 FAX 800-363-0105 No.) EAML AD eE88 INSURERIS) AFFORGINC COVERAGE NAIL # INSURED SCS Engineers 3900 Kilray Airport Way, Suite 100 Long Beach CA 90806-6816 usA INSURER& AIG Specialty Insurance Company 268R3 INSURER Eh National union Fire Ins Co of Pittsburgh 19445 INSURERO The Insurance co of the State of PA 19429 INSURERG: INSURER E: INSURER F: • THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWRHSTANDING 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. Links Shown are as requested MLYR LIR TYPE OF NSURANCE A 128 SUBA POLICY NUMBER POLE LIMITS A GENERAL X — LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE © OCCUR pnuP17322480 1 31/ 0 �� EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED— PREMISES tG occurrerasl $1,000,000 MEDEXP(Anyoneparaon) $5,000 PERSONAL SADVINJURY $2,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE UMRAPPLIES POLICY X PRO- in PER: LOC PRODUCTS - COMP/OP AGG $2,000,000 B AUTOMOBILE X X X LJABIUrY ANY AUTO '—SCHEDULED _ x _i AUTOS NON -OWNED AUTOS CA 327-51-37 01)11/2013 03/31/2014 COMBINED SINGLE LIMIT Me accident) $2,000,000 BODILY INJURY (Perpereon) BOOILYINJURV(Peracddem) PROPERTY DAMAGE (Per accident) A X UMBRELLALIAB EXCESsLUte X OCCUR CLAIMS -MADE PR0U17322481 • 03/31/2013 03/31/2014 EACHaccURRENCE $5,000,000 AGGREGATE $5,000,000 DEB I (RETENTION C r. C WORKERS COMPENSATION AND YIN ANY PROPRIETOR( PARTNER/EXECUTIVE OFFICER/MEMBERBi LUDED? a (Mandatory in NH) If yew desert:: under DESRIPTION OF OPERATIONS below NiA w0048250327 wC048250326 wc048250328 04/01/2013 04/01/2013 04/01/2018 04/01/7014 04/01/2014 04/01/1014 x TWC STlA,1T L IT I ORV E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE $1, 000, 000 E.L DISEASE -POLICY UNIT $1, 000, 000 A Env Prof (E&O) PR0P17322480 Prof/Poll Liab 03/31/2013 03/31/2014 Each claim Aggregate $2,00b,000 $2,000,000I DESCRIPTION OF OPERATIONS 'LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Ramada Schedule, Mmato spade le required) RE: Job No. 115 176'7.0r,, Monitoring Well Encroachment permit. city of National City, its officers, agents and employees are included as Additional Insured with respect to the General Liability and Automobile Liability po1•icies; granted a Waiver of Subrogation i'or Workers' Compensation policy and the General !.lability policy evidenced herein is Primary and Non-contributory to other insurance available, as required by written contract, but limited to the operations of the Insured under said contract. I I CERTIFICATE HOLDER CANCELLATION City of National City Attn: City Engineers 1243 National City Blvd. National city CA 91950 USA SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTIc WILL BE DELIVERED N ACCORDANCE WITH THE POUCY PROVISIONS. BolderIdentifier :ACF AUTHORIZED REPRESENTATIVE e.75FOfi Ra fM1Ad6 maQd c9:14' aura /P!(O4 a fMR G1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD -11- ENDORSEMENT This endorsement, effective 12:01 AM, 313112013 Fatms a part of Policy No: PROP/7322480 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED 1 PRIMARY COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICY In consideration of an additional premium of $Included it is hereby agreed that the following is included as an Additional Insured as respects Coverage A and B but only as respects liability arising out of your work for the Addition Insured by or for you. Additional Insured: BLANKET WHERE REQUIRED BY WRITTEN CONTRACT. This does not apply to bodiy injury or property damage arising out of the sole negligence or willful misconduct of, or for defects in design furnished by, the Additional Insured. As respects the coverage afforded the Additional insured, this insurance is primary and non-contributory, end our obligations are not affected by any other insurance carried by such Additional Insured whether primary, excess, contingent, or on any other basis. This endorsement does not increase the Company's limits of liability as specified in the Declarations of this policy. All other terms, conditions, and exclusions shall resin the same. 90667 (04/06) Cl2791 PAGE 1 OF 1 -12- ENDORSEMENT This endorsement, effective 12:01 A.M. 03/31/2013 forms a part of policy No. CA 3275137 by NATIONAL UNION F IRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: WHERE REQUIRED BY WRITTEN CONTRACT I. SECTION II - LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or 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 arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. 87950 (10/05) Page. 1 of 1 -13- WAIVER OF OLJR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on inception date of the policy untess a different date is indicated below. (The following "attaching clause need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 4101 /2U13 forms a part of Policy No. WC 4825 03 26 issued By THE INSURANCE COMPANY OF THE STATE OF PENNSYLVAN IA Premium INCLUDED 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. This agreement shall not operate directly or indirectly to benefit any one nut named in the Schedule. Schedule THE PREMIUM FOR THE ENDORSEMENT IS INCLUDED ANY PERSON OR ORGANIZAITON TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF RECOVERY AGAINST. UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE OCCURRENCE OF LOSS. This form is not applicable in California. Kentucky, New Hampshire, New Jersey, North Dakota, Ohio, Tennessee, Texas, Utah, or Washington. WC 00 03 13 (Ed. 04/84) Countersigned by Authorized Representative -14- WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on inception data of the policy unless a different date is indicated below. (The following "attaching clause?' need be completed only when this endorsement Is issued subsequent 10 preparation of the policy). This endorsement, effective t2:01 AM 4/01/2013 forms a part of Policy No. WC 4825 03 27 I~s usd By THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA Premium 1 NCLUDED 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. This agreement shall not operate directly or indirectly to benefit any one not narned in the Schedule. Schedule THE PREII I UM FOR THE ENDORSEMENT IS INCLUDED ANY PERSON OR ORGANIZAITON TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF RECOVERY AGAINST, UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE OCCURRENCE OF LOSS. This form is not applicable in California, Kentucky, New Hampshire, New Jersey, North Dakota, Ohio, Tennessee, Texas, Lltah, or Washington. WC 00 03 13 {Ed. 04/84) Countersigned by Afr)0,-(94 Authorized Representative -15- BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The f0llowing "attaching cause" need be completed only whim this endorsement is Issued subsequent to preparation, of the policy). This endorsement, effective 12:01 AM 04/01/2013 forms a part of Policy #WC 4825 03 28 By THE INSURANCE COMPANY OF THE STATE Of PENHSYLVAN I A We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shalt be TBD of the total estimated wOrkers compensation premium for this policy. WC040361 (Ed. 11 /90} -16- Date: 1/8/2014 Property Owner: Phone: Email: DATE FEE DESCRIPTION Traffic Control Plan Check Fee Sub Total ittairontitILcilirle Development Services Department 1243 National City Blvd National City, CA 91950 (619) 336-4380 INVOICE (2014-1136) Contractor: Bob Guzzler San Diego , CA 92123 Phone: 858 4012348 Email: bguzzler@s<sengineers.com FEE AMOUNT AMOUNT PAID AMOUNT DUE ACCOUNT NUMBER $476.00 $0.00 $476.00 001-06029-3557 $476.00 $0.00 6476.00 001-00020-3557 Encroachment Agreement Sub Total Processed by: $490.00 $490.00 $4661)0 $0.00 $0.00 6490.00 $400.00 sun $966 00 001-06029-3634 00146029-3634 -17-