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HomeMy WebLinkAbout2010 CON CEPA Operations - NCPD Property & Evidence Lab Fume HoodNOTE TO FILE 09-14-10 IN THE MATTER OF: Agreement by and between the City and CEPA Operations, Inc. (Certified Environmental Particulate Air) to Provide Annual Testing and Certification for the Fume Hood Located in the NCPD Property & Evidence Lab. Please Note the Following: FULLY EXECUTED ORIGINAL AGREEMENT WAS NEVER FILED WITH THE OFFICE OF THE CITY CLERK ORIGINATING DEPARTMENT: _ CDC _ Housing & Grants _ City Attorney _ Human Resources _ City Manager MIS _ Community Svcs. _ Planning Engineering X Police _ Finance _ Public Works Fire NTF CITY OF NATIONAL CITY SHORT FORM SERVICES AGREEMENT (Phis form can only be used for relatively low risk services as determined by the Purchasing Agent, City Attorney, or Risk Manager) This contract dated this 1st day of July, 2010, is made by and between the CITY OF NATIONAL CITY, a municipal corporation, (hereinafter "CITY"), and CEPA (CONTRACTOR). NOW, THEREFORE, CITY agrees to engage CONTRACTOR to perform the services set forth herein in accordance with the following terms and conditions: 1. Description of Services. CONTRACTOR shall provide yearly annual testing and certification for the Fume Hood Iocated in the Police Department's Property & Evidence Lab. CEPA will also install a Lab Hood Airflow Monitor on the Fume Hood per Title 8, California Code of Regulations, Section 5154.1 (all laboratory type hoods must have a quantitative airflow indicator that continuously indicates air is flowing into the exhaust system during operation. An airflow alarm system may be used if it provides an audible or visual alarm if flow decreases to less than 80% of required). 2. Length of Agreement. This agreement is for the period of 7/01/10 through 6/30/11. If agreeable to both parties at the time of expiration, the Agreement may be renewed for three (3) additional one year periods, but may not exceed $1000.00 in any given one-year period. The renewal agreement must be in writing, and updated proof of insurance must be submitted. 3. Compensation. The total compensation to CONTRACTOR for providing the services set forth herein shall not exceed an annual total of $1,000.00. The compensation for CONTRACTOR'S work shall be based upon and not exceed the rates given in Exhibit "A" and "B" (labor rates) without prior written authorization from the Purchasing Agent. 4. Payment Schedule. CITY will make payment within thirty (30) days of receiving and approving a billing statement for the satisfactorily completed services of CONTRACTOR. 5. Termination. CITY may terminate this Agreement at any time by providing one (1) day written notice to CONTRACTOR. 6. Independent Contractor. It is agreed that CONTRACTOR is an independent Contractor, and all persons working for or under the direction of CONTRACTOR are CONTRACTOR'S agents, servants and employees, and said persons shall not be deemed agents, servants or employees of CITY, and shall not be entitled to retirement, workers compensation, or other benefits of employees of the CITY. 7. insurance. ,CONTRACTOR shall obtain: A. ® If checked, Professional Liability Insurance (errors and omissions) with minimum limits of $1,000,000 per occurrence. B. Automobile insurance covering all bodily injury and property damage incurred during the performance of this Agreement, with a minimum coverage of $ 1,000,000 combined single limit per accident. Such automobile insurance shall include owned, non -owned, and hired vehicles ("any auto"). C. Commercial general liability insurance, with minimum limits of $1,000,000 per occurrence/$2,000,000 aggregate, covering all bodily injury and property damage arising out of its operations under this Agreement. Revised February 2009 D. Workers' compensation insurance in an amount sufficient to meet statutory requirements covering all of CONTRACTOR'S employees and employers' liability insurance with limits of at least $1,000,000 per accident. In addition, the policy shall be endorsed with a waiver of subrogation in favor of the City. Said endorsement shall be provided prior to commencement of work under this Agreement. E. The aforesaid policies shall constitute primary insurance as to the CITY, its officers, employees, and volunteers, so that any other policies held by the CITY shall not contribute to any loss under said insurance. Said policies shall provide for thirty (30) days prior written notice to the CITY of cancellation or material change. F. Said policies, except for the professional liability and workers' compensation policies, shall name the CITY and its officers, agents and employees as additional insureds, and separate additional insured endorsements shall be provided. G. If required insurance coverage is provided on a "claims made" rather than "occurrence" form, the CONTRACTOR shall maintain such insurance coverage for three years after expiration of the term (and any extensions) of this Agreement. In addition, the "retro" date must be on or before the date of this Agreement. H. Insurance shall be written with only California admitted companies which hold a current policy holder's alphabetic and financial size category rating of not less than A VIII according to the current Best's Key Rating Guide, or a company equal financial stability that is approved by the City's Risk Manager. In the event coverage is provided by non -admitted "surplus lines" carriers, they must be included on the most recent California List of Eligible Surplus Lines Insurers (LESL! list) and otherwise meet rating requirements. I. This Agreement shall not take effect until certificate(s) or other sufficient proof that these insurance provisions have been complied with, are filed with and approved by the CITY's Risk Manager. If the CONTRACTOR does not keep all of such insurance policies in full force and effect at all times during the terms of this Agreement, the CITY may elect to treat the failure to maintain the requisite insurance as a breach of this Agreement and terminate the Agreement as provided herein. J. All deductibles and self -insured retentions in excess of $10,000 must be disclosed to and approved by the CITY. K. Insurance certificates must specify certificate holder as: City of National City ATTN: Finance Dept./Purchasing Div. 1243 National City Blvd National City, CA 91950-4301 8. Hold Harmless. CONTRACTOR shall defend, indemnify and hold CITY, its Officers, employees and agents harmless from any liability for damage or claims of same, including but not limited to personal injury, property damage and death, which may arise from CONTRACTOR, or CONTRACTOR'S subcontractors, agents or employees' operations under this Agreement. CITY shall cooperate reasonably in the defense of any action, and CONTRACTOR shall employ competent counsel, reasonably acceptable to the City Attorney. 9. Acceptability of Work. The City shall, with reasonable diligence, determine the quality or acceptability of the work, the manner of performance and/or the compensation payable to the CONTRACTOR. 10. Business License. CONTRACTOR must possess or shall obtain business license from National City Finance Department before beginning work. Revised February 2009 2 I I. Miscellaneous Provisions. A. Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which, together, shall constitute but one and the same instrument, B. Captions. Any captions to, or headings of, the sections or subsections of this Agreement are solely for the convenience of the parties hereto, are not a part of this Agreement, and shall not be used for the interpretation or determination of the validity of this Agreement or any provision hereof. C. No Obligations 10 Third Parties. Except as otherwise expressly provided herein, the execution and delivery of this Agreement shall not be deemed to confer any rights upon, or obligate any of the parties hereto, to any person or entity other than the parties hereto. D. Exhibits and Schedules. The Exhibits and Schedules attached hereto are hereby incorporated herein by this reference for all purposes. E. Amendment to this Agreement. The terms of this Agreement may not be modified or amended except by an instrument in writing executed by each of the parties hereto. F. Waiver. The waiver or failure to enforce any provision of this Agreement shall not operate as a waiver of any future breach of any such provision or any other provision hereof. C. Applicable Lain. This Agreement shall be governed by and construed in accordance with the laws of the State of California. The CONTRACTOR shall comply with ail laws, including federal, state, and local laws, whether now in force or subsequently enacted. H. Entire Agreement. This Agreement supersedes any prior agreements, negotiations and communications, oral or written, and contains the entire agreement between the parties as to the subject matter hereof. No subsequent agreement, representation, or promise made by either party hereto, or by or to an employee, officer, agent or representative of any party hereto shall be of any effect unless it is in writing and executed by the patty to be bound thereby. 1. Successors and Assigns. This Agreement shall be binding upon and shall inure to the benefit of the successors and assigns of the parties hereto. J. Construction. The parties acknowledge and agree that (i) each party is of equal bargaining strength, (ii) each party has actively participated in the drafting, preparation and negotiation of this Agreement, (iii) each such party has consulted with or has had the opportunity to consult with its own, independent counsel and such other professional advisors as such party has deemed appropriate, relative to any and all matters contemplated under this Agreement, (iv) any rule or construction to the effect that ambiguities are to be resolved against the drafting party shall not apply in the interpretation of this Agreement, or any portions hereof, or any amendments hereto. IN WITNESS WHEREOF, this Agreement is executed by CITY and by CONTRACTOR. CONTRACTOR �j/'� ��{{ Company Name: LP �tAL j Contact Name: V v11t/ /6 4, , l ✓-t Address: /93 1 J: �/�t PL, oivrri fO CA 9/Z/ Phone: (3-/9U Fax: ('9c)97?3 - ©-)/2 Revised February 2009 3 Pmail: kLe, CsefR'T7-S%, C0^1 Taxpayer t.D. #:' V42034, Pleavleek applicable box, and note the number of signatures required: Corporation (two signatures of corporate officers) Partnership (one signature) Sole Proprietor (one s; Signature: Print Name; Title: ka---,s/awr C•v, Signature: %! Title: U', /54z6Nri1fg6 Print Name: CITY City of National City National City Police Department 1200 National City Boulevard National City, CA 91950 Ph: (619 336-451 1 Fx: (619) 336-4525 agon-rales@nationalcityea.gov Revised February 2009 4 Adolfo Gonza es Chief of Police Date: U ate- 75 ao l ° r A- IFIED ENYIRONMEIiTAL PARTICULATE AIR June 11, 2010 National City Police Dept Isela Cabrales, 1939 Lake Place * Ontario. California 91 '51 (909) 923.1988 • Fax: (909) 923-8712 As requested, the price for your annual testing and certification is as follows: lea- Biohazard Safety Cabinet certification $135.00 Trip Charge $20.00 *If we install the alarm at the same time as the certification, we will lower the alarm install price to $85.00. These prices are quoted with the intent that the work will be performed during normal working hours (8am to Spin, Monday through Friday). Please sign below and return (via fax or email) this quote and/or poit as proof of acceptance so we can process your order. Let me know if you would like to schedule or if you have any questions. Sincerely, Lesley J.Vaughn Service Coordinator Ivauglm@cepatest.com Customer signature: Date: Print name: r ,, CERTIFIED PARTICUX.AT June 11, 2010 National City Police Dept. Isela Cabrales 1939 take Place • Ontario al font i 91761 (909) 923-1988 • Fox: (909) 923-8712 Re: Lab Hood Airflow Monitor Install, Fume .Flood Cepa 3477, Lab Cal/OSHA has recently made changes to their laboratory hood ventilation standard (Title 8, Califbrnia Code of Regulations, section 5154.1). By January 1, 2008 all laboratory -type hoods must have a quantitative airflow indicator that continuously indicates air is flowing into the exhaust system during operation. An airflow alarm system may be used if it provides an audible or visual alarm if flow decreases to less than 80% of required airflow. Description Cost/Unit # of Units Cost Apex Basic Airflow Monitor (AFM) + applicable tax $275.00 1 $275.00 Labor to install alarm $170.00 1 $170.00 Mounting Plate -+- applicable tax (if needed) $16.23 1 $16.23 There will also be an added trip/fuel charge of $20.00. Note: The installation cost does not include electrical work that may be required. Like all AFM units, it is powered by a 24VDC transformer that requires a standard 1 l0VAC outlet. Power connections can normally be made at the fluorescent lighting electrical "J-Box" located at the top of the hood. Power must not turn off with light switch. If you have any questions or need additional information, please contact us at 909-923-1988. If you wish to schedule ask for Lesley. Sincerely, Lesley Vaughn Service Coordinator lvaughn(wcepatest. corn. 909-923-1988 909-923-8712 fax Goodman Insurance Services 114 Pacifica, Suite 430 Irvine, CA 92618 USA City of National City Attn: Finance Dept/Purchasing Div 1243 National City Blvd National City, CA 91950 USA 0:59:70 EBX BPO The attached document is a certificate of insurance provided to you on behalf of our insured. If you have questions regarding the content of this document, please contact Goodman Insurance Services at (949)769-3108 and ask for Susan. Please send all revision requests in writing as we are required to document the changes in our files. * We understand that the timely and accurate issuance of certificates is of great importance both to you and our insured. Because of this, we issue certificates of insurance within 24 hours of being requested. ** Goodman Insurance Services specializes in risk management and insurance services for California Contractors. We have specialty programs for workers' compensation,general liability, auto, property and excess insurance. If you are interested in finding out more about our programs, please contact Justin at (949)769-3101. cc: CEPA Operations, Inc. (EMAIL) The data included in this notice and in the attached document is confidential to Ebix BP0 and the party responsible for bringing you this information. Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877 669 8600 I:30 ACORDr, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 08/19/2010 PRODUCER LIC #0551220 Goodman Insurance Services 114 Pacifica, Suite 430 Irvine, CA 92618 Justin Goodman 1-949-769-3108 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED CEPA Operations, Inc. 1939 S. Lake Place Ontario, CA 91761 INSURERA: GEMINI INS CO 10833 INSURERS: PEERLESS INS CO 24198 INSURER C: INSURER D. INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR IIIrrIIIAAAADD'L jNSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMM/DD/YYI POLICY EXPIRATION DATE(MM/DD/YY) LIMITS A f X GENERAL XCOMMERCIAL __lCLAIMS _ 1__ GEN'L LIABILITY GENERAL LIABILITY ] MADE X OCCUR VCGP018060 01/01/10 01/01/11 EACH OCCURRENCE $1,000,000 DAMAG PREM EESjEa ocTEO curence) $ 5, 000 MED EXP (Anyone person) $ 50 , 000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMITAPPLES PER: POLICY X jECT LOC PRODUCTS - COMP/OP AGG $2,000,000 B X AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS BA3643834 05/28/10 05/28/11 COMBINED SINGLE LIMIT (Ea accident) $ 1 , 000, 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY. EA ACC (DENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WC OTH- IMIT TORV LLIMITS I ER E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The certificate holder(s) are named additional insured per the attached form CG 2010 10 01, primary and non-contributory wording VE 03 58 11 08 attached, and AUTO additional insured with waiver GECA 701 01 07 attached, as required by writte:- contract. CERTIFICATE HOLDER CANCELLATION 10 Days Notice for Non -Payment of Premium City of National City Attn: Finance Dept/Purchasing Div 1243 National City Blvd National City, CA 91950 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001(08) skim 17082370 ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/0B) 3:1 COMMERCIAL AUTO GOLD ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SECTION II • LIABILITY COVERAGE A. COVERAGE 1. WHO IS AN INSURED The following is added: d. Any organization, other than a partnership or joint venture, over which you maintain ownership or a majority interest on the effective date of this Coverage Form, if there is no similar insurance available to that organization. e. Any organization you newly acquire or form other than a partnership or joint venture, and over which you maintain ownership of a majority interest. However, coverage under this provision does not apply: (1) If there is similar insurance or a self -insured retention plan available to that organization; or (2) To "bodily injury' or "property damage" that occurred before you acquired or formed the organization. f. Any volunteer or employee of yours while using a covered "auto" you do not own, hire or borrow in your business or your personal affairs. Insurance provided by this endorsement is excess over any other insurance available to any volunteer or employee. g. Any person, organization, trustee, estate or governmental entity with respect to the operation, maintenance or use of a covered "auto" by an insured, if: (1) You are obligated to add that person, organization, trustee, estate or governmental entity as an additional insured to this policy by: (a) an expressed provision of an "insured contract", or written agreement; or (b) an expressed condition of a written permit issued to you by a govemmental or public authority. (2) The "bodily injury" or "property damage" is caused by an "accident" which takes place after: (a) You executed the "insured contract" or written agreement; or (b) the permit has been issued to you. GECA 701 (01/07) Includes copyrighted material of Insurance Services Offices, Inc. with its permission Page 1 of 4 2. COVERAGE EXTENSIONS a. Supplementary Payments. Subparagraphs (2) and (4) are amended as follows: (2) Up to $2500 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "Insured" at our request, including actual loss of earning up to $500 a day because of time off from work. SECTION III - PHYSICAL DAMAGE COVERAGE A. COVERAGE The following is added: 5. Hired Auto Physical Damage a. Any "auto" you lease, hire, rent or borrow from someone other than your employees or partners or members of their household is a covered "auto" for each of your physical damage coverages. b. The most we will pay for "loss" in any one "accident" is the smallest of: (1) $50,000 (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. If you are liable for the "accident", we will also pay up to $500 per "accident" for the actual loss of use to the owner of the covered "auto". c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by an amount that is equal to the amount of the largest deductible shown for any owned "auto" for that coverage. However, any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning. d. For this coverage, the insurance provided is primary for any covered "auto" you hire without a driver and excess over any other collectible insurance for any covered "auto" that you hire with a driver. 6. Rental Reimbursement Coverage We will pay up to $75 per day for up to 30 days, for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto". Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for a period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your materials and equipment from the covered "auto". GECA 701 (01/07) Includes copyrighted material of Insurance Services Offices, Inc. with its permission Page 2 of 4 5:10 If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under paragraph 4. Coverage Extension. 7. Lease Gap Coverage If a long-term leased "auto" is a covered "auto" and the lessor is named as an Additional Insured - Lessor, In the event of a total loss, we will pay your additional legal obligation to the lessor for any difference between the actual cash value of the "auto" at the time of the loss and the "outstanding balance" of the lease. "Outstanding balance" means the amount you owe on the lease at the time of loss less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; and lease termination fees. B. EXCLUSIONS The following is added to Paragraph 3 The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not apply to the accidental discharge of an airbag. Paragraph 4 is replaced with the following: 4. We will not pay for "loss" to any of the following: a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment. b. Equipment designed or used for the detection or location of radar. c. Any electronic equipment that receives or transmits audio, visual or data signals. Exclusion 4.c does not apply to: (1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto"; or (2) Any other electronic equipment that is: (a) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's"operating system; or (b) An integral part of the same unit housing any sound reproducing equipment described in (1) above and permanently installed in the opening of the dash or console of the covered "auto" normally used by the manufacturer for installation of a radio. D. DEDUCTIBLE The following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. GECA 701 (01/07) Includes copyrighted material of Insurance Services Offices, Inc. with its permission Page 3 of 4 SECTION IV. BUSINESS AUTO CONDITIONS A. LOSS CONDITIONS Item 2.a. and b. are replaced with: 2. Duties In The Event of Accident, Claim, Suit, or Loss a. You must promptly notify us. Your duty to promptly notify us is effective when any of your executive officers, partners, members, or legal representatives is aware of the accident, claim, "suit", or loss. Knowledge of an accident, claim, "suit", or Toss, by other employee(s) does not imply you also have such knowledge. b. To the extent possible, notice to us should include: (1) How, when and where the accident or loss took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the accident or loss. The following is added to 5. We waive any right of recovery we may have against any additional insured under Coverage A. 1. Who Is An Insured g., but only as respects loss arising out of the operation, maintenance or use of a covered "auto" pursuant to the provisions of the "insured contract", written agreement, or permit. B. GENERAL CONDITIONS 9. is added 9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Your unintentional failure to disclose any hazards existing at the effective date of your policy will not prejudice the coverage afforded. However, we have the right to collect additional premium for any such hazard. COMMON POLICY CONDITIONS 2.b. is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. GECA 701 (01l07) Includes copyrighted material of Insurance Services Offices, Inc. with its permission Page 4 of 4 7:10 Policy Number: VCGP018060 Insured Name:CEPA OPERATIONS, INC. Number: 27 CG 2010 10 01 Effective Date: 01/01/2010 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person Or Organization: AS REQUIRED BY WRITTEN CONTRACT; COMMERCIAL PROJECTS ONLY, INCLUDING APARTMENTS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who is An Insured is amended to include as an insured the person or organization shown to the Schedule, but only with respect to liability arising out ofyour ongoing operations performed for thaf insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury" or "property damage" occurring after; (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 2010 10 01 Page 1 of 1 Policy Number: VCGP018060 Insured Name:CEPA OPERATIONS, INC. Number: 36 VE 03 58 11 08 Effective Date: 01/01/2010 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY/NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART If you are required by a written contract to provide primary insurance then this policy shall be primary and non-contributory and condition 4, Other Insurance, as shown under Section IV on form CG 00 01 12 07, does not apply but only with respect to coverage provided by this policy for the additional named insured in the schedule. Additional Premium: 0.00 VE 03 58 11 08 Page 1 of 1 9:10 PRODUCE Ltt<I Ii-IUATE OF LIABILITY INSURANCE CATE(MMIDOTO011 GERALD B HIER INSURANCE AGENCY 239 N. Euclid Avenue Upland, CA 91786 (800)300-1922 SURD] Cepa Company 1939 S'. Lake Place Ontario, CA 91761-5795 ( THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: INSURER B. Truck Insurance Exchange 8/20/2010 NAIC# INSURER G. SURER 0: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS. LirP 51, TYPE OF INSURANC GENERAL LIABILITY ERGAL GENERAL LIABILITY CLAIMSMAOE OCCUR GEMI AGGREGATE LIMIT APPLIES PER: JECPRO. T. FOLIC n0BILE MOIUTY ANTAL/TO ALLOWNEOAUTOS SCHEDULED AUTOS HiRE0 AUTOS NON-0WNEDAUTOS OC POLICY NUMBER POLICY EFFECTIVE DATE/AMID/WY) POLICYE%PIAATION DArE(MWDO,Y) LIMIT EACH OCCURRENC DAMAGE TO RENTED PREMISES (Ea ocmnence) MEOEXP(Any one pel sail) PERSONAL AAOVINJU GENERAL AGGREGATE PRODUCTS • COMP/OP AGO COMBINED SINGLE LIMIT (EFn :HAD BOOILYINJURY (Per Fersen) BODILYI.NJURY PROPERTY DAMAGE (Pesarc4eM) GARAGE LIAOILITY ANYAUTO AUTOONLY.EAAGCIO NT OTHER THAN AUiOONLY EA ACC EXCESS/UMBRELLA LIABILITY OCCUR I I CLAIMSMADE DEDUCTIBLE ETENTION CH OCCURRENCE AGO AWN GAT A WORKFRSCOMPENSATIONAND EMPLOYERS' LIABILITY va'r W WMtTT.PAI M RGYFRNM1E a✓ICE0.MEMBER EN0.111.: 1 Ilyes.Eesorbeund.r SPECIALPR0VI5ION OTHER A0931-43-77 DESCRIPTIONOF DPERATIONSILOCATIONS/VEHICLES/ EXCLUSIONSADDED BYENDORSEMENT/SPECIAL PROVISIONS Waiver of Subrogation attached 01/01/10 01/01/11 WCSTATU- TORYDMITS OTH ER E.L.EACHAGCIDENT E L. DISEASE • EA EMPLOYEE E.L. DISEASE.POLICY LIMIT 1,000,000 1,000,000 1,000,000 CERTIFICATE HOLDER. City of National City ATTN: Finance Dept./Purchasing/Div. 1243 National City Blvd National City, CA 91950-4301 ( CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAR NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION 0R LIABILITY' OF ANY WO UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD25(2001108) O ACORD CORPORATION 1988 30 DAYS WRITTEN ,(z rAGI1ANGE EXCHANGE Vv LI mu -CENTURY NCCI CO. NO. NCCI CO. NO. INSURANCE CO. NCCI CO. N0. 18244 17744 12998 ,5000 lst Edition Named Insured COPELAND, WAYNE DBA: CEPA COMPANY 1939 S. LAKE PLACE ONTARIO, CA 91761 Effective 1/1/2010 — Date WORKERS' COMPENSATION ENDORSEMENT WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY Agent 29-21-333 A09314377-10 2010 Policy Number Policy of the Company Yew THIS MANUSCRIPT ENDORSEMENT CHANGES THE POLICY TO WHICH IT IS ATTACHED EFFECTIVE THE INCEPTION DATE OF THE POLICY, FORMS A PART OF POLICY NO.A0931 43 77, ISSUED TO: CEPA COMPANY, AND CONSTITUTES AS A BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT. 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 PrCEMIUMFOR 'THIS E1Vb0RSEMENI' SFiALI BE 3 /o a OF THE_.TOTAL ANNUAL WORKERS' COMPENSATION PREMIUM FOR THIS POLICY. This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all the terms of the policy. Countersigned A f' !f S) Authorized Representative 91.5000 (E5000) 1ST EDITION OFFICE OF THE CITY CLERK 1243 National City Blvd. National City, California 91950 Michael R. Dalla, CMC - City Clerk 619-336-4228 phone • 619-336-4229 fax CEPA OPERATIONS, INC. Certified Environmental Particulate Air Annual Testing and Certification for the Fume Hood Located in the NCPD Property & Evidence Lab Roni Zengota (PD) Forwarded Copy of Agreement to Contractor