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Home My WebLink About2012 CON (Encroachment Agreement) Restructure Petroleum Marketing - Monitoring WellsPLEASE COMPLETE THIS INFORMATION RECORDING REQUESTEb aY: CITY CLERK OF NATIONAL CITY 1243 National City Blvd National City, CA 91950 AND WHEN RECORDED MAIL TO: CITY CLERK OF NATIONAL CITY 1243 National City Blvd National City, CA 91950 D O C ## 2012-0333565 ilililI III IIIII IIIII �1111 HIII 11III IIIII �1111 IIIII IIIII Illll IIII III! JUN 07, 2012 11:39 AM OFFICIAL RECORDS SAN DIEGO COUNTY RECORDER'S OFFICE Ernest J. Dronenburg, Jr., COUNTY RECORDER FEES: 95.00 PAGES' 27 917.1 IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII Oil IIII THIS SPACE FOR RECORDER'S USE ONLY MONITORING WELL ENCROACHMENT PERMIT AND AGREEMENT: With Restructure Petroleum Marketing Services of California (RPMS-CA) for the Installation of Two (2) Groundwater Monitoring Wells at E. 4th Street and Palm Avenue (Please fill in document title(s) on this line) THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION 9172 MONITORING WELL ENCROACHMENT PERMIT AND AGREEMENT The City of National City hereby grants an Encroachment Permit to the undersigned, Restructure Petroleum Marketing Services of California (RPMS-CA) (hereinafter referred to as "PERMITTEE") 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 PERMITTEE. 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 PERMITTEE's real property that may be benefited by the installation and maintenance of the encroachment. Upon request by CITY, PERMITTEE 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 PERMITTEE 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 may cause such removal or relocation to be done at PERMITTEE's sole cost 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. 9173 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. PERMITTEE 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, VII" 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, PERMITTEE shall furnish CITY a certificate of insurance with all required endorsements evidencing the coverage required by this section. Should PERMITTEE 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. 8. 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 9174 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 any City right of way and easements, 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 any City right of way and easement, and for subsequent adjustments. 14. All operations conducted by the PERMITTEE 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 all 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 CITY'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 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 0 IONAL CITY Ro orrison, Mayor PERMITTEE: Restructure Petroleum Marketing Services of California (RPMS-CA) c/o Innovative Environmental Solutions (IES) Entity/Company Scott D. Levin / Sr. Project Manager Name & Title ATTACH NOTARY CERTIFICATION FOR THE NAME OF PERMITTEE SHOWN ABOVE. USE CALIFORNIA ALL PURPOSE ACKNOWLEDGEMENT NOTARY ONLY. PERMITTEE/APPLICANT INFORMATION: Scott D. Levin Mailing Address: Person in Responsible Charge 839 Second Street, Suite 2 (619) 368-7686 24/7 Phone Number Encinitas, CA 92024 Innovative Environmental Solution (IES) Firm Name PLAT SHOWING LOCATION OF WELL HEADS OR OTHER STRUCTURES, EASEMENT, OR RIGHT-OF- WAY, AND SEWER AND/OR DRAINAGE FACILITIES: SEE EXHIBIT "A", ATTACHED 9175 4 Encroachment Permit and Agreement Monitoring Well Tf1N-22-2009 12:04P FROM:NATIONAL CITY ENG 6193364397 TO:917606322471 F.8/8 9176. MONITORING WELL INSTALLATION QUESTIONS 1) What is the time of completion of the drilling and well construction? -1w tK_oAys 2) What is the time required to install each well? 6 LtaJ2 Wort t4 2f f J lra\ / LaCar,o'v 3) How long will the wells remain in the street? -2-5 ye- tars (prox) lyvlL� 4) How long will the abandonment of the wells be? (time frame) ,� % t'�AVS 5) How often will the wells be monitored and sampled? Scivli -A/4k m-L/ IC 6) How long will it take to purge and sample each well? 2 - 4 •Rtov .2S 7) Who will be responsible for removing the wells from the public right-of- way and restoring the street? ,�Es r2�Cif /, J E1 /ZeL LAvi iiiL i0 oP- GAL- FoAN A ('MS- tom) //Of MAL.c3 EL LA j 4 Za 22. 'TAnA9 336./ 9 8) Who will be responsible for top of well head adjustments? /Ni✓0vk rr✓E S`e,c-o N C E9 .39 sEo v S'r So T Z Rk,tnI f-i-A5 (A ' / 6c/ti/'Gov c1- Sc c Lev„✓ MO °3 -Z33o or- 3 s'-76“ -rw s is v,,,, s>e2 T1'c psf:4k 1 ovve vF 7+ t c , ✓fly e So-vv pDi . 6 r t W tao n/sv)&/�.41-�e -f/�-r ' (POI) wtl t c_ti ' A- eMA-✓`5' 'TP n 1-7I /C/ !o avA(LiT--L-17._"y personally appeared CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT c� crct r rec� ererc� ccc� erer .& OG,"CI' cr c^.coeccccrtircrec c< erer rercc,ceerecc<' State of California County of On �/ �'?.-4'i before n rthur P. Arqullla, Notary Public Date SCO� D. L,evi�Here Insert Name and Title of the Officer 1 917 7 Name(s) of Signers) OFFICIAL SEAL ANOTARY PUBLICACA FORN AE COMM. NO, 1872932 SAN DIEGO COUNTY MY COMM. EXP. JAN. 7, 2014 Place Nctary Seal Above who proved to me on the basis of atisfactory evidence to be the person(s) whose name( I re subscribed to the within instrument and acknowledged to me that he/they executed the same i hi her/their authorized capacity(ies), and that bjrer/their 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 j an4 an,4i offipi l seal. Signature OPTIONAL SignePbre e \Netery Public Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attache�locu en Title or Type of Document I/f / ' 1d Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Individual Corporate Officer — Title(s): Partner — L. Limited _J General _. Attorney in Fact Trustee Guardian or Conservator Other: Number of Pages: Signer Is Representing: RIGHTTHUMBPRINT OF SIGNER Signer's Name: Individual Corporate Officer — Title(s): Partner — LT Limited 1. General Attorney in Fact 1. Trustee Guardian or Conservator 7 Other Signer Is Representing RIGHTTHUMBPRINT OF SIGNER Top of thumb here x c u. x zc�czu u u ux cc�r� �� x ©2007 National Notey Association • 9350 De Sotc Ace., P.O.8ox 2402 • Chatsworth. CA 91313.2402. wmnv.NationalNotaryorg Item A5907 Reorder: Cal! Toll -Free 1-800-876-6827 ALL PURPOSE ACKNOWLEDGEMENT STATE OF CALIFORNIA COUNTY OF SAN DIEGO } } On May 7, 2012 before me, MICHAEL R. DALLA, City Clerk personally appeared RON MORRISON, MAYOR who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to on the attached instrument, and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person 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 hand and official seal. Signature ichael R. alla — City Clerk 9178 5\tE EN CPS 02390-00voil1i NOT TO SCALE NOTES: 1. Base map and surveyed field points surveyed by Professional Land Surveyor on 11/19/01 and 3/8/11. 2. Former UST System configuration locations are projected and approximte. IP GV PRD \\Pt\0 BV\\-°\NG PR'< 9 N LEGEND PROPOSED GROUNDWATER MONITORING WELL LOCATION RPMS-CA (FORMER E-Z SERVE) GROUNDWATER MONITORING WELL ESTATE OF AGNES BARBER(EAB) GROUNDWATER MONITORING WELL DUAL VAPOR EXTRACTION WELL AND AIR SPARGE WELL (RPMS-CA WELLS) r—I (_ _1 FORMER UST SYTEM FEATURE F�NGEI MUS\G 01; R E' CARP\NG�RRK� NP .o \tY P OP MWW--7A • MONITORING WELL LOCATION DETAIL MAP (MW-7A AND MW-15) FORMER RPMS (E-Z SERVE) LOCATION 100781 1604 E. 4TH STREET NATIONAL CITY, CALIFORNIA 91950 PROJECT NO. 100781-008 FILE NO. I:1WRIoo RPMS1100781VieporWFlgo 1V�� I 118• Solullo ental r nvlr ln nm EXHIBIT A 9180 DEPTH BELOW GROUND SURFACE (FOOT) 1 3' 8-INCH DIAMETER DRILLED BORING 90' 92' 95' 110' NOT TO SCALE �V �II114iv I44 I4ei Ip,OII ji`�.I.I +4.4+,' II`III`4* I�144 ++ "e#4 4.4' GiI;;IoiII 14444144•14I 4.4444/II`41 44444I44I I44I4++, 44.' 44 * 144I4144441 ,4II.4 ��4 I I�I4I4. III +04 4.,""e+f ��444%•• 444.4�y.44 I414I+1" ...4I4P14I I41004,. 4. Q44444.:• 4401•444 4.,4*••• 4/I41i4I4I iiii e • Z • i•.•s•_• -�.f.�. 1# r., .«h#.*. a' a .a `' • ..a =... .**,. mow.+ • 1♦4♦1' •♦1♦i♦h r • '4'a'♦' �1`♦' e♦ a 'f'♦♦a'* •'1.a h ♦' �r'1'♦ *• '.,,... # r ,a *.♦ —r` GROUND SURFACE WATERPROOF VAULT, TRAFFIC RATED CONCRETE SEAL, 3 FEET 4-INCH LOCKING EXPANSION PLUG BENTOITE SLURRY, 87 FEET 4-INCH SCHEDULE 40 PVC,BLANK CASING, 90 FEET BENTONITE PELLET SEAL, 2 FEET 4-INCH SCHEDULE 40 PVC, 0.020-INCH SLOT SCREEN, 15 FEET ESTIMATED DEPTH TO GROUNDWATER -98-100 FEET FILTER SAND, NO. 3 MONTEREY OR EQUIVALENT, 18 FEET 4-INCH PVC END PLUG ESTIMATED TOTAL DEPTH, 110 FEET (BOTTOM OF WELL SET APPROX. 10 FEET INTO THE WATER TABLE) PROPOSED MONITORING WELL CONSTRUCTION DETAILS (MW-7A AND MW-15) FORMER RPMS (EZ-SERVE) LOCATION 100781 1605 EAST 4TH STREET NATIONAL CITY, CALIFORNIA PROJECT NO. 100781-008 FILE NO. i:\Projects\RPMS11007811Reports\Figs Innovative Environmental Solutions EXHIBIT A-1 PRIVATE CONTRACT BOND - CITY OF NATIONAL CITY FAITHFUL PERFORMANCE KNOW ALL MEN BY THESE PRESENTS: THAT Innovative Environmental Solutions of Encinitas, California as Principal, and Western Surety Company a surety authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto CITY OF NATIONAL CITY, CALIFORNIA, in the sum of Two Thousand and 00/100Doliars ($ 2,000.00 ), for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors and assigns, jointly and severally, firmly by these presents. The conditions of the foregoing obligation is such that, whereas the above -bounded Principal is to obtain a drilling permit from the CITY OF NATIONAL CITY, CALIFORNIA, to do and perform the following work, to wit: NOW, THEREFORE, ifthe above -bounden Principal shall faithfully perform said work, then this obligation shall be void; otherwise to remain in full force and effect. SIGNED AND SEALED this 12th day of March APPROVED AS TO FORM: BY: Claudia 'ilva City Mt 20 12 Innovative Environmental Solutions (Name of Principal) By Title: S2 _ i/7140 By: Bart stewart,Attorney-in-Fact (Attach Notary Acknowledgment for Attorney -in -Fact) Address to which notice to Surety should be sent: 1455 Frazee Road, Suite 801 San Diego, Ca 92108 9181 Western Surety Loon any PP T TI PO -VI T? !1 a ; Toni: R 7 NC T. r , i jy� Know Ail hfeo By These Presents, Thai WESTERN SURETY CO:n><1PA]4 Y, a South Dakota corporation; is a duly ore_,ized and existing corporation haying is principal office, in the City of Sioux Falls, and Smote of South Dtco`a and that i1 does by vine of Le SiEn= era id sea] ha=in z—;-ed hereby =ke,: constirune and appoint Scott T Ries, Sharon E Ries, Bari Stewart, [Ti dividually of Encioi CA, its Gun a.d lawful Atorney(s)-in-Fact with full power and authority hereby coe_-t ed to si g,. seal 'id execute far and no ifs behalf bonds, andeit-skil,s and otheroblia_wy instruments of Siri]as nature Tn. IJ1hLLii': d Athounts - and to bind it thereby as fully and to the same extent as if such instruments were sided by a duly authorized of c r of the chi potation ad the its of said Aaorney, pursuant to the authority hereby given, are hereby rshfied and cooftwned. This Power of �,-Oney isu3_ and executedpursuant to cl, byauthority tithe hjt-1 _ 7 ptitiod on [5e reverse hereof, duly adopted, as indicated, by rho shareholders. of the corporation., En Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be sided by its Senior Vice Prasidcot and its coloorate seal to be hereto a ed on this 72nd day of inrwnry, 2010. State of South Dakota County of Mlcoehaana SS WESTERN SURETY COMPAN Paul :if FBrm-Ja_Serial- Vice?resident s. 2010, beforepersonallyCaton PaLl T. Brun t to r ' n � s 220 0;->' cr =emu: -- me, y._ — - -. . � known, who, bc,ng by DO duly svroa, did depose arzd � - � y. that he rcFide in rho City c i1 a F'IIc. i,s'e of Sou . nstn s; insi be is ,7,- Crninr Vice, President of WEST P..N SURETY COMPANY } described - �-�.fY GQA , . ;bed in and which executed the above i ;irusunr that' he bows the seal of said cotporadon; that he seal nixed to the said instrr-neat is sob oaporal..= - sod; chat itwas so `_ red pursuant to authority girao by tie Poad of Directors of said ccra,-tio;i End that he si =d his name the,rote pesuant to lilts ,uthcaity, and _cLrrowled es wire to he the -ct—nd tied of said corporation, My ca nniission expires Nov nber 30, 2012 s D. KRE L 15=5t_ N OrT sY PU_� ,'C -�t C �3 SOUTH DAKO A'l-p CitR,TrTCkT T. h. Nelson, tss� nt Se.....-tary of WESTERN SURETY COMPANY do hereby certify Rini the Power of Attorney here;nabove set fortis is still inn o c and further ,-ty that the 3; 1.-w of *hc CDTOIarIOD nt d on therevetst lneteof is;( l in force l tesanon j,wh -eoc I havehereunto subscribed y e an - �d ..d the seal ofthe said ;ono .Finn this 1��11 cay of , (71 V �/A F"-210-Of-08 `V'0ST; RN SURETY COMPANY 1( Nelsop, Assistant Secretary 9182 !G By -Law 9183 »D 2 a/] yD Sm22E Gk 9«Si 3« 1YCC ANZ This Power 4 Anorney: ;m e7,ealtbd t, and by alithority of foe foliCW9By-Law 'duly adopted % the shanelio1derrn of the Gm Section sybonds, policies, zd & POWersC Attorney,za<6 J zthe wa ss,&ea-au-Lod mw corporate :J&Gw % the President :o, Eat �i4seJ9Oz«= Vice ,<=gsuch oa officers s0Board z z The Poe.oideot Ely Vice Poesiderot il Secretary,zthe iev mz :5 Facta agents who aw have authority eissue n « policies, or lindertaldFlc,3n ere:J W G. ie corporatesEnot necessary for the 6Jany bonds, Plvn«m,. Powersz Attorneyv%» obligationszit,- corporation. =J aiay such o ma:6 _ seFl may be printed by facsimile. 9184 CALIFORNIA : ORNI A T T U T, ,T�..-y��iA �y,�.sF CERTIFICATE OF ACKNOWLEDGMENT State of California County of San Diego On 03 lax), before me, Laura Ashley Aceves, Notary Public (Here insert name and title of the officer) personally appeared Bart Stewart who proved to me on the basis of satisfactory evidence to be the persons} whose name is subscribed to the within instrument and acknowledged to me that 1e he/they executed the same in is authorized capacity(ies), and that by is ter/their signatures) 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. WI>r y hand and official seal. ublic (Notary Seal) 1 ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) El Attorney -in -Fact ❑ Trustec(s) Cl Other LAURA ASHLEY ACEVES # Commission No. 1927951 NOTARY PUBLIC-CALIFORNIA SAN DIEGO COUNTY My Comm. Expires MARCH 7, 2015 • INSTRUCTIONS FOR COMPLETING TIIIS FORM Any acknowledgment completed in California must contain verbiage exactly, as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to he recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the vet -haute u'cee; noi require the notary to do something that is illegal for a nora.ry in Jaiifornia (Le. certifying the auihori=ed capacity' of the signer). Please check the document carefully for proper notarial wording and attach this form if required. State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public)_ • Print the name(s) of document signer(s) who personally appear at the time of notarization Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • the notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form_ • Signature of the notary public must match the signature on file with the office of the county clerk_ • Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document_ • Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i e. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA v 12.10 07 800-873 9865 %NAM NotaryClasses corn 9185, STATE OF SOUTH DAKOTA COUNTY OF MINNEHAHA j ss On this loth day of January personally appeared Paul T. Bruflat officer of WESTERN SURETY COMPANY, a corporation, and the foregoing instrument for the purposes therein contained,' officer. IN WITNESS WHEREOF, I have hereunto set my hand a S. SPETRIK NOTARY PUBLIC cAL � r SEAL SE i SOUTH DAKOTA d � +Sassy �sS55s��< �5�•Sa + My Commission Expires August 11, 2016 STATE OF COUNTY OF On this day of SS ACKNOWLEDGMENT OF SURETY (Corporate Officer) 2012 , before me, the undersigned officer, who acknowledged himself to be the aforesaid that' he as such officer, being authorized so to do, executed by signing the name of the corporation by himself as such nd official seal. ary Public -- South Dakota ACKNOWLEDGMENT OF PRINCIPAL (Individual or Partners) , before me personally appeared known to me to be the individual described in and who executed the foregoing instrument and acknowledged to me that he executed the same. My commission expires STATE OF COUNTY OF On this day of Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) , before me personally appeared who acknowledged himself/herself to be the of a corporation, and that he/she as such officer being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself/herselfas such officer_ - My commission expires C rzs SZ E Q U p v D� C z License or Perm w O Name of Applicant Co Cc b Notary Public Approved this w 0 Ce ro 1:13211a a111131=1113Ell • 11 1 Effectizra DatP=October 1, 2011 T1ny vV� Western SuretyCompany LICENSE AND PERMIT BOND KNOW ALL PERSONS BY THESE PRESENTS: That we, Innovative Environmental Solutions 9186 Bond No 71158768 of Encinitas , State of California as Principal, and WESTERN SURETY COMPANY, a corporation duly licensed to do surety business in the State of California City of National City , as Surety, are held and firmly bound unto the , State of California , as Obligee, in the penal sum of Two Thousand and 00/100 DOLLARS ( $2, 000. 00 lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, firmly by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal has been licensed Faithful Performance Bond by the Obligee. NOW THEREFORE, if the Principal shall faithfully perform the duties and in all things comply with the laws and ordinances, including all amendments thereto, pertaining to the license or permit applied for, then this obligation to be void, otherwise to remain in full force and effect until October 1st , 2012 , unless renewed by Continuation Certificate. This bond may be terminated at any time by the Surety upon sending notice in writing, by First Class U.S. It1ai1 ache Obligee and to the Principal at the address last known to the Surety, and at the expiration "• [" from the 1a::'..1:: :)f c�:-i.. notice, this bond shall 1p50 facto `P.7.._tliltt%L' vnd the Surcry shli er'eu on lr°lieved from any liability for any acts or omissions of the Principal subsequent to said da"t Rate ; Ale number of years this bond shall continue in force, the number of claims made aatthis bondd he number of premiums which shall be payable or paid, the Surety's total limit of 1i6 Ity Mall not be cc unulative from year to year or period to period, and in no event shall the Surety's total 11 .. a& ' *amexceed the amount set forth above. Any revision of the bond amount shall not be fib Dated this loth Form 532-12-2011 day of January 2012 INNOVATIVE ENVIRONMENTAL SOLUTIONS Principal Principal WESTE SURET COMPANY By Paul T. Bruflat, Seliior Vice President, Western Surctu rompai x 9187 y POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: • That WESTERN SURETY COMPANY, a corporation organized and existing under the, laws of the State of South Dakota, and authorized and licensed .to dobusiness in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make, constitute and appoint Paul T. Bruflat of Sioux Falls State of South Dakota , its regularly elected Senior Vice President as Attorney -in -Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, the following bond: One Highway Permi t Ci ty of National City bond with bond number 71158768 for Innovative Environmental Solutions as Principal in the penalty amount not to exceed: $2 .000.00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force, to -wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys -in -Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its January Senior Vice _Press dent with the corporate seal affixed this 10th day of 2012 ATTEST r_- Nelson, Assistant Secretary STATE OF SOUTH DAKOTA 1 COUNTY OF MINNEHAHA } W EST SURE T COMPANY By r..... T. Erufiut.. 5 ,ior Vice Presiden 11414 Lai A,:;.,, Q i is On this 10th day of January , 2012 before me, a Notary Public, personally appeared Paid. T Brufi at and r, NP7 %on who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Senior Vi ce Presi dent and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. +a<, SSS.,..~..s....0..,..~....,,55.. + r D. KRELL s r NOTARY PUBLIC F4s L s s SOUTH DAKOTA s r r +,..SSSSSSS4SSSSSSSS4.'+..SS.., + My Commission Expires November 30. 2012 Form F1975-9-2006 ss Notary Public STATE OF COUNTY OF STATE OF SOUTH DAKOTA} ss COUNTY OF MINNEHAHA ACKNOWLEDGMENT OF SURETY (Corporate Officer) 9188 On this _..i? _rd . day of August 2011 , before me, the undersigned officer, personally appeared Paul T. szvfiat , who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY, a. corporation, and that he as such officer, being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself as such officer. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. +YY4444YYY4Y44YYY YY4YYY4Y+ S. EJCH NOTARY PUBLIC rr SOUTH DAKOTA S i r r Notary Public — South Dakota YYYYY4Y44444Y4YY4YY44Y My Commission Expires February ( 12, 201S (Sss l On this day of ACKNOWTEDGMENT OF PRTNCTPAI. (Individual or Partners) , before me personally appeared known to me to be the individual — described in and who executed the foregoing instrument and acknowledged to me that __ _ he _ executed the same. My commission expires STATE OF COUNTY OF On this day of Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) , before me personally appeared who acknowledged himself/herself to be the of , a corporation, and that he/she as such officer being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself/herself as such officer. My commission expires a E O U VI License or Pe 0 0 0 4, S Name of Applicant to 0 Notary Public Approved thi w 0 v CPL ENGINEERING DIVISION TRUST & AGENCY REVENUE TRANSMITTAL iNew ❑ Existing TIA No. 00 ` LI C I Dale: #7/2®1/( Amount 9189 Verified by: /14-Af tt-i Name of Business/Person Pay ri�g: innD Ua h'Ve. -62 i/ rrn m /Z.9114.1-7-0-743 $ 21�� Engineering Staff Name: Project Name: 44v 11 //z r;a %(�S (2- 01 / / ) Project Address: �'l'r AO_ ,,J ¢"� $! - APN No.(s) Purpose Pery&-orrin c r- AMOUNT�1($) ACCOUNT # DESCRIPTION 2 aid rer / #726-1141 X Trust & Agency Deposit Others: REFUND PAYABLE TO: (if applicable) , /�- ,, / ,�,I p Name & Address AV? C (Jl'.t " j V'Qi �-!�/ c/f f vrie,A /q,'/ y 77. Olt C( 21�G . 76 Z ` r ,5- (1. 9&)2 I certify under the penalty of law that the information submitted is to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. �r G� v ►mil Print Name f%c/ J i Date Engineering Permit No. Final Inspection Date: REFUND Date: Amount Refunded: ($) The sum shall be in the nature of a deposit only and as an advance against the obligation of the developer to pay the city for maps, public improvements, private grading plans, inspections, NPDES reviews, and any expenses provided for under city ordinances. Rev. 07/01/10 9190 CITY OF NATIONAL CITY Finance Department 619 336-4330 National City 2 / 42001 10/20/2011 13:30:24.000 Reg WXPCASHF1 Validation Receipt CHARGES- 726-1141 726114 monitoring wells $ 2000.00 Sub -total $*******2000.00 PAYMENT - Check - 1190 $ 2000.00 innovative environmental Change $**********O.uO THANK YOU! Business Hours: 7:00 - 6:00 Monday through Thursday Closed on Fridays 9191 DEVELOPMENT SERVICES DEPARTMENT r, ENGINEERING DIVISION REVENUE TRANSMITTAL Date: 10/20//i Permit No. 2,Oil." /73 Name of Business/Person Paying: in q ° Ua-,71(VAPN No.(s) Project Name: /14 ! Project Address: Purpose: Staff �l �v 1D4107 At 'e ar -oca Gy7 - e it)lA T&A Cross Reference No. No. Price Total Account Number Record of Survey X $796.00 001-06029-3634 Encroachment Agreement [ X $490.000 r a 001-06029-3634 Enforcement X Various 001-06029-3204 Special Driveway Permit X $368.00 001-06029-3130 Easement Check X $796.00 001-06029-3634 Lot Line Adjustment X $1,259.00 001-06029-3634 Sidewalk, Driveway, Curb Permit X $297.00 001-06029-3130 Deferral X $670.00 001-06029-3634 Sewer Permit X $381.00 001-06029-3125 Flood Hazard Area Permit X $201.00 / 001-06029-3147 Construction Permit (Grading) / X $396.00 39,i 0! 001-06029-3142 Annual Parking District Renewal X $35.00 001-06029-3146 Traffic Impact Study Review <3000 vehicles X $3,416.00 001-06029-3557 Traffic Impact Study Review >3000 vehicles X $6,833.00 001-06029-3557 Rev. 9/27/11 9192 CITY OF NATIONAL CITY Finance Department 619 336-4330 National City 2 / 42000 10/20/2011 13:27:27.000 Validation Receipt Reg WXPCASHF1 CHARGES- 001-06029-3142 EG 2011-173 $ 396.00 001-06029-3634 GF2136 2011-173 $ 490.00 001-00000-3650 ZCLEAR 001-06029-3557 $ 476.00 Sub -total $*******1362.00 PAYMENI- Check - 1189 $ 1362.00 innovative env sol Change $**********0.00 THANK YOU! Business Hours: 7:00 - 6:00 Monday through Thursday Closed on Fridays innovative Environmental Solutions August 22, 2011 City of National City Engineering Division 1243 National City Blvd. National City, CA 91950-4596 (619) 336-4380 RE: IES AUTHORIZED AGENT FOR ENCROACHMENT PERMITTING City of San Diego Representatives, For your records, the name (and contact information) listed below is an authorized agent for Innovative Environmental Solutions (IES) and has the authority to discuss, submit and sign letters, reports, applications, and other documents on behalf of IES and its Clients. Name: Title: Company: Address: Phone: Voice Mail: Fax: Email: Respectfully, Michael T. Davis President, IES Principal Geologist, PG #7400 mdavis@ies.consultants.com Scott D. Levin Senior Project Scientist / Manager Innovative Environmental Solutions (IES) 839 Second Street, Suite 2 Encinitas, CA 92024 (760) 632-2330 (619) 368-7686 (760) 632-2471 slevin cnr ies.consultants.com 9193 ■ 839 Second Street, Suite 2, Encinitas, Ca 92024 • 760.632.2330 FAX 760.632.2471 • www.iesconsultants.com n INNOENV-01 MES ACORDrS, CERTIFICATE OF LIABILITY INSURANCE DATE {MMJDDIWYY)9 6/5/2012 PRODUCER (858) 869-8300 Vanorsdale Insurance Services 6165 Greenwich Drive, Suite 200 San Diego, CA 92122 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 Innovative Environmental Solutions 839 2nd Street 2-B Encinitas, CA 92024 INSURERA Endurance American Specialty Insurance C, INSURER B Oak River Insurance Company 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 ADD INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE JMMJDDM') POLICY EXPIRATION DATE (MMJDDIYYI LIMITS A X GENERAL X LIABILITY COMMERCIAL GENERAL LIAHIL ry ECC10100767603 5127/2012 5127/2013 EACH OCCURRENCE $ 4,000,000 DAMAGE TO RENTED PREMISES (Ea occurence) $ 50,000 CLAIMS MADE X OCCUR MED EXE iAoy one person) $ 5.000 GEN'L X PERSONAL LADY INJURY ^> 4,000,000 GENERAL AGGREGATE S 4,000,000 AGGREGATE LIMIT APPLIES PER PCLICY JECT LOC PRODUCTS - COLA,/OP AGO S 4,000,000 A AUTOMOBILE X X LIABILITY ANY AUIO AL_ OWNEC AUTOS SCHEDULED ALTOS HIRED AUTOS NON -GAINED AUTOS ECC10100767603 512712012 5127/2013 COMB NED SINGLE LIMIT (Ea acod31) 1,000,000 BODILY INJURY (Po, pe,sen) $ BODILY INJURY (Per acLiJen1) $ PROPERTv DAMAGE (Per accident; $ GARAGE LIABILITY ANY AUTO ALTO ONLY- EA ACCIDENT OTHER 11 IAN EA ACC $ AUTO ONLY AGG EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCT BLE RETENTION $'. EACH OCCURRENCE $ AGGREUAI_ $ $ $ B WORKERS COMPENSATION AND 1 EMPLOYERSLIABILITY ' 2200015400111 ANY PROPRIETOR/PARTNER/EXECUTIVE ' OFFICER/MEMBER EXCLUDED? I. yes descnbe under SPECIAL PROMS. ONE baby/ 10I10I2011 1011012012 X CC STATI ER CRY LIMITS TH _ EL EACH .AceID=r r $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 3 1,000,OOD A OTHER Pollution Liability ECC10100767603 5127/2012 512712013 Limit: $4,000,000 Per Occ/Agg DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *Except 10 Days Notice of Cancellation is given for Non -Payment of Premium.* RE: Project- RPMS (E-Z Serve) Location 100781, Project NO. 100781-004. The City of National City and its officers, agents and employees is added as an additional insured in operations of the policyholder as respects to General Liability per form CG20261185 . Primary Wording applies per form FEI-546-ECC-0708. Waiver of Subrogation applies per form WC990110A for Workers Comp. THIS CERTIFICATE CANCELS AND SUPERSEDES THE CERTIFICATE PREVIOUSLY ISSUED ON 06104112.. CERTIFICATE HOLDER CANCELLATION City of National City 1243 National City Blvd National City, CA 91950- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BEFORE THE EXPIRATION MAIL 30 DAYS WRITTEN BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE BBn49 194 ACORD 25 (2001/08) 0 ACORD CORPORATION 1988 Endurance Innovative Environmental Solutions Endorsement Number: 24 Additional Insured — Designated Person or Organization This endorsement, effective 5/2712012 attaches to and lonns a part of Policy Number ECC101007676-03. This endorsement changes the Policy. Please read it carefully. CG 20 26 11 85 In consideration of an additional premium of Applied this endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City ofNational City 1243 National City Blvd National City, CA 91950 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO ES AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. Copyright, Insurance Services Office, Inc., 1984 9195 Endurance Innovative Environmental Solutions Endorsement Number: 15 Automatic Primary and Non -Contributory Insurance Endorsement Designated Work Or Project(s) This endorsement, effective 5/27/2012 attaches to and forms a part of Policy Number ECC 101007676-03. This endorsement changes the Policy. Please read it carefidly. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of an additional premium of $Applied and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party, it is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non- contributory to this insurance. FEI-548-ECC-0708 9196 WORKERS COMFENSAT.ION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10A (Ed 07-07) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be 2.00% of the total policy premium otherwise due on such remuneration. The minimum premium for this endorsement is S350.00 Schedule Person or Organization ALL ORGANIZATIONS FOR WHOM THE WAIVER OF SUBROGATION IS ISSUED Job Description ALL CALIFORNIA OPERATIONS 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 10110/2011 Policy No. 2200015400-111 Endorsement No. 1 Insured INNOVATIVE ENVIRONMENTAL SOLUTIONS (A CORP) Premium $ Insurance Company Countersigned by Oak River Insurance Company WC 99 0410A (Ed 07-07) 9197 RESOLUTION NO. 2012 — 91 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY APPROVING AN ENCROACHMENT PERMIT AND AGREEMENT WITH RESTRUCTURE PETROLEUM MARKETING SERVICES OF CALIFORNIA FOR THE INSTALLATION OF TWO GROUNDWATER MONITORING WELLS, ONE IN THE PARKING LOT OF GRANGER MUSIC HALL LOCATED AT 1604 EAST 4TH STREET, AND ONE IN THE PUBLIC RIGHT-OF-WAY ON PALM AVENUE, 315 FEET NORTH OF 4TH STREET WHEREAS, the Restructure Petroleum Marketing Services of California ("RPMS- CA"), through its contractor, Innovative Environmental Solutions, is seeking an encroachment permit and agreement for the installation of two groundwater monitoring wells, one located in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way on Palm Avenue, 315 feet north of 4th Street; and WHEREAS, the monitoring wells are a requirement of the County of San Diego Department of Health Environment to perform liquid phase hydrocarbons fingerprinting, and to fully assess dissolved -phase benzene in groundwater. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby approves an Encroachment Permit and Agreement with Restructure Petroleum Marketing Services of California ("RPMS-CA"), through its contractor, Innovative Environmental Solutions, for the installation of two groundwater monitoring wells one located in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way on Palm Avenue, 315 feet north of 4th Street, as required by the County of San Diego Department of Health Environment. Said Encroachment Agreement is on file in the office of the City Clerk. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby approves the Encroachment Permit and Agreement with Restructure Petroleum Marketing Services of California for the installation of two groundwater monitoring wells, one in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way located on Palm Avenue, 315 feet north of 4th Street. PASSED and ADOPTED this 1st day of M�c.,�012. on Morrison, Mayor ATTEST: �if/li� M , City Clerk ii is ael R. Dall OVE S TO FORM: Passed and adopted by the Council of the City of National City, California, on May 1, 2012 by the following vote, to -wit: Ayes: Councilmembers Morrison, Natividad, Rios, Sotelo-Solis, Zarate. Nays: None. Absent: None. Abstain: None. AUTHENTICATED BY: RON MORRISON Mayor of the City of National City, California National ational City, California Clerk of the Cit of By: Deputy I HEREBY CERTIFY that the above and foregoing is a full, true and correct copy of RESOLUTION NO. 2012-91 the City of National City, California, passed and adopted by the Council of said City on May 1, 2012. City Clerk of the City of National City, California By: Deputy CITY OF NATIONAL CITY, CALIFORNIA COUNCIL AGENDA STATEMENT MEETING DATE: May 1, 2012 AGENDA ITEM NO. 7 ITEM TITLE: A resolution of the City Council of the City of National City approving an Encroachment Permit and Agreement with Restructure Petroleum Marketing of California (RPMS-CA) for the installation of two (2) groundwater monitoring wells one located at 1604 E. 4th Street at the parking lot of Granger Music Hall and one well in the public right of way on Palm Avenue 315 feet north of 4th Street. PREPARED BY: Mauro Nebreja DEPARTMENT: Engineering PHONE: 336-4395 APPROVE f B EXPLANATION: On behalf of Restructure Petroleum Marketing Services of California (RPMS-CA), Innovative Environmental Solutions is proposing one (1) unit groundwater monitoring well at 1604 E. 4th Street, National City at the parking lot of Granger Music Hall and another one (1) unit in the public right of way on Palm Avenue approximately 316 feet north of 4th Street. An encroachment Permit and an Agreement were signed by Innovative Environmental Solutions on behalf of RPMS-CA, a fee was paid, and a notarize copy of the agreement was submitted with a liability insurance certificate and copies of applicable performance bonds. The documents were reviewed by the Legal Department and staff recommends that Council approve the Encroachment Permit and Agreement. FINANCIAL STATEMENT: ACCOUNT NO. N/A ENVIRONMENTAL REVIEW: N/A ORDINANCE: INTRODUCTION: FINAL ADOPTION: APPROVED: APPROVED: Finance MIS STAFF RECOMMENDATION: Adopt the Resolution. BOARD / COMMISSION RECOMMENDATION: N/A ATTACHMENTS: 1. Resolution 2. Notarized Encroachment Permit and Agreement 3. Exhibit A 4.. Receipt of Fee Paid 4 . Faithful Performance Bonds 5. Insurance Certificate C\ -{\1 RESOLUTION NO. 2012 — RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY APPROVING AN ENCROACHMENT PERMIT AND AGREEMENT WITH RESTRUCTURE PETROLEUM MARKETING SERVICES OF CALIFORNIA FOR THE INSTALLATION OF TWO GROUNDWATER MONITORING WELLS, ONE IN THE PARKING LOT OF GRANGER MUSIC HALL LOCATED AT 1604 EAST 4TH STREET, AND ONE IN THE PUBLIC RIGHT-OF-WAY ON PALM AVENUE, 315 FEET NORTH OF 4TH STREET WHEREAS, the Restructure Petroleum Marketing Services of California ("RPMS- CA"), through its contractor, Innovative Environmental Solutions, is seeking an encroachment permit and agreement for the installation of two groundwater monitoring wells, one located in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way on Palm Avenue, 315 feet north of 4th Street; and WHEREAS, the monitoring wells are a requirement of the County of San Diego Department of Health Environment to perform liquid phase hydrocarbons fingerprinting, and to fully assess dissolved -phase benzene in groundwater. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby approves an Encroachment Permit and Agreement with Restructure Petroleum Marketing Services of California ("RPMS-CA"), through its contractor, Innovative Environmental Solutions, for the installation of two groundwater monitoring wells one located in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way on Palm Avenue, 315 feet north of 4th Street, as required by the County of San Diego Department of Health Environment. Said Encroachment Agreement is on file in the office of the City Clerk. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby approves the Encroachment Permit and Agreement with Restructure Petroleum Marketing Services of California for the installation of two groundwater monitoring wells, one in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way located on Palm Avenue, 315 feet north of 4th Street. PASSED and ADOPTED this 1st day of May, 2012. ATTEST: Michael R. Dalla, City Clerk APPROVED AS TO FORM: Claudia Gacitua Silva City Attorney Ron Morrison, Mayor MONITORING WELL ENCROACHMENT PERMIT AND AGREEMENT The City of National City hereby grants an Encroachment Permit to the undersigned, Restructure Petroleum Marketing Services of California (RPMS-CA) (hereinafter referred to as "PERMITTEE") 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 PERMITTEE. 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 PERMITTEE's real property that may be benefited by the installation and maintenance of the encroachment. Upon request by CITY, PERMITTEE 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 PERMITTEE 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 may cause such removal or relocation to be done at PERMITTEE's sole cost 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. PERMITTEE 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, VII" 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, PERMITTEE shall furnish CITY a certificate of insurance with all required endorsements evidencing the coverage required by this section. Should PERMITTEE 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. 8. 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 2 Encroachment Permit and Agreement Monitoring Well 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 any City right of way and easements, 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 any City right of way and easement, and for subsequent adjustments. 14. All operations conducted by the PERMITTEE 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 all 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 CITY'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 3 Encroachment Permit and Agreement Monitoring Well 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 Ron Morrison, Mayor PERMITTEE: Restructure Petroleum Marketing Services of California (RPMS-CA) c/o Innovative Environmental Solutions (IES) Entity/Company Scott D. Levin / Sr. Project Manager Name & Title ATTACH NOTARY CERTIFICATION FOR THE NAME OF PERMITTEE SHOWN ABOVE. USE CALIFORNIA ALL PURPOSE ACKNOWLEDGEMENT NOTARY ONLY. PERMITTEE/APPLICANT INFORMATION: Scott D. Levin Mailing Address: Person in Responsible Charge 839 Second Street, Suite 2 (619) 368-7686 24/7 Phone Number Encinitas, CA 92024 Innovative Environmental Solution (IES) Firm Name 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 4 Encroachment Permit and Agreement Monitoring Well CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of Ca pia County of On / personally ap.eared } Arthur me, P. Arquilla, Notary Public Here Insert Name and Title al the Officer Names) of Signers) OFFICIAL SEAL P. AQUILLA N RARY THUUB 1C-R LFORN A COMM. NO. 1872932 SAN DIEGO COUNTY MY COMM. EXP. JAN. 7, 2014 Place Notary Seal Abo,e who proved to me on the basis of satisfactory evidence to be the person(s) whose name(yli:re subscribed to the in instrument and acknowledged to me that e/they executed the same L his er/their authorized apacity(ies), and that b hiss er/their 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. Signature OPTIONAL Though the information below is not required by law, it may prove valuable 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: Soner(s) Other Than I'iamed Above: Number of Pages: Capacity(ies) Claimed by Signer(s) Signer's Name: Individual - Corporate Officer — Title(s): Partner — ❑ Limited General Attorney in Fact Trustee - Guardian or Conservator - Other: Signer Is Representing: RIGH[THUMBPRIrfr OFSIGNER Signer's Name: Individual Ei Corporate Officer — Title(s): ❑ Partner — 11 Limited ❑ General Attorney in Fact -r Trustee Guardian or Conservator Other Signer Is Representing: RIGHTTHUMBPRINT • OFSIGNER - Too of thumb here ,,,r=0„,�'�z'., ra2007Nanonal Notary Assocmtion• 93S0 Oe Solo AwPO Box 2-C2.Cn snorth.CA9,313-2402- wwwNationalNotary org ttemr590r ReordecCa!ITou-tree 1-8W-6/6-6827 5 STATE OF SOUTH DAKOTA l 55 COUNTY OF MINNEHAHA I ACKNOWLEDGMENT OF SURETY (Corporate Officer) On this —23rd day of August 2011 , before me, the undersigned officer, personally appeared Paul T. Bruf 1at , who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY, a corporation, and that he as such officer, being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself as such officer. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. • S. ETCH ✓ • NOTARY PUBLIC — r SOUTH DAKOTA 5 rr • ' f Notary Public — South Dakota My Commission Expires February 12, 2015 STATE OF SS COUNTY OF ACKNOWLEDGMENT OF PRINCIPAL (Individual or Partners) On this day of , before me personally appeared known to me to be the individual . described in and who executed the foregoing instrument and acknowledged to me that he executed the same. My commission expires STATE OF COUNTY OF On this day of Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) , before me personally appeared who acknowledged himself/herself to be the of , a corporation, and that he/she as such officer being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself'herself as such officer. My commission expires 1✓ E 0 U DL cu License or Permit No. E-� z U id 0 CO Name of Applicant a v Notary Public Approved this 6 POWER OF ATTORNEY FOR THE MANAGEMENT OF CLAIMS TO THE CALIFORNIA UNDERGROUND STORAGE TANK CLEANUP FUND I, Jack Ceccarelli. President of Restructure Petroleum Mark( ng Services of California, Inc_ located at 9519 E. M L King Boulevard, Suite 100, "tampa, Florida 33610 appoint Noel Shenoi ofCalClean Inc_, 3002 Dow Avenue, Suite 142, Tustin, CA 97780 and Michael Davis of Innovative Environmental Solutions, Inc_, 839 Second Street, Suite 2, Encinitas, CA 92024 and Joseph Schaaf ofGeoEnviro Services, Inc., 5529 Kailas, Ventura, CA 93003 and Rafael Gallardo of Gallardo & Associates, Inc. 304 Belle Court, El Dorado Hills, CA 95762 as my agent (attorney -in -fact) to act for me in any lawful way by signing, submitting, or receiving all documents necessary to file my claims to, and to endorse checks from, the Underground Storage Tank Cleanup Fund for reimbursement of costs related to work performed by CalClean Inc., Innovative Environmental Solutions, Inc., GeoEnviro Services, Inc, or Gallardo &_ Associates, Inc. and their subconti actors, in response to petroleum releases at the sites listed in Attachment 1. This power of attorney is effective immediately and will continue until it is revoked, unless I direct otherwise on the line. below. If I have designated more than one agent, the agents are to act separately This power of attorney is governed by the Power of Attorney Law, California Probate Code Section 4000 et seq. I agree that any third party who receives a copy of this document may act under it. Revocation of the power of attorney is not effective as to a third party until the third party has actual knowledge of the revocation. I agree to indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney. Signed day off) 4.144. , 2008 (flat ante) / eaf9 tf lalmanr's till identification numbe.: SL m- Stare of � •�a._-- County of A/aw State of Florida County of Hillsborough The forgoing instrument was acknowledged before me this 30th day of Jan ary, 2008 by Jack Ceccarelli as President of RPMS CA, wwo is personally known to rYre. /11. %Jean M. Subecz, Notary Public Commission #00698012 The Claimant must attach a certificate of acknowledgement of notary public in compliance with Section 1189 of the Civil Code or other applicable law_ fSy accepting or acting tinder the appointment, the agenr assumes the fiduciary and other legal responsibilities of an agent. Noel Shenoi Michael Davis' Joseph Schaaf Rafael Gallardo (Sa�{,rjature ormWn1,.im-AcQ -/\ awn: _jrrfaori e 01 006mcy lacy tf0.7-t+ ,I Z (Pho+:c Nun,6cc) (Phone Nullbc6 <jl• I((- >- (Pt,n,„ Numh.rl (Pharr: Nuo tool NOTARY PUBLIC -STATE OF 1T,ORLDA "'''• Jean M. Subecz ;Commission #DD698012 Expires: JULY 26,2011 BONDED TT4tti ATLAITI IC BOND'.NG CO., INC Innovative Environmental Solutions August 22, 201 I City of National City Engineering Division 1243 National City Blvd. National City, CA 91950-4596 (619) 336-4380 RE: IES AUTHORIZED AGENT FOR ENCROACHMENT PERMITTING City of San Diego Representatives, For your records, the name (and contact information) listed below is an authorized agent for Innovative Environmental Solutions (IES) and has the authority to discuss, submit and sign letters, reports, applications, and other documents on behalf of IES and its Clients. Name: Title: Company: Address: Phone: Voice Mail: Fax: Email: Respectfully, Michael T. Davis President, IFS Principal Geologist, PG #7400 mdavisnr ies.consultants.com Scott D. Levin Senior Project Scientist / Manager Innovative Environmental Solutions (IES) 839 Second Street, Suite 2 Encinitas, CA 92024 (760) 632-2330 (619)368-7686 (760)632-2471 slevin()ies.consultants.com ■ 839 Second Street, Suite 2, Encinitas, Ca 92024 • 760.632.2330 FAX 760,6.32.2471 • www.iesconsultants.corn ■ 8 1.4 JfiN-22-2009 12:04P FROM:NATIONAL CITY ENG G193364397 TO:917606322171 P.8/8 MONITORING WELL INSTALLATION QUESTIONS I) What is the time of completion of the drilling and well construction? -7— i 4kI t< QA/S 2) What is the time required to install each well? )- 8 t aJ'2 1At?14 24--f pew ' • Lock-r oAJ 3) How long will the wells remain in the street? -2-5 4e Ars Norox / 1,✓t�lL� 4) How long will the abandonment of the wells be? (time frame) ,.5 7 VI- 4) 5) How often will the wells be monitored and sampled? $ i14 -414A/UA L 6) How long will it take to purge and sample each well? Z - q w f S 7) Who will be responsible for removing the wells from the public right-of- way and restoring the street? EST2✓Grf)2E fET tc.LEi/A4 /141z6Z ri 0P- CALi FoANLA (kV -�J //61 MA-e_Ci EG LA 12J-9 7-4 2 2 . TAnAe z1 f L 336 r 9 8) Who will be responsible for top of well head adjustments? Jnii✓c vk r (v6 r�N12 o.N .lAE�--1 '�/d� L � rjt- I-) o ,v S C=E S) g3oi .SEc o� a 5-r / <t.) - iC[[;t A/ 1 -i (',4 9 Zo'Z �IKJ Gc�,� ra c- r 5 rr� Lev, / ( o04 '3 z - Z33c r- -nos ,S i/n19?XL 1i1iE-PSEfZer10,4,/ UF-'- Q1 3n •'py+ . 6 i20r/Mr,✓-74L 7r/ (To-0 /in y' 64,1„wto -WC r,4 Artt-?`L.cy 9 CITY OF SAN DIEGO GpoaS- C cc\ cn CITY OF SAN DIEGO 4 4, s_4,1, ii II 1 i i s t El Torn \ • • • Production Wells Paradise Valley \ i \ Academy 1 Hospital i _ _:\ \ .-- — - EAB SITE [E-Z SERVE SITE NATIONAL CITY 0•\ REFERENCE NATIONAL CITY CALIF 7.5' QUADRANGLE 1967, PHOTOREVISED 1975 /' NAMED / UNNAMED SURFACE AND/OR CHANNELED WATERCOURSE (USGS, 1975) 0 1 INCH , $000 F EC! VICINITY MAP FORMER RPMS (E-Z SERVE) LOCATION 100781 1604 E. 4TH STREET NATIONAL CITY, CALIFORNIA 91950 PROJECT NO. 100781-008 FILE NO. i:\Projects\RPMS11007811Rpts\Figs Innovative Environmental Solutions EXHIBIT A n FORMta 5'' c FR" NOT TO SC AL F NOTES: 5a \ •AI ^^� \ \\\ \\ \\�' \ Y ESTATE CF AGNES BARBELL(LAO \ \ \ \ GHIJIINOWATER MCN. TOR,. WEE" 0 \ Q z \\ \.� r.� A \ r L J iGHMEH IIST S�'EM FEP iL11E I' A a 0.0 V O P nR �v \ \'R GE \ \ \TApo�P1 d v'✓ j�" VvV\A \ d 1 \ v H Pls AV SAAi ENCZ v PZY)V�V s�MSS �Z A D\ 1 A rl','..NC vRC\V\ 11 k t S�RV Ei \ o \ ��, %y 2 G TO ';L 6i ,V A\� A\ ,q' �a ,yPMS gCy�p;, -� \\ y \ o V 85 MIn(_7A Case map and S. eyea fats polrls surveyed N-Aolest cl•al Luna Sur"eyo on 11, a Forme.' UST Syalerrl Con9 gulallon lDea(lons are pro,ecled and approxlIrl le, I GEND _ PROPOSEC G0.JVNOWATER NONI TRAiNG WELL LOCATION 9 RPMS.".A;FORMER E•S SERVE; C ROJNLAPTER MONITOR.. WELL _A_ cuA" VAPOR EOTRACO ON WELL AND AIR SPARSE WELL ,P'MS•CA AL LAS; V AA vV AA rV v 5 \ \\ \\ \, N ) �� I \ 1'V A vf �1 A�' y \A \ 'S\J vv`vAVvA'�\' \ 5C /� \ v v 1 V/ S..ee' o�o vvvvv v `i/ '/F0�oa i \ , /� \\ uV L9 REc\Of V`t, MONITORING WELL LOCATION DETAIL MAP (MW-7A AND MW-15) FORMER ROMS IE•Z SERVE) LOCATION IC0781 1604 E, 4TH STREET NATIONAL CITY, CALIFORNIA 9'950 PROJECT NO. lOJ18'.Cpd FILE NO. IPICIeC15IRPMS\' DC''S' mR pc 51FI nos VOIlE E0Vl1105$ ry101 ��.�. }i aelullonl EXHIBIT A-1 DEPTH BELOW GROUND SURFACE (FOOT1 t 3' 8 INCH DIAMETER DRILLED BORING 90' 92' 95' 110' NOT TO SCAT F PROPOSED MONITORING WELL CONS IRUCTION DETAILS (MW-TA AND MW-15) FORMER RPMS (EZ-SERVE) LOCATION 100781 1605 EAST 4TH STREET NATIONAL CITY, CALIFORNIA GROUND SURFACE WATERPROOF VAULT TRAFFIC RATED CONCRETE SEAL, 3 FEET - 4-INCH I OCKING EXPANSION PLUG BENTOITE SLURRY, 87 FEET 4-INCH SCHEDULE 40 PVC BLANK CASING, 90FEET BENTONITE PELLET SEAL, 2 FEET 4-INCH SCHEDULE 40 PVC, 0 020-INCH SLOT SCREEN, 15 FEET ESTIMATED DEPTH TO GROUNDWATER -98-100 FEET FILTER SAND, NO 3 MONTEREY OR EQUIVALENT, 18 FEET 4-INCH PVC END PI ITC ESTIMATED TOTAL DEPTH, 110 FEET (BO FTOM OF WELL SET APPROX 10 FEET INTO FHC WATER TABLE) PROJECT NO 100781-008 FILE NO i:lProjects\RPMS110078l\Reports\Figs Innovative EXHIBIT Environmental G A^n Solutions 12 DEVELOPMENT SERVICES DEPARTMENT ENGINEERING DIVISION REVENUE TRANSMITTAL Date: 1969 / Name of Business/Person Payin : /%7/7DUC-`7 11 (V6/� 'APN No.(s) Project Name: J %'(/2 war f ntit --8-4meit/01., j eyj Project Address: - a"- Y< 4/07Ave ZO//- /73 Purpose: Staff At_e_thr74; Permit No. re e T&A Cross Reference No. No. Price Total Account Number Record of Survey X $796.00 �1 001-06029-3634 Encroachment Agreement / X $490.00 19 1 a 001-06029-3634 Enforcement X Various 001-06029-3204 Special Driveway Permit X $368.00 001-06029-3130 Easement Check X $796.00 001-06029-3634 Lot Line Adjustment X $1,259.00 001-06029-3634 Sidewalk, Driveway, Curb Permit X $297.00 001-06029-3130 Deferral X $670.00 001-06029-3634 Sewer Permit X $381 00 001-06029-3125 Flood Hazard Area Permit X $201.00 001-06029-3147 Construction Permit (Grading) / X $396.00 39‘2; 001-06029-3142 Annual Parking District Renewal X S35.00 001-06029-3146 Traffic Impact Study Review <3000 vehicles X $3,416.00 001-06029-3557 Traffic Impact Study Review >3000 vehicles X $6,833.00 001-06029-3557 Rev. 9/27/11 13 Plan Copy Service X $21.00 Engineering Compliance Fee X $553.00 Investigation Fee X $1 70.00 Utility Company Permit Fee X $512.00 Traffic Control Plan Check / X $476.00 Construction Fines & Penalties X Various Transportation Permits X $90/$16 Sale of plans & specifications X Various Storm Water Fee X Various Copies (first page) X $1.00 Copies, additional page, standard 81/2x11 Copies, additional page, color, 8 1/2x11 Copies, additional page, Oversize, standard Copies, additional page, Oversize, color 001-06029-3634 001-06029-3634 001-06029-3634 001-06029-3160 001-06029-3557 001-06029-3204 001-06029-3144 001-06029-3528 001-06029-3547 001-06029-3634 $0.15, X each 001-06029-3634 $0.25, X each 001-06029-3634 $.50, X each 001-06029-3634 $1.00 X each 001-06029-3634 Tot.! Transmitted Rev. 9/27/11 14 CITY OF NATIONAL CITY Finance Department 619 336-4330 National City 2 / 42000 10/20/2011 13:27:27.000 Validation Receipt Reg WXPCASHF1 CHARGES- 001-06029-3142 EG 2011-173 $ 396.00 001-06029-3634 GF2136 2011-173 $ 490.00 001-00000-3650 ZCLEAR 001-06029-3557 $ 476.00 Suh-total $****x**1362.00 PAYMENT - Check - 1189 innovative env so! $ 1362.00 Change $**********0.00 THANK YOU! Business Hours: 7:00 - 6:00 Monday through Thursday Closed on Fridays 15 PRIVATE CONTRACT BOND - CITY OF NATIONAL CITY FAITHFUL PERFORMANCE KNOW ALL BY THESE PRESENTS: THAT Innovative Environmental Solutions of Encinitas, California as Principal, and Western Surety Company a surety authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto CITY OF NATIONAL CITY, CALIFORNIA, in the suin of Two Thousand and 00/1001aollars ($ 2,000.00 ), for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators, successors and assigns, jointly and severally, firmly by these presents. The conditions of the foregoing obligation is such that, whereas the above -bounded Principal is to obtain a drilling permit from the CITY OF NATIONAL CITY, CALIFORNIA, to do and perform the following work, to wit: NOW, THEREFORE, if the above -bounden Principal shall faithfully perform said work, then this obligation shall be void; otherwise to remain in full force and effect. SIGNED AND SEALED this 12th day of March 20 12 APPROVED AS TO FORM: BY: Claudia Alva City Atto Innovative Environmental Solutions (Name of Principal) By: Title: St _ r//< } 71.1 U Western Surety Company — (Surety), ) B y: Bart Stewart,Attomey-in-Fact (Attach Notary Acknowledgment for Attorney -in -Fact ) Address to which notice to Surety should be sent: 1455 Frazee Road, Suite 801 San Diego, Ca 92108 N 16 cstern Surety Compa POWER OF ATTORNEY ?-PFOIN'IFZG EYDIV, I UAL - A r A1 TORIVi{,Y-IN-F.zCi ow AA i fea By These P, vrn is, inat V t T£_ RN SUDSY COr✓PAN f, a San- 6avin� its dnci� al oi; � D�ota co, or_; , P P �ce � +�e City e= SIOL; F u� � �o.: is a du}y o-_�;,>ed hsvin idsstiz' e ?Ad appoi�l �- nd Strst DPSou�S D�o� a� that it dots by vi-uc of `uz si.no re _�d d : sa g corparoon - - °eJ h-an iced 6zv�bv SScuii T Rie.s.Sha_on .�•-. _�_�s. tea;-E.:3�eirar.I�dir,�lt,ali D, Clll,, 1;A IiS tfli?p�d I`c'NPl1 ,iOnc �- ' d s C odie s) L t S ?I p ti Lod El ori'y h h by cou�'-id to u i _ r o61i:-to, Ivi,t„- _�d a�eu - >'� r,��orsl _ili;:_,,1.� aFor �dooiis6uh�ibooris, in d_ial[�lio�ri -- •TtOlLrii avd to hind it L`cr by us folly sdid e the. 'Ed-oe todsent �s i-.o�n ihst;nnzoES w:_z ii-D ,16y 3 dui Acuney, pursuant to'hz zuthGFity i,,repy iveo, e hochhy rad_i_d sohd ca,l.' ms: i ILSOn JOi-;c,.0 eitcsod_1, yoo j=1(Csa acts Oi Bald his Po' of ' ,ar.;y is �;ds �de��cutuJyus�ai'b dbya�soc,iyo�fsho Ia.�Poi��-do�.od5�fzy_,� the. s� oholdas zih„ ccnt o/ � don hot lkl�nas Fr'hr„ai VJ'S fir] C'0*[�� b,-O IS&j op this 2dd yo-t-, f7,)010, •��N s'otso. UcSc:. iS i, hZ oi.77,17.1Jy Ito Sthior'i1G>>.ylt: ]f sod ii �ClD Jr2` Sc^j i0 VVFSTEN D{Jr Site of Sous OckoLa County ='i ; ;1 P _1 N ❑ y of Jtau-,s, 0, Fi, � °-' i r chho 'ill � 6d rc9T I i .a,. L y JI S-0 _� F I1 '-'l , Lg -'c (i��., Nhp 1'l� �U'I ,� d ��11Lla t_i `_�Lr /iF ! Iv 'J t d it :7,j SO i '- Ili J, i ;c _f -d d ,c ,1 to 7J � v > Id -�iC2 -n �y r Poold i u, f - �.- i ij i . _ �7 l _ Seri ]l - f =:ow) : o ttic Ll id P - n_ use F 1�0, �d-�„�c,a��_ �u-„�IiPel.no::ry.�Id '7y cor.,asion=xpi-es (JO->.,n„r 30, )01 C^ rfFri_gr C �rnT J al l q b .y OC r - Y lal ST R:''d SfJP= : Ffr r A/Jo-, 4 17 r 2tc1 (�L-iii 1., tJ.,Is don .;>J=-t Cf�: CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of San Diego On before me, Laura Ashley Aceves, Notary Public (Here insert name and title of the officer) personally appeared Bart Stewart who proved to me on the basis of satisfactory evidence to be the person(s) whose name is subscribed to the within instrument and acknowledged to me that they executed the same in is authorized capacity(ies), and that by pis 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. ty hand and official seal. ubtic (Notary Seal) LAURA ASHLEY ACEVES 1 Commission No. 1927951 "•' t NOTARY PUBLIC-CALIFORNIA i" �=am % My Comm E*pues MARCH 7, 2015 ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must cantatn rerhiage- exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document The only exception is if a document is to be recorded outside of Cali)ornia. in such Instances. any- (tfternat(re acknouledgrnenr verbiage ay may he printed on such a document so long as the verbiage does not require the natal-) - to do something that is illegal for a notary to [ alilotn(a (i e- certgy Mg the arthort=ed capacity of the stgmuj� Fiecue check the document carefully for proper notarial hording and attach this fbrtn if required State and County information must be the State and County there the document Aga -torts) personally appeared hefore the notary public for acknowledgment. Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. The notary public must print his or her name as it appears within his or her cmmittission fotlowed by a comma and then your title (notary public). • Print the name(s) of document signer(s) oho personally appear at the time of notification • Indicate the correct singular or plural forms bi crossing off incorrect torts (l.e. heishe )ley; is fate ) or circling, the correct form,. Failure to correctly indicate this mfwmatton may lead to rejectmn of document recording Tire notary seal impression must be clear and photographically reproducible. Impression mutt not carer toot or Imes. It seal impression smudges, re -scat if a sufficient area pen 015 tithe( wise complete a different acknowlcdznnent form. Signature of the notanv public must match the signature on file with the office of the county clerk Additional Information is not required bit( could help to ensure this ackua+led intent is not misused or attached to a dal -event document Indicate title sr type of attached document, number of pages and date indicate the capacity claimed by the signer If tie claimed capacity is a corporate °Ricer, indicate the title (i e CFO, CFO, Secretary 1. • Securely attach this document to the signed document DESCRIPTION OF THE ATTACHED DOCUMLNI' (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date turn) If' tormation) CAPAC[TY CLAIMED tit' THE SIGNER ❑ Individual (s) CI Corporate Officer - (Tate) Partner(s) El Attorney -an -Fact Li Trustee(s) ❑ Other z 0 c) 1 2008 Version CAPA c I 10 0 800-873 -)8b? ussn NotarsClasses tom 18 A Effective Date: October 1, 2011 OD% Western Surety Company LICENSE AND PERMIT BOND KNOW ALL PERSONS BY THESE PRESENTS: Bond No 71158768 That we, Innovative Environmental Solutions of Encinitas , State of .California , as Principal, and WESTERN SURETY COMPANY, a corporation duly licensed to do surety business in the State of California , as Surety, are held and firmly hound unto the City of National City State of California , as Obligee, in the penal sum of Two Thousand and 00/100 DOLLARS ( $2, 000.00 ), lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, firmly by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal has been Licensed Faithful Performance Bond by the Obligee_ NOW THEREFORE, if the Principal shall faithfully perform the duties and in all things comply with the laws and ordinances, including all amendments thereto, pertaining to the license or permit applied for, then this obligation to be void, otherwise to remain in full force and effect until October 1st 2012 , unless renewed by Continuation Certificate. This bond may be terminated at any time by the Surety upon sending notice in writing, by First Class U.S. Mail to the Obligee and to the Principal at the address last known to the Surety, and at the expiration of thirty iu,4 `3 Y i_ays from the mailing of said notice, this bond shall ipso facto terminate and the Surety shall 4hereupoki b€`relieved from any liability for any acts or omissions of the Principal subsequent to said daFe, llgatcf[ess,'oe number of years this bond shall continue in force, the number of claims made ag. ain ,ghis bon,°�ap dhe number of premiums which shall be payable or paid, the Surety's total limit of liability shall not be cainulative from year to year or period to period, and in no event shall the Surety's total lidbclify,�fur�aI<claii s,=exceed the amount set forth above. Any revision of the bond amount shall not be a R cum1j' Dated this loch day of January 2012 INNOVATIVE. ENVIRONMENTAL SOLUTIONS By SURET Principal Principal COMPANY Paul T Bruflat, Se for Vice President Elf Form 5.37-12-7011 19 Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: _ . That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make, constitute and appoint Paul T. Bruflat of Sioux Falls State of South Dakota , its regularly elected Senior Vice President , as Attorney -in -Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, the following bond. One Highway PCrtnit City of flat inna1 City bond with bond number 71158768 for Innovative Environmental Solut ions as Principal in the penalty amount not to exceed: $2 . 000 00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force, to -wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys -in -Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Sent or Vi cP_President-__ with the corporate seal affixed this 10th day of 2012 ATTEST . Nelson, Assistant Secretary STATE OF SOUTH DAKOTA 1 SS COUNTY OF MINNEHAHA On this _____101h day of January 2 Paul ._T___lirn Flat and who, being by me duly sworn, acknowledged that they signed the above and Assistant Secretary, respectively, of the said WESTERN SURETY voluntary act and deed of said Corporation. {•SS,,<, ,,,,yb,,,4,,-,b.,&,, ,,Sy9',<,'-, 4 r D. KRELL r s SE NOTARY PUBLIC SE t $ r SOUTH DAKOTA r r r f ,,5,;s,,, -,s.,ss,,a.,,,,, •,,,,,Ssv + My Commission Expires November 30, 2012 Form F1975-9-2006 January WEST. jISURETCOMPANY By Paul T- Bruflat, Slnior Vice President 7sia 012 before me, a Notary Public, personally appeared NeLson Power of Attorney as Senior Vice Pre.s i dent - COMPANY, and acknowledged said instrument to be the Notary Public t • 20 CAIIFOM NA>eIONWEITV ENGINEERING DIVISION TRUST & AGENCY REVENUE TRANSMITTAL iNew LI Existing T/A No. 00 t19 I. I 7�� Verified by: /Y(. 1V �%A' /G/ Date: /19 2Ei/`( AmounC $ 2 ^� Engineering Staff Name: . pr Name of BusinessiPerson Paying: Mn a va. h'Ve -f UI fry? Sz9 /4-74 Project Name: Project Address: APN No,(s) Purpose ,ll4!!klr/OJ (2- leis un' 77) pq. M- zrc si ce AMOUNT ($) ACCOUNT # DESCRIPTION OA lip #726-1141 >< Trust & Agency Deposit Others: REFUND PAYABLE TO: (if applicable) , //717 o Ua Ve LI/7Th07a1- /c.7/7-- g_91 '` s( 7'6. ()A 9 >? Name & Address I certify under the penalty of law that the information submitted is to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Print Name /o/2c/1, SIGNATURE Date Engineering Permit No. Z(3/(- (,3 Final Inspection Date: REFUND Date: Amount Refunded: ($) The sum shall be in the nature of a deposit only and as an advance against the obligation of the developer to pay the city for maps, public improvements, private grading plans, inspections, NPDES reviews, and any expenses provided for under city ordinances. Rev. 07/01/10 21 CITY'CF NATIONAL CITY Finance Department 619 336-4330 National City 2 / 42001 0/20/2011 13:30:24.000 Reg WXPCASHF1 Validation Receipt CHARGES- 726-1141 726114 monitoring wells $ 2000.00 Sub -total $*******2000.00 PAYMENT - Check - 1190 $ 2000.00 innovative environmental Change $**********0.00 THANK YOU! Business Hours: 7:00 - 6:00 Monday through Thursday Closed on Fridays ACORD- CERTIFICATE OF LIABILITY INSURANCE INNOENV-01 MES PRODUCER Vanorsdale Insurance Services 19 Murphy Canyon Road, Suite 510 Diego, CA 92123 INSURED (858) 541-2900 Innovative Environmental Solutions 839 2nd Street 2-B Encinitas, CA 92024 DATE (MM!DD/YY(Y) 6/14/2011 THIS CERTIFICATE iS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERT FICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A Endurance American Specialty Insurance INSURER B. Oak River Insurance Company INSURER C. NAIC # INSURER D. INSURER E: COVERAGES NAMED ABOVE FOR THE ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICHO(THIS CERTIFICATENOTWITHSTANDING-- MAY BEISSUEDDINGI OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ,40D'L LTR N$RD TYPE OF INSIIRANCP POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY1 POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A X GENERAL X LIABILITY EACH OCCURRENCE $ 4,000,000 COMMERCIAL GENERAL. LIABILITY ECC10100767602 5/27/2011 5/27/2012 DAMAGE IOKENIED X PREMISES (Fa neLageoee) $ 50,000 CLAIMS MADE I I OCCUR MED EXP (Any one person) $ 5,000 4,000,000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 4,000,000 GENT X AGGREGATE LIMIT APPLIES PRO- I PER. PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY JECT I LOC A AUTOMOBILE LIABILITY ANY AUTO ECC10100767602 5/27/2011 5/27/2012 COMBINE (a acdden0 SINGLE LIMIT $ 1,000,000 _ X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BOX dent)INJU (Per accident) (Per accident) $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR L_ l CLAIMS MADE AGGREGATE $ $ D DEDUCTIBLE $ RETENTION B WORKERS COMPENSATION rms.. EMPLOYERS' LIABILITY Y I TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED, 2200015400101 10/10/2010 10/10/2011 EACH ACCIDENT $ 1,000,000 If yes, describe under CI. DISEASE - EA EMPLOYEE $ 1,000,000 SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 k OTHER Pollution Liability ECC10100767602 5/27/2011 5/27/2012 Limit: $4,000,000 Per OcclAgg lESCRIP DON OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS Except 10 Days Notice of Cancellation is given for Non -Payment of Premium.` E: Project- Former RPMS (E-Z Serve) Location 1008002, IES Project No. 100802-004. The City of National City and its officers, agents and nployees is added as an additional insured in operations of the policyholder as respects to General Liability per form CG20261185 . Primary ording applies per form FEI-548-ECC-0708. Waiver of Subrogation applies per form WC990110A for Workers Comp. 'COTIFIC ^ ATE HOLD CANCELLATION City of National City 1243 National City Blvd National City, CA 91950- 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 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 3ORD 25 (2001/08) 23 ©ACORD CORPORATION 1988 Endurance Innovative Environmental Solutions Endorsement Number: 23 Additional Insured — Designated Person or Organization This endorsement. effective 5127/2011 attaches to and forms a part of Policy Number ECC1010.07676-02. This endorsement changes the Policy. Please read it carefully. CG 20 26 11 85 In consideration of an additional premium of $Applied, this endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of National City 1243 National City Blvd National City, CA 91950 (If no entry appears above; information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. Copyright. Insurance Services Office, Inc.. 1984 24 Innovative Environmental Solutions Endurance Endorsement Number- 15 Automatic Primary and Non -Contributory Insurance Endorsement Designated Work Or Project(s) This endorsement, effective 5/27..12011 attaches to and forms a part of Policy Number EC 101007676-02. This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organizations) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract In consideration of an additional premium of $.- plied and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non- contributory to this insurance FEI 548-ECC-0708 25 • WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10A (Ed 07-07) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be 2.00 % of the total policy premium otherwise due on such remuneration. The minimum premium for this endorsement is $ 35n nil Schedule Person or Organization Job Description ALL ORGANIZATIONS FOR WHOM THE WAIVER OF SUBROGATION IS ISSUED ALL CALIFORNIA OPERATIONS 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 10/10/2010 Policy No. 2200015400-101 Endorsement No. 1 Insured INNOVATIVE ENVIRONMENTAL SOLUTIONS (A CORP) Premium $ nsurance Company Oak River Insurance Company WC 99 04 10A (Ed 07-07) Countersigned by 26 RESOLUTION NO. 2012 — 91 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY APPROVING AN ENCROACHMENT PERMIT AND AGREEMENT WITH RESTRUCTURE PETROLEUM MARKETING SERVICES OF CALIFORNIA FOR THE INSTALLATION OF TWO GROUNDWATER MONITORING WELLS, ONE IN THE PARKING LOT OF GRANGER MUSIC HALL LOCATED AT 1604 EAST 4TH STREET, AND ONE IN THE PUBLIC RIGHT-OF-WAY ON PALM AVENUE, 315 FEET NORTH OF 4TH STREET WHEREAS, the Restructure Petroleum Marketing Services of California ("RPMS- CA"), through its contractor, Innovative Environmental Solutions, is seeking an encroachment permit and agreement for the installation of two groundwater monitoring wells, one located in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way on Palm Avenue, 315 feet north of 4th Street; and WHEREAS, the monitoring wells are a requirement of the County of San Diego Department of Health Environment to perform liquid phase hydrocarbons fingerprinting, and to fully assess dissolved -phase benzene in groundwater. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby approves an Encroachment Permit and Agreement with Restructure Petroleum Marketing Services of California ("RPMS-CA"), through its contractor, Innovative Environmental Solutions, for the installation of two groundwater monitoring wells one located in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way on Palm Avenue, 315 feet north of 4th Street, as required by the County of San Diego Department of Health Environment. Said Encroachment Agreement is on file in the office of the City Clerk. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby approves the Encroachment Permit and Agreement with Restructure Petroleum Marketing Services of California for the installation of two groundwater monitoring wells, one in the parking lot of Granger Music Hall located at 1604 East 4th Street, and one in the public right-of-way located on Palm Avenue, 315 feet north of 4th Street. PASSED and ADOPTED this 1st day of M. 012. on Morrison, Mayor ATTEST: chi.4, d) Mic ael R. Dail , City Clerk OVEI ' S TO FORM: Gaci A: Silva Ci y Attorne Passed and adopted by the Council of the City of National City, California, on May 1, 2012 by the following vote, to -wit: Ayes: Councilmembers Morrison, Natividad, Rios, Sotelo-Solis, Zarate. Nays: None. Absent: None. Abstain: None. AUTHENTICATED BY: RON MORRISON Mayor of the City of National City, California MICHAEL R. DALLA City Clerk of the City of National City, California By: Deputy I HEREBY CERTIFY that the above and foregoing is a full, true and correct copy of RESOLUTION NO. 2012-91 of the City of National City, California, passed and adopted by the Council of said City on May 1, 2012. City Clerk of the City of National City, California By: Deputy