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2013 CON CEPA Operations - NCPD Property & Evidence Lab Fume Hood - 3rd Amendment
THIRD AMENDMENT TO AGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND CEPA OPERATIONS, INC. This Third Amendment to Agreement is entered into this 1st day ofJuly 2013, by and between the City of National City, a municipal corporation (the "CITY"), and CEPA Operations Inc. (the "CONTRACTOR"). RECITALS A. The Parties entered into an Agreement on July 1, 2010 ("the Agreement"), wherein CONTRACTOR agreed to provide annual testing and certification for the Fume Hood and for the installation of an air -flow monitor in the Police Department's Property and Evidence Lab for the period ofJuly 1, 2010 through June 30, 2011. The Agreement provided an option to extend the term of the Agreement for one-year, with up to three extensions. B. The Agreement allows the City of National City the option to extend the Agreement for one-year terms each fiscal year, up to three such extensions. C. The First Amendment to the Agreement extended the term from July 1, 2011 and expired on June 30, 2012 and the Second Amendment to the Agreement extended the term from July 1, 2012 and expired on June 30, 2013. D. The parties now desire to amend the Agreement to extend the term of the Agreement for an additional year, through Fiscal Year 2013-2014, beginning July 1, 2013 and ending June 30, 2014, for the total not to exceed amount of $175.00 1. The Description of Services in Section 1 of the Agreement for this one-year extension is amended to read as follows: CONTRACTOR shall provide yearly annual testing and certification for the Fume Hood located in the Police Department's Property and Evidence Lab. E. The parties further agree that with the foregoing exceptions, each and every term and provision of the Agreement dated July 1, 2010, shall remain in full force and effect. --- Signature Page to Follow --- IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first above written. CITY OF NATIONAL CITY Leslie Deese, City Manager CEPA OPE • i' ONS, INC. (Signatures of tw • e. • f rate officerr re By: (Prin ,Dry /c.G,, (Title) ji, '' ". , t (q AI tto (Print) (Title) First Amendment - 2 Between City of National City and CEPA Operations, Inc. ACORD. CERTIFICATE OF LIABILITY INSURANCE UA I E(MMRIUIYYYY) 1/15/2013 PRODUCER GERALD B HIER INSURANCE AGENCY 239 N. Euclid Avenue Upland, CA 91786 (800)300-1922 INSURED CEPA Operations, Inc. dba: CEPA Company 1140 E. Locust Street Ontario, CA 91761-4537 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Truck Insurance Exchange INSURER B: Mid -Century Insurance Company NAIC# 21709 21687 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 ADM INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY) POLICY EXPIRATION DATE(MM/DD!YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE I U RtN I tD PREMISES (Ea occurence) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY n PRO- JECTO CT pi LOC B X AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS Comp Ded: $500 60501-29-98 05/28/12 05/28/13 COMBINED SINGLE LIMIT (Ea accident) $2 000 O0O , , BODILY INJURY (Per person) $ X X BODILY INJURY (Peraccident) $ X X PROPERTY DAMAGE (Peraccident) $ X Collision: $500 GARAGE LIABILITY ANYAUTO AUTO ONLY -EA ACCIDENT $ EA ACC OTHER THAN $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ O OCCUR I CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WOI KERSCOMPENSATIONAND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I/yes, describe untler SPECIAL PROVISIONS below A0931-43-77 01/01/13 01/01/14 WC STATU- X TORYL MITS I OER E.L. EACH ACCIDENT $ 92,701 E.L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 E.L. DISEASE -POLICY LIMIT $ 1 , 000 , 000 B OTHER Hired Auto/ Physical Damage 60501-29-98 05/28/12 5/28/13 $80,000 DESCRIPTION OF OPERATIONS !LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of National City is named as additional insured CANCELLATION City of National City ATTN: Finance Dept/Purchasing Div 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 MAIL10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, RS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Ja' L/ ACORD 25(2001/08) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) POLICY NUMBER: 605012998 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. Endorsement Effective: 05/28/2011 Countersigned By: (Authorized Representative) Named Insured: CEPA CO SCHEDULE Name of Person(s) or Organization(s): City of National City (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 FARMERS WC 99 0619 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY Named . COPELAND, WAYNE (AN IND) Insured • DBA: CEPA COMPANY 1140 E. LOCUST STREET • ONTARIO CA 91761 Effective Date 09L0lL]3 Agent 29-21-333 A0931-43-77 2013 Policy Number Policy of the Company Year WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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 for which you perform work under a written contract that requires you to obtain this agreement from us. The additional premium for this endorsement shall be 3.0 % of the Workers' Compensation premium otherwise due for the state(s) listed below on such remuneration, subject to a minimum charge of All written contracts in the state(s) of: CA This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all the terms of the policy. Coun tcrsigned Authorized Representative 93. 369 1ST EDITION 9-01 16369111 PAGE 1 OF 1 WC990619A ACORD�, CERTIFICATE OF LIABILITY INSURANCE PRODUCER GERALD B HIER INSURANCE AGENCY 239 N. Euclid Avenue Upland, CA 91786 (800)300-1922 INSURED CEPA Operations, Inc. dba: CEPA Company 1140 E. Locust Street Ontario, CA 91761-4537 COVERAGES IDATE(MM/DD/YYYY) 6/4/2013 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# INSURER A: Truck Insurance Exchange 21709 INSURER B: Mid -Century Insurance Company INSURER C: 21687 INSURER D: INSURER E: 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. DI. DDti LTR NSRD DATE(MMIDD/YY1 TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n ECT n LOC AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS GARAGE LIABILM( ANYAUTO EXCESS/UMBRELLA LIABILITY OCCUR 7 CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERSCOMPENSATIONAND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE A OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER POLICY NUMBER A0931-43-77 POLICY EFFECTIVE DATE (MM/DD/YY) 01/01/13 POLICY EXPIRATION 01/01/14 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS CERTIFICATE HOLDER LIMITS EACH OCCURRENCE PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL BADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT (Ee accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Peraccident) AUTO ONLY- EA ACCIDENT OTHER THAN AUTO ONLY: AGG $ EACH OCCURRENCE $ AGGREGATE $ X TORYUMITS OTH- ER E.L. EACH ACCIDENT EA ACC $ $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ ]. 000 000 E.L. DISEASE -POLICY LIMIT $ 1 , 000 , 000 City of National City ATTN: Finance Dept/Purchasing Div. 1243 National City Blvd National City, CA 91950 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO D0 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 0.CORD 25 (2D01l08) AUTHORIZED REPRESENTATIVEyket l (EJACARli CA DDno w rrn.....,,., July 11, 2013 National City Police Isela Cabrales, The following is pricing for the annual test and certification of your Fisher Hamilton Fume Hood id# CEPA3477 due in October 2013: lea- Test/cert $155.00 Trip Charge $20.00 These prices are quoted with the intent that the work will be performed during normal working hours (8am to 5pm, Monday through Friday). Please sign below and return (via fax or email) this quote and/or po# as proof of acceptance so we can process your order. Let me know if you have any questions. Sincerely, ce/Aelfdeo-, LesleyJ. Vaughn Service Coordinator Ivaughn@cepatest.com Customer signature: Date: Print name: cepatest.co CITY OF NATIONAL CITY Office of the City Clerk 1243 National City Blvd., National City, California 91950 619-336-4228 phone / 619-336-4229 fax Michael R. Dalla, CMC - City Clerk CEPA OPERATIONS, INC. (Certified Environmental Particulate Air) Amendment #3 Police Dept. Property & Evidence Lab Fume Hood Ronni Zengota (Police) Forwarded Copy of Amendment to CEPA Operations