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HomeMy WebLinkAbout2016 CON Art D. Nielson Painting - Painting ServicesSHORT FORM SERVICES AGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND ART D. NIELSEN PAINTING, INC. THIS AGREEMENT is entered into this 7th day of July, 2016, by and between the CITY OF NATIONAL CITY, a municipal corporation (the "CITY"), and ART D. NIELSEN PAINTING, INC., a Corporation (the "CONTRACTOR"). NOW, THEREFORE, CITY agrees to engage CONTRACTOR to perform the services set forth herein in accordance with the following terms and conditions: 1. Description of Services. CONTRACTOR shall provide City Hall ceiling repainting and services as outlined in attached proposal, Exhibit "A". 2. Length of Agreement. The schedule is set forth below: a) Work to be started within five working days of the date of notice to proceed; and b) Work to be completed within thirty working days of start date, but no later than July 31, 2016. 3. Compensation. The total compensation to CONTRACTOR for providing the services set forth herein shall not exceed a one-time cost of $5,480.00. The compensation for CONTRACTOR'S work shall be based upon and not exceed the rates given in Exhibit "A" (the labor rates) without prior written authorization from CITY. 4. Payment Schedule. CITY will make payment within thirty (30) days of receiving and approving a billing statement for the satisfactorily completed services of CONTRACTOR. 5. Termination. CITY may terminate this Agreement at any time by providing a one (1) day written notice to CONTRACTOR. 6. Independent Contractor. It is agreed that CONTRACTOR is an independent Contractor, and all persons working for or under the direction of CONTRACTOR are CONTRACTOR'S agents, servants and employees, and said persons shall not be deemed agents, servants, or employees of CITY. 7. Insurance. CONTRACTOR shall obtain: A. f If checked, Professional Liability Insurance (errors and omissions) with minimum limits of $1,000,000 per occurrence. B. Automobile insurance covering all bodily injury and property damage incurred during the performance of this Agreement, with a minimum coverage of $1,000,000 combined single limit per accident. Such automobile insurance shall include owned, non -owned, and hired vehicles ("any auto"). C. Commercial General Liability Insurance, with minimum limits of either $2,000,000 per occurrence and $4,000,000 aggregate, or $1,000,000 per occurrence and $2,000,000 aggregate with a $2,000,000 umbrella policy, covering all bodily injury and property damage arising out of its operations, work, or performance under this Agreement. The policy shall name the CITY and its officers, agents and employees as additional insureds, and a separate additional insured endorsement shall be provided. The general aggregate limit must apply solely to this "project" or "location". The general aggregate limit must apply solely to this "project" or "location". The "project" or "location" should be noted with specificity on an endorsement that shall be incorporated into the policy. D. Workers' compensation insurance in an amount sufficient to meet statutory requirements covering all of CONTRACTOR'S employees and employers' liability insurance with limits of at least $1,000,000 per accident. In addition, the policy shall be endorsed with a waiver of subrogation in favor of the City. Said endorsement shall be provided prior to commencement of work under this Agreement. E. The aforesaid policies shall constitute primary insurance as to the CITY, its officers, employees, and volunteers, so that any other policies held by the CITY shall not contribute to any loss under said insurance. Said policies shall provide for thirty (30) days prior written notice to the CITY of cancellation or material change. F. Said policies, except for the professional liability and workers' compensation policies, shall name the CITY and its officers, agents and employees as additional insureds, and separate additional insured endorsements shall be provided. G. If required insurance coverage is provided on a "claims made" rather than "occurrence" form, the CONTRACTOR shall maintain such insurance coverage for three years after expiration of the term (and any extensions) of this Agreement. In addition, the "retro" date must be on or before the date of this Agreement. H. Insurance shall be written with only California admitted companies which hold a current policy holder's alphabetic and financial size category rating of not less than A:VII according to the current Best's Key Rating Guide, or a company equal financial stability that is approved by the City's Risk Manager. In the event coverage is provided by non -admitted "surplus lines" carriers, they must be included on the most recent California List of Eligible Surplus Lines Insurers (LESLI list) and otherwise meet rating requirements. I. This Agreement shall not take effect until certificate(s) or other sufficient proof that these insurance provisions have been complied with, are filed with, and approved by the CITY's Risk Manager. If the CONTRACTOR does not keep all of such insurance policies in full force and effect at all times during the terms of this Agreement, the CITY may elect to treat the failure to maintain the requisite insurance as a breach of this Agreement and terminate the Agreement as provided herein. J. All deductibles and self -insured retentions in excess of $10,000 must be disclosed to and approved by the CITY. K. Insurance certificates must specify certificate holder as: City of National City ATTN: Risk Manager 1243 National City Blvd National City, CA 91950-4301 8. INDEMNIFICATION AND HOLD HARMLESS. The CONTRACTOR agrees to defend, indemnify and hold harmless the City of National City, its officers, officials, agents, and employees, against and from any and all liability, loss, damages to property, injuries to, or death of any person or persons, and all claims, demands, suits, actions, proceedings, reasonable attorneys' fees, and defense costs, of any kind or nature, including workers' compensation claims, of or by anyone whomsoever, resulting from or arising out of the CONTRACTOR'S performance or other obligations under this Agreement; provided, however, that this indemnification and hold harmless shall not include any claims or liability arising from the established sole negligence or willful Revised May 2016 2 misconduct of the City, its agents, officers, or employees. CITY will cooperate reasonably in the defense of any action, and CONTRACTOR shall employ competent counsel, reasonably acceptable to the City Attorney. The indemnity, defense, and hold harmless obligations contained herein shall survive the termination of this Agreement for any alleged or actual omission, act, or negligence under this Agreement that occurred during the term of this Agreement. 8. Acceptability of Work. The City shall, with reasonable diligence, determine the quality or acceptability of the work, the manner of performance, and/or the compensation payable to the CONTRACTOR. 9. Business License. CONTRACTOR must possess or shall obtain business license from National City Finance Department before beginning work. 10. Miscellaneous Provisions. A. Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which, together, shall constitute but one and the same instrument. B. Captions. Any captions to, or headings of, the sections or subsections of this Agreement are solely for the convenience of the parties hereto, are not a part of this Agreement, and shall not be used for the interpretation or determination of the validity of this Agreement or any provision hereof. C. No Obligations to Third Parties. Except as otherwise expressly provided herein, the execution and delivery of this Agreement shall not be deemed to confer any rights upon, or obligate any of the parties hereto, to any person or entity other than the parties hereto. D. Exhibits and Schedules. The Exhibits and Schedules attached hereto are hereby incorporated herein by this reference for all purposes. To the extent any exhibits or schedules or provisions thereof conflict or are inconsistent with the terms and conditions contained in this Agreement, the terms and conditions of this Agreement will control. E. Amendment to this Agreement. The terms of this Agreement may not be modified or amended except by an instrument in writing executed by each of the parties hereto. F. Waiver. The waiver or failure to enforce any provision of this Agreement shall not operate as a waiver of any future breach of any such provision or any other provision hereof. G. Applicable Law. This Agreement shall be governed by and construed in accordance with the laws of the State of California. The CONTRACTOR shall comply with all laws, including federal, state, and local laws, whether now in force or subsequently enacted. H. Entire Agreement. This Agreement supersedes any prior agreements, negotiations and communications, oral or written, and contains the entire agreement between the parties as to the subject matter hereof. No subsequent agreement, representation, or promise made by either party hereto, or by or to an employee, officer, agent, or representative of any party hereto shall be of any effect unless it is in writing and executed by the party to be bound thereby. I. Successors and Assigns. This Agreement shall be binding upon and shall inure to the benefit of the successors and assigns of the parties hereto. J. Subcontractors or SubCONTRACTORs. The City is engaging the services of the CONTRACTOR identified in this Agreement. The CONTRACTOR shall not subcontract any portion of the work, unless such subcontracting was part of the original proposal or is allowed by the City. In the event any portion of the work under this Agreement is subcontracted, the subcontractor(s) shall be required to comply with and agree to, for the benefit of and in favor of the City, both the Revised May 2016 3 insurance provisions in Section 7 and the indemnification and hold harmless provision of Section 8 of this Agreement. K. Construction. The parties acknowledge and agree that (i) each party is of equal bargaining strength, (ii) each party has actively participated in the drafting, preparation and negotiation of this Agreement, (iii) each such party has consulted with or has had the opportunity to consult with its own, independent counsel and such other professional advisors as such party has deemed appropriate, relative to any and all matters contemplated under this Agreement, (iv) any rule or construction to the effect that ambiguities are to be resolved against the drafting party shall not apply in the interpretation of this Agreement, or any portions hereof, or any amendments hereto. IN WITNESS WHEREOF, this Agreement is executed by CITY and by CONTRACTOR on the date and year first above written. CITY OF NATIONAL CITY Leslie Deese, City Manager ART D. NIELSEN PAINTING, INC. (Corporation — signatures of two corporate officers required) (Partnership— one signature) (Sole proprietorship — one signature) G' (Name) Ryan Nielsen (Print) Vice President (Title) B (Name) Deanna Nielsen (Print) Treasurer (Title) Revised May 2016 4 CONTACT INFORMATION CITY OF NATIONAL CITY 1243 National City Boulevard National City, CA 91950-4397 Phone: (619) 336-4585 Fax: (619) 336-3597 Contact: Arturo Gonzalez Title: Acting Facilities Maint. Supervisor Dep.: Engineering/Public Works Email: arturog@nationalcityca.gov ART D. NIELSEN PAINTING, INC. P.O. Box 20795 El Cajon, CA 92021 Phone: (619) 444-9415 Fax: (619) 444-2767 Contact: Deanna Nielsen Moore Title: Office Manager Email: Deanna@nielsenpaintinginc.com Taxpayer I.D. No.: 953069208 Revised May 2016 5 ART D. Nielsen Painting, Inc. PO Box 20795 El Cajon, CA 92021 619-444-9415 Office 619-444-2767 Fax NAME/ADDRESS CITY OF NATIONAL CITY PUBLIC WORKS 2100 HOOVER STREET NATIONAL CITY CA 91950 619-405-9789 Cell 619-336-4585 Office ESTIMATE DATE 7/14/2016 P.O. NO. DESCRIPTION Total Attn: Arturo Job: City Hall Ceiling Repaint at Council Chamber, Conference Room & Lobby Cover/protect surfaces not to be repainted. Apply 2 coats of ceiling white to acoustic textured ceilings below. 1) Council Chamber Labor & Material 2) Large conference Room Labor & Material 3) Lobby & corridor. Labor & Material Work performed during regular business hours. 1,900.00 1,900.00 1,680.00 Total $5,480.00 Web Site 'EXHIBIT Au ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 6/14/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Michael Ehrenfeld Company 2655 Camino Del Rio North #200 San Diego CA 92108 INSURED Art D. Nielsen Painting Inc PO Box 20795 El Cajon CA 92021 CONTACT NAME: Cathy Burkhardt PHONE o Ext): t619) 683-9990 x148 No)c (619)683-9999 E-MDRAIESS: �' Cath B@ehrenfeldinsurance.com AD INSURER(S) AFFORDING COVERAGE NAIC # INsuRER A American Fire & Casualty Insurance INSURER B : 24066 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:2016 Auto REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DDNYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A _ X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BAA56449579 4/1/2016 4/1/2017 BODILYINJURY(Peraccident) $ HIRED AUTOS I NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N N / A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of National City, Its Elected Officials, Officers, Agents & Employees are named as Additional Insured including Waiver of Subrogation per form CA8810 0113. Form is attached and applies when required by written contract. Replaces certificate issued 3/8/16 CERTIFICATE HOLDER CANCELLATION eamaya@nationa1cityca.gov City of National City c/o Risk Manager 1243 National City Blvd. National City, CA 91950-4397 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �j�_�-- Marc Kaplan/CB �2.._-- /�/6`— ACORD 25 (2014/01) INS025 r2nl4nn © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO CA 88 10 01 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGE INDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 19 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 22 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 23 EXTRA EXPENSE -BROADENED COVERAGE 10 GLASS REPAIR - WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN / LEASE GAP 14 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 TWO OR MORE DEDUCTIBLES 17 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 18 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 20 SECTION II - LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self -insured retention plan available to that organization; © 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow, but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II - LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or CA881001 13 @ 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V - DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended of the following: We will pay towing and labor costs incurred, up to the limits shown below, each "auto" classified and rated as a private passenger type, "light truck" or "medium abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks' are trucks that have a gross vehicle weight (GVW) of 10,001 - 20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of $50 per day and a maximum limit of $1,500 by the addition time a covered truck" is dis- CA 88 10 01 13 © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE -BROADENED COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V - DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: CA88100113 © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. 14. LOAN / LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", Security deposits not refunded by a lessor, g• h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", i. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto' that incurred the loss. C. SECTION V - DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. CA88100113 @ 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 15. GLASS REPAIR - WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. 17. TWO OR MORE DEDUCTIBLES Under SECTION III PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group. SECTION IV - BUSINESS AUTO CONDITIONS is amended as follows: 18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 19. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. CA88100113 © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7 To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V - DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V - DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. CA881001 13 © 2013 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 ARTNIEI OP ID: KH '`'i; ,`"'r`� CERTIFICATE OF LIABILITY INSURANCE DATE{ 4/DDfY1'1'1) 06/14/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Wateridge Insurance Services 10717 Sorrento Valley Rd. San Diego, CA 92121 Tony Yahyai CONTACT Tony Yahyai PHONE FAX (IC No, Ext): 858-452-2200 (NC, No): 858-452-6004 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: WeSCO Ins Company 25011 INSURED Art D. Nielsen Painting, Inc. P.O. BOX 20795 El Cajon, CA 92021 INSURER B : Everest National Insurance Co 10120 INSURER C: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: • ---------- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD-C-SUB}, INSR WVD POLICY NUMBER POLICY EFF (MMIDDfYYYY) POLICY EXP (MMIDDIVYYY) LIMfTS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY -1 X WPA103148303 07/26/2015 07/26/2016 pREMISERER,FoccurDrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO- 11 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ - HIRED AUTOS NON -OWNED AUTOS (PERACCIDENT) GE $ ____I UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1 EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X WC STATU- TORY LIMITS OTH- ER B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? YIN N IA X 7600004775161 01/31/2016 01/31/2017 E L EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes. describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF NATIONAL CITY & ITS OFFICERS, AGENTS & EMLOYEES ARE ADD'L INSD W/RESPECTS TO GL PER ATTACHED -WORK COMP WAIVER APPLIES PER ATTACHED. RE: PAINTING SERVICES PERFORMED BY THE NAMED INSURED UNDER WRITTEN CONTRACT FOR THE CITY OF NATIONAL CITY. CERTIFICATE HOLDER CANCELLATION CITYNCI 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, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: WPA103148303 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name 01 Additional Insured Person(s) Or Organlzatlon(s) Any person or organization with whom or with which you have agreed In writing In a contract or agreement that such person(*) or organization(*) shall be included as an additional Insured on your policy. Location(s) 01 Covered Operations All locations at which you are performing operations for any person or organization with whom or with which you have agreed In writing In a contract or agreement that such person(s) or organization(s) shall be Included as an additional Insured on your policy. Information required to complete this Schedule, If not shown above, will be shown in the Declarations. A. Section It — Who Is An Insured is amended to include as an additional Insured the person(s) or organization(s) shown in the Schedule, but only with respect to [lability for 'bodily injury", "property damage" or "personal and advertising injury" caused, In whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; In the performance of your ongoing operations for the additional insured(s) al the location(s) designated above. However: 1. The insurance afforded to such additional Insured only applies to the extent permitted by law; and 2. I1 coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG20100413 B. With respect to the Insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "properly damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(*) al the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to Its Intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. © Insurance Services Office, Inc., 2012 Page 1 of 2 I IiSUAEU C. With respect to the Insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: 11 coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of Insurance; 1. Required by the contract or agreement; or 2, Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown In the Declarations. Page 2 of 2 ® Insurance Services Office, Inc., 2012 CG 2010 0413 INSURED POLICY NUMBER: WPA103148303 COMMERCIAL GENERAL LIABILITY CG20370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization with whom or with which you have agreed In writing in a contract or agreement that such person(s) or organization(s) shall be included as an additional Insured on your policy. All locations at which you are performing operations for any person or organization with whom or with which you have agreed in writing in a contract or agreement that such person(s) or organlzation(s) shall be included as an additional insured on your policy. This insurance also does not apply to any structure with an intended occupancy of a private residence, not including apartments. Information required to complete this Schedule, If not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown In the Schedule, but only with respect to liability for "bodily Injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional Insured and Included In the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional Insured is required by a contract or agreement, the most we will pay on behalf of the additional Insured is the amount of insurance: 1. Required by the contract or agreement; or 2, Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of insurance shown In the Declarations. CG 20 37 0413 *Insurance Services Office, Inc., 2012 Page 1 of 1 INSURED 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered bythis.policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on sueh remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR WHOM THE BLANKET WAIVER OF SUBROGATION NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER 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: 01/31/2016 Policy No. 7600004775161 Endorsement No. 001 Insured: Art D. Nielsen Painting Inc Premium $ INCL. Insurance Company: Everest National Insurance Company Countersigned By: - 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved, From the WCIRB's California Workers' Compensation Insurance Forms Manual -1999. ARTNIEI OP ID: C2 .....-- IQ.�....' CERTIFICATE OF LIABILITY INSURANCE DATE(MIUIDD,YYYYI 07/20/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCERS Wateridge Insurance Services 10717 Sorrento Valley Rd. SonSan Y Diego, CA 92121 Y Y CT JOSE CUELLAR PHONE, t):858-200-3371 b I; 858-200-3372 n ; JCUELLAR@WATERIDGE INSURERS) AFFORDING COVERAGE NAIL # 1NSU11ERA:Wesco Ins Company 25011 INSURED Art D. Nielsen Painting, Inc. P.O. BOX 20795 El Cajon, CA 92021 INSURER s : Everest National Insurance Co 10120 IN8URERC: INSURER D : INSURER E . INSURER F : -—MEL V 1171.J1N IV IJIV16 CR: THIS IS TO CER71VY THAT THE POLICIES OF INSURANCE USTED 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, UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRINSR TYPE OF INSURANCE ADDL SUM MD POLICY NUMBER POLICY EFF IM MIOOIYYYY) POLICY EX—h (MMtDDM'rn UMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X WPA103148304 07/26/2018 07126i2017 EACH OCCURRENCE $ 1,000,001 $ 100,00 I► I CLAIMS -MADE I X I OCCUR PREMISES (Ea ocou*rence) MED EXP An $ 5,001 one parson PERSONAL & ADV INJURY $ 1,000,00I GENERAL AGGREGATE $ 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/DP AGG $ 2,000,001 POLICY I X jEGT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (F8 accident) ANY AUTO ALL OWNED ('.--- SCHEDULED BODILY INJURY (Per pawn) $ AUTOS AUTOS NON BODILY INJURY (Per accident) 3 HIRED AUTOS -OWNED AUTOS PROPERTY DAMAGE (PER ACCIDENT) $ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABI(JTY Yr" +X INC STATU- TORY LIMITS OTH- ER B ANYPROPRIETORPARTNERJEXECUTIVE OFFICER/MEMBER EXCLUDED? N 1 A X 7600004775181 01131/2016 01/31/2017 E.L. EACH ACCIDENT $ 1,1100,001- (Mandatofy in NH) If yes, describe under EL. DISEASE - EA EMPLOYEE $ 1,000,001 D DESCRIPTION OF OPERATIONS below EL. DISEASE- POLICY LIMIT $ 1,000,001' DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) CITY OF NATIONAL CITY & ITS OFFICERS, AGENTS & EMLOYEES ARE ADD`L INSD - W/RESPECTS TO GL PER ATTACHED -WORK COMP WAIVER APPLIES PER ATTACHED. RE: PAINTING SERVICES PERFORMED BY THE NAMED INSURED UNDER WRITTEN CONTRACT FOR THE CITY OF NATIONAL CITY. ERTIF1CATE HOLDER CANCELLATION CITYNCI 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, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 26 (2010/05) 01988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: WPA1 031 48304 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE poupy„ PLEAS E BEAD IT CAREFULLY', ADDITIONAL INSURED — OWNERS, LESSEES OR. CONTRACTORS —.SCHEDULED PERSON OR ORGANIZATION Thi endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additionot Is red Person(*) 0 tOrganliatIon(e) Any, person, or. organi.4atiorrwith whorl oryvith with have agreed In writing In acontract or agreement thet.auch person(Ool organilatiOn(s) shall be inchidedastri additional insured On your policy.; however, this insurancewili not applyto any olaim, loss or liability which is determinecito besoley•the result ofthe additional Insured's:negligence or'soiely the -additional insured's responSiPility. LOCallonitiOf :CoVered Operations' All location's at Whioh'yoU are performing Cperetrone for any parson or .orhtzation with Whom .,Or with which yOu have -agreed in writing in a :contract -Qr agreement that such person(s) or organitation(s) ,snall be inolUded a .an additional insured on your p�hc Information requited 10-complete:this Bchedtile, if nOt.Stiow.n above, will. be shownin the Declarations, A. SeatiOn Who is An insured is amended tci inciucie as an 'additional insured fliaaers.bri(0) Or or anization(a.) shown In the' Schedule, but only will respect to liability for ".bodily injury", 'property damage., or "personal and advertising Injury" caused, in whole or in part, by: 1. Your acts ortimiSsions; or 2. The acts :or OriliaSbnt:ot thotei acting on your kehalt. in the performance of your, ongoing operations for the .additional IrisurecN at the locatiorKey designated above, 1--rowev.er 1, The ins.urance afforded to -such additional intured only applies to the etent permitted by law; and 2. If coverage'brovidoci to the additional' Insured is required. by a: contract, or agreement, the insurance afforded to :such additional insured Will hat be broader than that Which 'yot.ii are required by the contract or agreement to provide far auctv additional Insured B. With respect -to the. tnsuran&. afforded to these additional 'Insure.ds, the following :additional exciuslons apply; This instfrante..dOeS notapply to 'bodily. Injury'or 'properly clarnage'idocurring afleri 1. All work, including materials, parts or equipment furnished. in connection- with such work, on the project :(other than service, maintenance or:repair%) io be performed by dri On behalf af- the additional Frieured(S) at the location Of the -covered aberatiOnS has been cornpic:to;or 2, That pOttlori of "your work' ut of Which the injury or damage arises has been put to, ps.. intended use by .any person. or .organtation otherthan anather contractorcontractororS'illicontractbr. engaged In. performing :operations for a. prinCipalas a.part of the.s-ame-projact... CG 2.0 10.04:13 i inSUranai Services. Office, Pagel. lof 2. 0, With respectto the insurance afforded to. these additional insureds., the following ia added to Sa6ton ill —.Limits-Of Instifenbe:. If coverage provided to the. additional insured is, required by a critit*t or agreenierit, the most We will pay .on behalf of the additional insUred is. the efficient' of insurance.: 1. Required bythe contract or agreement; or 2. Available under the applicable Limits .cf Insurance shown in the Declaration% .whiCheveris less. This endorsementshall not increase the aPPliCable Limits of. ineufanc. .shown in the Deciaraitons. • Page 2 of 2 0 insurance Services Office, inc4201-2 CG 20 10 04:1.3. POLICY NUMBER: WPA103148304 COMMERCIAL. GENERAL LIABILITY CG20*37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ (T GAREFIJLLY. ADDITIONAL INSURED - OWNERS, LESSEES OR, CONTRACTORS COMPLETED: OPERATIONS This endorsementriodifies insuranceprovided.under the following: COMMERCIAL GENERAL LIMILITY COVERAGE. PART PRODUCTS/COMPLETED OPERATIONSIIABILITYLOVERAGE PART SQ*Du.LE Name Of Additional Insured Person(p) Or OrganIZatIONS)• Loctftion And Description Of CO:Notated Operations Any person or or9anizatiOn Witt Whom.or withwhich you hay.a agraed;inwritin9ina-contract or ogreemerit :that ch parson(%) or orgenization(s) 4.101v:foci as an additional Insured on your policy; hbViever;this insurance does notapplyto .any Ciaini, lest or liability -Which is.deterrhinecitO be sOielyThe reS(11fortha. additiOnal Arieureds. ne ligenCe or SOJelY the additienefineurpd'S reeponsitg All .iocatioris :at whidhyou have completed work, for any person or organization with whom or with which you heve agreed inWritingin a cb.ntract:Or agreement that such person(s) or. organizatiorqs) :shall be included aaan. additional insured .on your policy: Information- required to complete this ScheduW, if not.shawn above, will. be.shown In the DeOlarations. A. Sebtion II - Who '10 An !flawed le amended to include as an additional Insured #115) person(s) or organization(s) shown. in the SChectyle, bill only with respect *to , liability ..fdr P,b6dily 'Pliny' Or "property dayr.lage"--causiod, in whole or in part, by uyour work e at: the location designated .ond described in the Schedule .of this: 'endorsement performed tor the additional insured and included in 'the 'products -completed operations hazard"; However:. 1, The insuranoe afforded tb Suoh additional insured only 'applies to, the extent. permitted bylaw; and 2. if coverage previdedio: the additional insured IS required by a contract or agreement, the insurance afforded to% suchadditional insured will not be broader than that .which you are required .hy the. contract or agreement to OrtvIde for sildh.eddital Insuted , 13: With respect to the incuranco afforded to -these, additiOnal. insureds, the: following is added- to, Section Llmfts Of Insurance: If cOVerage provided to the- :additional insured is required by' a contract or agraerrient, the most'we Wit pay .pri behalf ol the •addltIonal Insured Is the. :amount of insurance: 1.. Fleouired i)ontrot xe-agroomont; or 2. Available Under the. .4plicable Lintits of Insuranpe shown in.thsbeplarations; whichever i less. This endorsement shall not increase the. applicable Limits -Of Ineurance-shown in the Declarations. CG 20 37 04 13 Insurance Services Office, Inc., 201:2 Regal off 6 WORKERS COhMPENSATION AND EMPLOYERS LIABILITY INS1JItA1KCE POLICY WC 0403 06 WAIVER OF -OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORINIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will, not enforce our.right against the person or organization named in the Schedule. (`This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) • You roust maintain payroll records accurately segregating the remuneration ofyour employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise duo oaasuch remuneration. SCHEDULE PERSON OR ORGANIZATION 3OB DESCRIPTION ANY PERSON OR ORGANIZATION FOR WHOM THE BLANKET WAIVER OF SUBROGATION NAMED INSU1tED HAS AGREED BY WRITTEN CoN R.ACT TO F URN'ISPI THIS WAIVER 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 Bffeetive: 01/31/2.016 Policy No. 7600004775161 Endorseinent No. 001 Insured: Art D. Nielsen Painting Inc Pretniurn $ INCL. Insurance Company: EverestNationai Insurance Company Countersigned By: .1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. Front the WCIRB's California Workers' Compensation Lasurance Forms Manual - 1999. , . I'IIRAIID CITY OF NATIONAL CITY Office of the City Clerk 1243 National City Blvd., National City, California 91950-4397 619-336-4228 phone / 619-336-4229 fax Michael R. Dalla, CMC - City Clerk ART D. NIELSEN PAINTING City Hall Repainting and Services Tirza Gonzales (Engineering/PW) Forwarded Copy of Agreement to Art D. Nielsen Painting