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HomeMy WebLinkAbout2017 CON Countywide Mechanical Systems - Plumbing Backflow Testing Certification RepairSHORT FORM SERVICES AGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND COUNTYWIDE MECHANICAL SYSTEMS, INC. THIS AGREEMENT is entered into this 8th day of February, 2017, by and between the CITY OF NATIONAL CITY, a municipal corporation (the "CITY"), and COUNTYWIDE MECHANICAL SYSTEMS, 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-wide on -site plumbing and backflow testing, certification, and repairs, as -needed and as directed by Arturo Gonzalez, the City's Facilities Maintenance Supervisor. 2. Length of Agreement. The duration of this Agreement is from January 31, 2017 through June 30, 2017. 3. Compensation. The total compensation to CONTRACTOR for providing the services set forth herein shall not exceed an annual total cost of $10,000.00 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 one (1) day's 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. ❑ 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, employees, and volunteers 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 "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, employees, and volunteers 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 91950-4397 8. Indemnification and Hold Harmless. The CONSULTANT agrees to defend, indemnify and hold harmless the City of National City, its officers, officials, agents, employees, and volunteers 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 CONSULTANT'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 Standard Short Form Agreement Page 2 of 5 City of National City and Revised January 2017 Countywide Mechanical Systems, Inc. established sole negligence or willful misconduct of the CITY, its agents, officers employees, or volunteers. CITY will cooperate reasonably in the defense of any action, and CONSULTANT 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, 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 Subconsultants. 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 Standard Short Form Agreement Page 3 of 5 City of National City and Revised January 2017 Countywide Mechanical Systems, Inc. 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 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 By he_ Leslie Deese, City Manager APPROVED AS TO FORM: George H. Eiser, III Interim City Attorney Standard Short Form Agreement Revised January 2017 COUNTYWIDE MECHANICAL SYSTEMS, INC. (Corporation — signatures of two corporate officers required) By: (Name) RANDALL A. SIGNORE (Print) VP - SERVICE & SPECIAL PROJECTS OPERATIONS (Title) By: Page 4 of 5 (Name) MICHAEL CANCEL (Print) SERVICE OPERATIONS MANAGER (Title) City of National City and Countywide Mechanical Systems, Inc. CONTACT INFORMATION CITY OF NATIONAL CITY 1243 National City Boulevard National City, CA 91950-4397 Phone: (619) 336-4585 Fax: (619) 336-4397 Contact: Arturo Gonzalez Title: Facilities Maintenance Supervisor Dep.: Public Works Email: arturog@nationalcityca.gov Standard Short Form Agreement Revised January 2017 Countywide Mechanical Systems, Inc. 1400 N. Johnson Ave Suite 114 El Cajon, CA 92020 Phone: 619-383-6000 Fax: 619-383-6063 Contact: Randy Signore Title: VP -Service & Special Projects Operations Email: ltaylor@countywidems.com Taxpayer I.D. No.: 36-4712003 Page 5 of 5 City of National City and Countywide Mechanical Systems, Inc. ((ountqwide �.. - mac anicai EXHIBIT A systems, Inc - City of National City Plumbing & HVAC Service Rate Sheet Standard Labor Rate $95/HR Overtime Rate (Nights and Weekends) $142.50/HR Holidays $190/HR Truck Charge $45 Minimum Service Call One hour minimum + Truck Charge If Prevailing Wage and Certified Payroll are required - Standard Labor Rate $120/HR Overtime Rate (Nights and Weekends) $180/HR Holiday $240/HR Truck Charge $45 Minimum Service Call One hour minimum + Truck Charge Plumbing Scope and Pricing: Main Line Jetter - $250 equipment charge + 2 hour minimum Main Line Cable - $100 equipment charge + 1 hour minimum Mini Jetter - $150 equipment charge + 2 hour minimum Leak Location (pressurized lines) - $150 equipment charge + 2 hour minimum Camera and/or line location (sewer and storm) - $150 equipment charge + 2 hour minimum Line Freezing (Up to 2" diameter) - $150 equipment charge + 2 hour minimum EXHIBIT A HVACR • PLUMBING • DESIGN -BUILD • SOLAR • SERVICE 1400 N. Johnson Ave Subte #114 • Et Cajcn, CA 92020 • Phone 619 449 9900 • Fax 619.449.9907 • License 96799E (ountywidelnicam cfnuntqwide _ -- Mechanical Systems, Inc. February 17, 2017 City of National City 1243 National City Blvd. National City, CA 91950 The individual below is authorized to sign for all matters regarding the Short Form Services Agreement between the City of National City and Countywide Mechanical Systems, Inc. and that his signature legally binds Countywide Mechanical Systems, Inc. to the agreement. 1. Michael Cancel C (Printed Name) (Signature) Thank you, (Signature) 6044_ Paul B. Duke, President (Date) Service Operations Manager (Title) HVACR • PLUMBING • DESIGN -BUILD • SOLAR • SERVICE 1400 N Johnson Ave. Suite #114 • Et Cajon, CA 92020 • Phone: 619.449.9900 • Fax' 619.449.9907 • License 967998 [nuntywidel'nf. earn ACORD� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/1/2017 1/11/2017 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 have ADDITIONAL INSURED provisions or 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 1362635 1400 N. JOHNSONAVE., SUITE 114 EL CAJON CA 92020 INSURED COUNTYWIDE MECHANICAL SYSTEMS, INC. CONTACT NAME: PHONE (A/C No. Exti: E-MAIL ADDRESS: FAX (A/C, No): INSURER(S) AFFORDING COVERAGE INSURER A : Old Republic General Ins Corporation INSURER B : Houston Casualty Company INSURER C : INSURER D : INSURER E : NAIC # 24139 42374 INSURER F COVERAGES - -- -- Mi. . 1VIV1. PIVITIQ . ..A.A xA.X 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/DD/YYYYJ POLICY EXP IMM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y N A7DG09221601 3/1/2016 3/1/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO PREMISES (EaENTED occurrence) $ 300,000 X CONTRACTUAL MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE X LIMIT APPLIES EC X PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE x X X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY X SCHEDULED AUTOS AUTOS ONLY Y N A7CA09221601 3/1/2016 3/1/2017 CO aBBINEDtSINGLE LIMB $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXX30�XX PROPERTY DAMAGE (Per accident) $ XXXXXXX $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y N H16XC5042101 3/1/2016 3/1/2017 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED - RETENT ON $ $ XXXXXXX A A A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under Y / N N N 1 A N A7DW09221601 AOS) A7CW09221601 ONLY) EXCLUDES PR, S VI STOP GAP ONLY: ND,OH,WA,WY 3/1/2016 3/1/2016 3/1/2017 3/1/2017 X STATUTE H_ ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: AS NEEDED PLUMBING AND HVAC SERVICES. THE CITY OF NATIONAL CITY, ITS ELECTED OFFICIALS, OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE ADDITIONAL INSURED ON GENERAL, AUTO AND EXCESS LIABILITY COVERAGE, AS REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. MMC'S GENERAL LIABILITY AND WORKERS COMPENSATION POLICIES EACH HAVE A $100,000 DEDUCTIBLE. CANCELLATION See Attachments 14457058 CITY OF NATIONAL CITY C/O RISK MANAGER 1243 NATIONAL CITY BOULEVARD NATIONAL CITY CA 91950 ACORD 25 (2016/03) 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 REPRESENTATIV 41 © 19882015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: A7DG09221601 COMMERCIAL GENERAL LIABILITY CG 2010 0413 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 of Additional Insured Person(s) or Organization(s): ANY PERSONS OR ORGANIZATIONS TO WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO THE LOSS EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Location(s) Of Covered Operations: VARIOUS AS REQUIRED PER WRITTEN CONTRACT. (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","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) at the location(s) designated above. 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or Miscellaneous Attachment: M472461 Master ID: 1362635, Certificate ID: 14457058 30 DAY NOTICE OF CANCELLATION - WRITTEN NOTICE For insurance provided under: - Commercial General Liability - Commercial Automobile Liability - Workers' Compensation/Employers Liability If the insurance carrier cancels or non -renews any of the above policies by written notice to the first Named Insured for any reason other than the nonpayment of premium, the carrier will also mail or deliver a copy of such written notice of cancellation or non - renewal to the Certificate Holder. Notice of cancellation for non-payment of premium will be mailed or delivered at least 10 days prior to the effective date of such cancellation. Miscellaneous Attachment: M463402 Master ID: 1362635, Certificate ID: 14457058 POLICY NUMBER: A7DG09221601 COMMERCIAL GENERAL LIABILITY CG 2010 0413 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 of Additional Insured Person(s) or Organization(s): ANY PERSONS OR ORGANIZATIONS TO WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO THE LOSS EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Location(s) Of Covered Operations: VARIOUS AS REQUIRED PER WRITTEN CONTRACT. (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", "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) at the location(s) designated above. 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment famished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or Miscellaneous Attachment: M472461 Certificate ID: 14457058 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. C. 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 10 04 13 Copyright, ISO Properties, Inc., 2004 Miscellaneous Attachment: M472461 Certificate ID: 14457058 POLICY NUMBER: AIDG09221601 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 SCHEDULE Name of Additional Insured Person(s) or Organization(s): ANY PERSONS OR ORGANIZATION TO WHOM OR TO WHICH YOU AR REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO THE LOSS EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Location And Description of Completed Operations: VARIOUS AS REQUIRED BY WRITTEN CONTRACT. (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 04 13 Copyright, ISO Properties, Inc., 2004 Miscellaneous Attachment: M472462 Certificate ID: 14457058 POLICY NUMBER: A7CA09221601 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ TT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE 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 the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: MMC CORP. Endorsement Effective Date: March 1, 2016 SCHEDULE Name(s) Of Person(s) Or Organization(s): WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT EXECUTED PRIOR TO LOSS (EXCEPT WHERE NOT FERMI I"1'ED BY LAW). Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA04441013 Miscellaneous Attachment: M472682 Certificate ID: 14457058 © Insurance Services Office, Inc. Page 1 of 1 POLICY NUMBER: A7DG09221601 COMMERCIAL GENERAL LIABILITY CG 25 03 05/09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT; PROVIDED THAT, THE CONTRACT IS SIGNED AN EXECUTED PRIOR TO ANY LOSS FOR WHICH COVERAGE IS SOUGHT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. Miscellaneous Attachment: M475822 Certificate ID: 14457058 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products - Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. CG 25 03 05/09 Miscellaneous Attachment: M475822 Certificate ID: 14457058 Fonn W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification 1 Name (as shown on your incorne tax return). Name is required on this line; do nob leave this line blank COUNTYWIDE MECHANICAL SYSTEMS INC 2 Business name/disregarded entity name. if different from above Give Form to the requester. Do not send to the IRS. 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: ❑ Individual/sole proprietor or ❑ C Corporation ►4 S Corporation 0 Partn.rship 0 Trust/estate single -member LLC ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ► Note. For a single -member LLC that is disregarded, do not check LLC, check the appropriate box in the line above for the tax classification of the single -member owner. ❑ Other (see instructions) ► b Address (number, street, and apt. or suite no.) 1400 N JOHNSON AVENUE SUITE 114 e City, state, and ZIP code EL CAJON, CA 92020 7 List account number(s) here (optional) 4 Exemptions (codes apply only to certain entities. not individuals: see instructions on page 3): Exempt payee code (d any) Exemption from FATCA reporting code (rf any) wee. ro occcoopto menyrr0 mania ar U$ Requester's name and address (optionall Faf i I Taxpayer identification Number (TIN) Enter your T1N in the appropriate box. The TIN provided must match the narne given on line 1 to avoid Social secu►ky number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part t instructions on page 3. For other entitles, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Certification Employer identification number 3 6 7 2 0 0 Under penalties of perjury, 1 certify that: 1. The number shown on this forrn is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that 1 am no Longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt Certification instructions, You must cross out item 2 above if you have been because you have failed to report all interest and dividends on your tax return interest paid, acquisition or abandonment of secured property, cancellation of generally, payments other than interest and dividends, you are not required to instructions on page 3. Sign Signature of Here U.S. person ► General Inions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release 11) is at www.irs.govlfw9. Purpose of Form An individual or entity (Form W-9 requester( who Is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your soda) security number (SSN), individual taxpayer identification number (1TIN) adoption taxpayer iderthhcaton number (ATIN), or employe identification number (EIN). to report an an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not hmrtsd to, the following: • Form 1099-INT (interest earned or paid) • Form 1099-DN (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-6 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-5 (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) from FATCA reporting is correct. notified by the IRS that you are currently subject to backup withholding For real estate transactions, item 2 does not apply. For mortgage debt, contributions to an individual retirement arrangement (IRA), and sign the certification, but you must provide your correct TIN, See the Date 12-14-16 • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not retum Form W-9 to the requester with a TiN, you might be subject to backup withholding. See What is backup withholding? on page 2 By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2 Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (rf arty) indicating that you are exempt from the FATCA reporting, is correct. See lM1at is FATCA reporting' on page 2 for further information, Cat. No. 10231 X Form W-9 (Rev. 12.2014) Form W -9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. oi .9 u to a) 1 Name (as shown on your income tax retum). Narne is required on this line do not leave this line blank CUUN'I'YWIUE MECHANICAL SYSTEMS INC 2 Business name/disregarded entity name, if different from above 3 Check appropnate box tor federal tax classification; check only one of the following seven boxes: IJ Individual/sole proprietor or ❑ C Corporation S Corporation ❑ Partnership single memo er LLC 0 Limited liability company. Enter the tax classification (C=C corporation, S $ corporation, P_partnership) Note. For a single -member LLC that is disregarded, do not check U.C: check the appropriate box in the tax classification of the single -member owner 0 Other (see instructions) ► 0 TrusVestate ► 4 Exemptions (codes apply only to certain entities, not individuals: see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (it any) the line above for (Napa. to acce,as nuant«ani panda the U S , 6 Address (number, street, and apt. or suite no.) 1400 N JOHNSON AVENUE SUITE 114 Requester's name arid address (optional) 6 City, state, and ZIP code EL : AJON, CA 92020 7 List account nurnber(s) here (optiortatl Taxpayer identification Number (TN) Enter your TIN in the appropriate box. The TIN provided must match the name given on !ine 1 to avoid backup withholding. For individuals, this is generally your social secunty number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part 1 instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a 77N on page 3_ Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Part II Certification or Employer identification number 3161 4 2 010 3 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (iRS) that I am subject to backup withholding as a resu't of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if arty) indicating that I am exempt Certification instructions. You must cross out item 2 above it you have been because you have failed to report al interest and dividends on your tax return. interest paid, acquisition or abandonment of secured property, cancellation of generally. payments other than interest and dividends, you are not required to instructions on page 3. Sign Here Signature of U.S. person ► General Inst?Cctions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Fort W-9 (such as legislation enacted atter we release it) is at www irs gov/fw9 Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (MN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: • Form 1099-INT (interest earned or paid: • Form 10ge-DIV (dividends, including those from stocks or mutual funds) • Form 1099•MISC (various types of income. prizes, awards. or gross proceeds) • Form 1099.6 (stock or mutual fund sales and certan other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) from FATCA reporting is correct notified by the IRS that you are currently subject to backup withholding For real estate transactions, item 2 does not apply. For mortgage debt, contributions to an individual retirement arrangement (IRA), and sign the certification, but you must provide your correct TIN. See the Date* 12-14-16 • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (bunion) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TiN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2 By swing the filled -out form. you: 1 Certify that the TN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding fax on foreign partners' share of effectively connected income, and 4. Certify that FATCA codes) entered on this form (f any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting, on page 2 for Further information. Cat. No, 10231X Form W-9 (Rev. 12-2014) Business Search - Business Entities - Business Programs California Secretary of State Page 1 of 2 Alex Padilla California Secretary of State 0� Business Search -Entity Detail The California Business Search is updated daily and reflects work processed through Monday, January 30, 2017. Please refer to document Processing Times for the received dates of filings currently being processed. The data provided is not a complete or certified record of an entity. Not all images are available online. C3414603 COUNTYWIDE MECHANICAL SYSTEMS, INC. Registration Date: 10/06/2011 Jurisdiction: CALIFORNIA Entity Type: DOMESTIC STOCK Status: ACTIVE Agent for Service of Process: C T CORPORATION SYSTEM Entity Address: Entity Mailing Address: 818 W 7TH ST STE 930 LOS ANGELES CA 90017 9330 STEVENS RD. SANTEE CA 92071 9330 STEVENS RD. SANTEE CA 92071 A Statement of Information is due EVERY year beginning five months before and through the end of October. Document Type SI-COMPLETE SI-COMPLETE jj File Date 09/12/2016 08/18/2015 * Indicates the information is not contained in the California Secretary of State's database. • If the status of the corporation is "Surrender," the agent for service of process is automatically revoked. Please refer to California Corporations Code section 2114 for information relating to service upon corporations that have surrendered. • For information on checking or reserving a name, refer to Name Availability. • If the image of a Statement of Information is not available online, for information on ordering a copy of that statement refer to Information Requests. • For information on ordering certificates, status reports, certified copies of documents and copies of documents not currently available in the Business Search such as a filing that is not a Statement of Information or filings for other types of business entities, or to request a more extensive search for records, refer to Information Requests. • For help with searching an entity name, refer to Search Tips. • For descriptions of the various fields and status types, refer to Frequently Asked Questions. https://businesssearch.sos.ca.gov/CBS/Detail 1 /31 /2017 LS ,SEI., °° TNF State of California r 'is_`= Secretary of State `r't , %,,F ' Statement of Information FF83758 FILED In the office of the Secretary of State of the State of California SEP-12 2016 This Space for Filing Use Only (Domestic Stock and Agricultural Cooperative Corporations) FEES (Filing and Disclosure): $25.00. If this is an amendment, see instructions. IMPORTANT — READ INSTRUCTIONS BEFORE COMPLETING THIS FORM 1. CORPORATE NAME COUNTYWIDE MECHANICAL SYSTEMS, INC. 2. CALIFORNIA CORPORATE NUMBER C3414603 No Change Statement (Not applicable if agent address of record is a P.O. Box address. See instructions.) 3 If there have been any changes to the information contained in the last Statement of Information filed with the California Secretary of State, or no statement of information has been previously filed, this form must be completed in its entirety. If there has been no change in any of the information contained in the last Statement of Information filed with the California Secretary of State, check the box and proceed to Item 17. Complete Addresses for the Following (Do not abbreviate the name of the city. Items 4 and 5 cannot be P.O. Boxes.) 4. STREET ADDRESS OF PRINCIPAL EXECUTIVE OFFICE CITY STATE ZIP CODE 9330 STEVENS RD., SANTEE, CA 92071 5. STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA, IF ANY CITY STATE ZIP CODE 6. MAILING ADDRESS OF CORPORATION, IF DIFFERENT THAN ITEM 4 CITY STATE ZIP CODE Names and Complete Addresses of the Following Officers (The corporation must list these three officers. A comparable title for the specific officer may be added; however, the preprinted titles on this form must not be altered.) 7. CHIEF EXECUTIVE OFFICER/ ADDRESS CITY STATE ZIP CODE TIMOTHY L CHADWICK 9330 STEVENS RD., SANTEE, CA 92071 8. SECRETARY ADDRESS CITY STATE ZIP CODE JASON JOHNSON 9330 STEVENS RD., SANTEE, CA 92071 9. CHIEF FINANCIAL OFFICER/ ADDRESS CITY STATE ZIP CODE MICHAEL J. TEAHAN 9330 STEVENS RD., SANTEE, CA 92071 Names and Complete Addresses of All Directors, Including Directors Who are Also Officers (The corporation must have at least one director. Attach additional pages, if necessary.) 10. NAME ADDRESS CITY STATE ZIP CODE TIMOTHY L CHADWICK 9330 STEVENS RD., SANTEE, CA 92071 11. NAME ADDRESS CITY STATE ZIP CODE PAUL DUKE 9330 STEVENS RD., SANTEE, CA 92071 12. NAME ADDRESS CITY STATE ZIP CODE R. JASON EVELYN 9330 STEVENS RD., SANTEE, CA 92071 13. NUMBER OF VACANCIES ON THE BOARD OF DIRECTORS, IF ANY: Agent for Service of Process If the agent is an individual, the agent must reside in California and Item 15 must be completed with a California street address, a P.O. Box address is not acceptable. If the agent is another corporation, the agent must have on file with the California Secretary of State a certificate pursuant to California Corporations Code section 1505 and Item 15 must be left blank. 14. NAME OF AGENT FOR SERVICE OF PROCESS C T CORPORATION SYSTEM 15. STREET ADDRESS OF AGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF AN INDIVIDUAL CITY STATE ZIP CODE Type of Business 16. DESCRIBE THE TYPE OF BUSINESS OF THE CORPORATION MECHANICAL CONTRACTING 17. BY SUBMITTING THIS STATEMENT OF INFORMATION TO THE CALIFORNIA SECRETARY OF STATE, THE CORPORATION CERTIFIES THE INFORMATION CONTAINED HEREIN, INCLUDING ANY ATTACHMENTS, IS TRUE AND CORRECT. 09/12/2016 MANDELINE HENDRICKS POA DATE TYPE/PRINT NAME OF PERSON COMPLETING FORM TITLE SIGNATURE SI-200 (REV 01/2013) Page 1 of 1 APPROVED BY SECRETARY OF STATE CITY OF NATIONAL CITY Office of the City Clerk 1243 National City Blvd., National City, California 91950-4397 619-336-4228 Michael R. Dalla, CMC - City Clerk March 1, 2017 Mr. Randy Signore Countywide Mechanical Systems 1400 N. Johnson Avenue, Suite 114 El Cajon, CA 92020 Dear Mr. Signore, On February 8th, 2017, an Agreement was entered into between the City of National City and Countywide Mechanical Systems, Inc. We are enclosing for your records a fully executed original Agreement. Sincerely, ii� Michael R. Dalla, CMC City Clerk Enclosure