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2017 CON Geraldo Cortez dba National City Electric - Electrical Services - Amendment #1
FIRST AMENDMENT TO THE AGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND NATIONAL CITY ELECTRIC THIS FIRST AMENDMENT TO THE AGREEMENT ("First Amendment"), is entered into this 23rd day of March, 2017, by and between the CITY OF NATIONAL CITY, a municipal corporation ("CITY"), and GERALDO CORTEZ, an individual, DBA "NATIONAL CITY ELECTRIC" (the "CONTRACTOR"). RECITALS WHEREAS, The CITY and the CONTRACTOR entered into an Agreement on October 13, 2016 (the "Agreement") wherein the CONTRACTOR agreed to provide City-wide on -site electrical maintenance, repairs, and remodeling on an as -needed basis through January 31, 2017, for a not -to -exceed amount of $10,000. WHEREAS, the parties desire to amend the Agreement to extend the term for five months, commencing on February 1, 2017 through June 30, 2017, for the not -to -exceed amount of $10,000. NOW, THEREFORE, the parties hereto agree as follows: 1. The Agreement entered into on October 13, 2016 shall be amended to extend the term of the Agreement for five months, commencing on February 1 through June 30, 2017, for the not -to -exceed amount of $10,000. 2. The total not -to -exceed amount of the Agreement and this First Amendment is $20,000. 3. With the exception of Sections 1 and 2 of this First Amendment, each and every term and provision of the October 13, 2016 Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first above written. CITY OF NATIONAL CITY GERALDO CORTEZ, an individual, DBA "NATIONAL CITY ELECTRIC" By IL Leslie Deese, City Manager APPROVED AS TO FORM: George H. 'iser, III Interim City Attorney By: ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 03/23/2017 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 INSURED CSS INSURANCE SERVICES 40 THIRD AVENUE CHULA VISTA, CA 91910 License #: 0181019 NATIONAL CITY ELECTRIC PO BOX 1375 NATIONAL CITY, CA 91951-1375 CONTACT NAME: Daniel E. McKenna PHONE _(A/C No ExtL (619)427-2662 (a C, N1 (619)427-0468 E-MAIL ADDRESS: dan@californiaspecialservices.com californias ecialservices.com INSURERSS) AFFORDING COVERAGE NAIC # INSURER A: U.S. SPECIALTY INSURANCE COMPANY INSURER : California Auto Insurance Company 38342 INSURER C: INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 00000000- • 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 IN SD SUBR w/Q, POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y U16SV94422-00 09/28/2016 09/28/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PREMISES (Ea occur ante) $ 100 OOO X BI/ PD DED $2000 MED EXP (Any one person) $ 5,900 PERSONAL & ADV INJURY $ 1 ,000,000 $ 2,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY L JECOT- i LOC OTHER: GENERAL AGGREGATE PRODUCTS -COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X ' __ __. LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY ---' SCHEDULED BA040000018556 10/29/2016 10/29/2017 (CEe aBcideDt)SINGLE LIMIT $ 1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ A _ X, UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y U16SV94422-00 09/28/2016 09/28/2017 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N 1 A STATUTE j EERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ A CONTRACTORS PERS PRO U16SV94422-00 09/28/2016 09/28/2017 STANDARD PACKAGE DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) CITY OF NATIONAL CITY ITS ELECTED OFFICERS, AGENTS, EMPLOYEES & VOLUNTEERS ERTIFICATE HOLDER CANCELLATION CITY OF NATIONAL CITY 1243 NATIONAL CITY BLVD. 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 REPRESENTn�JATIVE / ,a1/'4 (DEM) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by DEM on March 23, 2017 at 04:34PM ti:HCC Named Insured: NATIONAL CITY ELECTRIC Policy Number: U16AC94422-00 Insurer U.S. Specialty Ins Co — Admitted Carrier Endorsement Effective Date: 03/29/2017 Change Endorsement Number: 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY GENERAL CHANGE ENDORSEMENT The following endorsement modifies policy terms provided by the above listed policy number. Form CG 24 04 05 09 — Waiver Of Transfer Of Rights Of Recovery Against Others To Us — Scheduled Person or Organization is added to the policy with the following scheduled information: Name of Person(s) or Organization(s): CITY OF NATIONAL CITY ITS ELECTED OFFICERS, AGENTS, & EMPLOYEES 1243 NATIONAL CITY BLVD NATIONAL CITY CA 91950 Location: 1243 NATIONAL CITY BLVD NATIONAL CITY CA 91950 Description of Operations: Commercial Electrical repair/remodel work ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED HCS 060 08 11 12 Page 1 of 1 POLICY NUMBER: U16AC94422-00 COMMERCIAL GENERAL LIABILITY CG24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: CITY OF NATIONAL CITY ITS ELECTED OFFICERS, AGENTS, & EMPLOYEES 1243 NATIONAL CITY BLVD NATIONAL CITY CA 91950 Location: 1243 NATIONAL CITY BLVD NATIONAL CITY CA 91950 Description of Operations: Commercial Electrical repair/remodel work Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ CER HOLDER COPY SC `ATE N D ISSUE DATE: 06-23-2016 P.O. BOX 8192, CERTIFICATE OF CITY OF NATIONAL CITY 1243 NATIONAL CITY BLVD NATIONAL CITY CA 91950-4301 PLEASANTON, CA 94588 WORKERS' COMPENSATION INSU ANCE SC GROUP: POLICY NUMBER: CERTIFICATE ID: CERTIFICATE EXPIRES: 04-19-2016/ This is to certify that we have issued a valid Workers' Compensation insurance policy in a f California Insurance Commissioner to the employer named below for the policy period indica 157220-2016 2 4-19-2017 4-19-2017 rm approved by the d. This policy is not subject to cancellation by the Fund except upon 10 days advance written otice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its n. ma! expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter by the policy listed herein. Notwithstanding any requirement, term or condition of any contra. with respect to which this certificate of insurance may be issued or to which it may pertain afforded by the policy described herein is subject to all the terms, exclusions, and conditio Authorized Representative President and CEO UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POL CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER C COMPENSATION LAW. he coverage afforded or other document the insurance , of such policy. EXCLUDES THE FOLLOWING: HUSBAND AND WIFE EMPLOYER; CY ALSO AFFORDING LIFORNIA WORKERS' EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2016-06-23 ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF NATIONAL CITY EMPLOYER CORTEZ, GERALDO DBA: NATIONAL CITY ELECTRIC PO BOX 1375 NATIONAL CITY CA 91951 (REV.7-2014) PRIN IS [BOO,CN] ED : 06-23-2016 PO ICYHOLDER COPY 'ATE ND ISSUE DATE: 06-23-2016 P.O. BOX 8192, CERTIFICATE OF CITY OF NATIONAL CITY 1243 NATIONAL CITY BLVD NATIONAL CITY CA 91950-4301 PLEASANTON, CA 94588 WORKERS' COMPENSATION INS SC GROUP: POLICY NUMBER: CERTIFICATE ID: CERTIFICATE EXPIRES: 04-19-2016 This is to certify that we have issued a valid Workers' Compensation insurance policy in a California Insurance Commissioner to the employer named below for the policy period indic This policy is not subject to cancellation by the Fund except upon 10 days advance written We will also give you 10 days advance notice should this policy be cancelled prior to its n This certificate of insurance is not an insurance policy and does not amend, extend or alter by the policy listed herein. Notwithstanding any requirement, term or condition of any contr with respect to which this certificate of insurance may be issued or to which it may pertai afforded by the policy described herein is subject to all the terms, exclusions, and conditio Authorized Representative President and CEO UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE PO CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER • COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2016-06-2 ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF NATIONAL CITY EMPLOYER CORTEZ, GERALDO DBA: NATIONAL CITY ELECTRIC PO BOX 1375 NATIONAL CITY CA 91951 ANCE 9157220-2016 2 04-19-2017 04-19-2017 orm approved by the ted. notice to the employer. rrnal expiration. the coverage afforded t or other document the insurance s, of such policy. EXCLUDES THE FOLLOWING: HUSBAND AND WIFE EMPLOYER; CY ALSO AFFORDING LIFORNIA WORKERS' CURRENCE. IS [BOO,CN] (REV.7-2014) PRIN' ED : 06-23-2016 WAIVER OF SUBROGATION N Enclosed is your copy of a certificate of insurance on which t e certificate holder required a waiver of subrogation: 1. Please be advised that a waiver of subrogation requires t ::t a 3% surcharge will be applied by State Fund ONLY to the premium asses•.ed on the payroll of your employees earned while engaged in work for that ertificate holder who requested the waiver. (Note: if you have no employe payroll on that job, then there is no charge.) 2. To apply the 3% surcharge, you must also agree to maint in accurately segregated payroll records for employees engaged in word on job/s for the certificate holder who has the waiver. The payroll records :re subject to verification by an auditor. Example: Payroll for job: Sample Rate: Regular Premium equals: Surcharge: $5,000.00 13.300 $ 665.00 3.000 Additional Waiver charge: $ 19.95 Total premium equals $ 684.95 (665.00 + 19.95) 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 April 10, 2017 Mr. Geraldo Cortez National City Electric P.O. Box 1375 National City, CA 91951-1375 Dear Mr. Cortez, On March 23rd, 2017, a First Amendment to an Agreement was entered into between the City of National City and National City Electric. We are enclosing for your records a fully executed original Amendment. Michael R. Dalla, CMC City Clerk Enclosure CITY OF NATIONAL CITY Office of the City Clerk 1243 National City Blvd., National City, California 91950 619-336-4228 Michael R. Dalla, CMC - City Clerk August 28, 2017 Mr. Gerald Cortez National City Electric P.O. Box 1375 National City, CA 91950 Dear Mr. Cortez, On July 3, 2017, an Agreement was entered into between the City of National City and Gerald Cortez, D.B.A. "National City Electric". We are enclosing for your records a fully executed original Agreement. Michael R. Dalla, CMC City Clerk Enclosure CITY OF NATIONAL CITY Office of the City Clerk 1243 National City Blvd., National City, California 91950 619-336-4228 Michael R. Dalla, CMC - City Clerk August 28, 2017 Mr. Gerald Cortez National City Electric P.O. Box 1375 National City, CA 91950 Dear Mr. Cortez, On July 3, 2017, an Agreement was entered into between the City of National City and Gerald Cortez, D.B.A. "National City Electric". We are enclosing for your records a fully executed original Agreement. Michael R. Dalla, CMC City Clerk Enclosure