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HomeMy WebLinkAbout2018 CON Geraldo Cortez DBA National City Electric - Electrical ServicesSHORT FORM SERVICES AGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND NATIONAL CITY ELECTRIC THIS AGREEMENT is entered into this 1st day of September, 2018, by and between the CITY OF NATIONAL CITY, a municipal corporation (the "CITY"), and GERALDO CORTEZ, an individual, DBA NATIONAL CITY ELECTRIC, (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 shall provide City-wide, on -site electrical maintenance, including, but not limited to, repairs and remodeling as needed and as directed by the City's Facilities Maintenance Supervisor, currently Arturo Gonzalez. 2. Length of Agreement. The schedule is set forth below: The duration of this Agreement is from September 1, 2018 through June 30, 2019. This Agreement may be extended by mutual agreement upon the same terms and conditions for an additional one (1) year term. The Parties may exercise up to three one-year extensions. Any extension of this Agreement must be approved in writing by the City Manager. 3. Compensation. The total compensation to CONTRACTOR for providing the services set forth herein shall not exceed an annual total cost of $25,000. 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. ❑ 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"). 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. 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's Risk Manager, at the address listed in subsection G below, 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. The Certificate Holder for all policies of insurance required by this Section shall be: City of National City c/o Risk Manager 1243 National City Boulevard National City, CA 91950-4397 H. 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. I. Insurance shall be written with only insurers authorized to conduct business in California 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 of 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. J. 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 Standard Short Form Agreement Page 2 of 5 City of National City and Revised August 2017 National City Electric FY19 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. K. All deductibles and self -insured retentions in excess of $10,000 must be disclosed to and approved by the CITY. L. If the CONTRACTOR maintains broader coverage or higher limits (or both) than the minimum limits shown above, the CITY requires and shall be entitled to the broader coverage or higher limits (or both) maintained by the CONTRACTOR. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the CITY. 8. Indemnification and Hold Harmless. The CONTRACTOR 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 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 misconduct of the CITY, its agents, officers employees, or volunteers. 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. 9. 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. 10. Business License. CONTRACTOR must possess or shall obtain business license from National City Finance Department before beginning work. 11. 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, Standard Short Form Agreement Page 3 of 5 City of National City and Revised August 2017 National City Electric FY19 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 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. [Signature page to follow] Standard Short Form Agreement Page 4 of 5 City of National City and Revised August 2017 National City Electric FY 19 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>lt Leslie Deese, City Manager APPROVED AS TO FORM: By: For Angil P. Moms -Jones City Attorney By: Nicole Pedone Acting City Attorney 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.: Engineering & Public Works Email: arturog@nationalcityca.gov NATIONAL CITY ELECTRIC By: Gera i o Cortez, Own NATIONAL CITY ELECTRIC P.O. Box 1375 National City, CA 91950 Phone: Fax: Contact: Title: Email: (619) 857-0397 (619) 651-8881 Geraldo Cortez Owner ncelectric(a,gmail.com Taxpayer I.D. No.: 556-19-3730 Standard Short Form Agreement Page 5 of 5 City of National City and Revised August 2017 National City Electric FY19 Exhibit A National City Electric PO Box 1375 National City, CA 91951 Phone (619) 857-0397 Fax (619) 651-8881 Email: ncelectricl@gmail.com License C-10 #843770 05/15/2018 City of National City 1243 National City Blvd. National City, CA 9150 Att: Arturo Gonzalez In reference to our service we provide to the city of National City. Our hourly rates are as follows: $110 Per Man Hour ( These rates are for normal business hours: Monday -Friday 8:OOAM-4:30PM ) $135 Per Man Hour ( Overtime Rate: After 4:30PM Monday -Friday, Weekends, and Holidays) $135 Per Man Hour: Prevailing Wages ( These rates are for normal business hours: Monday - Friday 8:OOAM-4:30PM ) These rates are portal to portal. An electrical contractor places, installs, erects or connects any electrical wires. fixtures. appliances, apparatus. raceways. conduits, solar photovoltaic cells or any part thereof, which generate, transmit. transform or utilize electrical energy in any form or for any purpose. We appreciate your business and look forward to serving you. Sinc ely, aldo Cortez, City of National City Page I ACc CERTIFICATE OF LIABILITY INSURANCE ‘..."'--- DATE (MMIDD YYYY) 05/31/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THE CERTIFICATE HOLDER. THIS AFFORDED BY THE POLICIES INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may retiuire this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). INSURED provisions or be endorsed. an endorsement. A statement on PRODUCER CSS INSURANCE SERVICES CONTNAME: Daniel E. McKenni 40 THIRD AVENUE PHONE (AIC No. Exec (619)427-2662 ry°XC No): (619)427-0468 CHULA VISTA, CA 91910 E-MAIL ADDRESS: dan@califomiaspacialservices.com COVERAGE i NAIC # License #: 0181019 INSURER(S) AFFORDING INSURER A: U.S. SURANCE COMPANY INSURED GERALDO CORTEZ SPECIALTY I INSURER : California Auto Insurance Company 38342 DBA: NATIONAL CITY ELECTRIC INSURER C PO BOX 1375 INSURER D : NATIONAL CITY, CA 91951-1375 INSURER E• INSURER F COVERAGES CERTIFICATE NUMBER: 000Q0000-71924 REVISION NUMBER: 20 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS IS SUBJECT TO ALL THE TERMS, TYPE OF INSURANCE ADM Syy BR POLICY NUMBER I POUCY EFF L(MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) -- LIMITS A X COMMERCIAL GENERAL LIABILITY U17AC94422-01 ' EACH OCCURRENCE $ 1,000,000 109/28/2017 09/28/2018 CLAIMS -MADE OCCUR 5AMAGE TO PREMISES EaEoccurrence ! $ 100,000 EXP (Any one person) $ 5,000 ) _MED B ADV INJURY $ 1,000,000 hX'LAGOREGATEPMIITAPPUESPER: I J 7LOC (PERSONAL 6ENERALAGGREGATE $ 2,000,000 POUCY _ JECT ,PRODUCTS - COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY ANY AUTO BAO40000018556 10/29/2017 10/29/2018 lEa oMBINED SINGLE LIMIT accident) $ 1,000,000 �( i F--- BODILY INJURY (Per person) $ _ 1OWNEDSCHEDULED AUTOS ONLY I HIRED AUTOS NON -OWNED BODILY INJURY (Per accident) $ . AUTOS ONLY AUTOS ONLY PROPERTY (per DAMAGE accident) $ $ A X UMBRELLALIAB EXCESS LIAB X I OCCUR U17AC94422-01 09128/2017 09/28/2018 i CH OCCURRENCE $ 2,000,000 CLAIMS -MADE GGREGATE $ 2,000,000 I Yt , DED ; 1 RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ' OFFICER/MEMBER EXCLUDED, I 1 (Mandatory in NH) It yes, describe under N /A I Lam. DEL. i EL. PER OTH- STATUTE ER EACH ACCIDENT $ DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ A CONTRACTORS PERS PRO U17AC94422-01 09/28/2017 09/28/2018 STANDARD PACKAGE DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached if more space is required0 CITY OF NATIONAL CITY ITS ELECTED OFFICERS, AGENTS, EMPLOYEES & VOLUNTEERS CERTIFICATE HOLDER CANCELLATION CITY OF NATIONAL CITY 1243 NATIONAL CITY BLVD. NATIONAL CITY, CA 91950 SHOULD ANY OF THE ABOVE DE THE EXPIRATION DATE THEREOF ACCORDANCE WITH THE POLICY RIBED POLICIES BE CANCELLED BEFORE OTICE WILL BE DELIVERED IN ROVISIONS. AUTHORIZED REPRESE/NyTT/ATIVE/(// GV © 1988-2015 ACO ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Pr (DEM) D CORPORATION. All rights reserved. ted by DEM on May 31, 2018 at 01:45PM POLICY NUMBER: U17AC94422-01 CO RCIAL GENERAL LIABILITY HCS O4p061013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE R :AD IT CAREFU LY. PRIMARY AND NONCONTRIBUTORY A D BLANK WAIVER OF SUBROGATIO , T This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. PRIMARY AND NON-CONTRIBUTORY TO OTHER INSURANCE With respect to any person or organization that is an additional insured under this Coverage Part, the following is added to paragraph 4. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If you have agreed in writing in a contract or agreement that this insurance is primary and non- contributory relative to an additional insured's own insurance, then this insurance is primary and we will not seek contribution from that other insurance. For the purpose of this endorsement, the additional insured's own insurance means insurance on which the additional insured is a Named Insured. When this endorsement is attached to the policy it supersedes all other insurance conditions within. HCS 040 06 10 13 B. WAIVER OF SUBG Under SECTION IV LIABILITY COND Rights Of Recov Condition is ame following: We waive any rig against any persori payments we make out of: ROGRATION — BLA 1KET — COMMERCIAL GENERAL IONS, The Transfer Of ry Against Other To Us ded by the additlic n of the of recovery we riay have or organization b use of for injury or damn a arising a. Your ongoing op ations; or b. "Your work" i iuded in the "products - completed oper. •ns hazard". However, this waive applies only when you have agreed in writing to aive such rights of recovery in a contract or agr ent, and only if the contract or agreement: a. Is in effect or • : comes effective Airing the term of this policy, and b. Was executed p "tl,r to loss. Includes copyrighted material of Insurance Services office, Inc., with its pertission. Page 1 of 1 POLICY NUMBER: U17AC94422-01 COMM THIS ENDORSEMENT CHANGES THE POLICY. PLEASE R ADDITIONAL INSURED - OWNERS, L CONTRACTORS - SCHEDULED PE 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 person or organization for whom you are performing operations during the policy period when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Location(s) RCIAL GENERAL 4JABILITY CG2d100704 AD IT CAREFULLY. SSEES OR SON OR Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in file 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) desig- nated above. 8. With respect to the pinsurance afforded to these additional insureds, Ole following additional exclu- sions apply: This insurance does property damage" oc 1. All work, includin ment furnished in on the project (oth or repairs) to be the additional inst covered operations 2. That portion of ' injury or damage tended use by any than another con gaged in perform' as a part of the sa CG 20 10 07 04 © ISO Properties, Inc., 2004 got apply to "bodily injury" or urring after: materials, parts or equip - connection with such work. r than service, maintenance erformed by or on behalf of red(s) at the locatipn of the has been completed; or •ur work" out of which the rises has been put to its in- • rson or organization other actor or subcontractor en- g operations for a principal e project. Page 1 of 1 0 POLICY NUMBER: U17AC94422-01 COMM CIAL GENERAL LIABILITY CG20I370704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE R D IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1 Name Of Additional Insured Person(s) Or Organization(s): Any person or organization, when you and such parties have agreed in writing in a contract or agreement pertaining to "your work" performed during the policy period. This additional insured coverage does not apply to "excluded residential construction". "Excluded residential construction" means. a) the ground -up construction of any building whose units will be individually owned and titled; and, Location And De*cription Of Completed Otiferations b) 'your work" performed on the conversion of any building into a condominium or townhome. Information required to complete this Schedule, if not shown above, will be shown in e Declarations. 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 dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". CG20370704 © ISO Properties, Inc., 2004 Page 1 of 1 NATIONAL CITY ELECTRIC BA040000018556 10/29/17-10/29/18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE RE D IT CAREFULLY. Business Auto Broadening Endor' ment This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED I II. EMPLOYEES AS INSUREDS III. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V. SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII. ADDITIONAL TRANSPORTATION EXPENSE VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE Xl. GLASS REPAIR — DEDUCTIBLE WAIVER XII. TWO OR MORE DEDUCTIBLES XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV. WAIVER OF SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE H XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO — COVERAGE TERRITORY XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANG MCA85101213-CA URED) ARDS ISH Copyright 2013 Mercury Insurance Services, LLC. All rights reserve Includes copyrighted material of Insurance Services Office, Inc., with its P mission Page 1 of 6 BUSINESS AUTO COVERAGE FO NEWLY ACQUIRED OR FORMED ENTITY (Broad Form Named Insured) SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, t d. Any business entity newly acquired or formed by you provided you own 50% or more of the business entity separately insured for Business Auto Coverage. Covera maximum of 180 days following acquisition or formati Coverage under this provision is afforded only until th= Coverage does not apply to an "accident" which occur formed the organization. II. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, t e. Any "employee" of yours is an "insured" while using a own, hire or borrow in your business or your personal III. AUTOMATIC ADDITIONAL INSURED SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, t f. Any person or organization that you are required to inG on the Coverage Form in a written contract or agreeme executed by you before the "bodily injury" or "propert in effect during the policy period is an "insured" for Lia damages to which this insurance applies and only to th organization qualifies as an "insured" under the Who Is contained in Section II. IV. EMPLOYEE HIRED AUTO LIABILITY SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, th An "employee" of yours is an "insured" while operating under a contract or agreement in that "employee's" na while performing duties related to the conduct of your V. SUPPLEMENTARY PAYMENTS SECTION II — LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, Payments, Subparagraphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for violations) required because of an "accident" we cover. furnish these bonds. (4) All reasonable expenses incurred by the "insured" at ou request, including actual loss of earnings up to $500 a day because of time .ff from work. g. MCA85101213-CA M e following is added: ring the policy period nd the business entity is not e is extended up to a n of the business entity. end of the policy period. d before you acquired or following is added: vered "auto" you don't airs. following is added: ude as additional insured t that is signed and damage" occurs and that is ility Coverage, but only for extent that person or n Insured provision following is added: n "auto" hired or rented e, with your permission, usiness. . Supplementary elated traffic law e are not obligated to Copyright 2013 Mercury Insurance Services, LLC. All rights reservegL Includes copyrighted material of Insurance Services Office, Inc., with its P mission Page 2 of 6 VI. FELLOW EMPLOYEE COVERAGE: SECTION II — LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee This exclusion does not apply if you have workers' compensation insur your "employees". Coverage is excess over any other collectible incur. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Expenses, is replaced with the following: We will pay up to $50 per day to a maximum of $1000 for tem expense incurred by you because of the total theft of a coverer passenger type. We will pay only for those covered "autos" for Comprehensive or Specified Causes of Loss Coverage. We will transportation expenses incurred during the period beginning ending, regardless of the policy's expiration, when the covered we pay for its "loss". If your business shown in the Declaration dealership, we will also pay up to $1,000 for reasonable and ne you to return a stolen covered auto from the place where it is garaging location. VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage added: c. nce in -force covering all of ce. xtensions, a. Transportation .rary transportation "auto" of the private hich you carry either y for temporary hours after the theft and 'auto" is returned to use or is other than an auto essary costs incurred by covered to its usual xtensions, the following is If hired "autos" are covered "autos" for Liability Cover e in this policy and Comprehensive, Specified Causes of Loss, or Collision c erages are provided under this coverage form for any "auto" you own, then the Ph sical Damage Coverages provided are extended to "autos" you hire, subject to t following limit: (1) The most we will pay for "loss" to any hired "au o" is $50,000 or Actual Cash Value or Cost of Repair, whichever is less (2) $500 deductible will apply to any loss under thi coverage extension, except that no deductible shall apply to "loss" c used by fire or lightning Subject to the above limit and deductible we will provid! coverage equal to the broadest coverage applicable to any covered "auto" yo own of similar size and type. This coverage extension is excess coverage over a y other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions, 3.a., is amen( This exclusion does not apply to the accidental discharge of an a MCA85101213-CA Includes copyrighted material of Insurance Services Office, Inc., with its P Copyright 2013 Mercury Insurance Services, LLC. All rights resery ed to add the following: rbag. mission Page 3 of 6 X. LOAN/LEASE GAP COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE C. Limit of Insurance, the 4. In the event of a "total loss" to a covered "auto" shown in the t which Collision and Comprehensive Coverage apply, we will pa the lease or loan for that covered "auto," less: a. The amount paid under the Physical Damage Coverage, policy; and b. Any: (1) (2) Ilowing is added: hedule or declarations for any unpaid amount due on ection of the Overdue lease/loan payments at the time of th • "loss"; Financial penalties imposed under a lease for cessive use, abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insu : nce, Health, Accident or Disability Insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or lea •-s. XI. GLASS REPAIR — DEDUCTIBLE WAIVER SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible, the followi is added: No deductible applies to glass damage if the glass is repaired ra her than replaced. XII. TWO OR MORE DEDUCTIBLES SECTION III -PHYSICAL DAMAGE COVERAGE, D. Deductible, the followin: is added: If two or more "company" policies or coverage forms apply to t e same accident: 1. If the applicable Business Auto deductible is the smalles , it will be waived; or 2. If the applicable Business Auto deductible is not the sm . (lest, it will be reduced by the amount of the smallest deductible; or 3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose of this endorsement "company" means the co pang providing this insurance and any of the affiliated members of the Mercury Ins rance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss C•nditions, 2. Duties In The Event Of Accident, Claim, Suit, Or Loss, a., In the event of "accident", yo must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corp. ration. MCA85101213-CA Copyright 2013 Mercury Insurance Services, LLC. All rights reserve Includes copyrighted material of Insurance Services Office, Inc., with its P mission Page 4 of 6 XIV. WAIVER OF SUBROGATION SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Trans er of Rights Of Recovery Against Others To Us, section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against a y person or organization to the extent required of you by a written contract execut d prior to any "accident" or "loss", provided that the "accident" or "loss" arises out •f the operations contemplated by such contract. The waiver applies onl' to the person or organization designated in such contract. XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZA SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2. C Misrepresentation, or Fraud, the following is added: Any unintentional omission of or error in information given by to disclose all exposures or hazards existing as of the effective the policy period shall not invalidate or adversely affect the cov hazard or prejudice your rights under this insurance. However, undisclosed exposure or hazard to us as soon as reasonably pos This provision does not affect our right to collect additional pre of cancellation or non -renewal. XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. 0 Auto Physical Damage Coverage, is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following "autos" you own: 1. Any covered "auto" you lease, hire, rent or bor 2. Any covered "auto" hired or rented by your "en that individual "employee's" name, with your pi duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed v "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Ot following is added and supersedes any provision to the contrary: e. This insurance is primary to and will not seek contributic available to an additional insured under your policy pro (1) The additional insured is a Named Insured undei (2) You have agreed in writing in a contract or agre would be primary and would not seek contributi insurance available to the additional insured. MCA85101213-CA 5 ncealment, ou, or unintentional failure ate or at any time during rage for such exposure or ou must report the ible after its discovery. ium or exercise our right her Insurance, b. For Hired are deemed to be covered ow; and ployee" under a contract in rmission, while performing ith a driver is not a covered er Insurance, the n from any other insurance ided that: such other insurance; and ment that this insurance �n from any other Copyright 2013 Mercury Insurance Services, LLC. All rights reserve . Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 5 of 6 XVIII. HIRED AUTO - COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period, Coverage Territory, e. Anywhere in the world if:, is replaced by the following: e. Anywhere in the world if: (1) A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V — DEFINITIONS, C. "Bodily Injury" is amended by adding the following: "Bodily injury" also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease. MCA85101213-CA Copyright 2013 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 6 of 6 POLICYHOLDER COPY STATE ND ISSUE DATE: 04-19-2018 P O BOX 8192 PLEASANTON, CA 94588 CERTIFICATE OF WORKERS COMPENSATION INSURANCE CITY OF NATIONAL CITY 1243 NATIONAL CITY BLVD NATIONAL CITY CA 91950-4301 SP GROUP: POLICY NUMBER: 9157220-2018 CERTIFICATE ID: 2 CERTIFICATE EXPIRES: 04-19-2019 04-19-2018/04-19-2019 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT J#2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2018-04-19 IS 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 SP (REV.7-2014) P'C,HO] PRINTED : 07-09-2018 WAIVER OF SUBROGATION N TICE Enclosed is your copy of a certificate of insurance on which tihe certificate holder required a waiver of subrogation: 1. Please be advised that a waiver of subrogation requires thlat a 3% surcharge will be applied by State Fund ONLY to the premium assessed on the payroll of your employees earned while engaged in work for that gertificate holder who requested the waiver. (Note: if you have no employed payroll on that job, then there is no charge.) 2. To apply the 3% surcharge, you must also agree to maintin accurately segregated payroll records for employees engaged in wort 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) rag `bitNMENkATA�✓V'�/`aM1�/1J /NNINNN�NNIq\\���" October 11, 2018 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 Mr. Gerald Cortez National City Electric P.O. Box 1375 National City, CA 91950 Dear Mr. Cortez, On September 1, 2018, 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. Sincerely, pri Michael . Dalla, CMC City Clerk Enclosure