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HomeMy WebLinkAbout2022 CON California Commercial Pool Inc - Las Palmas Pool Renovation CIP 22-01OWNER - CONTRACTOR AGREEMENT LAS PALMAS SWIMMING G POOL RENOVATION TION PROJECT, CIP NO. 2 - 1 This Owner -Contractor Agreement ("Agreement") is made by and between the City of National City, 1243 National City Boulevard National City, California 91950 and California Commercial Pool Inc. ("Contractor"), 2255 E Auto Centre Drive, Glendora, CA 91740 on the 16th day of August, 2022, for the construction of the above referenced Project. In consideration of the mutual covenants and agreements set forth herein, the Owner and Contractorhave mutually agreed as f llo s: 1. CONSTRUCTION The Contractor agrees to do all the work and furnish all the labor, services, materials and equipment necessary to construct and complete the Project in a turn -key manner in accordance with this Agreement and all documents and plans referenced in Exhibit "A", (hereinafter "Contract Documents"), in compliance with all relevant. Federal, State of California, County of San Diego and City of National City codes and regulations, and to the satisfaction of the Owner. 2. CONTRACT PRICE Owner hereby agrees to pay and the Contractor agrees to accept as full compensation for constructing the project in accordance with these Contract Documents in an amount not to exceed the contract price as set forth in Exhibit "B" attached hereto and incorporated herein by reference. Payments to the Contractor shall be made in the manner described in the Special Provisions. 3. TIME FOR PERFORMANCE Time is of the essence for this Agreement and the Contractor shall construct the project in every detail to a complete and turn -key fashion to the satisfaction of the Owner within the specified duration set forth in the Special Provisions. 4. ION-DIRIMINTION In the performance of this Agreement, the Contractor shall not refuse or fail to hire or employ any qualified person, or bar or discharge from employment any person, or discriminate against any person, with respect to such person's compensation, terms, conditions or privileges of employment because of such person's race, religious status, sex or age. 5. AUTHORIZED OWNER REPRESENTATIVES On behalf of the Owner, the Project Manager designated at the pre -construction meeting shall be the Owner's authorized representative in the interpretation and enforcement of all Work performed in connection with this Agreement. 6. WORKERS' COMPENSATION INSURANCE a) By my signature hereunder, as Contractor, I certify that I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for Workers' Compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the Work of this Agreement. b) The Contractor shall require each subcontractor to comply with the requirements of Section 3700 of the Labor Code. Before commencing any work, the Contractor shall cause each subcontractor to execute the following certification: "I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against Iiabiiity for worker's compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the Work of this Agreement." 7 ENTIRE AGREEMENT; CONFLICT The Contract Documents comprise the entire agreement between the Owner and the Contractor with respect to the Work. In the event of conflict between the terms of this Agreement and the bid of the Contractor, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid conflicting herewith. 8. MAINTENANCE OF AGREEMENT DOCUMENTATION Contractor shall maintain all books, documents, papers, employee time sheets, accounting records and other evidence pertaining to costs incurred and shall make such materials available at its office at ail reasonable times during the term of this Agreement and for three (3) years from the date of final payment under this Agreement, for inspection by Owner and copies thereof shall be furnished to Owner if requested. 9. INDEPENDENT CONTRACTOR At all times during the term of this Agreement, Contractor shall be an independent contractor and shall not be an employee, agent, partner or joint venturer of the Owner. Owner shall have the ri; ht to control Contractor insofar as the results of Contractor's services rendered pursuant to this Agreement; however, Owner shall not have the right to control the means by which Contractor accomplishes such services. 10. LICENSES AND PERMITS Contractor represents and declares to Owner that it has all licenses, permits, qualifications and approvals of whatever nature which are legally required to practice its profession. Contractor represents and warrants to Owner that Contractor shall, at its sole cost and expense, keep in effect at all times during the terra of this Agreement, any licenses, permits, qualifications or approval's which are legally required for Contractor to practice its rofession. 11. GOVERNING LAW, VENUE This Agreement and the Contract Documents shall be construed under and in accordance with the laws of the State of California, and the appropriate venue for any action or proceeding arising from this Agreement and/or the Contract Documents shall be had in the Superior Court of San Diego, Central Branch. 12. COUNTERPARTS This Agreement may be executed in any number of counterparts, each of which shall for ail purposes be deemed to be an original. FALSE CLAIMS Contractor acknowledges that if a false claim is submitted to the Owner, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that the False Claims Act, California Government Code sections 12650, et seq., provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include within their scope fake claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. In the event the Owner seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorneys' fees. Contractor hereby acknowledges that the filing of a false claim may the Contractor to an administrative debarment proceeding wherein Contractor may be prevented from further bidding on public contracts for a period of up to five (5) years. I have read and understood all of the provisions of this Section 13, above: 14. AGREEMENT MODIFICATION This Agreement and the Contract Documents may not be modified orally or in any manner other than by an amendment in writing and signed by the Owner and the Contractor. IN WITNESS WHEREOF this Agreement is executed as of the date first written above. Alejandra Sotelo-Solis Mayor, City of National City APPROVED AS TO FORM: By: Barry Schultz Interim City Attorney Contractor: California Commercial Pool Inc. (Owner/0 -r signature) David E. Jackson, Vice President & Secretary Print name and title (Second officer signature if a corporation) Print, e and title Ryan Jackson, Vice President City of National City - 09051536 5 Contractor's City Business License No. 41517Class 5w State Contractor's License \o, and Class 2255 E Auto Centre Drive, Business street address Glendora, CA 91740 City, state and Zip Code Ifs • • ,. • • t EXHIBIT A CONTRACT DOCUMENTS TS Owner/Contractor Agreement Bid Schedule Addenda Plans Special Provisions (Specifications) San Diego County Regional Standard Drawings City of National City Standard Drawings Standard Specifications for Public Works Construction and Regional Supplements (Greenbook) State Standard Specifications State Standard Plans California Building, Mechanical, Plumbing and Electrical Codes Permits issued by jurisdictional regulatory agencies Electric, gas, and communications companies specifications and standards Sweetwater Authority specifications and standards Specifications, standards and requirements of MTS, BNSF, SANDA , Port of San Diego and all other agencies that may be adjacent and/or affected by the project, EXHIBIT B CONTRACT PRICE (NOTE - TO BE COMPLETED TO CONFORM WITH 81D SCHEDULE ITEMS) EXHIBIT B CONTRACT PRICE Bid Results for Las Palmas Swimming Pool Renovation Project (CEP No. 22-01) Item No. Description Mobilization Unit LS ot, 1 California Commercial 40,000 420,000 Pool Inc. i 40,000 2 Competition Pool Widening LS 1 420,000 Competition Pool Remove and Replace Piaster SF 10,954 38.35 420,086 -I Competition Pool Inlet / Fixture Replacement LS 1 64,000 64,000 5 Activity Pool Inlet Replacement LS SF 1 7,500 7,500 Pool Deck Removal 26,992 5.6 20, 151,155 Pool Deck Replacement SF 24,142 482,840 8 Remove Diving Boards LS 1 20,000 20,000 404000 9, 10 New Racing Platform Anchors EA EA 16 2.500 New Stancion Sockets 11 New Anchor Sockets for Grab Rails EA 1) New Disabled Lift Anchors EA 2 750 1,500 1 i New Lane Line Anchors EA 32 000 VGBA / AB1020 Main Drain Replacement EA LS 3 3,333 10,000 15 Expansion Joint Sealant Repair 1 5,000 5,000 16 New ADA Handrail EA 6,000 6,000 17 New Interior 5' Fence and Gates LF 921 543.48 50,000 18 19 Existing Pool Floor Alterations New Main Drains SF 2,250 11 11 11,667 24,998 EA 3 35,000 20 New Floor Inlet System and Piping Connections LS 1 184,000 184,000 21 22 New Pool Wall and Gutter New Pool Tire LF 169 2,360 233.33 398,840 349,995 SF 1,500 23 New Compliant Perimeter Fencing, Gates, Hardware LF 600 575 345,000 24 Mechanical Room System Component Replacement LS 1 33,936 33,936 25 Remove Existing Bldg. Side Fence & Reslope Deck LS 1 75,500 75,500 26 Rebar/Gunite Repair LF 150 -6.67 4,001 Total $3,206,850 i David E. Jackson CORPORATE CERTIFICATE certify that ! am the Secretary of the Corporation named as Contractor in the foregoing Contract; that Ryan Jackson who signed said contract on behalf of the Contractor, was then Vice President of said Corporation; that said contract was duly signed for and in behalf of said Corporation by authority of its- governing body -and-is with-inth.es .pe of it - or-po•r-ate-pow r . 1, David E. Jackson certify that I am the Secretary of the Corporation named as Contractor in the foregoing Contract; that David E. Jackson son Contractor, was then who signed said contract on behalf of the Vice President of said Corporation; that said contract was duly signed for and in behalf of said Corporation by authority of its governing body and is within the scope of its corporate powers. Corporate Seal: ,Itivi't 00 MM .44 Nt.4 ir 1 E0 gpos 14. "4.t. 4% IZA '.. C4 14)% 41k :: i t 4 : 0 4 "811 ,,,iii0°*•?„ E'i S.,,4 ' t - •do • 4 r : 0 f '#* ' .,• :„� i* O *• + *N/A PARTNERSHIP CERTIFICATE STATE OF _ ) COUNTY OF )ss On this day of , 20 before me, the undersigned, a Notary Public in and for said County and State, personally appeared: (Notary Seal) known to me to be of the partners of the partnership that executed the within instrument,, and acknowledged to me that such partnership executed the same. gnature:e: Name (Type or Print): My Commission expires: (Notary Public in and for said County and State) ORIGINAL THE. PREMIUM IS PREDICATED ON THE FINAL CONTRACT PRICE AND ISSUED IN ONE ORIGINAL COUNTERPART BOND NO EACX4022841 I , SUBJFrT Tf;1 ArilIJNTMENT. PREMIUM: $21,97100 THIS BOND SHALL TAKE EFFECTIVE AUGUST 16, 2022 UPON APPROVAL TO PROCEED WITH AWARD OF CONSTRUCTION BY THE CITY OF NATIONAL CITY AND AFTER AN AUTHORIZED OFFICIAL SIGNS THE AGREEMENT FORM. PERFORMANCE BOND WHEREAS, the City Council of the City of National City, by Resolution No. 201- , on the 16th day of August, 2022, has awarded California Commercial Poor Inc., hereinafter designated as the "Principal", the LAS PALMAS SWIMMING POOL RENOVATION PROJECT, CIP NO. -01 WHEREAS, said Principal is required under the terms of said contract to furnish a bond for the faithful ;erfor=mince of said contract. NOW, THEREFORE, we, the Principal and Endurance Assurance Corporation as surety, are held and firmly bound unto the City of National City, hereinafter called the "City", in the penal sum of Three Million, Two Hundred Six Thousand, Eight Hundred Fifty ( , 06,8 0.00) dollars lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT if the above bounden Principal, his/her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truiy keep and perform the covenants, conditions and agreements in the said contract any alteration thereof made as therein provides, on his or their part, to be kept and performed at the time and in the amount therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City of National City, its officers, agents, employees, and volunteers as therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and virtue. And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terns of the contract or to the work to be performed herein or the specifications accompanying the same shall in any wise affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or additions to the terms of the contract or to the work or to the specifications. In the event suit is brought upon this bond by the City and judgment is recovered, the surety shall pay all costs incurred by the City in such suit, including a reasonable attorneys fee to be fixed by the Court. IN WITNESS WHEREOF three identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety above named, on the 29th day of July , 0 22 Endurance ‘sura-(ice Corporatior��SE�L) California Commercial Pools, Inc. (SEAL) BY. (SEAL) (SEAL) Kenneth A. Coate, Attorney -In -Fact (SEAL) t \1 VI/A1 (jam (SEAL) ?yeeckePA--;,-- Principal Surety STATE OF PERFORMANCE BOND ATTORNEY -IN -FACT ACKNOWLEDGEMENT OF SURETY COUNTY of ) SS On this day of , 20 , before me, the undersigned, a Notary Public in and for said County and State, personally appeared known to me to be the person whose name is subscribed to the within instrument as the attorney -in -fact of the , the corporation named as Surety in said instrument, and alnorledged to me that he subscribed the name of said corporation thereto as Surety, and his own name as attorney -in -fat. NOTE: Signature of those executing for Surety must be properly acknowledged. NOTE: The Attorney -in -fact must attach a certified copy of the Power of Attorney. Signature: Name (Type or Print): Notary Public in and for said County and State My Commission expires: 411&:,„) SOMPO INTERNATIONAL INSURANCE POWER OF ATTORNEY 4252 KNOW ALL BY THESE PRESENTS. . that Endurance Assurance Corporation, a Delaware corporation, Endurance American Insurance Company, a Delaware corporation, andior Bond Safeguard insurance Company, a South Dakota corporation, each, a `Company" and collectively, '°sompo International,' do hereby constitute and appoint: Julia B. Bales, Kenneth A. Coate, Renae N. Baiideras as true and lawful Attorneys) -In -Fact to make, execute, seal, and deliver for, and on its behalf as surety or co -surety; bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single bond or undertaking so made, executed and delivered shall obligate the Company for any portion of the penal sum thereof in excess of the sum of ONE HUNDRED MILLION Dollars (100,OOO,O0O.00). Such bonds and undertakings for said purposes, when duly executed by said attcrr ey(s)-in-fact, shall be binding upon the Company as fully and to the same extent as if signed by the President of the Company under its corporate seal attested by its Corporate Secretary.. This appointment is made under and by authority of certain resolutions adopted by the sole shareholder of each Company by unanimous written consent effective the 15Th day of June, 2019, a copy of which appears below under the heading entitled "Certificate". This Power of Attorney is signed and sealed by facsimile under and by authority of the following resolution adopted by the sole shareholder of each Company by unanimous written consent effective the 151i' day of June, 2019 and said resolution has not since been revoked, amended or repealed RESOLVED, that the signature of an individual named above and the seal of the Company may be affixed to any such power of attorney or any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signature or seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, each Company has caused this instrument to be signed by the following officers, and its corporate seal to be affixed this 15th day of June, 2019, Endurance Assurance Corporatio By:: f Richard ek. ;'iWi'1 , ertiorr Counsel i sera fo f`1.. .--, ti its / .` % 1. i 1 A - I '. 2002 �' v.e r, - * F `Fl1111 II N1li Endurance American Inuracpelpairy By:Pr-e/elLogv). Pir:harriA oen pp 11,o, 1,S 1Ri.&�enior Counsel tr r i ' 1 SEAL i ° ;. ", 1996 ; v 1;1. `5% DELAWARE*~ r` �T' Bond Safeguard I ns a rrice By; te py Richard Apt?* ouhsel A •4yy SOUTH ;'�► DAKOTA, , 0 , INSURANCE ; .„ COMPANY •` x 01.4 ACKNOI LEDGEMENT 41 t,Uh1A1i1111ti ° 4411111 b On this 15#i' day of June 019 before me, personally cane the above signatories known to me, who being duly sworn of the Companies; and that he executed said instrument on behalf of each Cornpany by authority of his office underth By: CERTIFICATE did depose and say that helve ' +t 441iicer of each , a by ws of each Compan '--•- -•' _ t. min • 3T'A,TE OF TEN NE5Sit. WARY F OLIC Amy ay+lor, Not,- Public My Commissi n Expires 519123 I, the undersigned Officer of each Company, DO HEREBY CERTIFY that 1. That the original power of attorney of which the foregoing is a copy was duly executed can behalf of each Company and has not since been revoked, amended or modified; that the undersigned has compared the foregoing copy thereof with the original power of attorney, and that the same is a true and correct copy of the original power of attorney and of the whole thereof; 2. The following are resolutions which were adopted by the sole shareholder of each Company by unanimous written consent effective ,June 15, 2019 and said resolutions have not since been revoked, amended or modified: 'RESOLVED, that each of the individuals named below is authorized to make, execute, seal and deliver for and on behalf of the Company any and all bonds, undertakings or obligations in surety or co --surety with others F ICHARC M. APPEL BRAN J. E EGO , CHRISTOPHER i ONELAN, SHARON L. SiM , CHRISTOPHER L. SPARRO, MARIANNE L. V FILBERT and be it further RESOLVED, , that each of the individuals named above is authorized to appoint attorneys -in -fact for the purpose of making, executing, sealing and delivering bonds, undertakings or obligations in surety or co -surety for and on behalf of the Company." 3, The undersigned further certifies that the above resolutions are true and correct copies of the resolutions as so re orct0 and of the whole thereof, iN WITNESS WHEREOF, i have hereunto set my hand and affixed the corporate seal this dayfill By: Danie retary NOTICE: U. 8. TFE.A URY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL (OFAC1 No coverage is provided by this Notice nor can it be construed to replace any provisions of any surety bond or other surety coverage provided. This Notice provides information concerning possible impact on your surety coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential declarations of "national emergency". OFAC has identified and listed numerous foreign agents, front organizations, terrorists, terrorist organizations, and narcotics traffickers as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's website— httos://www.treasurv.00viresource-centerisanctionsiSDN-List. In accordance with OFAC regulations, if it is determined that you or any other person or entity claiming the benefits of any coverage has violated U,S. sanctions Jaw or is a Specially Designated National and Blocked Person, as identified by OFAC, any coverage will be considered a blocked or frozen contract and all provisions of arty coverage provided are immediately subject OFAC. When a surety bond or other form of surety coverage is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments may also apply. Any reproductions are void. Surety Claims Subrnission: LexonClaimAdministration4sompo-intl.com Telephone: 615-553-9500 Mailing Address: Sompo international 12890 Lebanon Road; Mount Juliet, TN 71 2-2870 CALIFORNIA ACKNOIATLEDGIVIENT znyt-InwiniaMargra8s{?=rJ7C 'CihC7-��C } flag - EsliffieMEga CIVIL CODE § 1189 st r; +r ye, A irn }, �s y*rti r- 'a�.0. ,��es *.sa•.� 414, a. 7 h `l a T'a �. '! ! 7 ` Hail '%i `47-.il-e A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which thus certificate is attached, anc_l not the truthfulness, accuracy, or validity of that document. State of California County of Riverside On JUL 2 92022 Date before me, } Karina J. Cotton, Notary Public Here Insert .Name and Title of the Officer - personally appeared e t t e Name(s) of .Sign e r(s) who proved to me on the basis of satisfactory evidence to be the person(s).whose nine - is re-subscri1 ed to the within instrument and acknowledged to me that he/she/they-executed the same in his/hor t cr authorized capacity(ie , and that by his/ e it eic-signatures) on the instrument the person -, or the entity upon behalf of which the persons) acted, executed the instrument. KARINA J. COTTON COMM. . #225774133 NOTARY PUBLIC CALIFORNIA PR RIVERSIDE COON MY Comm. Expires Sept.10, 2022 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature OPTIONAL Signature of Notaty Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than famed Above: Capacity(les) Claimed by Signer(s) Signer" Name: 0 Corporate Officer — Title(s): 01 Partner — 0 Limited 0 General ❑ Individual ❑ Attorney in Fact 0 Guardian or Conservator 0 Trustee 0 Other: Signer is Representing: Signer'sName: Q Corporate Officer — Titie(s): O Partner — ❑ Limited IJ General El Attorney in Fact Guardian or Conservator • Individual O Trustee ❑ Other: Signer is Representing: -�+Ld-Li4 f�•�. 1_J=f :L.1 •R.J�Vk�V'� [��+1�`�J�4S�!)3�4'£�{hs �rt t.+`w[`f {F,1j ©2019 National Notary y ssociation CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT GMENT CIVIL CODE §1189 . TAR -.^�w.ri: a�i l�►.^stiti k' i �►�* ! +� ` � :w:� *'tin' :i ': ti!:\ !^: { � `+"�` 'MI' • tet ik, V.01v` 4t.•• � .* rio ry public or other officer completing this certificate verifies only the identity of the individual who signed the ddccorn nt to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles ) On August ,2022 before me, H. Palumbo, Notary Public Date personally appeared David E. Jackson Here Insert Name and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name iF 'a.re subscribed to the within instrument and acknowledged to me that s/thy executed the same in Wier their authorized capacity(ie ), and that byheritheir signature() on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. l certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. H. PALUMBO COMM.* 22 04 NOTARY PUBLIC-CALIFORNIA V II LOS AtiGELES COUNTY Ighi 1 1" COMM. EXP. JULY 27, 02 " Place Notary Seal Above WITNESS my hand and official seal. Signature OPTIONAL n tune of Notary Public Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Per[ormance Bond - Las Palmas Number of Pages: Signer(s) Other Than capacities) Claimed by Signer(s) Signer's Name: David E_ Jackson i Corporate Officer Title(s): Mire President Partner — lLI Limited 1 General Individual Attorney in Fact fl Trustee ❑ Guardian or Conservator [l Other: Signer Is Representing: Document Date: 7/29722 Named Above: Signer's Name: Corporate Officer — Title(s): Partner — ❑ Limited El General i. I Individual El Attorney in Fact LI Trustee 0 Guardian or Conservator Other: Signer Is Representing: 841 / ..eliK .-r',0y-J' : A:.J 6:A. i ' fir ..V t_ .-' • Y4' ... f y T # „ i f= =1 * .. 'So% • ©2014 National Notary Association • www. NationalNotary.org • 1-800-US NOTARY (1-800-8 -8 ) Item # 90 r ORIGINAL ISSUED IN ONE ORIGINAL COUNTERPAT BOND NO. EACX4022841 1 iIE PREMIUM IS PREDICATED ON THE MII A.L CONTRACT PRICE AND 1S SUBJECT TO ADJUSTMENT. PREMIUM: 1N LUDEE IN THE PREMIUM CHARGED FAR THE PERFORMANCE BOND THIS BON SHALL TAKE EFFECT AUGUST 16, 2022 UPON APPROVAL TO PROCEED WITH AWARD OF CONSTRUCTION BY THE CITY OF NATIONAL CITY AND AFTER AN AUTHORIZED ED OFFICIAL SIGNS THE AGREEMENT FARM. PAYMENT BOND WHEREAS, the City Council of the City of National City, by Resolution. No. 01- , on the . n day of August, 2022 'has awarded California Commercial Pool inc., hereinafter designated as the "Principal", the LAS PALMAS WIMII1 POOL RENOVALION PROJECT, CIP NO. 2-01 WHEREAS, said Principal is required by Chapter 5 (commencing at Section 3225) and Chapter 7 (commencing at Section 3247), Title 15, Part 4, Division 3 of the California Civil Code to furnish a bond in connection with said contract; NOW, THEREFORE, we, the Principal and Endurance Assurance Corporation as surety, are held and firmly bound unto the City of National City, hereinafter called the "City", in the penal sum of Three Million Two Hundred Six Thousand, Ei. ht Hundred EiftvJ , o a85O.00). dollars lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if said Principal, his/her or its subcontractors, heirs, executors, administrators, successors, or assigns, shall fail to pay any of the persons named in Section 3181 of the California Civil Code, or amounts due Linder the Unemployment Insurance Code with respect to work or labor performed by any such claimant, or for any amounts required to be deducted, withheld, and paid over to the Franchise Tax Board from the wages of employees of the Contractor and his subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such work and labor the Surety will pay for the same in an amount not exceeding the sum hereinafter specified, and also, in case suit is brought upon this bond, a reasonable attorney's fee, to be fixed by the Court. This Bond shall inure to the benefit of any of the persons named in Section 31.81 of the California Civil Code, so as to give a right of action to such persons or their assigns in any suit brought upon this bond. It is further stipulated and agreed that the Surety on this bond shall not be exonerated or released from the obligation of this bond by any change, extension of time for performance, addition, alteration or modification in, to, or of any contract, plans, specifications, or agreement pertaining or relating to any scheme or work of improvement hereinabove described or pertaining or relating to the furnishing of labor, materials, or equipment therefore, not by any change or modification of any terms of payment or extension of the time for any payment pertaining or relating to any scheme or work of improvement hereinabove described, nor by any rescission or attempted rescission of the contract, agreement or bond, nor by any conditions precedent or subsequent in the bond attempting to limit the right of recovery of claimants otherwise entitled to recover under any such contract or agreement or under the bond, nor by any fraud practiced by any person other than the claimant seeking to recover on the bond anc that this bond beconstrued most strongly against the Surety and in favor of all persons for whose benefit such bond is given, and under no circumstances shall Surety be released from liability to those for whose benefit such bond has been given, by reason of any breach of contract between the owner of Public Entity and original contractor or on the part of any obliges named in such bond, but the sole conditions of recovery shall be that claimant is a person described in Section 3110 or 3112 of the California Civil Code, and has not been paid the full amount of his claim and that Surety does hereby waive notice of any such change, extension of time, addition, alteration or modification herein mentioned. IN WITNESS WHEREOF three identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety above named, on the 29th day of July , 20 22 EndurancQ ssqrance Corporation(SEAL) By: F ' __ - SEAL) Bye Kenneth A. Coate, Attorney -In -Fact (SEAL) DANIA e Surety California Commercial Pools, Inc. (SEAL) \f 64 (SEAL) ?c\c (/Y Principa ATTORNEY-1N-FACT ACKNOWLEDGEMENT OF SURETY STATE OF COUNTY OF On this day of )ss , 20 , before me, the undersigned, Notary Public in and for said County and State, personally appeared known—to—m-e—to—be—the—p-erson--- whose name is subscribed to the within instrument as the attorney -in -fact of the the corporation named as Surety in said instrument, and acknowledged to me that he subscribed the name of said corporation thereto as Surety, and his own name as attorney -in -fact. NOTE: Signature of those executing for NOTE: The Attorney -in -fact must attach a Surety must be properly i certified copy of the Power of acknowledged. Attorney. Signature: Name (Type or Print): (Notary Public in and for said County and State) My Commission expires: ATTACH ALL BONDS SOMPO INTERNATIONAL INSURANCE POWER OF ATTORNEY 4252 KNOW ALL BY THESE PRESENTS, that Endurance Assurance Corporation, a Delaware corporation, Endurance American Insurance Company, a Delaware corporation, and/or Bond Safeguard insurance Company, a South Dakota corporation, each, a "Company" and collectively, "Sompo international," do hereby constitute and appoint: Julia B. Bales, Kenneth A. Coate, Renae N. Balderas as true and lawful Attorneys) -In -Fact to make, execute, seal, and deliver for, and on its behalf as surety or co -surety; bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single bond or undertaking so made, executed and delivered shall obligate the Company for any portion of the penal sum thereof in excess of the sum of ONE HUNDRED MILLION Dollars (1O0,000,OOO.O0). Such bonds and undertakings for said purposes, when duly executed by said attorneys) -in -fact, shall be binding upon the Company as fully and to the same extent as if signed by the President of the Company under its corporate seal attested by its Corporate Secretary, This appointment is made under and by authority of certain resolutions adopted by the sole shareholder of each Company by unanimous written consent effective the 15th day of June, 2019, a copy of which appears below under the heading entitled "Certificate". This Power of Attorney is signed and sealed by facsimile under and by authority of the following resolution adopted by the sale shareholder of each Company by unanimous written consent effective the 15th day of June, 2019 and said resolution has not since been revoked, amended or repealed: RESOLVED, that the signature of an individual named above and the seal of the Company may be affixed to any such power of attorney or any certificate relating thereto by facsimile,, and any such power of attorney or certificate bearing such facsimile signature or seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, each Company has caused this instrument to be signed by the following officers, and its corporate seal to be affixed this 15'h day of June, 2019. Endurance Assurance Corporatio Endurance American Bond Safeguard (1)l� In era c p 1 I ur nc paTIy ! fy By. By. • By: ,� ��f� .► F Richard Appel; ,d�'�t ,, �eniory4) cinsel Richard Appel , Vi?i ,, entor Counsel Ric and ppe.m !! "� ,nnlor _ ouhsel #, stirano "fo it ,� f.,scan- iris F�., ., - --- . ,' :. ,51A i; �'\q,' W • # " '' y,.,, , 1 1 " ,o' ,�'•+Iy lA `%/may } 'V se'uTH /`'�. t w0.7 r+ i4 Ti w 41 1 SEAL ' " � 1i DAKOTA •4, 1ks! ' ► s i ; , _ o , INSURANCE ` + ;, �y�+ }2002 "" 1996 fr�p ,', cO PANY 5 ` e. E ARE +r y i, '3\ DELA7�''"f/RED "` : �.6% _ e '*-.,'; --_�i ti 4 �'•�.,, ` '`'" F ,,�`` ACKNOWLEDGEMENT ENT •,''r�i��r.�a .• �t*k� �, wp. 1161 On this 1 5th day of Jrane, 2019, before me, personally came the above signatories known to me, who being duly sworn, did depose and say that heitkoV,Rhilaerfpcer of each of the Companies and that he executed said instrument on behalf of each Company by authority of his office under the byws of each Company, • .r,,.....9 "0 CERTIFICATE By: or TitoomeStedi Pu L4C 4 My Cornmiss ilan Expires / f 3z i as r 1 a it I, the undersigned Officer of each Company, DO HEREBY CERTIFY that: 1, That the original power of attorney of which the foregoing is a copy was duly executed on behalf of each Company and has not since been revoked, amended or modified: that the undersigned has compared the foregoing copy thereof with the original power of attorney, and that the same is a true and correct copy of the original power of attorney and of the whole thereof, 2. The following are resolutions which were adopted by the sole shareholder of each Company by unanimous written consent effective June ne 15, 2019 and said resolutions have not since been revoked, amended or modified': "RESOLVED, that each of the individuals named below is authorized to make, execute, seal and deliver for and on behalf of the Company any and all bonds, undertakings or obligations in surety or co -surety with others: RICHARD M. APPEL, BRIAN J. BEGGS, CHRISTOPHER DON ELAN, SHARON L. S'IM , CHRISTOPHER L. SPARRO, MARIANNE L. WiLBERT and be it further RESOLVED, that each of the individuals named above is authorized to appoint attorneys -in -fact for the purpose of making, executing, sealing and delivering bonds, undertakings or obligations in surety or co -surety for and on behalf of the Company." The undersigned further certifies that the above resolutions are true and correct copies of the resolutions as so recorded _nd of the whole thereof. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal this day or 4, " 0 By: Dance S. y rie. e retary NO1ICE: U. S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CON ROL (OFAC) No coverage is provided by this Notice nor can it be construed to replace any provisions of any surety bond orother surety coverage providizd This Notice provides information concerning possible impact on your surety coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential declarations of "national emergency". OFAC has identified and listed numerous foreign agents, front organizations, terrorists, terrorist organizations, and narcotics traffickers as "Specially Designated Nationals and Blocked Persons' This list can be located on the United States Treasury's website — httos://vovw.treasurv.govlresource-center/sanctions/SDN-List. In accordance with O.FAC regulations, if it is determined that you or any other person or entity claiming the benefits of any coverage has violated U.S. sanctions law or is a Specially Designated National and Bleeped Berson, as identified by OFAC, any coverage will be considered a blocked or frozen contract and all provisions of any coverage provided are immediately subject to OFAC. When a surety bond or other form of surety coverage is considered to be such a blocked or frozen contract, no payments nor premium refunds may be madewithout authorization from OFAC. Other limitations on the premiums and payments may also apply. Any reproductions are void. Surety Claims Submission: LexcrnClaimAdminiatration sompo-intl.com Telephone: 515-553-9500 Mailing Address: Sompo International; 12890 Lebanon Road; Mount Judiet, TN 37122-2870 CALIFORNIAACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California Riverside. County of On JUL 242022 Date before me, Karina J. Cotton, Notary Public Here Insert Name and Title of the Officer personally appeared Kenneth . Coati. Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons)- whose name - is re- subscribed to the within instrument and acknowledged to me that he/she/they-executed the same in hisser/th i"r authorized capacity ies , and that by his/ er-/the-if-signatrrre(s) on the instrument the person )-, or the entity upon behalf of which the persons)- acted, executed the instrument. KARINA J. COTTON COMM. #2257741 z, NOTARY PUBLIC - CALIFORNIA m RIVERSIDE COUNTY My Comm . Expires Sept. 10 2022 Place Notary Seal aria'/or Stomp p Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature OPTIONAL Signature of Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document:. Document ent Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): In Partner — 0 Limited 0 General Partner n Limited ❑ General Individual ❑ Attorney in Fact ❑ Trustee o Guardian or Conservator D Other: Signer is Representing: 0 Individual a Attorney in Fact a Trustee o Guardian or Conservator El Other: Signer is Representing: 11,1. iwf t^ }.. 02019 National Notary Association y y . w: r s r t. -♦ t a _ �..f ti a _ _.�;} f '+gyp _:,. �7 - ...r� -� ,• • •r rJ; � a rt... -- . . .'..i.3:•i's a.,.•,s 's 'aa# 's�rsdt sta: i a.•�;� ,7e13Ia �- f-..,eat ol'erc c .• CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVJL CODE § 1189 4$ * • i _ uteri i • .'#4...0 \ r a i a' 4 s +I t` s s +� r* : -Mite. ..? i- .1!,+t"w'� ' 1e:. v' Vs. % +ram '+r`:'� ' �: �* ��!+ i+ :'ti •`, �"' .! : A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles n August I. 2022 before me, H. Palumbo, Notary Public Date Here Insert Name and Title of the Officer personally appeared David E. Jackson Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person() whose name /a&e subscribed to the within instrument and acknowledged to me that +3Yshe/they executed the same in MTheritheir authorized capacity, and that by� /fier/t ;,sir signature(s) on the instrument the person , or the entity upon behalf of which the person() acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. H. PALUMBO COMM.# 2299043 NOTARY PUBLIC-CALIFORNIA VI Los A GELES COUNT" MY COMM. EXP. JULY 27, 2023'e Place No to ry Seal Above WITNESS my hand and official seal. Signature OPTIONAL g ture of Notary Public Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Payment Bond Las Palmas Document Date: 7/29/22 Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: David E. Jackson Corporate Officer --- Title(s): Vice PrRsiciPnt Partner — ❑ Limited General Li Individual C Attorney in Fact ❑ Trustee E Guardian or Conservator El Other: Signer Is Representing: Signer's Name: O Corporate Officer — Title(s): ❑ Partner — i i Limited ❑ General ❑ Individual l Attorney in Fact PI Trustee El Guardian or Conservator • Other: Signer Is Representing: +"'► i �•*,.�/i+ :S.2 *'+/ice'+ i # i ces` 4'6'4`'.'' ,' fi : s4/".f'+�li Al f`';`,•4 '#'„!'� + f !�`' � �`M f ►fir+- 4 G' # ; e ms +" ':' AL, + .' !",'dI ..44cJ.2 ' f+ ©2014 National Notary Association • www.NationalNotary.org . 1-800-US NOTARY (1-8OO.876-6827) Item f#5907 ACC0RiOr CALICOM-01 RHAYNES CERTIFICATE OF LIABILITY INSURANCE DACE (MMIDDIYYYY) 7/ 7/20 2 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 1NSU E1 ( ), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: f TANT: if the certificate holder is an ADDITIONAL INSURED, the policies) must have ADDITIONAL AL 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 endorse ent(s). PRODUCER License # 0=3587 CDS Insurance Services 2001 E. Financial Way, Suite 200 Glendora, CA 91741 INSURED California Commercial Pools, Inc. -East-Auto-Centre-Drive Glendora, CA 91740 CONTACT Certificate Department NAME: (AJC, 10-9 00 1 FAX iArDf Iv�I:� � 10-9 E-MAIL certificates@cdsinsurance.com INSURER(S) AFFORDING COVERAGE INSURER A : Scottsdale Insurance Company INSURER B : Everest National ins Co NAIO # 41297 10120 INSURER e : Berkshire Hathaway Homestate Companies -IN uRER-D-:st hest r— urplus-Lines-Ins INSURER E 20044 10172 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO EFTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IUEI TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, T, 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 IBED HEREIN IS UBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL IN SD UBR'i POLICY NUMBER WVD : POLICY EFF (MIVJIDDIYYYY) POLICY EXP (IMIIIJJDDJYYYJ LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,00 1000 _ _..... _ CLAIMS -MADE 1 X OCCUR BC 00400 6/1 1 022 6/1212023 DEOEE TD Ea EoNcTcEence) 100,000 Contractual L,il. MED EXP (Any one person) 10,000 PERSONAL & ADV INJURY $ 1'000'00 GE 'I_ AGGREGATE LIMIT APPLIES PER: GENERAL A GRE ATE , ,000 POLICYT ; LOC PRODUCTS - COMP/OP AGG 2,000,000 OTHER: --- $ B ALJBTOI IOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) 10000,000 X ANY AUTO :DF CA00177 1 611 / 02 11 1 0 3 BODILY INJURY per person) OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) R-PODS ONLY rATonn ' 1 PROPERTY DAMAGE (Per accident) UMBRELLA LIAR X OCCUR EACH OCCURRENCE 0,000,000 X EXCESS LIAB CLAIMS -MADE XLS0125323 6/1 /2022 6112/2023AGGREGATE 6,000,000 DED 1 RETENTION! C ATION WORKERS AC D EMPLOYERS' LIABILITY PER 1 y #_STATUTE L H- ER ANY PROPRIETOR/PARTNER/EXECUTIVE n AUVD 4 71 1 l 0 '1 1 1 0 .. E.L. EACH ACCIDENT �I,000 000 $ OFFICER/MEMBER MEMBER EXCLUDED. N 1 A 'I,Oi0,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under DEOJRIPTIORI OF OPERATIONS below E.L, DISEASE - POLICY LILT 1,0000300 ...................._ . D D Pollution Pollution . 71791 00 ; 7r179'1 9 00 1 i 3/9/2022 319/2022 1 1 0 /91 0 eneral Aggregate Each Condition 2,000,000 2,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS J VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Designated Operations Covered By A Consolidated (Wrap-up) Insurance Program exclusion (with Limited Off -Site coverage) applies per attached endorsement form GLS-454s (-14). All Endorsements apply as per written contract. Re: Las Palmas Swimming Pool Renovation Project -1800 E. 22nd Street, National City CA 91950 The City of National City, its elected officials, officers, agents, employees and volunteers are named as additional insured as respects General Liability per attached endorsements Al: CG 20 10 07 04. Named as additional insured on the auto per form ECA 04 521 04 14. Waiver of subrogation applies to Work Comp per form WC 99 04 10. CERTIFICATE HOLDER CANCELLATION City of National ity clo Risk Manager 1243 National City Blvd. National City, CA 19 0-4 9' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE \\ ACORD 25 (2016/03) 1 -201 a ACORD l I P l ATI 1. All rights reserved. The ACORD name and logo are registered marks of ACORD ilk SCOTTSDALE INSURANCE COMPANY° ATTACKED TO AND FORMING A PART OF POLICY NUMBER ENDORSEMENT EFFECTIVE DATE (i ;.O1 AM. STANDARD TIME) B05 0400 06/12122 NAMED INSURED ENDORSEMENT NO la m:14,7k.MLFA AGENT NO. CALIFORNIAI POOLST 04767 •y'/F�'Nt4�ht74+Vklawka.^4?44ik�i+h�Wo--0ctll4�,.W.4hYurrrw \.�akk` wr.`-k'N w:w..,.�...t �.,+a 4l �: ,f ti . b+`�n�bvxx�r4w+Qkc.xsvawwvw`.+'Y`�.i9o-xS++mW.wn wrn3 r..,wtwc_•. THIS ENDORSEMENT CHANGES THE POLIO'. PLEASE READ IT CAREFULLY, 3'•'ib4ks5�ln'b.M4lkhK+shioN+rb1� avN z51 EXCLUSION -DESIGNATED OPERATIONS COVERED BY CONSOLIDATED (WR-AP-U.P-)-1 NS GE P G -WIT LIMITED- ` .SITE- 1 AGE)_. - This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description and Location of Operationfs): ALL LOCATIONS AND OPERATIONS FoR WHICH YOU ARE COVERED UNDER CONSOLIDATED, WRAP-UP SIMILAR INSURANCE PROGRAM. If no entry appears above, information required to complete this endorsement will be shown in the Decla- rations as applicable to thisendorsement.) The following exclusion is added to paragraph a Exclusions of COVERAGE A—BOD1LY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I —COVERAGES): This insurance does not apply to "bodily injury" or "property rty damage" arising out of either your ongoing operations or operations included within the "products -completed operations hazard" at the location de- scribed in the SCHEDULE of this endorsement, as a consolidated (wrap-up) insurance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated (wrap-up) insurance program: 1 Provides coverage identical to that provided by this Coverage Part; Has limits adequate to cover all claims; or Remains in effect, However, the exclusion does not apply to "bodily injury" or "property damage" arising out of your ongoing operations for a project covered under a consolidated (wrap-up) insurance program at locations other than the project site, if no coverage for these operations is found in the consolidated (wrap-up) program. GLS-464s(-14 AUTHORIZED REPRESENTATIVE Includes copyrighted materiel of DSO Properttes, Inc,, with its permission. Copyright, ISO Properties, Inc., 2013 Page 1o1 DATE • POLICYNUMBER: BCS0040025 COMMERCIALGENERAL LIABILITY 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATIOt.J This ndor ment modifies insurance provi firth following. COMMERCIAL I R.L LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Frs Or o . io ANY VERSON 0 RGAI\f T{ION WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENTt EXECUTED RTO . TO THE OCCURRENCE TO WHICH THIS INSURANCE APPLI , THAT SUCH PERSON OR ORGANIgATION ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY wrovem.-4.1.1rrwn4a4- - ti Iv i ✓w ,.,-.M. M.�/�ch'�. Information required to ctom of Covered rat =LOCATIONS K. ........•.1.1...na+.W 1,.14 71,1,+.711T..+51 3 beue.•ae.,aq {�� 'wW aWi4 `T�.����.�.a....� letlete this Schedule, if not shown above, will be shown in the Declarations. A Section — Who Is An Insured is amended to include as are additional insured theperson(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", ry", ''property damage" or "personal and advertising Injury" caused, in whole or in part, by: 1. Your acts or omision ;or . 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. CO 20 1 B. With respect to the insurance afforded to these additional insureds, the following additionalexclu- sions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 locaflon of the covered operations has been completed; or . That portion of '`your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a princi- pal as a part of the same project ISO Properties, Inc,, 2004 Page I of 1 Irisrirc d Copy Policy #:CF2CA00177221 COMMERCIAL AUTO ECA 04 521 04 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIO..:.fAL II:4SURED -DESIGNATED ORGANIZAT1Ot::: This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART SCHEDULE Name f Additional insured Orapitization ALL ORGANIZATIONS THAT ARE Rfaiiififf6BY WRITTENCONTRACT C ACT WITH THE NAMED INSURED TO BE NAMED AS AN ADDITIONAL INSURED THIS POLICY WITH REGARD TO THEIR OPERATION, MAINTENANCE, OR USE OF A COVERED "AUTO", '4\ v..,...._. Information reqpired to comp1etethis Schedule if not shown above will be shown in. the Declarations. The following is added to the Who Is Insured paragraph under Section 11— Liability Coverage: The organization shown in the Schedule with respect to the operation; maintenance, or use of a covered "auto" if you are required to add such organization to this policy as an additional insured in order to ply with the terns of a written "insured contract" or written rrnnt. This does not apply when such contract or agreement: A. Involves the owner or anyone else from whom you hire or borrow a covered "auto" unless it is "trailer" connected to covered "auto" you own; or ECA 04 521 04 14 B. Is executed after the date of "loss", This paragraph does not apply if: 1. The terms and conditions of the written n "insured contract" had been agreed upon prior . You can definitively establish that the terms and conditions of the written 'insured contract" ultimately executed are the sane as those which had been agreed upon prior to the "accident" or "loss". Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office, Inc., used with its permission Pagel of I INSURED COPY WORKERS II PE SATI I AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10 (Ed. 01-19) ,�r1rT'ihit u,-t:oac,o:f: wayc...�:y '�I..1,,I:.%"' 1,�,.Hv.4 rh.:�rtl.rz.y�v..o-3ai Y., �.aw..�udrK.rta�v. Yi+�li E,r�... mY.wb.NI.ry Yhr-.L.n�orw..MNIF;a+Hr�NY.-----1..-._i.. ,.. a++. K+z „Y: rafwvnGNi..o�..cM+XY}M4'-i.T*r+l r.+.tX-.{>-S+M w-•raw-n u..cif.],.nw'-*-�i:f t�n*firyNYMrtit:+i �=R P�u�c rtwMGA4lirtf�WA'x'h�F}.17e4?invniGi �A.ixo%':i-0cl+, ..r.I;4 .. :.w.k+x. +.i !tl->allFr.u}twp,�e+. r.o-xi�e{•+!e WAIVER F OUR RIGHT TO RECOVER VE FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy, We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Blanket Waiver Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description All CA Operations Waiver Premium (prior to adjustments) This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only ►wen this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 091 / 0 1 Insured: California Commercial Pools, Inc, Policy No.: CAWC248571 Endorsement No.: Insurance Company: Berkshire Hathaway Home t to Ins Co WC990410 (Ed. 01-19) Premium Countersigned by City of National City BUSINESS TAX CERTIFICATE "For Services Provided in National City_ California Only" Business Name Business Location Business Owner(s) CALIFORNIA COJIIVMERC1AL POOLS INC 2255 AUTO CENTRE DR GLENDORA, CA 91740-6721 CALIFORNIA COMMERCIAL POOLS INC CA Lt FCC RAN IA COMMERCIAL POOLS INC C 2255 AUTO CENTRE DR GLENDORA0 CA '91.740- 721 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS THAT is OTHERWISE PRfHIRITF fl CALIFORNIA COMMERCIAL POOLS INC CALIFORNIA NATIONAL $ `.l I Pif,Tht Pun XV E D 2022 TO I3E POSTED IN A CONSPICUOUS PLACE AND NOT TRANSFERABLE OR ASSIGNABLE Business Type Contractor - General (Based Out Of City) Account Number 09051536 Effective Date Expiration Date July 27. 2022 December 31, 2022 City 1Manager NOTE: IT IS YOUR OBLIGATION TO RENEW THIS CERTIFICATE WHETHER OR NOT YOU RECEIVE A RENEWAL NOTICE For all inquiries regarding this certificate, contact HdL Business Tax Support Center at (619) 382-2596 Thank you for your payment on, your NationalCity Business Tax Certificate. ALL CERTIFICATES MUST BE AVAILABLE FOR INSPECTION UPON REQUEST. If you have questions concerning your business license, contact the Business Support Center via email at: NationalCity©HdLgov.corn or by telephone at: (619) 382-2596 Keep this portion for your license separate in case you need a replacement for any lost, stolen, or destroyed license. A fee may be charged for a replacement or duplicate certificate. This certificate does not entitle the holder to conduct business before complying with all requirements of the National City Municipal code and other applicable laws, nor to conduct business in a zone where conducting such business violates law. If you have a fixed place of business within the National City, please display the Business Tax Certificate below in a conspicuous place at he premises. Otherwise, every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or here person, or affixed in plain view any cart, vehicle, van or other movable structure or device at all times if required by the Collector. Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender -based discrimination of business establishments. A full notice is available in English or other languages by going to: https:/Iwvvvv.dca.ca.gov/publicationsi - CALIFORNIA =- NATIONAL I 11 / MIL UItPORAi%9 BUSINESS TAX SUPPORT CENTER 8839 N CEDAR AVE #212 FRESNO, CA 93720-1832 CALIFORNIA COMMERCIAL POOLS INC 2255 AUTO CENTRE DR GLENDORA, CA 91740-6721 f National Cit%City BUSINESS TAX CERTIFICATE Account Number: 09051536 Date of Issue: 07/27/20 2 City of National City BUSINESS TAX CERTIFICATE "Fur Services Provided in National City. California Only" Business Name Business Location Business Owner(s) AYCON INC 9520 FAD ETT ST STE 218 SAN DIEGO, CA 92126-4452 AYCON INC AYCON INC 9520 PADGE! 1 ST STE 218 SAN DIEGO, CA 92126-4452 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS THAT IS OTHFRWISF PROH'IRITED. 'CALIFOffNIA ATIONALCir Ip. _rift} t11Al EO 2022 TO BE POSTED IN A CONSPICUOUS PLACE A N D NOT TRANSFERABLE OR ASSIGNABLE Business Type Contractor - General (Based Out Of City) Account Number 09050092 Effective Date April 04, 2022 Expiration Date December 31, 2022 City Manager NOTE: IT IS YOUR OBLIGATION TO RENEW THIS CERTIFICATE WHETHER OR NOT YOU RECEIVE EIVE A RENEWAL NOTICE For all inquiries regarding this certificate, contact Hdl- Business Tax Support Center at (619) 382-2596. AYCON INC Thank you for your payment on your National City Business Tax Certificate. ALL CERTIFICATES MUST BE AVAILABLE FOR INSPECTION UPON REQUEST. If you have questions concerning your business license, contact the Business Support Center via email at. Nationa1City HclLgov,corn or by telephone at: (619) 382-2596 Keep this portion for yorfr license separate in case you need a replacement for any lost, stolen, or destroyed license A fee may be charged for a replacement or duplicate certificate. This certificate does not entitle the holder to conduct business before complying with all requirements of the National City Municipal code and other applicable laws, nor to conduct business in a zone where conducting such business violates law If you have a fixed place of business within the National City, please display the Business Tax Certificate below in a conspicuous place at he premises. Otherwise, every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or her person, or affixed in plain view any cart, vehicle, van or other movable structure or device at all times if required by the Collector. Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender -based discrimination of business establishments.. A fill notice is available in English or other languages by going to https://www.r ca.ca.govipublicationsi AE.0 ORMA 1141 fa ONAL airy taE.! RPant alKO BUSINESS TAX SUPPT CENTER 8839 N CEDAR AVE #212 FRESNO, CA 3 20-1 32 AYCON INC 9520 PADGETT ST STE 218 SAN DIEGO, CA 92126-4452 rsto Duo City of National City E BUSINESS TAX CERTIFICATE Account Number: Date of Issue: 090 0092 04/04/2022 City National City BUSINESS TAX CERTIFICATE "For Services Provided in National City, California Only" Business Name Business Location Business Owner(s) REBEL INDUSTRIES, INC. 2509 WILDI OSE LN UPLAND, CA 91784-1017 REBEL INDUSTRIES, INC REBEL INDUSTRIES, INC. 17053 CAMPO DR PARKER, , CO 80134-7613 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS THAT Is (TTHFRtNisE PR(]HIHIT�I _ - CALIFORNIA - T1 L CITV to Ui (HOUR ATlI° Business Type Account. Number Effective Date Expiration Date 2022 TO BE POSTED IN A cONSPIctiotis PLACE AND NOT TRANSFERABLE OR ASS'IGIIABLE Contractor - Sub (Based In City) 09051542 August 01, 2022 December 31, 2022 City Manager NOTE: IT IS YOUR OBLIGATION TO RENEW THIS CERTIFICATE WHETHER OR NOT YOU RECEIVE A RENEWAL NOTICE For all inquiries regarding this certificate. contact HdL Business Tax Support Center at (619) 352-259 . REBEL INDUSTRIES, INC Thank y©u for your payment on your National City Business Tax Certificate. ALL CERTIFICATES MUST BE AVAILABLE FOR INSPECTION UPON REQUEST. If you have questions concerning your business license, contact the Business Support Center via email at: NationalCity©FldLgov.corn or by telephone at: (619) 382-2596 Keep this portion for your license se-parate in case you need a replacement for any lost, stolen, or destroyed license. A fee may be charged for a replacement or duplicate certificate. This certificate does not entitle the holder to conduct business before complying with all requirements of the National City Municipal code and other applicable laws, nor to conduct business in a zone where conducting such business violates law. If you have a fixed place of business within the National City, please display the Business Tax Certificate below in a conspicuous place at he premises. Otherwise, every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or her person, or affixed in plain view any cart, vehicle, van or other movable structure or device at all times if required by the Collector. Starting January 1. 2021, Assembly Bill 1607 requires the prevention of gender -based discrimination of business establishments. A full notice is available in English or other languages by going to: https://www.dca.cagovipublicationsi CALIFORNIA _ Tip! .t-3Y CIO KP 1114 VT" BUSINESS TAX CENTER 8839 N CEDAR AVE #212 REBEL INDUSTRIES, INC. 17053 CAMPO DR PARKER{ CO80134-7613 SUPPC'L7 "r_ AU, City of National City BUSINESS TAX CERTIFICATE Account Number: 0901 42 Date of Issue: 0 10`I /2022 1 City of National City BUSINESS TAX CERTIFICATE "For Services Provided in National City, California Only" Business Name Business Location Business Owner(s) AQUA CONSTRUCTION INC 922 FOUNTAIN SPRINGS LN GLENDORA, CA 91741-2324 AQUA CONSTRUCTION INC AQUA CONSTRUCTION INC 922 FOUNTAIN SPRINGS LN GLENDORA, CA 91741-2324 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS TI-IAT I OTHERWI E PROHIBITED. _eALIFO 14 - NATIONAI, CITY i3 r'r•wwrrnt vrru 2022 TO BE POSTED IN A CONSPICUOUS PLACE AND NOT TRANSFERABLE OR ASSIGNABLE Business Type Contractor - Sub (Based Out Of City) Account Number Effective Date Expiration Date 09051541 August 05, 2022 December 31, 2022 City Manager NOTE: IT IS YOUR OBLIGATION TO RENEW THIS CERTIFICATE WHETHER OR NOT YOU RECEIVE A RENEWAL NOTICE For all Enquiries regarding this certificate. contact I-IdL Business Tax Support Center at (619) 382- 5 6 AQUA CONSTRUCTION INC Thank you for your payment on your National City Business Tax Certificate. ALL CERTIFICATES MUST BE AVAILABLE FOR INSPECTION UPON REQUEST. If you have questions concerning your business license, contact the Business Support Center via email at: NationalCity@HdLgov_corn o.r by telephone at: (619) 382-2596 Keep this portion for your license separate in case you need a replacement for any lost, stolen, or destroyed license. A fee may be charged for a replacement or duplicate certificate. This certificate does not entity theholder to conduct business before complying with all requirements of the National City Municipal code andother applicable laws, nor to conduct business in a zone where conducting such business violates law. If you have a fixed place of business within the National City, please display the Business Tax Certificate below in a conspicuous plane at he premises. Otherwise, every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or her person, or affixed in plain view any cart, vehicle, van or other movable structure or device at all times if required by the Collector. Starting January 1. 2021. Assembly Bill 1607 requires the prevention of gender -based discrimination of business establashnients A full notice is available in English or other languages by going to: https:llwww.dca.ca.govlpubll atkonsi AL1FORNIA_. &T I i iiiii. 3 J rNr ir►tw(iA A t t;3 BUSINESS TAX SUPPD CHO CENTER &Ito CEDAR AVE #212 AQUA CONSTRUCTION INC 92 2 FOUNTAIN SPRINGS LN GLENDORA, CA 91741 2324 City of National City BUSINESS TAX CERTIFICATE Account Number: 09051541 Date of Issue: 0810512422 Cityof National City BUSINESS TAX CERTIFICATE "For Services Provided in National City, California Only" Business Name Business Location Business Owner(s) SC POOLS 555 W ALLEN AVE UNIT 9 SAN DIMAS, CA 91773-1477 SC SAX COMPANIES INC SC POOLS 555 W ALLEN AVE UNIT 9 SAN DIMAS, CA 91773-1477 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT ABUSINESS THAT IS OTI-IFRWISE PRfHHRITFIi. — CALIFORNIA - NATIONAL 1 T rigCba rent 2022 TO BE POSTED IN A CONSPICUOUS PLACE AND NOT TRANSFERABLE OR ASSIGNABLE Business Type Contractor - Sub (Based Out Of City) Account Number 09051548 Effective Date Expiration Date August 01, 2022 December 31. 2022 City Manager NOTE: IT IS YOUR OBLIGATION TO RENEW THIS CERTIFICATE WHETHER OR NOT YOU RECEIVE A RENEWAL NOTICE For all inquiries regarding this certificate, contact HcIL Business Tax Support Center at (619) 382-2596_ SC POOLS Thank you for your payment on your National City Business Tax Certificate. ALL CERTIFICATES MUST BE AVAILABLE FOR INSPECTION UPON REQUEST. If you have questions concerning your business license, contact the Business Support Center via email at: NationalCity@HdLgov.com or by telephone at: (619) 382-2596 Keep this portion for your license separate in case you reed a replacement for any Cost. stolen, or destroyed license. A fee may be charged for a replacement or duplicate certificate. This certificate does not entitle the holder to conduct business before complying with all requirements of the National City Municipal code and other applicable laws, nor to conduct business in a zone where conducting such business violates law. If you have a fixed place of business within the National City, please display the Business Tax Certificate below in a conspicuous place at he premises. Otherwise. every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or her person, or affixed in plain view any cart, vehicle, van or other movable structure or device at all times if required by the Collector Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender -based discrimination of business establishments. A Bill notice is available in English or other languages by going to. httpsJfwww.cicaca.govlpubli ticnsl R CALIFORNIA NikriiONALCHIT -i BUSINESS TAX SUPPO CENTER 88 9 N CEDAR AVE #212 SC POOLS 555 W ALLEN AVE UNIT 9 SAN DIMAS, CA 91773-1477 City of National City BUSINESS TAX CERTIFICATE Account Number: 09051548 Date of Issue: 08/01/2022 811122, 2:41 PM Receipt Guest fa Home Report a Problem Find Account 4 Submit Payment Receipt Business License Online Payment Thank. you for your payment Payment Date: /1/ 0 2 2:42:12 PSI Confirmation -#.: 02 104 (3833648249) Paying 09051552 QUALITY REBAR, INC Account Information Account it 09051552 Expire Date 12/31/2022 Name QUALITY REBAR, INC Address 13275 GREGG ST STE B City PO AY Phone (858) 679-3934 Summary Standard Input Balance Due State CASp Fee (AB1379) 1.00 $4.00 Contractor/Subcontractor (Dustide) C or El Licensed 1.00 $50.00 Total Balance Due $54 OO Credit Card Processing Fee $ .00 Total Due $56.00 Payment Information Credit Card #` x6414 Payment Amount $56.0O Powined br HrIL https:ina.tionalcily.hd1gov.comIPay/Pay3 1:' 9 Frw.-. (Rev. December 2014) Department of the Treasury internal Revenue Service Request for Taxpayer Identification Number and Certiflcation 1 Name (as shown on your income tax return), fume is r u ri on this At wt. ie v Wank California Commercial Poo1st Inc. 2 Business n n &di reg r'ded entity name, if different from above 3 Check appropriate box for federal tax classification: check only one of the following seven boxes: Individual/sole proprietor or c corporation 1 1S Corporation El Partnership LJ Trustlesiate single -member LW Limited l liability company, Enter the tax classification (C=C corporation, S=S corporation, P=p rtrrer hip) Note,. Fora single-rnert bcr LLC that is disregarded, do not check LL ; check the appropriate box in the line above for the tax classification of the single -member- owner. Li Other i(see instructions 5 Address (number, street, and apt. Dr suite no.) 2256 E. Auto Centre Drive 6 City, state, and ZIP code Gl ndor , GA 91740 7 List account number() here (optional) Identification Number MN) Give Form to the requester. not send to the IRS. 4 Exemptions (cods apply only to certain entities, not individuals: see instructions ctions on page ): Exempt payee code (if any) Exemption from FATCA reporting code (If any) Ee uesti is s_narr e_ d-address-isi ptlonal - niter your TIIn the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number ( I ). However, for resident alien, sole proprietor, or disregarded entity, see the Part i instructions on page 3. For other entities, it is your employer identification number er (EI »). if you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for lino 1 and the chart on page 4 for guidelirtes on whose number to enter. Certificaticin Under penalties of perjury, I certify r that: 1. The number shown on this form is lily correct taxpayer identification number or l am waiting for a number to be issues 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 (IR) 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 ! air no longer subject to backup ithhlding; and 3. i am a U.S. citizen or other LIS. person (defined below); and 4. The FATCA code(s) entered on this form n if any) indicating that I am exempt from FATCA reporting is correct, Certification instructions. You rnust cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real ette transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN, Sergi the instructions on. page. . Sign Signature Here .i u.s. person 0- General Instructions Sofa! security number or Invfoyer identification number 9 F5.- ......._ i 4• I } Section references are to the Internal Revenue Code unless otherise noted. Future developments, Information about developments affecting Form J- (such as legislation enacted after we release it) is at www.frs.gewirw9, Purpose of Form An individual or entity (Form W-9 requester) ster) who is required to the an information return with the IRS rnust obtain your correct taxpayer identification number (TN) which may be your social security number ( N), individual taxpayer identification number (ITN), adoption taxpayer identification number (AT1N), or employer identification number ( IN), 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 1099µI T (interest earned or park}) • Form t 0 9-Did (dividends, including those from stooks or mutual funds) • Form O J-1 l (various types of income, e, prizes, awards, or gross proceeds) • Form 109 a-[B (stock or mutual fund sales and certain other transactions by brokers) * Form 1O99- (proceeds from real estate transactions) * Form 1099-K (merchant card and third party network transactions) Date l 06/17/2022 9 Form 1098 (home. mortgage interest), 1 O B-F (student loan interest), t 9 µT (tuition) • Forrn I09 - (canceled debt) • Form 1099- (acquisition or abandonment of secured property) se Fora l-9 only if you are a U.S. person (including a resident alien), to provide your correct TiN. ff you cio not return Form It to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on pace 2. By signing the filled -out form, you: 1, Certify that the TIN you are giving is oorreot (or you are waiting for a number to be issued), 2. Certify that you are riot subieot to backup withholding, or 3. Claim exemption from backup withholding If you are a US. exempt payee, If applicable, you are also certify ng 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 vithhulding tax on foreign partners" 5hEi-e of effectively connected income, and 4.. Certify that FATCA code(s) entered on thls form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporti!n on page 2 for further information, Cat. No. 10231X Form W- (Rev. 1 - 0 4) C7C)RCI CALICOM-D1 CERTIFICATE OF LIABILITY INSURANCE 7127/2022 RHAYNES DATE (MM/DOIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER F 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( ), AUTHORIZED REPRESENTATIVE ENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: T: If the certificate holder is an ADDITIONAL INSURED, the policies) 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 endorsernent(s). PRODUCER License # 0088587 CDS Insurance Services 2001 E. Financial Way, Suite 200 Glendora, CA 91741 INSURED California Commercial Pools, Inc. 2255 Ea _A_uto a ntre_D ive Glendora, CA 91740 0 o40T Certificate Department PHONE E► I= 926 10-9 00 (Act No, Ex��: � AIIE E-rUTDAILSS: certificates@cdsinsurance.com INSURER(S) AFFORDING COVERAGE FAX 626 (A/C, No); () 610M9 99 INSURER A:Scottsdale Insurance Company INSURER B : Everest National Ins Co INSURER c : Berkshire Hathaway Homestate Companies INsuRER-c-Mesteh ster urpl us -Lines -ins INSURER E : INSURER F COVERAGES E-----.-__.- CERTIFICATE NUMBER: REVISION NUMBER: NAIC # 41 297 10120 20044 -01-7 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ED 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 TEEMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR 1 TYPE OF INSURANCE ADDLISUBE INSO WVD • A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR x Contractual Liab. k GEN'L AGGREGATE LIMIT APPLIES PER: n POLICY X Ifp T L I LOO 1 1 OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS p �..�„ TO oNNLY x POLICYNUMBERPOLICY EFF (MMfDD1Y Y 1 BCS0040025 CF2CA00177221 X UMBRELLA LIAB EXCESS LIA8 DED RETENTION $ OCCUR CLAIM -MAin 6/12/2022 POLICY EXP (M M!D DJYYYY) EACH OCCURRENCE LIMITS 1,000,000 I AMA E TO IN 6112/20 3 PREM OI.. (EaREoccurrTERence) . MED EXP (Any one person) I S PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - CQMP(OP AGG 6/12/2022 6112/2023 COiv1BINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY Q MADE Par accident) ;7 L 01 5323 6/121 022 6/1 1 0 3 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory Erg NH) If yes. describe under DESCRIPTION OF OPERATIONS befog D Pollution D Pollution Y/N N/A X CAWC248571 G71791592003 G71791592003 EACH OOURRENCE AGGREGATE S '100,Q0 10,000 1,000,000 2,000,000 2,000,000 ,000,000 6,000,000 6,000,000 9/3/2021 9/3/2022 3/9/2022 3/9/2022 .. U-7,,TuTE DR l � 1,000,000 ACCIDENT E.L. DISEASE - EA EMPLOYEE E,L. DISEASE - POLICY LIMIT 3191 023 3/9120 3 General Aggregate Each Condition 1,000,000 1,000,000 2,000,000' 2,000, 000 DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES (ACORD 1 01 } Additional Remarks Scheduler may be attached if more space is required) Designated Operations Covered By A Consolidated (Wrap-up) Insurance Program exclusion (with Limited Off -Site coverage) applies per attached endorsement forty CLS-454s (5-14). All Endorsements apply as per written contract. Re: Las Palmas Swimming Pool Renovation Project -1800 E. 22nd Street, National City CA 91950 The City of National City, its elected officials, officers, agents, employees and volunteers are named as additional insured as respects General Liability per :attached endorsements Al: CG 20 10 07 04. Named as additional insured on the auto per form ECA 04 521 04 14. Waiver of subrogation applies to Work Comp per form WC 99 04 10. _CERTIFICATE HOLDER A CELLATI N City of National City c/o Risk Manager 1 243 National City Blvd. National City, CA 91950.4397 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE \\ ACORD 2 (2016/03) 1988-2015 ACORD CORPORATION, All rights reserved. The ACORD D name and logo are registered marks of ACORD Jk. SCOTTSDALE IN5UI2ANCE COMPANY® ATTACHED ! ENDORSEMENT EFFECTIVE DATE FORMING A PART t` OF 02:I11 A.M. T TIME} POLICY NAMED I U f ED AGENT O, ENDORSEMENT NO. BCS0040025 06/12/22 CALIFORNIA E CIA POOLS, 04767 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION —DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED WL -J. S U - .0 - - -G.R A M-WIT - U M I T D- '• •SF " -G E• e• ----- . --- --- This endorsement modifies insurance provided under the following; COMIVIERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description and Location of Operation(): ALL LOCATIONS AND OPERATIONS FOR WHICH YOU ARE COVERED UNDER CONSOLIDATED, WRAP—UP OR MILSURAN. PROGRAM. If no entry appears above, information required to complete this endorsement will be shown in the Decla- rations as applicable to this endorsement) The following exclusion is added to paragraph a Exclusions of COVERAGE A —BODILY INJURY AND PROPERTY DAMAGE UU L1T (SECTION I— VE G ; This insurance does riot apply to `bodily injury" or }`property damage" arising out of either your ongoing operations or operations included within the "products -completed operations hazard, at the location de- scribed in the SCHEDULE of this endorsement, as a consolidated (wrap-up) insurance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated (wrap-up) insurance program I Provides coverage identical to that provided by this Coverage Part; Has limits its adequate to cover all claims; or Remains in effect, However, the exclusion does not apply to "bodily injury" or "property rty damage" arising out of your ongoing operations for a project covered under a cdosolidated (wrap-up) insurance program at locations other than the project site, if no coverage for theseioperations is found in the consolidated (wrap -urn) program. AUTHORIZED REPRESENTATIVE Includes copyrighted material of ISO Properties, Inc,, with its permission, Copyright, ISO Properties, Inc., 2013 ,L - 4 ( -f4) Page I of DATE • POLICY NUMBER: BCS0040025 COMMERCIAL GENERAL LIABILITY CO 0 10 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 foElowir_: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE roowh�wh.cwxvximsowYwtlwwri.Wriaurrw.M..ir�u.rtlwrtsar4 Yt�v.N:w.r:.w.iwws..ra...r,� �sYwoGWn iY. T���r� Name Of Additional Insured Person(s) r Org4nizationK ANY PERSON OR ORGARIZATION WHEN REQUIRED BY WRITTEN CONTRACT AGREEMENT, EXECUTED PRIOR TO T E1 OCCURRENCE TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY Locations) Of Covered Qpqations ALL—LOCAT I ON S Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. Section 11 — Who Is An Insured is amended ed include as an additional insured the pros 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 f I part, by: 4i. Your acts or omissions; or . The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additIonai insureds)at the location(s) desig- nated above. 1 B. With respect to the insurance afforded to these additional insureds, the following ddiitlonai exclu- sions apply: This insurance does not apply to "bodily it jur r" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed or on behalf of the additional insured(s) at the location of the covered operations has been completed; or . That portion of Jiyour work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a princi- pal as a part of the same project. CG 0 10 07 04 ISO Properties, Inc,, 2004 Page 1 of 1 El Iasurtd Copy Policy #:CF2CA00177221 COMMERCIAL AUTO ECA '1 041 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDTIONAL INSURED - DES1G:.ATED ORGA This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART SCHEDULE IZATION Name Of diti l Insured ipr ton .._ _ I U_ I G l l 'lol S H T ARE REQUIRED TTl WR E CONTRACT WI INSURED TO E NAMED AS AN ADDITIONAL INSURED ED 'l IS POLICY WITH REGARD TO EIl OPERATION, MAINTENANCE, ICE, SE OF A COVERED " TO" c fo rrnation required to complete this Sch d l ,..if riot shown above, will be shown in the Declarations. The following is added to the Who Is An Insured El, paragraph under Section 11 - Liability Coverage: The organization shown in the Schedule with respect to the operation, maintenance, r use of a covered "auto, if you are required to add such organization to this policy as an additional insured in order to comply with the terns of a written "insured contract" or written agreement. This does not apply when such contract or agreement: A. Involves the owner or anyone else from whom you hire or borrow a covered "auto" unless it is "trailer" connected to a covered `auto" you own; or ECA 4 521 0414 Is executed after the date of "loss", This paragraph does not apply if: 1. The terms and conditions of the written 'Insured contract" had been agreed upon prior to the "accident" or gloss"; and 2. You can definitively establish that the terms and Conditions of the written "insured contract" ultimately executed are the same as those which had been agreed upon prior to the "accident" or "loss". Copyright, Everest Reinsurance Company, 2014 Includes copyrighted material of Insurance Services Office, Inc., used with Its permission Page lof 1 INSURED COPY WORKERS MPENSATI J AND EMPLOYERS LIABILITY INSURANCE POLIO' WC 99 04 10 ., BEd. - 19) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORN1A BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual premium, with a minimum ur initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Blanket Waiver Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver, Job Description All CA Operations Waiver Premium (prior to adjustments) This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 3 /03I 0 1 Policy No.: CAVVC;248571 Endorsement No.: }r ur+ d: California Commercial Pools, Inc. InsuranceCompany: Berkshire Hathaway Homestate ins Co WC 990410C (Ed. 01-1) Premium $ Countersigned by gilz2zz 5//eigt. .. `:rrcxY'-d I r'74..o �.� n. wy,„�rrr4c�.. .�.i1 a t' � �� '"� } 1 Lti K i �'�����:""�'+S'ti+w'Yl�r`..����.�-'l. � ,. ..,- -a-�f. t' City f National City BUSINESS TAX CERTIFICATE "For Services Provided in National City, California nil" Business Name Business Location Business wner(s) CALiFORNIA COMMERCIAL POOLS INC 2255 AUTO CENTRE DR GLENDORA, CA 91740- 721 CALIFORNIA COMMERCIAL POOLS INC CALIFORNIA COMMERCIAL POOLS INC 2255 AUTO CENTRE DR GLENDORA, CA 91740-6721 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS THAT iS OTHERWISE PROWIRITED, CALIFORNIA COMMERCIAL POOLS INC • N 2022 TO BE POSTED IN A CONSPICUOUS PLACE AND NOT TRANSFERABLE OR ASSIGNABLE Business Type Contractor - General (Based Out Of City) Account Number 09051536 Effective Date Expiration Date July 27, 2022 December 31, 2022 City Manager NOTE: IT IS YOUR OBLIGATION TO RENEW THIS CERTIFICATE WHETHER OR NOT YOU RECEIVE A RENEWAL NOTICE For all inquiries regarding this certificate, contact IriciL Business Tax Support Center at (619) 362-2596. Thank you for your payment on your National City Business Tax Certificate. ALL CERTIFICATES MUST BE AVAILABLE FOR INSPECTION UPON REQUEST. If you have questions concerning your business license, contact the Business Support Center via email It: National ity©HdLgov,com or by telephone at: (619) 38 - 596 Keep this portion for your license separate in case you need a repiacemnt for any lost, stolen, or destroyed license, A fee may be charged for a replacement or duplicate certificate. This certificate does not entitle the holder to conduct business before complying with all requirements of the National City Municipal code and other applicable laws, nor to conduct business in a zone where conducting such business violates la v, If you have a fixed place of business within the National City, please display the Business Tax Certificate below in a conspicuous place at he premises. Otherwise, every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or her person, or affixed in plain view any cart, vehicle, van or other movable structure or device at all times if required by the Collector, Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender -based discrimination of business establishments. A full notice is available in English or other languages by going to: https://ww v.dca.ca.govIpublicationsf ..r~ BUSINESS TAX SUPPORT CENTER } Nikr G' 8839 N CEDAR AVE #212 F E NO, CA 93720-1832 MCC FLls01/. l# CALIFORNIA COMMERCIAL POOLS INC 2255 AUTO CENTRE DR GLENDORA, CA 17 0-67 1 117;.'Aij5!. Cit y of Natrona! City BUSINESS TAX CERTIFICATE Account Number: 09051536 Date of Issue: 0712712022 '7 i++7"• '� s ��i:.tisr.,.�18*��ti..�.�-`��Rawr,A-oc� ?��.�..�lC���.'�t �•ti 3x::r� '�^�=4F.*rc,+r�'.tiv�.��� 4"�kS�'�iFFk,.:Jry,�_... ..,�yG,.•�5-� �..tt,,;''��a�•�"arr",t'�:i,==+11�� ,i�_.i�i.4'1�:7S71t'� �`]'' � e: �•-r City of National City BUSINESS TAX CERTIFICATE "For Services Provided in National City, CaliforniaOnly" Business Name Business Location Business Owner(s) AYCON INC 9520 PAD ETT ST STE 218 SAN DIEGO, CA 92126-4452 AYCON INC AYCON INC 9520 PAD ETT ST STE 218 SAN DIEGO, A 92126-4452 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS THAT IS THERUW E PROI-IIRIT IT. AYCON INC ry: Business Type Account Number Effective Date Expiration Date 2022 TO BE POSTED IN ACONSPICUOUS PLACE AND NOT TRANSFERABLE OR ASSIGNABLE Contractor - General (Based Out Of City) 09050092 ►April 04, 2022 December 31, 2022 City Manager NOTE: IT IS YOUR OBLIGATION TO RENEW THIS CERTIFICATE WHETHER OR NOT YOU RECEIVE A RENEWAL NOTICE For all inquiries regarding this certificate, contact HdL Business Tax Support Center at (19) 382-2596. Thank you for your payment on your National City Business Tax Certificate, ALL CERTIFICATES MUST BE AVAILABLE FOR INSPECTION UPON REQUEST, If you have questions concerning your business license, contact the Business Support Center via email at: National ity©HdLgov,00rn or by telephone at: (619) 382-2596 Keep this portion for your license separate in case you need a replacement for any lost, stolen, or destroyed license. A fee may be charged for a replacement or duplicate certificate. This certificate does not entitle the holder to conduct business before complying with all requirements of the National City Municipal code and other applicable laws, nor to conduct business in a zone where conducting such business violates law. If you have a fixed place of business within the National City, please display the Business Tax Certificate below in a conspicuous place at he premises. Otherwise, every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or her person, or affixed in plain view any cart, vehicle, van or other movable structure or device at all times if required by the Collector. Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender -based discrimination of business establishments. A full notice is available in English or other languages by going to: https:IJw.dca.ca.golpublioations/ ,0A 14F;4 Rr1 ?A. N N4 C BUSINESS TAX SUPPORT CENTER 8839 N CEDAR AVE # 1 FRESNO, CA 93720-1832 AYCON INC 9520 PAD TT ST STE 218 SAN DIEGO, CA92126-4452 g City of National City BUSINESS TAX CERTIFICATE Account Number: 09050092 Date of Issue: 04/04/2022