HomeMy WebLinkAbout2022 CON SWCS Inc. - Police Pistol Range HVAC and Safety Improvements CIP No. 20-05OWNER - CONTRACTOR AGREEMENT
EEMENT
Police Pistol Range HVAC and Safety Improvements
Ci,P NO. 20-05
This Owner -Contractor Agreement ("Agreement") is made by and between the City of National City, 1243
National City Boulevard National City, California 91950 and SWCS Inc. "Contractor"), 11653 Riverside Dr.,
Ste. 1531 Lakeside, California 92040 on the 6thda f December, 2022 for the construction of the above
referenced Project.
In consideration of the mutual covenants and agreements set forth herein, the Owner
and Contractor have mutually agreed as follows:
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 stisfaction of the Owner
within the specified duration set forth in the Special Provisions.
4. NON-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.
. 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.
. WORKERS' COMPENSATION INSURANCE
a) By my signature hereunder, as ontractor, 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 t.o 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 liability 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 ofthe terms ofthe 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 all 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 right 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 approvals which are legally required for Contractor to
practice its profession.
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
all purposes be deemed to be an original.
13. FALSE CLAIMS
Contractor acknowledges that if a fake claim is submitted to the Owner, it may be
considere6 fraud. and Contractor may be subject to criminal prosecution. Contractor
acknowledges that the False Claims Act, California Government Code sections 150, et
seq., provides for civil penalties where a person knowingly submits a false claim to a
public entity. These provisions include within their scope false 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 15, above:
itial) (Initial
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.
Owner:
ejandra So``elo
Mayor, City of National City
A'PROVED AS TO FORM:
By:
Barry Schult
Interim City Attorney
Contractor:
CLIto er/Officer gnature)
__ rani (9 Srti Vfr9Kflbr'
E
Pr! t rre and title
sig, . ure i a orporatiort)
eVg 6,1 dthirhi ifart
Print name and title
66fLot �I
Contractor's City Business License No.
43 VP) /r - '1751C C 7F-0)6 LP 11P2-811)3
State Contractor's License No. and Class
I1N53 rl)yt/yr1,t IS3
Business street address
LG+lufiplk 2p4-1o
City, State and Zip Code
EXHIBIT
CONTRACT DOCUMENTS
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 I IIT , BNSF, SANDAG, Port of San Diego
and all other agencies that may be adjacent and/or affected by the project.
EXHIBIT B
CONTRACT PRICE
Bid for Police Pistol Range HVAC and Safety improvernents - SWCS Inc.
Item
Section
Description
Unit
Quantity
Unit Price —
Line Total
1
Base Bidincludes
Provide Lump Sum cost for the required items as described in the design package. Cost
but not limited to demolition of existing features, purchase and installation of
all specified materials, general trade items, electrical trade items,. and final system
commissioning.
LS
1
$619,311.00
Subtotal
$619311.00
Additive Bid
Provide daily rate for as -needed 24-hour fire watch if dampers connected to alarm
system or sprinklers need to be removed, replaced or adjusted. See additional
description of fire watch requirements in the specifications. Note, this item will be used
under a change notice if services are required and the duration will be deterrnined in
coordination with the contractor, the construction manager and the city.
LS
1
$4,800.00
$4,800.00
i if-rrotoI
$4.800.00
ic: i,
5624,111.00
CORPORATE CERTIFICATE
tr-7 certify that I am the Secretary of the
Corporation named as Contractor in the foregoing Contract;that
4-6-72 fTh ,who signed said contract on behalf of the
Contractor, was then ,(J.-'n-t--
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.
1, certify that I am the Secretary of the
Corporation named as Contractor in the foregoing Contract;that
who signed said contract on behalf of the
Contractor, was then 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:
CALIFORNIA
NATIONAL y
City of National City
(To be submitted only when there are no employees subject to Workers'Compensation)
DECLARATION AND ADDENDUM TO ALL CONTRACTS AWARDED TO:
1S-- [10 1,tit! Inc
(Company Name)
For the purpose of inducing the City of National City to go forward with any contracts awarded to
SkuS �nG
5 (pnt?ni( ,(rnifi»
(Company). I declare as follows:
(name) f & ` P'r( f / 41/170-- (me) am
authorized to execute this document on behalf of _(company) with respect to compliance with the California
Workers' Compensation and Labor laws. All work required will be performed personally and solely by
volunteers of l- 1` -t (company),
who are independent contractors. If, however, /Aft d I (company)
shall ever be required to hire employees or Subcontractors to perform this contract,
c CS C (company) shall obtain Workers Compensation Insurance and/or
provide proof of workers' Compensation Insurance coverage to the City of National City.
This document constitutes a declaration by ( J ?
(company) against its financial interest, relative to any claims which may be asserted under the California
Workers' Compensation and/or Labor laws against the City, of National City relating to any bid or contract
awarded w- (company).
5w( Ins
(company) will defend, indemnify, and
hold harmless the City of National City, its officers and employees, from any and all claims and liability,
including Workers' Compensation claims and liability that may be asserted or established by any party in
the event it hires an employee in violation of this addendum or if a volunteer of the organization makes a
claim against or aiieges liability of the City of National City for workers' Compensation, and it will further
indemnify the City of National City, its officers and employees, for all damages the City thereby suffers.
I agree that these declarations shall constitute an addendum to any bid or contract awarded to:
Dated: fVG0-41 j'] , 20 z L
(company)
V\11 (,, \.) (-
(Insert company name in all caps)
p)
By
d ure o �d-KAsenfatrve)
SIM if() j fir(j1 6(61E,
(Nance and Title)
Bond no. 6131044791
Premium: ium: , .0
PERFORMANCE BOND
WHEREAS, the City Council of the City of National City, by Resolution No.
n the 6th day of Pecernber,202,Z, has awarded SWCS Inc. hereinafter designated
as the "Principal", for the POLICE PISTOL RANGE HVAC AND SAFETY IMPROVEMENTS,
TS,
CRP NO.. 2O
WHEREAS, said Principal is required under the terms of said contract to furnish a
bond for the faithful performance of said contract.
NOW, THEREFORE, we, the Principal and
United States Fire Insurance ampan as surety, rheld nd firmly
bound unto the City of National city, hereinafter called the "City", , in the penal sum of
Six Hundred Twenty-four Thousand, One Hundred Eleven ($624,111 ($624,111.001 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, shalt in all things
stared to and abide by, and well and truly 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 terms 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 attorney's
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 Suretyabove named,on the l tl of November
0 2 .
p day ,
II , Inc., dba Southwest Construction Services, Inc.
United States Fire Insurance Company
(SEAL) (SEAL)
J4A-_(SEAL) '-'� ���� (SEAL)
Tara Bacon, Attorney -in -fact (SEAL) V l,t (SEAL)
Surety Principa
ACKNOWLEDGMENT
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 San Diego
11/17/2022 before me, Samantha Smith, Notary Public
(insert name and title of the officer)
personally appeared Stephanie Smith
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) 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.
WITNESS hand and official seal
Signature
(seal)
IMEL }OMB. Alp
SAMANTHA SMITH
r. Notary Public • California
San DteRo County
Curirrii5sion a 2286053 -
my Comm. Expires Aar 23, 2023
see attached Notary Acknowledgment
PERFORMANCE BOND
ATTORNEY-1N-FACT ACKNOWLEDGEMENT OF SURETY
STATE OF
)ss
COUNTY OF
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 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 1 NOTE: The Attorney -in -fact must attach a
Surety must be properly
acknowledged.
certified copy of the Power of
Attorney.
Signature:
Name (Type or Print):
Notary Public in and for said County and State
My Commission expires:
ACKNOWLEDGMENT
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 San Diego
112--beforeme, Minna Huovila, Notary Public
(insert name and title of the officer)
personally appeared Tara Bacon
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islare
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) 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.
WITNESS my hand and official seal.
Signature
(Seal)
I' IN IA HUoff'I1.
COMM. #2313883
NOTARY PUBLIC-CALIFORNIA LO
SAN DIEGO COUNTY
My Commission Expire
DECEf BEP 6, 2023
POWER ATTORNEY
UNITED STATES FIRE INSURANCE COMPANY
PRINCIPAL OFFICE .. M RRI T WN, NEW JERSEY
87171
KNOW ALL MEN BY THESE PRESENTS: That United States Fire Insurance Company, a corporation duly organized and existing under the laws ofthe
state ofDelaware, has made, constituted and appointed, and does hereby make, constitute and appoint:
Lawrence F. McMahon, Sarah Myers, Lilia De Loera, Janice Martin, Dale G. Harshaw, John R. Qualin, Geoffrey Shelton,
Tara Bacon, Minna Huovila, Maria Hallmark
each, its true and lawful Attorney s-InFact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and
deliver: Any and all bonds and undertakings of surety and other documents that the ordinary course of surety business may require, and to bind United States
Fire insurance Company thereby as fully and to the same extent as if such bonds or undertakings had been duly executed and acknowledged by the
regularly elected officers of United States Fire Insurance Company at its principal office, in amounts or penalties: Fifty Million Dollars $ , ,0 .
This Power of Attorney limits the act of those named therein to the bonds and undertakings specifically named therein, and they have no authority to
bind United States Fire Insurance Company except in the manner and to the extent therein stated.
This Power of Attorney is granted pursuant to Article IV of the By -Laws of United States Fire Insurance Company as now in full force and effect,
and consistent with Article 1Il thereof, which Articles provide, in pertinent part:
Article I, Execution of Instruments - Except as the Board of Directors may authorize by resolution, the Chairmen of the .Board, President, any
Vice -President, any Assistant Vice President, the Secretary, or any Assistant Secretary shall have power on behalf of the Corporation:
(a) to execute, affix the corporate seal manually or by facsimile to, acknowledge, verify and deliver any con acts, obligations, instruments and
documents whatsoever in connection with its business including, without limiting the foregoing, any bonds, guarantees, undertakings,
recogni ances, powers of attorney or revocations of any powers of attorney, stipulations, policies of insurance, deeds, leases, mortgages,
releases, satisfactions and agency agreements;
(b) to appoint, in writing, one or more persons for any or all of the purposes mentioned in the preceding paragraph (a), including affixing the
seal ofthe Corporation.
Article III, Officers, Section 3.11, Facsimile Signatures. T.he signature of any officer authorized by the Coiporation to sign any bonds,
guarantees, undertakings, recognizances, stipulations, powers of attorney or revocations of any powers of attorney and policies of insurance
issued by the Corporation may be printed, facsimile, lithographed or otherwise produced. In addition, if and as authorized by the Board of
Directors, dividend warrants or checks, or other numerous instrutnents similar to one another in form, may be signed by the facsimile signature
or signatures, lithographed or otherwise produced, of such officer or officers ofthe Corporation as from time to time may be authorized to sign
such instruments on behalf of the Corporation. The Corporation may continue to use for the purposes herein stated the facsimile signature of
any person or persons who shall have been such officer or officers of the Corporation, notwithstanding the fact that he may have ceased to be
such at the time when such instruments shall be issued.
IN WITNESS %WHREF, United States Fire Insurance Company has caused these presents to be signed and attested by its appropriate officer and
its corporate seal hereunto affixed this 28th day of September, 2021.
UNITED STATES FIRE INSURANCE COMPANY
Matthew E. Lubin, President
State of New Jersey}
County of Morris
On this 28th day of September, 2021, before me, a Notary public of the State of New Jersey, came the above named officer of United States Fire
Insurance Company, to me personally known to be the individual and officer described herein, and acknowledged that he executed the foregoing
instillment and affixed the seal ofUnited States Fire Insurance Company thereto by the authority ofhis office.
Ivie,t(44-044 Vd644409-ei
Melissa H. D'Alessio (Notary Public)
1, the undersigned officer ofUnited States Fire Insurance Company, a Delaware corporation, do hereby certif that the original Power of Attorney of which
the foregoing is a full, true and correct copy is still in force and effect and has not been revoked,
IN WITNESS WHEREOf I haw hereunto set my hand and affixed the corporate seal of United States Fire Insurance Company on the 1 th day
of November 2
UNITED STATES FIRE INSURANCE COMPANY
.117
Michael C. Fay, Senior Vice President
PAYMENT EI T BOND
Bond no. 6131044791
Premium: Included in
Perfomiance Bond
WHEREAS, the City Council of the City of National City, by Resolution No. 0 2-
on the r dayolimpgcprOpriLmz has awarded SWCS Inc. , hereinafter designated
as the "Principal", for the POLICE PISTOL RANGE HVAC AND SAFETY IMPROVEMENTS,
CIP NO. 20-05
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 United States Fire Insurance Company
as surety, are held and firmly bound unto the City of National City, hereinafter called the
"City", in the penal sum of i __H n r d Twenty-four Thousand One Hundred Eleven
L$624,111OO1 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 Cyril Code, or amounts due
under the Unemployment Insurance Code with respect to work r 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 ttorney's fe, to be fixd by thCourt.
This Bond shall inure to the benefit of any of the persons named in Section 3181 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 ofclaimants 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
and that this bond be construed 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
22
and Surety above named,on the '17th of November 20
_ day
LI Wed Stats Fire Insurance Company
L 0A
Fj.
Tara Bacon, Attorney -in -fact
Surety
{SEAL}
(SEAL)
(SEAL)
Inc., dba Southwest Construction Services, Inc.
(SEAL)
L,
v t UQM &tn
Principal
(SEAL)
(SEAL)
ACKNOWLEDGMENT
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 San Diego
11/17/2022
before me, Samantha Smith, Notary Public
(insert name and title of the officer)
personally appeared Stephanie Smith
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
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
(seal)
SAMANTHA SMITH
:�. Notary Public - California
San Diego County
Commission 2286053
my Comm. E Aires .Apr 23,, 2023
see attached Notary Acknowledgment
ATTORNEY -IN -FACT ACKNOWLEDGEMENT OF SURETY
STATE 0 F -- - -- - - - )
COUNTY OF
!Mi•=••=•INL)11
} ss
On this day of ............., ......... , 20..._...,_.R,,. 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
• w h +r+�-ter
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
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:
A7TACH ALL BONDS
ACKNOWLEDGMENT
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 San Diego
10.466 ) �) 3g):2---1 before me,
Minna Fluovila, Notary Public
(insert name and title of the officer)
personally appeared Tara Bacon
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ai-
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument
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
(Seal)
MINNA HUOVILA
COMM, #2313883
NOTARY PUBLIC-CALIFORNIA
SAN DIEGO COUNTY
My Commission Expires
DECEMBER 6, 2023
POWER F ATTORNEY
UNITED STATES FIR, IN UR .N E COMPANY
PRINCIPAL OFFICE - MORRISTOWN, NEW JERSEY
87171
KNOW ALL MEN BY THESE PRESENTS: That United States Fire Insurance Company, a corporation duly organized and existing under the laws ofthe
state of Delaware, has made, constituted and appointed, and does hereby make, constitute and appoint:
Lawrence F. McMahon, Sarah Myers, Lilia De Loera, Janice Martin, Dale G. IIarshaw, John R. Qualin, Geoffrey Shelton,
Tara Bacon, Minna Huovila, Maria Hallmark
each, its true and lawful Attorneys -In-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and
deliver: Any and all bonds and undertakings of surety and other documents that the ordinary course of surety business may require, and to bind United States
Fire Insurance Company thereby as fully and to the same extent as if such bonds or undertakings had been duly executed and acknowledged by the
regularly elected offi.cers of United States Fire Insurance Company at its principal office, in amounts or penalties: Fifty Million Dollars 0,000, 0 .
This Power of Attorney limits the act of those named therein to the bonds and undertakings specifically maned therein and they have no authority to
bind United States Fire Insurance Cornpany except in the manner and to the extent therein stated.
This Power of Attorney is granted pursuant to Article IV of theBy-Laws of United States Fire Insurance Company as now in Lull force and effect,
and consistent with Article III thereof, which Articles provide, in pertinent part:
Article IV, Execution of Instruments - Except as the Board of Directors may authorize by resolution, the Cha%an of the Board, President, any
Vice -President, any Assistant Vice President, the Secretary, or any Assistant Secretary shall have power on behalf ofthe Corporation:
a to execute, affix the corporate seal manually or by facsimile to, acknowledge,verify and deliver any contracts, obligations, instruments and
documents whatsoever in connection with its business including, without limiting the foregoing, any bonds, guarantees, undertakings,
recognizances, powers of attorney or revocations of any powers of attorney, stipulations, policies of insurance, deeds, leases, .mortgages,
releases, satisfactions and agency agreements;
(b) to appoint, in writing, one or more persons for any or all of the purposes mentioned in the preceding paragraph (a), including affixing ing the
seal ofthe Corporation.
Article III, Officers, Section 3,11, Facsimile Sig -natures. The signature of any officer authorized by the Corporation to sign any bonds,
guarantees, undertakings, recognizances, stipulations, powers of attorney or revocations of any powers of attorney and policies of insurance
issued by the Corporation may be printed, facsimile, lithographed or otherwise produced. In addition if and as authorized by the Board of
Directors, dividend warrants or checks, or other numerous instruments similar to one mother in form, may be signed by the facsimile signature
or signatures, lithographed or otherwise produced, of such officer or officers ofthe Corporation as from time to time may be authorized to sign
such instruments on behalf of the Corporation. The Cotporation may continue to use for the purposes herein stated the facsimile signature of
any person or persons who shah have been such officer or officers of the Corporation notwithstanding the fact that he may have ceased to be
such at the time when such instruments shall be issued.
IN WITNESS WHEREOF, F, United States Fire Insurance Company has caused these presents to be signed and attested by its appropriate officer and
its corporate seal hereunto mixed this 28th day of September, 2021.
UNITED TATES FIE INSURANCE COMPANY
Matthew E. Lubin, President
State of New Jersey}
County of Morris }
On this 28th day of September, 2021, before me, a Notary public ofthe State of New Jersey, came the above named officer of -United States Fire
Insurance Company, to me personally known to be the individual and officer described herein, and acknowledged that he executed the foregoing
instrument and affixed the seal of United States Fire Insurance Company thereto by the authority of his office.
de(4, xe1/2004sto,
Melissa H. D'Alessio (Notary Public)
I, the undersigned officer of United States Fire Insurance Company, a Delaware corporation, do hereby certify that the original Power of Attorney of which
the foregoing is a full, true and correct copy is still in force and effect and has not been revoked.
IN WITNESS WHERE1 have hereunto set my hand and affixed .ed the corporate seal of United States Fire Insurance Company on the 1 th day
of November 2
UNITED STATES FIRE INSURANCE COMPANY
Michael C. Fay, Senior Vice President
CALIFORNIA --F
I c y
13zify
nvcoutponKrgo
City of National City
INSURANCE REQUIREMENTS
Please forward to your Insurance Agent immediately
PRIOR to performing services for the City of National City, the City must have current
Certificates of Insurance on file for all companies, contractors, and consultants.
Re Insurance Certificates per the it rs A regiment:
Professional Liability Insurance (errors and omissions) with minin um limits of 1 M per
occurrence (if applicable)
Commercial General Liability coverage with limits of coverage at least $2M per
occurrence/$4M aggregate or in the alternative limits of at least 1 M per occurrence/UM
aggregate with M umbrella or excess coverage; this is subject to a discretionary review
for services to be rendered wherein a greater level of coverage may be required:
Must include separate endorsement adding as additional insureds: The City of National City,
its elected officials, officers, agents, employees and volunteers". The actual endorsements or
policy language regarding automatic additional insureds must be provided.
General aggregate limits must apply solely to this "project" or "location". This "project" or
}"location;' rust be identified with specificity on a separate endorsement.
Commercial Auto Liability coverage with limits of coverage of at least Si M, Combined
Single Limit; this is subject to a discretionary review for services to be rendered wherein a
greater level of coverage may be required:
Must include "any°" auto.
Must include separate endorsement adding as additional insureds: "The City of National City,
its elected officials, officers, agents, employees and volunteers". The actual endorsements or
policy language regarding automatic additional insureds must be provided.
Workers' Compensation coverage to meet California statutory limits, plus employers
liability coverage of coverage as set out in the agreement with the following
stipulations:
Q Workers' Compensation Waiver of Subrogation in favor of the City is required.
If there are no employees subject to Workers Compensation law, submit a signed Declaration
(provided on next page).
Deductibles or Sifts (Self -Insured Retention) in excess of $10,000 must be disclosed.
CERTIFICATE HOLDER: City of National City, c/o Risk Manager 1243 National City
Boulevard, National City, CA 91950.4397.
Insurance Document submittal:
Email insurance certificates to Tirza Gonzales in Engineering/Public Works Department
(1gonzalesnationalcitvca.qov); her telephone number is (619) 336
Mail the certificates and endorsements to: City of National City
clo Risk Manager
1243 National City Blvd
National City. CA g 1 g 4397
Questions: Risk Manager: (619) 336-4370
Office Assistant: (619) 336-4232
PRIOR to performing services for the City of National City, the City must have current
Certificates of Insurance on file for all companies, contractors, and consultants.
Re Insurance Certificates per the it rs A regiment:
Professional Liability Insurance (errors and omissions) with minin um limits of 1 M per
occurrence (if applicable)
Commercial General Liability coverage with limits of coverage at least $2M per
occurrence/$4M aggregate or in the alternative limits of at least 1 M per occurrence/UM
aggregate with M umbrella or excess coverage; this is subject to a discretionary review
for services to be rendered wherein a greater level of coverage may be required:
Must include separate endorsement adding as additional insureds: The City of National City,
its elected officials, officers, agents, employees and volunteers". The actual endorsements or
policy language regarding automatic additional insureds must be provided.
General aggregate limits must apply solely to this "project" or "location". This "project" or
}"location;' rust be identified with specificity on a separate endorsement.
Commercial Auto Liability coverage with limits of coverage of at least Si M, Combined
Single Limit; this is subject to a discretionary review for services to be rendered wherein a
greater level of coverage may be required:
Must include "any°" auto.
Must include separate endorsement adding as additional insureds: "The City of National City,
its elected officials, officers, agents, employees and volunteers". The actual endorsements or
policy language regarding automatic additional insureds must be provided.
Workers' Compensation coverage to meet California statutory limits, plus employers
liability coverage of coverage as set out in the agreement with the following
stipulations:
Q Workers' Compensation Waiver of Subrogation in favor of the City is required.
If there are no employees subject to Workers Compensation law, submit a signed Declaration
(provided on next page).
Deductibles or Sifts (Self -Insured Retention) in excess of $10,000 must be disclosed.
CERTIFICATE HOLDER: City of National City, c/o Risk Manager 1243 National City
Boulevard, National City, CA 91950.4397.
Insurance Document submittal:
Email insurance certificates to Tirza Gonzales in Engineering/Public Works Department
(1gonzalesnationalcitvca.qov); her telephone number is (619) 336
Mail the certificates and endorsements to: City of National City
clo Risk Manager
1243 National City Blvd
National City. CA g 1 g 4397
Questions: Risk Manager: (619) 336-4370
Office Assistant: (619) 336-4232
Cityof National City
BUSINESS TAX CERTIFICATE
"For Services Provided in National City, California Only"
Business Name SWCS, INC.
Business Location 11653 RIVERSIDE DR STE 153
LAKESIDE, CA 92040-2371
Business Owner(s) SWCS, INC.
SWCS, INC.
11653 RIVERSIDE IDE DR STE 153
LAI ESIDEr CA 040-2371
THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS
THAT IS C)THFR NISF PROHIRITFII
- A iFORNI4 —
l 1 Win ci
i//,
2022
TO BE POSTED IN A CONSPICUOUS PLACE
AND
NOT TRANSFERABLE OR ASSIGNABLE
Business Type Contractor General (Based Out
Of City)
Account Number 09048019
Effective Date
Expiration Date
January 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) 382-2596.
SWCS, 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: IationalCity HdLgov.cam or by telephone at: (619) 38 - 5 6
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 Tao 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: https://www.cica.ca,gov/publicationsf
GALIFOPNIA
NAT 1 NAL CM'
1331
ttn gm pop% Pa Ir.
3U I IE S TAX
CENTER
8839 , CEDAR AVE #212
SWCS, INC,
11653 RIVERSIDE DR STE 153
LAKESIDE, CA 92040-2371
SUPPO El El
El 417.
City of National City
BUSINESS TAX CERTIFICATE
Account Number:
Date of Issue:
09048019
01/01/2022
4tel.October 20181
I ep rtment of the Treasury
Imernal Revenue Service
Request for Taxpayer
dentification Number and Certification
0. Go to www.lir.govJFo,rrnW9 for instructions and the latest information.
,'are (as tho wr- on your income tax return). Name is required on triis line: do rot leave this line blank.
SWCS Inc. Luba Southwest Construction Services
2 wines:-; riameidisregarJec.i E ntit'y name. if Ji 'far€nt ;r .rn a )ovs
L
Give Form to the
requester. Do n o l
send to the IRS.
3 Crte k a'l. oroprrate box for Ieoeral tax classification of the Jerson i t'rp4e name iS enterrec Sri lire ' l�l: y.�c 0r,1t}
following seven boxes.
inditAuallisole pr prietor Or
s;n r te-r' 'er"rer LAG
E14, COIrPOrati0-1
E
one ,i
Corporation El PartnersEli rjst hest tr
Limited liability ornoa lv. Enter t`ze tax class :.; .b*. zC C cu{p }a::cry. S-4 corporation. P=Parkr rshiri
Note: Check the appropriate box Sri the line above for tr'i~ tax classilicatror of the single -member own .i. Do not cPrcor
LLC if the Lar$ classified as d single -member mb r L_C that :s disregarded corn the owner unless the owner of the Li-C is
another LLC that Fs not disregarded from the owner for :. ;. ;ede.al tax pJrposes. Other1,' rse. a single -member LAC that
is disre►gardeo from :he owner should check the appropriate box for :he tax classification tion c' its owner.
Other isee ir.s4r uctikns;
5 Address crurriDer, street, and apt. or slte nc .; See instructicris.
11653 Riverside Dr Ste 153
6 City. state. and
Lakeside A 9 040
7 List account numbers llere (optional)
Part I
4 Exeinptbons (codes apply only to
t'ertain entities. not indivuuucals: see
nstructions on page )
.pt payee , cd 1i` arA
Exe'nptior `rorr-I rATIJA
code •
,- 1
Requester's name and acr d r+L ss (co it iah
Taxpayer Identification Number (TlN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on lime 1 to a`woic
bac-cup withholding. For individuals. this is generally your social security number ( N). However. for a
resident sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other
entities, it is your employer identification number (EI. ). If you do not have a number. see How to get a
TIN, later.
Note: If :he account is in more than one name. see the instructions for line 1. Also see What Name and
Number To GiVe the Requester for guidelines on wnose number to enter.
Certification
Under penalties of perjure. l certify tha :
1_ The number shown on this lorm is my coffee taxpayer cdenrtic :con T'tan er (or l arr waiting tor a n•vernher to be issued to rne). and
2. 1 am not suniect to backup withholding because. lad l am exempt from backup witnnolding or (b) I have not t been notified try the Internal Revenue
Service (IRS) that I am subject to bacnwp withholding as a resJIT ot a Tailure to report all interest or dividends. or (iv) the IRS has not'tieti me ',hall arr
no longer suotect to oackup vehholdirig: and
I air a U.S. citizen or other U.S. person (defined oelow): aid
Social security number
or
Employer identification number
5
0
7
8
'1
4. The FATCA codes) entered, on this form (if aver) nd cating tihat I am exempt from MICA reporting is correct.
Certification instructions. You rnust cross out item 2 above it you have oeen notified by the IRS that you are currently subject to ac.icup withholding becaus,
you have failed to reps all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acgJis'ttor or abandonment of secured property. tr 1c llatinn ct debt. contributions. to ar individual retirer rtent arrangement ORA), arc generally, payMents
ether Irian interest and divideryrds, you are '3ot required to sign ;he cer:-ficaricr_ but you must provide your correct TIN, See the instructions tor Part 11. later.
Sign
Here
Signature of
U.S. person ►
General Ins n
See;}trot references -are to tfe internal Revenue Code unless otnermise
rot -
Future developments. For the latest information about developments
related to Form VV-9 and its instructions. such as legislation enacted
after they were published. go to www,rrs. gov/FormW9.
Purpose of Form
art iri, rvidual or entity (Form W-9 requester) who is required to file an
in -formation return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(' ). individual taxpayer identification number (ITN). adoption
taxpayer identification number (AT1N), or employer identification number
(EN). fio report on an information return the amount paid to you. or other
amount reportable on are information return. Examples of information
returns include, but are not limited to, the following,
• Form 1 O -1NT (interest earned or paid,
Date go- V„_ 02 /
• Form 109 DIVl (divider -Ids. irtcl rt#irr `hose from stocks or mutual
funds)
• Form 109 -MI 0 (various types of income, prizes. awards. or gross
proceeds)
• Form 1099-B +stock or mutual fund sales aria certain other
transactions by brokers)
• Form i g9- (proceeds trorn real estate, transactions)
• Form 10 - (merchant card and third party network transactions)
• Form 1098 'home mortgage interest). 1 8-E (student loan v-Itere.s:,.
1098--T (tut it l
i Fortn r 9 - (canceled debt)
• Form 1099- (acquisition or r.b►andonnter : of se -cured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien. to provide your correct TIIV.
If you do not return Form W-9 to tide requester with a TffSJ. you might
e siJoject to backup wi!nholdi'ng. S eWhat. is backup withholding.
is t&r.
=_.aL o. 2.
r-0rm W-9 f;ev. G-20t
ACCAR,I7`
SWCSMG01 BFENG
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMWDD/YYYY)
11/17/2022
,THIS CERTIFICATE IS ISSUED ED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INBURER(8), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER License # 0C36061
San Diego-Aliiant Insurance Services, Inc.
701 B St 6th FI
San Diego, CA 9 101
INSURED
SWCS, Inc DBA: Southwest Construction Services
11653 Riverside Drive, Ste.153
Lakeside, CA 92040
COVERAGES
CERTIFICATE NUMBER:
CODE CT Halley Aguirre
A
PHONE
(AIC, No, Ext):
FAX
(A/C, No):
DRESS: Hailey.Aguirre@alliant.com
INSURER(S) AFFORDING COVERAGE
INSURER A :Great American Assurance Company
INSURER B :Allstate Insurance Company
INSURER c : Great American Protection Insurance Company
INSURER D : Insurance Company of the West
INSURER E :
INSURER F :
NAIC
26344
1 232
38580
27847
REVISION NUMBER:
THIS IS TO Ei TIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, EMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE ATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR
LTR
TYPE OF 11SURANCE
A
X
COMMERCIAL GENERAL LIABILITY
X
CLAIMS -MADE [ X OCCUR
Deductible: $5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
OTHER:
B
X
PJft
LOC
ADDLSUBR
INSD wlwvi:
POLICY NUMBER
GLP4051269
AUTOMOBILE LIABILITY
X
X
X
ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
Auto Liab bed: $0
c
X
UMBRELLA LIAB
EXCESS LIAB
X
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
648921879
POLICY EFF POLICY EXP
(MMIDD/YYYY) 4MMIDDIYYYY
2/10/2022
X
OCCUR
CLAIMS -MADE
DED
X {_RETENTION $
10,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
YIN
N/A
UMB4051270
X WSD 506639 00
6/30/2023
211012022 2/1012023
LIMITS
EACH OCCURRENCE
1,000,000
DAMAGE TO RENTED
PREMISES Ea accurrzn
50,000
MED EXP Any one person)
PERSONAL & ADV INJURY $
GENERAL AGGREGATE
Excluded
1,000,000
2,000,000
PRODUCTS -COMP/OP ACC
2,000,000
COMBINED SINGLE LIMIT
4Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident).
2/10/2022 6/30/2023 AGGREGATE
1,000,000
5,000,000
,000,000
X P E
6/30/2022 6/30/2023E.L. EACH ACCIDENT
Eh1T
OTH-
ER
EL. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
1,00 ,000
1,000,000
1,000,000
DESCRIPTION OF OPERATIONS! LOCATIONS IVEHICLES ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Re: 22-051 Police Pistol Range HVAC Safety TI
The City of National City, its elected officials, officers, agents, employees and volunteers are named as Additional Insured, Waiver of Subrogation applies.
CERTIFICATE HOLDER
City of National City
c/o Risk Manager
1243 National City Blvd
National City, CA 9190-497
CANCELLATION
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)
ID 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Great American Assurance uompany
Policy number: GLP4051269
CG 20 37 (Ed. 07/04)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, S, LESSEES OR
CONTRACTORS ACTORS - COMPLETED OPERATIONS
S
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY VEI A E PART
Schedule
Name of Additional Insured Person(s) or
Or an i ation(s) :
Any person or organization that "you" and such person or "Your work' performed during this policy period,
organization have agreed in writing in a contract that such
person or organization be added as an additional insured
on "your" policy, but only for "your work" performed during Additional Premium: Included
this policy period.
Location and Description of Completed Operations:
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
SECTION II - WHO Is AN INSURED is amended to include as are Additional Insured the person(s) or organization(s)
shown in the Schedule, but only with respect to liability for "bodily injury' or "property damage" caused, in whole or in
part, by „your work" at the location designated and described in the schedule of this endorsement performed for that
Additional Insured and included in the "products -completed operations hazard."
Copyright, ISO Properties, Inc., 2004
CG 20 37 (Ed. 07/04) (Page 1 of 1)
ureat American Assurance uompany
Policy number: GLP4051269
CG 20 33
(Ed. 07 04)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC
STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. SECTION II - WHO IS H INSURED is
amended to include as an Additional Insured
any person or organization for whom you are
performing operations .when you and such
person or organization have agreed in writing
in a contract or agreement that such person
or organization be added as an Additional In-
sured on your policy. Such person or or-
ganization is an Additional Insured only with
respect to liability for "bodily injury," "prop-
erty damage' or "personal and advertising in-
jury" caused, in whole or in part, by:
1. your acts or omissions; or
2. the acts or omissions of those acting on
your behalf;
in the performance of your ongoing oper-
ations for the Additional Insured.
A person's or organization's status as an Ad-
ditional Insured under this endorsement ends
when your operations for that Additional In-
sured are completed.
B. With respect to the insurance afforded to
these Additional Insureds, the following addi-
tional exclusions apply:
This insurance does not apply to:
1. "Bodily injury," "property damage" or "per-
sonal and advertising injury" arising out of
the rendering of, or the failure to render,
any professional architectural, engineering
or surveying services, including:
a. the preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or draw-
ings and specifications; or
b. supervisory, inspection, architectural
or engineering activities.
. "Bodily injury," or "property damage" oc-
curring after:
a. all work, including materials, parts or
equipment furnished in connection
with such work, on the project (other
than service, maintenance or repairs)
to be performed by or on behalf of
the Additional Insured(s) at the location
of the covered operations has been
completed; or
b. that portion of "your work" out of
which the injury or damage arises has
been put to its intended use by any
person or organization other than an-
other contractor or subcontractor en-
gaged in performing operations for a
principal as a part of the same project.
rn n 22 (Pei n7inzn Y.
Copyright, ISO Properties, Inc., 2004
rear American Assurance urompany
CG 25 03 (Ed. 05i09)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED TEI CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Schedule
Designated Construction Pr je t s :
Any construction project where "you" are performing operations when "you" have agreed in writing in a contract or
agreement that a separate General Aggregate Limit shall apply to such construction project, but only if "your work" on
or at the construction project is performed during the period of this policy.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. For all sums which the Insured becomes legally obligated to pay as damages caused by "occurrences" under
SECTION I - COVERAGE E , and for all medical expenses caused by accidents under SECTION t - COVERAGE C,
which can be attributed only to ongoing operations at a single designated construction project shown in the schedule
above:
1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction
project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.
2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages
under Coverage A, except damages because of "bodily injury" or "property damage" included in the
"products -completed operations hazard," and for medical expenses under Coverage C regardless of the number
of:
a. insureds;
b. claims made or "suits" brought; or
c. persons or organizations making claims or bringing "suits."
3. Any payments made under Coverage A for damages or under coverage C for medical expenses shall reduce
the Designated Construction Project General Aggregate Limit for that designated construction project. Such
payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any
other Designated Construction Project General Aggregate Limit for any other designated construction project
shown in the Schedule above.
4. The limits shown in the Declarations for Each Occurrence, Damage to Premises Rented to You and Medical
Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the
Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate
Limit.
O Insurance Services Office, Inc., 2008
CG 25 03 (Ed. 05/09) (Page 1 of 2)
cireat American Assurance company
B. For all sums which the Insured becomes legally obligated to pay as damages caused by "occurrences" under
f 5
SECTION I - COVERAGE , and for all medical expenses caused by accidents under SECTION I - COVERAGE C,
which cannot be attributed only to ongoing operations at a single designated construction project shown in the
Schedule above:
1. any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce
the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit,
whichever is applicable; and
2. such payments shall not reduce any Designated Construction Project General Aggregate Limit.
C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for
damages because of "bodily injury" or "property damage" included i,ri the "products -completed operations hazard" will
reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the
Designated Construction Project General Aggregate Limit.
D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or
if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project
will still be deemed to be the same construction project.
E. The provisions of SECTION III - LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue
to apply as stipulated.
O Insurance Services Office, Inc 2008
CG 25 03 (Ed. 05/09) (Page 2 of 2)
COMMERCIAL AUTO
A.A CW 201011
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO ENHANCEMENT ENDORSEMENT
Coverage provided under this policy is modified by the aftaohr ant of this endorsement. If there is ny conflict in
coverage provisions between this form and any state specific endorsement also attached to this policy, the
provision(s)of the state specific form shall apply.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
In SECTION 1- COVERED AUTOS, the following
changes are made:
The following is added:
D. Physical Damage Coverage for Temporary
Substitute and Leased Autos
If Physical Damage e Coverage is provided by this
policy, the following Finds of "autos" are covered
"autos" for the same coverages provided by the
policy:
1. Any private passenger "auto", or other than
private passenger vehicle with gross vehicle
weight of 20,000 lbs. or less, you do not own
while used with the permission of the owner as
a temporary substitute for a covered autos" you
own that is out of service because of its:
a. Breakdown;
own;
b. Repair;
c, Servicing;
d. "Loss"; or
e. Destruction.
2 Private passenger "autos" and other than private
passenger vehicles with gross vehicle weight of
10,000 lbs. or less, leased, hired, rented, or
borrowed for a period of 30 days or less, This
does not include any vehicle you lease, hire,
rent, or borrow from any of your ",employees,
or partners or members of their households.
In SECTION Ii UABIUTY COVERAGE, the
following changes are made:
Under A. Coverage, Who Is n Insured, the
following is added:
Includes copyrighted material of Insurance Services Office, Inc,, with its permission
d. Any organization, other than a partnership or joint
venture, over which you maintain ownership or in
which you hold a majority interest. This provision
applies only if there is no similar insurance provided
to that organization.
e. Any organization you acquire or form after policy
inception, other than a partnership or joint venture,
over which you maintain ownership, or in which
you hold a majority interest. Coverage under this
provision does not apply;
(1) If there is similar insurance provided to that
organization; or
(2) To "bodily injury" or 'property damage's that
occurred before you acquired or formed the
organization.
f Any person or organization that you are required to
name as an additional insured under the terms of a
written job contract, or by written insurance
requirements executed prior to any covered "loss"
or claim. This protection applies only if the person
or organization is liable for the conduct of an
"insured" and only to the extent of that liability.
Under A. Coverage, Coverage Extensions,
Supplementary Payments, subparagraphs 2 and (4)
are replaced with the following:
(2) to $5,000 for cost of bail bonds (including
bonds for related traffic law violations) required
because of an "accident" we cover. We do not
have to furnish these bonds.
AA CW 20 10 11 Allstate Insurance Company
[nsured Full Copy
Page 1 of
(4) All reasonable expenses incurred by the "insured"
at our request, including loss of earnings up to
$500 a day because of time off from work.
Under B. Exclusions, 'ellow Employee, the following
paragraph is added:
But this exclusion does not apply to "bodily injury" to
a fellow "employee" caused by any person whose
position within the insured organization is at or above
the level of manager or supervisor.
Coverage afforded by this provision is excess over
any other collectible insurance.
In SECTION Ill - PHYSICAL DAMAGE COVERAGE,
the following changes are made:
Under A. Coverage, Glass Breakage - Hitting A Bird
Or Animal - Falling Objects Or Missiles, the following
is added:
If damage to glass is repaired in lieu of being
replaced, no deductible will apply for repair only.
Under A. Coverage, Coverage Extensions, the
following is added:
c. Personal Effects Coverage
In the event of a total theft of your covered "auto',
for which you carry either Comprehensive nsive or
Specified Causes of Loss coverage, we will pay up
t for the personal effects which are:
1. owned by you; and
2 in your covered "auto" at the time of the total theft
of such "auto".
No deductible applies to Personal Effects Coverage.
Under Ai Coverage, the following is added:
. Lease and Loan Gap Coverage
In the event of a total "loss' to a covered "auto"
shown in the Schedule or Declarations for which a
specific premium charge indicates that physical
damage coverage applies, we will pay ,any unpaid
amount due on the lease or loan for a covered
"auto", less:
a. The amount paid under the Physical Damage
Coverage section of the policy; and
b. Any:
(1) Overdue lease/loan payments at the time of
the "loss";
(2) Financial penalties imposed under a
lease for excessive use, abnormal wear
and tear or high mileage;
(3) Security deposits not returned by the
lessor;
(4) Costs for extended warranties, Credit
Life Insurance, Health, Accident or
Disability Insurance purchased with the
loan or lease; and
Carry-over balances from previous loans
or leases.
Under D. Deductible, the following paragraph is
added:
When Collision Coverage is provided by this
policy, the deductible amount will not be
subtracted from the loss payment in collisions
involving your covered "auto" and another auto
covered by Allstate Insurance Company or any
of it's affiliates.
In SECTION IV o BUSINESS AUTO
CONDITIONS, the following changes are made:
Under A. Loss Conditions, Duties in The Event
Of Accident, Claim, Suit Or Loss Condition, the
following is added under subpart a:
knowledge of an 'accident" or "loss" by any of
your agents, servants or "employees" shall not
in itself constitute knowledge e by you, unless
you or one of your corporate officers or
managers, or any assignee, shall have received
such notice from the agent, servant or
"employee".
When you report an occurrence of any
"accident"' or "loss" to a Worker's Compensation
carrier or self insured plan providing the named
insured"s Worker's Compensation insurance
which later develops into a claim submitted
under this policy, failure to report such
"accident" or "loss" to us at the same time shall
not be deemed a violation of this condition.
After you become aware of such liability claim
arising from the "accident" or ''loss", you must
give us prompt notice.
Under A. Loss Conditions, Transfer of Rights of
Recovery Against Others To Us, the following
is added:
We waive any right of recovery we may have
against any person or organization because of
payments we make for injury or damage arising out
of work you perform under a contract with such
person or organization, in which you have agreed
to waive your right of such recovery{
Includes copyrighted material of Insurance Services Office, Inc., with its permission
AA CW 20 10 11 Allstate Insurance Company
Irlsijred FuI! Copy
Page 2 of
Under B. General Conditions, Concealment,
Misrepresentation Or Fraud, the following is
added:
This condition does not apply to any omission or
failure to r vid material facts if the omission or
failure was unintentional.
Includes copyrighted material of Insurance Services Office, Inc., with its permission
AA CW20 10 11
Allstate insurance Company Page 3 of 3
Insured Full Copy
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE E POLICY
r. {
WAIVER OF OUR RIGHT TO RECOVER VE FROM OTHERS ENDORSEMENT - BLANKET
(Ed. 8-00)
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 3% of the total California Workers' Compensation premium
otherwise due.
Schedule
Person r._ranition
Any person or organization when required
by written contract
Job Description
All California Operations
Policy Number: ber: IlSD 5066398 00 Insured: SWCS, Inc.
Endorsement Effective: 0 2 22 Coverage Provided by: Ins Co of the West
Issue Date: 06/30/22 Countersigned by:
WC 99 06 34
(Ed. 8-00)