HomeMy WebLinkAbout2023 CON E&H General Contracting - MLK Community Center Kitchen UpgradeOWNER CONTRACTOR AGREEMENT
MLK Community Center Kitchen Upgrade and New Flooring
CIP NO. 22-06
This Owner -Contractor Agreement ("Agreement") is made by and between the City of National City, 1243
National City Boulevard National City, California 91950 and E&H General Contracting 1 . " tr t r" ,
8402 N MagnoHa Ave. Ste. B, Santee, California 92071 on the 17th day of January, 20231 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:
I. 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.
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 Contractorshall 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. NON-DISCRIMINATION
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,
. WORKERS' ' OMPE ATIOI INSURANCE
a) By 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 1 will comply with such provisions before
commencing the performance of the Work f this Agreement.
b) The Contractor shalt require each subcontractor to comply with the
requirements nt f Section 3700 of the Labor Code. Before commencing any Work, the
Contractor shall cause each subcontractor to execute the following certification:
HI 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 provisions with such before commencing the performance of thWork of
this Agreement.,'
7. ENTIRE AGREEMENT; T; ONFLI T
The Contract Documents comprise the entire agreement between the Owner and the
respect Contractor with 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.
MAINTENANCE OF AGREEMENT DOCUMENTATION
Contractor shall raintain 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 ears 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 I TRA TOR
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 shalt 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 term 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 construes: 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 anc/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 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 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 Sect.. n 15, above:
(Initial)
(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:
Ron Morrison Mayor,
City of National City
APPROVED AS TO FORM:
By: c$4•47 deLgoter
Barry Schultz
Interim City Attorney
Contractor:
E&H neral Con "Ong Inc.
(Owner/01<er signature)
�e M v�.1e ES A f� ?Ze's i bE�►/ T
Print name and title
(Second officer signature if a corporation
45A wt.S--
Print name and tine ,
s !' " 'i T
Contractor's City Business License No.
O.Z 90 a- GEw&---)2440,..-?loi teI A-461
State Contractor's License No. and Class
84. Q. t ..i SITE .
Business street address
S'A-4.17-6--e- IC . 2. 0-7
City, State and Zip Code
EXHIBIT A
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
CaliforniaBuilding, Mechanical, Plumbing bing 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 MT, BNSF, SAIA, Port of San Diego
and all other agencies that may be adjacent and/or affected by the project
EXHIBIT B
CONTRACT PRICE
Bid for MLK Community Center — Kitchen Upgrade and New Flooring E & H General
Contracting Inc.
CIP NO. 22-06.
Base Bid - Restrooms
2 Bast Bid Hallway / Entry
3 Base Bid Hallway( Entry
4 Base Bid Gathering r •
base Bid - Gathering Area
6 Bass the M Kitchen
7 Base Bid - Kitchen
B Base Bid - Kitchen
Base Bid, - Kitchen
11 Base Bid - Kitchen•
Base Bid Electrical
13 Base Bid . Plutribln9
Removannish DisplayCase
Flooring
Door Transitions
.Flo.oring... .
Door Transitions
Equipment
rriV i of WW1 ficIr Refrigerator
Addition of 1-2 Sprinklers
Concrete Pad for Condensing Unit
Other: flooringt concrete, ceili V roof
Electrical Scope Item
Plumbing Scope item
TOTAL BASE BID .
14 AdditiveTesting existing Blab for moisture tontent
15 Additive _ Damp Proofing
16 Additive Waterproofing
S
SF
SF
EA
LS
LS
LS
LS
LS
EA,
SF
SF
1
2000
8500
1
iotal.
.,, $:4.
00
$200.00$200.00
4. 00 * 0D.
$40800,00 $4,t800.00
$74060,0D $7A00.00
it $914945.00 ,.,94.E
1 $51i000,00 $521000.03
10.509 $5,25. ....$.p..5.0.10
11 . .
CORPORATE CERTIFICATE
1 r.-± ► kd OiktA f IA/0
certify that I am the Secretary of the
Corporation named as Contractor in the foregoing Contract;that
zi-4, AA /1444,3/47-e-A-
who signed said contract on behalf of the
was then of said
Contractor, ,
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, gta4.40"4,6. FsiskIA-10F)*
certify that 1 am the Secretary of the
Corporation named as Contractor in the foregoing Contract; that
, who signed saidcontract on behalf of the
Contractor, was then S-E-c/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.
Corporate Seal:
Executed in Triplicate
PERFORMANCE BOND
Bond No. 2332212
Premium: $9;498,00
Subject to Adjustment Based
on Final Contract Price
WHEREAS, the City Council of the City of National City, by Resolution No. -
—__, on the 17th day of January, 2023, has awarded ESLEI General ntr in n..c
hereinafter designated as the "Principal", for the MU< COMMUNITY CENTER M KITCHEN
UPGRADES AND NEW FLOORING, CIP NO. .22-06
WHEREAS, said Principal is required under the terms of said contract to furnish a
bond for thfaithful performance of said contract.
NOW, THEREFORE, we, the Principal and
Swiss Re Corporate Solutions Arnerica Insurance Corporation . as surety, are held and firmly
bound unto the City of National City) hereinafter called the "its,, in the penal sum of
Five Hundred Ninty7Nine Thousand, Eight Hundred Ten ($599,810.00I 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 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
=-
w+o#ia l l l n ydi Oh"
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 7th day of December , 20 22
Swiss Re Corporate Solutions America Insurance Corporation (SEAL)
Lawrence F. McMahon, Attorney -in -Fact
E & H General Conlractin9�—� (SEAL)
(SEAL) � J� � (SEAL)
i..J
(SEAL) 4E644e7 11:41q (SEAL)
-is GE's° r1a
Surety Principal
Please See Attached California All -Purpose Acknowledgment
PERFORMANCE BOND
ATTORNEY -IN -FACT ACKNOWLEDGEMENT OF SURETY
STATE OF
COUNTY F
On this day of,.. _, 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
)ss
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
certified copy of the Power of
Attorney.
Signature:
Name (Type or Print):
Notary Public in and for said County and State
My Commission expires:
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 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
County of San Diego
}
On I 2/j ,,f before me, D n na Estee Alvarado
Date Insert Name of Notary exactly as it appears an the official seal
personally appeared
Lawrence F. McMahon
tr Notary Public,
z
DANYNA ES T EE AEA DO
Notary Public California
Sari Diego County
Ccnmissian # 2407519
My Comm. Expires Jun 8, 2026
4. 1-... _..- .r•.� —
Place Notary Seal Above
Name(s) ofSigner(s)
who proved to me on the basis of satisfactory evidence to
be the personJ/ whose name(/ is/are subscribed to the
within instrument and acknowledged ed to me that heigiNWHON
e ecuned the same in hisilliteffiai authorized capacity } ►,
and that by his/Wit/NW signature„ ' on the instrument t e
person(, or the entity upon behalf of which the person(WJ
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 my hand and official seal.
Signature
OPTIONAL
Signature of
Dan na Estee Alvarado
Though the information ,below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Individual
• Corporate Officer Titles):
Number of Pages:
Partner Limited D General
• Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
El Other
Signer is Representing:
RIGHT THUMBPRINT
OF SIGNER
Top of thumb here
Signer's Name:
Li Individual
Corporate Officer Titles):
L Partner ❑ Limited l General
[❑ Attorney in Fact
Trustee
Guardian or Conservator
Other:
El
TI
Signer is Representing:
RIGHT THUMBPRINT
OF SIGNER
Top of thumb here
k
SWISS RE CORPORATE SOLUTIONS
SWISS RE CORPORATE SOLUTIONS AMERICA INSURANCE CORPORATION " RCSICu
SWISS RE CORPORATE
P R TE SOLUTIONS PREMIER INSURANCE RP RATI I ("SRCSPIC")
PY "
WESTPORT 1 INSURANCE CORPORATION ("WIC")
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT SRCSAIC, a corporation duly organized and existing under laws of the State of Missouri, and
having its principal office in the City of Kansas City, Missouri, and SRCSPIC, a corporation organized and existing under the laws of the State of
Missouri and having its principal office in the City of Kansas City, Missouri, and WIC, organized under the laws of the State of Missouri, and having its
principal office in the City of Kansas City, Missouri, each does hereby make, constitute and appoint:
LAWRENCE F. McMAHN, MARIA V. GUISE, SARAH MYERS, JANICE MARTIN, and JAMES DANIEL CASTLE
JOINTLY OR SEVERALLY
Its true and lawful At torney s -iri-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of:
FIFTY MILLION 0,000,0 0. 0 DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both SRCSAIC and SRCSPIC at meetings duly called and held on the 18th of November ember 0 1 and WIC by written consent of its
Executive Committee dated July 18, 2011.
"RESOLVED, that any two of the President, any Managing Director, any Senior Vice President, any Vice President, the Secretary or any Assistant
Secretary be, and each or any of them hereby is, authorized to execute a Power of Attorney qualifying the attorney named in the given Power of
Attorney to execute on behalf of the Corporation bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to
attest to the execution of any such Power of Attorney and to attach therein the seal of the Corporation; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Corporation may be affixed to any such Power of Attorney or to
any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding imago the Corporation when so affixed and in the future with .re2ard to any bond, undertaking or contract of surety to which itis attached."
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Erik Jonssells, Sonior Vice President of S CSAYC & Senior'Vice President
of SRCSPIC & Senior Mice President of WIC
Gerald lagrorwski, Via President of SRCSAIC & Vice President of SRCSPIC
& Vice Presidcut of WIC
IN WITNESS WHEREOF, SRCSAIC, SRCSPIC, and WIC have caused their official seals to be hereunto affixed, and these presents to be signed by their
authorized officers
this,,.10 d a y of NOVEMBER , 20_ 22
Slate of Illinois
County of Cook
Swiss Re Corporate Solutions America Insurance Corporation
Swiss Re Corporate Solutions Premier Insurance 'orportion
Westport Insurance Corporation
On this 10 day of 1 VE BR , 20 22 before me, a Notary Public personally appeared Erik Janssens , Senior Vice President of SRCSAIC
and Senior Vice President of SRCSPIC and Senior Vice President of WIC and Gerald Jagrowsii , Vice President of SRCSAIC and Vice President of
SPCSPTC and Vice President of WIC, personally known to me, who being by me duly sworn, acknowledged led ed that they signed the above Power of Attorney
as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies.
0.111444
OA toy_
I, J .; "ti fi l er the duly elected Senior Vice President and Assistant Secretary of SRCSAIC and SRCSPIC and "SIC, do hereby certify that the above and
foregoing is a true and correct copy of a Power of Attorney given by said SRCSAIC and SRCSPIC and WIC, which is still in full force and effect.
IN WITNESS SS WHEREOF, I have set my hand aild affixed the seals of the Companies this 7th day of DE EMBER , 20 22
gy •J
Jeffrey Goldberg, Senior Vice President
Assistant Secretary of SRCSAIC and
SRCSPIC and WIC
Executed in Triplicate
PAYMENT BOND
Bond No, 2332212
Premium Included in the Performance Bond
WHEREAS, the City Council of the City of National City, by Resolution No. 023-
, on the 17th dyf_ January, 2023 has awarded E ,H _General _ ntr cthiff ...,,
hereinafter designated as the "Principal", for the MLK COMMUNITY CENTER - KITCHEN
UPGRADES AND NEW FLOORING, CIP . 22-06
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 wis�o�or orate o[ution America Insurance Corporation,
as surety, are held and firmly bound unto the City of National City, hereinafter called the
"City", in the penal sum of Five Hundred Nint -ine Thousand, Eight Hundred Ten
f$599,81O.001 dollars lawful money of the United States, for the payment of which sum
well and truly to e 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
under the Unemployment Insurance Code with respect to work or labor performed by
any suh 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 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.
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e•
1ViSEAL:
r� 1973
4 S 113 j.:1 4,
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
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
and Surety above named, on the 7th Tay of December - , 2022
Swiss Re Corporate Sorutiop rnerice Insurance Corporation (SEAL)
Lawrence F. McMahon, Attorney -in -Fact
Surety
(SEAL)
(SEAL)
E & H General Contracting Inc.
ristilb ES5 r 044*
1QE'S
Principal
(SEAL)
(SEAL)
(SEAL)
Please See Attached California All -Purpose Acknowledgment
ATTORNEY -IN -FACT ACKNOWLEDGEMENT OF SURETY
STATE OF
COUNTY OF
..._______)
)ss
On this day of _, before me, the undersigned, a
Notary Public in and for said County and State, personally appeared
- - v 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
Surety must be properly
acknowledged.
1
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: - - -- -- --
ATTACH ALL BONDS
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT Civil Code § 1189
[heciocument
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
, to which this certificate is attached, and not the truthfulness, accuracy or validity of that document.
STATE OF CALIFORNIA
County of San Diego
On
7 Ic' 2L- before me,
Date
personally appeared
z
}
Danyna Estee Alvarado , Notary Public,
Insert Name of Notary exactly as it appears on the official seal
Lawrence F. McMahon
DANYNA ES 'E E ALVARADO
Notary Pubiic • California
San Diego County _.
Commission # 2407519
My Comm, Expires. Jun 8. 2026
Place Notary Seal Above
1.6
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(la whose name(0 is/are subscribed to the
within instrument and acknowledged to me that he/ i /
executed the same in his/IIMMINN authorized capacity ' ,
and that by hisithititaitef signature, . on the instrument e
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.
Witness my hand and official seal.
Signature
Signature o
na Estee Alvarado
OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
capac ty(ies) Claimed by Signer(s)
Signer's Name:
Individual
Corporate Officer Title(s):
El Partner Limited fl General
ID Attorney in Fact
El Trustee
El Guardian or Conservator
❑ Other:
Signer is Representing:
Number of Pages:
RIGHT TH MBPINT
OF SIGNER
Top of thumb here
Signer's Name:
[ I ndividual
Corporate Officer Title(s):
DI Partner Limited j General
El Attorney in Fact
Trustee
0 Guardian or Conservator
El Other:
Signer is Representing:
RIGHT THUMBPRINT
OF SIGNER
Top of thumb here
SWISS RE CORPORATE SOLUTIONS
SWISS RE CORPORATE SOLUTIONS AMERICA INSURANCE CORPORATION ("SRCSAIC")
SWISS RE CORPORATE SOLUTIONS PREMIER INSURANCE CORPORATION("SRCSPIC")
WESTPORT INSURANCE CORPORATION ("WIC")
GENERAL POWER P ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT SR.CSAIC, a corporation duly organized and existing under laws of the State of Missouri, and
having its principal office in the City of Kansas City, Missouri, and SRCSPIC, a corporation organized and existing under the laws of the State of
Missouri and having its principal office in the City o:r Kansas City, Missouri, and WIC, organized under the laws of the State of Missouri, and having its
principal office in the City of Kansas City, Missouri, each does. hereby make, constitute and appoint:
LAWRENCE F. McMAHON, MARIA V. GUISE, SARAH MYERS, JANICE MARTIN, and JAMS DANIEL CASTLE
JOINTLY OR SEVERALLY
Its true and lawful Attorn y s -in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of:
FIFTY MILLION 0,000, 00, 0 DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both SRCSAIC and SRCSPIC at meetings duly called and held on the 18th of November 2021 and WIC by written consent of its
Executive Conrunittee dated July 18, 20 [ 1.
"RESOLVED, that any two of the President, any Managing ing Director, any Senior Vice President, any Vice President, the Secretary or any Assistant
Secretary be, and each or any of them hereby is, authorized to execute a Power of Attorney qualifying the attorney named in the given Power of
Attorney to execute on behalf of the Corporation bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to
attest to the execution of any such Power of Attorney and to attach therein the seal of the Corporation; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Corporation may be affixed to any such Power of Attorney or to
any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding ulon the Corporation when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached."
NOIP
1OT rte." l 4
SEALIFY4
01414#Irein►
"l� 41 �r��14 r ,+�y�,A�,
* ' w{ 4 r14.
W
qY r r
+ w
*,.
4
tik:S: lir" I Itk()>%‘'
jd
{
By.
Erik Janssens, Senior vice President of SRCSAIC & Senior Vice President
of SRCSPIC & Senior Vice President of'WIC
Gerald d Jagrowsi i, Vice President of SRCSAIC & Vice President of SRCSPIC
& Vice President of WIC
IN WITNESS WHEREOF, SRCSAIC, SRCSPIC, and WIC have caused their official seals to be hereunto affixed, and these presents to be signed by their
authorized officers
this day of 1 VEM E 20 22
State of Illinois
County of Cook
Swiss Re Corporate Solutions America insurance Corporation
Swiss Re Corporate Solutions Premier Insurance Corporation
Westport Insurance Corporation
On this O day of NOVEMBER
, 0 2 before me, a Notary Public personally appeared Erik Janssens , Senior Vice President of SRCSAIC
and Senior Vice President of SRCSPIC and Senior Vice President. of WIC and cieralci J growsl i , Vice President of SRCSAIC and Vice President of
SPCSPIC and Vice President of WIC, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney
as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies,
4 I y
liSaty�y��
I, Jeffrey Goldberg* the duly elected Senior Vice President and Assistant Secretary of SRCSAIC and SRCSPIC and WIC, do hereby certify that the above and
foregoing is a true and correct copy of a Power of Attorney given by said. SRCSAIC and SRCSPIC and WIC, which is still in full force and effect.
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 7th day of DECEM ER 20 22
rk "
'Y
Jeffrey Goldberg, Senior Vice President &
'
Assistant Secretary of SRCSAIC and
SRCSPIC and WIC
A CGR El
THIS CERTIFICATE IS ISSUED AS A MATTER F INFORMATION ONLY AND CONFERS NO RIGHTS HTS 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 E DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING Il SUI ER(S) AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poll (les) must have ADDITIONAL NAL 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).
CO TACT David Brinihall
NAME:
PRODUCER
DJM insurance Services
10038 Marathon Parkway, 2nd Fl
Lakeside
INSURED
COVERAGES
CERTIFICATE OF LIABILITY INSURANCE
E GENERAL CONTRACTING INC
8402 N Magnolia Ave Ste# B
Santee
CA 92040
CA 92071
PRONE 8 6) 961- 570
A1U N. Ext
* AID supporta@djl lns.coe
ADDRESS,
NSURR(S) AFFORDING COVERAGE
INSURER A : Scottsdale Insurance Co
INSURER B :
INSURER C
DATE (MMJDD!YYYY)
12/12/2022
FAx
NNo (6619) 938-2504
NAIL
41297
INSURER D
INSURER B
INSURER F
CERTIFICATE NUMBER: MASTER 12 12 2022
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIVIED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING DIN ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS ITION OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR
LTR
A
A
A
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE
OCCUR
GENTAGGREGATE LIMIT APPLIES PER:
PRO- LOC
POLICY 1.. 1 JEGT
OTHER:
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
• I I1
INS 1
wvo
POLICY NUMBER
RB50004'!4]
RB 0084747
FOLIC FF
MM/DDIYYY
OBI10/2022
08i10l 0
08110 2023
8/10/202
REVISION NUMBER:
EACH OCCURRENCE
OCCURRENCE
G
PREMISES Ea occurrence
MEDsxa (Anyooa person)
EXP lane person)
PERSONAL & ADV INJURY
IN,JUi Y
AGGREGATE
GENERAL AGGREATE
PRODUCTS - COMP/OP AGG
$ 1,000,000
$ 50,000
5,000
I,000,000
2,000,000
2,000,000
$
■
■ Eo
x X
UMBRELLA 41A9
EXCESS LIAR
UMBRELLA LIAB
LIAB
OED
■ ■
s� CHEDU LED
AUTOS
NON -OWNED
AUTOS ONLY
•
■
OCCUR
CLAIMS -MADE
A NS/A
RETENTION $ .
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
(�ntlNoy�n NMj E%CLUDFD�
Ism �tleseAbe under
OM PENSAT'I N
LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OI�FICERIMEMSER EXCLUDED?
(Mandatory in NI -I)
if yes, describe under
DESCRIPTION OF OPERATIONS below
YIN
N/A
XL50119046
XL O 11 04
1210812022
12/08/2022
OB110I2023
08/101 023
COMBINED�SINGLE LIMIT
SINGLE LIMIT
Ea accident
BODILY INJURY (Per person)
BODILY INJURY (Per persons)
BODILY INJURY (Per BODILY (Per accident]
PROPERTY DAMAGE
DAMAGE
Per accident
EACH OCCURRENCE
AOREGATERE0.4TE
PE
E.L. EACH ACCIDENT
OTH-
EL. DISEASE - EA EMPLOYEE
E-POLICv� i
EL. DISEASE - POLICY LIMIT
2,000,000
2000,000
$
$
$
DESCRIPTION OF OPERATIONS J LOCATIONS / VEHICLES (ACORD 1011 Additional Remarks Schedule, may he attached If more space Is required)
As per written contract, The City of National City, its elected officials, officers, agents, employees and volunteers are included as additional insured with
respects to the General Liability coverage, per form #SDS-41 (1-19). Primary and non-contributory wording endorsement applies with respect to the
General Liability insurance coverage, per form #SD - 5 (1-18). Waiver of Subrogation applies with respect to the General Liability insurance coverage, per
form # D -48 (1-18). Per Project Aggregate endorsement applies with respect to the General Liability insurance coverage, per form SDS-80 (07-22).
Excess Liability policy form to follow the General Liability policy form.
CERTIFICATE HOLDER
City of National City, c!o Risk Manager
1243 National City Boulevard
National City
CA 91950-4397
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
1988-2015 ACORD D RP F ATI N. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 25 (2016/03)
Underwritten by Scottsdale Insurance Company
ENDORSEMENT
NO2
ATTACHED TO AND
FORMING A PART OF
POLICY NUMBER
RBS00 4747
ENDORSEMENT EFFECTIVE DATE
(12:01 A.M. STANDARD TIME)
12/08/2022
NAMED INSURED
E & H General Contracting Inc
AGENT N,
047BZ
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
Designated Construction Projects);
140 East 12th St., National City, Ca 91950
A. For all sums which the insured becomes legally obligated to pay as damages caused by an "occur-
rence" under SECTION 1—COVERAGES, COVERAGE A — BODILY ILY INJURY AND PROPERTY
DAMAGE LIABILITY, or offenses under COVERAGE B—PERSONAL AND ADVERTISING ING INJURY
LIABILITY and for all medical expenses covered under SECTION 1—COVERAGES, COVERAGE
C—MEDICAL PAYMENTS, that can be attributed only to ongoing operations at the designated con-
struction 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 underSECTION 1—COVERAGES, COVERAGE A —BODILY INJURY AND
PROPERTY DAMAGE LIABILITY,e cept damages because of "bodily injury' or "property dam-
age"
included in the "products -completed operations hazard," SECTION 1—COVERAGES, COVER-
AGE B—PERSONAL AND ADVERTISING G INJURY LIABILITY for "personal and advertising in-
jury," and for medical expenses underSECTION I— OVERA ES, OVERA E C—MEDICAL
PAYk E TSr g rdless of the number of:
as Insureds;
b. Claims made or "suits" brought; or
Persons or organizations making claims or bringing "suits."
3. Any payments made under SECTION I—COVERAGES,COVERAGE A—BOD1LY INJURY Y AND
PROPERTY DAMAGE LIABILITY and SECTION 1—COVERAGES, COVERAGE B—
PERSONAL AND ADVERTISING INJURY LIABILITY and for damages or under SECTION I --
COVERAGES, COVERAGE C—MEDICAL PAYMENTS for medical expenses shall reduce the
Includes copyrighted material of ISO Properties, lnot, with its permission.
Copyright, ISO Properties, Inc., 2013
SDS-83 0 - ) Page 1 of
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 or by separate endorsement.
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 Designat-
ed Construction Project General Aggregate Limit.
B. For all sums which the Named Insured becomes legally obligated to pay as damages caused by an
"occurrence" underSE TI I I— OVERAGE , COVERAGE A --BODILY INJURY AND PROPER-
TY DAMAGE LIABILITY, or offenses under COVERAGE B—PERSONAL AND ADVERTISING IN-
JURY LIABILITY, and for all medical expenses caused by an accident under SECTION I —
COVERAGES, COVERAGE —E I AL PAYME 1TS,which cannot be attributed only to ongoing
operations at a single designated construction project shown in the Schedule above:
1. Any payments made under SECTION 1—COVERAGES, COVERAGE A —BODILY INJURY AND
PROPERTY DAMAGE LIABILITY and SECTION I—COVERAGES,COVERAGEB—PERSONAL
AND ADVERTISING INJURY LIABILITY for damages, or under SECTION I —COVERAGES,
COVERAGE —I EC I AL PAYMENTS for medical expense shall reduce the amount available
under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whi-
chever is applicable; and
2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit.
C. When coverage for liability arising out of the `products -completed operations hazard" is provided, any
payments for damages because of "bodily injury" or "property damage" included in the "products -
completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and
not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate
Limit.
D. If the applicable designated construction project has been abandoned, delayed or abandoned and
then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifi-
cations 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 endorse-
ment shall continue to apply as set forth in the policy.
F. The terms and conditions of this endorsement will not apply to any construction project not specifical-
ly designated in this endorsement.
G. This endorsement is only applicable if the designated construction project is identified specifically at
the top of this endorsement.
H. Notwithstanding any of the provisions above or elsewhere in the policy, the maximum amount of all
separate per project aggregate payments we will be obligated to indemnify for losses occurring or
commencing during this policy term for the separate Construction Project General Aggregate Limits -
combined will be limited to the sum of five million dollars ($5,000,000) collectively.
All other terms, conditions and provisions of the policy remain unchanged.
/ _ 1 2/os/2oz2
AUTHORIZED REPRESENTATIVE DATE
Includes copyrighted material of ISO Properties, Inc,, with its permission.
Copyright, ISO Properties, Inc., 2013
SDS-83 (07- ) Page 2 of
Natioftwiche
-1:. `t'
Underwritten by Scottsdale Insurance Company
ENDORSEMENT
NO.
ATTACHED TO AND
FORMING A PART OF
POLICY NUMBER
ENDORSEMENT EFFECTIVE DATE
(1 ;O1 A.I. STANDARD TIME)
f B S o 4747
08/10/2022
NAMED INSURED
E H General Contracting Inc
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED -ONGOING OPERATIONS --
OWNERS, LESSEES OR CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL, LIABILITY COVERAGE FORM
SCHEDULE
AGENT NO.
047BZ
Name Of Additional Insured Person(s)
Or Organi ati n ;
Location(s) Of Covered Operations
Any "additional insured" person, entity or
organization where work is performed by you if
ongoing operations coverage is required by insured
contract
Any location of "additional insured" person, entity or
organization where work is performed by you it
ongoing operations coverage is required by insured
contract.
SECTION 11 WHO IS AN INSURED, is amended to include, for COVERAGE A— o iLY INJURY AND
PROPERT
Y DAMAGE LIABILITY, only, as an additional insured, the person, entity or organization des-
ignated in this endorsement for whom the Named Insured is performing ongoing operations only when the
Named insured has agreed with the person, entity or organization in an "insured contract" to name the
person, entity or organization as an "additional insured."
arson entityor organization is only an "additional insured" with respect to liability for "bodi-
ly Such person, of the
l injut" or "property damage"caused, in whole or in part, by the ongoing operations
Named Insured performed for the "additional insured" at the designated location.
2. The "insured contract" must be currently in effect or become effective during the policy period, be
executedprior rior to the "bodily injury, or "property damage" first happening and be between the
Named Insured and the"additional insured."
3. This coverage does not apply to "bodily injury" or 'property damage" after
a. "Your work" for the additional insured has been completed; or
b. That portion of "your work" out of which the "bodily injury" or "property damage" arises has
been put to its intended use by any person or organization.
4. The applicable limit of our liability shall not be increased by the inclusion of the additional insured
under the policy.
5. We shall have no duty to indemnify the additional insured for damages, claims or any other liabili-
ties arising from actions, inactions, errors or omissions of the "additional insured."
SDS-41 (1-19) Page 1 of
. Our duty to contractually indemnify the additional insured under an "insured contract" pursuant to
this endorsement shall be limited to that sum derived by applying the percentage of fault of the
Named Insured as determined by the trier the trier -of -fact to the total damage sum allocated by
the trier -of -fact to the "additional insured.}a Under no circumstances shall we pay more than this
proportionate contractual indemnity share required of the policyholder in the "insured contract.,
, Any contractual indemnity payments made on behalf of any additional insured under an "insured
contract" shall reduce the applicable limits of insurance on a dollar for dollar basis. Any contrac-
tual indemnity payments paid to or on behalf of the "additional insured" pursuant to this endorse-
ment are subject to the terms, conditions and limitations of the policy.
B. This endorsement does not create a duty on our part to defend the additional insured or to partic-
ipate in, contribute to, or reimburse any person, organization or entity for any fees or expenses
incurred in the defense of the "additional insured."
SECTION IV —COMMERCIAL GENERAL LIABILITY CONDITIONS, Condition 2. Duties In The Event
Of Occurrence, Offense, Claim Or Suit of the policy is amended to include:
An additional insured under this endorsement shall in addition to complying with all provisions of the
Po
l i cy:
1. Give written notice to us of an occurrence or an offense which may result in a claim or "suit' with-
in thirty 0 days of notice to the `additional insured."
. Give written notice to us of a claim or "suit" brought against the "additional insured" within thirty
(30) days of the additional insured being served with the claim or "suit."
3. Give written notice to any other insurer who has or may have coverage under its policy or policies
for a claim, "suit" or demand for defense or indemnity within thirty days of the "additional in-
sured" being served with the claim, "suit" or demand for defense or indemnity. Such notice must
demand the full coverage available under the policy. The "additional insured" will not take any ac-
tion to waive or limit such other coverage available to It.
. Obtain and provide to us copies of each and every policy from each and every insurer identified
pursuant to the preceding paragraph.
The following's added to SECTION V —DEFI IITIONS:
ADDITIONAL INSURED
"Additional insured" means any person or organization that the Named Insured has agreed in an "in-
sured contract" to name as an "additional insured" and has been named or identified by description in
an "additional insured" endorsement issued and attached to the policy. Coverage is afforded under
this policy for an additional insured for Coverage A liability only.
"Bodily injury" and "property damage" coverage is afforded to the `additional insureds" as provided
in the insuring agreement and subject to all policy provisions, provided that the "bodily injury" or
"property damage" also:
1. First takes place after the execution of the "Insured contract"; and
. Arises from "your work" performed for the "additional insured"(s) during the policy period or arises
from "your" "ongoing operations."
This endorsement is subject to all terms, conditions and exclusions of the policy, which remain
unchanged.
AUTHORIZED REPRESENTATIVE
/- 07i29i2022
DATE
SDS-41 (1-1) Page 2 of
„ilk SCOTTSDALE INSURANCE COMPANY®
ATTACHED TO AND
FORMING A PART OF
POLICY NUMBER
RBS0084747
ENDORSEMENT EPFEDT1VE DATE
(12:01 A.M. STANDARD TIME)
08/10/2022
ENDORSEMENT
NO.
NAMED INSURED l AGENT NO.
E H General Contracting Inc
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
BLANKET ADDITIONAL INSURED -ONGOING OPERATIONS PRIMARY AND
NONCONTRIBUTORYOWNERS, LESSEES OR CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SECTION lWHO IS AN INSURED, ED, is amended to include, for COVERAGES A— OILY INJURY
AND PROPERTY DAMAGE LIA ILITY,only, as an additional insured, the person, entity or organization
designated Mn
this endorsement for whom the Named Insured has performed operations only when the
Named Insured has agreed with the person, entity or organization in an insured contract to name the per-
son, entity or organization as an additional insured.
person, entityor organization is only an additional insured with respect to liability for "bodily
'� � Such p � inof the Named
injury” or- "property damage" caused, whole or in part, by the ongoing operation
Insured performed for the additional insured.
2. The
"insured contract" must be currently in effect or become effective during the policy period, be
executedprior
to the "bodilyinjury"or "property damage' first happening and be between the
Named insured and the additional insured.
3. This coveragedoes not apply to "bodily injury" or "property damage" after:
a. "Your work"for the additional insuredhas been completed; or
po
rtion
That of "your work" out of which the "bodily injury" or "property damage»arises has
been put to its intended use by any person or organIzation.
, The applicable Limit of our liability shall not be increased by the inclusion of the additional insured
under the policy.
shall5. have no dutyto indemnify the additional insured for damages, es, claims or any other liabili-
ties arising from actions, inactions, errors or omissions of the additional insured. -
6. Our duty to contractually indemnify the additional insuredunder an "insured contract" shall be li-
mited to that sum derived applying the percentage of fault of the Named Insured as deter-
mined ' dthe trier the trier -of -fact to the total damage sum allocated by the trier -of -fact to the
mine by
additional insured. Under no circumstances shalt we pay more than this proportionate ontratual
indemnity share.
7. Any contractualindemnity
payments made on behalf of any additional insured under an "insured
,� hall reduce the applicable limits of insurance on a dollar for dollar basis. Any contractual
corrtrac� s �
indemnity a ments are subject to the terms, conditions and limitations of the policy.
SDS-55 (1 -1 Page 1 of
13. This endorsement does not create a duty on ourpart to defend the additional insuredor to partici-
pate in,
contribute to, or reimburse any person, organization or entity for any fees or expenses in-
curred in the defense of the additional insured.
SECTION IV —COMMERCIAL GENERAL LIABILITY CONDITIONS, Condition 2. Insured's Duties In
The Event Of Occurrence, Offense, Claim Or Suitof the policy is amended to include:
An additional onal insuredunder this endorsement shall in addition to complying with all provisions of the
policy:
1. Give written notice tous of an "occurrence" or an offense which may result in a claim or "suit" with-
in thirty days of notice to the additional insured.
2. Give written notice to us of a claim or "suit" brought against the additional insured within thirty
(30)
days of the additional insured being served with the claim or "suit'.
3. Give written notice to any other insurer who has or may have coverage under its policy or policies
for a claim,"suit" ult" or demand for defense or indemnity within thirty days of the additional in-
sured being
served with the lain,"uit"r demand for defense or indemnity"Such notice must
demand the full coverage available under the policy.The additional insured will not take any ac-
tion to waive or limit such other coverage available to it.
4. Obtain and provide to us copies of each and every policy from each and every insurer identified
pursuant to the preceding paragraph.
The coverage provided by this endorsement is primary and non-contributory and no insurance held or
" "insured shall be called upon to cover damages under this policy up tothe limitsof
owned by the additional P
this policy, but only if the
"bodily injury"or"property damage" under this policy is caused directly, in whole
or in part, from your ongoing operations performed for the additional insured.
This endorsement is subject towhich terms, conditions and exclusions of the policy, remain
unchanged.
07/29/2022
AUTHORIZED REPRESENTATIVE DATE
D - 1 1 ) Page 2 of
A SCOTTSDALE INSURANCE COMPANY®
ENDORSEMENT
NO.
ATTACHED TO AND
FORMING A PART OF
POLICY NUMBER
RBS0084747
ENDORSEMENT EFFECTIVE DATE
(1 :GI A.M. STANDARD TIME)
08/10/2022
NAMED INSURED
E & H General Contracting Inc
AGENT NO.
047BZ
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Name of Person or Organization:
SCHEDULE
Any person or organization against whom
subrogation is required to be waived by an
"insured contract".
Designated Construction Project:
Any construction project performed by you for any
person or organization against whom subrogation is
required to be waived by an „insured contract".
SECTION
RI —COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer Of Rights Of
Recovery o i st Others To is deleted in its entirety and replaced by the following:
8. Transfer Of Rights Of Recovery Against Others To Us
If any insured has rights to recover all or part of any payment we have made under the applicable
Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair
0 "suit" �} to usand helpus
such rights. At our request, such insured will bringsuit or transfer those rights
enforce them.
We waive anyright of recovery we may have against the person or organization shown in the
r
Schedule above because of payments we make for "bodily injury" "property prpe ty damage" arising
out of "your work" done under an (`insured contract" with that person or organization at the
designated construction project.
This waiver applies onlyif the designated construction project shown in the Schedule above is
p
completed and only to the construction project designated in the above schedule.
All other terms, conditions and exclusions of the policy remain unchanged.
Q7/29/2Q22
_Z
AUTHORIZED REPRESENTATIVE DATE
SD -4 1-1 Page I of
ACCORD
THIS CERTIFICATE IS ISSUED
A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES T 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 I BURER() AUTHORIZED
REPRESENTATIVE OR PRODUCER, UCEI , AND THE CERTIFICATE HOLDER IMPORTANT:be endorsed.
oed.
If the certificate ate holder Isan ADDITIONAL INSURED, the olicy(Ie) must have ADDITIONAL INSURED provisions or , A statement nt
If SUBROGATION N 1 WAIVED, subject to the terms and conditions of the policy, certain policies mayrequire an endorsement
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)l
o ACT Amy Crummy
NAME:
CERTIFICATE OF LIABILITY INSURANCE
DATE (MIVI/DDIYYYY)
12/06/2022
PRODUCER
Alvarado Pacific Insurance Services
7777 Alvarado Rd. #605
La Mesa
INSURED
COVERAGES
THIS IS TO CERTIFY THA
T THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED EC NAMED ABOVE FOR THE TOPONAMED
ICY S
PERIOD
INDICATED, NOTWITHSTANDINGANY REQUIREMENT, TERM CAR CO DITIO F ANY CONTRACT OR OTHER DOCUMENT WITH
RESPECT LL THE TERMS,
T
CERTIFICATE MAY BE ISSUED MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
HEREINIS
EXCLUSIONS I AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWNMAY HAVE BEEN REDUCED BY PAID
POLIC EFF P i L CY
10,111DDIYYYY MMiDD
E&H General Contracting Inc
8402 N Magnolia Ave. #1
Santee
INSURER D :
INSURER E
REVISION NUMBER:
SR
LTR
A
POLICY
OTHER:
oIV{I IIVEI I N I
E� a��Iden �
AUTOMOBILE LIABILITY
BODI�.Y 1I�JU1� Per peron)
ANY AUTO
IIIIIIIIIIIIIII
OWNED ED SCHEDULED H 7DILY II 1, INJURY Per accident)
AUTOS ONLY AUTOS rROPEIT1' DAAO
HIREi DN-OUVI ED Per ac ldent
AUTOS ONLY ild AUTOS C�NL`�
UMBRELLA LIAB OCCUREACH OCCURRENCE
EXCESS L1A AG F EGATE
11 CLAIMS -MADE DED al RETENTION $
WORKERS COMPENSATION
PER . OTH-
AND EMPLOYERS' LIABILITY f 1 Id /29/2023 E.L. EACH AkCCIC}EfST
AN PROPRIETOR/PARTNER/EXECUTIVE ! 9 849 Q J2 I2 22 °
OFFICE /ME BER EXCLUDED? I .L. DISEASE - EA EMPLOYEE
Mandatory In NI-1}
If arcs, describe under E. L. DISEASE SE - POLICY LIMIT
DESCRIPTION 0�' OPERATIONS belov�
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
DESCRIPTION OF OPERATIONS ! LOCATIONS J VEHICLES (ACORD i01, Additional Remarks Schedule, may be attached If more alpaca Is required)
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
CLAIM -MADE
OCCUR
CA 91942-8282
CA 92071
PHONE (619) 668-4600
Ext
E-M• IL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
Air No . (619) 469-1569
NAIC #I
35076
INSURER A : State ompen action Ins Fund mom
INSURER C
CERTIFICATE NUMBER: CL2 12632961
EF1'L, AGGREGATE LIMIT APPLIES PER:
IIO- 1 LOC
JEOT
.I
INSU
WVD
POLICY NUMBER
111.
4 L f
E LIN11T
EACH OCCURRENCE
PREMISES Ea occurrence
MED E P (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
ATE
PRODUCTS - COMP/OP AGG
$
$
$
$ 1,000,000
$ 1o00,000
1,000 000
$
CERTIFICATE HOLDER
City of National City
c/a Risk Manager
1243 National City Blvd
National City
CA 91950-4397
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN
ACCORDANCE DA►I CE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
zesgeftae7
C11988.2015 ACORD CORPORATION. Ali rights reserved.
ACORD 2 (01 10 )
The ACORD name and logo are registered marks of ACORD
STATE
BROKER COPY
COMPENS-ATION
N U .F # Ni
FUND
HOME OFFICE
SAN FRANCISCO
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME THE
TIME INDICATED AT
PACIFIC STANDARD TIME
ENDORSEMENT E M * "
WAIVER OF SUBROGATION
BLANKET. BAS I S
EFFECTIVE SEPTEMBER 29, 2022 AT 12.01 A.M.
AND EXPIRING SEPTEMBER 29, 2023 12.01 A.M.
I GENERAL CONTRACTING, INC
8402 N MAGNOLIA E
SANTEE, CA .2
' 993 2
RENEWAL
SD
- -9 1 - 2
PAGE
WE HAVE THE RIGHT TO RECOVER OURPAYNENTS 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 WRITTENCONTRACT TEAT REQUIRES YOU
TO OBTAIN THIS .AGREEMENT FROM US.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE
2.00% OF THE TOTAL POLICY PREMIUM.:
SCHEDULE.:
PERSON OR ORGANIZATION
ANY PERSON OR ORGANIZATION
FOR WHOM THE NAMED INSURED
HAS: AGREED BY WRITTEN
CONTRACT TO I .IS THIS
WAIVER
JOB DESCRIPTION.
BLANKET WAIVER OF
SUBROGATION
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS„ 1TI R I T , OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED; NOTHING ELSEWHERE IN THIS POLICY SHALL HELD TO OE
VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS F. THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
SEPTEMBER 30, 2 2
PRESIDENT AND CEO
2572
AUTHORIZED REP . TN IVE
SCW FORM 10217. iR . '2O 4)
OLD OP 217
. C:=" !7es' . a{t- _�w''.Fi'2:°st��a^`_`w= yl--r'�-'s?`,"fir zYF=x z:? !:e_. •3:¢S
City of National City
BUSINESS TAX CRTIFICATE
"For Services Provided in National City, California Only"
Business Name
Business Location
BusinessOwner(s)
E & H GENERAL CONTRACTING INC.
8402 MAGNOLIA AVESTE
SANTEE, CA92071-4638
E & H GENERAL CONTRACTING INC.
E H GENERAL CONTRACTING INC.
8402 MAGNOLIA AVETE B
SANTEE/ CA92071-4638
THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS
THAT is THE ISF PROHIBITED_
Business Type
Account Number
Effective Date
Expiration Date
2023
TO LIE ROOTED IN A COMIPiCUOUSPLACE
4��1RRppq.J ]iq��y*� ��a ;{} �r�} porgy ys yyL��9r��� [µ,.me; y[
'N 7i TR 1 Ii, i '# A SIGN �aDL
Contractor - General (Based Out
Of City)
09051656
January 01 # 2023
December ber 31, 2023
City Manager
NOTE: IT IS YOUR OBLIGATION TO RENEW THIS
CERTIFICATE WHETHER OR OT YORECEIVE A
RENEWAL NOTICE
For all inquiries regarding this certificate, contact Wit.
Business Tax Support Center at 1) 2-2 .
a
t.
re
77.
r_#rLc'..rfi�� .i'.3''�'Sx}r:ati.t:a2C ;ite-+tisE.rfi�c4�-ram'•rl—J4�ws•-''
F- ;r';� �r''WY/=: r'S.rF: F.3..,nfki¢�'r;_ f'r'fxo-:.'?,lsr';t-e�, n5 r! .?rn�r^•.tL.
E & H GENERAL CONTRACTING INC,
Thank you for your payment on your National City Business Tax Certificate. ALA, CERTIFICATES MUST BE AVAILABLE .AB FOR
INSPECTION UPON REQUEST. If you have questions concerning your business license, contact the Business Support Center
via email at; NationalCity@HdLgov4com or by telephone et: (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 appiloable laws, nor to conduct business in a zone where conducting such business violates law.
If o 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
p
the Ckt 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.cicaaca.govipublicationsi
qotn:MOO ef:. I BUSINESS TAX BUFFO
CENTER
)1kr
18839 N CEDAR AVE12
E & 11 GENERAL CONTRACTING INC.
8402 N MAGNOLIA AVET
SANTEE, CA92071-4638
City of National City
BUSINESS TAX CERTIFICATE
Account Number: 09051656
01101/2023
Date of Issue:
h � 1� R'4�F� F { h4�
a.F#p?Lr� ;
J
litiontomo
City of National City
BUSINESS TAX CERTIFICATE
„Far Services Provided In National City, California Only"
Business Name 5 & 1iGENERAL CONTRACTING INC.
Business Location � t�l"�EECA 920N7 �4698 STEOLIA AVE �
Bus�n+�as DWmer{e) E & H GENERAL CONTRACTING INC.
GENERAL CONTRACTING INC.
MAGNOLIA AVE
SANTEE, CA 920714.638
THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSiNESS
THAT I OTHPITIVIIMF PRosmarr l .
� � �0. ;, = ,te a"
4r�Ax
tottookiNlik 144
illtaiiros
Business Type
Account Number
Effective Date
Expiration Date
2022
{,LPL �G }'� £ y {}� Y 4 i7'.Yl'^ 0
l sxww.�rp i-.. al �j'1 ��i �u ���r�r'tii�,
P3 }dry 3 55y*
K- cc ir.- 1 �F /W pS{!� +r� i .T {�f, 7 1N. 4 +� 4A j 1 4 ",j' iy,Lr i1F
1��.[ }. 'J Fu�i� 4r F�tY�J��'.�v�l+%'i.�{iF �' i���+�'�I � ��W+�.i
Contractor General (Based Out
Of City)
09051656
September 29. 2022
December 31. 2022
City Manager
NOTE:' IS YOUR OBLIGATION TO RENEW THIS
CERTIFICATE WHETHER OR NOT YOU RECEIVE A
RENEWAL. NOTICE contact .
For all inquiries regarding this �%
BusineFss, Tax Support Center at 9) B G.
GENERAL CONTRACTING INC.TTES r ST �►1r E AVAILABLE
FOR
your National Business Tax r��a Centerct the Business Support
INSPECTION UPON REQUEST, if you have ur ► rsae cer irrg your business license, cones
vi
a email
at NationalCity6HdLgov.com or by telephone at
�y case
[�y.,y■77 need rMf� replacement foranylost, stolen. or destroyed license. Keep this
portion • for your. license separate �� R X+AI� 1.�7A 7 FAA II"
may be charged for a replacement
Thr ' l the holder t conduct business before I � irements of the
Nationai
i ,
Municipal t � nor conduct business i zone where condo
business
within the t�l �, please having i bu�� �
s Tax Certificate below in a
I you fixed_every Business Tax Certificate holder not g car cither
conspicuousn
place at hepremises. Tax Certificate upon � � person. or affixed � plain view �
movable structure or device at ail
the Cityshall times if required by the Collector.
S�� � � � �l Ill 107 ru�[r+ ire �going to: :�l�+�*,ca.+u�ri+iti
t January sed discrimination of business
available In English or other languages by
establishments. A full notice is
Buslless TAX SUPPORT CENTER
ern! 8639 N CEDAR AVE #212
FRESNO, CA 93720-1832
GENERAL CONTRACTING INC.
8402 N MAGNOLIA AVE STE
SANTEE, CA92071-4638
•
City of National City
BUSINESS TAX CERTIFICATE ;
Account Number 091
666
pate of Issue;
City of National City
BUSINESS TAX CERTIFICATE
"For Services Provided in National City, California Only"
Business Name
Business Location
Business Owner(s)
MAGNESITE SPECIALTIES, INC
8686 PRODUCTION AVE STE A
SAN DIEGO, CA 92121-2207
CURTIS (PIES) TYREE
MAGNESITE SPECIALTIES, INC
868E PRODUCTION AVE STE A
SAN DIEGO, CA 92121-2207
THIS BUSINESS TAX CERTIFICATE DOES f OT PERMIT A BUSINESS
THAT IR OTHFRWISP PR()F-CIRITFrl
NATIONALf
fI!rC[)flirartA
2022
TO ICE POSTED 1N A CONSPICUOUS PLACE
AND
NOT TRANSFERABLE OR ASSIGNABLE
Business Type Contractor - General (Based Out
Of City)
Account Number 09012223
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,
MAGNESITE SPECIALTIES, 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.com 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://www.dca.ca.govipublications/
c,AUroomi -
NATIONAL CITY
BUSINESS TAX
CENTER
8839 N CEDAR AVE #212
MAGNESITE SPECIALTIES, INC
8686 PRODUCTION AVE STE A
SAN DIEGO, CA 2121-2207
Vs
City of National City
BUSINESS TAX CERTIFICATE
Account Number: 0901 223
01 /01120 2
Date of Issue:
City National City
BUSINESS TAX CERTIFICATE
''For Services Provided in National City. California Only",
Business Name
Business Location
Business Owner(s)
A & S FLOORING INC
2'l6'I FENTON ST
CHULA VISTA, CA 91914-3517
ALFONSO GUTIERREZ
A Et S FLOORING INC
2461 FENTON ST
CHULA VISTA, CA 1914-3517
THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS
THAT IS [ THFRW1 F PROH1RLTFD
-.—.- w- Ae.--!
NA.TIONAL CITY
I'•l l.nruniAit V
4 ---. ��w.� -, !•was-Y"et ,��se+i 'S r
Business Type
Account Number
Effective Date
Expiration Date
2022
1-0 BE POSTED IN A CONSPICUOUS PLACE
AND
TRANSFERABLE' Oft ASS1G1rABLE
Contractor - Sub (Based Out Of
City)
09003444
January 01, 2022
December 31, 2022
City Manager
NOTE: IT IS YOUR OBUGATION 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- 596.
:,-T+ '4-7 —•
A & S FLOORING 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@ildLgov.com 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 few
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 ether
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.ca_gov/publications/
CALIFORNIA —
NATIONAL , T
14 color fix gal t
BUSINESS TAX
CENTER
8839 N CEDAR AVE #212
ALFONSO GUTIERREZ
A & 5 FLOORING INC
2461 FENTON ST
CHULA VISTA, A, CA 91914-3517
SUPPODE
City of National City
BUSINESS TAX CERTIFICATE
Account Number:
Date of Issue:.
09003444
01/01/2022
City National City
BUSINESS TAX CERTIFICATE
"For Services Provided in National City, California Only"
Business Name
Business Location
Business Owner(s)
H P S MECHANICAL, INC.
3100 E BELLE TER
BAKERSFIELD, .SFIELD, CA 93307-6830
HPS MECHANICAL, INC.
HPS MECHANICAL, INC.
3100 E BELLE TER
BAKERSFIELD, CA 93307-6830
THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS
ITHAT IS OTHFRWISE PROHIRITEf
CALIFORNIA -
NATIONAL CM V
1aCc, wort
2022
TO BE POSTED IN A L ONSPtCUOUS PLACE
AND
NOT TRANSFERABLE OR ASSIGNABLE
Business Type Contractor - Sub (Based Out Of
City)
Account Number 09051816
Effective Date
Expiration Date
December 19, 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 HclL
Business Tax Support Center at (19) 382-2596.
HPS MECHANICAL, INC.
Thank you for your payment on your National City Business Tax Certificate. ALL CERTIFICATES MUST BE AVAILABLE FOR
INSPECTION UPON REQUEST, T, If you have questions concerning your business license, contact the Business Support Center
via email at: NationalCity HdLgov.com or by telephone at: (1 ) 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 taws, nor to conduct business in a zone where conducting such business v elates 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,ca.govlpIJblications/
CALIUQRH4I4
NATiC
IN.C(S,WOL( *1 T111
BUSINESS TAX
CENTER
8839 CEDAR AVE #212
HPS MECHANICAL, INC.
3100 E BELLE TER
BAKERSFIELD, CA 93307-6830
SUPPO
City of National City
BUSINESS TAX CERTIFICATE
Account Number:
Date of Issue:
09051816
12/1912022
aW-9 Number
Request for
Taxpayer
rrn
(�ev. October 01�� Identification and Ce
rtification
Department of the Treasury
� Go to +�'
InternalW.i . oV/FonnW9 for instructions and the latest information.
Revenue Service
Name (as shown on your tax return). Name Is required on this line; do not leave this line blank.
E & H General Contracting Inc.
2 Business namefdisregarded entity name, if different from above
o
NE 2
ic
rri
0
(I)
entered
following seven boxes.
r car � Corporation� Corporation
El individual/sole proprietor
single-mon1bcr LLC
� �Partrr+r�rsi�ip) �
corporation, Limited liability company. Enter the tax classification (=- corporation, single -member owner. Do not check
•the appropriate aa�c in ilia line above for the tax classification of kho �e owner unless the owner of tine LLC is
fiat ,. Checks ardo
LLCif the LLC is oiassilieci as a singlraaycx1c,rt1k�or LLC that is di�'ref federal tax frapu��oe5. Otherwise, a single -member L1_ that
another LLCthat is not disregarded from the owner for 1�. � boxfor the tax �clas�tficattor� of its owner.
k; disregarded from the owner should check the appropriate
Requester's name and address (optionrtl)
Give Form to the
requester. Do not
send to the IRS.
Other (son instructions)
5 Address (number, street, and apt. or suite no.) See instructions.
8402 N Magnolia Ave STE B
6 City, :stater and ZIP code
Santee l CA 92071
7 List account number(s) here (optional)
Pad I Taxpayer per Identification Number (TIN)
TIN provided must match the name given on line 1 to i�o riate box. The
Enter your TIN in the appropriate thisis generallyyour social security number (SSt��l), However, for a
backup withholding. For individuals, e the instructions for Part I, Idler`, For other
resident alien, sole proprietor, or disregarded entity,l� , if you do not have a number, sod How to e>t
entities, it is your employer identification number (�
TIN, later. struttiarl for Itine .Also cct Name and
Note: If the account is in more than. one name, see the in
Number To Give the Requester for guidelines on whose number to enter.
Part it
3 Check appropriate
rate box tor federal tax classification of the person whose name is
...-------------
Certification
Underpenaltiesof perjury, I certify that:
identification number (or l am waiting for a number to be issued to me); andRevenue
identification
Wig on this form is my correct taxpayerwithholding, or fib) I have not been notified bythe Internal that 1 am
1.1aen�shown
.lam not subject(IRS) to backup withholding because: (a) I am exempt from backup report all interest or dividends, or (c) the IRS has notified me
am subject to backup withholding as a result of a failure to rep
�c�rvic� that I no longer subject to backup withholding; and
. 1 am a
U.S. citizen or other U.S. person (defined below); and FATCA reporting is correct.
on this form Of any) indicating that I am exempt fromp rrrentl subject to backup withholding because
4. The FATGA code(s) entered.For mortgage interest withholding
above if you have been notified by the IRS that you are c� apply.
you Certification instructions. reot interest
must cross out itema +rnents
your tax return. For real estate transactions, item does r�oran �rynent (ii�A�), and generally, payments
have failed b report all it sect and dividends on t TIN. See the A), and
for Part y, later.
cancellation of debt, contributions to an individual rettrerrierrec
acquisition or annr dividends,
of secured pro erty,d to sign ifi ation, but you must provide your co
other than interest and divtderlds, � not ec�uire �4F12- 9 /2- 02-2
C��tc ►
on line 1. Check only one of the
Partnership
Tru `,t/estnte
4 Exemptions (codes apply only to
certain entitles, not individuals, see
instructions on page 3):
Exempt payed code (if any)
E eniptior t from FATCA reporting
code (if any)
(, i y? trl: ,Jo tICCOu#ti5 rT : , r ! I � 01117.itil2 MU 11S
Social security number
or
Employer identification number
IMO
0
5
3
Sign ' signature of
Here U.S. wean IP
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Formvv-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
.
Purpose of Form an
required to file
An individual or entity (Form ' - requester) who is r q taxpayer
information
return with the IRS must obtain your correct.
identifica
tion number (TIN) which may be your social security number
S Individual taxpayer identification number (ITli),; adopt
� ��employer identification number
taxpayer identification number �A'Ti�l), or the amount paid to you, or other
(EI), to report on an information roturetui!+n. Examples of information
amount reportable on an information the follo►in�,.
returns Include, but are not limited to, h
a Form 109 -INT (interest earned or paid)
• Form -Dl dividends, including those from stocks or mutual
funds)
• Form 1 o 9-MI p (various types of income, prizes, awards, or gross
proceeds)
• Form I099 B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 109 - (proceeds from real estate transactions)
• Form 1099-K ( merchant card and third party network transactions)
• Form lCiJ8 (home mortgage interest), 1098-E (student loan interest),
'�
1098-T (tuition)
* Form 109 - (canceled debt)• Formsecured property)
1099-A (acquisition or abandonment of R
Use Form W-9 only if you are a U.S. person {including a resident
alien), to provide your correct TIN. if you do notreturnINyou might
Form - to the requester with a T1N,
be su
b `ect to backup withholding, See What is backup withholding,
later.
Cat. No. 10231X