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GRISWOLD INDUSTRIES
INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL ® DATE: JUL 2 2 2019 AGREEMENT TO PROVIDE FLOW CONTROL VALVE MAINTENANCE, REHABILITATION, AND REPLACEMENT SERVICES THIS AGREEMENT is made and entered into this 2nd day of July, 2019 by and between Griswold Industries dba Cla-Val ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. On April 2, 2019, the City issued Request for Proposal No. 18-052, by which it sought a contractor to provide preventative maintenance, rehabilitation, and replacement services for the City's water pressure reducing and pressure sustaining valves. B. Contractor submitted a responsive proposal that was selected by the City. Contractor represents that it is able and willing to provide the services described in the scope of work that was included in RFP No. 18-052. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contracting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES Contractor shall perform the services included in RFP No. 18-052 and that is incorporated in full by reference herein. 2. COMPENSATION that were described in the scope of work that was attached as Exhibit A. Contractor's proposal is a. City agrees to pay, and Contractor agrees to accept as total payment for its services under this Agreement, the rates and charges identified in Exhibit B. The total sum to be expended under the term of this Agreement, including any extension periods, shall not exceed $500,000. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals and Scope of Work, which may reasonably be expected by City. A-2019-102 u 3. TERM This Agreement shall commence on the date first written above and terminate on July 1, 2022, unless terminated earlier in accordance with Section 17, below. The term of this Agreement may be extended for one 2-year period upon a writing executed by the City Manager and City Attorney. 4. PREVAILING WAGES Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 5. INDEPENDENT CONTRACTOR Contractor shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Contractor under this Agreement ("Documents & Data"). Contractor shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Contractor represents and warrants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data which were provided to Contractor by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the California Labor Code, Contractor, if Contractor has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work tinder this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be cancelled or reduced in coverage or changed in any other material aspect, by Contractor, without thirty (30) days prior written notice to the City. (iv) Contractor shall supply City with a fully executed additional insured endorsement. r, If Contractor fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 8. INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Contractor or its subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Contractor shall defend, indemnify and hold harmless the City, its officers, agents, representatives, and employees against any and all liability, including costs, and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright contained in the work product or documents provided by Contractor to the City pursuant to this Agreement. 10. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Contractor under this Agreement. 11. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information' shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 13. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 r. 1 Executive Director Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, CA 92702 To Contractor: Cal -Val 1701 Placentia Avenue Costa Mesa, CA 92627 Attn: Michael Trosper, Wester Regional Service Manager A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these timeframes, weekends, federal, state, County or City holidays shall be excluded. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. hi the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Contractor. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Contractor or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 15. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Contractors retained by City. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 17. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Contractor to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 18. NON-DISCRIMINATION Contractor shall not discriminate because of race, color, creed, relation, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or in connection with any activities under this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 19. JURISDICTION -VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 20. PROFESSIONAL LICENSES Contractor shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Page 7 of 8 Santa Ana and all other governmental agencies. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 21. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA Daisy Gomez Kristine Clerk of the Council City Manager APPROVED AS TO FORM CONTRACTOR SONIA R. CARVALHO City Attorney By: aeLlyy. J#n M. Funk e: 6r,'s�old Jolos- kits J& CIA-Vul Assistant City Attorney ttle: Fwci'Ii�,'es Fe Id gir✓ice i5Kie �jlan`ciei RECOMstMENDED FOR APPROVAL Fuad S. Si Executive Public We PE, PLS Agency s Page 8 of 8 CITY OF SANTA ANA EXHIBIT A RFP NO.: 18.052 FLOW CONTROL VALVE MAINTENANCE PROGRAM SCOPE OF WORK Introduction and Background: The City of Santa Ana is located in the heart of Orange County, California and is approximately 27 square miles. The City provides potable drinking water for all of the City's residents and businesses. The City's water production system consists of 22 wells, 4 pressure control stations, 7 Metropolitan Water District connections, 7 water booster stations and 8 reservoirs and 2 sanitary sewer lift stations. Control and monitoring of the water system and sewer facilities is coordinated via the City SCADA system using a series of radios to send and receive data from remote locations to the City Home SCADA control room. Flow and pressure control through the water system is achieved using Cla-Val valves per Appendix A. Description of Work: The City is requesting proposals for the purpose of rehabilitating, replacing and maintaining all Cla-Val pressure control valves within the water production facilities. The contract term shall be for three years with a City option to renew for one additional 2-year term. The Contractor will be expected to hold firm pricing on all contract items supplied for the duration of the contract. Labor Increases shall be subject to mutually agreeable terms between the City and the Contractor. Contractor Responsibilities: 1, INSPECTION/PREVENTATIVE MAINTANENCE (BID ITEMS 1.3) Inspection shall include annual examination of all valves and any pilot valve systems associated with the valves listed in Appendix A. Preventative maintenance shall be performed every 12 months at each valve system in order to elongate the lifespan of the valves and to determine how the operating conditions of the system are affecting the valve. The preventative maintenance inspection shall verify the working condition of the valve. Preventative maintenance should consist of, but not limited to, the removal of lime deposits/mineral buildup from the valve stem and other metal parts, inspection of parts, calibration of settings, maintaining and cleaning the strainers, exercising the valves, checking the pilot tubing for leaks, inspecting pilot disc retainers, and confirmation that the diaphragm assembly is properly functioning. Preferably, preventative maintenance should be accomplished without removing the valve from the line. In addition to preventative maintenance, the Contractor shall, upon request from the City, deploy to any valve and/or pilot valve site and perform a working inspection of the existing valve if the City encounters any valve operational issues. The Contractor shall repair or replace any parts of the valve found to be worn or otherwise in need of replacement. All internal parts of the valve shall be cleaned of mineral deposits prior to reassembly of the valve. When required (typically every 5 years), complete valve CITY OF SANTA ANA RFP NO.: 18-052 FLOW CONTROL VALVE MAINTENANCE PROGRAM rebuilds/rehabilitations should be performed in which the main valve and its respective pilot controls are cleaned internally, all rubber parts are replaced, and all metal parts replaced where needed. All repairs and rehabilitations shall be made in accordance with Cla-Val guidelines and as directed by the City. The Contractor shall be factory trained in maintaining all piloting systems offered by Cla-Val and shall fix/repair all piloting systems in accordance with Cla-Val guidelines and as directed by the City. Work under this section shall also include full valve replacement complete with all necessary pilot systems and/or electronic controls. Valves listed in Appendix A are representative of the majority of the Cla-Val valves in use in the City but is not a complete listing. For bidding purposes, assume all repair items on the bid sheet do not include repairs of the pilot control systems. The City acknowledges that additional costs will be incurred for pilot system repairs and will vary depending upon the type of piloting system on each valve. Assume that a full repair of the valve will include costs for replacement of all parts that could be replaced in a standard Cla-Val diaphragm valve. For bidding purposes, assume repair of the following components; replacement of disk and seat on Model 90-01 for the various sizes as listed on the Fee Schedule. III. NEW VALVE (BID ITEMS 10-11) If the Contractor has determined rehabilitation of a valve system is not feasible or at the City's direction, replacement of the valve with a new valve shall take place. Furthermore, if the cost to repair the valve exceeds 50% of the cost to replace, replacement of the valve with a new valve shall take precedence. When work includes the replacement of valves, City staff will remove the existing valve and install the new replacement valve. The consultant/contractor will assist with the specification of the new replacement valve, supply the new replacement valve, and assist in the calibration and testing of the new replacement valve upon successful installation by City staff. IV. VALUE ADDED RELATED SERVICES The Contractor may propose additional related services that the City has not specifically identified in this RFP to accomplish the stated goals of this RFP. Value added related services will be considered by the City and may or may not be incorporated in the agreement. All parts and materials must be supplied new and Cla-Valve factory approved. V. PROJECT MANAGEMENT & COORDINATION When a request for service is issued to the City, the Contractor shall issue an estimate to the City's designated project manager. The Contractor shall not proceed with any work without the approval of the City's designated project manager. Contractors shall invoice the City on a monthly basis for all work performed during the period or provide a one-time invoice at the completion of work issued. Each invoice shall be accompanied by a summary of tasks performed, results and progress on long-term tasks if any. CITY OF SANTA ANA RFP NO.: 19-052 FLOW CONTROL VALVE MAINTENANCE PROGRAM VI. MINIMUM QUALIFICATIONS The Contractor shall meet the following minimum qualifications: 1. Be factory authorized, trained and knowledgeable in Cla•Val valves for maintenance, operation and installation. (Provide proof of training upon issuance of a contract with the City) 2. Be confined space entry certified. 3. Have access to factory direct inventory for replacement parts, new valves and related appurtenances. 4. Provide Technical and Engineering support from the manufacturer upon request from the City. VIi. FEE SCHEDULE: Contractor shall submit a fee schedule as described in Section IV.8.3 of RFP. Furthermore, Contractor shall submit additional labor, material and equipment rates along with fee schedule. Contractor's labor and equipment rate sheet shall list rates for all labor designations, equipment and materials. The City may request related services that will be paid at the vendor's standard labor and equipment rate submitted. Fee proposal shall be outlined as follows: Appendix A ,Pl ],a wen mom°�, La PRV - 1 Min Valve Tvoe model site llnshl funetien Stock No. Catal°e No. Main Unit Hynrol iW-ED 6 Presure Relief 650.01-569F 00-018 Nonh Valve SNe BAN Sweet nRate losil fsn St No. Catalog No. pilot One IJ3 20.200 Prostateuye Sustaining 79222-0EC CRL Main Valve Type Motel Sint prich Function SStozk NO, Wastes Main Unit Hytrol 100-20 10 Pressure Relief SOO 01-353E 650-01B SouN Va ve uiG110F11! Sorina Bate losll it2N-02N. a I ° Pilot One 112 20000 .re SustFundlonaining Pro ssure5ustalning J92E2-02C CRL J. if. a uan,r, sanw nn....•w PRV - 2 Main Valve Noe m2k 1 1 funcion t t kNo talog No. Main Unit Hytrol 8 Preswre Relief 50-04.35R 8-50.048 North Valve la h Soling Rate (*all un n Stook No. Cat N o. Pilot One 1J2 20-200 Preswrestinsining 79222420 CRL Valve Tvoe m9w SGglins6) FunRwn stock N°, Wad-NP' Main Unit Glow Globe l0.lOOG 10 Pressure Relief W-04-36F 10-50.099 South Valve Slzerhl Sorin a Rate loll l functlen S3�lJ,, Catalog No, Pilot One 1 /2 20.200 Prmum Sustining 79222-020 CRL 3en ap n wan° nve, aanv nna v.vuv+ PRV - 3 Main Valve Tvoe mew $iae finNl fundlon jock No. Cattle, o Main Unit Nytol 1000 8 Pmmre Relief 5004d5H 8.50-048 East Valve We lent)/25orba Rite losil i S1xkNo. Catalog not One 2/2 20-i00 Pmssum 5uttaining 792Z2.002 l. GRL Main Valve Tv,, m2m Site Inch) Function Stock No, Catalog Main Unit Globe 1000 12 Pressure Relief 50.04-350 12-SO-04D West Valve Size llnrhl Swim Rate losil iJWSSIPP SI4S�4• SEIi1PRH9+ Riot One 1J2 20.200 Pressure5ustainkg 79222420 CRL +azws in ss,,ama.n....ww PRV-4 Main Valve Type MO (nc Size h n le Stui CatalogNo. Main Unit Globe ING 10 Pressure Relief 50.04-36F 10.50.048 North Va re Catalog No. Size t Sorine Rate (on Funi,tle, Stock N9 Plbt One 112 20.200 Pressumure5u>tainin6 792R-02 79222 CRL Main Volvo Tvoe m2m SnCfinch Funaion Stock No, Catalog No. Main Unit Hytra ING a Pressure Relief 50-04-35H a-50046 West Valve Sit, flo,h Spring Pat, 1 11 Funalon State N ao Piles Ore112 20200 Pressure Sustaining 79222.020 CRL Appendix A 2315 N Bristol S. Santa Ana. CA92706 SA-1 Main Valye Type M9dgl S;ee finch] Function Stotk No calala o. Main Unit Globe 12 Bypass TV3564 12-90 Bypass SI e finch Spring Rate [aril Function Stock No Catalog No. Pilot One Pressure Sustaining Main Value Tvoe hwd Size llnchl Fu0ction Stock No. Catalog No. Pressure Main Unit Globe 15 Pressure Reducing 9041-1747F 1690-0IAB Reducing Sim firtchSpring gate losll Fun Stock No, Utaloa No, Pilot One 3/8 30-3W Pressure Reducing 71941-04H MD SE Conner Bristol St & First St, Santa Aru CA 92701 SA-2 Main Valve Type Model Site in h Noeticln Stock No. No Main Unit Globe 12 TV 9564 96 Size (inch] Sodnv Rate feel) Function $196 No, Catalog N Bypass Pilot One 1/2 Pressure Sostakung Sizeloth Syrinx Rate Its Function Stock No Catalog No, Pilot Two 1/2 Flow Control Santa Ana. CA 92M SA-3 Man Value Tvoe Model Sir, n Fu,xT,l, Stack N. Dialog No. Main Unit Globe 30 30721 10.91 Bypass POot Onn Site inch 5odne Ratelosll Fum n Slad No. Catalog No 112 76SMF NNSIIA (fecls, Sprint Rate toil Nocuous Steak No. Catalog ft. Holy" Metpr Operetor [RA 12" N Tustin Ave. Santa Ana. lA 92707 SA-4 Main Vale Type Model Sire f.,61 Eunction Stock No. Catalog No. Main Unit Globe 10 Tu3S6-2 12-W Bypass Pilot One S ie firichl Sorina We fps] l Function Stack No. gtakur-No 3G300 829130H CRD10A Sizalin,h)Sorina Rate rod] Furt:pn Stock No. Ialuo ale Not Two us 3407 COHS2 Appendix A 1103 N Insen NYC, Nn[a wnar �w<rvs SA-6 Main Valve Type Model SueA95J u^ o Stock No Cetel,g NO Main Unit Bailey 16 512e(Inchl Suring Rate (psi) F cio Slot catalogi'1.9+ North Valve pilot One 3/8 30d00 PressuntSmaining 829130H CRD10A I i Soiling Rate l,sil Fundlon Stock No. Catalog o pilot Two 3/8 Fbw Control 76830021' COHSIIA Valve I". Model Site(inch) F,ncepn Speck No, No. Main Unit Globe Globe 1006 30 23316015 649-oIABOKCE Si.cllnthl Spring Rate fool Function SledNo.catalog No. hfddle VaWe Pilot One 318 30-M Pressure Summing 79744048 CRA Site (inch l Sod". Rate lost! Function Stock tie. Catalog No. Pilot Twu 318 Flow contrd 703MZF WHS11A Main Valve T Mo Model a Inc See Function Step N,. SgS�gN.- Main Unit Hytml ING 6 23315001D "-0 DIABOKCE Ir tlnchl S.Hne Rate Will Fundion Slick No. a[3Sloe NO, South Valve Pilot One 7/8 30.300 Prmn..Sustaining 79744048 CRA 1 inh sonng Rate bail ncti0n Rod NO. to log No Plot Two 319 Flaw Control 103002F CMHSIIA Main Vale Tvoe Model Slxellnshl Function StmkN.o Sital4ANo. Main Unit Hytroi IWG 8 Relief Pressure S 01-1010 8-50-018 SR. In Spring Rate him) Function Stock No. Catalog Nor Pressure Relief Pilot One 1/2 20-200 Pressure Relief 7922242C CRL So.1^sW Sonna Rate fold Fina,.n Stmk No. Catalog No, Net Two 3/9 Fbw Control 7609a02F CON511A au mane sa. SA-7 Ma n Valve Noe Model Sim firth] Function Stock.N9. Caainn,N, Main Unit 5 10 23316DIS 84%OIABOKCE Sim finch) 4orne Raw Imll function Stock". Dt.lo8 H3 Valve One Pilot One are 1683021 CONSIIA Sivelimlil <or be Rate tail function No Catalog Pll,t Tvro 3/3 30300 79744048 CRA Main Valve Don, Model Size flnchl uncUo aeSLc No. tSp398N.. Main Unit 10 2331701K "9-01A11DKCE $,rime Raetosil Wnttian Stack No Catalm No. Middle Valve Pilot One 3/8 7683002F CON511A SIiC.NDLM Sorine Rate fall Functi,^ Stock No. Catabe No. Pllct Two 3/8 3P300 79744048 CRA Main Valve Tvoe M9g91 a finch function^ S14Sk Nor ig5g(od-N° rE Main Unit 5 g SO-01IO1D 8-5001B Sonnet Rate fad ularo Stuck No. Catalog No. Pilot One 1 /2 20 200 Pn ssu,r Relief 79222-02C CRL Appendix A 2736 N Cambridee St. Santa Ana. "9G7o1 Cambridge Station Main unit I Main Valve Type I Model S le mcM1 n ion Stock No. Catalog No. Bypass Hytrol IOOG 8 Pressure Relief 51401272E e-58-038 Pilot One Em Salim Rate Ftawtion took No. Catalog No. 2/2 20.200ps1 Pressure Relief 79212412C CRL 17305. Sanmta F% Santa Ana, CA 92705 East Station Main Unit Main Valve Tyne Made Slm Fumtlon Stusd No. Catalpa No. Globe 10 in Pressure Relief 73064.05 SOK Pressure Relief Pilot One h Inh Spring Rate FunctionStockNo. Catalog No. 1/2 Pressure Relief Mein Unit Main Valve Type .Model Size Fu Ion tad . Catalp¢No. Pressure Relief Xytrol 14 In 72962-06 206-3A4ARC Pilot One Size [inch) Spring e Function rod No. atalo N . 3/8 30-130 psi C9320 CPA 2401 N Bristol St, Santa Ana, U 92706 Garthe Station Main Unit Main Valve Type Model ,E .y Funnion Stod Nc, Caaaloe No. Globe 12 in Bypass 210.13-37C 12330-138H Bypass Pilot One Size inch Spring Rate Function Stock No. Catalog No. 112 20-200 psi Pressure5ustiining 79222.02C CRL Pilot Two Site Inch Spring Rate Fun Ion Stock No. Catalpa No. SAO psi Level Control 104381Yll C0SS Main Unit Main VaNeTme Model Sim Fu coon Struck No.Gbloe No, Globe 12 in Pressure Relief 50.01-1196 125001B Pressure Belief Pilot One Vic Ilmh]Spring Rate Wn ti4n Stock No. Catalog No. 1/Z 20-200 psi Pressure Relief 79222-02C CRL 730 E Memory Ln. Santa Ana. CA 927M Crooke Station nitMain Valle Tyce odel 1 Funttlon Np tat N . r-U Hytml IOOG 8in Bypass 59-01272E 8.58.018ByPd55t One Site Inch Spring Rate Fu ion took No. tat No. 2/2 20-200 psi Pressure Relief 79222-02C CRL 1727 W Alton Ave. Santa Ana. CA 92705 South Station Main Unit Main Valve Type Mode Are Fundun, Sock No Catalog No Globe 14 in Bypass 62299 206-3A-1RK North Bypass POot One Size Inch Spring t Function kNo- Caraloa No. 3/4 65.180 psi Pressure Sustaining C9294 CRLS Pilot Two Sltech SpriteRat Function t kf. Catalog No, 3/B 30. C9320 CRA Main Unit Main Valve Type Model 2m Function Stock No. cataw No. 141n Bypass 621N 206-3A-IRX South Bypass Pilot One Sliefinchl Sortie Rate Function Stock No. Catalog No. 3/4 65.180 Psi Pressure Sustaining C9294 CRLS Pilot Two Sizefinchl Spring Rate Function Smck No. Cata No. 3(8 30i1 p C9320 CAA Main Unit Main Valve Type Model She Function Stock No. Catalog No. Globe 101n Pressure Relief 455SB 30.6-50 KS Pressure Relief Pilot One Size (inch) ri Rate Function Stock No. Catalpa No. 314 65-190 psi Pressure Relief C9294 CRLS Appendix A 723 W Walnut St, Santa Ana, CA 92701 Walnut Station Main Valve Type Milk Si F.ni StOCR No, Catalog No. Main Uni[ Gbbe in Bypass C4028 8.1w 0vpass Si In N Spina Rate Control Saltines n Ian Fu ct Stock No. Catalog No. Pllol One Vl 26200 ps1 73 ps1 Pressure 8ellei 79222-02 CRl 730 C Mennow In, Santa Ana, CA 92706 Well 28 Ma Main Unit MWA'�MO..tW M24d S3Y FUnc0on 4i �, Globe 61n slow Off TV-4940 01ow 0!f Pilot One Sfa61fBSM brings Rat BBOLkIOEa 5S4.iK.d^' /3SBIP6.Gfk' ' 112 50450psl pressure Relief C9288 CAL 1727 W Alton Ave. Santa Ana. CA 92705 Well 34 Tvue d92$^.� 5)LS EVl15SIBld FSS£k0'4r AR.aRAngla SM dlpw Off S0Oide00 8-60-018 Blow [Malini7_yalve (Inc Site 'iP.11US.Bit° EUB'A89 Stuck No, Catalog N'9. 1/2 20-200 psi pressure Railer 79222-02C CAL 1718 N Want, In, Santa Ana CA 92706 Well 3S Morin Vnit Grain Valve iVoe M9m EN Fung le SI9Sk.No ,Q,[glpg,Up, Angle 21000 sin 010wOff 50.01.1414C 8-50.018 Blow ON pllptOne S!64SuringRoleP.0 4t24rL3 1/2 20400, pit pregsuraReBef 7922zw4 CAL 2W7 W McFadden.. Santa Ma. CA 92704 Well 37 Main Unit M.BUJYA'NADO mam SNO .Firrom40 Ammo Catalog No. Angle 21000 $In slow Off %01.1414C 8-a0.01s 01"Oft pilot One p�...n�..� No St9CB,N4' Cat 36N200pax not6 Lyuse Be 1(2 iO200➢si Pr0aswe Belief 78222472C CAL CAL 2736 N Cembr dee it. Santa Ana. a 90702 Well 38 Main Valve Tm Model $,(gg Function pFiFB.Ng, ¢taro¢Nn Main Unit I Angle 21000 Bin Blow Off $601.14140 50-018 Macaw Pilot One MO Mill 54114960 - Function Bffi[ik 99141488%14., 1(2 20200 psi plessurp Rulief 79222,02C CAL CITY OFSANTAANA EXHIBIT B RFP NO.: 18-052 FLOW CONTROL VALVE MAINTENANCE PROGRAM FEE SCHEDULE The undersigned declares that he/she has carefully examined the request for proposal, that he/she has examined the Proposed Scope of Services, and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said Proposed Scope of Services, for the unit price(s) set forth in the following schedule: Note: This contract is subject to prevailing wages. TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: CIN Item # Bid Item Unit Quantit Unit Amount 1 Labor 1 Man Prevailing Wage AR 164 tPrriice $yZL—O $ 75 256, °, 2 Labor 2 Men Prevailing Wage HR 164 s289. s 117, 3% , 3 Travel Per Day EA 20 s2_ , SrJ-, 560 • Model 90-01 U it-2 $ZCJ 7, j 0, 00 S i27 4 Repair 6" Pressure Control Valve EA 5 5. Repair 8" Pressure Control Valve EA 10 $ q— � $ 1 700• 6. Repair 10" Pressure Control Valve EA to rr $ �r�• °� $ r• Soo, 7. Repair 12" Pressure Control Valve EA 5 $ YR-Y oo $270, 0° 8. Repair 14' Pressure Control Valve EA 2 C 0° s7 l 3• O° $ 1#SSb 9. RepRepair16" Pressure Control Valve EA 2 (�L(�j °° $ o 'v • $1 o �/© °o r Complete New 8" Model 90-01 1501b Flanged/Epoxy Coated, Stainless Steel Trim, Complete Stainless Steel Pilot 0° $7i 520. o ° ° s 37 oo 10. System, Opening & Closing Speed Controls. EA 5 • Up Stream & Downstream Pressure Gauges, X101 Valve Position Indicator Complete New 10' Model 90-01 1501b FlangedrEpoxy Coated, Stainless Steel Trim, Complete Stainless Steel Pilot Controls. r0,0�% qo oa $! v� ?7D. t 1. System. Opening & Closing Speed EA 10 S Up Stream & Downstream Pressure Gauges, X101 Valve Position Indicator 12 Discount off list price on unforeseen y N/A v �, replacement parts Total $ Z-3M 5', mo G " CERTIFICATE OF LIABILITY INSURANCE DATE mvr) lk 2019 0512012019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER _ -CONTACT Marsh Risk & Insurance Services NAME: 17901 Von Kaman Avenue, Suite 1100 (949)399-5800; License#0437153 Irvine, CA 92614 PHONE FAX EINC.No: E-MANo ADDRESS: INSURERS AFFORDING COVERAGE NAICp Attn: NwpodBeach.CerlRequesl@mamh.cemlF: 212-948A323 CN102166416-STND-GAWUP-19- INSURER A: Hartford Fire Insurance Com n 19682 INSURED Griswold Industries, Cla-Val Company INSURER B : N/A WA Ave Cost Placentia Avenue Costa Mesa, CA 92627-0475 INSURER C: Twin CI Fire Insurance Company 29459 INSURER D: NIA N/A INSURER E INSURER F: �a�rsnvw CENnrH.A l e Numtft=K: Los-W243175001 REVISION NU THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD MBER. INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRR A X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR $1,000,000 SIR AO UBR POUCYNUMSER 72ECSOA1987 POLICY EFF MMIDDIYYYY 04/01/2019 POLICY EXP MMIDEVYYYY 04/01/2020 LIMITS EACH OCCURRENCE $ 1,0D0,000 PREMISES Ea occumnlM $ 300,000 x MED EXP (Any one person) $ PERSONAL& ADV INJURY $ 11000,000 GENT x AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑ LOC JECT GENERA -AGGREGATE g 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: A AUTOMOBILE X x LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED x NON -OWNED AUTOS ONLY AUTOS ONLY 72UENUM3154 04101/2019 04101/2020 Ea aBe 151NGLE LINT $ 1�� BODILY INJURY (Perperson) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per aaident $ 8 UMBRELLALIAB EXCESS DAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE g DEO RETENTION$ WORKERSCOMPENSAMON ANDEMPLOYERS'DABILITY YIN OFFlCERRAEMaEReAicowoED'I ECUTIVE (Mandatory In NH) Use. describe under DESCRIPTION OF OPERATIONS below X PER OTH- STATUTE ER $ A C N/A 7 WNG93100 - 72WEH03564 (L,MD,M,NJ,NC, DR,TX,VA) 04101/2019 /01/2020 04/01/2020 E.L. EACH ACCIDENT $ 1,000.000 E.L DISEASE -EA EMPLOYE 000 $ 1,000,000 E.L. DISEASE -POLICY LIMIT E 1 OW DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be summed IT mom space is mctutmd) The Cilyof Sana Ana, its officers, employees, agents, volunteers, and representatives are included as additional insured (except workers'compensation) where required by written contract. Thisinsuranceis primary and non-conMbutory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditons with respect to General Liability. VED Y RISK Iwil'u— � City of Santa Ana B SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza 19 2 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 198E 14 i7 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services I Claudia Hernandez ©1988-2016 ACORD CORPORATION. All rights reserved. I<o.ory o) i ne Ax ur<u name ano logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holders) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. RgE IIENV D & MPPRpOV oD 22&-- Form IH 0313 06 11 Page 1 of 1 0 2011,The Hartford A C d CERTIFICATE OF LIABILITY INSURANCE Gosno12o 0DY Y' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 Marsh Risk & Insurance Services 17901 Von Kaman Avenue, Suite 1100 an CONTACT NAME: INC No PHONE FA% N (949) 399-5BOO: License #0437153 EAIAIL ADDRESS Irvine, CA W614 Attn: NewpoftBeach.CertRequmt@mamh.wm/F: 212-9484323 INSURERS AFFORDING COVERAGE NAIC0 INSURER A: Hartod Fire Insurance Company 19682 CN10211i6416STND-GAWUP-2(F INSUREDGnswold Industries, Cla-Val Company v/ 1701 Placentia Avenue INSURER B : N/A NIA INSURER C : Tern City Fire Insurance Company 29459 Costa Mesa, CA 926274475 INR : N/A N/A INsuRERSUREEp : N/A NIA INSURER F : COVERAGES CERTIFICATE NUMBER: LOS-00243176D07 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMSR LTR TYPE OF INSURANCE AD U POLICYNUMBER POLICY EFF flMMDDPrYYY1 POLICY UP (MWDDrYYYY) UWTS A X COMMERCIALGENEM JAISRUTY CLAIMS -MADE MOCCUR $1,000,000 SIR 72ECSOA1987 04/01/2020 04,01021 EACHOCCURRENCE E I,000,000 PREMISES$ 300,000 X MED UP orn pari $ PERSONAL &ADV INJURY $ 1.000,000 GENT AGGREGATE LIMIT APPLIES PER X POLICY ❑ JECT LOC OTHER' GENERALAGGREGATE $ 2.000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 $ A AUTOMOBILELIABILRY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOSHIRED X NO"WNED AUTOS ONLY AUTOS ONLY 72UENUM3154 04r01/2020 0012021 COMBINED SINGLE LIMIT (Es Accident $ 1000000 BODILY INJURY(Per Person) $ J BODILV INJURY (Paracaaenp E PROPERTY DAMAGE Far awdem) $ E UMBRELLA LIAR EXCESS LIAR OCCUR CLAMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED RETENTION E A C WORKERSCOMPENSATIOH AND EMPLOYERS' LMBILRY ANYPROPRIETORIPARTNER/EXECU RIVE YIN OFFICERIMEMBEREXCWDEDT (Mandatory in NH) eb Use, ne.c e Uncer SCRIPTIONCFOPERATIONShelow NIA 72WNC93100(CA) 72WEH03564 (ADS) O/g112020 1 21 04N1/2021 / ✓ X STAT E OHH. E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ IT0001000 E.L DISEASE - POLICY LIMIT E 1 �0.(X70 DESCRIPTgN OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, AtlOKional Remarks Schedule, may M aeachad N more space Is reRuired) The City of Sana Ana, its officers, employees, agents, volunteers, and representatives are included as additional insured (except workers' compensation) where requered by written contact. The insurance i5 primary and rwn-contributory over any existing insurance and limited to kabihty arising out of the operations of the named insured subject to policy terms and Conditions; Mth respect to General Liability. ✓ Ciryof Santa Ana By RISK MANAGEMENT DIVISION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza M �O•$O ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 AUTHORUZEDREPRESENTATIVE ANGIE ACEVEdo of Marsh Risk & Insurance Services Pam Petersen ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient /proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. REVIEWED & APPROVED By Risk MANAGEMENT DIvisioN MAY 2020 ANGIE ACEVEdo Form IH 03 13 06 11 Peg® 1 of 1 0 2011, The Hartford Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! Upsj!Qjfstpo Ebuf;!3133/17/1:!1:;39;22!.18(11(