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HomeMy WebLinkAboutCLINICAL LABORATORIES OF SAN BERNARDINO, INCINSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES a' t-13-1 CLERKCOUNCI DATEitu i � 2020 A-2020-154 AGREEMENT TO PROVIDE WATER QUALITY �pSAMPLING AND TESTING SERVICES l ) ITrHUISf AGREEMENT is made and entered into this 21 st day of July, 2020 by and between Clinical Laboratory of San Bernardino, Inc. ("Consultant"), 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 May 18, 2020, the City issued Request for Proposal No. 20-014, by which it sought a qualified consultant to provide water quality sampling and testing services for the Water Resources Division of the Public Works Agency. B. Consultant submitted a responsive proposal that was selected by the City. Consultant represents that it is able and willing to provide the services described in the scope of work that was included in REP No. 20-014. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant 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: 1. SCOPE OF SERVICES Consultant shall perform the services described in the scope of work that was included in RFP No. 20-014 and that is attached as Exhibit A, and as further delineated in Consultant's proposal, which is attached as Exhibit B and incorporated in full. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services under this Agreement, the rates and charges identified in Exhibit B. The total annual. sum to be expended under the term of this Agreement, including any extensionperiods, shall not exceed $77,000. 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. Page 1 of 8 3. TERM This Agreement shall commence on the date first written above and terminate on July20, 2023; 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 Consultant 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, Consultant agrees to fully comply with such Prevailing Wage Laws. Consultant 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 Consultant 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 Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant 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 Consultant under this Agreement ("Documents & Data"). Consultant shall require all subconsultants to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subconsultant prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant 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. Page 2 of 8 7. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subconsultants, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant 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 Consultant'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, Consultant, if Consultant 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 under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant 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 Consultant pursuant to this section: (i) Consultant 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 famished 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 Consultant, without thirty (30) days prior written notice to the City. (iv) Consultant shall supply City with a fully executed additional insured endorsement. Page 3 of 8 f If Consultant 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 Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant 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 Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, Consultants, special counsel, and representatives from liability: (1) forpersonal 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 Consultant or its subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 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 Consultant 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 Consultant'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 Consultant. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant 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 Consultant to the City pursuant to this Agreement. 10. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant 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 Page 4 of 8 law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant 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. Consultant 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 Consultant under this Agreement. 11. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant 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 Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Consultant 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 Fax 714- 647-6956 Executive Director Public Works Agency Page 5 of 8 City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, CA 92702 To Consultant: Clinical Laboratory of San Bernardino 21881 Barton Road Grand Terrace, CA 92313 Attn: Bob Glaubig, Laboratory Director 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 Consultant regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In 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 Consultant. 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 Consultant 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 Consultant, Consultant 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 Consultants 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 Page 6 of 8 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, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant 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 Consultant 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 Consultant 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 Consultant 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. Consultant 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 Consultant 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 Santa Ana and all other governmental agencies. Consultant 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. Page 7 of 8 A-2020-154 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: a;'�o 2�� �z 3 < Z— - Q Daisy Gomez Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By: 70, -f�— AShn M.Funk Assistant City Attorney FOR APPROVAL �c�a `iti Nabil Saba Executive Director Public Works Agency CITY OF SANTA ANA istine Ridge City Manager CONSULTANT 3, Name: Bob Glaubig Title: Laboratory IPWctor Page 8 of 8 EXHIBIT A APPENDIX ATTACHMENT 1: SCOPE OF WORK CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR WATER QUALITY SAMPLING & TESTING SERVICES SCOPE OF SERVICES DESCRIPTION AND SCOPE OF WORK The City of Santa Ana is issuing this Request for Proposals (RFP) for Water Quality Sampling & Testing Services. The City of Santa Ana requests the services of an analytical laboratory to provide timely, high - quality analytical analysis of the City's domestic water system. Analysis shall be in accordance with "Standard Methods', Title 22 of the California Code of Regulations entitled "California Domestic Water Quality and Monitoring Regulations", and Code of Federal Regulations, and shall consist of bacteriological quality, general physical quality, general mineral, lead & copper, nitrate/nitrite, inorganics, fluoride, haloacetic acids and total trihalomethanes. The City has 50 designated sample sites. All routine water samples will be drawn from these sites. In addition, the City has 10 designated sample sites for Fluoride analysis. Non -routine water samples will be collected by the City in specially prepared bottles provided by the consultant to be collected and tested by the consultant. A. IMPLEMENTATION City staff shall have the right to modify, reduce, or delete the services as needed by City. 2. BACTERIOLOGICAL QUALITY (i) Routine: Samples shall be collected by the Consultant, in appropriate sterilized bottles to which a chlorine reducing agent has been properly added, on a weekly basis at 50 designated sample points. Total coliform analyses are to be conducted using either the multiple tube fermentation method analyzing a minimum of 100-ml of water either with using 5- tube 20-ml portions or 10-tube 10-ml portions, the membrane filter technique, the presence/absence (P-A) coliform test, or the minimal medium (Coliform) test. Reporting of positive samples shall be based on the presence or absence of coliforms in each sample rather than an estimation of coliform density. Upon detecting that either a routine or repeat sample is either total coliform or fecal coliform positive, or a sample is invalidated due to interference problems, the Consultant shall notify the City within twenty-four hours. To complete the notification, consultant must contact a live individual. The appropriate contact person for the City is the Water Services Quality Supervisor at (714) 305-4798 or the Principal Engineer at (714) 673-3408. When voice mail is used to leave a message, the Consultant shall contact the City's Dispatch Office at (714) 647-3380 between the hours of 7:00 a.m. and 3:30 p.m. If notification is required during a weekend or holiday, the Water Services Quality Supervisor at (714) 305-4798; if unavailable contact Principal Civil Engineer at (714) 673-3408. In addition, a copy of the City's Emergency Notification Plan will be provided and reviewed with the City of Santa Ana - RFP 20-014 Water Quality Sampling & Testing Services Consultant, prior to commencement of services. Thereafter, an updated City Emergency Notification Plan will be provided to Consultant by the City Representative. In the event that the Consultant is unable to contact the City within 24 hours, the Consultant shall notify the State Water Resources Control Board — Division of Drinking Water Duty Officer at (800) 852-7550 or (916) 845-8911. Upon detecting that a routine or repeat sample is total coliform positive, the Consultant shall perform a fecal coliform test. The Consultant shall, within twenty-four hours after notifying the City that a single routine sample is total coliform positive, collect three repeat samples. One shall be from the same total coliform positive sample point. The other two locations shall be determined by the City, one to be located within five service connections upstream and the other within five service connections downstream of the total coliform positive sample point. If total coliforms are detected in any repeat sample, the Consultant must within twenty-four hours, after notifying the City that a repeat sample is total coliform positive sample, collect another set of repeat samples from the same locations. (ii) Water Mains or System Repairs: Samples shall be collected by the City in appropriate sterilized bottles provided by the Consultant to which a chlorine reducing agent had been properly added. Sampling may consist of two samples per month and shall be picked up by the Consultant at the City Corporate Yard Meter Shop within twelve hours of notification. The Consultant shall notify the City of the results by fax within four hours of the completion of the test. (iii) Wells: Samples shall be collected by the City in appropriate sterilized bottles provided by the Consultant to which a chlorine reducing agent has been properly added. Sampling shall consist of twenty samples per month and shall be picked up by the Consultant at the City Corporate Yard Meter Shop within twelve hours of notification. (iv) Customer Complaint: Samples shall be collected by the City in appropriate sterilized bottles provided by the Consultant to which a chlorine reducing agent has been properly added. Sampling may consist of four samples per month and shall be picked up by the Consultant at the City Corporate Yard Meter Shop within twelve hours of notification. 3. HETEROTROPHIC PLATE COUNT Routine: samples shall be collected by the Consultant in appropriate sterilized bottles to which a chlorine reducing agent has been added on a weekly basis at the same time and at the same 50 designated sample points. Consultant shall use the necessary dilutions to report the results at concentrations up to 500 colony forming units per milliliter. 4. TOTAL CHLORINE RESIDUAL Routine: samples shall be field analyzed by the Consultant on a weekly basis at the same time and at the same 50 designated sample points. DPD method of analysis and the reading shall be made by the means of a colorimeter. Color disc is not acceptable. Results must be reported to 0.1 mg/I. Colorimeter must be calibrated per the City of Santa Ana - RFP 20-014 Water Quality Sampling & Testing Services manufacturer's requirements. Documents showing the calibration shall be provided upon request. 5. GENERAL PHYSICAL QUALITY (i) Routine: the Consultant shall collect Samples in appropriate sample bottles on a monthly basis at the 50 designated sample points. The analysis shall consist of turbidity, odor, color, field pH, and temperature. (ii) Customer Complaint: Samples shall be collected by the City in specially prepared sample bottles provided by the Consultant and may consist of four samples per month and shall be picked up by the Consultant at the City Corporate Yard Meter Shop within twelve hours of notification. The analysis shall consist of turbidity, odor, and color. 6. GENERAL MINERAL Samples shall be collected by the City in specially prepared sample bottles provided by the Consultant and may consist of twenty samples on a yearly basis (as needed) and shall be picked up the Consultant at the City Corporate Yard Meter Shop within twenty-four hours of notification. 7. INORGANICS Samples shall be collected by the City in specially prepared sample bottles provided by the Consultant and may consist of twenty samples on a yearly basis (as needed) and shall be picked up by the Consultant at the City Corporate Yard Meter Shop within twenty-four hours of notification. 8. TRIHALOMETHANES The City shall collect samples in specially designed sample vials containing a chlorine reducing agent and sealed with TFE-faced septa and screw caps. It shall consist of twelve samples on a quarterly basis beginning in February and shall be picked up by the Consultant at the City Corporate Yard Meter Shop within twelve hours of notification. 9. HALOACETIC ACIDS 10. The City shall collect samples in specially designed sample vials containing crystalline NH4CI, which converts free chlorine to a combined chlorine residual and sealed with TFE- faced septa and screw caps. It shall consist of twelve samples on a quarterly basis beginning in February and shall be picked up by the Consultant at the City Corporate Yard Meter Shop within twelve hours of notification. Samples shall be collected by the City in specially prepared sample bottles and shall consist of six nitrate samples on a monthly basis and an additional six samples on a quarterly basis. Nitrite samples shall consist of nine samples on a semi-annual basis. The Consultant shall pick up samples at the City Corporate Yard's Meter Shop within twelve hours of notification. Upon detecting nitrate level above the MCL of 10 mg/I as N is exceeded, the Consultant shall notify the City within twenty-four hours. To complete the notification consultant must City of Santa Ana - RFP 20-014 Water Quality Sampling & Testing Services contact a live individual. The appropriate contact person for the City is the Water Services Quality Supervisor at (714) 305-4798 or the Principal Civil Engineer at (714) 673-3408. When voice mail is used to leave a message, the Consultant shall contact the City's Dispatch Office at (714) 647-3380 between the hours of 7:00 a.m. and 3:30 p.m. If notification is required during a weekend of holiday, the Water Services Quality Supervisor may be contacted at (714) 305-4798 or Principal Civil Engineer at (714) 673-3408. In addition, a copy of the City's Emergency Notification Plan will be provided and reviewed with Consultant, prior to commencement of services. Thereafter, City's Emergency Notification Plan will be provided to Consultant on an annual basis by the City's Representative. In the event that the Consultant is unable to contact the City within 24 hours, the Consultant shall notify the Orange County Environmental Health Office at (714) 433-6000. 11. FLUORIDE B. REPORTS Samples shall be collected by the Consultant, in appropriate sterilized bottles on a monthly basis at 10 designated sample points. The Consultant shall provide the following information within seven days of the completion of each analysis: (i) Name of the laboratory and either the person responsible for performing the analysis or the laboratory director. (ii) Date of report. (iii) The analytical method used. (iv) The name, date, and time of sampling and identification of the person who collected the sample. (v) Identification of the sample as a routine, repeat, replacement, or "other" sample when appropriate 2. Chain of Custody: The Consultant shall provide to the City chain of custody forms for each sample collected by the City, when the Consultant provides the necessary sample container. City of Santa Ana - RFP 20-014 Water Quality Sampling & Testing Services EXHIBIT B June 03, 2020 Rodolfo Rosas, P.E. Public Works Agency City of Santa Ana 215 South Center Street Santa Ana, CA 92703 RE: Water Quality Sampling & Testing Services — RFP 20-014 Clinical Laboratory of San Bernardino, Inc. appreciates the opportunity to submit a bid for the City of Santa Ana Water Quality Sampling & Testing Services — RFP 20-014. Enclosed please find our proposal for the sampling, pickup and testing of requested samples as required by the City of Santa Ana's Title 22 State of California water quality monitoring regulations. The requirements and costs expressed in this proposal will remain in effect through the initial and possible contract extensions periods; through 2025. All proposal specifics, offers, or changes can be authorized by either myself, Bob Glaubig, Laboratory Director or Melinda Furnas, President/Owner. As your current vendor, we hope to maintain our 25 plus year relationship with the City of Santa Ana, and continue to provide the same quality sampling and testing service. Thank you. Sincerely, l� Bob Glaubig Laboratory Director Clinical Laboratory of San Bernardino, Inc. California ELAP Number 1088 California Corporation C0537386 CW. Clinical Laboratory of San Bernardino, Inc Water Quality Sampling & Testing Services Request for Proposal Response RFP No. 20-014 for City of Santa Ana Due: June 04, 2020 at 4:00 pm Post Office Box 329 Son Bernardino, CA 92402 (909)825-7693Fa-c(909)825-7696 FLAP Number 1088 i Clinical Laboratory of San Bernardino, Inc Water Quality Sampling & Testing Service Request for Proposal Response / City of Santa Ana / RFP No. 20-014 Table of Contents Proposal Compliance Summary ............................................... Page 1 Statement of Qualifications Experience and Qualifications ....................................... Page 2 Professional Personnel .................................................. Page 2 Key Staff Members....................................................... Page 3 Work Flow Summary ................................................... Page 4 References.................................................................. Page 5 Resumes................................................................................................... Page 6 Clinical Lab Organizational Chart .............................................. Page 13 FeeSchedule.......................................................................... Page 14 References............................................................................................... Page 16 Non -Collusion Affidavit........................................................................ Page 17 Non -Lobbying Certification ...... ....... Page 18 Non -Discrimination Certification........................................................ Page 19 California Water Board Certification ELAP Certificate........................................................ Page 21 ELAP Field of Testing Certificate ................................... Page 22 Post 012iee Box 329 Son Bernardino, CA 92402 (909)815-7693Far (909)815-7696 ELAP Number 1088 Clinical Laboratmy of San Bernardino, Inc Proposal Compliance Summary We have read the proposal requirements, and do state that Clinical Laboratory of San Bernardino, Inc. will comply with all requirements outlined in RFP 20-014. Specific compliance statements requested in the RFP do follow: • We have received Addendum Number One, and meet all minimum qualifications. Proof of Clinical Laboratory ELAP certification is found within this RFP response. Clinical Laboratory is working toward, and will be compliant with, TNI requirements as defined by State of California ELAP, by October 01, 2023. Clinical Laboratory celebrated on 50' years of analytical service to Southern California clients in 2017. We far exceed the minimum 5 years of service with many clients; including the City of Santa Ana. • If chosen, Clinical Laboratory has submitted contract conditions and prices which will remain valid through the initial 3 year and optional 2 year extension. • The Point of Contact for all service, contract, and billing issues will be Tish Bernstein. Tish is the current Project Manager for City of Santa Ana and very knowledgeable of the City of Santa Ana's sampling and testing requirements. In her absence, Bob Glaubig, our Laboratory Director will step in to resolve any issues. • Clinical Laboratory currently has a City of Santa Ana business license, and will maintain this license through the duration of the contract. • Clinical Laboratory currently has insurance covering the City of Santa Ana and will maintain this insurance for the duration of the contract. • Clinical Laboratory concurs with all provisions of the Consultant Agreement as outlined in Attachment 5 of the RFP. Page 1 Post Office Boi-329 Sun Bernardino, C4 92402 (909)825-7693Fax (909)825-7696 FLAP Awnber 1088 Clinical Laboratory of San Bernardino, Inc Statement of Qualifications Experience and Qualifications Clinical Laboratory of San Bernardino, Inc., located at 21881 Barton Road in Grand Terrace, California, has been providing quality analytical testing to cities and water districts throughout Southern California since 1968. The laboratory began as a medical lab and soon expanded into the area of water testing. The medical end of the business was dropped many years ago and the laboratory continued, maintaining the Clinical Laboratory name, with a specialty of drinking and wastewater analyses. Clients of Clinical Laboratory include customers ranging in size from large cities and water districts to small mobile home parks. The laboratory works closely with State and regulatory personnel to keep abreast of current regulation changes to help our clients remain in compliance. The California Water Quality Board (ELAP) has certified Clinical Laboratory of San Bernardino, for complete bacteriological testing of potable water and wastewater. Our Microbiology Department performs over 1500 coliform bacteria analyses per week and is one of the largest in the state. Our ELAP certification allows us to do bacteriological analyses by 10 or 15 tube Multiple Tube Fermentation, Colilert Presence/Absence, Quantitray, and Heterotrophic Plate Count The staff of Clinical Laboratory includes chemists and analysts with educational degrees ranging from Bachelor of Science to Master of Science. Professional Personnel Clinical Laboratory of San Bernardino, Inc. hires and retains professional staff, each of which hold degrees pertaining to this industry, therefore we feel all of our staff are an integral part of serving our clients. A brief description of each position we feel are the key(s) to successful completion of analysis programs follows. Laboratory Director The laboratory director oversees the total operations of the laboratory, and assures all aspects of the laboratory analysis, from sample receipt/log-in to final reporting, are both accurate and complete. The laboratory director is also in -charge of all the technical and analytical aspects in the laboratory. Efficient and effective planning capabilities are two important qualities in order to fulfill the primary objectives of the laboratory. Quality Control Manager/Safety Manager Reviews and oversees the quality control and quality assurance aspects of analytical methodologies being performed in the laboratory. Communicates with the laboratory director on QA/QC needs and various factors for improving the efficiency in the laboratory. Quality Control is also in charge of the safety operations. Client Services Manager/Project Manager Our client service manager and his team act as a liaison between the client and the laboratory. They are responsible for all aspects of serving the client. From project initiation, bottle orders, technical Page 2 Post Office Box 329 San Bernardino, C9 92402 (909)825-7693 Fwc (909)825-7696 ELAP Number 1088 Clinical Laboratory of San Bernardino, Inc `' questions and final reporting/electronic data deliverables. Our client services team makes sure projects flow through the laboratory processes smoothly and assists clients with their questions and monitoring needs. Chemists/Analysts/Laboratory Technicians Our analytical staff perform laboratory analyses using approved standard operating procedures, generating results that are dependable, accurate, and supported by acceptable quality control data. This is accomplished by monitoring the daily quality control acceptance criteria, such as precision and accuracy of data, maintaining logs of instruments, standard preparation log, satisfactory operating conditions, and routine calibration checks. Performing data validation of all results generated; checks and reviews results and quality control is required before passing them to department supervisors for final review. Field Technicians Our field technicians are trained on proper sampling techniques, sample storage, and transportation of samples. We have 5 full time field technicians that have 5-25 years of experience with Clinical Laboratory of San Bernardino, Inc. They are responsible for collecting samples from drinking water distribution sites, drinking water wells, and wastewater treatment plants. Samples are placed in a cooler with blue ice immediately and transported back to the laboratory using chain of custody documentation. Key Staff Members The Clinical Laboratory of San Bernardino, hic. Organization Chart, as seen on page 3, highlights y departments which are critical in success of the City of Santa Ana contract. Bob Glaubig - Laboratory Director In addition to supervising routine laboratory operations as laboratory director, Bob will also be the back up project manager for the City of Santa Ana contract. Should the primary back up manager be out or unavailable, all client inquiries, supply orders, special sample pickups, and report generation will go through Bob. Leticia Bernstein —Project Manager Tish will be the Project Manager, and primary Lab Contact, for all issues involving the City of Santa Ana. All client inquiries, supply orders, special sample pickups, and report generation will go through Tish. Colin Dwyer — Microbiology Department Manager Colin, and his staff we be performing the requested microbiological and general physical analyses for the City of Santa Ana contract. The microbiology staff are responsible for in lab receipt of samples, log in of samples into our in-house laboratory network, entering completed results into the network, and reviewing these results for accuracy. Page 3 Post Office Box 329 San Bernardino, GI 92402 (909)825-7693 F Lv (909)825-7696 ELAP M1'waber 1088 Clinical Laboratory of Scan Bernardino, Inc Roberto Cabrera — Quality Assurance / Quality Control Manager Roberto is in charge of the overall quality control/quality assurance program which dictates the accuracy and client confidence of the bacteria and general physical results generated by the microbiology department. Roberto is also in charge of our volatile organics department. Stu Styles — Client Services Manager Stu will be the backup, backup contact for supply orders, special sample pickups, and report generation should both Tish and Bob be out for the day. Bryan Blowney— Field Service Manager Bryan will be in charge of arranging sample pickups for the City of Santa Ana contract. Sample pickups, both routine and same day special, will be handled by Bryan and his field staff. Khurshid Ahmed — Inorganic Chemical Department Manager Khurshid is in charge of our inorganics department. Analyses such as metals, anions, and wet chemistry are supervised with in his department. Dean Palmer— Semi -Volatile Compound Department Manager Dean is in charge of our semi -volatile department. Analyses such as haloacetic acids (HAAs) are supervised with in his department. Work Flow Summary The following outlines the work flow progression for samples analyzed for City of Santa Ana under this contract. Sample Pickup at City of Santa Ana Samples are sampled, or picked up by, our field staff either on a routine schedule or from a special pickup request by the City of Santa Ana staff. Sample counts are made and recorded on the COC. The sample receipt is signed by our staff on site. Samples are placed in our sample coolers containing bagged, wet ice. Samples remain in the plastic tray bags, as received, during transport to the lab. Sample Receipt at Lab Samples are delivered to the lab and received by our microbiology staff or sample receiving staff. The receipt temperature is determined and recorded on the COC. Sample container IDs listed on the COC are compared to containers received. In any issues with receipt temperature, hold time, or sample ID are apparent, the City of Santa Ana primary contact will be notified immediately, either by the microbiology staff or Clinical Lab project manager. All relevant sample information will be logged into the laboratory network. Sample Analysis The microbiology staff will begin all sample analyses within hold time. All microbiology and general physical samples requested through the City of Santa Ana contract will be started on the day of sample receipt. At completion of each analysis, results will be recorded on the bench sheet, and Page 4 Past O.lice Box 329 San Bernardino, CA 92402 (909)825-7693 Fax (909)825-7696 ELAP Number 1088 Clinical Laboratory of San Bernardino, Inc entered into the laboratory network. A second member of department, independent of the primary analyst, will review the entered analysis results for accuracy. Project Review and Reporting The project manager will review the network to assure all sample information, such as sample ID, sample date/time, sampler name, field results, and requested analyses have been correctly entered into the laboratory network. Once all samples information and results have been entered and reviewed for accuracy, the report analysis report will be generated and emailed to the requested City of Santa Ana staff members. References We have chosen three reference clients for which Clinical Laboratory performs full service microbiological, general physical, and other Title 22 analyses. All three are located in Orange County, and all three have Tish Bernstein as their Project Manager, City of Santa Ana 215 South Center Street Santa Ana, CA 92703 Contact: Robert Hernandez (714) 647-3316 City of Buena Park P.O. Box 5009 Buena Park, CA 90622 Contact: Mike McGee (714) 562-3701 City of Fountain Valley P.O. 8030 Fountain Valley, CA 92708 Contact Tom Grose (714) 593-4624 Page 5 Post Office Box 329 Son Bernardino, C9 92402 (909)825-7693 Fax (909)825-7696 ELAP Number 1088 Bob Glaubig Laboratory Director Education/Trainin Bachelor of Science, Soil Science —Cal Poly University, Pomona, CA (1981). Master of Science, Chemistry — University of California, Riverside, CA (1984). Experience Summary Thirty years experience conducting both research and applied analyses of water, air, and soil at University, Federal, and commercial levels. Research disciplines have included soil chemistry, air pollution, and applied environmental management. Equipment and techniques utilized include Dionex Ion Chromatography, Perkin Elmer Atomic Spectrophotometry, Technicon automated colorimetry, Hewlett Packard gas chromatography, and High Pressure Liquid Chromotography. Laboratory management skills have included initial set-up for the USDA Forest Fire Laboratory in Riverside, CA which required set-up of instrumentation, design of an in-house QA/QC program, and writing the Laboratory Methods Training Manual. Computer duties have included development and implementation of a computerized chemical inventory system, and development of computer programs which interactively collect and process data from analytical instruments. Mr. Glaubig has been employed at Clinical Lab since 1995 during which time he has been involved in all aspects of the laboratory operation, from Sample Receiving to the processing of final reports. Bob is also expert in Title 22 regulatory requirements and EDT transfers, having worked closely with the State for many years. Page 6 Roberto Cabrera Organic Semi-volatiles Chemist / Quality Assurance Manager Education/Trainina Master of Science, Plant Physiology — University of California, Davis Master of Science, Agricultural Science — Cal Poly, San Luis Obispo Experience Summary Chemist — Chemical Waste Management, Modesto CA Performed Gas Chromatography analyses of total petroleum hydrocarbons and volatile organic compounds in water and soil. Inorganic Chemist — Associated Labs, Orange CA Performed analysis, quality control, and data review for ion chromatography methods for water and soil. Organic Chemist — Clinical Lab, Grand Terrace, CA. Semivolatile chemist performing Gas Chromatography analyses of pesticides. Analytical Methods include EPA 507, EPA 508, EPA 515, EPA 525, EPA 531, EPA 547 and EPA 549. Responsible for new method development and certification. Quality Assurance / Quality Control Manager. Page 7 Khurshid Ahmed Inorganic Chemist/Supervisor Education/Training Bachelor of Science, Chemistry Master of Science, Analytical Chemistry Experience Summary Analytical Chemist/Supervisor—Applied Engineering & Remediation Laboratories, CA Conducting analyses of water, waste water and hazardous waste for minerals, trace metals and various other inorganic components based on EPA and SW 846 methods. Also responsible for treatment of waste water and hazardous waste, setup, operation, maintenance and troubleshooting of various instruments. Analytical Chemist/Inorganic Supervisor — American Environmental Testing Lab, CA Conducting analyses on water, drinking water, soil and other hazardous waste for minerals, metals, trace metals, Chromium VI, Perchlorate and other inorganic components using EPA and SW 846 methods. Analytical Chemist/inorganic Supervisor — Clinical Lab, Grand Terrace CA Supervises all aspects of the Inorganic Division which includes analysis of metals, anions, classical wet chemistry, and wastewater panels. Assures results accuracy through the use of quality assurance samples and analysts training. Responsible for instrument operation techniques and maintenance. Works closely with Quality Assurance Manager on SOP revisions and calibration issues. Page 8 Dean Palmer GC/MS Chemist Education/Trainina Bachelor of Science, Chemistry — California Polytechnic University, Pomona, CA Experience Summary GC/MS Supervisor —Associated Labs, Orange CA Responsible for organizing and directing the affairs of the GC/MS department. Supervising and training of chemists as well as performing volatile, semi -volatile, and air analyses using current and new GC/MS instrumentation. Reviewing data and QC reports along with updating of laboratories SOPS. Also responsible for all minor and major routine maintenance of the instrumentation. GC/MS Chemist— Del Mar Analytical, Irvine CA Responsible for performing volatile, semi -volatile, and air analyses using current and new GC/MS instrumentation. Reviewing data and QC reports along with updating of laboratories SOPS. Also responsible for all minor and major routine maintenance of the instrumentation. GC/MS Chemist — Clinical Lab, Grand Terrace. CA Responsible for performing volatile, semi -volatile, and air analyses using current and new GC/MS instrumentation. Analytical Methods include EPA 525, EPA 552, and TOC (SM5310). Reviewing data and QC reports along with updating of laboratories SOPs. Also responsible for all minor and major routine maintenance of the instrumentation. Page 9 Colin Dwyer Microbiology Supervisor Education/Training Bachelor of Science, Environmental Biology - University of California Riverside Experience Summary Microbiology Lead Analyst — Clinical Lab, Grand Terrace CA 8 years lab experience, prepared and setup test for Total Coliform, E. Coli, Fecal Coliform, Heterotrophic Plate Count and Iron related Bacteria. Perform Quality Control to media, bottles and glassware to assure integrity of the tests and prevent contamination. Notify clients of their results within the allotted time and assist them with their questions. Microbiology Supervisor— Clinical Lab, Grand Terrace CA Testing for total and fecal coliforms using enzyme based and biochemical reactions, heterotrophic plate counts, iron related bacteria, and preparing and sterilize media. Review data and QC reports along with updating SOP's. Page 10 Leticia Bernstein Project Manager Education/Training Bachelor of Science: Chemistry -Biochemistry - California State University, San Bernardino Experience Summary R&D Chemical Stability Analyst/Lab Trainer - GAR Laboratories, Inc. Formulation & Testing Data analysis, and documentation Data tracking, batch adjustments, testing, creating COAs Lab Trainer QC/CA Chemist - Liquid Technologies, Inc. Supervisor of manufacturing, and compounding staff Batch adjustments, testing, and batch release QC & Micro Lab Supervisor - Penrose Enterprises, Inc. Developed QC and Micro validation/manufacturing system for company Supervisor of QC, micro, manufacturing, and compounding staff Supervision of all incoming & outgoing raw and finished product Batch adjustments, stability, testing, and batch/product release Project Manager - Clinical Lab, Grand Terrace CA Client Services Data review and reporting Invoicing Scheduling Page 11 John Stu Styles Client Services Manager / Project Manager Educationrrraining Bachelor of Science, Biochemistry — University of California Riverside Experience Summary Technical Superintendent Intern — Smurfit Newsprint Corp., Pomona CA Supervised day-to-day chemical needs for this manufacturer of recycled newsprint. Interacted daily with chemical vendors, checking on orders and verifying deliveries. Maintained daily contact with chemical handlers and machine operators. Designed spreadsheets for record keeping and reports. Field Chemist — Onsite Environments, Torrance CA Provided hazardous waste management and customer service. Interfaced extensively with customers, dealing effectively with project managers, engineers,and other technical personnel. Perform hazardous waste management, lab packing, shipping, recycling, and manifest oversight. Field Supervisor — Onyx Environmental Services, LLC, Azusa CA Provide on -site supervision for environmental and safety activities. Oversee activites of 3-member crew, as well as members of Maintenance and Environmental Health and Safety Departments. Deal extensively with vendors and outside service providers. Manage waste manifests for accurate tracking from point of origin to disposal for waste leaving facility. Client Services Manager — TestAmerica, Ontario CA Worked with clients to provide excellent service for all of their needs. Responsible for data reports, uploading data to DPH's EDT and the EPA CDX server. Also worked as technical director, signing off on analysts' standard operating procedures and initial displays of competence. Responsible for hazardous waste, kept track of all waste streams, manifests also coordinating pickups with waste disposal company. Duties also included site emergency coordinator. Client Services Manager/Sales — Clinical Lab, Grand Terrace CA Responsible for all client service activities. Manages Client Services staff to assure responsible representation to Clinical Laboratory clients. Responsible for client training seminarstcontinuing education program. Responsible for hazardous storage and disposal. Promotes sales and marketing of laboratory services. Oversees new business development and provides quotes. Seminars/Continuing Education October 2012- Southern California Water Utilities Association member Page 12 Stu Style Proiect Manager Haft Fresquo: Chris Mortise: Clinical Laboratory of San Bernardino, Inc. Grand Terrace Organizational Chart IT Manager Kenny Kugler RadioChem Manager Art Hernandez Microbiology Mgr Colln Dwyer Lead Analysts Kaye Dualon Mongkol Kso Ricardo Voladox Bias uxuats President Melinda Fumas Laboratory Director Bob Glaubig Volatiles / QA Manager RobertoCabrera I Cristian Morales Corey Hurst Inorganics Mar Michael Fbreo Mareta Amador Elisabeth Gonove, Forhan Kalarn Alex Pugs Leonardo Reyes Page 13 I Melinda Pumas I Quotes / Bids Manager Bob Glaubig SemiNolatiles Roberto Cabrera Liezel Sand Zachary Barker Field Services Mar Jahn Lacere Ricardo Ramirez Mike Sola nor LeBmn Shipp Juan Hernando: Anthony Lornell Front Office Manager Dolores Falcon SyMs Vargas Esmereids Grenada Sample Receiving 'aanete Remende Rebecca McLeam Semi-Volatiles Dean Palmer APPENDIX ATTACHMENT 3: FEE PROPOSAL CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR WATER QUALITY SAMPLING & TESTING SERVICES Certification - I certify that I have read, understand and agree to the terms and conditions of this Request for Proposals. I have examined the Scope of Services (Exhibit A) and am familiar with the scope of work locations. I am familiar with all the existing conditions and limitation that may impact work requests. I understand and agree that I am responsible for reporting any errors, omissions or discrepancies to the City for clarification prior to the submission of my proposal. Proposal Item Price - Pricing shall be based on a (hourly cost, time and materials basis - see narrative) for services described in Exhibit A. Fee must be inclusive of all costs, including but not limited to, direct and indirect costs for labor, overhead, incidental supplies, travel, mileage, and fuel. Any special materials will be purchased by the contractor only after discussed and authorized by the City projects manager or designee in writing. Proposer shall attach a separate hourly rate schedule with hourly rates for staff time per lob classification. If the City requires additional related services not listed in the fee schedule below, those services will be performed and compensated at time and materials costs as shown on the proposer's hourly rate schedule submitted. Quantities listed below are annual estimates, the City reserves the right to increase or decrease quantities as necessary. LINE DESCRIPTION QUANTITY UNIT UNIT PRICE EXTENDED TOTAL PRICE Routine Weekly Samples collected and 1 tested by Consultant for Bacteriological 2,600 Each $ 15.00 $ 39,000.00 Quality, Heterotrophic Plate Count and Chlorine Residuals Routine Monthly Samples collected and 2. tested by consultant for General 600 Each $ 7.50 $ 4,500.00 Physical Quality 3 Routine Monthly Samples collected and 120 Each $ 8.00 $ 960.00 tested by consultant for Fluoride Routine Quarterly Samples collected by 4. City and tested by Consultant for 48 Each $ 60.00 $ 2,880.00 Haloacetic Acids Routine Quarterly Samples collected by 5. City and tested by Consultant for 48 Each $ 30.00 $ 1,440.00 Trihalomethanes Routine Monthly & Quarterly Samples 6. collected by City and tested by Consultant 96 Each $ 16.00 $ 1,536.00 for Nitrates/Nitrites Non -Routine samples collected by City and tested by Consultant for 7. Bacteriological Quality, Heterotrophic 100 Each $ 15.00 $ 1500.00 Plate Count and Chlorine Residuals (As -Needed Page 14 City of Santa Ana - RFP 20-014 Water Quality Sampling & Testing Services Non -Routine samples collected by City 8. and tested by Consultant for General 100 Each $ 7.50 $ 750.00 Physical Quality As -Needed) Non -Routine samples collected by City 9. and tested by Consultant for General 50 Each $ 45.00 $ 2,250.00 Minerals As -Needed Non -Routine samples collected by City 10. and tested by Consultant for Inorganics 100 Each $ 70.00 $ 7,000.00 As -Needed 11. Lead & Copper Rule (As -Needed) TBD Each $ 20.00 $ 12. Lead Sampling in Schools (As -Needed) TBD Each $ 11.00 $ Total: $ 61,816.00 Clinical Laboratory of San Bernardino, Inc. LEGAL NAME OF 21881 Barton Road, Grand Terrace, CA 92313 Phone (909) 825-7693 Fax (909) 825-7696 PHONE AND FAX NUMBERS BUSINESS ADDRESS Bob Glaubig Laboratory Director PRINTED NAME OF AUTHORIZED AGENT SIGNATURE OF AGENI June 03, 2020 glaubig@clinical-lab.com E-MAIL ADDRESS 95-2504488 1088 FEDERAL ID NUMBER (IF APPLICABLE) ENVIRONMENTAL LABORATORY ACCREDIDATION PROGRAM CERTIFICATE NUMBER (ELAP #) THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. Page 15 City of Santa Ana - RFP 20-014 Water Quality Sampling & Testing Services APPENDIX ATTACHMENT 4: REFERENCES CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR WATER QUALITY SAMPLING & TESTING SERVICES List and describe fully the contracts performed by your firm which demonstrate your ability to provide the supplies, equipment or services included in the scope of the proposal specifications. Attach additional pages if required. The City reserves the right to contact each of the references listed for additional information regarding your firm's qualifications. Reference Customer Name: City of Santa Ana Address: 215 South Center Street Santa Ana, CA 92703 Contact Individual: Robert Hernandez Phone Number: (714) 647-3316 Facsimile Number: (714) 647-3345 Contract Amount: $ 44,752.78 per year (2019) Year: Current Client: 25+ years Description of supplies, equipment, or services provided: Provided sampling/pickups/analysis of drinking water samples for Bacteriological, General Physical, other Title 22 analyses. Reference Customer Name: City of Buena Park Address: P.O. Box 5009 Buena Park, CA 90622 - Contract Amount: $ 30,589 per year (2019) Description of supplies, equipment, or services provided: Contact Individual: Mike McGee Phone Number: (714) 562-3701 Facsimile Number: (714) 562-3669 Year: Current Client: 15+ years Provided sampling/pickups/analysis of drinking water samples for Bacteriological, General Physical, other Title 22 analyses. Reference Customer Name: City of Fountain Valley Contact Individual: Tom Grose Address: P.O. Box 8030 Fountain Valley, CA 92708 Phone Number: (714) 593-4624 Facsimile Number: (714) 556-7362 Contract Amount: $ 28.906 per year (2019) Year: Current Client: 15+ years Description of supplies, equipment, or services provided: Provided sampling/pickups/analysis of drinking water samples for Bacteriological, General Physical, other Title 22 analyses. THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. Page 16 City of Santa Ana - RFP 2M14 Water Quality Sampling & Testing Services APPENDIX ATTACHMENT 6: CERTIFICATION NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) , In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and Will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non -collusion Affidavit is part of the Proposal. BIDDERS are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed: Melinda Furnas fixd/ yJ4 1--u/A4O State of California County of San Bernardino Subscribed and sworn to (or affirmed) before me on this 2 day of jE42(,, 20;Q by MaIMVM , proved to me on the basis of satisfactory evidence to be the person(a) who appeared before me JASPREET KAUR COMM. #2250547 -- NOTARY PUBLIC - CALIFORNIA rv'n - SAPI BERNAROINO COUNTY My Corm. Expires Aug 16, 2012 Notaryublic Signature Notary Public Seal Page 17 City of Santa Ma - RFP 20-014 Water Quality Sampling & Testing Services Page I of I NON -LOBBYING CERTIFICATION The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Signed: /at ='"'�"��7 Title: Bob Glaubig, Laboratory Director Firm: Clinical Laboratory of San Bernardino, Inc. Date: June 03, 2020 Page 18 City of Santa Ana - RFP 20-014 Page 1 of 1 Water Quality Sampling & Testing Services g NON-DISCRIMINATION CERTIFICATION The undersigned consultant or corporate officer, during the performance of this contract, certifies as follows: The Consultant shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Consultant shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Consultant agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Consultant shall, in all solicitations or advertisements for employees placed by or on behalf of the Consultant, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Consultant shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Consultant's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Consultant shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Consultant shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Consultant's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Consultant may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. The Consultant shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Consultant becomes involved in, or is threatened with, litigation with a subconsultant or vendor as a result of such direction by the administering agency, the Consultant may request that the United States enter into such litigation to protect the interests of the United States. Page 19 City of Santa Ana - RFP 20-014 Page 1 of 2 Water Quality Sampling & Testing Services g 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any consultant of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signed:�7 Title: Bob Glaubig, Laboratory Director Firm: Clinical Laboratory of San Bernardino, Inc. Date: June 03,2020 Page 20 City of Santa Ana - RFP 20-014 Page 2 of 2 Water Quality Sampling & Testing Services g 36 CALIFOPNiA Water Boards STATE WATER RESOURCES CONTROL ROARO CALIFORNIA STATE REGIONAL WATER QUALITY CONTROL BOARDS ENVIRONMENTAL LABORATORY ACCREDITATION PROGRAM CERTIFICATE OF ENVIRONMENTAL ACCREDITATION Is hereby granted to Clinical Laboratory of San Bernardino, Inc. 21881 Barton Road Grand Terrace, CA 92313 Scope of the certificate is limited to the "Fields of Testing" which accompany this Certificate. Continued accredited status depends on successful completion of on -site inspection, proficiency testing studies, and payment of applicable fees. This Certificate is granted in accordance with provisions of Section 100825, et seq. of the Health and Safety Code. Certificate No.: 1088 Expiration Date: 1/31/2022 Effective Date: 2/1/2020 ('/ r C.- I I k� Sacramento, California Christine Sotelo, Chief subject to forfeiture or revocation Environmental Laboratory Accreditation Program Page 21 0 CALIFORNIA STATE o ENVIRONMENTAL LABORATORY ACCREDITATION PROGRAM WaW Boards Accredited Fields of Testing Clinical Laboratory of San Bernardino, Inc. 21881 Barton Road Grand Terrace, CA 92313 Phone: 9098257693 Certificate No. 1088 Expiration Date 1131/2022 Field of Testing: 101,010 001 101.020 004 101 - Microbiology of Drinking Water Heterotrophic Bacteria Total Coliform (Enumeration) SM 9215 B SM 9221 B,C 101.020 005 Fecal Coliform (Enumeration) SM 9221 13,E 101.050 001 Total Coliform P/A SM 9223 B Colilert 101.050 002 E. coli P/A SM 9223 B Colilert 101.050 005 Total Coliform P/A SM 9223 B Colilert 18 101.050 006 E cali P/A SM 9223 B Colilert 18 101.050 007 Total Califon (Enumeration) SM 9223 B Colilert 18 101.050 008 E. call (Enumeration) SM 9223 B Colilert 18 Field of Testing: 102 - Inorganic Chemistry of Drinking Water 102.020 001 Turbidity EPA 180.1 102.026 001 Calcium EPA 200.7 102.026 002 Magnesium EPA 200.7 102.026 003 Potassium EPA 200.7 102.026 004 Silica EPA 200.7 102.026 005 Sodium EPA 200.7 102.026 006 Hardness (Calculation) EPA 200.7 102,030 003 Chloride EPA 300.0 102.030 005 Fluoride EPA 300.0 102.030 006 Nitrate (as N) EPA 300.0 MUM 007 NiWte (as N) EPA 300.0 102.030 009 Sulfate (as SO4) EPA 300.0 102.045 001 Perchlorate EPA 314.0 102.060 001 Nitrate (as N)(Calculator) EPA 353.2 102.061 001 Nibite (as N) EPA 353.2 102.100 001 Alkalinity SM 2320 B-1997 102.130 001 Specific Conductance SM 2510 B-1997 102,140 001 Residue, Filterable TDS SM 2540 C-1997 102.175 001 Chlorine, Free SM 4500-CI G-2000 102,175 002 Chlorine, Total Residual SM 4500-CI G-2000 102.191 001 Cyanide, Total SM 4500-CN F-1999 102.203 001 Hydrogen Ion (pH) SM 4500-1-1+B-2000 102.240 001 Phosphate,Ortho(as P) SM 4500-PE-1999 As of 2/1/2020 , this list supersedes all previous lists for this certificate number. Customers: Please verify the current accreditation standing with the State. Page 1 of 7 Page 22 Clinical 102.260 Laboratory of San Bernardino, Inc. 001 Organic Carbon -Total (TOC) SM 5310 B-2000 Certificate No.: 1088 Expiration Date: 1/31/2022 102.261 001 Dissolved Organic Carbon (DOC) SM 5310 B-2000 102.270 001 Surfactants SM 5540 C-2000 102.280 001 UV254 SM 5910 B-2011 Field of Testing: 103- Toxic Chemical Elements of Drinking Water 103.040 002 Antimony SM 3113 B 103.040 003 Arsenic SM 3113 B 103.040 005 Beryllium SM 3113 B 103.040 103.040 006 007 Cadmium Chromium SM 3113 B SM 3113 B 103.040 010 Lead SM 3113 B 103.040 012 Nickel SM 3113 B 103.040 013 Selenium SM 3113 B 103.040 014 Silver SM 3113 B 103.130 001 Aluminum EPA 200.7 103.130 003 Badum EPA 200.7 103.130 004 Beryllium EPA 200.7 103.130 103.130 103.130 005 007 008 Cadmium Chromium Copper EPA 200.7 EPA 200.7 EPA200.7 103.130 009 Iron EPA 200.7 103.130 011 Manganese EPA 200.7 103.130 012 Nickel EPA 200.7 103.130 015 Silver EPA 200.7 103.130 017 Zinc EPA200.7 103.130 018 Boron EPA200.7 103.140 001 Aluminum EPA 200.8 103.140 103.140 002 003 Antimony Arsenic EPA 200.8 EPA 200.8 103.140 004 Barium EPA 200.8 103.140 005 Beryllium EPA 200.8 103.140 006 Cadmium EPA 200.8 103.140 007 Chromium EPA 200.8 103.140 008 Copper EPA 200.8 103.140 009 Lead EPA 200.8 103.140 010 Manganese EPA 200.8 103.140 011 Mercury EPA 200.8 103.140 012 Nickel EPA 200.8 103.140 013 Selenium EPA 200.8 103.140 014 Silver EPA 200.8 103.140 015 Thallium EPA 200.8 103.140 016 Zinc EPA 200.8 As of 2/1/2020 , this list supersedes all previous lists for this certificate number. Customers: Please verify the current accreditation standing with the State. Page 2 of 7 Clinical Laboratory of San Bernardino, Inc. 103.140 017 Boron EPA 200.8 Certificate No.: 1088 Expiration Date: 1/31/2022 103.140 018 Vanadium EPA 200.8 103.140 019 Strontium EPA 200.8 103,150 014 Thallium EPA 200.9 103.150 015 Vanadium EPA 200.9 103.310 001 Chromium (VI) EPA 218.6 Field of Testing: 104 - Volatile Organic Chemistry of Drinking Water 104.030 001 1,2-Dibromoethane (EDB, Ethylene Dibromide) EPA 504A 104.030 104.035 104.040 002 001 001 1,2-Dibromo-3-chloropropane (DBCP) 1,2,3-Tdchloropropane(TCP) Benzene EPA 504.1 SRL 524M-TCP EPA 524.2 104.040 007 n-Butylbenzene EPA 524.2 104.040 008 sec-Butylbenzene EPA 524.2 104.040 009 tert-Butylbenzene EPA 524.2 104.040 010 Carbon Tetrachloride EPA 524.2 104.040 011 Chlorobenzene EPA 524.2 104.040 015 2-Chlorotoluene EPA 524.2 104.040 104.040 104.040 016 019 020 4-Chlorotoluene 1,3-Dichlorobenzene 1,2-Dichlorobenzene EPA 524.2 EPA 524.2 EPA 524.2 104.040 021 1,4-Dichlorobenzene EPA 524.2 104.040 022 Dichlorodifluoromethane EPA 524.2 104.040 023 1,1-Dichloroethane EPA 524.2 104.040 024 1,2-Dichloroethane EPA 524.2 104.040 025 1,1-Dichloroethene (1,1-Dichloroethylene) EPA 524.2 104.040 026 cis-1,2-Dichloroethene EPA 524.2 104.040 027 trans-1,2-Dichloroethene EPA 524.2 104.040 104.040 028 029 Dichloromethane(Methylene Chloride) 1,2-Dichloropropane EPA 524.2 EPA 524.2 104.040 033 cis-1,3-Dichloropropene EPA 524.2 104.040 034 trans-1,3-Dichloropropene EPA 524.2 104.040 035 Ethylbernwe EPA 524.2 104.040 037 Isopropylbenzene EPA 524.2 104.040 041 N-propylbenzene EPA 524.2 104.040 042 Styrene EPA 524.2 104.040 043 1,1,1,2-Tetrachloroethane EPA 524.2 104.040 044 1,1,2,2-Tetrachloroethane EPA 524.2 104.040 045 Tetrachloroethylene (Tetrachloroethene) EPA 524.2 104.040 046 Toluene EPA 524.2 104.040 047 1,2,3-Trichlombenzene EPA 524.2 104.040 048 1,2,4-Tdchlorobenzene EPA 524.2 104.040 049 1,1,1-Tdchloroethane EPA 524.2 As of 2/1/2020 , this list supersedes all previous lists for this certificate number. Customers: Please verify the current accreditation standing with the State. Page 3 of 7 Clinical Laboratory of San Bernardino, Inc. 104.040 050 1,1,2-Trichloroelhane EPA 524.2 Certificate No.: 1088 Expiration Date: 1/31/2022 104,040 104.040 104.040 051 052 054 Trichloroethene Tdchloro8uoromethane 1,2,4-Tdmethylbenzene EPA 524.2 EPA 524.2 EPA 524.2 104.040 055 1,3,5-Trimethylbenzene EPA 524.2 104.040 056 Vinyl Chloride EPA 524.2 104.040 057 Xylenes, Total EPA 524.2 104,045 000 Trihalomethanes, Total EPA 524.2 104.045 104.045 001 002 Bromodichloromethane Bromofonn EPA 524.2 EPA 524.2 104.045 003 Chloroform EPA 524.2 104.045 004 Dibromochloromethane EPA 524.2 104.050 002 Methyl led -butyl Ether (MTBE) EPA 524.2 104.050 003 tert-Amyl Methyl Ether (TAME) EPA 524.2 104.050 004 Ethyl led -butyl Ether(ETBE) EPA 524.2 104,050 005 Trichlorofri8uoroethane EPA 524.2 104.050 006 tert-Butyl Alcohol(TBA) EPA524.2 Field of Testing: 105 - Semi -volatile Organic Chemistry of Drinking Water 105.030 105.030 001 002 Alachlor Mazine EPA 507 EPA 507 105.030 007 Molinate EPA 507 105.030 009 Simazine EPA507 105.050 005 Chlordane(total) EPA 508.1 105.050 010 Enddn EPA 508.1 105.050 011 Heptachlor EPA 508.1 105.050 012 Heptachlor Epoxide EPA 508.1 105.050 013 Hexadrlorobenzene EPA 508.1 105.050 105.050 014 015 Hexachlaracydopentatiene Lindane (HCH-gamma) EPA 508.1 EPA 508.1 105.050 016 Methoxychlor EPA508A 105.050 028 PCBs as Araclors EPA 508.1 105.050 029 Toxaphene EPA508.1 105.083 001 2,4-D EPA515.4 105.083 002 Dinoseb EPA515.4 105.083 003 Pentachlorophenol EPA 515.4 105.083 004 Pidoram EPA 515.4 105.083 005 2,4,5-TP(Silvex) EPA 515.4 105.083 006 Dalapon EPA 515.4 105.083 007 Bentazon EPA 515.4 105.090 001 Alachlor EPA 525.2 105.090 003 Akr ine EPA 525.2 105.090 004 Benzo(a)pyrene EPA 525.2 As of 2/1/2020 , this list supersedes all previous lists for this certificate number. Customers: Please verify the current accreditation standing with the State. Page 4 of 7 Clinical Laboratory of San Bernardino, Inc. 105.090 008 Di(2-elhylhexyl) Adipate Certificate No.: 1088 Expiration Date: 1/31/2022 EPA 525.2 105.090 009 Di(2-aff-Ahexyl) Phthalate EPA 525.2 105.090 022 Molinate EPA 525.2 105.090 025 Simazine EPA 525.2 105.090 028 Thiobencarb EPA 525.2 105.100 001 Ndicarb EPA 531.1 105.100 002 Ndicarb Sulfone EPA 531.1 105.100 003 Aldicarb Sulfoxide EPA 531.1 105.100 105.100 105.100 004 005 006 Carbaryl Carbofuran 3-Hydroxycarbofuran EPA 531.1 EPA 531.1 EPA 531.1 105.100 007 Methomyl EPA 531.1 105.100 008 Oxamyl EPA 531.1 105,120 001 Glyphosate EPA 547 105.140 001 Endothall EPA 548.1 105.150 001 Diguat EPA 549.2 105.200 001 Bromoacetic Add EPA 552.2 105.200 003 Chloroacetic Add EPA 552.2 105.200 005 DibromoaceticAcid EPA 552.2 105.200 006 Dichloroacetic Add EPA 552.2 105.200 007 Tdchloroacetc Acid EPA 552.2 105.200 008 Haloacetic Acids(HAA5) EPA 552.2 Field of Testing: 106 - Radionuclides in Drinking Water 106.092 001 Uranium EPA200.8 106.270 001 Gross Alpha SM 7110C Field of Testing: 107 - Microbiological Methods for Non -Potable Water and Sewage Sludge 107.001 001 Total Coliform (Enumeration) SM 9221 8,C-2006 107.001 002 Fecal Coliform (Enumeration) SM 9221 C,E-2006 Field of Testing: 108 - Inorganic Constituents in Non -Potable Water 108.007 001 Residue, Volatile EPA 160.4 (1971) 108.009 001 Turbidity EPA 180.1 (1993 Rev. 2.0) 108.013 001 Calcium EPA 200.7 (1994 Rev. 4.4) 108.013 002 Magnesium EPA 200.7 (1994 Rev. 4.4) 108.013 004 Potassium EPA 200.7 (1994 Rev. 4.4) 108.013 005 Silica, Dissolved EPA 200.7 (1994 Rev. 4.4) 108.013 006 Sodium EPA 200.7 (1994 Rev. 4.4) 108.017 002 Chloride EPA 300.0(1993 Rev. 2. 1) 108.017 003 Fluoride EPA 300.0(1993 Rev. 2.1) 108.017 004 Nitrate (as N) EPA 300.0 (1993 Rev. 2.1) 108.017 005 Nitrate -Nitrite (as N) EPA 300.0 (1993 Rev. 2.1) 108.017 006 Nitrite (as N) EPA 300.0 (1993 Rev. 2.1) 108.017 008 Sulfate (as SO4) EPA 300.0 (1993 Rev. 2.1) As of 2/1/2020 , this list supersedes all previous lists for this certificate number. Customers: Please verify the current accreditation standing with the State. Page 5 of 7 Clinical Laboratory of San Bernardino, Inc. 108.025 001 Ammonia (as N) EPA 350.1 (1993 Rev. 2.0) Certificate No.: 1088 Expiration Date: 1/31/2022 108.029 001 Kjeldahl Nitrogen,Total (as N) EPA 351.2 (1993 Rev. 2.0) 108.033 001 Nitrate -Nitrite (as N) EPA 353.2 (1993 Rev. 2.0) 108.033 002 Nitrite (as N) EPA 353.2 (1993 Rev. 2.0) 108.053 002 Oil 8 Grease Total EPA 1664 B 108.063 001 Alkalinity SM 23208-2011 108.069 001 Specific Conductance SM 2510 B-2011 108.071 001 Residue, Total SM 2540 8-2011 108.073 001 Residue, Filterable TDS SM 2540 C-2011 108.075 001 Residue, Non -filterable TSS SM 2540 D-2011 108.079 001 Residue, Settleable SM 2540 F-2011 108.114 001 Chlonne, Total Residual SM 4500-CI G-2011 108.137 001 Hydrogen on (pH) SM 4500-H+B-2011 108.173 001 Oxygen, Dissolved SM 450M G-2011 108.175 108.175 001 002 PhosphatoOrtho (as P) Phosphoms,Total SM 4500-P E-2011 SM 4500-P E-2011 108.201 108.207 001 001 Sulfide (as S) Biochemical Oxygen Demand SM 4500-5 D-2011 SM 5210 B-2011 108.207 002 Carbonaceous BOD SM 5210 B-2011 108.215 001 Organic Carbon -Total (TOC) SM 5310 8-2011 108.225 001 Surfactants SM 5540 C-2011 108.325 001 Chemical Oxygen Demand Hach 8000 Field of Testing: 109 - Metals and Trace Elements in Non -Potable Water 109.623 001 Aluminum EPA 200.7(1994 Rev. 4.4) 109.623 004 Barium EPA 200.7 (1994 Rev. 4.4) 109.623 005 Beryllium EPA 200.7 (1994 Rev. 4.4) 109.623 006 Boron EPA 200.7 (1994 Rev. 4.4) 109.623 007 Cadmium EPA 200.7 (1994 Rev. 4.4) 109.623 008 Chromium EPA 200.7 (1994 Rev. 4.4) 109.623 009 Cobalt EPA 200.7 (1994 Rev. 4.4) 109.623 010 Copper EPA 200.7 (1994 Rev. 4.4) 109.623 011 Iron EPA 200.7 (1994 Rev. 4.4) 109.623 013 Manganese EPA 200.7 (1994 Rev. 4.4) 109.623 014 Molybdenum EPA 200.7 (1994 Rev. 4.4) 109.623 015 Nickel EPA 200.7 (1994 Rev. 4.4) 109.623 017 Silver EPA 200.7 (1994 Rev. 4.4) 109.623 022 Zinc EPA 200.7 (1994 Rev. 4.4) 109.625 001 Aluminum EPA 200.8 (1994 Rev. 5.4) 109.625 002 Antimony EPA 200.8(1994 Rev. 5.4) 109.625 003 Arsenic EPA 200.8 (1994 Rev. 5.4) 109.625 004 Barium EPA 200.8 (1994 Rev. 5.4) 109.625 005 Beryllium EPA 200.8 (1994 Rev. 5.4) As of 2/1/2020 , this list supersedes all previous lists for this certificate number. Customers: Please verify the current accreditation standing vnth the State. Page 6 of 7 Clinical Laboratory of San Bernardino, Inc. 109,625 007 Cadmium Certificate No.: 1088 Expiration Date: 1/31/2022 EPA 200.8(1994 Rev. 5.4) 109.625 008 Chromium EPA 200.8 (1994 Rev. 5.4) 109.625 009 Cobalt EPA 200.8 (1994 Rev. 5.4) 109.625 010 Copper EPA 200.8 (1994 Rev. 5.4) 109.625 013 Lead EPA 200.8 (1994 Rev. 5.4) 109.625 014 Manganese EPA 200.8 (1994 Rev. 5.4) 109,625 015 Molybdenum EPA 200.8(1994 Rev. 5.4) 109.625 016 Nickel EPA 200.8 (1994 Rev. 5.4) 109.625 109.625 109.625 017 018 019 Selenium Silver Thallium EPA 200.8 (1994 Rev. 5.4) EPA 200.8 (1994 Rev. 5.4) EPA 200.8 (1994 Rev. 5.4) 109.625 022 Vanadium EPA 200.8 (1994 Rev. 5.4) 109,625 023 Zinc EPA 200.8(1994 Rev. 5.4) 109.627 015 Thallium EPA 200.9 (1994 Rev.2.2) 109.629 001 Chromium (VI) EPA 218.6 (1994 Rev. 3.3) 109.669 002 Antimony SM 3113 B-2010 109.669 003 Arsenic SM 3113 B-2010 109.669 005 Beryllium SM 3113 B-2010 109.669 006 Cadmium SM 3113 B-2010 109.669 007 Chromium SM 3113 B-2010 109.669 012 Lead SM 3113 B-2010 109.669 015 Nickel SM 3113 B-2010 109.669 016 Selenium SM 3113 B-2010 109.669 017 Silver SM 3113 B-2010 Field of Testing: 126 - Microbiological Methods for Ambient Water 126,003 001 Total Coliform (Enumeration) SM 9221 B,C-2006 126.003 002 Fecal Coliform (Enumeration) SM 9221 C,E-2006 126.017 001 E. troll (Enumeration) Colilert 18 As of 2/1/2020 , this list supersedes all previous lists for this certificate number. Customers: Please verify the current accreditation standing with the State. Page 7 of 7 "v d CERTIFICATE OF LIABILITY INSURANCE °" 42112U20 PYYYY) 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 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 endorsements . PRODUCER Wood Gutmann & Bogart Insurance Brokers License 0679263 CONTA T Melissa V nelis MAMEPNONE 714Aonelis 9 FAX E#1aIL mi nelis bib.com 15901 Red Hill Ave., Suite 100 Tustin CA92780 INSURER(S) AFFORDING COVERAGE NAICS INSURER A: Continental Casualty Co INSURED CLINI-2 Clinical Laboratory of San Bernardino, Inc. Geo-Monitor, Inc. INSURER B: Hartford ACC & Indemnity CO INSURER c: American Cas Co of Reading PA 20424 INsuRER D : Continental Insurance Company PO Box 329 San Bernardino CA 92402 INSURER E INSURER F CERTIFICATE 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. INLTR SR TYPE OF INSURANCE SUER POLICYNUMBER MADOL OLUUY� MMMO Y LIMITS C GENERAL LIABILITY Y B(X`M75 2/12020/ 211/Z021. EACH OCCURRENCE 3LODD000 X COMMERCIALGENERALLWBILITY ✓/ J/ 1 S1DD.000 MEO IEXP (Any we 510,000 CLAIMS -MADE MOCCUR PERSONAL B ADV INJURY f 1000,000 GENERAL AGGREGATE S2.000.000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000.000 Poucy X PRO- X LOC $ B AUTOMOBILE LIABILITY / 72UECHFW15 Vi0oD 21Inul COMBINED SINGL LIM X ANY AUTO ,/ ALL OWNED SCHEDULED AUTOS AUTOS J ✓ BODILY RLURY(Per person) S BODILY INJURY (Per acdtlm0 S "RED AUTOS ANIIT VMEO "RED PROPERTY DAMAGE $ 0 X UMBRELLA LIAR X OCCUR CUE6070281162 2I1=0 W=1 EACH OCCURRENCE AGGREGATE LIAB CWMS-MADE DED X RETENTIONS IDOW B YrORKER3 COMPENSATION EMPLOYERS' LIABILITY PROPRIETORIPARTNERIEXECUTNE YINE.L OFFICERMEMBER EXCLUDED' NIA(Mandalay 72WECAESFUo 2/1/2020 211=?1. /ANY X wC STATU- OT14AND 3$5.=.=EXLESB EACH ACCIDENT EL DISEASE-EAEMPLOYE In NH) der Byosde5OlbeaFOEL DESCRIPTION OF OPERATIONS Chow DISEASE -POLICY LIMIT A Envaememal ProfesawrW Lra011 m Cle. Made Cove Dadu be:$100.OW EEH276170520 V1r2020 ✓ 2/112°Zt / Par Clam J00°.000 Ag)yaVeie J.W0.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atmch ACORD 101. AddlUre gnal Remarks Schedule. N moapace Is required) RE: All Operations usual to the Insured's operations subject to the policy terms and conditions Certificate holder is named as additional insured on the General Liability per attached CNA75081XX(1-15) as required by written contract subject to the terms and conditions of the policy. CeNficate of Insurance shall provide thirty (30) day prior written notice of cancellation per form to follow from carrier. Primary and Nan -Contributory applies on the General Liability per attached By Risk MAI City of Santa Ana V Risk Management Division APR 20 Civic Center Plaza, 4th Floor / Santa Ana CA 92701 ---�� ACEVEdo 1$HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y}IE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. (D1988-2010 ACORD I ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this Coverage Part; including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. bodily injury, property damage, or personal and advertising injury to the extent caused by: 1. the Named Insured's acts or omissions; or 2. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations specified in the written contract; or B. bodily injury or property damage to the extent caused by your work specified in the written contract and included in the products -completed operations hazard, and only if 1. the written contract requires the Named Insured to provide the additional insured such coverage, and 2. this coverage part provides such coverage. It. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. ads or omissions of the additional insured, or of anyone acting on the additional insured's behalf; or B. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, 8 field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or C. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. B IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written c contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance grantyR�+,y�l��r� � rilion entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as f sk MANAGEMENT DIVISION i� mm CNA75081XX (1-15) Policy No: 6072997663 Page 1 of 2 Endorsement No: 6 TRANSPORTATION INSURANCE COMPANY ANGIE ACEVEdo Effective Date: 02/01/2019 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA Al Rights Reserved. Includes cepynghted matenei or Insurance Services DIFce. Im, wdh 013 permission. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors -with Products -Completed Operations Coverage - Limited Liability Endorsement The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim, 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part, 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim, and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 4 does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. Vl. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy: and B. was executed prior to: 1. The bodily injury or property damage: or 2. The offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. REVIEWED & APPROVED By Risk MANAGEMENT DivisioN AP`T2020 ANGiE ACEvEdo CNA75081XX (1 - 15) Page 2 of 2 TRANSPORTATION INSURANCE COMPANY Policy No: 6072997663 Endorsement No: 6 Effective Date: 02/01/2019 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA AR Rights Reserved. Includes copyrighted material of Insurance Ser k s Office, Inc., with its permissm. '`� d CERTIFICATE OF LIABILITY INSURANCE °"T412, 020 ' 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 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 endorsements). PRODUCER Wood Gutmann 8 Bogart Insurance Brokers License 0679263 15901 Red Hill Ave., Suite 100 courA r Melissa) nelis PNONE . 714-agnelis 9 F"% E#1AlL mi nelis bib.com Tustin CA 92780 INSURE S AFFORDING COVERAGE NAIL e INSURER A: Continental Casualty Co INSURED / CLINI-2 Clinical Laboratory of San Bernardino, Inc. J/ Geo-Monitor, Inc. INSURER B: Hartford ACC g Indemnity Cc INSURER c: American Cas Co of Reading PA 20424 PO Box 329 San Bernardino CA 92402 INsuRER o : Continental Insurance Company INSURER E: _ INSURER F : COVERAGES CFRTIFICATF MI IMRFR- lnn,11719Gn DcvlmnM .. 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. ILTR TYPE OF INSURANCE POLICY NUMBER MMII�IYEYFYY M UY� y LIMITS C GENERAL LIABILITY Y W72997665 V1=20/ EACH OCCURRENCE SI.CCO(W X COMMERCLILGENERAI LUABILRY CLAIMS -MADE a OCCUR ✓/ / R p $1WDOD MED EXP (My one persD+ $ 10,01x) PERSONAL S ADV INJURY I100GAOG GENERAL AGGREGATE I2.000AW GENL AGGREGATE LIMIT APPLIES PER PRODUCTS -COMPIOP AGG S2.DX)WG POUCY X jFr PRO- X LOC f 8 AUTOMOBILE LIABILITY / 72UECHFW15 El11020 2`1=1 COMBINED SINGLE LIMIT ANY AUTO 1/ ALL OWNED SCHEDULED AUTDB AUTOS / I X BODILY IMURY(Per parson) S BODILY INJURY (Per amiden0 f HIRED Atr05 AUTOS 1Y E f f D X UMBRELLA UAS X OCCUROCCURQlE6G76281162 21112020 VICo21 EACHOCCURRENCE $5,=,000 AGGREGATE f5,00°,000 EXCESS LW CLAIMS -MADE DIED I X I RETENTION s 111 f B WORKERS COMPENSATION AND EMPLOYERS UJA91LITY ANY PROPRIETORIPARTNERE ECUTIVE YIN OFHCERMEMSER EXCLUDED? ❑ NIA RWELAE9FU9 2112020 2711� X WC STATU- DTI+ EL EACH ACCIDENT $i== E.L DISEASE -EA EMPLOYE StDaD000 (MMgalor, 1^NNI do deem aawder EL DISEASE -POLICY LIMIT St,000,0W DESCRIPTION OF OPERATIONS below A Enviom WPmfass.I Uadl Cla. Mach Coverage � owbvt, e. SiWp00 EEH27617W23 2/1/2020 L1rt°2Y / Per Claim ],O = A9pregete 3,OW.WO DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (Aastl1 ACORD 101. A4419mal Rsm ks f hWuls, 9 man apace Is requlrad) RE: All Operations usual to the insured's operations subject to the policy terms and conditions Certificate holder is named as additional insured on the General Liability per attached CNA75081XX(1-15) as required by written contract subject to the terms and conditions of the policy. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation per form to follow from Carrier. Primary and Nan -Contributory applies on the Gepeial Liability -per attached CERTIFICATE HOLDER C-111MCF1 I ATInM By RISk MANq('jEMENT DIN I„A}IOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE // o tE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Santa Ana 1/ ,� pppp ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division !1f R ZQ AUTHORIZE EPRESENTATNE 20 Civic Center Plaza, 4th Floor - Santa Ana CA 92701 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD civa CNA PARAMOUNT Primary and Noncontributory - Other Insurance Condition Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is understood and agreed that the condition entitled Other Insurance is amended to add the following: Primary And Noncontributory Insurance Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a, the additional insured is a named insured under such other insurance; and b. the Named Insured has agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. REVIEWED & APPROVED By Risk MANAGEMENT DivisiON AP 2020 ANftiE ACEvEdo i CNA74987XX (1-15) Policy No: 6072997663 Page 1 of 1 Endorsement No: 34 AMERICAN CASUALTY CO OF READING,PA Effective Date: 04/13/2020 SL Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. CopyngM CNA An RigMs Reserved. Includes copAhM material of Insurance Services Office, Inc., with ifs permission. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this Coverage Part; including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. bodily injury, property damage, or personal and advertising injury to the extent caused by: 1. the Named Insured's acts or omissions; or 2. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations specified in the written contract; or B. bodily injury or property damage to the extent Caused by your work specified in the written contract and included in the products -completed operations hazard, and only if 1. the written contract requires the Named Insured to provide the additional insured such coverage; and 2. this coverage part provides such coverage. It. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. Ill. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. acts or omissions of the additional insured, or of anyone acting on the additional insured's behalf; or B. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or C. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section enfitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance grant; tAg"( rA �€election entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as fo sk MANACtEMENr DIVISION GNA75081XX (1-15) - Policy No: 6072997663 Page 1 of 2 —�� Endorsement No: 6 TRANSPORTATION INSURANCE COMPANY ANGIE ACEVEdo Effective Date: 02/01/2019 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA Al Rights Resenetl. Indudes copyrighted rnatii W of Insurance Serrices ORice. Inc.. with its permission. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim, 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 4 does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. The bodily injury or property damage; or 2. The offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. REVIEWED & APPROVED By RISk MANAQCMENT DIVISION APT2020 ANGiE ACEvEdo CNA75081XX (1-15) Policy No: 6072997663 Page 2 of 2 Endorsement No: 6 TRANSPORTATION INSURANCE COMPANY Effective Date: 02/01/2019 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyrphl CNA AO Rlphb Resen,ad. Includes copydghled material of Insurance Sernces Oebe. Inc. with its panniabn. l D'9'ta°y signed by Francine R. Villareal Francine R. Villarea Date: 2021.02.08 13:16:46-08'00' ACCORD® CERTIFICATE OF LIABILITY INSURANCE r DATE(MM/DD/YYYY) Ill 2/1/2021 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Melissa Ignells Wood Gutmann & Bogart Insurance Brokers PHONE License 0679263 A/c No Ext: 714-450-1669 p/X No: ADMDRESS: mignelis@wgbib.com 15901 Red Hill Ave., Suite 100 INSURER(S) AFFORDING COVERAGE NAIC # Tustin CA 92780 INSURERA: Continental Casualty Co INSURED CLINI-2 INSURERB: Hartford ACC & Indemnity Co Clinical Laboratory of San Bernardino, Inc. Geo-Monitor, Inc. INsuRERc: American Cas Co of Reading PA 20427 INSURERD: Continental Insurance Company PO Box 329 San Bernardino CA 92402 INSURERE: Hartford Underwriters Ins Co INSURER F : COVERAGES CERTIFICATE NUMBER: 69885336 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYY POLICY EXP MMIDD/YYY LIMITS C GENERAL LIABILITY Y 6072997663 2/1/2021 2/1/2022 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $ 100,000 CLAIMS -MADE OCCUR VIED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 PRO- POLICY X JECT X LOC $ B AUTOMOBILE LIABILITY 72UECHF6015 2/1/2021 2/1/2022 COMBINED SINGLE LIMIT Ea accident $ 1 000 000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS D X UMBRELLA LAB X OCCUR CUE 6076281162 2/1/2021 2/1/2022 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $ 10,000 $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 72WECAE9FU9 2/1/2021 2/1/2022 X WCSTATU- OTH- TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N /A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Environmental Professional Liabil 276170923 2/1/2021 2/1/2022 Per Claim 3,000,000 Claims Made Coverage Aggregate 3,000,000 Deductible: $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: All Operations usual to the insured's operations subject to the policy terms and conditions Certificate holder is named as additional insured on the General Liability per attached CNA75081 XX(1-15) as required by written contract subject to the terms and conditions of the policy. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation per form to follow from carrier. Primary and Non -Contributory applies on the General Liability per attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza, 4th Floor AUTHORIZE -,REPRESENTATIVE Santa Ana CA 92701 1°x Risk Managzrrtenti?iviaian REVIEWED &APPROVED SY: P, @ 1988-2010 ACORD C4 ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD _ _— Wsk Management Analyst CNA CNA PARAMOUNT Primary and Noncontributory - Other Insurance Condition Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is understood and agreed that the condition entitled Other Insurance is amended to add the following: Primary And Noncontributory Insurance Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. the additional insured is a named insured under such other insurance; and b. the Named Insured has agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA74987XX (1-15) Page 1 of 1 AMERICAN CASUALTY CO OF READING,PA Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Policy No: Endorserr Effective I Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its cF Risk ManagzmertLD isian ,'q REVIEWED & APPROVED BY.- . ' --� Risk Pjanagement Analyst CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this Coverage Part; including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. bodily injury, property damage, or personal and advertising injury to the extent caused by: 1. the Named Insured's acts or omissions; or 2. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations specified in the written contract; or B. bodily injury or property damage to the extent caused by your work specified in the written contract and included in the products -completed operations hazard, and only if 1. the written contract requires the Named Insured to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. acts or omissions of the additional insured, or of anyone acting on the additional insured's behalf; or N 0 B. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, 0 including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, 0 field orders, change orders or drawings and specifications; and N 2. supervisory, inspection, architectural or engineering activities; or C. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: CNA75081XX (1-15) Pol Page 1 of 2 EndorsemE RAMwagemedDiviaion TRANSPORTATION INSURANCE COMPANY Effectiv =� °, REVIEWED&APPROVmSY: Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. �� .. ° Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Risk hrfanagement Analyst CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 4 does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. The bodily injury or property damage; or 2. The offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75081XX (1-15) Pol Page 2 of 2 EndorsemE RAMwagemedDi lion TRANSPORTATION INSURANCE COMPANY Effectiv =� �°x REVIEWED&APPROVED BY: Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. �""" i Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Risk hrfanagement Analyst NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Clinical Lab of San Bernardino Name: Project A-2020-154 Number: Project Agreement To Provide Water Quality Sampling And Testing Services Name: The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: POLICY EXPIRATION TYPE OF INSURANCE COI DATE FILE NAME NUMBER DATE CERT- AUTOMOBILE LIABILITY 7036574348 02/01/2024 01/27/2023 572347297.pdf CERT- ENVIRONMENTAL PROFESSIONAL LIABIL EEH276170923 02/01/2024 01/27/2023 572347297.pdf CERT- GENERAL LIABILITY 6072997663 02/01/2024 01/27/2023 572347297.pdf WORKERS COMPENSATION AND CERT- 7036574351 02/01/2024 01/27/2023 EMPLOYERS' LIABILITY 572347297.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 2/1/2023 2:42 PM 74/30/2025 (MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 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 endorsement(s). PRODUCER CONTACT NAME: Suzanne B.POsada IAG Insurance Services PHONE FAX 111 Corporate Drive, Suite 100 A/C No EXt: 949-396-1015 vc,No):949-387-2324 Ladera Ranch CA 92694 ADDRESS: sbp@iagins.com INSURER(S)AFFORDING COVERAGE NAIC# License#: OD78344 INSURERA:American Casualty Company of Reading, 20427 INSURED CLINLAB-01 INSURER B: Continental Casualty Company 20443 Clinical Laboratory of San Bernardino Geo-Monitor, Inc. INSURERC: Oak River Insurance Co. 34630 21881 Barton Road INSURERD:Transportation Insurance Company 20494 Grand Terrace CA 92313 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:887937365 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY Y Y 6072997663 2/1/2025 2/1/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea or $100,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO LOC PRODUCTS-COMP/OP AGG $2,000,000 X JECT OTHER:El $ D AUTOMOBILE LIABILITY Y Y 7036574348 2/1/2025 2/1/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident B X UMBRELLALIAB X OCCUR CUE6076281162 2/1/2025 2/1/2026 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$in ono $ C WORKERS COMPENSATION Y CLWC666456 2/1/2025 2/1/2026 X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Environmental Prof Liability Y EEH276170923 2/1/2025 2/1/2026 Per Claim $4,000,000 Claims Made Aggregate $4,000,000 Deductible $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:All Operations usual to the insured's operations are subject to the policy terms and conditions. City of Santa Ana,its officers,officials,employees,and volunteers are included as Additional Insureds to the General Liability. Coverage is Primary& Non-Contributory,and a Waiver of Subrogation applies. Blanket Auto Liability Additional Insured is included as required by written contract.Waiver of Subrogation applies with respect to Auto Liability. Blanket Waiver of Subrogation for Workers'Compensation shall apply as required by written contract per the attached endorsement. See Attached... CERTIFICATE HOLDER APPROVED CANCELLATION By Tu Tran Nguyen of 7:16 am,May 01,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Dg1,11y,i,�Ed ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Public Works Agency Tu Train by To Tran Robert Hernandez ogtY. Nguyen Dd1eZozs.os.o� AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza 07d7 12- ° Santa Ana CA 92701 R 1a K.Le U @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CLINLAB-01 LOC#: ACC o ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED IAG Insurance Services Clinical Laboratory of San Bernardino Geo-Monitor, Inc. POLICY NUMBER 21881 Barton Road Grand Terrace CA 92313 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Blanket Waiver of Subrogation for Professional Liability shall apply as required by written contract per the attached endorsement. 30-Day Notice of Cancellation applies. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage - Limited Liability Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this Coverage Part; including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. bodily injury, property damage, or personal and advertising injury to the extent caused by: 1. the Named Insured's acts or omissions; or 2. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations specified in the written contract; or B. bodily injury or property damage to the extent caused by your work specified in the written contract and included in the products-completed operations hazard, and only if 1. the written contract requires the Named Insured to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: a A. acts or omissions of the additional insured, or of anyone acting on the additional insured's behalf; or M M B. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, 0 including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, 0 field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or C. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: CNA75081 XX(1-15) Policy No: 6072997663 Page 1 of 2 Endorsement No: 8 AMERICAN CASUALTY CO OF READING,PA Effective Date: 02/01/2025 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Indudes copyrighted material of Insurance Services office,Inc.,with its permission. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage - Limited Liability Endorsement The Condition entitled Duties In The Event of Occurrence,Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 4 does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. The bodily injury or property damage; or 2. The offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75081 XX(1-15) Policy No: 6072997663 Page 2 of 2 Endorsement No: 8 AMERICAN CASUALTY CO OF READING,PA Effective Date: 02/01/2025 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Indudes copyrighted material of Insurance Services Office,Inc.,with its permission. CNA CNA PARAMOUNT Primary and Noncontributory - Other Insurance Condition Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is understood and agreed that the condition entitled Other Insurance is amended to add the following: Primary And Noncontributory Insurance Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. the additional insured is a named insured under such other insurance; and b. the Named Insured has agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. N f0 a M M O O ti N O O M O O O N O O CNA74987XX(1-15) Policy No: 6072997663 Page 1 of 1 Endorsement No: 10 AMERICAN CASUALTY CO OF READING,PA Effective Date: 02/01/2025 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Indudes copyrighted material of Insurance Services office,Inc.,with its permission. CNA CNA PARAMOUNT Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WHOM THE NAMED INSURED HAS AGREED IN WRITING IN A CONTRACT OR AGREEMENT TO WAIVE SUCH RIGHTS OF RECOVERY, BUT ONLY IF SUCH CONTRACT OR AGREEMENT: 1. IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; AND 2. WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY GIVING RISE TO THE CLAIM. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products-completed operations hazard. All other terms and conditions of the Policy remain unchanged. M M This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. M O O O N O O CNA75008XX(10-16) Policy No: 6072997663 Page 1 of 1 Endorsement No: 11 AMERICAN CASUALTY CO OF READING,PA Effective Date: 02/01/2025 Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Indudes copyrighted material of Insurance Services office,Inc.,with its permission. CNA Business Auto Policy Policy Endorsement ADDITIONAL INSURED - PRIMARY AND N•N-CONTRIBUTORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Person Or Organization ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT TO NAME AS AN ADDITIONAL INSURED. 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II - LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Form No: CNA71527XX (10-2012) Policy No: BUA 7036574348 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 02/01/2025 Endorsement No: 12; Page: 1 of 1 Policy Page: 64 of 97 Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. CNA Business Auto Policy Policy Endorsement WAIVER OF OF OF • AGAINST OTHERS TO OF • • • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Endorsement Effective Date: 02/01/2025 SCHEDULE Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR TO LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. Form No: CA 04 44 10 13 Policy No: BUA 7036574348 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 02/01/2025 Endorsement No: 4; Page: 1 of 1 Policy Page: 49 of 97 Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 Copyright Insurance Services Office, Inc., 2011 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10 C (Ed. 01-19) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Blanket Waiver Person/Organization Blanket Waiver— Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium (prior to adjustments) All CA Operations 350.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 02/01/2025 PolicyNo.: CLWC666456 Endorsement No.: Insured: Premium $ Insurance Company: Oak River Insurance Company Countersigned by WC990410C (Ed. 01-19) Professional Liability and Pollution Incident Liability Insurance CMA 4. fully cooperate with the Insurer or the Insurer's designee in the defense of a claim, including but not limited to assisting the Insurer in: the conduct of suits or other proceedings, settlement negotiations, and the enforcement of any right of contribution or indemnity against another who may be liable to the Insured. The Insured shall attend hearings and trials and assist in securing evidence and obtaining the attendance of witnesses; 5. refuse, except solely at the Insured's own cost, to voluntarily make any payment, admit liability, assume any obligation, or incur any expense, without the Insurer's prior written approval; and 6. pay the deductible amount when due. After the Insured reports a circumstance or a claim is made and the Insured has the right under any contract to either reject or demand arbitration or other alternative dispute resolution process, the Insured shall only do so with the Insurer's prior written consent. C. The Insured's Rights and Duties in the Event of a Circumstance If the Insured reports a circumstance for which there may be coverage under this Policy, and the Insured gives the Insurer written notice containing as much detail as the Insured can reasonably provide regarding: 1. what happened and the professional services or activities the Insured performed; 2. the nature of any possible injury or damages; and 3. how and when the Insured first became aware of such circumstance, then any claim or related claims that subsequently may be made against the Insured arising out of such circumstance shall be deemed to have been made on the date the Insurer received written notice of the circumstance. The Insured will cooperate with the Insurer in addressing the circumstance, and refuse, except solely at the Insured's own cost, to voluntarily make any payment, admit liability, assume any obligation, or incur any expense without the Insurer's prior written approval. D. Subrogation If any Insured has rights to recover amounts from another, those rights are transferred to the Insurer to the extent of the Insurer's payment. The Insured must do everything necessary to secure these rights and must do nothing after a claim is made to jeopardize them. The Insurer hereby waives subrogation rights against any person or organization to the extent that the Named Insured has, prior to a wrongful act or circumstance, entered into a written agreement to waive such rights. E. Premium All premium charges under this Policy will be computed according to the rules, rates and rating plans that apply at the effective date of the current policy term. F. Examination and Audit The Insured agrees to allow the Insurer to examine and audit the Insured's financial books and records that relate to this insurance. The Insurer may do this at any time during the policy term or any extensions, and up to three years after the end of the policy term. G. Legal Action Limitation 1. The Insured agrees not to bring any legal action against the Insurer concerning this Policy unless the Insured has fully complied with all the provisions of this Policy. 2. If, after the final adjudication or settlement of a claim, there is any dispute concerning tort allegations against the Insurer regarding the handling or settlement of any claim, the Insured and the Insurer agree to submit such dispute to any form of alternative dispute resolution acceptable to both Form No:CNA79034XX(11-2022) Policy No: EEH276170923 Policy Page 13 of 17 Policy Effective Date:02/01/2025 Underwriting Company:Continental Casualty Company Policy Page: 15 of 25 151 North Franklin Street,Chicago,IL 60606 Copyright CNA All Rights Reserved.