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HomeMy WebLinkAboutOCEAN BLUE ENVIRONMENTAL SERVICES, INC. (4)INSURANCE ON FILE WORK MAY PROCEED A-2021-198 UNTIL INSURANCE EXPIRES 01 11. 22 CLERK OF COUNCIL DATE: FIRST AMENDMENT TO AGREEMENT TO PROVIDE SPILL RESPONSE, HAZARDOUS WASTE DISPOSAL, AND STORM DRAIN FACILITY MAINTENANCE SERVICES l THIS FIRST AMENDMENT to the above -referenced agreement is entered into on October 5, 2021, by and between Ocean Blue Environmental Services, Inc. ("Consultant"), and the City of N Santa Ana, a charter city and municipal corporation organized and existing under the Constitution o and laws of the State of California ("City"). cli RECITALS 4-- c A. The parties entered into Agreement No. A-2021-097-01, dated June 15, 2021, by which Consultant agreed to provide spill response, hazardous waste disposal, and storm drain facility maintenance services ("Agreement"). The term of the Agreement is for three years (with one two-year option exercisable by the City), and the Agreement remains in effect. B. The primary purpose of the Agreement is for spill response, hazardous waste disposal, and storm drain facility maintenance services, though the Consultant represents it is able and willing to provide COVID-19 Sanitization Services to assist the City in controlling the spread of COVID-19 and variants. C. The parties now wish to amend the scope of services to provide further COVID-19 Sanitization Services, and to adjust the amount to be expended under the Agreement using funds provided under the American Rescue Plan Act ("ARPA"). D. ARPA was signed into law in March 2021. ARPA provides funding for a number of different programs, including the Coronavirus State and Local Fiscal Recovery Fund ("SLFRF"), to provide monetary support to local governments to respond to, mitigate, and recover from the COVID-19 public health emergency. E. The scope of services provided by Consultant is an allowable use under the SLFRF because it addresses public health risks related to homelessness and exacerbated by the pandemic, and because it improves conditions in areas of the City used primarily by underserved communities and/or in qualified census tracts. The Parties therefore agree: Section 1, Scope of Services, is amended to include COVID-19 Sanitization Services, as further described in Exhibit A, attached hereto and incorporated herein by reference. 2. Section 2, Compensation, is amended to increase the not -to -exceed expenditure under the Agreement from $350,000 to $600,000 for the one-year term ending on June 30, 2022. As the recipient of ARPA SLFRF funds, Consultant will be required to comply with any and all compliance requirements for the use of SLFRF funds, any and all reporting requirements for expenditures of SLFRF funds, as well as compliance with 2 CFR 200.332 regarding pass - through entities. Page 1 of 2 3. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above. ATTEST -Daisy Gomez Clerk of the Council APPROVED AS TO FORM Sonia R. Carvalho City Attorney By: Ryan O. Hodge Assistant City Attorney RECOMMENDED FOR APPROVAL Nabil Saba, PE Executive Director Public Works Agency CITY OF SANTA ANA Kristine Ridge City Manager CONSULTANT Name: Justin Lee Title: President Page 2 of 2 EXHIBIT A SCOPE OF SERVICES A. COVID-19 SANITIZATION SERVICES 1. Contractor shall provide COVID-19 Sanitization Services at congregate settings and on high - contact surfaces throughout the public right-of-way including, but not limited to: a. Bus shelters; b. Street furniture; c. Signs; d. Waste receptacles; e. Park facilities; f. Santa Ana Regional Transportation Center (SARTC); g. City Hall; h. Libraries; i. Senior Centers; j. Other surfaces/locations identified by the City. 2. Methods to provide COVID-19 Sanitization Services shall include, but are not limited to: a. Pressure washing surfaces with disinfection solutions; b. Hand-wiping/scrubbing surfaces with disinfection solutions; c. Using a hand-held sprayer with disinfection solutions; d. Other methods suggested by Contractor and approved by the City. Contractor shall manifest, transport, and dispose of all waste and wastewater generated from providing COVID-19 Sanitization Services to the satisfaction of the California Department of Toxic Substance Control (DTSC), the United States Department of Transportation (DOT), the United States Environmental Protection Agency (USEPA), the permitted disposal facilities receiving the waste or wastewater, and any other applicable Federal, State, or local regulations. No waste or wastewater generated from providing COVID-19 Sanitization Services shall be transported to the City's Corporate Yard for disposal. 4. Contractor shall only use disinfection solution(s) proven to be effective at eliminating COVID- 19. Disinfection solutions must be approved by the City prior to use. 5. Contractor shall ensure all employees are supplied with and use adequate Personal Protective Equipment (PPE) while providing COVID-19 Sanitization Services. 6. Contractor shall establish a safe perimeter to ensure the public is not impacted while providing COVID-19 Sanitization Services. 7. Contractor shall immediately notify the City if any of its employees conducting COVID-19 Sanitization Services test positive for COVID-19 and shall take all necessary precautions, as recommended by the Orange County Health Care Agency, to mitigate the spread of COVED-19 to City Staff and the public. Page 1 of 2 EXHIBIT A 8. Contractor shall implement Best Management Practices (BMPs) to ensure no disinfection solutions or wastewater are discharged into the City's stormdrain system and there are no negative environmental impacts associated with COVID-19 Sanitization Services. Contractor shall immediately notify the City in the event any disinfection solutions or wastewater are discharged into the City's stormdrain system. 9. Contractor shall document all COVID-19 Sanitization Services and send the City weekly updates, including photos and dates, of each location sanitized. Page 2 of 2 Francine R. evixys.ewa.,drea Villareal a.�. OCEABLU-06 m ADAVIS2 '4`�R� CERTIFICATE OF LIABILITY INSURANCE OAT/3012DIYYYV) 6130/2021 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0757776 CANTACT Alisha Davis N ME: HUB International Insurance Services Inc. 9855 Scranton Road Suite 100 PHONE o, Ext): (677) 625-2681 FAX Nel:(951 231-2572 ) E-MAIESS: alisha.davis@hubinternational.com San Diego, CA 92121 INSURE S AFFORDING COVERAGE NAIL ir INSURER A: Greenwich Insurance Company 22322 INSURED INSURER B:XL Specialty Insurance Company 37885 INSURER c:Indian Harbor Insurance Company 36940 Ocean Blue Environmental Services, Inc. INSURER D: 925 West Esther Street Long Beach, CA 90813 INSURER E INSURER F : COVERAGES CERTIFICATE MIIMRFR- RFVLCInM MI HAPPIP. 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 OROTHER DOCUMENTWITH RESPECTTO 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. HER TYPE OF INSURANCE ADDL BUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X X GEC300156801 711/2021 7/112022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES(Ea occumeres) 100,000 MEDEXP An one ison $ 5,000 PERSONAL BADV INJURY $ 1,000,000 POLICY LIMIT � APPLIES PER M- LOC GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE X PRODUCTS-COMP/OPAGG 21000,000 X OTHER: DIED: $5,000 B AUTOMOBILE LIABILITY COMBI tlEED SINGLE LIMIT $ 1,000,000 X ANYAUTO AUTOSOONLV AUUTHOSSVUyN�D X X AECO05699101 71112021 7/1121M BODILY IWURV War Ders..) $ BODILY INJURY Per accident $ Pe�ax,Cen DAMAGE $ X AUTOS ONLY AUTOS ONLY MCS-90 Pollution Hazardous Waste 5,000,000 C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 9,000,000 AGGREGATE 9+ODD,000 X EXCESS LIAB CLAIMSWADE UECO05699201 71112021 71112022 DED I X I RETENTION$ 10,000 B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN pp�-Mat ry inN qIEXCLUDED? (Mantlatory,n NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA X WEC300156701 71112021 71112022 �( PER OTH- STATUTE ER E.L EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 7,D00,000 C Pollution I Environm X PECO05703301 711/2021 71112022 Each Occ/Aggregate 5,000,000 C Professional Liab PECO05703301 7/112021 7/112022 Each Occ/Aggregate 5,000,000 DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: A-2021.097.01 and RFP #21-004 City of Santa Ana, officers, agents, employees, and volunteers are Additional Insured's with regards to the General Liability policy when required by a written contract, per the attached endorsement forms CG2010 12119 and CG2037 12119. Primary wording applies with regards to the General Liability policy when required by a written contract, per the attached endorsement form XIL424 06105. Waiver of Subrogation applies with regards to the General Liability policy when required by a written contract, per the attached endorsement form CG240412119. Additional Insured applies with regards to the Auto Liability policy when required by a written contract, per the attached endorsement form XIC411 10113. Waiver of Subrogation applies with regards to the Auto Liability policy when required by a written contract, per the attached endorsement form CA044410113. Auto Pollution applies per the attached form CA9948 10113. Waiver of SEE ATTACHED ACORD 101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE _ n IA '�FS' `,"�. ?` o_•M1¢tT2 Management I ont iEVIEVVED & APPROPVE®BY. ACORD 25 (2016/03) @ 1988-2015 ACORD C The ACORD name and logo are registered marks of ACORD - Risk Management Analyst ACORO" llkl� AGENCY CUSTOMER ID: OCEABLU-06 LOC #: 1 ADDITIONAL REMARKS SCHEDULE ADAVIS2 Page 1 of 1 AGENCY License# 0757776 NAMED INSURED HUB International Insurance Services Inc. Ocean Blue Environmental Services, Inc. 925 West Esther Street Long Beach, CA 90813 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: Subrogation applies with regards to the Workers Compensation policy when required by a written contract, per the attached endorsement form WC040306 04/84. Excess Liability follows form to the General Liability, Auto Liability and Employers Liability. MCS-90 applies to the Auto Liability and Excess Liability per the attached forms. ACORD 101 (2003101) © 2008 ACORD COF The ACORD name and logo are registered marks of ACORD n:y .s' Risk MsnsgenadDisisinn REVIEWED 6 APPROVED Sr. Rm— WIMOM Risk Management Analyst POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or Organization(s) Locations Of Covered Operations Any person or organization where required by written All Locations as required per written contract. contract provided that such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", 'property damage" or 'personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or This insurance does not apply to 'bodily injury" or "property damage" occurring after: 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for 2• the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 12 19 C Insurance Services Office, Inc., 2018 =n... "Mougm erdDhisian �,, REVIEWED & APMR BY. ® Risk Management Analyst C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Risk Mnwgemad Divieinn SY/: �.3+'.uav:; [REVIEWED&pAPPR( r Mtry.f.N.1 R. Vr[t!✓L4c(. �® Ruk Management Analyst POLICY NUMBER: GEC300156801 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization where required by written contract provided that such contract was executed prior to the date of loss. All Locations as required per written contract., Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 ��,7 7f { � 1, °; Risk Maaigeinad DWw1an exm & APPRO�V/m By. o (iiE N Z r 4m,,V:IGti.�[ RA Management Analyst ENDORSEMENT# This endorsement, effective 12:01 a.m., 07-01-2021, forms a part of Policy No. GEC300156801 issued to Ocean Blue Environmental Services, Inc. by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART It is agreed that to the extent that insurance is afforded to any Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract. All other terms and conditions of this policy remain unchanged. XIL 424 0605 ©, 2005, XL America, Inc. Risk M agema,tD[Wdan REME &/wrRov ft F",..,c,,.� R. vj&.ut M�Mlm. Risk Management Matpt POLICY NUMBER:GEC300156801 COMMERCIAL GENERAL LIABILITY CG24041219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization where required by written contract provided that such contract was executed prior to the date of loss (as permissable by law) Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such persons) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 © Insurance Services Office, Inc., 2018 gim WdeManag0WdDivision RVIEWm S APPROVm BY: - Risk Management Analyst POLICY NUMBER: AECO05699101 XIC 411 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM A. COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" any person or organization you are required in a written contract to name as an additional insured, but only for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 1. You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission; Provided that: a. The written contract is in effect during the policy period of this policy; b. The written contract was signed by you and executed prior to the "accident" causing 'bodily injury" or "property damage" for which liability coverage is sought; and C. Such person or organization is an "insured" solely to the extent required by the contract, but in no event if such person or organization is solely negligent. B. The Limits of Insurance provided for the Additional Insured shall not be greater than those required by contract and, in no event shall the Limits of Insurance set forth in this policy be increased by the contract. C. General Conditions, Other Insurance is amended as follows: Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether such insurance is primary, excess, contingent or on any other basis unless the contract specifically requires that this policy be primary. All terms, conditions, exclusions and limitations of this policy shall apply to the liability coverage provided to any additional insured, and in no event shall such coverage be enlarged or expanded by reason of the contract. All other terms and conditions of this policy remain unchanged. XIC 411 1013 © 2013 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permi, F it P. vjuvul Risk Management Malpt POLICY NUMBER: AECO05699101 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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: OCEAN BLUE ENVIRONMENTAL SERVICES, INC. Endorsement Effective Date: July 1, 2021 SCHEDULE Name(s) Of Person(s) Or Organization(s): WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT EXECUTED PRIOR TO LOSS (EXCEPT WHERE NOT PERMITTED BY LAW). 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. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 ^ TUdt Mmwana D1*1 n RenEweD 6 APPROVED Sr. "®' Risk Management Malyst COMMERCIAL AUTO CA 99 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO AND MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: 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. A. Covered Autos Liability Coverage is changed as follows: 1. Paragraph a. of the Pollution Exclusion applies only to liability assumed under a contract or agreement. 2. With respect to the coverage afforded by Paragraph A.1. above, Exclusion B.6. Care, Custody Or Control does not apply. B. Changes In Definitions For the purposes of this endorsement, Paragraph D. of the Definitions Section is replaced by the following: D. "Covered pollution cost or expense" means any cost or expense arising out of: 1. Any request, demand, order or statutory or regulatory requirement that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or 2. Any claim or "suit' by or on behalf of a govemmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of "pollutants". "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto" or b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured". Paragraphs a. and b. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if. CA 99 48 10 13 © Insurance Services Office, Inc., 2011 (1) The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overtum or damage. RZlskMmwgana t)Mdon lh-v m&APPROVID BY. Rtsk Management Analyst WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Where required by written agreement signed prior to loss All California Operations. 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 07/01/2021 Policy No. WEC300156701 Endorsement No. Insured Insurance Company Ocean Blue Environmental Services, Inc. XL Specialty Insurance Company Countersigned By WC 04 03 06 (Ed. 04-84) Copyright 1984 Workers' Compensation Insurance Rating Bureau of California. All Rights Re: Rlek Mutugmtod Division x rR�Ev e&Eo&pAPPROVED BY. raRrY,��.l D Vi.LLNM/.L ®' Rhk Management Ana1pt FORM MCS-90 OMB No.: 2126-0008 Expiration: 3/31/2021 US DOT Number: Date Received: Please note, the expiration date as stated on this form relates to the process for renewing the Information Collection Request for this form with the Office of Management and Budget. This requirement to collect information as requested on this form does not expire. For questions, please contact the Office of Registration and Safety Information, Registration, Licensing, and Insurance Division. A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2126-0008. Public reporting for this collection of information Is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590. United States Department of Transportation �W�; Federal Motor Carrier Safety Administration Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 OCEAN BLUE ENVIRONMENTAL SERVICES, Issued to INC. of Long Beach, CA 90813 (Motor Carrier name) (Motor Carrier state or province) 505 Eagleview Blvd., Dated at Exton, PA 19341 on this 1" day of July, 2021 Amending Policy Number: AECO05699101 Effective Date: July 01, 2021 Name of Insurance Company: XL Specialty Insurance Company Countersigned by: (authorized company representative) The policy to which this endorsement is attached provides primary or excess insurance, as indicated for the limits shown (check only one): ® This insurance is primary and the company shall not be liable for amounts in excess of $ 1, 000, 000 CSL for each accident. ❑ This insurance is excess and the company shall not be liable for amounts in excess of $ for each accident in excess of the underlying limit of$ for each accident. Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FMCSA, to verify that the policy is in force as of a particular date. The telephone number to call is: (800)688-1840. Cancellation of this endorsement may be effected by the company of the insured by giving (1) thirty-five (35) days' notice in writing to the other party (said 35 days' notice to commence from the date the notice is mailed, proof of mailing shall be sufficient proof of notice), and (2) if the insured is subject to the FMCSA's registration requirements under 49 U.S.C. 13901, by providing thirty (30) days' notice to the FMCSA (said 30 days' notice to commence from the date the notice is received by the FMCSA at its office in Washington, DC). FORM MCS-90 Page 1 of 4 1EWED & APPROVED Y. ((REVIEWm &ppAPPRO�V/ID BY. Risk Management Analyst FORM MCS-90 OMB No.: 2126-0008 Expiration: 3/31/2021 Filings must be transmitted online via the Internet at http://www.fmcsa.dot.gov/urs. FORM MCS-90 Page 2 of 4 Risk Mwmgmwd R wEwm& Bpi^. �—=—� Risk Management Analyst FORM MCS-90 OMB No.: 2126-0008 Expiration 3/31/2021 DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions or which results in bodily injury, property damage, or environmental damage which the insured neither expected nor intended. Motor Vehicle means a land vehicle, machine, truck, tractor, trailer, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. Bodily Injury means injury to the body, sickness, or disease to any person, including death resulting from any of these. Property Damage means damage to or loss of use of tangible property. The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended to assure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Motor Carrier Safety Administration (FMCSA). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company) agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for public liability resulting from negligence in the operation, maintenance or use of motor vehicles subject to the financial responsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not each motor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in any territory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does not apply to injury to or death of the insured's employees while engaged in the course of their employment, or property transported by the insured, designated as cargo. It is understood and agreed that no condition, provision, stipulation, or limitation contained in the policy, this endorsement, or any other endorsement thereon, Environmental Restoration means restitution for the loss, damage, or destruction of natural resources arising out of the accidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measures taken to minimize or mitigate damage to human health, the natural environment, fish, shellfish and wildlife. Public Liabilitymeans liability for bodily injury, property damage, and environmental restoration. or violation thereof, shall relieve the company from liability or from the payment of any final judgment, within the limits of liability herein described, irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions, and limitations in the policy to which the endorsement is attached shall remain in full force and effect as binding between the insured and the company. The insured agrees to reimburse the company for any payment made by the company on account of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that the company would not have been obligated to make under the provisions of the policy except for the agreement contained in this endorsement. It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against the insured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction against the company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately to each accident and any payment under the policy because of anyone accident shall not operate to reduce the liability of the company for the payment of final judgments resulting from any other accident. FORM MCS-90 Page 3 of 4 /^�cn Risk Nimugenent lNWelan c� RE�neAm & nrrRov®er: l' FU11 4 P. VWAVAd ®, - Risk Management Analyst FORM MCS-90 Revised 3/31/2020 OMB No.: 2126-0008 Expiration 3/31/2021 SCHEDULE OF LIMITS — PUBLIC LIABILITY Type of carriage Commodity transported January 1, 1985 (1) For -hire (in interstate or foreign Property (nonhazardous) $750,000 commerce, with a gross vehicle weight rating of 10,000 or more pounds). (2) For -hire and Private (in Hazardous substances, as defined in 49 CFR 171.8, $5,000,000 interstate, foreign, or intrastate transported in cargo tanks, portable tanks, or hopper - commerce, with a gross type vehicles with capacities in excess of 3,500 water vehicle weight rating of 10,000 gallons; or in bulk Division 1.1, 1.2, and 1.3 materials, or more pounds). Division 2.3, Hazard Zone A, or Division 6.1, Packing Group I, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403. (3) For -hire and Private (in Oil listed in 49 CFR 172.101; hazardous waste, $1,000,000 interstate or foreign commerce, hazardous materials, and hazardous substances in any quantity; or in intrastate defined in 49 CFR 171.8 and listed in 49 CFR 172.101, commerce, in bulk only; with a but not mentioned in (2) above or (4) below. gross vehicle weight rating of 10,000 or more pounds). (4) For -hire and Private (In Any quantity of Division 1.1, 1.2, or 1.3 material; any $5,000,000 interstate or foreign commerce, quantity of a Division 2.3, Hazard Zone A, or Division with a gross vehicle weight 6.1, Packing Group I, Hazard Zone A material; or rating of less than 10,000 highway route controlled quantities of a Class 7 pounds). material as defined in 49 CFR 173.403 'The schedule of limits shown does not provide coverage. The limits shown in the schedule are for information purposes only. FORM MCS-90 Page 4 of 4 Riele Matssgem RUVEDeia . ary5 ��. REVEWD7 E, APPR�O/V�®aV�: �� rM4i�/M t P_ VXM'4'1 ��Risk Management Analyst FORM MCS-90 OMB No.: 2126-0008 Expiration: 3/31/2021 US DOT Number: Date Received: Please note, the expiration date as stated on this form relates to the process for renewing the Information Collection Request for this form with the Office of Management and Budget. This requirement to collect information as requested on this form does not expire. For questions, please contact the Office of Registration and Safety Information, Registration, Licensing, and Insurance Division. A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2126-0008. Public reporting for this collection of information is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Motor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590. j" United States Department of Transportation Federal Motor Carrier Safety Administration Endorsementfor Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 OCEAN BLUE ENVIRONMENTAL SERVICES, Issued to INC. (Motor Carrier name) 505 Eagleview Blvd., Dated at Exton, PA 19341 on this of Long Beach, CA 90813 (Motor Carrier state or province) day of July, 2021 Amending Policy Number: UECO05699201 Effective Date: July 01, 2021 Name of Insurance Company: Indian Harbor Insurance Company Countersigned by: (authorized company representative) The policy to which this endorsement is attached provides primary or excess insurance, as indicated for the limits shown (check only one): ❑ This insurance is primary and the company shall not be liable for amounts in excess of $ _ for each accident. ® This insurance is excess and the company shall not be liable for amounts in excess of $ 4,000, 000 for each accident in excess of the underlying limit of$ 1, 000, 000 for each accident. Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FMCSA, to verify that the policy is in force as of a particular date. The telephone number to call is: (800)688-1840. Cancellation of this endorsement may be effected by the company of the insured by giving (1) thirty-five (35) days' notice in writing to the other party (said 35 days' notice to commence from the date the notice is mailed, proof of mailing shall be sufficient proof of notice), and (2) if the insured is subject to the FMCSA's registration requirements under 49 U.S.C. 13901, by providing thirty (30) days' notice to the FMCSA (said 30 days' notice to commence from the date the notice is received by the FMCSA at its office in Washington, DC). FORM MCS-90 Page 1 of 4 Qm. Risk Mouge wdElmdon® g�' r � : REMPRED & APPRQYBY: ,I , feu i:. VtlLt.,rwl Risk Management Analpt FORM MCS-90 OMB No.: 2126-0008 Expiration: 3/31/2021 Filings must be transmitted online via the Internet at http://www.fmcsa.dot.gov/urs. FORM MCS-90 Page 2 of 4 Risk Mowgmwd DM91on ewm APPROV ) fnen.(�+s P. V:rtfti � Ruk Management Malpt FORM MCS-90 OMB No.: 2126-0008 Expiration 3/31/2021 DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions or which results in bodily injury, property damage, or environmental damage which the insured neither expected nor intended. Motor Vehicle means a land vehicle, machine, truck, tractor, trailer, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. Bodily Injury means injury to the body, sickness, or disease to any person, including death resulting from any of these. Property Damage means damage to or loss of use of tangible property. The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended to assure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Motor Carrier Safety Administration (FMCSA). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company) agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for public liability resulting from negligence in the operation, maintenance or use of motor vehicles subject to the financial responsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not each motor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in any territory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does not apply to injury to or death of the insured's employees while engaged in the course of their employment, or property transported by the insured, designated as cargo. It is understood and agreed that no condition, provision, stipulation, or limitation contained in the policy, this endorsement, or any other endorsement thereon, Environmental Restoration means restitution for the loss, damage, or destruction of natural resources arising out of the accidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measures taken to minimize or mitigate damage to human health, the natural environment, fish, shellfish and wildlife. Public Liability means liability for bodily injury, property damage, and environmental restoration. or violation thereof, shall relieve the company from liability or from the payment of any final judgment, within the limits of liability herein described, irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions, and limitations in the policy to which the endorsement is attached shall remain in full force and effect as binding between the insured and the company. The insured agrees to reimburse the company for any payment made by the company on account of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that the company would not have been obligated to make under the provisions of the policy except for the agreement contained in this endorsement. It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against the insured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction against the company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately to each accident and any payment under the policy because of anyone accident shall not operate to reduce the liability of the company for the payment of final judgments resulting from any other accident. FORM MCS-90 Page 3 of 4 ` .B•,,Q g Re EWEo oAD SY. s F W-Ww.a 2 VtU '"I Risk Management Malyrt FORM MCS-90 Revised 3/31/2020 OMB No.: 2126-0008 Expiration 3/31/2021 SCHEDULE OF LIMITS — PUBLIC LIABILITY Type of carriage Commodity transported January 1 1985 (1) For -hire (in interstate or foreign Property (nonhazardous) $750,000 commerce, with a gross vehicle weight rating of 10,000 or more pounds). (2) For -hire and Private (in Hazardous substances, as defined in 49 CFR 171.8, $5,000,000 interstate, foreign, or intrastate transported in cargo tanks, portable tanks, or hopper - commerce, with a gross type vehicles with capacities in excess of 3,500 water vehicle weight rating of 10,000 gallons; or in bulk Division 1.1, 1.2, and 1.3 materials, or more pounds). Division 2.3, Hazard Zone A, or Division 6.1, Packing Group I, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403. (3) For -hire and Private (in Oil listed in 49 CFR 172.101; hazardous waste, $1,000,000 interstate or foreign commerce, hazardous materials, and hazardous substances in any quantity; or in intrastate defined in 49 CFR 171.8 and listed in 49 CFR 172.101, commerce, in bulk only; with a but not mentioned in (2) above or (4) below. gross vehicle weight rating of 10,000 or more pounds). (4) For -hire and Private (In Any quantity of Division 1.1, 1.2, or 1.3 material; any $5,000,000 interstate or foreign commerce, quantity of a Division 2.3, Hazard Zone A, or Division with a gross vehicle weight 6.1, Packing Group I, Hazard Zone A material; or rating of less than 10,000 highway route controlled quantities of a Class 7 pounds). material as defined in 49 CFR 173.403 *The schedule of limits shown does not provide coverage. The limits shown in the schedule are for information purposes only. FORM MCS-90 Page 4 of 4 Z REVIE &APPR�ov/m By. G r 4M-6i , K Vj&44d Ruk Management Malyst NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Ocean Blue Environmental Services, Inc. Name: Project A-2021-198 Number: First Amendment To Agreement To Provide Spill Response, Project Hazardous Waste Disposal, And Storm Drain Facility Name: Maintenance Services 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 23-24 COI - City of Santa AUTOMOBILE LIABILITY BAP204073510 07/01/2024 06/27/2023 Ana - Biohazard crime scene.pdf 23-24 COI - City of Santa GENERAL LIABILITY GLP204073210 07/01/2024 06/27/2023 Ana - A-2021-097-01.pdf 23-24 COI - City of Santa PROFESSIONAL LIABILITY CPP204073910 07/01/2024 06/27/2023 Ana - Biohazard crime scene.pdf WORKERS COMPENSATION AND 23-24 COI - City of Santa WCA204073610 07/01/2024 06/27/2023 EMPLOYERS' LIABILITY Ana - A-2021-097-01.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 7/10/2023 1:16 PM