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INTER-PACIFIC
INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES D(p It ZoZz C: cNj I)Ai _ A-2022-025-01 CM AGREEMENT TO PROVIDE ON -CALL ELECTRICAL REPAIR AND Pyylj CaYwl4Vki6 (y fhgyl IxL)l,r REHABILITATION SERVICES THIS AGREEMENT is made and entered into this 15th day of February 2022 by and between Inter -Pacific, Inc., an Illinois corporation dba Inter -Pacific Systems, Inc. ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. On October 14, 2021, the City issued Request for Proposal No. 21-122, by which it sought a qualified contractor to provide on -call electrical repair and rehabilitations services for the City's Public Works Agency. B. Contractor submitted a responsive proposal that was among those selected by the City. Contractor represents that it is able and willing to provide the services described in the scope of work that was included in RFP 21-122. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contracting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES On an on -call basis, and at the City's sole discretion, Contractor shall perform the services described in the scope of work that was included in RFP No. 21-122, which is attached as Exhibit A and incorporated in full, and as further described in Contractor's Proposal, which is attached as Exhibit B and incorporated in full. 2. COMPENSATION a. City neither warrants nor guarantees any minimum or maximum compensation to Contractor under this Agreement. Contractor shall be paid only for actual services performed under this Agreement at the rates and charges identified in Exhibit B. Contractor is one of two (2) contractors selected to provide services on an on -call basis under RFP 21-122. The total compensation for services provided by all contractors selected under RFP No. 21-122, including any extension period, shall not exceed the shared aggregate amount of six million dollars and zero cents ($6,000,000). Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Page I of 10 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. 3. TERM This Agreement shall commence on February 15, 2022 and terminate on February 14, 2025, unless terminated earlier in accordance with Section 17, below. The term of this Agreement may be extended for one (1) two (2) year period upon a writing executed by the City Manager and City Attorney. 4. PREVAILING WAGES Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 5. INDEPENDENT CONTRACTOR Contractor shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship 'fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Contractor under this Agreement ("Documents & Data"). Contractor shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Contractor represents and warrants that Contractor has the legal right to license any and all Page 2 of 10 Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data which were provided to Contractor by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Minimum Scope and Limit of Insurance 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: ISO Form Number CA 00 01 covering any auto (Code 1), or if Contractor has no owned autos, hired, (Code 8) and non -owned autos (Code 9), with a limit no less than $1,000,000 per accident for bodily injury and property damage. 3. Workers' Compensation: as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. 4. If Contractor is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $2,000,000 per claim with $2,000,000 in the aggregate. If the Contractor maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. b. Other Insurance Provisions Additional Insured Status: The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connectionwith such Page 3 of 10 work or operations. General liability coverage can be provided in the form of an endorsement to the Contractor's insurance (at least as broad as ISO Form CG 20 10 11 85 or if notavailable, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 2037 if a later edition is used). 2. Primary Coverage: For any claims related to this contract, the Contractor's insurance coverage shall be primary coverage at least as broad as ISO CG 20 01 04 13 as respects the City, its officers, officials, employees, and volunteers. Any insurance or self- insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Contractor's insurance and shall not contribute with it. Notice of Cancellation: Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the City. 4. Waiver of Subrogation: Contractor hereby grants to City a waiver of any right to subrogation that any insurer of said Contractor may acquire against the City by virtue of the payment of any loss under such insurance. Contractor agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Self -Insured Retentions: Self -insured retentions must be declared to and approved by the City. The City may require theContraetor to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self -insured retention may be satisfied by either the named insured or City. 6. Acceptability of Insurers: Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City. 7. Claims Made Policies (applicable only to professional liability): i. The Retroactive Date must be shown, and must be before the date of the contract or the beginning of contract work. ii. Insurance must be maintained and evidence of insurance must be provided for at leastfive (5) years after completion of the contract of work. Page 4 of 10 iii. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a Retroactive Date prior to the contract effective date, the Contractor must purchase "extended reporting" coverage for a minimum of five (5) years after completion of work. 8. Verification of Coverage: Contractor shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage requiredby this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing allpolicy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. 9. Subcontractors: Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that City is an additional insured on insurance required from subcontractors. 10. Special Risks or Circumstances: City reserves the right to modify these requirements, including limits, based on the nature of therisk, prior experience, insurer, coverage, or other special circumstances. 8. INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Contractor or its subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 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 Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Page 5 of 10 Notwithstanding the foregoing, to the extent Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Contractor shall defend, indemnify and hold harmless the City, its officers, agents, representatives, and employees against any and all liability, including costs, and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright contained in the work product or documents provided by Contractor to the City pursuant to this Agreement. 10. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Contractor under this Agreement. It. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Page 6 of 10 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 City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, CA 92702 To Contractor: Inter -Pacific Systems, Inc. 1421 Edinger Ave., Unit A Tustin, CA 92780 Attn: Richard Kok, President rkukka,inter-nacific.com A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these timeframes, weekends, federal, state, County or City holidays shall be excluded. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. 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 Contractor. The parties agree that any terms or conditions of any purchase order or other instrument Page 7 of 10 that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Contractor or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 15. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services that are the subject to this Agreement performed by City personnel or by other contractors retained by City. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 17. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Contractor to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 18. NON-DISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply Page 8 of 10 with all applicable federal, state and local laws and regulations. 19. JURISDICTION -VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 20. PROFESSIONAL LICENSES Contractor shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 21. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA ais a y Gomez Kris me Ridge Clerk of the Council City Manager [signatures continued on next page] Page 9 of 10 APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By: randon Salvatierra Deputy City Attorney FOR APPROVAL ,;�Nabil Saba, PE Executive Director Public Works Agency INTER -PACIFIC SYSTEMS, INC. Name: Title: Page 10 of 10 EXHIBIT A CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES Appendix ATTACHMENT 1: SCOPE OF WORK City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 13 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES SCOPE OF WORK A. INTRODUCTION AND BACKGROUND The City of Santa Ana is located in the County of Orange in Southern California. The City encompasses 27.2 square miles and a population over 343,000 people. The City of Santa Ana Public Works Agency — Water Resources Division oversees and maintains the daily operations of the Water System and Sanitary Sewer System. The City of Santa Ana's water system is comprised of approximately 478 miles of water main, 45 MG of storage at five (5) sites, seven (7) MWD connections, 21 groundwater wells, seven (7) pump stations, four (4) pressure regulating stations and utilizes two (2) pressure zones. The City of Santa Ana Public Works Agency Water Resources Division is soliciting proposals from qualified industrial electrical firms to provide on -call electrical repair and rehabilitation services. The City intends to select and enter into agreements with up to three firms to provide the described services for an aggregate annual amount amongst all selected firms. B. CONTRACTOR RESPONSIBILITIES The City of Santa Ana invites proposals to establish multiple contracts with vendors for electrical maintenance, repair, and rehabilitation at the City's water and wastewater facilities. Qualified respondents will be expected to provide new electrical installations, as well as scheduled and unscheduled electrical maintenance and/or repairs on an "as needed" basis. The Contractor shall provide all labor, materials, services, and equipment necessary for the complete installation of electrical systems. All work shall be in accordance with applicable trade practices, workmanship, meet warranties and shall conform to all applicable laws, codes and regulations. Business hours are considered from 7:00 A.M. to 5:00 P.M. (Monday through Friday). Any time outside of business hours of operation may be considered after hours/weekends. All work will be scheduled upon confirmation of scope and cost and completed within the time agreed upon for each specific item of work. The Contractor may not begin work before receiving a written Notice to Proceed by the City's Project Manager. All services, equipment and materials provided by the Contractor must be in accordance with all applicable Federal, State and local regulations, laws, and codes such as the California Electric Code, California Building Code, and other applicable codes not listed. C. SCOPE OF SERVICES The Contractor shall provide all transportation, labor, materials and equipment necessary to repair, replace, and install existing and new electrical systems as required for the following types of facilities; Water Booster Stations, Sewer Lift Stations, Water Reservoir Sites, Pressure Control Stations, and Water Well Sites. The Contractor shall provide the following scope of services: City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 14 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 1. ELECTRICAL SERVICES The Contractor shall be able to perform, but are not limited to, the following electrical services: • Repair or replacement of motor control stations (up to 480 volts) • Repair or replacement of exterior wiring, interior wiring, conduit, solid state soft starters, variable -frequency drives (VFD), motor controls and motor control centers (MCC), switch gears, fuses, electrical circuit boxes, transformers, programmable logic controllers (PLCs), etc. • Trouble shooting of existing electrical wiring and appurtenances (electrical testing) • New installations of electrical wiring and appurtenances • Telecommunication installations • Instrumentation installations and fiber connections (not including programming) • Technical electrician support to City Staff as requested • Lighting installations • Electrical distribution and control equipment installations (underground distribution conduit, cables, and pull boxes) • Poles, pole foundations and concrete work installations and excavations • Excavations, backfilling and compaction for trenches and pull boxes • Branch circuit panels and wiring installations • Shop and record drawings, material submittals; and work schedules 2. PERFORMANCE TESTS When requested by the City and upon completion of electrical installation, the Contractor shall test and demonstrate that the system operates in accordance with the Drawings and Specifications. Performance tests shall include, but are not limited to, the following: Wire Testing; The Contractor shall perform insulation resistance tests on each complete circuit prior to energizing. Insulation resistance between the conductors and between the conductors and ground shall not be less than 25 megaohms. 2. Operation Testing: The Contractor shall test the operation of each control panel and associated interlocks to verify proper functionality and performance. 3. RECORD DRAWINGS The Contractor shall be capable of providing electrical plans marked with any changes, deviations or addition to any part of the electrical work. The Contractor shall clearly indicate on as -built plans the following information: 1. All conduits runs installed 2. Locations of underground conduits and stubouts accurately dimensioned 3. Forming, cabling, and identification of all power and control circuits within pull boxes and terminal box City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 15 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 4. All changes, deviations, in locations, routing, or dimensions or additions to any part of the electrical work 5. Interior views of each pull box identifying each conduit entrance by conduit number 4. TRAINING AND OPERATION MANUALS The Contractor shall offer training services and provide operation, maintenance and repair manuals consisting of all system drawings, block diagrams, schematics, shop drawings, and other pertinent data required to completely describe the operation and maintenance of the electrical system. The manuals shall be submitted prior to the final acceptance of the system and shall reflect the as -built conditions. The electrical system information in the operation and maintenance manuals shall contain: System operating instructions for normal operational conditions utilizing names of controls as they appear on nameplates 2. Calibration and maintenance instructions 3. Troubleshooting instructions 4. Instructions for ordering replacement parts 5. List of fuses, lamps, seals, and other expendable equipment and devices 6. Parts list including the make, model, and manufacturer of the equipment listed 5. EMERGENCY ON -CALL SERVICES The Contractor shall be able to provide emergency on -call electrical maintenance and repair services within four (4) hours of receiving the call. The Contractor's service technician is required to be on site and commence work within four (4) hours of initial contact if deemed by the City to be an emergency. The response time may be waived by the City if service can wait to be performed during Contractor's normal business hours. D. CODE COMPLIANCE All materials and workmanship shall be in strict conformity with standards of the latest editions including revisions of the following: • Institute of Electrical and Electronics Engineers (IEEE) • National Electrical Manufacturers Association (NEMA) • International Electrotechnical Commission (IEC) • National Electrical Code (NEC) standards • National Fire Protection Agency (NFPA) • American National Standards Institute (ANSI) • American Society of Testing and Materials (ASTM) • Insulated Cable Engineers Association (ICEA) • International Electrical Testing Association (NETA) City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 16 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES • National Electrical Contractors Association (NECA) • State Department of Industrial Safety (CAL/OSHA) • Underwriters' Laboratories (UL) • California Building Code (CNC) E. PROJECT MANAGEMENT AND COORDINATION When a request for service is issued by the City, the Contractor shall issue a project estimate and schedule to the City's designated Project Manager. The Contractor shall not proceed with any work without the approval in the form of a notice to proceed from the City's designated project manager. Contractors shall invoice the City on a monthly basis for all work performed during the period or provide a one-time invoice at the completion of work issued. Each invoice shall be accompanied by a summary of tasks performed, contract agreement number, results and progress on long-term tasks if any. F. VALUE ADDED RELATED SERVICES The Contractor may propose additional related services that the City has not specifically identified in this RFP to accomplish the stated goals of this RFP. Value added related services will be considered by the City and may or may not be incorporated in the agreement. All parts and materials must be supplied new and factory approved. G. SUBCONTRACTORS The use of Subcontractors is allowed, but will require approval by City prior to start of any assigned work. Upon commencement of work, the Contractor shall be responsible for services provided by any subcontractor as if Contractor were providing the services with its own organization. When a Subcontractor performs all or any part of the work, a markup shall be applied to the Subcontractors actual cost of such work. The Contractor may add a markup of 10 percent on the first $5,000 of the subcontracted portion of the extra work and a markup of 5 percent on work added in excess of $5,000 of the subcontracted portion of the work may be added by the Contractor. The following markup percentages shall be added to the Contractor's costs and shall constitute the markup for all overhead and profits (to the sum of the costs and markups, one (1) percent shall be added as compensation for bonding): 1) Labor................................................................................................20 2) Materials...........................................................................................15 3) Equipment Rental............................................................................. 15 4) Other Items and Expenditures.......................................................... 15 I. MINIMUM QUALIFICATIONS C;iy of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 17 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES The Contractor shall meet the following minimum qualifications: All work is to be performed in compliance with all applicable codes, ordinances, laws, standards, due care, and Occupational Safety and Health Administration (OSHA) safety requirements. The Contractor shall hold a current California C-10 Electrical Contractors License. The Contractor shall have a minimum of five (5) years of experience in providing industrial control panel building services. The Contractor shall possess state and local permits, licenses and certificates required by law to commence, carry, and complete the work. Provide all necessary equipment to competently perform and complete work as specified. J. SAFETY Proposer shall be solely and completely responsible for the condition of the project site, including safety of all persons and properties during the performance of the work. In addition, proper safety equipment must be worn at all times. These requirements shall apply continuously until the contract is terminated and shall not be limited to normal working hours. The Contractor/Consultant shall assure that each employee or subcontractor under the contractor's supervision is trained in the work practices necessary to safely perform his or her job. K. INSURANCE REQUIREMENTS The successful bidders shall furnish the City with original copies of valid insurance policies herein required upon execution of the contract and shall maintain said policies in full force and effect at all times during the term of this contract. Said insurance policies shall comply with all requirements set forth in these specifications. Contractor(s) shall keep a current certificate of insurance at the City of Santa Ana at all times and shall immediately report any changes to the City. L. FEE SCHEDULE Contractor shall submit a fee schedule as described in Section IV.B.3 of RFP. The Well 32 Reservoir Rehabilitation Plans provided as Exhibit A and the General Specifications in Exhibit B are to be used as the basis for completing the Fee Schedule form and any other documents requested below (assume all system integration programming will be provided by the City). Upon award of a contract, work will proceed as authorized by the City, but may not necessarily be the project as described in Fee Proposal (inclusive of Exhibit A and Exhibit B). No separately stated freight or deliveries will be considered. Bidders shall include all costs in the unit price bid. Furthermore, the Contractor shall submit additional labor, material and rental equipment rates along with fee schedule. Contractor's labor and equipment rate sheet shall list rates for all City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 18 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES labor designations, equipment, rentals, and materials. The bid items specified in the fee schedule are for reference purposes only. Labor increases shall be subject to mutually agreeable terms between the City and the Contractor. The City may request related services that will be paid at the vendor's standard labor and equipment rate submitted. Fee proposal shall be outlined as follows: ---End of SCOPE OF WORK Section --- City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 19 EXHIBIT B 19 Inter -Pacific Bid for: RFP No.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES CITY OF SANTA ANA PUBLIC WORKS AGENCY 22 S. Daisy Avenue, Bldg A Santa Ana, CA 92703 Attn: Armando Fernandez, P.E. Bid Deadline: November 16, 2021 4:OOPM PDT 9 Inter -Pacific Inter -Pacific, Inc. 1421 Edinger Ave Unit A Tustin, CA 92780 C-7, C-10 License #917831 Enoch Kang Project Engineer 949-529-5977 x204 ekang@inter-pacific.com Richard Kuk President 949-529-5977 x107 rkuk@inter-pacific.com Central Office 1278 Barclay Blvd Buffalo Grove, IL 60089 FEIN 20-0514362 GSA Contract GS-07F-5611 P Cage Code 3A4G3 DUNS #083763834 SEALED BID — CONFIDENTIAL — DO NOT OPEN UNTIL BID OPENING 1�Pa2c 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 www.inter-Pacific.com IN Inter -Pacific November 16, 2021 To: City of Santa Ana Public Works Agency 220 S. Daisy Avenue, Bldg A Santa Ana, CA 92703 Attn: Armando Fernandez: We [Inter -Pacific] are herein submitting our response to the Santa Ana On -Call Electrical Services Request For Proposal. We confirm that all elements of the RFP have been considered and that we are qualified and capable of performing all work that has been proposed. In addition, we are willing to enter a contract under the terms and conditions prescribed by this RFP. Inter -Pacific is a nationwide integrator of video surveillance, networking, and AV products with offices near Chicago since 2002 and in Tustin, CA since 2014. Inter -Pacific provides complete System Integration services including design and engineering for the Federal, State, and Municipal government agencies. You will find that our experience includes work on projects of similar or greater scope providing quality, value, and service that meets and exceeds expectations. Our employees and staff have the necessary knowledge and experience to complete minor electrical maintenance to major electrical upgrades. show a great deal of commitment towards the work of our clients. Inter -Pacific is a Veteran owned, SBA certified 8(a) Disadvantaged Minority Enterprise. We strongly hope that our bid will be considered positively. We look forward to working with you. Enoch Kang, Project Engineer Richard Kok, Project Manager / President 21Page 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 www.inter-Pacific.com N Inter -Pacific 77 au' Table of Contents 1. Title Page 2. Letter of Interest 3. Table of Contents 4. Executive Summary i. Company Profile 6. Previous Relevant Projects 7. Corporate Hierarchy and Key Personnel 8. Cost Proposal 9. Required Forms and Documents 31Pa�_� 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 www.inter-Pacific.com M Inter -Pacific 4. Executive Summary Inter -Pacific understands that The City of Santa Ana is seeking proposals from firms that would be able and willing to offer On -Call electrical services for the Well 32 and Chemical Building sites. We propose that our services will meet or exceed all expectations outlined in the RFP. We have professionally designed and installed large-scale electrical solutions for nearly twenty years. We have successfully completed electrical upgrades for colleges, school districts, and several other city public works projects. Inter -Pacific offers "one -stop" solutions for conduit installation, wiring pulling, and start up/testing of various types of generators. Our dedicated engineers and installers stand ready to ensure City of Santa Ana expectations and requirements are met. We have reviewed all additional drawings for the site and VFD specifications and are pleased to provide a total bid of$770,573.20 thanks to outstanding relationships we have with our conduit and wiring suppliers. If you have any questions about our proposal, please reach out to me at (949) 529-5977. Respectfully, A6w.x� Richard Kuk President 41Paee 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 www.inter-Pacificxom 5. Company Profile Inter -Pacific is a nationwide integrator of video surveillance, networking, and AV products with offices near Chicago since 2002 and in Tustin CA since 2014. Inter -Pacific provides complete System Integration services including design and engineering for the Federal, State, and Municipal government agencies. You will find that our experience ("Experience and References") includes work on projects of similar or greater scope. Inter -Pacific is a Veteran owned, SBA certified 8(a) Disadvantaged Minority Enterprise. Services available and/or provided by Inter -Pacific, Inc: o Full CCTV/ Video Surveillance design, integration and installation o Lighting Upgrades o UPS and Generator Installation and Maintenance o Structured Cabling and Network Installation o Fiber Optic cabling, Connection and Switching o Wireless Integration o Control Room and Public Address systems o Access Control and Communication o Trenching and Boring Inter -Pacific is an Authorized Solution Provider for: • Axis Communications Vivotek • Genetec Firetide • Pelco ExacgVision • Bosch Milestone • Cisco OnSSi • Hanwha Techwin (Samsung) Geovision • Sony Inter-Pacific's competitive advantage over other A/E firms is our relationship with numerous manufacturers and experience of completing many Design to Build projects. We have handled all phases of complex video surveillance projects to ensure the system's design and features meet the needs of the end users. Inter -Pacific shall collaborate with District, District advisors, and local agencies as necessary to capture existing conditions, develop an installation plan and complete the turnkey system. Insurance and Bonding: Inter -Pacific, Inc. is fully insured and bonded. Limits include $1 million per occurrence, $2 million general aggregate. Certificate of Liability Insurance can be provided. Additional information can be found on the website at www.inter-pacific.com. S�Page 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 www.inter-Pacitic.com 9 Inter -Pacific 6. Previous Relevant Projects Saddleback College — IT IDF Room ePower Project Installation of new underground wiring and conduit, electrical panels, transformers, receptacles, access panels, thermostats, junction boxes, submersible electrical vaults, and steel cable troughs. Contact: Louis Sessler, (949) 582-4947, Isessler@saddleback.edu Location: 28000 Marguerite Parkway, Mission Viejo, CA 92692 Original Value: $399,000.00 (including $42,000.00 allowance) Total Value: $377,557.07 Period of Performance: January 27, 2020 —July 7, 2020 City of Pico Rivera - Electrical Panel Replacement at Plant No. 2 Capital Improvement Project No. 21297 Electrical power upgrade for Water Plant. Installed new transformer, replaced new Main Switch Board (MSB) and Motor Control Center (MCC). New electrical feed from SoCal Edison with trenching and new concrete pads. Contact: Gabriel Gomez, (714) 732-0398, gabriel.gomez@libertyutilities.com Location: 8316 Washington Blvd, Pico Rivera, CA 90660 Original Value: $325,000.00 Total Value: $334,689.21(addition of cam locks on MSB, grounding rod and well) Completion: August 2017 — February 2018 City of Santa Ana - Lighting Upgrade, Structured Cabling, & Camera Systems LED Lighting upgrade of all City Water Plants, including installing light poles and Camera Systems. Personnel involved: Evan Kao, Project Engineer, Ben Hurtado, Primary Electrician Contact: Cesar Barrera, 714-673-3408, cbarrera@santa-ana.org Location: Water Resources Division, Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701 Original Value: $136,480 Total Value: $160,560 Period of Performance: September 2017 — March 2019 City of Santa Ana — City Yard Electrical and Communication Upgrade. Ran conduit and installed 85 Cosa Private Network, 9 SCADA, and 3 PLC drops from TR room and Server room electrical panels to 1st floor Control room and 2nd floor open area. New junction boxes and face plates to accommodate all new drop locations. Contact: Miguel Renteria, 714-586-6294, mrenteria@santa-ana.org Location: Santa Ana City Yard 220 S. Daisy Ave, Santa Ana, CA 92703 Original Value: $80,191.45 Total Value: $114,559.25 Period of Performance: May 2021 Kern County Superintendent of Schools - WAN Fiber Network Installation of new WAN fiber network connecting 3 schools within Kern County Unified School District. Provided boring and placement of manholes and conduit over 2 miles to provide high speed network connectivity. Provide pathways, fiber terminations, single mode fiber optic patch cables, and cabinets. Contact: Jenny Hannah, (661) 636-4000 Location: 1300 17th St, Bakersfield, CA 93301 Original Value: $178,532 . Total Value: $178,532 Period of Performance: March 2017 Additional references available upon request "�, .INAW 6 1 P a v e 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 www.inter-Pacific.com N Inter -Pacific 7. Corporate Hierarchy and Key Personnel Inter -Pacific will assign three key personnel to complete the project. All assigned employees shall be professionally qualified for the roles which they shall perform. Assigned staff are local (Tustin, CA), licensed, and will be available throughout the lifespan of the project. Richard Kuk — President, Project Manager (POC) Experience Sprint/Nextel Communications — Engineering Manager supervisor to 14 Engineers maintaining the Wisconsin, Indiana, Illinois network. Worked with Motorola to implement all new technologies. USAF Captain — Defense Contract Management Command (DCMC) Program Manager for Sundstrand Aerospace overseeing team of Contracting, Engineers, QA and Finance personnel. USAF Procurement Officer for Columbus AFB, MS Defense Acquisition Professional Level II Certified - DePaul University, MBA - USAF Academy, Bachelor of Science Job Duties - Primary POC to Customer - Lead Project Manager and Designer of Control Room Systems - Develop Master Project Plan - Review Drawings and SOW - Evaluate cost and progress of contractors Benjamin Hurtado — Electrician Experience - CA Journeyman License 4154219 ABC Apprenticeship 4.5-year program Electrician Supervisor —Oregon National Guard, Electrical Heating upgrade for warehouse Specialist in lighting and control system Enoch Kang— Project Engineer (POC) Experience - University of California, Irvine, Bachelor of Arts Job Duties - Prepare project proposals - Create project drawings - Design and implementation of daily deliverables - Supervise contractors - Develop training and user documents (as needed) - Perform site surveys - Plan and schedule timelines and project milestones 7 1 P a g e 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 www.lnter-Pacificxom M Inter -Pacific 8. 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Required Forms and Documents (please see attachments as per project documents required) 9 1 P a g e 1421 Edinger Ave, Unit A (949) 529-5977 Tustin, CA 92780 ww .Inter-Pacific.com CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES APPENDIX ATTACHMENT 2: FEE PROPOSAL Certification - I certify that I have read, understand and agree to the terms and conditions of this Request for Proposal. I have examined the ATTACHMENT 1: SCOPE OF WORK. 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. Proposer shall submit hourly rates schedule, which shall include but not limited to, direct and indirect costs for labor, for staff per job classification, material, equipment rates, 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. Prior to commencement of services, Contractor shall provide separate quotes, upon request by the City, which shall be approved by the City's Public Works Water Resources Division. FEE SCHEDULE The undersigned declares that he/she has carefully examined the request for proposal, that he/she has examined the Proposed Scope of Services, and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said Proposed Scope of Services, for the unit price(s) set forth in the following schedule: Note: This contract is subject to prevailing wages. TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: Inter -Pacific, Inc. Item # Bid Item Unit Quantity Amount Well 32 Electrical Rehabilitation 1. Electrical Conduit LS 1 $ 20,000.00 2. Building and Site Electrical System LS 1 $ 20,000.00 3. VFD Motor Control Center LS 1 $ 105,000.00 4. Automatic Transfer Switch LS 1 $ 10,000.00 5. Instrumentation and Control Equipment LS 1 $ 20,000.00 Building Lighting LS 1 $10,000.00 EpElectrical Equipment and Facilities Chemical Building) LS 1 $ 196,000.00 City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 20 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 8 Instrumentation and Control Equipment Chemical Building) LS 1 $ 20,000.00 9. Building Lighting (Chemical Building) LS 1 $ 10,000.00 10. Fiber Optics Conduits (Y Conduits) LF 3,900 $ 235,573.20 11. Fiber Optic Pull Box EA 8 $73,500.00 12. Mobilization/Demobilization LS 1 $ 15,000.00 13. Commissioning and Training EA 1 $40.500.00 14. As Built Plans, O&M Manuals and Warranties LS 1 $3,000.00 Total $ 778,573.20 Contractor shall submit additional labor, material and rental equipment rates along with fee schedule. Contractor's labor and equipment rate sheet shall list rates for all labor designations, equipment and materials. 'PLEASE SEE ATTACHED SPREAD SHEET BIDDER INFORMATION: Legal Company Name: Inter -Pacific, Inc. Complete address: 1421 Edinger Ave Unit A, Tustin, CA 92780 Phone Number: 949-529-5977 ext. 204 Email Address: ekang@inter-pacific.com Authorized Signature: /, /1— Name: Enoch Kang Title: Project Engineer City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 21 APPENDIX CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES ATTACHMENT 3: PROPOSER'S REFERENCES 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 Saddleback College Customer Name: IT IDF Room ePower Project Contact Individual: Louis Sessler Address: 28000 Marguerite Parkway, Mission Viejo, phone Number: (949) 582-4947 Contract Amount: $377,557.07 Description of supplies, equipment, or services provided: Installation of new underaround wirina and conduit. Facsimile Number: Isessler@saddleback,edu Year: January 27, 2020 — July 7, 2020 Reference City of Pico Rivera - Electrical Panel Replacement at Plant No. 2 Gabriel Gomez Customer Name: Contact Individual: Address: 8316 Washington Boulevard, Pico Rivera, CA 9131561) Contract Amount: $334,689.21 of supplies, equipment, or services provided: E Reference City of Santa Ana - Lighting Upgrade Structured Cabling, & Camera Systems Customer Name: Phone Number: 714-732-0398 Facsimile Number: 9abriel.gomez@libertyutilities.com Year: August 2017 — February 2018 Contact Individual: Cesar Barrera Address: Water Resources Division, Santa Ana, �iO/`�a Number: 714-673-3408 Civic center Plaza, an a Ana CA 1 Facsimile Number: cbarrera@santa-ana.org Contract Amount: $160,560.00 Description of supplies, equipment, or services provided: Year: September 2017 — March 2019 City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 22 Reference Customer CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES City of Santa Ana — City Yard Electrical and Communication Upgrade Contact Individual: Miguel Renteria Address: Santa Ana City Yard 220 S. Daisy Ave,Phone Number: Santa Ana, CA 9270— Contract Amount: $114,559.25 Description of supplies, equipment, or services provided: Facsimile Number: Year: May 2021 714-586-6294 mrenteria 0 santa-a na.org THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 23 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES Appendix ATTACHMENT 4: STANDARD AGREEMENT City of Santa Ana ::FP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 24 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES CONSULTANT AGREEMENT CITY OF SANTA ANA THIS AGREEMENT is made and entered into this 16 day of November , 2021 by and between Inter -Pacific, 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. The City desires to retain a Consultant having special skill and knowledge in electrical repair and rehabilitation services. B. Consultant represents that Consultant is able and willing to provide such services to the City. 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 a. Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in Scope of Services - Exhibit A, attached hereto and incorporated by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in Compensation - Exhibit B. The total amount to be expended under this Agreement shall not exceed $XXX,XXX during the term of this Agreement, including any extension periods exercised under Section 3. 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. 3. TERM This Agreement shall commence on the date first written above for a number (3) year -term City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 25 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES with the option for the City to grant up to a one two (2)-year renewal, exercisable by a writing by the City Manager and the City Attorney, unless terminated earlier in accordance with Section 17. below. 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 subcontractors to agree in writing that City is granted a non- exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. 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 Contractor by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 7. INSURANCE City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 26 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, 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. Workers' Compensation Insurance. In accordance with the California Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for workers' 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 furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be cancelled or reduced in coverage or changed in any other material aspect, by Consultant, without thirty (30) days prior written notice to the City. (iv) Consultant shall supply City with a fully executed additional insured endorsement. 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, City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 27 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 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) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the 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 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 City of Santa,Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 28 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 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 Marl TTIRMIRTN Executive Director, Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, CA 92702 To Consultant: City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 29 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES Consultant's Firm Name Inter -Pacific, Inc. Address 1421 Edinger Ave CityState, Zip Code Unit A p Tustin, CA 92780 Attn: Enoch Kang 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 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. City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 30 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 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. 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. City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 31 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES b. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. signatures follow on next page City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 32 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Daisy Gomez Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney M John M.Funk Senior Assistant City Attorney RECOMMENDED FOR APPROVAL Nabil Saba, P.E. Executive Director Public Works Agency CITY OF SANTA ANA Kristine Ridge City Manager CONSULTANT Inter -Pacific, Inc. Name: Richard Kuk Title: President APPENDIX ATTACHMENT 5: CERTIFICATIONS City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 33 CITY OF SANTA ANA RFP NO.. 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 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 State of California County of 0 rat3� �1 Subscribed and sworn to (or affirmed) before me on this U day of �OV' , 207�- , by _R(0\ynJl/�[I,L=proved to me on the basis of satisfactory evidence to be the person(s) Who appeared before me Notary Public Signature Notary Public Seal KATNBEEN KUK comm. #2221981 z i. Notary Public - California o ' 1 4 Orange County `}' _My Comm. Expires Nov. 16, 2021r City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 34 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 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: Title: President Firm: Inter -Pacific, Inc. Date: 11 /16/2021 City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 35 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 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. City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 36 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES 7. 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. 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: Title: President Firm: Inter -Pacific, Inc. Date: 11 /16/2021 City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 37 CITY OF SANTA ANA RFP NO.: 21-122 ON -CALL ELECTRICAL REPAIR AND REHABILITATION SERVICES ***END OF RPF 21-122** City of Santa Ana RFP 21-122 On -Call Electrical Repair and Rehabilitation Services Page 38 Francine R. D,„nly,gn�ayr,mrnee. Real �1 INTER-2 °11°'C°' D011201202YY) ovzo/zozz 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 endorsements . PRODUCER 916-773-3800 ISUFrancis-Pinneylns soca 2266 Lava Ridge Court Roseville, CA95661 Eric Moore cxME?DT ISU Francis -Pinney Ins. Svrs PHONE 916-773-3800 FAX 916-773�484 Arc,No, EXt : AIC, No): ADORE,,. certificates@isuors.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Security National Insurance Co 19879 INSURED Inter -Pacific Inc. 1421 Ave, Suite INSURER B: West American Insurance Co. Ohio Security Ins. Co INSURER C: y INSURER D : American Fire & Casualty Co. Tustin, CA 92760 A92 INSURER E NSURER F: COVFRAGFS CFRTIFICATF NIIMRFR• 01=111cinki Mnllanco. 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 IXEL TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY E%P LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE LX] OCCUR X BKW56144681 09/08/2021 09108/2022 EACH OCCURRENCE 11000,000 DAMAGE TO RENTED PREMISES Ea occumence) $ 500,000 MED EXP (Any one arson 15,00D PERSONAL &AOV INJURY 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑jEa LOG GENERA -AGGREGATE 1 2,000,000 GEN'L X PRODUCTS - COMP/OP AGO 21000,000 OTHER C AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident)X $ 1,000,000 BODILY INJURY Perperson) ANY AUTD X BAS62698905 01/29/2022 01/29/2023 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident PROPERTY DAMAGE Peraccidenl $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY D UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 41000,000 X EXCESS LIAR CLAIMS -MADE ESA56144681 09/08/2021 09/0812022 AGGREGATE 41000,000 DIED RETENTION$ S 1 A WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY yyVV �/llNNNNI ANY PROPRIETOWPARTNER/EXECUTIVE u OFF[CEMMEMBE) EXCLUDED? u If yes, describe under DESCRIPTION OF OPERATIONS below NIA X SWC1342257 06/0912021 06/0912022 1C I RPE�RTUTF OTH- EL. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYE 1,6DU,DU9 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 30 day prior written notice of cancellation. 10 day notice for non payment of premium. The City of Santa Ana, its officers, officials, employees and volunteers are included as additional insured on the General Liability per attached endorsement form. Commercial Auto is named as additional insured City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 ACORD 25 (2016103) SANTAII SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE "-"L A_7 Risk MoragMtmEDivf®IaL agei REVIEWED&APPROVED BY: ©1988-2015 ACORD C 83Mi:111f1L' �nEar,�.re R. The ACORD name and logo are registered marks of ACORD I I'" -� -' Risk Managemem AnRy,t NOTEPAD: HOLDER CODE SANTA11 INTER-2 PAGE INSURED'S NAME Inter -Pacific Inc. OP ID: LM Date 01/20/2022 per attached endorsement form. Workers Compensation waiver of subrogation per attached endorsement form, when required by written contract. ,.,_ REVIEWED&APPRW Br. P'. �neal� Risk Management Analyst COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 3 ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi RiAMUM90nadDtvuiwt ,n REmEwED&AP'PIcvao By., [ r �ILiYNh[ z V14u'.1 Ruk Management Malyst ' With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other s valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52feet long; and N (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (1) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Insurance. © 2013 Liberty Mutual Insurance�Il��"� CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi � arc Managenwnl Analyst It. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection Sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph t.b. is replaced by the fallowing: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of written agreement; or I I rsmkMaugrmmeoa� REmEwED 6/Vazov By., "�.4�uit1111iJ�� f�.rr•r^.+•a 2. V;Pks�:a� 90W Ruk AAanngenrent Nialyll or b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. 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 insur- ance 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. With respect to Paragraph 1.e. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) 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 (2) 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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.e. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. Risk MwagemadUlMsiun REvtEWEn&APPROVED Sr © 2013 Liberty Mutual Insurance � . f4xw,'� Z Wtv.4d CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permissi, Risk Management Analyst -:° 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing 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; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) 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 (2) 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. 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: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION s This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. g RielrMV0gernMLDiMbDn ((RE EWEo& AP'PIRQBy. /�V[(m I. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi —� Risk Management nnalyu b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. s — 7. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; e b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until „ we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d))does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supery - ees" of yours. However, none of these "employees" are insureds for "bodily i wdrMaugemmtohieion 1; REV ID&M pPPROV®eY: © 2013 Liberty Mutual Insurance ; fna'✓Lat �' �` CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi _- t advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause 'bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to 'bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or .,employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. 'Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. RtdeMaagemaeDMdon Revie[ &APPROVED Sr. 7t © 2013 Liberty Mutual Insurance F,.>u R. V` A,,,d CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi �� Risk Management Analyst P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to 'bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. _ Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the 'products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. _ Risknougattedl)MItnn y3j rR�EmE &APPRov®8r 2013 Liberty Mutual Insurance `,, CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permissi - ftkmanagement Analyst CNA 04 01 06 18 CALIFORNIA ADVISORY NOTICE TO POLICYHOLDERS COMMERCIAL AUTO FORMS REVISIONS Dear Valued Policyholder, Thank you for selecting us as your carrier for your commercial insurance. We are in the process of im- plementing policy administration system improvements. As a result, we are replacing certain coverage forms and endorsements with other forms, which will result in changes to your coverage. This notice contains a brief summary of coverage changes organized by individual endorsement. Please note that not all of the endorsements indicated may apply to your specific policy. In addition, this notice does not reference every editorial change made to the endorsement or coverage form; it only reflects significant coverage changes. Please read your policy and review your Declarations page for complete coverage information. No coverage is provided by this notice, nor can it be construed to replace any provisions of your policy. If there are discrepancies between your policy and this notice, the provisions of the policy shall prevail. These changes shall become effective as of the effective date of your replacement policy. Please note that this notice does not apply to you or your policy in the event you have received, or do receive, a notice of cancellation or nonrenewal. Should you have questions after reviewing the changes below, please contact your independent agent. Thank you for your business. Expiring Form Expiring Form Number New Form New Form Number Auto Plus Endorsement CA 71 10 03 07 California Business Auto AC 85 43 06 18 Coverage Enhancement Endorsement Safeco Optimum CA 72 42 12 08 Package Waiver of Collision CA 71 20 05 98 Deductible AC 85 43 06 18 - California Business Auto Coverage Enhancement Endorsement If your policy previously included CA 71 10 03 07 - Auto Plus Endorsement, this endorsement has been replaced by the AC 85 43 06 18 - California Business Auto Coverage Enhancement Endorsement. In some cases, the limits previously provided are being increased and several additional provisions and reductions are included. The summary below provides a brief description of these changes. BROADENING IN COVERAGE Supplementary Payments The limit for bail bonds has been increased from $2,000 in the Business Auto Coverage Form to $3,000 in the new California Business Auto Coverage Enhancement Endorsement (AC 85 43 06 18). The limit for reasonable expenses incurred by you at our request have been increased from $250 per day to $500 per day. • Employees as Insureds Coverage is being expanded to include as insureds, your employees while operating an auto hired or borrowed under a written contract or agreement in that employee's name with your permission and in your business. This coverage is excess over any other insurance available to the employee. Waiver of Subrogation The policy is amended to provide that subrogation rights are now waived for any person or or- ganization that has waived those rights, in a written contract or written agreement, prior to an accident or loss. Lp.-RiRokMarugarta dDiAslart EMEWM&APPeov®sr:2018 Liberty Mutual InsuranceCNA 04 01 06 18 Includes copyrighted material of InsuranceServices Office, Inc.,with its permissiauk nlanagenren[Anary:c • Hired Autos Physical damage coverage is extended to autos your employee hires or rents under a written contract or agreement in that employee's name but only if the damage occurs in the conduct of your business. The deductible will be the largest deductible applicable to any owned auto. Towing or Labor This new coverage applies: Private passenger autos - $75 per disablement; Light trucks (Gross Vehicle Weight) 10,000 lbs. or less - $75 per disablement; and Medium trucks (Gross Vehicle Weight) 10,001 to 20,000 lbs. - $150 per disablement. Rental Reimbursement Coverage has been expanded from $50 per day to $75 per day for rental expenses incurred by you for the rental of an auto. We will also pay $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered auto. Audio, Visual and Data Electronic Equipment Coverage The sublimit has been eliminated. Coverage is now provided at the lesser of the actual cash value or the cost to repair or replace. It is, however, subject to an adjustment for depreciation and physical condition. • Loan/Lease Gap Coverage The sublimit has been eliminated. Coverage is now provided for the total loss to a covered auto in any one accident limited to the greater of the balance due (subject to certain limitations) on the loan or lease or the actual cash value of the damaged or stolen property at the time of loss. Parked Auto Collision Coverage (Waiver of Deductible) If an owned private passenger type or light truck is legally parked and unoccupied, and is struck by another vehicle, your collision deductible will not apply. This coverage does not apply to any loss if the covered auto is in the charge of any person or organization engaged in the automobile busi- ness. • Two or More Deductibles Under Physical Damage Coverages, if two are more Liberty Mutual Insurance Company policies or coverage forms apply to the same accident, the smallest deductible will be waived or if this policy is not the smallest deductible, the deductible under this policy will be reduced by the smaller deductible. Hired Auto Physical Damage Coverage Territory The coverage territory for all Hired Autos is changed to anywhere in the world. Additionally , the coverage is excess over other collectible insurance. Bodily Injury Redefined Bodily injury has been redefined to include mental injury, shock or fright. • Personal Effects Coverage The limit is increased from $500 to $600 for "personal effects." Physical Damage Deductible -Vehicle Tracking System Any comprehensive deductible will be reduced by 50% for a theft 'loss" in which a vehicle tracking device was used as the method to recover the vehicle. Primary and Non -Contributing if Required by Written Contract or Written Agreement If an insured agrees to be primary and non-contributing in a written contract we will be primary and without right of contribution. IN COVERAGE Blanket Additional Insured The designated person or organization is included as an insured for the operation, maintenance or use of a covered auto. Coverage for bodily injury or property damage applies if the accident occurs after the contract, agreement or permit is issued and applies for the duration of the contract, permit or agreement. 0 2018 Liberty Mutual Insurance CNA 04 01 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permissi IN RwkMuaganmLDMsian gi RE no � & APPROVED Sr. F44�c.,.r iZ. vs"At Rak Management Analyst Amended Fellow Employee Exclusion This coverage now requires you have workers compensation in force for all your employees in order for coverage to apply. Additionally, the coverage is now excess over any other collectible insurance (i.e. the employee's personal auto policy). If there is no coverage, other than workers compensation, available, this coverage will be primary. Audio, Visual and Data Electronic Equipment Coverage Changes in format to make the coverage easier to read. • Accidental Airbag Deployment This insurance is excess over any other collectible insurance or reimbursement from a manufac- turer's warranty. However, we will pay any deductible applicable to that other coverage or war- ranty. REDUCTION IN COVERAGE Extra Expense - Broadened Coverage = The amount we pay to return your stolen covered auto to you is $1000. This may be considered a reduction in your limit. Personal Effects Coverage This coverage applies to personal effects up to $600 stolen with your covered auto and is excess over any other collectible insurance. Personal effects are defined as tangible property that is worn or carried by an insured. Personal effects do not include tools, equipment, jewelry, money or securities. New Vehicle Replacement Cost New Vehicle purchase price cost is not included as part of your new policy. • Newly Formed or Acquired Subsidiaries This coverage now includes limited liability company's (LLC's) which represents a broadening in language. However, coverage is now limited to only newly acquired or formed entities for a period of ninety (90) days after formation. When the insured purchases or forms a new entity, the entity should be disclosed to Liberty Mutual within ninety (90) days. • Additional Insured by Contract, Agreement or Permit The coverage now specifies that a written contract or written agreement must be in place for additional insured status to be granted. It also requires the insured to submit a claim to the addi- tional insured's insurer if the insured has not agreed in writing to be primary and non-contributing. • Waiver of Transfer of Rights of Recovery Against Others to Us This coverage now requires the insured to have expressly waived the right to subrogation in a written contract or written agreement. • Extended Cancellation Condition The extended cancellation condition is being removed - Please contact your agent for information on adding this condition on your policy. m Broad Form Insured This coverage is now limited to newly acquired or formed entities, other than partnerships or join ventures, for a period of 90 days after acquisition or formation. CA 72 42 12 08 - Safeco Optimum Package If your policy previously included this endorsement, the following coverages will no longer be provided: Diminishing Deductible; Waiver of Adjustment for Depreciation; • Emergency Expenses; and Electronic Lock and Key Replacement. The following coverage can be included if requested. Contact your agent for additional information. Original Equipment and Manufactured Parts CA 71 20 05 98 - Waiver of Collision Deductible This endorsement is being discontinued. If you do not have AC 85 43 06 18 - California Business Auto Coverage Enhancement Endorsement on your policy, you will have a collision deductible regardless of the type of vehicle or if the other "auto" involved in the collision is insured by Safeco IN America or any of its affiliated companies. R1a1Mwc9emmLDMsiun =i Renenso & APPROWD Br. © 2018 Liberty Mutual Insurance 9 f•�,� (�, (/( CNA 04 01 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permissi RMW. Ruk Manager ni Poiaryet WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Any person or organization as required by written contract 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 6/9/2021 Policy No. SWC1342257 Insured Inter -Pacific, Inc Insurance Company Security National Insurance Company Endorsement No. 0 Premium $ 21,239 Countersigned by Rbli MmgemmtUitislon Ww9,t- REVI EWED&APPRov®6Y:WC 00 03 13Risk Management Analyst Coverage Is Provided In: Liberty American Fire and Casualty Company - a stock company Mutual. INSURANCE Excess Liability Policy Declarations Basis: Occurrence 11 NAMED INSURED & MAILING ADDRESS INTER -PACIFIC INC. INTER -PACIFIC SYSTEMS, INC. 1421 Edinger Ave Ste A Tustin, CA 92780 Named Insured Is: CORPORATION Policy Number: ESA (22) 5614 46 81 AGENT MAILING ADDRESS & PHONE NO. (415) 788-9810 ISU INS SVCS OF SAN FRANCISCO PO BOX 512965 LOS ANGELES, CA 90051-0965 Named Insured Business Is: SALES AND INSTALL OF AV AND NETWORK (ITEM 2) POLICY PERIOD From 09/08/2021 TO 09/08/2022 12:01 AM Standard Time at Insured Mailing Location (ITEM 3) PREMIUM CHARGES Explanation of DESCRIPTION PREMIUM Charges F.xress 1.iahalf; $11,4srnn f'ertifird Arts of Terrorism Coverage $177 nn 1Tnrl nAor91 Total Advance Charges $13,456.00 Note: This is not a bill BASIS OF PREMIUM: NON-AUDITABLE( X) AUDITABLE( ) LIMITS OF INSURANCE DESCRIPTION LIMIT EACH OCCURRENCE $4,000,000 AGGREGATE (WHERE APPLICABLE) $4,000,000 T14ESE LIMITS OF INSURANCE APPLY IN EXCESS OF THE UNDERLYING LIMITS OF INSURANCE INDICATED IN (ITEM 5) OF THE DECLARATIONS. Issue Date To report a claim, call your Agent or 1-844-325-2467 Authorized DS 70 22 01 08 Risk ManTgemenl N,alys[ 56144681 N0344487 270 INSURED COPY Liberty Mutual. INSURANCE Coverage Is Provided In: Policy Number: American Fire and Casualty Company - a stock company I ESA (22) 5614 46 81 (ITEM 5) SCHEDULE OF UNDERLYING INSURANCE; CARRIER, POLICY NUMBER AND PERIOD TYPE OF COVERAGE LIMITS OF INSURANCE FIRST UNDERLYING INSURANCE GENERAL $1,000,000 EACH OCCURRENCE WEST AMERICAN INSURANCE LIABILITY LIMIT COMPANY BKW(22)56144681 09/08/2021 - 09/08/2022 FIRST UNDERLYING INSURANCE OHIO SECURITY INSURANCE COMPANY BAS(22)62698905 O1/29/2021 - 01/29/2022 $1,000,000 PERSONAL AND ADVERTISING INJURY LIMIT $2,000,000 GENERAL AGGREGATE LIMIT $2,000,000 PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT OWNED AND FIRED $1,000,000 COMBINED SINGLE AND/OR NONOWNED LIMIT AUTO LIABILITY To report a claim, call your Agent or 1-844-325-2467 DS 70 23 01 08 56144681 N0344487 270 INSURED COPY f41HYn k. Vc &Vd Ruk Management Anayst Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! 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Name: Project A-2022-025-01 Number: Project Agreement To Provide On-Call Electrical Repair And Name: Rehabilitation 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 22-23 REN CERT AUTOMOBILE LIABILITY BAS62698905 01/29/2023 09/09/2022 City of Santa Ana w- Forms.pdf 22-23 REN CERT GENERAL LIABILITY BKW56144681 09/08/2023 09/09/2022 City of Santa Ana w- Forms.pdf InterPacific PROFESSIONAL LIABILITY WAIVER 09/28/2023 10/04/2022 Exemption for Professional.pdf Inter-Pacific Inc. WORKERS COMPENSATION AND SWC1391498 06/09/2023 06/06/2022 COI Exp 9-8-22 EMPLOYERS' LIABILITY RMD06152022.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 10/4/2022 7:08 PM NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Inter-Pacific Inc. Name: Project A-2022-025-01 Number: Project Agreement To Provide On-Call Electrical Repair And Rehabilitation Name: 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 CERT AL & 22-23 Other Lines AUTOMOBILE LIABILITY BAS62698905 01/29/2024 01/18/2023 - City of Santa Ana.pdf 22-23 REN CERT GENERAL LIABILITY BKW56144681 09/08/2023 09/09/2022 City of Santa Ana w- Forms.pdf InterPacific PROFESSIONAL LIABILITY WAIVER 09/28/2023 10/04/2022 Exemption for Professional.pdf Inter-Pacific Inc. WORKERS COMPENSATION AND SWC1391498 06/09/2023 06/06/2022 COI Exp 9-8-22 EMPLOYERS' LIABILITY RMD06152022.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 2/2/2023 11:39 AM NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Inter-Pacific Inc. Name: Project A-2022-025-01 Number: Project Agreement To Provide On-Call Electrical Repair And Name: Rehabilitation Services The Certificate of Insurance (COI) submitted indicates that the coverages comply with the insurance requirements. The compliant coverage(s) are: POLICY EXPIRATION TYPE OF INSURANCE COI DATE FILE NAME NUMBER DATE 24-25 REN CERT as of 1.29.2024 (City of AUTOMOBILE LIABILITY BA862698905 01/29/2025 02/13/2024 Santa Ana - All OPs).pdf 23-24 REN CERT City GENERAL LIABILITY BKW56144681 09/08/2024 09/12/2023 of Santa Ana w- Forms.pdf InterPacific Exemption PROFESSIONAL LIABILITY WAIVER 02/14/2025 10/09/2023 for Professional.pdf 23-24 REN WC- AL & WORKERS COMPENSATION AND SWC1442131 06/09/2024 06/15/2023 22-23 Other Lines - EMPLOYERS' LIABILITY City of Santa Ana.pdf No further action is required at this time. Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 2/15/2024 11:18 AM 710/9/2025 E(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: Certificate Team Inszone Insurance Services, LLC PHONE FAX 2721 Citrus Road, Suite A A/C No Ext: 877-308-9663 A/c,No):916-400-2625 E-MRancho Cordova, CA 95742 ADDRESS: certs@inszoneins.com INSURER(S)AFFORDING COVERAGE NAIC# License#:OF82764 INSURERA: General Insurance Company of America 24732 INSURED INTEINC-15 INSURERB: Insurance Company of the West 27847 Inter-Pacific, Inc. 39 Peters Canyon Road INsuRERc:West American Insurance Company 44393 Irvine, CA 92606 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1878422685 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 INSD WVD POLICYNUMBER MM/DD MM/DD C X COMMERCIAL GENERAL LIABILITY Y Y BKW62698905 9/8/2025 9/8/2026 EACH OCCURRENCE $1,000,000 DAMAGES( RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence) ccurrence) $500,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑ PRO ❑ JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 X OTHER: $ A AUTOMOBILE LIABILITY Y Y AZG62698905 9/8/2025 9/8/2026 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 UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION Y WSA 5084780 00 6/9/2025 6/9/2026 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (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 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) RE:All CA Operations performed by the Named Insured. The City of Santa Ana, its officers,officials,employees and volunteers are included as Additional Insured,with Primary/Non-Contributory and Waiver of Subrogation,as respects to General Liability and Auto Liability, per Forms CG 88 10 04 13, CG 85 83 04 13 and AC 00 33 10 21.Waiver of Subrogation applies to Workers'Compensation per form WC 99 06 34 When required by Written Contact. Digicauysigned Tu Tran byrurran Nguyen Nguyen Da 355o1-0P00z APPROVED CERTIFICATE HOLDER CANCELLATION i By Tu Tran Nguyen at 2:35 pm,Oct 22,2025 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. Attn: Heidi Chou 215 S. Center St., M-85 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ` @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BKW62698905 COMMERCIAL GENERAL LIABILITY CG 85 83 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS - PRODUCTS/COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract or written agreement. Such person or organization is an additional insured but only with respect to liability for "bodily injury" or "property damage": 1. Caused by "your work" performed for that additional insured that is the subject of the written contract or written agreement; and 2. Included in the "products-completed operations hazard". However: a) The insurance afforded to such additional insured only applies to the extent permitted by law; and b) 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 The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV -Commercial General Liability Conditions. B. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: 1. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the ° location where such "bodily injury" or "property damage" occurs. 2. "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications; and b. Supervisory, inspection, architectural or engineering activities. © 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission . Page 1 of 2 C. With respect to the insurance afforded by this endorsement, exclusion I. Damage To Your Work of Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products- completed operations hazard". D. With respect to the insurance afforded to these additional insureds, the following is added to Section II - 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 contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declaration. whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. E. With respect to the insurance afforded by this endorsement, Section IV - Commercial General Liability Conditions is amended as follows: 1. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claims Or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. Paragraph 4. of Section IV -Commercial General Liability Conditions is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insur- ance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. © 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission . Page 2 of 2 POLICY NUMBER: BKW62698905 COMMERCIAL GENERAL LIABILITY CG88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III -Limits Of Insurance. 2. Paragraph 6. under Section III -Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 1. Under Supplementary Payments -Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: ° d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. ° G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II -Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or s (c) The ownership, maintenance, or use of any elevators covered by this insurance. 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 insur- ance 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. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) 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 (2) 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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing 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; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) 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 (2) 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. 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: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form ° or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior 'occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an 'occurrence", offense, claim or "suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II -Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is ° effective in your state. O. BODILY INJURY REDEFINED Under Section V -Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or your work" done under a ° contract with that person or organization and included in the "products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 8 of 8 POLICY NUMBER: AZG62698905 COMMERCIAL AUTO AC 00 33 10 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO POLICY BASE EXTENSION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by endorsement. SECTION II—COVERED AUTOS LIABILITY COVERAGE is amended as follows: 1. Newly Formed Or Acquired Subsidiaries The following is added to SECTION II —COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured: d. Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period shown on the Declarations. Coverage shall apply for the first ninety (90) days after your acquisition or the formation of such subsidiary, including the date of acquisition or formation. If you wish to add or continue coverage you must ask us to insure the subsidiary within ninety (90) days after you acquire or form the subsidiary. However, "insured"does not include any subsidiary that: (1) Is a partnership or joint venture; or (2) Is an "insured" under any other automobile policy except a policy written specifically to apply in excess of any coverage provided by this policy; or (3) Has exhausted its Limit of Insurance for any policy with effective dates overlapping the date of acquisition or formation; or (4) Following the entity's acquisition or formation by you, has had any other automobile policy cancelled or non-renewed. Coverage under this provision d. does not apply to "bodily injury" or "property damage" caused by an accident that occurred before you acquired or formed the subsidiary. 2. Employee Hired Auto The following is added to SECTION II —COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured: e. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. Paragraph 5.b. of the Other Insurance Condition in the Business Auto and Auto Dealers Coverage Forms and Paragraph 5.f. of the Other Insurance - Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos"you own: 1. Any covered "auto" you lease, hire, rent or borrow; and AC 00 33 10 21 ©2021 Liberty Mutual Insurance Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy 2. Any covered "auto" hired or rented by your"employee" under a contract in an "employee's"name,with your permission, while performing duties related to the conduct of your business. However, any "auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". 3. Employees As Insureds The following is added to the SECTION II—COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1.Who Is An Insured: f. Any"employee" of yours is an "insured"while using a covered "auto"you don't own, hire or borrow in your business or your personal affairs. 4. Additional Insured By Contract,Agreement Or Permit The following is added to SECTION II —COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured: g. Any person, organization or governmental or public authority with respect to the operation, maintenance or use of a covered "auto", provided that you and such person, organization, or governmental or public authority have agreed in a written contract, written agreement, or permit, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person, organization or governmental or public authority is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you exhausted the written contract or written agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit. The "insured" is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity. Unless the "insured" has agreed in writing to be primary and noncontributory per provision 13. of this endorsement, this policy is excess over any other collectible insurance. 5. Supplementary Payments SECTION II — COVERED AUTOS LIABILITY COVERAGE, 2. Coverage Extensions, a. Supplementary Payments, Paragraph (4) is replaced by the following: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 per day because of time off from work. SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows: 6. Physical Damage—Additional Transportation Expense Coverage Paragraph AA.a. Coverage, Coverage Extensions,Transportation Expenses of SECTION III—PHYSICAL DAMAGE COVERAGE, is amended to provide a limit of$50 per day and a maximum limit of$1,500. 7. Extra Expense—Broadened Coverage The following is added to SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: c. We will pay up to$1,000 for costs incurred to return a stolen auto to you. Page 2 of 4 ©2021 Liberty Mutual Insurance AC 00 33 10 21 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy 8. Accidental Airbag Deployment SECTION III—PHYSICAL DAMAGE COVERAGE, B. Exclusions Paragraph 3.a. is replaced by the following: a. Wear and tear, freezing, mechanical or electrical breakdown. However, this exclusion does not apply to the accidental discharge of an airbag if Comprehensive or Collision Coverage is shown in the Declarations. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other insurance or warranty. 9. Glass Repair—Waiver Of Deductible (Coverage Not Applicable In FL) SECTION III—PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by the addition of the following: No deductible will apply to covered glass damage if the glass is repaired rather than replaced. SECTION IV—BUSINESS AUTO CONDITIONS is amended as follows: 10. Amended Duties In The Event Of Accident, Claim, Suit, Or Loss SECTION IV—BUSINESS AUTO CONDITIONS, Paragraph A.2.a. is replaced in its entirety by the following: a. In the event of"accident", claim, "suit" or"loss", you must promptly notify us when it is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) Member, if you are a limited liability company; (4) An executive officer or the "employee"designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (a) How, when and where the "accident"or"loss" took place; (b) The "insured's" name and address; and (c) The names and addresses of any injured persons and witnesses. 11. Waiver Of Transfer Of Rights Of Recovery Against Others To Us SECTION IV — BUSINESS AUTO CONDITIONS, Paragraph A.S., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident" or"loss", our rights are waived also. 12. Hired Auto Coverage Territory SECTION IV—BUSINESS AUTO CONDITIONS, Paragraph B.General Conditions, Item 7.b.(5), Policy Period, Coverage Territory, is replaced with the following: Anywhere in the world, for covered "autos" hired for thirty (30) days or less. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. AC 00 33 10 21 ©2021 Liberty Mutual Insurance Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy 13. Primary And Non-Contributory If Required By Written Contract Or Written Agreement The following is added to SECTION IV — BUSINESS AUTO CONDITIONS, B. GENERAL CONDITIONS, 5. Other Insurance and supersedes any provision to the contrary: e. Subject to the applicable limits of liability,this Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: (1) Such "insured" is a Named Insured under such other insurance; and (2) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance collectible to such "insured". SECTION V— DEFINITIONS is amended as follows: 14. Bodily Injury Redefined Under SECTION V— DEFINITIONS, Paragraph C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. Page 4 of 4 ©2021 Liberty Mutual Insurance AC 00 33 10 21 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-BLANKET 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 % of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER THE WRITTEN CONTRACT TO FURNISH THIS WAIVER. 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 06/09/2025 Policy No. WSA 5084780 00 Endorsement No. Insured INTER-PACIFIC INC Premium Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) INSURED Nguyen, Tu Tran From: tnguyen20@santa-ana.org Sent: Wednesday, March 19, 2025 10:13 AM To: Ortiz, Samuel Cc: Franklin, Fallon; Casuga, Narisa Subject: RE: Request for Inter-PAcific INC> COI Review Good morning Sam, I spoke to Aarti and RMD can accept the current policy limits for the Commercial General Liability. However, the contractor is required to maintain Professional Liability insurance with coverage of $21VI per occurrence and $21VI in the aggregate, as they will be performing work that requires a license. ply If Contractor is or employs a 11ccn ed prol'essionai such as ar architect or engineer- Professional liability (ergs and omissions' insurancc, with a combined single limit of not less than $2,000,OOC per claim with $2,000,000 in the aggregate. Thank you, Tu Tran Nguyen I Acting HR Technician City of Santa Ana - Human Resources Department n 20 Civic Center Plaza I Santa Ana, CA 92701 Office: 714-647-5141 Email: TNguyen2WD-santa-ana.orq I santa-ana.orq/human-resources I Linkedln I nstagram City Hall hours are 8 a.m. to 5 p.m. Monday through Thursday, and 8:00 a.m. to 5:00 p.m. every other Friday. Click here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Nguyen,Tu Tran Sent:Thursday, March 13, 2025 9:31 AM To: Ortiz, Samuel <sortiz@santa-ana.org> 1 Cc: Franklin, Fallon <ffranklin@santa-ana.org>; Casuga, Narisa <ncasuga@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good morning Sam, I forwarded the request over to Aarti and I will get back to you as soon as I receive a response. Thank you, Tu Tran Nguyen I Acting HR Technician City of Santa Ana - Human Resources Department n 20 Civic Center Plaza I Santa Ana, CA 92701 Office: 714-647-5141 Email: TNguyen20(aD_santa-ana.org I santa-ana.org/human-resources Linkedln I nstagram City Hall hours are 8 a.m. to 5 p.m. Monday through Thursday, and 8:00 a.m. to 5:00 p.m. every other Friday. Click here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Ortiz, Samuel Sent:Wednesday, March 12, 2025 1:05 PM To: Nguyen,Tu Tran <tnguyen20@santa-ana.org> Cc: Franklin, Fallon <ffranklin@santa-ana.org>; Casuga, Narisa <ncasuga@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good Afternoon Tu, The following message below was sent by Inter-Pacific regarding the COI and the insurance requirement needed. Could "Thank you for the clarification but we are unable to obtain the required insurance requirements at a reasonable cost. Only way we can proceed is if the City is willing to pay for the additional insurance costs. You are the only customer we have requesting the excessive coverage limits. Please consider waiving this requirement for us to proceed." Is it possible to proceed with sending this to Aarti to see if the waiving of the requirements is an actual option? Thank you, Sam Ortiz I Assistant Engineer Public Works Agency 1 215 S. Center Street I Santa Ana, CA 92703 (0): 714-647-3376 1 (C): 714-852-0838 1 sortiz@santa-ana.ore 2 From: Nguyen,Tu Tran <tnguyen20@santa-ana.org> Sent:Wednesday, March 12, 2025 7:47 AM To: Casuga, Narisa <ncasuga@santa-ana.org>; Ortiz, Samuel <sortiz@santa-ana.org> Cc: Franklin, Fallon <ffranklin@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good morning Narisa, The vendor's current policy is $1 M per occurrence and $21VI aggregate. To meet the CGL insurance requirements of $21VI per occurrence and $41VI aggregate, the vendor could potentially request a minimum of Excess/Umbrella Liability policy of $1 M per occurrence and $21VI aggregate. Per occurrence: $1 M (Current CGL policy) + $1 M (Excess/Umbrella) = $21VI (Required per agreement) Aggregate: $1 M (Current CGL policy) + $21VI (Excess/Umbrella) = $41VI (Required per agreement) Please let me know if you have any additional questions. Thank you, Tu Tran Nguyen I Acting HR Technician City of Santa Ana - Human Resources Department n 20 Civic Center Plaza I Santa Ana, CA 92701 II.n,- Office: 714-647-5141 Email: TNguyen20Ca)-santa-ana.orq I santa-ana.orq/human-resources Linkedln I nstagram City Hall hours are 8 a.m. to 5 p.m. Monday through Thursday, and 8:00 a.m. to 5:00 p.m. every other Friday. here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Casuga, Narisa Sent:Tuesday, March 11, 2025 3:29 PM To: Nguyen,Tu Tran <tnguyen20@santa-ana.org>; Ortiz, Samuel <sortiz@santa-ana.org> Cc: Franklin, Fallon <ffranklin@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good afternoon Tu, Can you provide me with the umbrella amount requirement please? 3 DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 6/17/2026 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: Certificate Team Inszone Insurance Services, LLC PHONE FAX 2721 Citrus Road, Suite A A/C No Ext: 877-308-9663 vc,No:916-400-2625 E-MRancho Cordova CA 95742 ADDRESS: certs@inszoneins.com INSURER(S)AFFORDING COVERAGE NAIC# License#:OF827641 INSURERA:West American Insurance Company 44393 INSURED INTEINC-15 INSURERB: General Insurance Company of America 24732 Inter-Pacific Inc. 39 Peters Canyon Road INsuRERc: State Compensation Ins Fund 35076 Irvine, CA 92606 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2140899685 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 INSD WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y Y BKW62698905 9/8/2025 9/8/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE � OCCUR PREMISES TO ccED PREMISES Ea occurrence) $500,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY D PRO JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y AZG62698905 9/8/2025 9/8/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION Y 9403228-2026 6/9/2026 6/9/2027 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICE R/M EMBER EXCLUDED? ❑ N/A (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 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) RE:All CA Operations performed by the Named Insured. The City of Santa Ana, its officers,officials,employees and volunteers are included as Additional Insured,with Primary/Non-Contributory and Waiver of Subrogation,as respects to General Liability and Auto Liability, per Forms CG 88 10 04 13, CG 85 83 04 13 and AC 00 33 10 21.Waiver of Subrogation applies to Workers'Compensation per form OLD DP 217 When required by Written Contact. APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 3:10 pm,Jun 22,2026 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. Attn: Heidi Chou 215 S. Center St., M-85 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 � f ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BKW62698905 COMMERCIAL GENERAL LIABILITY CG 85 83 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS - PRODUCTS/COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract or written agreement. Such person or organization is an additional insured but only with respect to liability for "bodily injury" or "property damage": 1. Caused by "your work" performed for that additional insured that is the subject of the written contract or written agreement; and 2. Included in the "products-completed operations hazard". However: a) The insurance afforded to such additional insured only applies to the extent permitted by law; and b) 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 The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV -Commercial General Liability Conditions. B. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: 1. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the ° location where such "bodily injury" or "property damage" occurs. 2. "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications; and b. Supervisory, inspection, architectural or engineering activities. © 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission . Page 1 of 2 C. With respect to the insurance afforded by this endorsement, exclusion I. Damage To Your Work of Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products- completed operations hazard". D. With respect to the insurance afforded to these additional insureds, the following is added to Section II - 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 contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declaration. whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. E. With respect to the insurance afforded by this endorsement, Section IV - Commercial General Liability Conditions is amended as follows: 1. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claims Or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. Paragraph 4. of Section IV -Commercial General Liability Conditions is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insur- ance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. © 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission . Page 2 of 2 POLICY NUMBER: BKW62698905 COMMERCIAL GENERAL LIABILITY CG88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III -Limits Of Insurance. 2. Paragraph 6. under Section III -Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 1. Under Supplementary Payments -Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: ° d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. ° G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II -Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or s (c) The ownership, maintenance, or use of any elevators covered by this insurance. 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 insur- ance 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. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) 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 (2) 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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing 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; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) 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 (2) 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. 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: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form ° or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior 'occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an 'occurrence", offense, claim or "suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II -Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is ° effective in your state. O. BODILY INJURY REDEFINED Under Section V -Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or your work" done under a ° contract with that person or organization and included in the "products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 8 of 8 POLICY NUMBER: AZG62698905 COMMERCIAL AUTO AC 00 33 10 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO POLICY BASE EXTENSION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by endorsement. SECTION II—COVERED AUTOS LIABILITY COVERAGE is amended as follows: 1. Newly Formed Or Acquired Subsidiaries The following is added to SECTION II —COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured: d. Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period shown on the Declarations. Coverage shall apply for the first ninety (90) days after your acquisition or the formation of such subsidiary, including the date of acquisition or formation. If you wish to add or continue coverage you must ask us to insure the subsidiary within ninety (90) days after you acquire or form the subsidiary. However, "insured"does not include any subsidiary that: (1) Is a partnership or joint venture; or (2) Is an "insured" under any other automobile policy except a policy written specifically to apply in excess of any coverage provided by this policy; or (3) Has exhausted its Limit of Insurance for any policy with effective dates overlapping the date of acquisition or formation; or (4) Following the entity's acquisition or formation by you, has had any other automobile policy cancelled or non-renewed. Coverage under this provision d. does not apply to "bodily injury" or "property damage" caused by an accident that occurred before you acquired or formed the subsidiary. 2. Employee Hired Auto The following is added to SECTION II —COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured: e. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. Paragraph 5.b. of the Other Insurance Condition in the Business Auto and Auto Dealers Coverage Forms and Paragraph 5.f. of the Other Insurance - Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos"you own: 1. Any covered "auto" you lease, hire, rent or borrow; and AC 00 33 10 21 ©2021 Liberty Mutual Insurance Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy 2. Any covered "auto" hired or rented by your"employee" under a contract in an "employee's"name,with your permission, while performing duties related to the conduct of your business. However, any "auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". 3. Employees As Insureds The following is added to the SECTION II—COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1.Who Is An Insured: f. Any"employee" of yours is an "insured"while using a covered "auto"you don't own, hire or borrow in your business or your personal affairs. 4. Additional Insured By Contract,Agreement Or Permit The following is added to SECTION II —COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured: g. Any person, organization or governmental or public authority with respect to the operation, maintenance or use of a covered "auto", provided that you and such person, organization, or governmental or public authority have agreed in a written contract, written agreement, or permit, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person, organization or governmental or public authority is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you exhausted the written contract or written agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit. The "insured" is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity. Unless the "insured" has agreed in writing to be primary and noncontributory per provision 13. of this endorsement, this policy is excess over any other collectible insurance. 5. Supplementary Payments SECTION II — COVERED AUTOS LIABILITY COVERAGE, 2. Coverage Extensions, a. Supplementary Payments, Paragraph (4) is replaced by the following: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 per day because of time off from work. SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows: 6. Physical Damage—Additional Transportation Expense Coverage Paragraph AA.a. Coverage, Coverage Extensions,Transportation Expenses of SECTION III—PHYSICAL DAMAGE COVERAGE, is amended to provide a limit of$50 per day and a maximum limit of$1,500. 7. Extra Expense—Broadened Coverage The following is added to SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: c. We will pay up to$1,000 for costs incurred to return a stolen auto to you. Page 2 of 4 ©2021 Liberty Mutual Insurance AC 00 33 10 21 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy 8. Accidental Airbag Deployment SECTION III—PHYSICAL DAMAGE COVERAGE, B. Exclusions Paragraph 3.a. is replaced by the following: a. Wear and tear, freezing, mechanical or electrical breakdown. However, this exclusion does not apply to the accidental discharge of an airbag if Comprehensive or Collision Coverage is shown in the Declarations. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other insurance or warranty. 9. Glass Repair—Waiver Of Deductible (Coverage Not Applicable In FL) SECTION III—PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by the addition of the following: No deductible will apply to covered glass damage if the glass is repaired rather than replaced. SECTION IV—BUSINESS AUTO CONDITIONS is amended as follows: 10. Amended Duties In The Event Of Accident, Claim, Suit, Or Loss SECTION IV—BUSINESS AUTO CONDITIONS, Paragraph A.2.a. is replaced in its entirety by the following: a. In the event of"accident", claim, "suit" or"loss", you must promptly notify us when it is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) Member, if you are a limited liability company; (4) An executive officer or the "employee"designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (a) How, when and where the "accident"or"loss" took place; (b) The "insured's" name and address; and (c) The names and addresses of any injured persons and witnesses. 11. Waiver Of Transfer Of Rights Of Recovery Against Others To Us SECTION IV — BUSINESS AUTO CONDITIONS, Paragraph A.S., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has in a written agreement waived those rights before an "accident" or"loss", our rights are waived also. 12. Hired Auto Coverage Territory SECTION IV—BUSINESS AUTO CONDITIONS, Paragraph B.General Conditions, Item 7.b.(5), Policy Period, Coverage Territory, is replaced with the following: Anywhere in the world, for covered "autos" hired for thirty (30) days or less. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. AC 00 33 10 21 ©2021 Liberty Mutual Insurance Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy 13. Primary And Non-Contributory If Required By Written Contract Or Written Agreement The following is added to SECTION IV — BUSINESS AUTO CONDITIONS, B. GENERAL CONDITIONS, 5. Other Insurance and supersedes any provision to the contrary: e. Subject to the applicable limits of liability,this Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: (1) Such "insured" is a Named Insured under such other insurance; and (2) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance collectible to such "insured". SECTION V— DEFINITIONS is amended as follows: 14. Bodily Injury Redefined Under SECTION V— DEFINITIONS, Paragraph C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. Page 4 of 4 ©2021 Liberty Mutual Insurance AC 00 33 10 21 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 07/25/2025 62698905 PLCM-CL EC Insured Copy STATE Endorsement Agreement COMPENSATION INSURANCE Waiver of Subrogation FUND Blanket Basis 9403228-2026 Home Office New San Francisco NF All Effective Dates are 9-95-93-31 at 12:01 AM Pacific Page 1 of 1 Standard Time or the Time Indicated at Effective June 9, 2026 at 12:01 AM Pacific Standard Time and Expiring June 9, 2027 at 12:01 AM INTER - PACIFIC SYSTEMS INC 39 PETERS CANYON ROAD IRVINE, CA 92606 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. Schedule Person or Organization Job Description Any person or organization for whom the Blanket Waiver of Subrogation named Insured has agreed by written contract to furnish this waiver Nothing in this endorsement shall be held to vary, alter,waive or extend any of the terms, conditions, agreements, or limitations of this policy other than as above stated.Nothing elsewhere in this policy shall be held to vary, alter,waive or limit the terms,conditions, agreements or limitations in this endorsement. Countersigned and Issued at San Francisco June 16,2026 2572 Authorized Representative President and CEO SF—END Rev.2/2025 OLD DP 217 Nguyen, Tu Tran From: tnguyen20@santa-ana.org Sent: Wednesday, March 19, 2025 10:13 AM To: Ortiz, Samuel Cc: Franklin, Fallon; Casuga, Narisa Subject: RE: Request for Inter-PAcific INC> COI Review Good morning Sam, I spoke to Aarti and RMD can accept the current policy limits for the Commercial General Liability. However, the contractor is required to maintain Professional Liability insurance with coverage of $21VI per occurrence and $21VI in the aggregate, as they will be performing work that requires a license. ply If Contractor is or employs a 11ccn ed prol'essionai such as ar architect or engineer- Professional liability (ergs and omissions' insurancc, with a combined single limit of not less than $2,000,OOC per claim with $2,000,000 in the aggregate. Thank you, Tu Tran Nguyen I Acting HR Technician City of Santa Ana - Human Resources Department n 20 Civic Center Plaza I Santa Ana, CA 92701 Office: 714-647-5141 Email: TNguyen20(aD-santa-ana.orq I santa-ana.orq/human-resources Linkedln I nstagram City Hall hours are 8 a.m. to 5 p.m. Monday through Thursday, and 8:00 a.m. to 5:00 p.m. every other Friday. Click here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Nguyen,Tu Tran Sent:Thursday, March 13, 2025 9:31 AM To: Ortiz, Samuel <sortiz@santa-ana.org> 1 Cc: Franklin, Fallon <ffranklin@santa-ana.org>; Casuga, Narisa <ncasuga@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good morning Sam, I forwarded the request over to Aarti and I will get back to you as soon as I receive a response. Thank you, Tu Tran Nguyen I Acting HR Technician City of Santa Ana - Human Resources Department n 20 Civic Center Plaza I Santa Ana, CA 92701 Office: 714-647-5141 . Email: TN guyen20(aD_santa-ana.org I santa-ana.org/human-resources Linkedln I nstagram City Hall hours are 8 a.m. to 5 p.m. Monday through Thursday, and 8:00 a.m. to 5:00 p.m. every other Friday. Click here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Ortiz, Samuel Sent:Wednesday, March 12, 2025 1:05 PM To: Nguyen,Tu Tran <tnguyen20@santa-ana.org> Cc: Franklin, Fallon <ffranklin@santa-ana.org>; Casuga, Narisa <ncasuga@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good Afternoon Tu, The following message below was sent by Inter-Pacific regarding the COI and the insurance requirement needed. Could "Thank you for the clarification but we are unable to obtain the required insurance requirements at a reasonable cost. Only way we can proceed is if the City is willing to pay for the additional insurance costs. You are the only customer we have requesting the excessive coverage limits. Please consider waiving this requirement for us to proceed." Is it possible to proceed with sending this to Aarti to see if the waiving of the requirements is an actual option? Thank you, Sam Ortiz I Assistant Engineer Public Works Agency 1 215 S. Center Street I Santa Ana, CA 92703 (0): 714-647-3376 1 (C): 714-852-0838 1 sortiz@santa-ana.ore 2 From: Nguyen,Tu Tran <tnguyen20@santa-ana.org> Sent:Wednesday, March 12, 2025 7:47 AM To: Casuga, Narisa <ncasuga@santa-ana.org>; Ortiz, Samuel <sortiz@santa-ana.org> Cc: Franklin, Fallon <ffranklin@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good morning Narisa, The vendor's current policy is $1 M per occurrence and $21VI aggregate. To meet the CGL insurance requirements of $21VI per occurrence and $41VI aggregate, the vendor could potentially request a minimum of Excess/Umbrella Liability policy of $1 M per occurrence and $21VI aggregate. Per occurrence: $1 M (Current CGL policy) + $1 M (Excess/Umbrella) = $21VI (Required per agreement) Aggregate: $1 M (Current CGL policy) + $21VI (Excess/Umbrella) = $41VI (Required per agreement) Please let me know if you have any additional questions. Thank you, Tu Tran Nguyen I Acting HR Technician City of Santa Ana - Human Resources Department n 20 Civic Center Plaza I Santa Ana, CA 92701 Office: 714-647-5141 Email: TNguyen20Ca)-santa-ana.orq I santa-ana.orq/human-resources I Linkedln I nstagram City Hall hours are 8 a.m. to 5 p.m. Monday through Thursday, and 8:00 a.m. to 5:00 p.m. every other Friday. here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Casuga, Narisa Sent:Tuesday, March 11, 2025 3:29 PM To: Nguyen,Tu Tran <tnguyen20@santa-ana.org>; Ortiz, Samuel <sortiz@santa-ana.org> Cc: Franklin, Fallon <ffranklin@santa-ana.org> Subject: RE: Request for Inter-PAcific INC>COI Review Good afternoon Tu, Can you provide me with the umbrella amount requirement please? 3 CITY OF SANTA ANA Risk Management a division of Human Resources w Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR PROFESSIONAL LIABILITY INSURANCE I Richard Ku k ("Representative"),attest that I am an authorized (Name and Title of Vendor Representative) representative of Inter-Pacific, Inc. ("Company"), and (Consultant/Company Name) possess the authority to legally bind Company. In my capacity as Representative of Company, I represent and confirm the following, as relates to the agreement between Company and City of Santa Ana, agreement number A-2022-025-01 ("Agreement")to provide Electrical Maintenance ("Services"): (Services to be provided under agreement/contract) During the course and scope of Company's agreement with the City of Santa Ana, Company will not use the services of an expert necessitating professional liability/errors &omissions liability insurance coverage in the performance of Services to, for, or on behalf of City of Santa Ana. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum professional liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. March 20, 2025 Sigma Date Richard Y. Kuk Print Name President Title rkuk@inter-pacific.corn Contact Information,i.e.,Telephone Number and/or Email Address Affidavit of Exemption for Professional Liability Insurance 11.12.2024