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HomeMy WebLinkAboutBUTIER ENGINEERING, INCINSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES wo 1 2512D23 CLERK OF COUNCIL DATE: A-2022-142 PtvA �5eomThorncis) (pZ.)2 THIS SECOND AMENDMENT to the above -referenced agreement is entered into on July 19, 2022 by and between Butier Engineering, Inc. ("Contractor") and the City of Santa Ana, a charter o city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). cli CD RECITALS A. The parties entered into Agreement No. A-2021-005, dated January 19, 2021, by which Contractor agreed to provide construction engineering services for the South Main Corridor Project for the City's Public Works Agency ("Agreement"). The Agreement runs through January 18, 2024, with options to extend the Agreement for up to two (2) one (1) year periods. The Agreement is current and in effect. B. On September 21, 2021, the parties entered into a First Amendment to the Agreement (#A- 2021-186) to increase the overall compensation of the Agreement. C. The parties now wish to further amend the Agreement to increase the compensation to pay for services required for the duration of the Agreement, including any exercised extension periods. The Parties therefore agree: 1. Section 2, Compensation, subsection a, shall be amended to increase the compensation by $376,000. The total sum to be expended under this Agreement, including any extension periods, shall not exceed $1,612,924. 2. Except as modified by this Second Amendment, all terms and conditions of the Agreement, as amended, shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA Daisy Gomez ;I Kristine Ridge 4vClerk of the Council City Manager [signatures continue on the next page] City Council 23 — 9 7/19/2022 APPROVED AS TO FORM: Sonia R. Carvalho City Attorney By: ;-G. � Brandon Salvatierra Deputy City Attorney FOR APPROVAL Nabil Saba Executive Director Public Works Agency BUTIER ENGINEERING, INC.: Title: City Council 23 — 10 7/19/2022 A ,. _: _ Diaitally sinned by 9 AC Ra CERTIFICATE OF LIABILITY INR4U E Angie 022.08Aceved.1 Date: 2022.08.1 DATE23/20/VVYYI 6/23/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS I NT.NILAUE- PGMATE 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 pollcy(les) 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 AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd., Suite 230 Lafayette CA 94549 NAME. Nancy Ferrick FAe No: PHONE , 510-272-1400 _ E-MAIL ADDRESS: nano .ferrick assured artners.com INSURERS AFFORDING COVERAGE NAICC INSURER A: Travelers Casualty and Surety Co of America 31194 n INSURED BUTIEENGI INSURER B: The Travelers lndemnl Company of Connecticut 25682 INSURER C: Travelers Property Casualty Company of America 25674 Butler Englneenng, Inc. Tustin Financial Center 17B22 E 17th St., Suite 404 INSURER D: INSURER E: Tustin CA 92780 INSURER F : TF V 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. INTRR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF POLICY EXP DD LIMITS B X I COMMERCIAL GENERALLULBILITY Y Y 680IR125463 6/25/2022 6/25/2023 EACH OCCURRENCE $1,000,000 CLAIMS -MADE 'X, OCCUR PREMISES Ea occurrence S1,000,000 MED EXP (Any one person) $10,000 PERSONALSADV INJURY $11000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY JECar Lac OTHER B AUTOMOBILE LVU3ILITY Y Y BABR860917 6/25/2022 625/2023 COMBINED SINGLE LIMIT Ee isecideritl $1,000,000 BODILY INJURY (Pat person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLYMAUTOS X HIRED NON-0WNED AUTOS ONLYAUTOS ONLY FeOreceMryenDAMAGE E $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEO I I RETENTION $ C WORNERSCOMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOWPARTNERIEXECUTIVE _N OFFICERIMEMBEREXCLUDE01 (Mandatory In Nei NIA Y UBOR659873 7/1/2021 7/V2022 X STATUTE EiiH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 If yea, describe under DESCRIPTION OF OPERATIONS below A Pi-daniond Liability 107108511 6/25/2022 6/252023 $1,DW," S2,o0C. per Claim Annual Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Sohedule, may W attached if mom apace is raquirW) RE: SOUTH MAIN CORRIDOR IMPROVEMENTS PROJECT / RFP At 20-115. The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as Additional Insured for General and Auto Liability as required by written Contract or agreement. General Liability Insurance is primary and non-contributory per policy form. A Waiver of Subrogation applies per the attached endorsement(s). 30 Days Notice of Cancellation. Cancellation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division, 4th Floor 20 Civic Center Plaza (M-21) ALITHORIZEQPEPRESENTATIVE P.O. Box 1988 Santa Ana, CA 92702 RWrMoNganad%gdlm 019884015 ACORO REIAEV/ED&APPROvEORY. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD11'' ; ®. Risk Management Speaalht COMMERCIAL GENERAL LIABILITY POLICY NUMBER 6801ra125463 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Names of Additional Insured Person(s) or Organization(s): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part, provided that such written contract was signed by you before, and is in effect when, the "bodily injury" or "property damage" occurs or the "personal injury' or "advertising injury" offense is committed. Location of Covered Operations: Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "personal injury' or "advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring, or "personal injury" or "advertising injury" arising out of an offense committed, after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on behalf of the additional insured(s) at the loca- tion of the covered operations has been com- pleted; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. CG D3 61 03 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights re CG T8 01 XX XX Includes copyrighted material of Insurance Services Office, Inc. with it DATE OF ISSUE: 06/25/2022 Rld[MRnPgimimt.Diwfan �. 4j� g Acevao �� Risk ManagementSpecialis[ COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 6801RI25463 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part for "bodily injury" or "property damage" included in the "products - completed operations hazard", provided that such contract was signed and executed by you before, and is in effect when, the bodily injury or property damage occurs. Location And Description Of Completed Operations Any project to which an applicable contract described in the Name of Additional Insured Person(s) or Organization(s) section of this Schedule applies. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional in- sured and included in the "products -completed opera- tions hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 CG T8 02 XX XX neTG r)P tcet IF:- 06/25/2022 RideMnuganadDh6[an REVIEWED 6 APPRCN® BY. link Management Speaelist Policy# 6801R125463 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each Insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of liilitu d. Primary And Non -Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis, this insurance is primary to other insurance that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury" or"property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements In the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any Information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each Insured against whom claim is made or "suit" is brought. a. Transfer Or Riahts Or Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At ourrequest, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or speck market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding websites, only that part of a website that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 G 2D17 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance services Office, Inc. with Its permis Ride Iduagemmt Dlsielnn Rwn &ArrgQv®ar: ` A+.g:r Auvraia - Risk Management Specikist Policy 4 6801 R1 25463 occupational therapist or occupational therapy assistant, physical therapist or speech -language pathologist; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the violation of a penal statute or ordinance relating to the sale of pharmaceuticals committed by, or with the knowledge or consent of the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x- ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, CG D3 79 02 19 COMMERCIAL GENERAL LIABILITY that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section It — Who Is An Insured. K. MEDICAL PAYMENTS — INCREASED LIMIT The following replaces Paragraph 7. of SECTION III — LIMITS OF INSURANCE: 7. Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person, and will be the higher of: a. $10,000; or b. The amount shown in the Declarations of this Coverage Part for Medical Expense Limit. L. AMENDMENT OF EXCESS INSURANCE CONDITION — PROFESSIONAL LIABILITY The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis, that is Professional Liability or similar coverage, to the extent the loss is not subject to the professional services exclusion of Coverage A or Coverage B. M. BLANKET WAIVER OF SUBROGATION — WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a written contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the signing of that contract or agreement. © 2017 The Travelers Indemnity Company. All rights reserved Includes copyrighted material of Insurance Services Office, Inc. with its perms Rial i ldowgrnmrt Divtdan REVIEWED 6 APPROVE) Br. ol.s' A+� Auv4(o Risk Management Specialist BABR660917 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS E. TRAILERS —INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. B. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE. An "employee" of yours is an "insured" while operating a covered "auto" hired or rented under a contract or agreement in an "em- ployee's" name, with your permission, while H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT —INCREASED LIMIT I. WAIVER OF DEDUCTIBLE — GLASS J. PERSONAL PROPERTY K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (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 busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". C. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: CA T4 20 02 15 © 2015 The Travelers Indemnity Company All rights reserved. RiskMnugmiattDivielm Includes copyrighted material of Insurance Services Office, Inc. with its permissi• lil" p&APPRw®BY: Risk Management Spedkist COMMERCIAL AUTO Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or bor- rowed with a driver; or (b) Any "auto" that is hired, rented or bor- rowed from your "employee". G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT (4) All reasonable expenses incurred by the "insured" at our request, including actual The following replaces the first sentence in Para - loss of earnings up to $500 a day be- graph A.4.a., Transportation Expenses, of cause of time off from work. SECTION III — PHYSICAL DAMAGE COVER- AGE: E. TRAILERS — INCREASED LOAD CAPACITY The following replaces Paragraph C.1. of SEC- $1,500We will pay up to $50 per day to maximum of TION I — COVERED AUTOS: curred for temporary transportationn expense in- urred by you because of the total theft of a cov- 1. "Trailers" with a load capacity of 3,000 ered "auto" of the private passenger type. pounds or less designed primarily for travel H. AUDIO, VISUAL AND DATA ELECTRONIC on public roads. EQUIPMENT — INCREASED LIMIT F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage If hired "autos" are covered "autos" for Covered Autos Liability Coverage but not covered "autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an owned "auto", then the Physical Damage Cover- age is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" to any one "auto" that you hire, rent or borrow is the lesser of: (a) $50,000; (b) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. Paragraph C.1.b. of SECTION III — PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. J. PERSONAL PROPERTY The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property Coverage We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (i) Owned by an "insured"; and (2) In or on your covered "auto". This coverage only applies in the event of a total theft of your covered "auto". No deductibles apply to Personal Property cover- age. Page 2 of 3 © 2015 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permissi : R ty�oDhWmt - Risk Management Specialist K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto"; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of the "loss" (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (a) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior to any "accident" or "loss", pro- vided that the "accident" or "loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. CA T4 20 02 15 © 2015 The Travelers Indemnity Company. All rights reserved Includes copyrighted material of Insurance Services Office, Inc. with its permissi RidsMasugmtadDWIan _ REVIEWED &APPRWD EIr �I ® Risk Management SpeciXist W WORKERS COMPENSATION TRAVELERS AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — POLICY NUMBER: uB9R669873 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description Any Person or organization for which the insured has agreed by written contract executed prior to loss 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.) Insurance Company Countersigned by Travelers Property Casualty Company of America RAMww9 matDMsbn % REVIEWEDSAPPRQJB]BY: `!..Ini1111k.1 A-juAaN44 Risk Management Speoa sl of DATE OF ISSUE: 6/23n022 A� �® CERTIFICATE OF LIABILITY INSURANCE DATE IMWDOIYYYYI 07105/2022 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 In an ADDITIONAL INSURED, the policy(les) 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 andorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endoreement(s). PRODUCER CONTACT NAME Marsh Affinity Marsh Affinity AIC No, Ezt: 800.743-8130 ac Na: a division of Marsh USA Inc. Aooaess: ADPTotelSou.,limarsh.com PO Box 14404 NSURERIS) AFFORDING COVERAGE rules Des Moines, IA 50306-9686 INSURER A: AID Inatem. Canaan 19399 INSURED INSURERB: INSURERC: ADP TotalSource DE IV, Inc. INSURERD: 5800 Windward Parkway Alpharetta, GA 30005 U91F: INSURER E: INSURER F: Butler Engineering Inc 17822 17th St Ste 404 Tustin, CA 92780 COVERAGES CERTIFICATE NUMBER: 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, RISK LTR TYPEOFNSURANCE A DL INED Ueft WVo POLICY NUMBERPOLICYSIFF IMWOD/YYYYI EXP (MWDDwvr Y) LINKS COMMERCWLOENERALLDUa ClAIM6-MADE ❑OCCUR EACMOCCURRENCE s DAMAGE TO rtw SPPMIE NED EXP (Any one person) S PERSONAL a ADV INJURY S GENL AGGREGATE LIMIT APPUES PER: POLICY E]jEO ❑LOC O HER' GENERALAGOREGATE 4 PRODUCTS-COMP/OP AGO S S AUTOMOBILE H WISILIfY ANY AUTO OWNED SCHEDULED AVTOS ONLY AUtos AUTOS ONLY AIUTOS ONNLV COMBINED SINGLE LIMIT Ea ecddeN 3 BODILY INJURY (Par person) S BODILY INJURY (PerauJ4enp $ Pa�a�Een1� GE E i S UMBRELI UAS EXCESSL OCCUR CIAIMSMADE EACH OCCURRENCE S AGGREGATE S DIED I RETENTIONS S A WORKERS COMPENSATION ANDEMPLOYERS'WIBILRY YIN ANYPROPRETORIPARTNE DED:CUTNE ❑ OFFIDERIMEMBER EXCLUDED? IIAn4siftexrx NH)and under IDES DESCRIPTION DESCRIPTION OF OPERATIONS bNam WC 063449479 CA D7/011g022 07IOt12023 - X TATUTE ER L EACH ACCIDENT $2.000,000 E.L DIBEASE- EA EMPLOYEE 52,000,000 E.L. OISEA6E-POLICY LIMIT 52.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORQ 101, Additional Remerke Scheduk, may In, anached if mole spot k mqulre t) All w ekeae employees w tying for Buser Engtheenng Inc, pad untler ADP T.teSouroe, Inc', peymll, are covered untler Me above etsktl poli,. Booth Main CanMor Improvements Prai, City Of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORMEo REPRESENTATIVE lb -W, 4r o The ACORD name and logo are registered marks of ACORD `3d1111a;1' Risk Management Division REv EWED 6 APmtDvEDBY: _. A a.�:4 A�4L�4aa - Risk Management Specialist WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 43 03 06 (Ed. 4-V WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 Job Description: This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is Issued subsequent to preparation of the policy.) Endorsement Effective 07/01/2022 Policy No. WC 053449479 CA Endorsement No. Insured Insurance Company AIU Insurance Company ADP Totasource DE IV, Inc. 5800 Windward Parkway Alpharetta, CA 30005 LC/F: Butler Engineering Inc 17822 17th St Ste 404 Tustin, CA 92780 Countersigned by ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual 92001. RiskMan%awdDnislon REVIEWED 6 APPRcV By: c? A+)rcr Auv44 Risk Management Specialist