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Home My WebLink AboutCROSSTOWN ELECTRICAL & DATA, INCINSURANCE ON FILE A-2022-157-01 WORK MAY PROCEED UNTIL INSURANCE EXPIRES (2.3. 2I) CLERK OF COUNCIL DATE: AGREEMENT WITH CROSSTOWN ELECTRICAL & DATA, INC., TO PROVIDE ON- aW��adeh Ate!) CALL CONSTRUCTION SERVICES FOR THE CITY OF SANTA ANA (AU)2 THIS AGREEMENT is made and entered into on this 16th day of August, 2022 by and between Crosstown Electrical & Data, hic., a California corporation ("Contractor"), and the City of Santa N Ana, a charter city and municipal corporation organized and existing under the Constitution and o laws of the State of California ("City" ). rn ® RECITALS LU A On March 21, 2022, the City issued Request for Proposal ("RFP") No. 21-095, by which it sought a qualified contractor to provide on -call construction services for traffic signals, street lights, and concrete wheel chair ramps 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 ofwork that was included in RFP 21-095. C. In undertaking the performance of this Agreement, Contractor represents that h 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 consulting fmn 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: L 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. 21-095, which is attached as Exhibit A, and as more specifically delineated in Contractor's proposal, which is attached as Exhibit B and incorporated in full. 2. COMPENSATION a City neither wan -ants 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 C- Contractor is one of two (2) contractors selected to provide demolition services on an on -call basis under RFP 21-095. The total compensation for these services provided by all such contractors selected under RFP 21-095 shall not exceed the shared aggregate amount of Two Million, Five Hundred Thousand Dollars and Zero Cents ($2,500,000) during the term ofthe Agreement, including any extension periods. b. Payment by City shall be made within 45 days (folty-five) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Page 1 of 10 Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and tenninate on June 30, 2025, unless terminated earlier in accordance with Section 16, below. The term of this Agreement may be extended for up to two (2) one-year periods 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 $ 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. Ifthe 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, ajoint venture relationship, or m allow the City to exercise discretion or control over the professional manner in which Contractor perfonns 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 walTants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and walTanty in regard to Page 2 of 10 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 Prior to undertaking performance ofwork 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 L Commercial General Liability (CGL): Insurance Services Office Form OG 00 01 covering CGL on• an "occunence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $5,000,000 per occurrence. If a general aggregate limit applies, either the general aggregatelimit 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 I), or if Contractor has no owned autos, hired, (Code 8) and non -owned autos (Code 9), with a limit no less than $5,000,000 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. Builder's Risk (Course of Construction): insurance utilizing an "All Risk". (Special Perils) coverage Lllll, with limits equal to the completed value of the project and no coinsurance penalty provisions. 5. Contractors' Pollution Legal Liability and/or Asbestos Liability and/or Errors and Omissions, if project involves environmental hazards, with limits no less than $1,000,000 per occunence or claim, and $2,000,000 policy aggregate- 6 Broader Coverage: 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. Page 3 of 10 b. Other Insurance Provisions L 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 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 Fonn CG 20 10 11 85 or ifnotavailable, 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). Primary Coverage: For any claims related to this contract, the Contractor's insurance coverage shall be primary coverage at least as broad as ISO GG 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 ofthe Contractor's insurance and shall not contribute with it 3. 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 awaiver of any right to subrogation that any insurer of said Contractor may acquire against the City by virtue ofthe 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 ofwhether or not the City has received a waiver of subrogation endorsement from the insurer. 5. Self -Insured Retentions: Self -insured retentions must be declared m and approved by the City. The City may require theContractor 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. Builder's Risk (Course of Construction) Insurance: 1. Contractor may submit evidence ofBuilder's Risk insurance in the forin of Course of Construction coverage. Such coverage shall name the City as a loss payee as their interest may appear. ii. Ifthe project does not involve new or major reconstruction, at the option ofthe City, an Installation Floater may be acceptable. For such projects, a Property Installation Floater shall be obtained that provides for the improvement, remodel, modification, alteration, conversion or Page 4 of 10 adjustment to existing buildings, structures, processes, machinery and equipment. The property Installation Floater shall provide property damage coverage for any building, structure, machinery or equipment damaged, impaired, broken, or destroyed during the performance ofthe work, including during transit, installation, and testing at the City's site. 7. 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 ANII, unless otherwise acceptable to the City. 8. Verification of Coverage: Contractor shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies ofthe applicable policy language effecting coverage requiredby this clause) and a copy ofthe Declarations and Endorsement Page ofthe 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 anytime. 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. For CGL coverage, subcontractors shall provide coverage with a folm at least as broad as CG 20 38 04 13. 10. Special Risks or Circumstances: City reserves the right to modify these requirements, including limits, based on the nature oftherisk, prior experience, insurer, coverage, or other special circumstances. & INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold brainless 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, its subcontractors, agents, employees, or other persons acting on its 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 ofthe telms of or effects arising from this Agreement. This indemnity and hold hmmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason ofthe events mfelTed to in this Section or by reason ofthe telms of, or effects, arising from this Agreement. The Contractor farther agrees to indemnify, hold harmless, and pay all costs for the defense ofthe City, including Page 5 of 10 fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 9 INTELLECTUAL PROPERTY INDEMNMCATION Contractor shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Contractor to the City pursuant to this Agreement. I 11_IIIt'71v 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 flute (3) years from the date of final payment to Contractor under this Agreement. 11. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor agrees that A 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 Infolmation" 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 ofnon-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. Page 6 of 10 12. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 13. 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 with all applicable federal, state and local laws and regulations. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, 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 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 is not embodied herein. 15. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other contractors retained by City. 16. 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(s) completed as of such date, and in such case Page 7 of 10 such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 17. 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. 18. 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. 19. 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. 20. 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. C. In the event of any conflict or inconsistency between the terms and conditions in this Agreement and any terms or conditions set forth in any Exhibit, purchase order, or other document relating to the transactions contemplated by this Agreement, the terms and conditions set forth in this Agreement shall prevail. Page 8 of 10 d. This Agreement is the final contemporaneous agreement(s) superseded by this Agreement. 21. NOTICE and complete agreement and any prior or for similar services between the parties is 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 With courtesy copies to: Nabil Saba Executive Director, Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, California 92702 Fax:714-647-5635 To Contractor: Benjamin Heermance, CFO Crosstown Electrical & Data, Inc. 5454 Diaz Street Irwindale, CA 91706 blheernrance(tD,crosstowndata. 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 time frames, weekends, federal, state, County or City holidays shall be excluded. Page 9 of 10 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: WClerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: Bra n Salvatierra Deputy City Attorney RECOMMENDED FOR APPROVAL: G Nabil Saba Executive Director Public Works Agency CITY OF SANTA ANA Kristine Ridge City Manager CROSSTOWN ELECTRICAL & DATA, INC. "ICA, Benja�rmance Chief Financial Officer Page 10 of 10 EXHIBIT A RE -ADVERTISEMENT Appendix ATTACHMENT 1 SCOPE OF WORK CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR ON -CALL CONSTRUCTION SERVICES FOR TRAFFIC SIGNALS, STREET LIGHTS AND CONCRETE WHEELCHAIR RAMPS RFP NO.: 21-095 INTRODUCTION The City of Santa Ana (City) desires to enter into an agreement with a qualified construction company(ies) for the repair and/or installation of traffic signals, street lights, concrete paving wheel chair ramps, and/or other infrastructure within the public right of way that may experience failures within the term of the agreement on an on -call and emergency work for general improvements, on an as needed, Individual Task Order basis. Ancillary related work includes, but is not limited to, occasional replacement traffic pavement markings and sign replacements and related support services and paid for as described in Section I.A. "Nature of Work" in the RFP. The purpose of this request for proposals is to obtain qualified construction companies to augment the City's capacity to perform On Call Construction Service in the event of system failures. DESCRIPTION OF WORK The scope of work will vary per Task Order within the public right-of-way. It may include, but not be limited to, the procurement and/or removal of materials, excavation, installation, backfill, compaction, grading, sidewalk and paving, curb and gutter, fencing, guardrail, barrier, traffic signal systems, street lights, conduits, wiring, and pavement markings, signs, sign posts and miscellaneous other street furniture, and repairing various items within the public right-of-way, traffic control, mobilization, compliance with this agreement and all other work necessary to complete on -call Task Orders specified per incident. The work completed shall be in compliance with the City's Standard Plans, Caltrans Standard Plans and the "Greenbook" and Caltrans' Standard Specifications and as specified in this agreement. Work shall also be in compliance with the City's Standard Plan No. 1160, "Street Work and Utility Permit General Provisions." City of Santa Ana RFP 21-095 Exhibit Page Al-1 RE -ADVERTISEMENT QUANTITIES FOR FEE SCHEDULE (UNDER SEPARATE COVER) For the purposes of providing a Fee Schedule based on the below Sample Task Orders, the following work items and quantities are provided. The Fee Schedule in Attachment 5: Each Fee Schedule shall include a schedule of the hourly billing rates for ALL contractor and subcontractor staff and labor personnel. Additionally, for each discipline that a company seeks to be considered, the below table(s) would be completed for the purpose of review of the proposals. For example, if a Contractor is submitting for Traffic Signal and Concrete Paving — Wheel Chair Ramp, Sample Task Orders A and C would be completed as part of the Fee Schedule by filling in of the last two columns for the relevant sample task orders by category. However, actual work will be paid for as described in Section I.A. "Nature of Work," and according to the schedule of hourly billing rates. Sample Task Orders for Traffic Signal, Street Light and Concrete Paving - Wheel Chair Ramp in public right-of-way related work are, respectively: Sample Task Order A — Traffic Signal (Assume all work within Paved areas) Item Description Qty Unit Unit Price Total I Install City Furnished Type 332 Cabinet on New Foundation 2-4 phases) 1 EA 2 Install City Furnished Type 332 Cabinet on Existing Foundation (2-4 chases I EA 3 Install City Furnished Type 332 Cabinet on New Foundation (4-8 phases) EA 4 Install City Furnished Type 332 Cabinet on Existing Foundation 4-8 phases)1 EA 5 Furnish & Install Type lA Pole on New Foundation 1 EA 6 Furnish & Install Type to Pole on Existing Foundation 1 EA 7 Furnish & Install Type 15TS Pole on New Foundation I EA 8 Furnish & Install Type ISTS Pole on Existing Foundation 1 EA 9 Furnish & Install 2" Conduit 75 LF 10 Furnish & Install 3" Conduit too LF 11 Furnish & Install 4" Conduit 300 LF 12 Furnish & Install No. 6 Pull Box 10 EA 13 Furnish & Install No. 6E Pull Box 2 EA 14 Famish & Install Traffic Signal Loop Detector (Type E Loop) 10 EA 15 Famish & Install Bicycle Loop Detector (Circular Type D Loon) 10 EA 16 Furnish & Install Traffic Signal Loop Detector (Type E Loop) 20 EA 17 Furnish & Install Bicycle Loop Detector (Circular Type D Loon) 20 EA 18 Furnish & Install Traffic Signal Loop Detector (Type E Loon) 60 EA 19 Furnish & Install Bicycle Loop Detector (Circular Type D Loop) 60 EA City of Santa Ana RFP 21-095 Exhibit Page Al-2 RE -ADVERTISEMENT Furnish & Install Overhead Reflectorized Street Name EA 20 Sign (RSNS) 4 Install City Furnished Overhead Reflectorized Street EA 21 Name Sign (RSNS) 4 Furnish & Install 12 Strand Single Mode Fiber Optic LF 22 SMFO Cable 300 Furnish & Install 24 Strand Single Mode Fiber Optic LF 23 (SMFO) Cable 300 Furnish & Install 144 Strand Single Mode Fiber Optic LF 24 (SMFO) Cable 1000 25 Furnish & Fusion Splice 1 Stand SMFO 48 EA 26 Furnish & Fiber Optic Splice Enclosure 2 EA 27 Pothole Pole Locations for Utility Conflicts 5 EA Fumish and Install 3-M V inyl Wrap by Econolite for EA 28 T e 332 Cabinet 5 Sample Task Order B — Street Lighting (Assume all work within Paved areas) Item Description Qty Unit Unit Price Total I Furnish & Install Meter Service Pedestal per C.O.S.A. Std. Plan on New Foundation 1 EA 2 Furnish & Install Double King Street Light Pole per C.O.S.A. Std. 1126A on New Foundation I EA 3 Furnish & Install Single King Street Light Pole per C.O.S.A. Std. 1126E on New Foundation I EA 4 Famish & Install Ameron Street Light Pole per C.O.S.A. Std. 1126H on New Foundation I EA 5 Furnish & Install #8 AWG Wire (Co er) 100 LF 6 Furnish & Install #10 AWG Wire (Copper) 100 LF 7 Furnish & Install #12 AWG Wire Co er 100 LF 8 Furnish & Install #6 AWG Overhead Wire (Aluminum) 100 LF 9 Furnish & Install 2" Conduit PVC Schedule 40 100 LF 10 Furnish & Install 3" Conduit PVC Schedule 40 100 LF 11 Furnish & Install No. 3 Pull Box 4 EA 12 Furnish & Install No. 5 Pull Box I EA Sam pie Task Order C — Concrete Paving - Wheel Chair Ramps Item Description Qty Unit Unit Price Total 1 Unclassified Excavation 550 CY 2 PCC Sidewalk (17=4") 2,500 SF 3 PCC Curb Ramp 3,000 SF 4 PCC Curb and Gutter (C.O.S.A. Std. Plan I101, Type A-2-8) 100 LF 5 PCC Curb (C.O.S.A. Std. Plan 1101, Type B-I) 100 LF 6 PCC Spandrel (C.O.S.A. Std. Plan 1109) 500 SF City of Santa Ana RFP 21-095 Exhibit Page Al-3 RE -ADVERTISEMENT 7 PCC Cross Gutter (C.O.S.A. Std. Plan 1109) 500 SF 8 18" Deep Polyethylene Root Barrier (C.O.S.A. Sid. Plan 1124 & 1124B) 50 LF 9 Root Shaving (C.O.S.A. Std. Plan 1124A) 6 EA SURETY BOND For each Task Order Issued by Public Works Agency, the City may or may not require the Contractor to provide cash deposit or surety "Payment" and "Performance" bond. Depending upon the size, nature and risk of the work, the City may use the amounts specified by the "Greenbook," surface drainage or street improvement plan measurements, or the approved itemized cost for each On -call or Emergency Task Order to calculate bond amounts, if any. Task Order work shall be per the City's Standard Plans, As -Built Plans, or other direction from the Public Works Agency. If required for a Task Order, the cash deposit or the surety bonds shall guarantee the construction of all necessary improvements for the Task Order, however. Bid Bonds were not required at the time of the submittal of RFP Proposal. For Task Orders, the City also reserves the right to retain 10% of progress pay amounts for the one-year warranty work. If so, the cash deposit shall be released approximately 135 days after all related permits and/or other approvals required are signed off by the City's Construction Inspector, and the passage of any lien periods. In the event the work is not completed within one year of the date that a street work permit or Task Order is signed, applicant agrees that the City may apply the cash deposit to the cost of completing the work and such work may be completed at the sole convenience of the City of Santa Ana. CONTRACTOR RESPONSIBLITIES Contractor must be able to respond to City's request for emergency repair work on a timely and urgent manner. The contractor shall be available on an on -call basis, 2417, and ready to respond in the event of an emergency. Service calls shall be responded within one hour. Contractor's repair crews must be able to arrive at job site within 8 hours of approval from City to commence work. Regular business hours are considered from 7:00 am to 5:00 pm (Monday through Friday). Anytime outside of business hours of operation may be considered after hours/weekends. The Contractor shall, prior to award of contract and without additional expense to the City, possess all licenses and permits (unless waived by the City) required for the performance of the work required by this contract, including but not limited to a California Class (A or C-10) Contractor's license and a City of Santa Ana Business License. 1. Street work shall be required to be performed by a licensed contractor for any and all the work in the public right of way. The contractor must provide the following prior to initiating Task Order work. a. A City of Santa Ana business license. b. A Certificate of Insurance of general liability containing requirements as set forth by the City Attorney and per the Standard Agreement. c. A Contractors license (with appropriate classification). d. Proof of Worker's Compensation Insurance. City of Santa Ana RFP 21-095 Exhibit Page A1-4 RE -ADVERTISEMENT 2, Provide BMPs and/or erosion control plans for planned Task Order work unless directed otherwise by the City. 3. If required, the Contractor shall submit, for review and approval, a surface drainage/grading/erosion control plan, prepared by a registered civil engineer, showing the direction and means of flow within the street. SUBCONTRACTORS Any Subcontractors intended to be used, shall be listed in the proposal. Any additional subcontractors that may become necessary, shall require approval by the City prior to start of any assigned work. When a Subcontractor performs all or any part of the work, a markup shall be applied to the Subcontractor's 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. PAYMENT AND INVOICING: Selected Contractor shall invoice the City based on time and material according to the City's standard invoice template. Tasks and hours shall be clearly identified and all rates must match those included in the approved agreement. City shall retain ten percent (10%) of the invoice amount from each payment until the completed Project has been accepted by the City. CITY RESPONSIBILITIES:' The City will provide information in its possession relevant to the preparation of the required information in the RFP. The City will provide only the staff assistance and the documentation specifically in referred to herein. • Furnish scope of work and provide general direction as needed for any assigned Task Orders • All plan check coordination within the City • Construction administration • Electronic files (sample plans & specifications, City of Santa Ana's CADD Standards), if needed • Electronic files for title sheets and sheet borders, if needed DEFINITION OF ITEMS (SAMPLE TASK ORDERS A (TRAFFIC SIGNAL). B (STREET LIGHT) C (CONCRETE PAVING - WHEELCHAIR RAMPS)): The unit prices paid for the items listed in the Contractor's Proposal as defined herein shall be considered full compensation for furnishing all labor, materials, tools, and equipment, and doing all work involved in furnishing and installing the materials complete and in place, in accordance with the details shown on the Plans, as specified herein, and as directed by the Engineer. All incidental work which is neither shown on the Plans nor otherwise specified, and which is necessary to complete the improvements as shown on the Plans and as specified in the Contract Documents (defined in the Contract/Agreement), shall be furnished and installed as though such work were shown on the Plans or specified in the Contract Documents, and no additional compensation shall be allowed therefore. City of Santa Ana RFP 21-095 Exhibit Page A1-5 RE -ADVERTISEMENT Each Sample Task Order's work items include, but are not limited to, the following listed below for the Fee Schedule Submittal. Actual Task Order work, if granted, will generally be on a competitive bid, Time and Materials, basis as described in Section I.A. "Nature of Work" in the RFP, in accordance with labor rates for the type of work and material required per Task Order granted and according to the schedule of rates provided as part of this proposal. "The Sample Task Order information provided will primarily be used to compare various proposals." Sample Task Order A - Traffic Signal Items of Work (Assume all work within Paved areas) Bid Item No. 1— Install City Furnished Type 332 Controller Cabinet on New Foundation (2-4 phases): This work consists of installing a City furnished Type 332 Controller Cabinet for a 2-4 phase operation on a new foundation. Contractor shall perform all needed excavations, and furnish all materials needed to install Type 332 Controller Cabinet and shall include but not be limited to, concrete foundation, conduit, concrete restoration, installing and re -connecting all field wiring, traffic control and traffic signal turn -on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. City will furnish and install traffic signal controller and provide technical turn -on support including traffic signal timing. The lump sum price bid to Install City Furnished Type 332 Cabinet shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 2 — Install City Furnished Type 332 Controller Cabinet on Existing Foundation (2-4 phases): This work consists of installing a City furnished Type 332 Controller Cabinet for a 2-4 phase operation on an existing foundation. Contractor shall furnish all materials needed to install Type 332 Controller Cabinet and shall include but not be limited to, installing and re -connecting all field wiring, traffic control and traffic signal turn -on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. City will furnish and install traffic signal controller and provide technical turn -on support including traffic signal timing. The lump sum price bid to Install City Furnished Type 332 Cabinet shall include full compensation for furnishing all labor, materials, tools, equipment, and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. City of Santa Ana RFP 21-095 Exhibit Page A1-6 RE -ADVERTISEMENT Bid Item No. 3 — Install City Furnished Type 332 Controller Cabinet on New Foundation (4-8 phases): This work consists of installing a City furnished Type 332 Controller Cabinet for a 4-8 phase operation on a new foundation. Contractor shall perform all needed excavations, and furnish all materials needed to install Type 332 Controller Cabinet and shall include but not be limited to, concrete foundation, conduit, concrete restoration, installing and re -connecting all field wiring, traffic control and traffic signal turn -on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. City will furnish and install traffic signal controller and provide technical turn -on support including traffic signal timing• The lump sum price bid to Install City Furnished Type 332 Cabinet shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 4 — Install City Furnished Type 332 Controller Cabinet on Existing Foundation (4-8 phases): This work consists of installing a City furnished Type 332 Controller Cabinet for a 4-8 phase operation on an existing foundation. Contractor shall furnish all materials needed to install Type 332 Controller Cabinet and shall include but not be limited to, installing and re -connecting all field wiring, traffic control and traffic signal turn -on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. City will furnish and install traffic signal controller and provide technical turn -on support including traffic signal timing. The lump sum price bid to Install City Furnished Type 332 Cabinet shall include full compensation for furnishing all labor, materials, tools, equipment, and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 5 — Furnish and Install Type 1A Traffic Signal Pole on New Foundation: This work consists of famishing and installing Type IA Traffic Signal Pole including conduit, excavation, concrete foundation, concrete restoration, installing and re -connecting all field wiring, complete removal of existing foundation, traffic control and traffic signal turn -on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. The unit price bid per each Type IA Traffic Signal Pole shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 6 — Furnish and Install Type IA Traffic Signal Pole on Existing Foundation: This work consists of removing and salvaging existing Traffic Signal pole, famishing and installing Type IA Traffic Signal Pole including conduit, concrete restoration, installing and re -connecting all field wiring, traffic City of Santa Ana RFP 21-095 Exhibit Page Al-7 RE -ADVERTISEMENT control and traffic signal tum-on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. The unit price bid per each Type IA Traffic Signal Pole shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 7 — Furnish and Install Type 15TS New Traffic Signal Pole: This work consists of furnishing and installing Type 15TS Traffic Signal Pole including conduit, excavation, concrete foundation, concrete restoration, installing and re -connecting all field wiring, complete removal of existing foundation, traffic control and traffic signal tum-on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. The unit price bid per each Type 15TS Traffic Signal Pole shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 8 — Furnish and Install Type 15TS Traffic Signal Pole on Existing Foundation, This work consists of removing and salvaging existing Traffic Signal pole, furnishing and installing Type 15TS Traffic Signal Pole including conduit, concrete restoration, installing and re -connecting all field wiring, traffic control and traffic signal tum-on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. The unit price bid per each Type 15TS Traffic Signal Pole shall include full compensation for famishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 9 to 11 —Furnish and Install PVC Conduit: This work consists of furnishing and installing Polyvinylohloride (PVC) traffic signal and/or interconnect communication conduit including pull tape, ground wire, fittings, duct seal and appurtenances complete and in place, per latest Caltrans Standards, City of Santa Ana Specifications and of the size indicated on the plans. The unit price bid per linear foot of PVC Conduit shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 12 to 13 — Furnish and Install Pull Box: This work consists of furnishing and installing and/or replacing pull box including the removal and/or modification of any interfering portions of existing pullbox, conduit, PCC, etc, per latest Caltrans Standards, City of Santa Ana Specifications and of the size indicated on the plans. The unit price for each Pull Box shall be considered full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No City of Santa Ana RFP 21-095 Exhibit Page Al-S RE -ADVERTISEMENT additional compensation will be allowed therefore. Bid Item No. 14 to 19 — Furnish and Install Traffic Signal Loop Detector This work consists of furnishing and installing Caltrans Loop Detector including splice connections, curb termination conduit, fittings and sealant per latest Caltrans Standards, City of Santa Ana Specifications and of type indicated on the plans. The unit price for each Traffic Signal Loop Detector shall be considered full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 20 — Furnish and Install Overhead Reflectorized Street Name Sign (RSNS) This work consists of furnishing and installing Overhead Reflectorized Street Name Sign (RSNS) including RSNS, sign frame & panel assembly, mounting assembly and fittings per latest Caltrans Standards, City of Santa Ana Specifications, City Standard Plans and of size and message indicated on the plans. The contractor is responsible for any modification to the mounting framework to ensure proper fit of the RSNS. The unit price for each Overhead Reflectorized Street Name Sign (RSNS) Detector shall be considered full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 21— Install City Furnished Overhead Reflectorized Street Name Sign (RSNS) This work consists of installing City famished Overhead Reflectorized Street Name Sign (RSNS). Contractor shall furnish all materials needed to install RSNS and shall include but not be limited to sign frame & panel assembly, mounting assembly and fittings per latest Caltrans Standards, City of Santa Ana Specifications, City Standard Plans and of size and message indicated on the plans. The contractor is responsible for any modification to the mounting framework to ensure proper fit of the RSNS. The unit price for each Install City Furnished Overhead Reflectorized Street Name Sign (RSNS) Detector shall be considered full compensation for furnishing all labor, materials, tools, equipment, and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed therefore. Bid Item No. 22 to 24 — Furnish and Install Single Mode Fiber Optic Cable: This work consists of famishing and installing Corning Cable Systems Single Mode Fiber Optic Cable including trace wire, labeling, reel testing, OTDR testing and appurtenances complete and in place, per latest Caltrans Standards, City of Santa Ana Specifications and of fiber strands indicated on the plans. The unit price bid per linear foot of Single Mode Fiber Optic Cable shall be considered full compensation for famishing materials, labor, equipment, tools and incidentals and no additional compensation will be allowed therefore. City of Santa Ana RFP 21-095 Exhibit Page AI-9 RE -ADVERTISEMENT Bid Item No. 25 — Furnish and Install Fusion Splice 1 Strand of Single mode Fiber Optic (SMFO): This work consists of furnishing and installing Fusion Splice 1 Strand Single Mode Fiber Optic Cable including pigtails, connectors, labeling, and OTDR testing per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on the plans. The unit price bid per each Fusion Splice 1 Strand Single Mode Fiber Optic Cable shall be considered full compensation for famishing materials, labor, equipment, tools and incidentals as required and no additional compensation will be allowed therefore. Bid Item No. 26 — Furnish and Install Fiber Optic Splice Enclosure: This work consists offumishing and installing a Coming Cable Systems Fiber Optic Splice Closure including splice trays, pigtails, connectors, per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on the plans. The unit price bid per each Fiber Optic Splice Closure shall be considered full compensation for famishing materials, labor, equipment, tools and incidentals and no additional compensation will be allowed therefore. Bid Items No. 27 — Pothole Pole Locations for Utility Conflicts: Payment for Pothole Pole Locations for Utility Conflicts shall be at contract unit price bid per each item listed in the Bid Proposal, and shall include full compensation for famishing all materials, labor, equipment, tools, disposal of all removed materials, and incidentals as required and no additional compensation will be allowed therefore. Bid Items No. 28 — Furnish and Install 3-M Vinyl Wrap by Econolite for Type 332 Cabinet: This work consists of famishing and installing 3-M vinyl wrapping with Clean Slate Group graffiti resistant laminate, manufactured by Econolite. Vinyl wrap shall be installed onto existing cabinet in strict adherence to manufacturer recommendations and shall be free of air bubbles, wrinkles, and/or lifted sections, edges or comers. Vinyl graphics theme and layout shall be reviewed and approved by Engineer prior to printing and installing vinyl on cabinet. The unit price for each 3-M Vinyl Wrap by Econolite shall be considered full compensation for famishing all labor, materials, tools, equipment, traffic signal cabinet preparation and appurtenances for all related items of work necessary for the installation of the vinyl wrap. No additional compensation will be allowed therefore. City of Santa Ana RFP 21-095 Exhibit Page Al-10 RE-ADVERTISEVIENT Sample Task Order B - Street Light Items of Work (Assume all work within Paved areas) Bid Item No. 1 — Furnish and Install Meter Service Pedestal per C.O.S.A. Std. Plan on New Foundation: This work consists of famishing and installing Meter Service Pedestal including excavation, new concrete foundation, conduit, concrete restoration, installing and re -connecting all field wiring, traffic control and street light turn -on support per latest Caltrans Standards, City of Santa Ana Specifications and as indicated on plans. Contractor shall famish and install meter service pedestal, coordination with service provided Southern California Edison (SCE) and provide technical street light tam -on support. The lump sum price bid to Furnish and Install Meter Service Pedestal shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed. Bid Item No. 2 — Furnish and Install Double King Street Light Pole per C.O.S.A. Std. 1126A on New Foundation: This work consists of furnishing and installing Double King Street Light Pole including excavation, concrete foundation, conduit, concrete restoration, installing and re -connecting all field wiring, traffic control and traffic signal tum-on support per latest Caltrans Standards, City of Santa Ana Standard 1126A, Specifications and as indicated on plans. The unit price bid per each Double King Street Light Pole shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed. Bid Item No. 3 — Furnish and Install Single King Street Light Pole per C.O.S.A. Std.1126E on New Foundation: This work consists of famishing and installing Single King Street Light Pole including excavation, concrete foundation, conduit, concrete restoration, installing and re -connecting all field wiring, traffic control and traffic signal tum-on support per latest Caltrans Standards, City of Santa Ana Standard 1126E, Specifications and as indicated on plans. The unit price bid per each Single King Street Light Pole shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed. City of Santa Ana RFP 21-095 Exhibit Page Al-11 RE -ADVERTISEMENT Bid Item No. 4 — Furnish and Install Ameron Street Light Pole per C.O.S.A. Std. 1126H on New Foundation: This work consists of famishing and installing Ameron Street Light Pole including excavation, concrete foundation, conduit, concrete restoration, installing and re -connecting all field wiring, traffic control and traffic signal turn -on support per latest Caltrans Standards, City of Santa Ana Standard 1126H, Specifications and as indicated on plans. The unit price bid per each Ameron Street Light Pole shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed. Bid Item No. 5 to 8 — Furnish and Install #8, #10 and #12 AWG Wire (Copper) and #6 AWG Overhead Wire (Aluminum) This work consists of furnishing and installing AWG Wire Copper or Aluminum, including splice connections, curb termination conduit, fittings and sealant per latest Caltrans Standards, City of Santa Ana Standards, Specifications and of type indicated on the plans. The unit price bid per linear foot shall be considered full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed. Bid Item No. 9 to 10 — Furnish and Install PVC Schedule 40 Conduit: This work consists of furnishing and installing Polyvinylchloride (PVC) street lighting electrical conduit including pull tape, ground wire, fittings, duct seal and appurtenances complete and in place, per latest Caltrans Standards, City of Santa Ana Standards, Specifications and of the size indicated on the plans. The unit price bid per linear foot of PVC Schedule 40 Conduit shall include full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed. Bid Item No. 11 to 12 — Furnish and Install Pull Box: This work consists of furnishing and installing and/or replacing pull box including the removal and/or modification of any interfering portions of existing pullbox, conduit, PCC, etc, per latest Caltrans Standards, City of Santa Ana Standards, Specifications and of the size indicated on the plans. The unit price for each Pull Box shall be considered full compensation for furnishing all labor, materials, tools, equipment, paving and appurtenances for all related items of work necessary for the installation. No additional compensation will be allowed. City of Santa Ana RFP 21-095 Exhibit Page Al-12 RE -ADVERTISEMENT Sample Task Order C - Wheelchair Ramp items of Work Item No. 1 - Unclassified Excavation Payment for Unclassified Excavation shall be at the contract unit price per Cubic Yard listed in the Fee Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. Payment for unclassified fill, if any, is considered as included in the unit price paid for unclassified excavation. Payment for over -excavation shall be paid for at the unit price for unclassified excavation. Item No. 2 - PCC Sidewalk (T=4") The work under this item consists of grading, compacting subgrade, and constructing 4-inch thick PCC Sidewalk in accordance with the provisions of Section 301-1, "Subgrade Preparation," and Section 303-5, "Concrete Curbs, Walks, Gutters, Cross Gutters, Alley Intersections, Access Ramps, and Driveways," of the Standard Specifications, plans, and contract document specifications. Payment for this item shall be at the contract unit price bid per Square Foot as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. Payment for thickness (T=6") shall be paid 1.5 times the unit price. Item No. 3 - PCC Curb Ramp The work under this item consists of grading, compacting subgrade, and constructing 4-inch thick PCC Curb Ramp including detectable warning surface, curb & gutter in accordance with the provisions of Section 301- 1, "Subgrade Preparation," and Section 303-5, "Concrete Curb, Walks, Gutters, Cross Gutters, Alley Intersections, Access Ramps, and Driveways," of the Standard Specifications and contract document specification . Payment for this item shall be at the contract unit price bid per Square Foot as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. Item No. 4 - PCC Curb & Gutter (A-2-8) The work under this item consists of grading, compacting subgrade, and constructing PCC Curb & Gutter in accordance with the provisions of Section 301-1, "Subgrade Preparation," and Section 303-5, "Concrete Curbs, Walks, Gutters, Cross Gutters, Alley Intersections, Access Ramps, and Driveways," of the Standard Specifications, plans, and contract document specifications. Payment for this item shall be at the contract unit price bid per Linear Foot as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. City of Santa Ana RFP 21-095 Exhibit Page Al-13 RE -ADVERTISEMENT Item No. 5 - PCC Curb (B-1) The work under this item consists of grading, compacting subgrade, and constructing PCC Curb in accordance with the provisions of Section 301-1, "Subgrade Preparation," and Section 303-5, "Concrete Curbs, Walks, Gutters, Cross Gutters, Alley Intersections, Access Ramps, and Driveways," of the Standard Specifications, plans, and contract document specifications. Payment for this item shall be at the contract unit price bid per Linear Foot as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. Item No. 6 - PCC Spandrel The work under this item consists of grading, compacting subgrade, and constructing 9-inch thick PCC Spandrel in accordance with the provisions of Section 301-1, "Subgrade Preparation," and Section 303-5, "Concrete Curbs, Walks, Gutters, Cross Gutters, Alley Intersections, Access Ramps, and Driveways," of the Standard Specifications, plans, and contract document specifications. Payment for this item shall be at the contact unit price bid per Square Foot as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. Item No. 7 - PCC Cross Gutter The work under this item consists of grading, compacting subgrade, and constructing 9-inch thick PCC cross gutter in accordance with the provisions of Section 301-1, "Subgrade Preparation," and Section 303-5, "Concrete Curbs, Walks, Gutters, Cross Gutters, Alley Intersections, Access Ramps, and Driveways," of the Standard Specifications, plans, and contract document specifications. Payment for this item shall be at the contract unit price bid per Square Foot as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. Item No. 8 - Furnish and Install 18" Deep Polyethylene Root Barrier Payment for this item shall be at the contract unit price bid per linear foot as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. Item No. 9 - Root Shaving Payment for this item shall be at the contract unit price bid per Each as listed in the Bid Proposal, and shall include full compensation for doing all work, including furnishing all materials, labor, equipment, tools, and incidentals as required and no additional compensation will be allowed therefore. City of Santa Ana RFP 21-095 Exhibit Page Al-14 EXHIBIT B Or�,ylgi. City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, �� OT3 STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Electrical Data, Inc. Due Date: April 19, 2022 April 19, 2022 City of Santa Ana 20 Civic Center Plaza, M-43 Santa Ana, CA 92701 To Whom it May Concern: Crosstown Electrical and Data Inc. ("Crosstown") is pleased to submit this proposal in response to the City of Santa Ana On -Call Construction Services for Traffic Signals, Street Lights and Concrete Wheel Chair Ramp Project, RFP No.: 21-095, Crosstown Electrical and Data, Inc. is a Southern California based Electrical & General Contractor specializing in the Installation of Electrical and ITS Infrastructure, fiber optics, copper, wireless, communications, closed circuit television systems, conduit installation, traffic signal installations, modifications, and maintenance. We were incorporated in 1998 as a C-Corporation and are in our twenty- fourth successful year providing these services. Our corporate office is at 5454 Diaz Street in the City of Irwindale, California. We own an 11,000 SF building with offices, test laboratory, fabrication shop, and storage yard. Crosstown has a strong management team, with each member having at least twenty years of field experience, both in the technical and management areas for the installation of electrical, ITS and other complex systems. Crosstown has developed an in-house team who is highly proficient in the implementation, installation, integration and maintenance of electrical and ITS Infrastructure, fiber optic, video, wireless, and data communications systems and have established themselves as premier integrators and installers of Traffic, Transportation, Rail, and Public Works related electrical infrastructure and systems in Southern California. Crosstown also has a strong construction division specializing in the installation of conduit, traffic signals, wire/cable, pedestrian equipment and complete intersections. We are licensed to contract for all types of electrical and general construction work (A and G-10 License Number 756309). For the Concrete portion of this project, we will be using a subcontractor who maintains a C-8 license. We are signatory with the local electrical unions (IBEW Locals 11, 440, 441, 477, and 952) and have the resources to gear up rapidly should a contract require such action. We also own all of our own bucket trucks, work trucks, bobcats, crane, boring rig, and traffic control equipment. Crosstown is a Corning Network Preferred Installer, which allows a 25-year LANscape Solutions extended warranty to end users. Crosstown also has a Traffic Signal Maintenance Division that currently employs professional IMSA certified traffic signallstreet light electricians and an operational staff consisting of dispatchers, billing specialists, customer service representatives, purchasing agent, and management team which allows us to provide 2417 support. Crosstown currently has 138 employees and has averaged over 31 million dollars worth of work per year over the past 3 years. We are financially strong, bondable, and have an excellent relationship with our banking facility, American Business Bank. Crosstown agrees to provide its most recent audited financial statement upon the City's request. A bonding capacity letter has been included as an attachment to this RFP. Page 11 City of Santa Ana � ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, C'C]),15lll'1'1I STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Electrical Data. Inc. Due Date: April 19, 2022 Crosstown has reviewed the Agreement, per Attachment 2, and finds the terms acceptable and will be willing and able to sign and comply with the Agreement when issued. Per the specification, this proposal is valid for a period of 120 days after submission. Our firm is very confident that we can provide superior service and meet all of the requirements set forth in this request for proposals. Thank you for your time and consideration and we look forward to serving the city of Santa Ana. Best Regards, 1L. Benjamin Heermance — Chief Financial Officer 5454 Diaz St. Irwindale, CA 91706 Phone: (626) 813-6693 bheermancea..crosstowndata.com 21 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, ! T P STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS C e trical S'Ibat , 7 I Due Date: April 19, 2022 TABLE OF CONTENTS 1. Cover Letter ...................................................................................................................1 2. Table of Contents......................................................................................................... 3 3. Company Qualifications...............................................................................................4 4. Qualifications of Management Staff and Key Personnel...........................................5 S. Company Experience/ References..............................................................................7 6. Understanding of Scope..............................................................................................9 7. Company Organization...............................................................................................18 8. Financial Statement....................................................................................................18 9. Attachments................................................................................................................19 • Attachments 3-1 to 3-12 • Resumes • Subcontractor Information • Bonding Capacity Letter Pn_. 31 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Due Date: April 19, 2022 Crc�ss�or��z Electrical. Data lnc. COMPANY QU.ALiFICA TIONS and Ti;81M EXPERIENCE Crosstown Electrical & Data, Inc. was incorporated in 1998 and has been providing Electrical, ITS and traffic signal services successfully for the past 24 years and we are proud to now offer a Traffic Signal Maintenance Division with the acquisition of the former Computer Services Company that has been continuously providing Traffic Signal Maintenance services over the past 40 years. Crosstown is 100% owned and operated by Mr. David Heermance. We currently have 138 employees with the qualified staff necessary to perform the tasks and services required of this request for proposal. Crosstown has excellent relationships with many cities throughout California and maintains multiple on -call traffic signal maintenance contracts. Crosstown maintains a Class "A" General Construction license and a class "C-10" Electrical license, No. 756309, which Expires 11/30/22. We are registered with the Department of Industrial Relations, DIR # 100000155. The individuals that are able to sign for and bind the company include Crosstown's officers:David P. Heermance, President; Wendy Parker, Vice President; Andrea Heermance, Secretary; and Benjamin Heermance, Chief Financial Officer. Below is Contact information for the Main Point of Contact for this project: Company Name: Legal Form of Company: License no.: Federal Employer ID #: DIR #: Project Contact: Telephone Number: Cell Phone: Email: Corporate Office: 41 Crosstown Electrical & Data, Inc. Corporation 756309 22-3611877 1000000155 David P. Heermance, President (626) 813-6693 (626) 926-0031 daveO-crosstowndata.com 5454 Diaz Street Irwindale, CA. 91706 (626) 813-6693 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, ' la czsSf bi'vi.1 STREET LIGHTS, AND CONCRETE WHEEL CHARRAMPS Electrical , [Data, inc. Due Date: April 19, 2022 KEY PERSONNEL / QUALIRCATiONS A. Crosstown's Management Contacts and Key Staff Crosstown will maintain adequate level of labor resources as required by the Scope of Work. The designated manager will have full involvement of the work effort. The following key personnel and support team will be associated with the fulfillment of this Scope of Work and performance of specified tasks. L David Heermance, President - (50% availability) Mr. Heermance is the President and CEO of Crosstown Electrical & Data, Inc. which has been providing Electrical and communication services since 1998. He holds a General Construction Class A license as well as an Electrical Class C-10 License and has led Crosstown to experience continual growth and success each year. Mr. Heermance brings over40 years of overall experience in the installation, operation, maintenance and management of electronic equipment, communications, traffic signals and fiber optic systems to his team. He has in-depth knowledge and understanding of data communications, fiber optics, video, and their application to traffic signals and Intelligent Transportation Systems. Furthermore, Mr. Heermance has developed exceptional management skills in relation to construction and maintenance and ensures that each project is completed successfully and with a satisfied customer. ii. Jerry Davis — (60% availability) Senior Traffic Signal Maintenance Operations Manager: As Senior Operations Manager Jerry is also the Contact Compliant Manager for this contract. He is responsible for providing strong strategic leadership for the company by working with other management staff and ownership to establish long-range goals, strategies, plans and policies. As well as plan, develop, organize, implement, direct and evaluate the organization's fiscal function and performance, Jerry works closely with our entire team as well as our clients. He is responsible for the day-to-day direction, oversight and quality control of and delivery of service on this contract. Jerry has over 35 years of experience in traffic signal construction, maintenance and service operations, many of those years have been spent in high profile leadership roles. Jerry worked many of his years in this industry as an IBEW Union journeymen electrician, foreman, and general foremen and as a Project Engineer for Steiny & Co. Jerry came to CSC in early 2013 to oversee all aspects of the company's operations and now manages all Traffic Signal Maintenance operations at Crosstown. He is an active IMSA Member and holds his IMSA Work Zone Safety, Level I and Level II Traffic Signal Field Technician Certifications. iii. Alex Zepeda — (40% availability)Superintendent: / NEC Certified / IMSA Field Electrician Level 11: Alex came to Crosstown in 2005 and has over 18 years of experience in communication integration work. He specializes in CCTV camera 51 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, C11 OT�V]2 STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Sectrloal Data,Inc. Due Date: April 19, 2022 installation and integration. Alex worked for CSC from 2001-2005 where he got his IMSA Field Electrician Level II. During this time he was a field electrician and has the background on Traffic Signal Cabinets as well as the maintenance of City intersections. Alex has experience in all types of wireless communication systems and integration and an excellent understanding of communication media such as copper and fiber technologies. He is a Certified Electrician and Fiber Optic Installer and has Certifications for Bridge Wave Wireless Technology and Comnet Ethernet and Communication also OSHA 10/30 Certification. Alex received his Associates Degree in 2002 from ITT in Science of Electronic Engineering. Alex is available for on -call or backup needs for an IMSA certified technician. Iv. Ricardo Avila— (30% availability) Construction Superintendent: Mr. Avila is a State Certified Electrician and has been with Crosstown since 2009. He is extremely knowledgeable in all aspects of construction and electrical installations and has great leadership skills. He is OSHA certified, lead and asbestos certified and trench excavation safety trained. See attached resume for additional information. v. James P. Nelson — (30% availability) Fiber Optic Supertintendent: Mr. Nelson is a certified fiber optics installer and OSHA 10130 certified. He has been with Crosstown since 2011 and is responsible for managing our fiber optics division See attached resume. A. Michael Linden- (30% availability) Maintenance Electrician 1 NEC Certified 1 IMSA Field Electrician Level III: Michael has an Associate Degree in Electronics Technology and has his Level III IMSA Field certification. He has over 25 years of experience as a certified technician. Mr. Linden is also IMSA Work safety certified, has up to date training on Econolite controller and software, as well as McCain 2070 controller and software training, has taken iteris VDS training courses and is Bucket truck certified. He began working in the traffic signal maintenance field in 1985 and has worked for the cities of Concord, CA and Everett, WA as well as for Gray Electric Company and Cal Signal Corp. for Traffic Signal Maintenance. Most recently before coming to us he had worked with the City of Long Beach, CA from Oct 2018 to Apr 2019 and the City of Burlingame, CA Apr 2010 to Oct 2018 as a traffic signal maintenance technician. A1. Shea Grotke- (30% availability) Maintenance Technician / IMSA Field Technician Level II: Shea has a Bachelors of Arts in Computer Science from Cal State San Bernardino. He has experience as a General Maintenance Supervisor of a Building Complex and working in General Construction for Shimmick. Shea joined Crosstown in March of 2020 and has his IMSA Work Zone Safety and Traffic Signal Level I certifications, and recently passed his level II test and will have his certification soon. Shea is also an IBEW Union Traffic signal Maintenance Technician, he is bucket truck certified, and trained in Iteris Video Detection systems, Gridsmart Video Detection systems, and Econolite Controller Page 61 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, CL"Y�SS =0T'1'11 STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Electrical __ Due Date: April 19, 2022 Programming. He has currently been providing Maintenance services in the cities of Laguna Hills, West Hollywood, Maywood and Los Alamitos. B. Subcontractors See attachments for additional information for each subcontractor. Smithson Electric. Inc. — Loop installation Chris Zell 1938 E. Katella Avenue Orange, CA 92867 chrisla smithsonelectric.com Pavement Rehab Company — Wheelchair Ramps/Roadwork Vivian Tran 1181 Princess Ct. Costa Mesa, CA 92626 vivianT(a)paverehabco.com CUE T REFERENCES A. List of Current Representative Projects and Contact information. Crosstown currently works with several cities for On -Call Traffic Signal Maintenance. Below are several cities that we currently have 24/7 Maintenance contracts with that we have reliably been able to respond to th eagency's on -call and/or emergency needs within the past 5 years. Please see attached reference list for additional construction projects completed with similar work to the sample task orders as well as reference projects for our Concrete and Loop subcontractors. City of Downey (101 Intersections, Traffic Signal Maintenance & Emergency on Call Services) Edwin Norris, Deputy Director of Public Works 11111 Brookshire Ave., Downey, CA 90241 (562)904-7110 enorris cadowneyca.orq City of San Dimas (36 Intersections, Traffic Signal Maintenance & Emergency on Call Services) Chase Buckelew, Public Works Maintenance Superintendent 245 East Bonita Avenue, San Dimas, CA 91773 (909)394-6270 cbuckelewaci.san-dimas.ca. us 71 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Edi'OT 112 ElertriCal;`-..' Oata,lnc. Due Date: April 19, 2022 City of Azusa (47 Intersections, Traffic Signal Maintenance & Emergency on Call Services) Robert Delgadillo P.E., Director of Public Works / City Engineer 213 E. Foothill Boulevard, Azusa, CA 91702 (626)812-5248 rdelgadilloCa azusaca.gov City of Laguna Hills (49 Intersections, Traffic Signal Maintenance & Emergency on Call Services) Kenneth Rosenfield, Director of Public Works 24035 El Toro Road, Laguna Hills, CA 92653 (949)707-2655 kronsenfieldCa.ci.laguna-hil Is.ca. us City of El Monte (73 Intersection, Traffic Signal Emergency on Call Services) Frank Drevdahl, Public Works Administrative Analyst 3990 Arden Drive, El Monte, CA 91731 f drevdahMelmonteca.gov City of Monterey Park (63 Intersections, Emergency on Call Services) Cesar Vega, Civil Engineer Associate 320 W. Newmark Avenue, Monterey Park (626) 307-1320 cveoa(a.monterevpark.ca.00v Traffic Signal Maintenance & CA 91754 City of Hemet (41 Intersections, Traffic Signal Maintenance & Emergency on Call Services) Matt Devore, Facilities Maintenance Technician 3777 Industrial Avenue, Hemet, CA 92545 (951) 765-3710 mdevoreCfthofhemet.org 81 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, !� - STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Electrical,', .01 a iT Due Date: April 19, 2022 UNDERSTANDING OF THE SCOPE OF SERVICES The following sets forth Crosstown Electrical & Data's (Crosstown's) approach and understanding to accomplishing the tasks outlined in the Scope of Work (SOW). Crosstown complies with all applicable federal, state and local laws, codes, ordinances and regulations. Crosstown acknowledges the four main tasks set forth in this RFP and will provide and understanding of each task. General It is understood that the City of Santa Ana is seeking qualified construction companies to be on -call for Traffic Signals, Street Lights, and Concrete Wheel Chair Ramp work to assist the City to restore these items when necessary. It is understood that actual task order cost totals will be based on competitive basis cost proposals for the scope of work identified at the time of each task order. Crosstown will have all required tools, materials, equipment, apparatus, facilities and skilled labor services available to perform all work necessary for this RFP. A hydraulic bucket truck capable of reaching a height of at least 28 feet above ground will be available. Crosstown will provide all vehicles and traffic control necessary by our crews and vehicles will be equipped with permanently mounted warning strobe lights, traffic cones, construction warning signs. Traffic control/lane closures will conform to the California Manual on Uniform Traffic Control Devices. Crosstown will maintain a valid Class A and Class C-10 contractor license. Contractor license No. 756309 which expires on 11/30/22. We will also apply for and maintain a current City of Santa Ana Business license throughout the duration of the agreement. Crosstown will pay prevailing wages pursuant to Labor Code section 1771 and is registered with the Department of Industrial Relations, DIR #1000000155. Crosstown will be using a subcontractor, Pavement Rehab, which will maintain a C-8 License. Crosstown will also use a loop subcontractor, Smithson Electrical, Inc, which maintains a CA 0 license. It is understood that Crosstown will provide and maintain on -call services twenty-four (24) hours, seven (7) days per week and will be ready to respond in the event of an emergency. Service calls will be responded within one hour. Crosstown's repair crews will arrive at the job site within 8 hours of approval from the city to begin work. We will have available all required tools, equipment, apparatus, and materials to perform all work necessary to perform traffic signal, street light or concrete work as needed and required per task order. P 1 91 City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, �'1Ayj�12 STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Electrlcas, Data, nc. Due Date: April 19, 2022 Crosstown will maintain and provide mobile communication that allows the City direct phone and email communications with all supervisors and technicians assigned to the City and their designated representatives. This telephone number shall be made available to all persons designated by the City. Crosstown understands that needs may be different per task order and Crosstown will approach each task order in an individualized manner to provide the best service possible to the City of Santa Ana. Once the work is identified, a detailed quote will be prepared to inform the City of any possible costs. Once the task order is approved, Crosstown will assign the work to an appropriate Superintendent. Crosstown can perform all Traffic Signal and Street Light work, conduit work, Fiber and communication with its own forces. If the need arises for loops or concrete work Crosstown will subcontract work to the listed subcontractors and /or city approved subcontractors as needed. Crosstown will have all material approved by the city, procure all material and provide the labor and equipment to complete the Job in a timely manner and with the satisfaction of the City. In regards to the sample task orders provided with this RFP, Crosstown is very comfortable with the work required in these tasks and has the resources and crews available to complete the stated work upon approval. Page 101 City of Santa Ana , ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, ! "" ` STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Eel b-, 75.7- ti,71 Due Date: April 19, 2022 Company Orgariizaiion:al Chart GENERAL CONSTRUCTIONAND UNDERGROUND L DIVISION David P. Neennance e,es�denrCtO �Ben Neennaoce Wendy Pater i Chief Flnenclaoffcar j Vice president cotiMUNICAFION TRAMI SIGNAL ANUIMEWGEr FIRER OPTIC DIVISION TRANSPORTATION MAINTFRIANCE S ISTF.M 5 DIVISION DIVISION I Riranlo Avila Lames Nelson - i Alex ZeYeda Superintendent Superintendent Superintendent Ter,, Secrist Rryan Hond General Foreman Foreman5plicen Andr""rtterea NellGarmtt Foreman JOumeymdn Electrician Splicer 45+Foreman, Joumeyman,taboni and Operating Engineers (';ior' 111 G+Joumeyman Fiber Opticiechnicians 5an+Nasser Network Engineer ieny Laos Senlor Operation Manager Abraham Morales Leonardo Alvarado Foreman IMSA Field Electrician Leve1111 30F Foreman, Stea Cmtke Joumeymanand IMSA RelCTechncian NetssorkEngineers Laugh CdIvinitan5ml Project Manager Midwe Urden IIASAFIeld Electrl an Levelili Gait Grclke IMSA FieldTechniclan Levelll SPECIAL PROJECTS, TUNNELS & PUSVER G ENERAtIOPIDiVI516N JOTge Gomez Superintendent 15+Foreman, JWmeyman,Laborars and Operating Engineer; Albert5om IMSA Field Electrician Levellll City of Santa Ana ON -CALL CONSTRUCTION SREVICES FOR TRAFFIC SIGNALS, C1'OSgq L11 STREET LIGHTS, AND CONCRETE WHEEL CHAIR RAMPS Electrical Data.lnc. Due Date: April 19, 2022 ANANCIAL STATEMENT Our firm is financially strong and bondable and we have an excellent reputation for providing quality service to various cities and government agencies throughout Southern California. Crosstown has a 3 year average of over 30 million dollars in revenue. Crosstown is pleased provide a copy of our reviewed financial statements upon request. REFERENCES See attached documentation for additional reference information for Crosstown as well as our subcontractors. T`3YACHIMIENTS • Attachments 3-1 to 3-12 • Resumes • Subcontractor Information • Bonding Capacity Letter f i. 121 RE -ADVERTISEMENT Appendix ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT CERTIFICATIONS NMLOOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS In accordance 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 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 No sion Affidavit ' part of the Proposal. Signing this Proposal on the signature portion ereof sl also cons ' Signature of this Non -collusion Affidavit, BIDDERS are cautioned t rnaldnls e ' on may subject the certifier to criminal prosecution. Signed State of California County of LOS MIGELES Subscribed and sworn to (or affirmed) before me on this J q day of APRIL , 202Z by DAVID P. HEERMANCE , proved to me on the basis of satisfactory evidence to be the persons) who appeared before me. (SEE ATTACHED) Notary Public Signature Notary Public Seal City of Santa Ana RFP 21-095 Page A8.1 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles Subscribed and sworn to (or affirmed) before me on this 19th day of April 20 22 , by David Heermance proved to me on the basis of satisfactory evidence to be the persoonnN• who appeared before me. p0,21 SHALEA BERRY Notary Public. California Los Angeles County Lomrnissian; 7281271 My Comm. Expires Mar 16. 2823 (Seal) Signature RF AnVF.RT19PMPNT Appendix _---------. ATTACHMENT 3-2: NON -LOBBYING CERTIFICATION CERTMCATIONS 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 ofCongress, 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 paidor will be paid to any person for influencing or attempting to influence any 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, loan or cooperative agreement, the undersigned shall complete and submit a "Disclosure of Lobbying Activities". This certification is a material representation of fad 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 sub recipients shall certify and disclose accordingly. CROSSTOWN Signed and Printed Name: PRESIDENT Date APRIL 18, 2022 City of Santa Ana RFP 21-095 Page A3-2 RE-ADVERTISEIIIENT Appendix ATTACHMENT 3-3: NON-DISCRIMINATION CERTIFICATION CERTII ICATIONS The undersigned consultant or corporate officer, during the performance of this contract, certifies as follows: 1. 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. 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 niles, 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. 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 City of Santa Ana RFP 21-095 Page AM 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 sub -consultant 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 1 , and any consultant of public works violating this Section is subject to all pen ies imposed fpr iiolation of the Chapter. Signed: DAVID P. Title: Firm: CROSSTOWN ELECTRICAL & DATA, INC. Date: APRIL 18, 2022 City of Santa Ana RFP 21-095 Page A3-4 RE -ADVERTISEMENT Appendix ATTACHMENT 3-4: CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that the following is true and correct. Contractor's Name: CROSSTOWN ELECTRICAL & DATA, INC. Business Address: 5454 DIAZ STREET IRWINDALE CA 91706 Business E-Mail Address: DAVE@CROSSTOWNDATA.COM Telephone: (626) 813-6693 State Contractor's License No. and Class: 756309 , CLASS A & 0-10 License Expiration Date: 11 /30/22 State Dept. of Industrial Relations (DIR) Registration No.: State Dept. of Industri Re7ons (DIR) Registration Expira n Date: Signed: Title: PRESIDENT 1000000155 City of Santa Ana RFP 21-095 Page A3-5 RE -ADVERTISEMENT Appendix ATTACHMENT 3-5: PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, 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. Since the services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. 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. The undersigned certifies that the foregoing is true and correct Name of Firm CROSSTOWN EIS. ECTRICAL & DATA, Signature of CONTRACTOR Title PRESIDENT (if an individual, so state) City of Santa Ana RFP 21-095 Page A3-6 RE -ADVERTISEMENT Appendix ATTACIIlVIENT 3-6: OWNERSHW AFFIDAVIT OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) DAVID P. HEERMANCE , being duly swom, deposes and says: ❑ I DrMUAL That he/she is the patty making the foregoing proposal: ❑ PARTNERSHIP That he/she is a member of the co-parnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co- partnership by: who constitute the other members of the co -partnership. CORPORATION That he is oP. CROSSTOWN ELECTRICAL & DATA, INC. a corporation which is making the foregoing proposal: JOINT VENTURE That he is of: one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for himself or any other person. Signature of CONTRACTOR Subscribed and sworn to before me this 19 day of APRI L 2022 Signature of officer Administering Oath (Notary Public) City of Santa Ana RFP 21-095 Page A3-7 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles Subscribed and sworn to (or affirmed) before me on this 19th day of April 20 22, by David Heermance proved to me on the basis of satisfactory evidence to be the personK who appeared before me. SHALEA 6ERR Notary Public - California Los Angeles County x'y-,fy + Commission d 2291272 My Comm, Expires Ma; 16, 2023 (Seal) Signature-- / . , RE -ADVERTISEMENT Appendix ATTACHMENT 3-7: LIST OF SUB -CONTRACTORS LIST OF SUB -CONTRACTORS Section 4100 et, seq. of the Public Contract Code requires listing of all subcontractors with the proposal/bid for all subcontract work exceeding the following amount: o Streets, highways including bridge projects: '/2% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: ''/2% of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR). CONTRACTOR proposes to subcontract certain portions of the work to the firms listed below: Name 6MITHSON �eerr�i License #/Exp. blf�i Gib DIR Reg. #/Exp. IOl)UDO I b I d Location 193E E-KA'CEu,A AVE Phone -IIq 1611-IrgC✓6 Type Of Work t--OOP INSTAL Amount $ 55, S50 . 00 Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount $ Name License DIR Rel Locatiot Phone Type Of Amount Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount $ Name Name License #/Exp. License #/Exp. DIR Reg. #/Exp. AIR Reg. #/Exp. License # License # Location Location Phone Phone Type Of Work Amount $ r-er Signature of CO RACTOR Type Of V Amount $ City of Santa Ana RFP 21-095 Pago A3-8 Appendix ATTACHMENT 3-8: REFERENCES REFERENCES RE -ADVERTISEMENT The following are the names, addresses, and telephone numbers for THREE public agencies for which the CONTRACTOR has performed similar work within the past three years. 1. CITY OF SANTA CLARITA; 23920 VALENCIA BLVD. SANTA CLARITA CA 91355 Name and Address of Owner. Name and Telephone Nun $2,638,893.06 Contract Amount i familiar with project. _L BOXES/CONTROLLERS Type of Work 2. CITY OF SAN DIMAS; 245 E. BONITA AVE. SAN DIMAS CA 91773 Name and Address of owner. STEVEN BARRAGAN - (909) 394-6247 Name Contract familiar with project. rIONITRAFFIC SIGNAL Type of Work 05/2021 Date Completed Date Completed 3. CITY OF LOS ANGELES; 200 NORTH SPRING STREET, LOS ANGELES, CA 90012 Name and Address of owner. SHANE SMITH - (310) 345-1229 Name Number of person familiar with $4,722,233.00 TRAFFIC SIGNAL MODIFICATION 04/2020 Contract Amount Type of Work Date Completed The following are the names, addresses, email addresses, and telephone numbers of all brokers and sureties from whom CONTRACTOR intends to procure insurance and bonds. FIDELITY AND DEPOSIT COMPANY OF MARYLAND: 777 SOUTH FIGUEROA ST, SUITE 3900 LOS ANGELES CA 90017• (213) 270-0845 BROKER- COMMERCIAL SURETY BOND AGENCY; 411 N. BATAVIA ST., SUITE 201, ORANGE, CA; (714) 51&1232 INSURANCE - MCRAE ASSOCIATES INSURANCE SERVICES,1265 N. MANASSERO ST, SUITE 303, ANMEIM, CA 92807; (714) 779-6999 City of Santa Ana RFP 21-095 Page A3-9 RE -ADVERTISEMENT Appendix ATTACHMENT 3-8: REFERENCES PAVEMENT REHAB REFERENCES: REFERENCES, (CONTINUED) The following are the names, addresses, and telephone numbers for THREE public agencies for which the SUBCONTRACTOR has performed similar work in the past five years. I CITY OF SAN BERNARDINO - 290 NORTH D STREET, SAN BERNARDINO CA 92401 Name and Address of Owner. GEORGE FONVILLE (MATICH PM) 909-228-1656 DONNA FUENTES (SIR INSPECTOR) 909-384-5140; Name and Telephone Number of person familiar with project. DECEMBER 2020 $1,155,000 CONCRETE IMPROVEMENTS AT VARIOUS LOCATIONS Contract Amount Type of Work Date Completed 2 COUNTY OF RIVERSIDE - 4060 COUNTY CIRCLE DR, RIVERSIDE, CA 92503 Name and Address of owner. ANDREW POTTER (RIVCO ENG TEC Name and Telephone Number i $344,000 CONCRETE Contract Amount 951.850-6066; BRYAN BOUDREAUX with project. AT VARIOUS LOCATIONS Type of Work 3 CITY OF UPLAND -1370 NORTH BENSON AVE, UPLAND, CA 91786 COATING) 714-713-7981 OCTOBER 2020 Date Completed Name and Address of owner. DAVID RODRIGUEZ (UPLAND INSPECTOR) 909-376-2490; Name and Telephone Number of person familiar with project. $290 000 CONCRETE IMPROVEMENTS AT VARIOUS LOCATIONS APRIL 2022 Contract Amount Type of Work Date Completed The following are the names, addresses, email addresses, and telephone numbers of all brokers and sureties �omTyw� om. CONTRACTOR intends to procure insurance and bonds. ure m oan HARCO NATIONAL INSURANCE COMPANY 2400 EAST KATELLA AVE. SUrrE 250, ANAHEIM, CA 92806 Surety Brokerage TURNER SURETY AND INSURANCE BROKERAGE SURETY 714-602-9170 AGENT 714-955-4022 City of Santa Ana RFP 21-095 Page A3-10 RE -ADVERTISEMENT Appendix ATTAC RWENT 3-8:.REFERENCES SMITHSON ELECTRIC, INC. REFERENCES. (CONTINUED) The following are the names, addresses, and telephone numbers for THREE public agencies for which the SLIBCONTRACTOR has performed similar work in the past five years. 1• City of Orange Name and Address of Owner, 2. 3. D20,000.00 Installation of traffic loop detectors ANNUAL Contract Amount Type of Work Date Completed Name and Address of owner, Steve Howard. City of Riverside, (951) 712-3904 Name and Telephone Number of person familiar with project. 925,000.00 Installation of traffic loop detectors ANNUAL Contract Amount Type of Work Date Completed Name and Tolephone Number of person familiar with project. $3,210,000.00 Installation of traffic loop detectors ONGOING Contract Amount Type of Work Date Completed The following are the names, addresses, email addresses, and telephone numbers of all brokers and sureties from whom CONTRACTOR intends to procure insurance and bonds. HUB International Insurance Services Contact: Gall Schrenk, Commercial Account Manager 3390 UnNersftyy Ave. Suite 300 Rlverside,CA 92501 951) T7H763 all.Schrank@hubfnternaUanal.com City of Santa Ana RFP 21-095 Page A3.10 RE -ADVERTISEMENT Appendix ATTACHMENT 3-9: STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS TAT ,ME f REGARDING APPRENTICESHIP REOUIUMENTS The undersigned CONTRACTOR is familiar with the requirements of Section 1777.5 of the State Labor Code regarding employment of apprentices, and understands that contractors on contracts exceeding $30,000 or 20 working days shall: 1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public work for a certificate approving the contractor under the apprenticeship standards for the employment and training of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or apprentices on the public work, in the same amount or upon the same basis and in the same manner as the other contractors, except ors not signato the trust agreement shall pay a like amount to the Califomia Appren . eship Signed: Title: PRESIDENT Firm: CROSSTOWN ELECTRICAL 8, DATA, INC. Date: APRIL 18, 2022 City of Santa Ana RFP 21.095 Page A3-11 RR-AnvRR".izP PxrT Appendix -- - -- ATTACHMENT 3-10: STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS STATEMENT REGARDING "ANTI-KICKBACK"_REOUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from ' do' g, by any mea , ny person employed in the construction or repair of public work, to give up any p�of tl)cov4Vnsat o which he/she is otherwise entitled. Signed: Title: PRESIDENT Firm: CROSSTOWN ELECTRICAL & DATA, INC. Date: APRIL 18, 2022 City of Santa Ana RFP 21-095 Page A3-12 RE -ADVERTISEMENT Appendix ATTACHMENT 3-11: PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the CONTRACTOR shall complete, under penalty of perjury, the following questionnaire: Has the CONTRACTOR, any officer of the CONTRACTOR's organization, or any employee of the CONTRACTOR's Company who has a proprietary interest in the CONTRACTOR, ever been disqualified, removed, or otherwise prevented from proposing/bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. - City of Santa Ana Kr r 2-055 Page A3-13 RR AnVPT?TiCRMRNT - ATTACHMENT 3-12: STATEMi, NT REGARDING COMMUNITY WORKFORCE AGREEMENT (CWA) REQUIREMENTS STATEMENT REGARDING COMMUNITY WORKFORCE AGREEMENT (CWA) REQUIREMENTS This is to certify that the undersigned CONTRACTOR, and subcontractors, have read and understood the CWA entered into by and between the City of Santa Ana, the Los Angeles/Orange Counties Building and Construction Trades Council, and the signatory Craft Councils and Local Unions, effective as of September 1, 2017. The CWA is available at: biW-//www.santa-ana.orglpwa/documents/CWA.p ndf The undersigned CONTRACTOR hereby agrees to comply with all terms and conditions of the CWA, and is capable of completing construction of the project continuously, and without interruptions or delays. If awarded any work covered by the CWA, CONTRACTOR will also be required to sign the Letter of Assent that appears as Attachment A to the CWA. Public Works Construction Permit: The Contractor may be required to obtain a Public Works Construction Permit if the CWA thresholds for a Task Order are met or exceeded as described in this RFP's Section IILE "Licenses & Permits." The undersigned has reviewed and understands that a Public Works Construction Permit for CWA administration fees and deposit that may be required as described in this RFP's Section IILE "Licenses & Penuits." Signed: Title: PRESIDENT Firm: CROSSTOWN ELECTRICAL & DATA, INC. Date: APRIL 18.2022 City of Santa Ana RFP 21-095 Page A3-14 ALEX ZEPEDA CrbS T2 SUPERINTENDENT Electrical Data, lnc. 5454 Diaz St., Irwindale, CA 91706 626-813-6693 • 626-869-0192 Fax • Alex@crosstowndata.com EDUCATION ITT Technical Institute, Science of Electronic Engineering, Associates Degree, 2002 Electrical Training Institute, IBEW/NECA, Apprenticeship Training CERTIFICATIONS • Bridge Wave Wireless Technology Certification • Certified Electrician and Fiber Optic Installer • Comnet Ethernet and Communication Certification, 2017 • OSHA 10/30 Certification WORK HISTORY Crosstown Electrical & Data— General Foreman 4/2005--Current • Supervise multiple crews for fiber optic, CCTV and communication installation projects • Coordinate construction schedules with general contractors and owners • Procure material for projects as required. • Manage project budgets, track Time and Material Work and ensure projects come in on time and within budgets. • Perform Integration and installation of switches, encoders, Video Detection Systems • Traffic CCTV installation, testing and troubleshooting • Building Traffic Operation Centers, installation of video monitors, and various communication equipment and cabling. • Utilize expertise In communication and Intelligent transportation systems to train others. CSC — Traffic Signal Technician 5/2001-4/2005 Maintain and troubleshoot traffic signal and communication systems PROFESSIONAL EXPERIENCE Mr. Zepeda has over eighteen years of experience in communication and integration work. He specializes in CCTV camera Installation and Integration and is an IMSA Level 2 traffic signal technician. He has experience In all types of wireless communication systems and Integration and has an excellent understanding of communications media such as copper and fiber technologies. Mr. Zepeda has worked on and managed hundreds of communication projects and excels at bringing projects In on time and with satisfied customers. REFERENCE PROJECTS • City of Glendale, Traffic Signal and ITS Improvement Project — Install CCTV cameras, Ethernet switches and TMC equipment • City of Los Angeles Harbor Gateway ATSAC— Furnish/Install CCTV communications Equipment • City of Anaheim, Katella Ave, State College Blvd and Orangewood ITS Master Plan— Furnish and Install CCTV, Video Detection, and perform implementation of ITS field elements. • RCTC Tolled Express Lanes SR-91 project, Install Gantry equipment to include cameras, antennas, laser and audit cameras. • SR-91 Corridor Improvement Project —Systems integration and Implementation with Cofiroute, Oversaw the installation of all communication equipment to include Cisco network switches, CCTV and all system integration and testing. Electrical DatV EDUCATION JAMB P. NELSON SUPERINTENDENT 5454 Diaz St., Irwindale, CA 91706 626-813-6693 • 626-869.0192 Fax Monrovia High School, Monrovia, CA, High School Diploma,1992 CERTIFICATIONS • Certified Fiber Optics Installer (FOI124993) • Certified Fiber Optics Technician Outside Plant (FOSP126651) • OSHA 30 Certified • OSHA 10 Certified WORK HISTORY Crosstown Electrical & Data — Fiber Splicer 2011-Current • Responsible for the installation, termination and splicing of fiber optic cables. • Responsible for the testing of fiber optic cable using OTDR and Power Meters/Light Source • Responsible for analyzing the OTDR and power meter results. Lincoln Pacific Builders —Fiber Splicer and Electronics Integration 2009-2011 • Responsible for the Installation, termination and splicing of fiber optic cables. • Responsible for the testing of fiber optic cable using OTDR and Power Meters/Light Source • Responsible for the installation and integration of all video and data equipment modems, transceivers, CCTV and VDS cameras Corban Electric & Data, Inc. — Field Supervisor 2008-2009 • Managed all personnel in the field responsible for fusion splicing • Responsible for take -offs and ordering of job materials • Verified and approved all employee time cards Dynalectric— Fiber Splicer and Electronics Integration 2005-2DOB Responsible for the installation, termination and splicing of fiber optic cables. Responsible for the termination and testing of fiber optic cables using OTDR and power meter. Responsible for the installation and integration of all video and data equipment modems, Transceivers, CCTV and VDS cameras REFERENCE PROJECTS: City of Glendale, Traffic Signal and ITS Improvement Project — Furnish/install fiber distribution units and splice closures and perform splicing, termination and testing of fiber optic cable. City of Oxnard, intelligent Transportation System Project — Perform splicing, termination and testing of 144 SM, 96 SM, 48 SM, 24 SM and 6 SM fiber installed on the project. City of Fullerton, Brea Blvd., Commonwealth Ave, Lemon St., Anaheim Blvd —Perform splicing, termination and testing of fiber cable. ifi'OS 10T 1I Electrical -Data, Ina EDUCATION RICARDO AVILA SUPERINTENDENT 5454 Diaz St., Irwindale, CA 91706 626-813-6693 • 626-869-0192 Fax • Ricardo.Avila@crosstowndata.com Electrical Training Institute, State Certified Electrician, 2013 Los Angeles Trade Technical College, Electrical Construction and Maintenance Certificate CERTIFICATIONS • OSHA 10/30 Certified • Lead and Asbestos Certified • Trench Excavation Safety Trained WORK HISTORY Crosstown Electrical & Data, Inc. — Superintendent 2009 — Current • Supervise multiple crews for construction and electrical installations from start to finish. • Procure material for projects as required. • Communicate with Owners and General Contractors to meet project goals and deadlines. • Manage project budgets and perform tracking of all Time & Material work. • Utilize an in-depth knowledge of various construction plans, products and supplies to maximize project effectiveness and profitability. • Strive for all projects to come In on time and within budget at completion. • Coordinate construction schedules with general contractors. • Utilize expertise In the installation of conduit, pull boxes, fiber optic cable, copper cable, wire, traffic signals, cabinets and various other skills to perform field work and to train others. RECENT REFERENCE PROJECTS: • OCTA Adams Ave RTSSP Project (Huntington Beach) • OCTA Newport Ave/Blvd Corridor TSSP (City of Tustin & County of Orange) • OCTA Bristol Street RTSSP (Newport, Costa Mesa & Santa Ana) • OCTA Chapman Corridor TSSP (Garden Grove, City of Orange, & County of Orange) • Caltrans Contract 07A3661-C— Electrical System Restoration to As -Build Condition in Ventura County. • Caltrans Contract 07A3662-8— Electrical System Restoration to As -Build Condition in Los Angeles County. • Caltrans 07-293804 — Modify Communication System at Route 110/405 separation to Imperial • Caltrans 07-308604— Upgrade ramp metering systems CAI" Electrical rData, lnc. EDUCATION RICARDO AVILA SUPERINTENDENT 5454 Diaz St., Irwindale, CA 91706 626-813-6693 ^ 626-869-0192 Fax • Ricardo.Avila@crosstowndata.com Electrical Training Institute, State Certified Electrician, 2013 Los Angeles Trade Technical College, Electrical Construction and Maintenance Certificate CERTIFICATIONS • OSHA 10/30 Certified • Lead and Asbestos Certified • Trench Excavation Safety Trained WORK HISTORY Crosstown Electrical & Data, Inc. —Superintendent 2009 — Current • Supervise multiple crews for construction and electrical installations from start to finish. • Procure material for projects as required. • Communicate with Owners and General Contractors to meet project goals and deadlines. • Manage project budgets and perform tracking of all Time & Material work. • Utilize an in-depth knowledge of various construction plans, products and supplies to maximize project effectiveness and profitability. • Strive for all projects to come In on time and within budget at completion. • Coordinate construction schedules with general contractors. • Utilize expertise in the installation of conduit, pull boxes, fiber optic cable, copper cable, wire, traffic signals, cabinets and various other skills to perform field work and to train others. RECENT REFERENCE PROJECTS: • OCTA Adams Ave RTSSP Project (Huntington Beach) • OCTA Newport Ave/Blvd Corridor TSSP (City of Tustin & County of Orange) • OCTA Bristol Street RTSSP (Newport, Costa Mesa & Santa Ana) • OCTA Chapman Corridor TSSP (Garden Grove, City of Orange, & County of Orange) • Caltrans Contract 07A3661-C— Electrical System Restoration to As -Build Condition in Ventura County. • Caltrans Contract 07A3662-B — Electrical System Restoration to As -Build Condition in Las Angeles County, • Caltrans 07-293804— Modify Communication System at Route 110/405 separation to Imperial • Caltrans 07-308604— Upgrade ramp metering systems W1113N11 [0111I0.INC. 1939 E MIKA ARNNI 5 1T S9N 99ANOU40P96]-5199 = 01419919566.17141991-9559 =.�„,x Sla(¢ti¢.11u.fi14518•CI9R¢g.No.1006901619 Smithson Electric, Inc. has been a tender in the traffic loop detector industry in Southern California for over 30 years. Smithson Electric, Inc. is the maintenance/on-call loop contractor for several cities and municipalities. Superintendent/General Foreman, Allan Alvaro, started with Smithson Electric, Inc. in 1991. He began as a Laborer and moved over to become an Electrician approximately three years later. Allan is a certified electrician with the State of California (#E155470G) and has been running jobs for Smithson Electric, Inc. for over 25 years. Additionally, he is OSHA-30 certified. Allan is a wealth of knowledge in regards to the traffic loop detector industry. He is consistently sought out by coworkers, customers (including inspectors) to answer questions and offer suggestions and insight. Smithson. Electric, Inc. take great pride in our employees, services provided and our reputation in the industry. Sincerely, Patrick T. Smithson, President y—( -jr 7 p2 Z Date Corporate/Company Profile Carter Enterprises Group Inc dba Pavement Rehab Company was incorporated in 2018 Pavement Rehab Company maintains a C-12 license (Earthwork and Paving) and a C-8 license (Concrete). We have divisions specializing in concrete, asphalt maintenance and crack seal. We work predominately in the Inland Empire, Los Angeles County and Orange County areas. Pavement Rehab Company maintains a staff with extensive experience performing maintenance projects throughout Southern California. The Pavement Rehab Company office is located at 1181 Princess Ct, Costa Mesa, CA 92626. Phone (714) 238-1444. Robert Steen- President and Operations Manager. Kalisie Liavaa- C-8 License holder- 10 years of Public Works contracting. Tim Fitzpatrick- Chief Estimator - 10 years of Public Works contracting. Josh Nava- Project Manager/Estimator- 5 years of Public Works contracting. Vivian Tran- Project Manager/Estimator- 5 years of Public Works contracting. Joe Pinedo- Concrete Superintendent- 30 years experience in Public Works contracting. Roberto De La Cruz- Paving Foreman.- 20 years experience in Public Works contracting. Kaitlin Fitzpatrick- Certified Payroll. We look forward to working together soon. If you have any questions or requests, please contact Tim Fitzpatrick (714) 397-0733. Thank you, Robert Steen- President Pavement Rehab Company PAVEMENT REHAB COMPANY 1181 Princess Ct, Costa Mesa, CA 92626 — Corporate Headquarters: (714) 238-1444 - FAX: (714) 333-4844 ZURICH April 14, 2022 Ruben Castaneda City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 Zurich North Aimrica Sumy Los Angeles Branch 777 S. Figueroa Street, Suite 3900 Los Angeles. California 90D'17 Phone 213 270-0715 Faz 213 270-0845 Re: Crosstown Electrical & Data, Inc. On -Call Construction Services for Traffic Signals, Street Lights, and Concrete Wheel Chair Ramps - RFP No. 21-095 To Whom it May Concern, Crosstown Electrical & Data, Inc. is a valued surety client of Fidelity and Deposit Company of Maryland and has asked us to write to you regarding their bond capacity. Whereas we have not set a maximum single / aggregate bond limit, we would consider bonds as large as $35,000,000.00 within an aggregate program of $100,000,000.00. Our investigation of Crosstown Electrical & Data, Inc. clearly indicates a company that is thoroughly versed in the construction industry, with a wealth of experienced people, who have become known for their ability to complete jobs on schedule and within budget, complemented with excellent workmanship. We assure you that based on our normal conditions being prevalent and all underwriting conditions being met, we can foresee no difficulty in fulfilling requests by your organization to execute faithful performance and labor and materials bonds, as required by the terms of a contract awarded to Crosstown Electrical & Data, Inc. Fidelity and Deposit Company of Maryland is a California Admitted Surety Insurer, is listed on the Federal Register Circular 570, and is rated A+ (Superior) XV by A.M. Best. You understand, of course, that our consideration and issuance of bonds is a matter solely between Crosstown Electrical & Data, Inc. and ourselves, and will be subject to our standard underwriting at the time of the request, which will include but not be limited to the acceptability of the contract documents, bond forms and project financing. We assume no liability to third parties or to you by issuance of this letter or if for any reason we do not execute said bond or bonds. Regards, FIDELITY AND DEPOSIT COMPANY OF MARYLAND Dwight Reilly Attorney -in -Fact A member of the 9 Zurich Pinanciat Services Group ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On 04/14/2022 before me, Melissa Ann Vaccaro, Notary Public (insert name and title of the officer) personally appeared Dwight Rail] who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Is/are subscribed to the within instrument and acknowledged to me that helshe/they executed the same In his/her/their authorized capacity(les), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. MELISSA ANN VACCARO WITNESS my hand and official seal. COMM. r2241394 e \ ; Notary Fubuocalifornla Qf1AN0E COUNTY � \(\ } MyCamm.Explmr May 12,2022 Signature) _{l Y��°^ x�LC L1n� (Seal) Melissa Ann Vaccaro ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That fire ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State ofNew York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the memo side hereof and are hereby certified to be in fell force and effect on the date hereof, do hereby nominate, constitute, and appolut Daniel IIUrCKABAY, Frank MORONES, Dwight REILLY, Arturo AYALA, Shauaoa ROZFI.LE OSTROM, Ben WOLFS, Chelsea ARNOLD, Ben STONG, Michael D. STONO, R.NAPPI of Orange, California, its true and lawful agent and Attorney -in -Fact, to make, execute, seal mud deliver, far, and on its behalf as surety, and as its act and deed: any and all bonds and undertahfngs, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully end mnp(Y, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of to ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., die regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland, in their own proper persons, The said Vice president does hereby certify that the extract set forth on the reverse side hereof is o if= Copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed hirether names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICA-14 CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 08th day of Apra, A.D. 2022. wwmii Wamwa a Iwau,. F SC'a'n,.�rq�'S c°�i„ e•"" ^ 91" ogh'yye ou„�o�'ee�e„'4' 37�gj'�o�eFO1, c Peo�sae y'§`pSFAl�w,gts§g iS-tiFALL r'9EALw +m"„mr'v"s '''ayhWm`d 'nxuwmm�,c" ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D. Murray Vice President By.• Dawn E Drown Secretory State of Maryland County of Baltimore On this 08th day of April, A.D. 2022, before the subscriber, a Notary Public of the State of Maryland, duly cammissioned and qualified, Robert D. Murray, Vice President mad Dawn E Drawn, Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding fnstmmemt, and acknowledged the execution of some, mud being by me duly swum, deposelh mod suit[, first hdshe is the said officer of the Company aforesaid, and that the seats nOTixad to the preceding insmunent are the Corporate Seals of said Companies, and gun the said Corporate Seals and the signature es such officer were duly affixed and subscribed to the said fnstmahenl by the authority mid direction of the said Corporadoas. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ptlgY ;;: s Constance A Dunn, Notary Public n'i;`na< P My Commission Expires: July 9, 2021 9pimo", Authenticity of this bond can be confirmed at bandvalidator zurieima.cam or 410-5594790 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attornevs-in-Fnm. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written ImIrtuneat under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke my such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AM- CAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 9, of the By -Laws ofthe Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duty called and held on the 15th day of December 1998. RESOLVED: 'That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney -Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company.' This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the loth day of May, 1990. RESOLVED: 'That the facsimile or mechanically reproduced seal or the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed - IN TESTIMONY WIMREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this I4th day of April 2022 . NQmy"b x��soa,rS. P /�/ eonrbh F' eerogr ,''z31gy�EAL�gf t { BFAL i eaFAL"�' `"a.,.�-flJflJa °iwe�'k'V.QF6 By; Mary Jean Pethick Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, IL 60196.1056 Ph: 900-626.4577 If your jurisdiction allows for electronic reporting of surety claims, please submit to: reportsfclaims(abairich is corn Authenticity of this bond can be confirmed at ban dvalidator.zurichno, coin or 410-559-8790 EXHIBIT C RE -ADVERTISEMENT QUANTITIES FOR ' E SCHEDULE (CINDER SEPARATE COVER) For the purposes of providing a Fee Schedule based on the below Sample Task Orders, the following work items and quantities are provided. The Fee Schedule in Attachment 5: Each Fee Schedule shall include a schedule of the hourly billing rates for ALL contractor and subcontractor staff and labor personnel. Additionally, for each discipline that a company seeks to be considered, the below table(s) would be completed for the purpose of review of the proposals. For example, if a Contractor is submitting for Traffic Signal and Concrete Paving— Wheel Chair Ramp, Sample Task Orders A and C would be completed as part of the Fee Schedule by filling in of the last two columns for the relevant sample task orders by category. However, actual work will be paid for as described in Section I.A. "Nature of Work," and according to the schedule ofhourly billing rates. Sample Task Orders for Traffic Signal, Street Light and Concrete Paving - Wheel Chair Ramp in public right-of-way related work are, respectively: Sample Task Order A — Traffic Signal (Assume all work within Paved areas) Item Description Qty Unit Unit Price Total I Install City Furnished Type 332 Cabinet on New Foundation 2-4 haws I EA $ 14,225.00 $14,225.00 2 Install City Furnished Type 332 Cabinet on Existing Foundation 2A4 phases)I EA 4175.00 4176.00 3 Install City Furnished Type 332 Cabinet on New Foundation 4-8 haws I EA $ 15,225.00 $15,225.00 4 Install City Furnished Type 332 Cabinet on Existing Foundation 4 S phases)i EA 5175.00 5175.00 5 Furnish & Install Type IA Pole on New Foundation 1 EA $13,835.00 $13,835.00 6 Furnish&Install Type IAPoleonExistin Foundation ] I EA $ 4,855.00 4,855.00 7 Furnish & Install Type 15TS Pole on New Foundation 1 EA 18,280.00 18,280.00 8 Furnish & Install Type 15TS Pole on Existing Foundation i EA 9,450.00 9,450.00 9 Furnish & Insta112" Conduit 75 LF $ 150.00 $ 11 250.00 10 Furnish & Install 3" Conduit 100 LF $ 150.00 $15,000.00 11 Furnish & Install 4" Conduit 300 LF 125.00 37,500.00 12 Furnish & Install No. 6 Pull Box 10 EA $ 2,350.00 $ 23,500.00 13 Furnish & install No, 6E Pull Box 2 EA $ 3,275.00 $ 6,550.00 14 Furnish & Install Traffic Signal Loop Detector (Type E Loa 10 SA $ 665.00 $ 6,650.00 15 Furnish & install Bicycle Loop Detector (Circular Type DLoo 10 EA $ 700.00 $ 7,000.00 16 Furnish & Install Traffic Signal Loop Detector (Type E Loop) 20 RA $ 525.00 10 500.00 17 Furnish & Install Bicycle Loop Detector (Circular Type D Loop)EA 20 $ 555,00 $ 11,100.00 I S Furnish & Install Traffic Signal Loop Detector (Type E l,ou 60 EA $ 525.00 $ 31,500.00 19 Furnish & [nsta11 Bicycle Loop Detector (Circular Type D Loo 60 BA $ 555.00 $ 33.300.00 City of Santa Ana RFP 21-09.9 Exhibit Page A1-2 RE -ADVERTISEMENT 20 Furnish & Install Overhead Reflectorized Street Name EA $ 1,050.00 $ 4,200.00 Sign RSNS 4 21 Install City Furnished Overhead Reflectorized Street $ 450.00 $ 1,600.00 Name Si SNS 4 22 Furnish & Install 12 Strand Single Mode Fiber Optic LF $ 3.15 $ 945.00 SMFO Cable 300 23 Furnish & Install 24 Strand Single Mode Fiber Optic LF $ 4.75 $ 1,425.00 SMFD Cable 300 24 Furnish & Install 144 Strand Single Mode Fiber Optic LF (SMFO) Cable 1000 I 6.30 6,300.00 25 Furnish & Fusion Splice 1 Stand SMFO 48 EA $ 42.00 $ 2,016.00 26 Furnish & Fiber Optic Splice Enclosure 2 EA 800.00 4,000.00 27 Pothole Pole Locations for Utility Conflicts 5 EA 1,6 00.00 8,1 00.00 28 Furnish and Install 3-M Vinyl Wrap by Econolite for EA Typo 332 Cabinet 5 2,090.00 10 450.00 Sample Task Order B — Street Lighting (Assume all work within Paved areas) Item Description Qty Unit UnitPrice Total I Furnish & Install Meter Service Pedestal per C.O.S.A. Std. Plan on New Foundation I EA 11,875.00 11,8 55.00 2 Furnish & Install Double King Street Light Pole per C.O.S.A. Std.1126A on New Foundation 1 EA $ 20,830.00 $ 20,830.00 3 Furnish & Install Single King Street Light Pole per C.O.S.A. Std. 1126E on New Foundation I EA $ 15,260.00 $ 15,260.00 4 Furnish & Install Ameron Street Light Pole per C.O.S.A. Std. 1126H on New Foundation 1 E 9,865.00 9,865.00 5 Furnish & Install #8 AWG Wire Co r 100 LF $ 2.00 $ 200.00 6 Furnish & Install #10 AWG Wire (Copper) 100 LF $ 1.50 $ 150.00 7 Furnish & Install 012 AWG Wire (Copper) 100 LF 1.50 150.00 8 Furnish & Install 06 AWG Overhead Wire Aluminum 100 LF $ 10.00 $ 1,000.00 9 Furnish & Install 2"Conduit PVC Schedule40 100 LF $ 125.00 12,500.00 10 Furnish & Install 3" Conduit PVC Schedule 40 100 LF 11 Furnish & Install No. 3 Pull Box 4 EA 2,080.00 8,320.00 12 1 Furnish & Install No. 5 Pull Box 1 1 EA 1 $ 2,875.001 $ 2,875.00 Sample Task Order C — Concrete Pavin - Wheel Chair Ramps Item Description Qty Unit I Unit Price Total I Unclassified Excavation 550 Cy 61.00 33550.00 2 PCC Sidewalk Cl--4") 2,500 SP $ 17.25 $ 43,125.00 3 PCC Curb Ramp 3,o00 SF 51.00 153,000.00 4 PCC Curb and Gutter (C.O.S.A. Sod Plan 1101, Type A-2-8 100 IF 5 PCC Curb (C.O.S.A, Std. Plan 1101, Type B-1) 100 LF 100.00 10 000.00 6 1 PCC Spandrel (C.O.S.A. Std. Plan 1109) 500 SF $ 1 $ 27,500.00 City of Santa Ana RFP 21-095 Exhibit Page A1-3 RE -ADVERTISEMENT 7 PCC Cross Gutter (C.O.S.A. Std. Plan 1109) 500 1 SF 67.00 33,500.00 8 18" Deep Polyethylene Root Barrier (C.O.S.A.. Sid. 50 - Plan 1124 & 112413) $ 333.00 $ 16.650.00 9 Root Shaving (C.O.S.A. Std. Plan 1124A) 1 6 1 BA 2,200.001 13 320.00 S`lllPoIIiw:ii]►lt: For each Task Order Issued by Public Works Agency, the City may or may not require the Contractor to provide cash deposit or surety "Payment" and "Performance" bond. Depending upon the size, nature and risk of the work, the City may use the amounts specified by the "Greenback," surface drainage or street improvement plan measurements, or the approved itemized cost for each On -call or Emergency Task Order to calculate bond amounts, if any. Task Order work shall be per the City's Standard Plans, As -Built Plans, or other direction from the Public Works Agency. If required for a Task Order, the cash deposit or the surety bonds shall guarantee the construction of all necessary improvements for the Task Order, however, Bid Bonds were not required at the time of the submittal of RFP Proposal. For Task Orders, the City also reserves the right to retain 10% of progress pay amounts for the one-year warranty work. If so, the cash deposit shall be released approximately 135 days after all related permits and/or other approvals required are signed off by the City's Construction Inspector, and the passage of any lien periods. In the event the work is not completed within one year of the date that a street work permit or Task Order is signed, applicant agrees that the City may apply the cash deposit to the cost of completing the work and such work may be completed at the sole convenience of the City of Santa Ana. Contractor must be able to respond to City's request for emergency repair work on a timely and urgent manner. The contractor shall be available on an on -call basis, 24/7, and ready to respond in the event of an emergency. Service calls shall be responded within one hour. Contractor's repair crews must be able to arrive at job site within 8 hours of approval from City to commence work. Regular business hours are considered from 7:00 am to 5:00 pm (Monday through Friday). Anytime outside of business hours of operation may be considered after hours/weekends. The Contractor shall, prior to award of contract and without additional expense to the City, possess all licenses and permits (unless waived by the City) required for the performance of the work required by this contract, including but not limited to a California Class (A or C-10) Contractor's license and a City of Santa Ana Business License. 1. Street work shall be required to be performed by a licensed contractor for any and all the work in the public right of way. The contractor must provide the following prior to initiating Task Order work. a. A City of Santa Ana business license. b. A Certificate of Insurance of general liability containing requirements as set forth by the City Attorney and per the Standard Agreement. c. A Contractors license (with appropriate classification). d. Proof of Worker's Compensation Insurance. City of Santa Ana RFP 21-095 Exhibit Page A1-4 RE -ADVERTISEMENT 2. Provide BMPs and/or erosion control plans for planned Task Order work unless directed otherwise by the City. 3. If required, the Contractor shall submit, for review and approval, a surface drainage/grading/erosion control plan, prepared by a registered civil engineer, showing the direction and means of flow within the street. Any Subcontractors intended to be used, shall be listed in the proposal. Any additional subcontractors that may become necessary, shall require approval by the City prior to start of any assigned work. When a Subcontractor performs all or any part of the work, a markup shall be applied to the Subcontractor's 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. PAYMENT AND INVOICING: Selected Contractor shall invoice the City based on time and material according to the City's standard invoice template. Tasks and hours shall be clearly identified and all rates must match those included in the approved agreement. City shall retain ten percent (101/o) of the invoice amount from each payment until the completed Project has been accepted by the City. CITY RESPONSIBILITIES: The City will provide information in its possession relevant to the preparation of the required information in the RFP. The City will provide only the staff assistance and the documentation specifically in referred to herein. • Furnish scope of work and provide general direction as needed for any assigned Task Orders • All plan check coordination within the City • Construction administration • Electronic files (sample plans & specifications, City of Santa Ana's CARD Standards), if needed • Electronic files for title sheets and sheet borders, if needed The unit pricespaidfor the items listed in the Contractor's Proposal as defined herein shall be considered full compensation forf trnishing all labor, materials, tools, and equipment, and doing all work involved in furnishing and installing the materials complete and in place, in accordance with the details shown on the Plans, as specified herein, and as directed by the Engineer. All incidental work which is neither shown on the Plans nor otherwise specified, and which is necessary to complete the improvements as shown on the Plans and as specified in the ContractDocuments (defined in the Contract/Agreement), shall bef urnished and installed as though such work were shown on the Plans orspecifted in the Contract Documents, and no additional compensation shall be allowed therefore. Chy of Santa Ana RFP 21-095 Exhibit Page Al-5 SANTA ANA ON CALL CONSTRUCTION SERVICES "Schedule of Hourly Billing Rates" CONTRACTOR NAME: Crosstown Electrical to Data, Inc. RATES VALID THROUGH: 5/1/2022 T1* • Classification Standard Time Overtime Doubletime General Foreman $ 550.00 $ 205.00 $ 260.00 Foreman $ 139.00 $ 888.00 $ 237.00 Journeyman Electrician $ 130.00 $ 772.00 $ 215.00 Joumeman Splicer $ 133.00 $ 178.00 $ 222.00 85% Apprentice $ 115.00 $ 152.00 $ 189.00 Operator $ 127.00 $ 167.00 $ 157.00 Laborer Group I II $ 99.00 $ 333.00 $ 168.00 Laborer Group V $ 102.00 $ 138.00 $ 174.00 ALL RATES TO BE PER CURRENT CALTRANS EQUPMENT RATE GUIDE. PLEASE NOTE ONE VEHICLE HOUR TO BE ADDED TO EACH LABOR HOUR WORKED, EXAMPLE: JOUNEYMAN ELECTRICAN 1 HOUR @ $130 PLUS 1 HOUR WORK TRUCK @ $37A 9 = $167.19 PER HOUIR MATERIAL: COST PLUS SALES TAX AND 15% MARK-UP EFFECTIVE 04-01-22 THRU CROSSTOWN ELECTRICAL DATA, INC. 03-31.23 CALTRANS EQUIPMENT RATES 2022 Equipment Description Caltrans Description Caltrans Rate Class Make Code $25,30 Pick Up Truck F250 & F150 TRUCK T & TT 0006 $25.30 $37,19 Work Truck F350 & F450 TRUCK T & TT 1220 $37.19 $39.41 Work Truck F550 TRUCK T&TT 2028 $39.41 $51,07 2 Axle Dump Truck TRUON TRUN 2 AXL $51.07 $67.69 3 Axle Dump Truck TRUON TRUN 3 AXL $67.69 $37.19 Utility Work Truck TRUCK T & TT 1220 $37.19 $41.68 $4.17 Generator ELGEN GEN 003 OD8 $4.11 $0.32 Threader (Ridged 300) ELTOL TOOL 045 060 $0.32 $39.41 Mason Truck F550 TRUCK T & TT 20 28 $39.41 $50.48 $11.07 Generator ELGEN GEN 003 008 $4.17 Rotohammer ELTOL TOOL 045060 $0.32 Cordless Combo Kit ELTOL ATOL 045060 $0.32 Water Tank TANKM WATR 000599 $0,40 Concrete Mixer CONMX SORP 11-16 $5.86 Expendable bits, blades, discs, wheels, etc. paid by separate Invoice. $39,41 Work Truck F550 TRUCK T & TT 2028 $39.41 $45.08 $5 67 Generator ELGEN GEN 003 008 $4.17 Threader (Rigid 300) ELTOL TOOL 045 060 $0.32 Portable Threader (Rigid 700) ELTOL TOOL 080100 $0.54 Drill Motor (Hole Hawg) ELTOL TOOL 045 060 I $0.32 Cordless Combo Kit ELTOL ATOL 04S OGO 1 $0,32 Expendable bits, blades, discs, wheels, etc. paid by separate invoice. $25,10 Compressor AIRCP PORT 016025 $20.80 Air Hose Price Included with Compressor Chipping Gun AIRTO ATOL 1D 20 $0.50 Clayspade AIRTO ATOL 4060 $1.14 Jack Hammer AIRTO ATOL 60 $1.61 Tamper AIRTO ATOL 3040 $1.05 Expendable drill steel, bits and breakers points paid by separate invoice $28.65 iSplice Van F250 & F150 TRUCK T & TT 06 12 $28.65 $4fi.04 $17.39 Fusion Splicer TEST I FUJI I FSM60 $8.38 Cleaver Price included with Fusion Splicer OTDR TEST AFTL M200K $4.73 Test Equipment, Power Meter TEST CRNG M400R $4.03 Electrlcal Gen„Inverter, DC Converter ELGEN CCEP CV573 $0.25 $138.67 Dump Truck TRUON TRUN 3AXL $67.69 Traller (2 axle) TRAIL LB -A 100 $15.67 John Deer 410G Backhoe LDRRT DEER 25086 $55.31 $112.71 Dump Truck TRUON TRUN 3AXL $67.69 Trailer (2 axle) TRAIL LB -A 100 $15.67 Bobcat TRACS <50 C $29.35 $36.08 Mini Excavator HCECL VLVO EC35C $31.49 12' Tilt Trailer TRAIT TB-2 08-10 $4.59 $30.93 Mini Skid Steer TRACS D-W SK755 $25.38 12'TIItTrailer TRAIT TB-2 08-10 $4.59 Auger Attachment AUGAC AUGF 24X5 $0.75 Trench Attachment TRACS LOWE I X21 $0.96 EFFECTIVE 04-01-22 THRU CRO55TOWN ELECTRICAL DATA, INC. 03.31-23 CALTRANS EQUIPMENT RATES 2022 Equipment Description Caltrans Description Caltrans Rate Class Make Code $117.05 Crane TRUON TRUN 3AXL $67.69 National 20 TON 90' HCETG B-E 1300 $49.36 $155.09 Ditch Witch Directional Bore Machine AUGHZ D-W 1T20XP $70.45 Horizontal Bore Rods (50') AUGHZ VERM 40ARSO $0.32 Horizontal Bore Rods (50') AUGHZ VERM 40AR50 $0.32 Horizontal Bare Rods (50') AUGHZ VERM 40ARSO $0.32 Horizontal Bore Rods (50') AUGHZ VERM 40ARSO $0.32 Trailer (2 axle) TRAIL LB -A 100 $15.67 10 wheel flatbed TRUON TRUN 3AXL $57.69 $74.44 Directional Bore Support Truck TRUCK T&TT 2028 $39,41 Generator ELGEN GEN 003 008 $4.17 Threader (Rigid 300) ELTOL TOOL 045 060 $0.32 Vacuum Trailer VACDB D-W FX30.5 $30.54 $36.17 Vacuum, Debris VACDB D-W FX30-5 1 $313,54 Pressure Washer WATBM HOTS 245 $4.15 Trailer TRAIT T13-2 0406 $1.48 $128.39 Vacuum Truck VACIT VACT 810 $128.39 $77.89 Bucket Truck TRUCK T&TT 2028 $39.41 Hydraulic Llft HYLFT BOOM 25-49 $38.23 Electrical Gen.,lnverter, DC Converter ELGEN CCEP CV573 $0.25 $13.74 Winches, F/O Cable puller WINCH ARCO TM2000 $13,74 Trailer Price Included with cable puller $25.35 Asphalt Roller ROVIB WACK 7850 $20.76 12'TIItTraller TRAIT TB-2 08-10 $4.59 $3A8 Arrowboard-TM TRAFA FLAS TM $3.48 $0.94 Arrowboard - RM TRAFA FLAS RM $0.94 $10.66 CMS Sign Solar TRAFA CMSN SOLI $10.66 $0.52 Barricade w/Flasher (Day) TRAFC 1BAR Al $0.52 $0.27 Barricade w/out Flasher (Day) TRAFC 1SAR A2 $0.27 $16,27 Traffic Cone 28" (per 100) (Day) TRAFC 2TC B100 $16.27 $25.10 Traffic Cone - Refl (per 100) (Day) TRAFC I 2TC I D100 $25.10 $6.53 Illuminated Sign (Day) TRAFC I 431G 12V $6.53 $6.67 Flashing Beacon (Day) TRAFC SBEA 12V $6.67 $3.01 Fiagtree (Sign, Stand& 3 Flags) (Day) TRAFC 6FSS EACH $3.01 $5.86 Concrete Mixer CONMX SORP 11-16 $5.86 $3.41 Hand held Concrete Saw SAWCO ABOP 0-10 $3.41 $7.67 Concrete Saw (walk behind) SAWCO ABOP 10.20 $7.67 $18.00 Blade Sawkerf SAWCO ABSK 100'/IN $18.00 $0.18 Blade Sawkerf SAWCO ABSK LF-INDE 1 $0.18 $1.13 Concrete Vibrator CONVB CVIB EVHD $1.13 $2.89 Water Dolly TRAIW WATR SOOWYL $2.89 $2.10 Dump Trailer TRAIL! DUMP 10KH $2.10 $4.07 Compactors, Pan, Handgulded COMHG COMP D-250 $4.07 $9.89 Compactors, Handgulded COMHG COMP 250 $9.89 $10.11 - Hammer, Demolition Breaker HAMMR STAN 1160 $10.11 $4.25 Tractors, Attachment,18" Planer TRACS BCAT P18 $4.25 $0.51 Tractors, Attachment, 60" Sweeper TRACS SCAT 560 $0.51 $039 lWelder WELD FDR LN-25 $0.39 SANTA ANA ON CALL CONSTRUCTION SERVICES "Schedule of Hourly Billing Rates" SUBCONTRACTOR NAME: SMITHSON ELECTRIC, INC. RATES VALID THROUGH: 12131112022 LABOR: Classification ` `'Standard Tlme ' Overtime : `Ooubletlm�.:'.' Electrician - Foreman $107.41 $146.15 $184.90 Electriolan- Journa man $93.73 $133.14 $167,55 Laborer -Grou 4 $73.10 $97.35 $121.69 Laborer -Grou 1 $69,89 $92.54 $115,18 F-OUIPMENT: �E.qutprn@nf.. Z.Description..:., -. . ,..:z:)JM;;;`;....:: t;.:;.,, ... Rate :;.:::-;;:..'.... F-550 Truck HR $ 39.41 F-550 Truck HR $ 39.41 F-550 Truck HR $ 39.41 Vacuum/WaterTrk HR $ 60.39 Trailer HR $ 15.67 Concrete Saw HR $ 21.27 Concrete Saw HR $ 21.27 Hotmelt Machine HR $ 21.27 Alr Compressor HR $ 19.16 Arrowboard HR $ 3.48 Arrowboard HR $ 3.48 MATERIAL: COST PLUS SALES TAX AND "/o MARK-UP 1, Hot Melt Sealant $0.81 per lb 30 Ibs per loop 2. Type 2 Loop Wire $0.23 per foot 20-30 ft per loop PAVEMENT REHAB COMPANY Labor and Equipment Rates Effective: 4 19 2022 LABOR RATES Classification Standard Time Time and a Half Double Time Superintendent $220.00 $330.00 $440.00 Foreman $190.00 $285.00 $380.00 Grade Checker $145.00 $217.50 $290.00 Labor/Raker $135.00 $202,50 $270.00 Finisher/mason $135.00 $202.50 $270.00 BG Operator $145.00 $217.50 $290.00 Operator $145.00 $217.50 $290.00 Screedman $145.00 $217.50 $290.00 Rollerman $145.00 $217.50 $290.00 EQUIPMENT RATES Equip. Operated Rate per HR Eguip. Operated Rate per HR Equip. Operated Rate per HR Paving Machine (10') $300.00 Skip Loader $265.00 Truck - Super 10 $195.00 Paving Machine (7-8') $260.00 Skip Combo $295.00 Truck -10 Wheel $190.00 Bobtail $240.00 Blade12G $265.00 Truck - Semi $200.00 Bobtail w/Breaker $270.00 Blade 140G $275.00 Truck -High Side $225.00 Bobtail w/Sweeper $755.00 Backhoe $275.00 Tack Truck $235.00 Bobtail w/Grinder $635.00 Backhoe w/Breaker $345.00 Tack Wagon $115.00 AC Grinder (4') $805.00 950 Loader $300.00 Conc Form Truck $110 + Mat. AC Grinder (6'-8') $1,035.00 966 Loader $355.00 Crew Truck $115.00 Water Truck $210.00 Roller (5-8 tn) $155.00 Street Sweeper $240.00 Concrete Saw $260.00 Roller (3-5 tn) $135.00 Arrow Board $115,00 Core Machine $260.00 Berm Machine $150.00 Mobilization 2 HRs/Equipment - Min. one Way Note: 1) Rates include Supervision, Overhead & Profit. 2) Price is valid for 1 year from submission date. 3) Labor rates are billed with 4 or 8 hour clauses. 4) Equip. & Labor moved for specificallyfor extra workto be billed with 8 hour min. RE -ADVERTISEMENT QUANTITIES FOR + , E SCHEDULE (UNDER SEPARATE COVER) For the purposes of providing a Fee Schedule based on the below Sample Task Orders, the following work items and quantifies are provided The rice Schedule in Attachment 5: Each Fee Schedule shall include a schedule of the hourly billing rates for ALL contractor and subcontractor staff and labor personnel. Additionally, for each discipline that a company seeks to be considered, the below table(s) would be completed for the purpose of review of the proposals. For example, if a Contractor is submitting for Traffic Signal and Concrete Paving — Wheel Chair Ramp, Sample Task Orders A and C would be completed as part of the Fee Schedule by filling in of the last two columns for the relevant sample task orders by category. However, actual work will be paid for as described in Section I.A. "Nature of Work," and according to the schedule of hourlybilling rates. Sample Task Orders for Traffic Signal, Street Light and Concrete Paving -Wheel Chair Ramp in public right-of-wayrelated work are, respectively: Sample Task Order A — Traffic Signal (Assume all work within Paved areas) Item Description Qty Unit Unit Price Total 1 Install City Furnished Type 332 Cabinet on New BA $14,225.00 $14,225.00 Foundation 2 4phases) 1 2 Install City Furnished Type 332 Cabinet on Existing Foundation 2-4 ruses 1 4175.00 4175.00 3 Install City Furnished Type 332 Cabinet on New EA $15,225.00 $15,225.00 Foundation 4-9phases) i 4 Install City Furnished Type 332 Cabinet on Existing FA Foundation 4-8phases) I 8 5175,00 $ 5175.00 5 Furnish & Install Type IA Pole on New Foundation 1 EA 13 835.00 $ 13,835.00 6 Furnish & Install a IA Pole on Malin Foundation 1 EA $ 4,856.00 4,855.00 7 Furnish & Install Typo 15TS Pole on New Foundation 1 EA 18,280.00 $18,280.00 8 Furnish & Install Type 15TS Pole on Existing EA Foundation 1 9,450.00 9,450.00 9 Furnish & Install 2" Conduit 75 LF $ 150.00 $11,250.00 10 Furnish & Install 3" Conduit 100 LF $ 150.00 $15,000.00 11 Furnish & Install 4" Conduit 300 LF 125.00 $37,500.00 12 Furnish & Install No. 6 Pull Box 10 EA $ 2,350.00 $ 23,500.00 13 Furnish & Install No. 6E Pull Box z EA $ 3,275.00 $ 6,550.00 14 Furnish & Install Traffic Signal Loop Detector (Type E EA $ 665.00 $ 6,650.00 o 10 15 Furnish & Install Bicycle Loop Detector (Circular Type FA $ 700.00 $ 7,000.00 D Lop 10 16 Furnish & Install Traffic Signal Loop Detector (Type E Lop 20' $ 525.0011 10 500.00 17 Furnish & Install Bicycle Loop Detector (Circular Type EA $ 555.00 $ 11,100.00 D Loop)20 18 Furnish & Install Traffic Signal Loop Detector (Type E EA $ 525.00 $ 31,500.00 Loop) 60 19 Furnish & Install Bicycle Loop Detector (Circular Type &A $ 555.00 $ 33,300.00 D Lop 60 City of Santa Ana RFP 21-095 Exhibit Page A1-2 RE -ADVERTISEMENT 20 Furnish & Install Overhead Reflectorized Street Name EA $ 1,050.00 $ 4,200.00 Si a NS 4 21 Install City Furnished Overhead Reflectorized Street EA Name Si SNS 4 $ 450.00 $ 1,800.00 22 Furnish & Install 12 Strand Single Mode Fiber Optic LF $ 3.15 $ 945.00 SMFO Cable 300 23 Furnish & Install 24 Strand Single Mode Fiber Optic IF SMFo Cable 300 $ 4.75 $ 1,425.00 24 Furnish & Install 144 Strand Single Mode Fiber Optic IF SMFo Cable 1000 6.30 6,300.00 25 Furnish & Fusion Splice I Stand SMFO 48 EA $ 42.00 $ 2,016.00 26 Furnish & Fiber Optic Splice Enclosure 2 SA 800.00 4,000.00 27 Pothole Pole Locations for Utility Conflicts 5 EA ,630.00 $, 0.00 28 Fuunish and Install 3-M Vinyl Wrap by Econolite for HA e 332 Cabinet 5 2 090.00 0 10 450.00 Samnle Task Order B — Street Lighting (Assume all work wltldn Paved areas) Item Description Qty Unit Unit Price Total I Furnish & Install Meter Service Pedestal per C.O.S.A. Std. Plan on New Foundation 1 EA 1 ,875.00 11,8 55.00 2 Furnish & Install Double King Street Light Pole per C.O.S.A. Std. 1126A on New Foundation I EA $ 20,830.00 $ 20,830.00 3 Furnish & Instal. Single King Street Light Pole per C.O.S.A. Std.1126E on New Foundation I EA $ 15,260.00 $ 15,260.00 4 Furnish & Install Ameron Street Light Pole per C.O.S.A. Std.1126H on New Foundation 1 EA $ 9,865.00 9865.00 5 Furnish & Install 08 AWG Wire (Copper) 100 LF $ 2.00 $ 200.00 6 Furnish & Install #10 AWG Wire Co er 100 IF S 1.50 150.00 7 Furnish & Install #12 AWG Wire (Copper) 100 LF 1.50 $ 150.00 8 Furnish & Install #6 AWG Overhead Wire Aluminum 100 IF $ 10.00 $ 1,000.00 9 Furnish & Install 2" Conduit PVC Schedule 40 100 IF $ 125.00 1 12,500.00 10 Furnish & Install 3" Conduit PVC Schedule 40 100 IF , 11 Furnish & Install No. 3 Pull Box 4 EA 2,080.00 8,320.00 12 Furnish & Install No. 5 Pull Box I FA $ 2,875.00 $ 2,875.00 Sam le Task Order C — Concrete Paving - Wheel Chair Raml is Description Q Unit Unit Price Total 1 Unclassified Excavation 550 CY 61.00 33 550.00 2 PCC Sidewalk (T=4") 2,500 SF $ 17.25 $ 43,125.00 FItem 3 PCC Curb Ramp 3,000 SF 51.00 153,000.00 4 FCC Curb and Gutter (C.OB.A. Std. Plan 1101, Type A-2-S 100 LF 5 PCC Curb (C,O.S.A. Std. Plan 1101, Type B-1) 100 LF 100.00 10 000.00 6 PCC Spandrel (C.O.SA. Std. Plan 1109) 500 SF $ 55.00 $ 27 500.00 City of Santa Ana RFP 21-095 Exhibit Page A1-3 RE -ADVERTISEMENT 7 PCC Cross Gutter (C.O.S.A. Std. Plea. 1109) 500 SF 67.00 $33,500.00 8 18" Deep Polyethylene Root Barrier (C.O.S.A. Std. 50 IF Plan 1124 & 1124B) $ 333.00 16 650.00 9 Root Shaving (C.O.S.A. Std, Plan 1124A) 6 BA 2.200.00 $13 320.00 SURETY BOND For each Task Order Issued by Public Works Agency, the City mayor may not require the Contractor to provide cash deposit or surety "Payment" and "Performance" bond. Depending upon the size, nature and risk of the work, the City may use the amounts specified by the "Greenbook," surface drainage or street improvement plan measurements, or the approved itemized cost for each On -call or Emergency Task Order to calculate bond amounts, if any. Task Order work shall be per the City's Standard Plans, As -Built Plans, or other direction from the Public Works Agency. If required for a Task Order, the cash deposit or the surety bonds shall guarantee the construction of all necessary improvements for the Task Order, however. Bid Bonds were not required at the time of the submittal of RFP Proposal. For Task Orders, the City also reserves the right to retain 10% of progress pay amounts for the one-year warranty work. If so, the cash deposit shall be released approximately 135 days after all related permits and/or other approvals required are signed off by the City's Construction Inspector, and the passage of any lien periods. In the event the work is not completed within one year of the date that a street work permit or Task Order is signed, applicant agrees that the City may apply the cash deposit to the cost of completing the work and such work maybe completed at the sole convenience of the City of Santa Ana. CONTRACTOR RESPONSIBLITIES Contractor must be able to respond to City's request for emergency repair work on a timely and urgent manner. The contractor shall be available on an on -call basis, 24/7, and ready to respond in the event of an emergency. Service calls shall be responded within one hour. Contractor's repair crews must be able to arrive at job site within 8 hours of approval from City to commence work. Regular business hours are considered from 7.00 am to 5:00 pm (Monday through Friday). Anytime outside of business hours of operation may be considered after hours/weekends. The Contractor shall, prior to award of contract and without additional expense to the City, possess all licenses and permits (unless waived by the City) required for the performance of the work required by this contract, including but not limited to a California Class (A or C-10) Contractor's license and a City of Santa Ana Business License. 1. Street work shall be required to be performed by a licensed contractor for any and all the work in the public right of way. The contractor must provide the following prior to initiating Task Order work a. A City of Santa Ana business license. b. A Certificate of Insurance of general liability containing requirements as set forth by the City Attorney and per the Standard Agreement. c. A Contractors license (with appropriate classification). d. Proof of Worker's Compensation Insurance. Clty of Santa Ana RFP 21-095 Exhlblt Page Al 4 RE -ADVERTISEMENT 2. Provide BMPs and/or erosion control plans for planned Task Order work unless directed otherwise by the City. 3. If required, the Contractor shall submit, for review and approval, a surface drainage/grading/erosion control plan, prepared by a registered civil engineer, showing the direction and means of flow within the street. SUBCONTRACTORS Any Subcontractors intended to be used, shall be listed in the proposal. Any additional subcontractors that may become necessary, shall require approval by the City prior to start of any assigned work. When a Subcontractor performs all or any part of the work, a markup shall be applied to the Subcontractor's 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. PAYMENT AND INVOICING: Selected Contractor shall invoice the City based on time and material according to the City's standard invoice template. Tasks and hours shall be clearly identified and all rates must match those included in the approved agreement. City shall retain ten percent (10%) of the invoice amount from each payment until the completed Project has been accepted by the City. CITY RESPONSIBILITIES: The City will provide information in its possession relevant to the preparation of the required information in the RFP. The City will provide only the staff assistance and the documentation specifically in referred to herein. • Furnish scope of work and provide general direction as needed for any assigned Task Orders • All plan check coordination within the City • Construction administration • Electronic files (sample plans & specifications, City of Santa Ana's CADD Standards), if needed • Electronic files for title sheets and sheet borders, if needed The unitprices paid for the items listed in the Contractor's Proposal as defined herein shall be considered full compensation for furnishing all labor, materials, tools, and equipment, and doing all work involved in furnishing and installing the materials complete and in place, in accordance with the details shown on the Plans, as specified herein, and as directed by the Engineer. All incidental work which is neither shown on the Plans nor otherwise specified, and which is necessary to complete the improvements as shown on the Plans and as specified in the Contract Documents (defined in the Contract/Agreement), shall be furnished and installed as though such workwere shown on the Plans or specified in the Contract Documents, and no additional compensation shall be allowed therefore. City of Santa Ana RFP 21-095 Exhibit Page Al-5 SANTA ANA ON CALL CONSTRUCTION SERVICES "Schedule of Hourly Billing Rates" CONTRACTOR NAME: Crosstown Electrical & Data, Inc. RATES VALID THROUGH: 5/1/2022 L Classification Standard Time Overtime Doubletime General Foreman $ 150.00 $ 205.00 $ 260.00 Foreman $ 139.00 $ 188.00 $ 237.00 Journeyman Electrician $ 130.00 $ 172.00 $ 215.00 Journeman Splicer $ 133.00 $ 178.00 $ 222.00 85% Apprentice $ 115.00 $ 152.00 $ 189.00 Operator $ 127.00 $ 167.00 $ 157.00 Laborer Group III $ 99.00 $ 133.001 $ 168.00 Laborer Group V $ 102.00 $ 138.00 $ 174.00 EQUIPMENT: ALL RATES TO BE PER CURRENT CALTRANS EQUPMENT RATE GUIDE. PLEASE NOTE ONE VEHICLE HOUR TO BE ADDED TO EACH LABOR HOUR WORKED, EXAMPLE: JOUNEYMAN ELECTRICAN 1 HOUR @ $130 PLUS 1 MATERIAL: COST PLUS SALES TAX AND 15% MARK-UP EFFECTIVE 04-01-22 THRU CROSSTOWN ELECTRICAL DATA, INC. 03.31-23 CALTRANS EQUIPMENT RATES 2022 Equipment Description Caltrans Description Caltrans Rate Class Make Code $25.30 Pick Up Truck 11250 & F150 TRUCK T & TT 0006 $25.30 $37.19 Work Truck F350 & F450 TRUCK T & TT 1220 $37.19 $39,41 Work TruckF55O TRUCK T&TT 2028 $39.41 $51.07 2 Axle Dump Truck TRUON TRUN 2AXL $51.07 $67.69 3 Axle Dump Truck TRUON TRUN 3AXL $67.69 $37.19 Utility Work Truck TRUCK T&TT 1220 $37.19 $41.68 $4.17 Generator ELGEN GEN 003009 $4.17 $0.32 Threader (Ridged 300) ELTOL TOOL 045 060 $0.32 $39.41 Mason Truck F550 TRUCK T & TT 2028 $39.41 $50.48 $11.07 Generator ELGEN GEN 003 008 $4.17 Rotohammer ELTOL TOOL 04506D $0.32 Cordless Combo Kit ELTOL ATOL 045 060 $0.32 Water Tank TANKM WATR 000599 $0.40 Concrete Mixer CONMX SORP 11.26 $5.86 Ex endable bits, blades discs, wheels, etc. paid by separate Invoice. $39.41 WerkTruck F550 TRUCK T&TT 2028 $39.41 $45.08 $5.67 Generator ELGEN GEN 003008 $4.17 Threader (Rigid 300) ELTOL TOOL 045 060 $0,32 Portable Threader (Rigid 70O) ELTOL TOOL 080100 $0.54 Drill Motor (Hole Hawg) ELTOL TOOL 045060 $0.32 Cordless Combo Kit ELTOL ATOL 045060 $0.32 Expendable bits, blades, discs, wheels, etc. paid by separate invoice. $25.10 Compressor AIRCP PORT 1 016025 $20.80 Air Hose Price Included with Compressor ChlppingGun AIRTO ATOL 1020 $0.50 Cfayspade AIRTO ATOL 4060 $1.14 Jack Hammer AIRTO ATOL 60 $1.61 Tamper AIRTO ATOL 3040 $1.05 Expendable drill steel, bits and breakers points paid by separate Invoice $28.65 Splice Van F250 & F15O TRUCK T & TF 0612 $28.65 $46.04 $17.39 Fusion Splicer TEST I FUJI FSM60 $8.38 Cleaver Price included with Fusion Splicer OTDR TEST AFTL M200K $4.73 Test Equipment, Power Meter TEST CRNG K4400R $4.03 Electrical Gen.,lnverter, DC Converter ELGEN CCEP CV573 $0.25 $138.67 Dump Truck TRUON TRUN 3AXL $67.69 Trailer (2 axle) TRAIL LB -A 100 $15.67 John Deer410G Backhoe LDRRT DEER 250BG $55.31 $112.71 Dump Truck TRUON TRUN 3AXL $67,69 Trailer (2 axle) TRAIL I LB -A 100 $15.67 Bobcat TRACS <50 C $29,35 $36.08 MinlExcavator HCECL VLVO EC35C $31,49 12'TIItTraller TRAIT TB-2 08-10 $4.59 $30.93 Mini Skid Steer TRACS D-W SK755 $25.38 12'711tTraller TRAIT TB-2 08.10 $4,59 AugerAttachment AUGAC AUGF 24X5 $0.75 Trench Attachment TRACS LOWE X21 $0.96 EFFECTIVE 04-01-22 THRU CROSSTOWN ELECTRICAL DATA, INC. 03-31-23 CALTRANS EQUIPMENT RATES 2022 Equipment Description Caltrans Description Caltrans Rate Gass Make Cade $117.05 Dane TRUON TRUN 3AXL $67.69 Natlonal20 TON 9D' HCETG f B-E 1 1300 $49.36 $155.09 Ditch Witch Directional Bore Machine AUGHZ D-W JT20XP $70,45 Horizontal Bore Rods (So') AUGHZ VERM 40ARSO $0.32 Horizontal Bore Rods (50') AUGHZ VERM T 40AR50 $0.32 lHorizontal Bore Rods (50') AUGHZ VERM I 40ARSO $0.32 Horizontal Bore Rods (50') AUGHZ VERM 40AR50 $D.32 Trailer (2 axle) TRAIL LB -A 100 $15.67 10wheelflatbad TRUON TRUN 3AXL $67.69 $74 44 TRUCK T&TT 2028 $39.41 rDirectionalBoreSupportTruck ELGEN GEN 003 008 $4.17 gid 300) ELTOL TOOL D45 06D $0.32 ler VACDI3 D-W fX30-5 $30.54 $36.17 Vacuum, Debris VACDB D-W FX30-5 $30.54 lPressureWasher WATBM HOTS 245 $4.15 Traller TRAIT TB-2 0406 $1.48 $128.39 Vacuum Truck VACIT VACT 810 $128.39 $77.89 Bucket Truck TRUCK T&TT 2028 $39.41 Hydraulic Lift HYLFT BOOM 25.49 $38.23 Electrical Gen.,lnverter, DC Converter ELGEN CCEP CV573 $0.75 $13.74 Winches, F/OCable Puffer WINCH ARCO TM2000 $13,74 Trailer Price included with cable puller $25.35 Asphalt Roller ROVIB WACK 7850 $20.76 12'TIItTraller TRAIT TB-2 08-10 $4.59 $3.48 Arrowboard - TM TRAFA FLAS TM $3.48 $0.94 Arrowboard -RM TRAFA FLAS RM $0.94 $10.66 CMS Sign Solar TRAFA CMSN SOLI $10.66 50.52 Barricade w/Flasher (Day) TRAFC SBAR Al $0.52 $0.27 Barricade w/out Flasher (Day) TRAFC 1BAR A2 $0.27 $16.27 Traffic Cone 28" (per200) (Day) TRAFC 27C 6100 $16.27 $25.10 Traffic Cone -Refl(per100)(Day) TRAFC 2TC D100 $25.10 $6.53 Illuminated Sign (Day) TRAFC 4SIG 12V $6.53 $6.67 Flashing Beacon (Day) TRAFC SHEA 12V 1 $6.67 $3.01 Flagtree (Sign, Stand & 3 Flags) (Day) TRAFC 6FSS EACHL$7.67 $5.86 Concrete Mixer CONMX SORP 11-16 $3.41 Hand held Concrete Saw SAWCO ABOP 0-10 $7.67 Concrete Saw (walk behind) SAWCO ABOP 10 20 $18.00 Blade Sawkerf SAWCO ABSK 100'/IN$0.18 Blade Sawkert SAWCO ABSK LF-INDE$1.13 Concrete Vibrator CONVB CVIB EVHD $2.89 Water Dolly TRAIW WATR 500WYL $2,89 $2.10 Dump Trailer TRAIU DUMP 10KH $2.10 $4.07 Compactors, Pan, Handguided COMHG COMP 0-250 $4.07 Compactors, Handgulded COMHG COMP 250 $9.89 $10.11 Hammer, Demolition Breaker HAMMR STAN 1160 $10.11 $4.25 Tractors, Attachment, 18" Planer TRACS BCAT P18 $4,25 $0,51 Tractors, Attachment, 60" Sweeper TRACS SCAT S60 $0.51 $0.39 Welder WELD FOR LN-25 $0.39 SANTAANA ON CALL CONSTRUCTION SERVICES "Schedule of Hourly Billing Rates" SUBCONTRACTOR NAME: SMITHSON ELECTRIC, INC. RATES VALID THROUGH: 12/31/2022 Olassifioatlon. • ' Standard Time. I.7-Nertime :'` `Qoubletltne.r':' Electrician - Foreman $107.41 $146,15 $184.90 Electrician -Bourne man $98.73 $133.14 $167.65 Laborer- Group 4 $73.10 $97.35 $121,69 Laborer -Group 1 $69.89 $92.54 $116.18 EQUIPMENT: Qascripflon< lJM; Rats F-550 Truck HR $ 39,41 F-550 Truck HR $ 39,41 F-560 Truck HR $ 39.41 Vacuum/WaterTrk HR $ 60,39 Trailer HR $ 15.67 Concrete Saw HR $ 21.27 Concrete Saw HR $ 21.27 Hotmelt Machine HR $ 21.27 Air Compressor HR $ 1916 Arrowboard HR $ 3.48 Arrowboard HR $ 3.48 MATERIAL: COST PLUS SALES TAX AND % MARK-UP 1, Hot Melt Sealant $0.81 perlb 30 Ibs per loop 2. Type 2 Loop Wire $0,23 per foot 20-30 ft per loop PAVEMENT REHAB COMPANY Labor and Equipment Rates Effective: 4 19 2022 LABOR RATES Classification Standard Time Time and a Half Double Time Superintendent $220.00 $330.00 $440.00 Foreman $190.00 $285.00 $390.00 Grade Checker $145.00 $217.50 $290.00 Labor/Raker $135.00 $202.50 $270.00 Finisher/mason $135.00 $202.50 $270.00 BG Operator $145.00 $217.50 $290.00 Operator $145.00 $217.50 $290.00 Screedman $145.00 $217.50 $290.00 Rollerman $145.00 $217,50 $290.00 EQUIPMENT RATES Equip. Operated Rate per HR Equip. Operated Rate per HR Equip. Operated Rate per HR Paving Machine (10') $300,00 Skip loader $265.00 Truck - Super 10 $195.00 Paving Machine (7-8') $260.00 Skip Combo $295.00 Truck - 10 Wheel $190.00 Bobtail $240.00 Blade 12G $265,00 Truck - Semi $200.00 Bobtail w/Breaker $270,00 Blade 140G $275.00 Truck -High Side $225.00 Bobtailw/Sweeper $255.00 Backhoe $275.00 Tack Truck $235.00 Bobtail w/Grinder $635.00 Backhoe w/Breaker $345.00 Tack Wagon $115.00 AC Grinder (4') $805.00 950 Loader $30D.00 Conc Form Truck $110 + Mat. AC Grinder (6'-8') $1,035.00 966 Loader $355.00 Crew Truck $115.00 Water Truck $210.00 Roller (5-8 tn) $155.00 Street Sweeper $240.00 Concrete Saw $260.00 Roller (3-5 tn) $135.00 Arrow Board $115.00 Core Machine $260.00 Berm Machine $150.00 Mobilization 2 HRs/Equipment- Min. one Way Note• 1) Rates Include Supervision, overhead & Profit. 2) Price is valid for 1 year from submission date. 3) Labor rates are billed with 4 or 8 hour clauses. 4) Equip. & Labor moved for specifically for extra work to be billed with 8 hour min. CERTIFICATE OF LIABILITY INSU 1e Digi aII�T 2") 20 FHR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS ON THE Cr_'RT ICA -S�-L� R--tTHIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER T D - 14EU 45CIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BET �4 (t-69WRIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICENSE NO. 0637431 PATRICK MCRAE INSURANCE SERVICES 1265 N. MANASSERO ST. SUITE 303 ANAHEIM HILLS, CA 92807 NAME: ACT PATRICK MCRAE PHONE t (714) 779-6999 FAX (714) 779-6903 ADDRESS: certrequest@mcraeinsurance.insure INSURE S AFFORDING COVERAGE NAIC# INSURERA: NAVIGATORS SPECIALTY INSURANCE CO. 36056 INSURED INSURERB: INSURANCE COMPANY OF THE WEST 27847 CROSSTOWN ELECTRICAL & DATA, INC. 5454 DIAZ STREET IRWINDALE CA 91706 INSURERC: INTEGON NATIONAL INSURANCE COMPANY 29742 INSURERD: ATLANTIC SPECIALTY INSURANCE COMPA 27154 INSURERE: GREAT AMERICAN INSURANCE CO. 16691 INSURER F: wvr=re wLmo CER iriCAf E Numtstcw REVISION NUM...• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCWLGENERAL LIABILITY X X LA21CGLZ04TP71C. 09/03/202109/03/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR DEDUCTIBLE $5,000 PER DDAMAGES R_E_NT D_ PREMISEMEDEXP $ 1Og000 XCU OCCURENCE X An onepamon) $ 5,000 X OGP PERSONAL S ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[K LOG JEC PRODUCTS -COMP/OPAGO $ 2,000,000 EBL $ 1,000,000 OTHER: C AUTOMOBILE LIABILITY X X 2005675448 11/05/202111/05/2022 Ea ecoitleWNGLELIMIT $ 1,000,000 ANYAUTO COMP:$1,000 X BODILY INJURY (Par person) $ OWNED X COLL: $1,000 AUTOS ONLY AUTOS BODILY BODILY INJURY (Per accident) $ _ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X PROPERTY DAMAGE Per accident $ - E UMBRELLALIAS X OCCUR TUE257205203 06/03/252109103/2022 EACH OCCURRENCE $ 10,000,000 EXCESS LIAR CLAIMS -MADE UNDERLYING LIMITS: X AGGREGATE $ 10,000,000 GL; AL; EL POLICIES X 0 DED RETENTION$ $ B WORKERANDEMPSCOMPEA x WVE5030354-07 06/031202206/0312023 X STATUTE ERH ANDENIPLOTORIPARTNELIABILITY YIN E.L. EACH ACCIDENT $ 1,000,000 OF ICEMMEM EREXCLUDEED?ECUTIVE FN] NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, descnbe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below D PROPERTY & 710039414 apip p CONTRACTORS $1.000 DEDUCTIBLE 05/101202 5/10f202 at00B000 ...a oRPremisss aapo.a reaseeg0 3'WiDao al COV. INCL. THEFT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF SANTA ANA IS NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NONCONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED. RE: ON CALL CONSTRUCTION SERVICES FOR TRAFFIC SIGNALS, STREET LIGHTS AND CONCRETE WHEELCHAIR RAMPS, PROJECT #RFP NO: 21- 095, JOB #TBD te�c1 CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 CIVIC CENTER PLAZA, M-43 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SANTA ANA, CA. 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f4-J7 Ira,.. �n Riak MnncgmtmtD[Welan •f I` REnnEwEn &APPROVED By. ©1988-2015 ACORD I w' :. I '; A fe # ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Risk Management Spedalist POLICY NUMBER:LA21CGLZ04TP71C. COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization for whom you are performing "commercial construction" during the period of this policy and have agreed in a written contract to add as an additional insured for products -completed operations. "Commercial construction" does not include any habitational or residential construction other than hotels or apartments. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 wA Maag..dona,[. goo _ REVIEWED&APPROV®BY: A,.0 Acw4io —WRisk Management Specialist required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 z 'p^,I•G• °,.. RAMwaFe tDMsim ? REVI & APPROY®BY: I( if, AAzw,� Aiju Aeo44 Risk Management SpeciXist POLICY NUMBER:LA21CGLZ04TP71C. COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be primary contrary: and would not seek contribution from any other Primary And Noncontributory Insurance insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 RIA REVIEWED & APPROVED BY: ' A+jp Aeav44 Risk Management Spe.a rg POLICY NUMBER: LA21 CGLZ04TP71C. COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization for whom you are performing operations during the policy period when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and any other person or organization you are required to add as an additional insured under the contract or agreement described above. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 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) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "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. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Risk MourmerdEl can Ll a REVIEWED&APPRCWMBY: A,-�, Avw44 gs�wm— Risk Management SpeaArst 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. C. With respect to the insurance afforded to these 2. Available under the applicable Limits of Insurance additional insureds, the following is added to shown in the Declarations; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the most we Limits of Insurance shown in the Declarations. will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or CG 20 10 04 13 © Insurance Services Office, Inc., 2012 / Risk MaruganadDiviefua REV EW D 6 APPROVED Sr (Li1fl l ��1 A- ju Ac444 ® Risk Management Specialist POLICY NUMBER: LA21CGLZ04TP71C. COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization when you and such person or organization have agreed in writing in a contract or agreement that you will waive any right of recovery against such person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above 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". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 . cE RideMmcgemodDMsimt REVIEWED&APPROV®BY: A4 fe Aa,,44 M Risk Management Specialist POLICY NUMBER:LA2ICGLZ04TP71C. COMMERCIAL GENERAL LIABILITY NPC 71108 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL AGGREGATE LIMIT PER PROJECT WITH AN OVERALL GENERAL AGGREGATE CAP This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: All Projects Overall General Aggregate Cap: $5,000,000 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally a. Insureds; obligated to pay as damages caused by "occur- b. Claims made or "suits" brought; or rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents c. Persons or organizations making claims or under COVERAGE C (SECTION 1), which can be bringing "suits'. attributed only to ongoing operations at a single 3. Any payments made under COVERAGE A for designated construction project shown in the damages or under COVERAGE C for medical Schedule above: expenses shall reduce the Designated Con- 1. A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- that designated construction project. Such ignated construction project, and that limit is payments shall not reduce the General Ag- equal to the amount of the General Aggregate gregate Limit shown in the Declarations nor Limit shown in the Declarations. Subject to shall they reduce any other Designated Con - the application of the General Aggregate Limit struction Project General Aggregate Limit for to each of your projects, the maximum any other designated construction project amount we will pay under the General Aggre- shown in the Schedule above. gate Limit for all claims arising from all 4. The limits shown in the Declarations for Each projects is the Overall General Aggregate Cap Occurrence, Fire Damage and Medical Ex - shown in the Schedule above. pense continue to apply. However, instead of 2. The Designated Construction Project General being subject to the General Aggregate Limit Aggregate Limit is the most we will pay for the shown in the Declarations, such limits will be sum of all damages under COVERAGE A, subject to the applicable Designated Con - except damages because of "bodily injury" or struction Project General Aggregate Limit. "property damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C regard- less of the number of: NPC 711 0811 RiakMa agawt Miclnn e REVIEWED APPRwM Br. A4,p Actv44 �' RISK Management Speamn B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which cannot be attributed only to ongoing operations at a sin- gle designated construction project shown in the Schedule above: 7. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Construction Project General Aggre- gate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the 'products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Construction Project General Aggregate Limit. Page 2 of 2 D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contract- ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated. Risk MarogementD[ielan A,1-:1 AcwA4 ' ®' Risk Management5peaalist . WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 m 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 prentium for this endorsement shall be otherwise due. Person or Organization ANY PERSON / ORG WHEN REQUIRED BY WRITTEN CONTRACT 3 % of the total California Workers' Compensation prerrium Schedule Job Description ALL CA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when this endorsement is issued subsequent to preparation of the poky.) Endorsement Effective 06/03/2022 PolicyNo.WVE 5030354 07 Endorsement No. Insured CROSSTOWN ELECTRICAL & DATA 1 Prerrium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST I" I WC 99 D6 34 (Ed. 8-00) Countersigneb By f w f INSURED RlekMvugeme tD[winn REVIEI D&APPRDV®BY: A, J AM4 now Risk Management Spenah,t Policy No.: 2005675448 Effective: 11/05/2021 (12:01 A.M.) Integon National Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED COVERAGE If you pay the premium for this Blanket Additional Insured Endorsement, we agree with you that any person or organization with whom you have executed a written agreement prior to any loss is added as an additional insured with respect to such liability coverage as is afforded by the policy, but this endorsement applies to such additional insured only as a person or organization liable for your operations and then only to the extent of that liability. This endorsement does not apply to acts, omissions, products, work, or operations of the additional insured. Regardless of the provisions of paragraph A. of the Other Insurance section of this policy, if the person or organization with whom you have executed a written agreement has other insurance under which it is the named insured and that insurance also applies, then this endorsement is primary to, and non-contributory with, that other insurance when the written contract or agreement between you and that person or organization, signed and executed by you before the bodily injury or property damage occurs and in effect during the policy period, requires this endorsement to be primary and non-contributory. In no way does this endorsement waive the Other Insurance section of the policy, nor make this policy primary to third parties hired by the insured to perform work for the insured or on the insured's behalf. o RAMWd9werdDMs1m Rwei DS APPROVE]By. ®. A+� Aewa(o Risk Management Specialist Integon National Insurance Company This Endorsement Applies Only If Form Number 10379 (01012014) Appears on the Declarations Page. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION All the provisions of this Policy apply except as modified by this endorsement. Policy No.: 2005675448 Effective: 11/05/2021 This endorsement is issued to: CROSSTOWN ELECTRICAL & DATA GENERAL PROVISIONS OUR RIGHT TO RECOVER PAYMENT section will not apply to: CITY OF SANTA ANA 20 CIVIC CENTER PLAZA, M-43 SANTA ANA, CA. 92701 RiskMmagvment DW[un RfiVIEXIM&APPROVED BY: 41It�1*I IIA J A+gu Acw44 RIMIM Rnk Management Specialist A� o CERTIFICATE OF LIABILITY INSU �e Digi all"'21 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS ON THE Cr:RJI.`14f(AiC EIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER T IISSdd 14LOf5 i BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BET 1l•.�tl VIE 44F. �,®IJfQJI�IRIZED = 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 LICENSE NO.0637431 PATRICK MCRAE INSURANCE SERVICES 1265 N. MANASSERO ST. SUITE 303 ANAHEIM HILLS, CA 92807 CONTACT NAME: pATRICK MCRAE PHONE E (714) 779-6999 FAX Net: (714) 779-6903 EMAIL q ADDRESS: centre uest mcrdeinsurance.insure INSURERS AFFORDING COVERAGE NAIC N INSURERA: NAVIGATORS SPECIALTY INSURANCE CO. 36056 INSURED INSURERS: INSURANCE COMPANY OF THE WEST 27847 INSURER c: INTEGON NATIONAL INSURANCE COMPANY 29742 CROSSTOWN ELECTRICAL & DATA, INC. 5454 DIAZ STREET IRWINDALE CA 91706 INSURER0: ATLANTIC SPECIALTY INSURANCE COMPA 27154 INSURERE: GREAT AMERICAN INSURANCE CO. 16691 INSURERF: CERTIFICATE 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. ILTR TYPE OF INSURANCE ADDLSUBR INSDIMDI POLICYNUMBER POLICY EFF MMrD POLICY EXP MWD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR XCU X X LA2ICGLZ04TP71C. DEDUCTIBLE $5,000 PER OCCURENCE 09/03/202109/0312022 EACHOCCURRENCE $ 1,000,000 DA GE TO RE ED PREMISES Eaoccurrenca $ 100,000 X MED EXP (Any one arson) $ 5.000 CCP PERSONAL &AOV INJURY $ 1,000,000 X AGGREGATE LIMIT APPLES PER POLICYI JET D LOC GENERAL AGGREGATE $ 2,000,000 GEN'L PRODUCTS-COMP/OP ADD $ 2,000,000 EBL $ 1.000.000 OTHER C AMOMOBILELIABILITY X X ANY AUTO AUTOS ONLY X AUHOSULED HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X X 2005675448 COMP: $1,000 COLL: $1.000 11/05/2021 11/05/2022 COMBINED ISINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ _ BODILY INJURY (Per accident) $ _ PROPERTYDAMAGE P accident $ - E X UMBRELLALUB EXCESS LIAR X OCCUR CLAIMS -MADE TUE 2572052 03 UNDERLYING LIMITS: GL; AL; EL POLICIES 06/03/2021 09/03/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10.000,000 X DELI RETENTION$ 0 $ B ANOEMPLOYMSENSATN YIN OFFICERMEM ERE OWAWROPRIETOWPARTNERIOEEXEOCUTIVE (Mandatory in NH) UDESCRIPTION OF OPERATIONS below N/A x WVE 5030354-07 06/031202206/03/2023X STATUTE ERH E.L. EACH ACCIDENT $ 1,000.000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 EA_ DISEASE -POLICY LIMIT $ 1,000,000 D { PROPERTY & CONTRACTORS 710039414 81,000 DEDUCTIBLE COV. INCL. THEFT 05/10/202 5/10/202 Ds 51,41AM P.,noywl P,emius Se0 WO Laautl BPP wemaai DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD IDI, Additional Remarries Schedule. maybe attached if more space is required) CITY OF SANTA ANA IS NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NONCONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. `SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED. RE: ON CALL CONSTRUCTION SERVICES FOR TRAFFIC SIGNALS, STREET LIGHTS AND CONCRETE WHEELCHAIR RAMPS, PROJECT #RFP NO: 21- 095, JOB #TBO CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 CIVIC CENTER PLAZA, M-43 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SANTA ANA, CA. 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE d. IJ 1966-2015 ACORD (- ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Rhx Management speamst POLICY NUMBER:LA2ICGLZ04TP71C. COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization for whom you are performing "commercial construction" during the period of this policy and have agreed in a written contract to add as an additional insured for products -completed operations. "Commercial construction" does not include any habitational or residential construction other than hotels or apartments. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 0413 © Insurance Services Office, Inc., 2012 A,� Acwvfa ` RUM,, Specinlis[ required by the contract or agreement to provide for such additional insured. GG 20 37 04 13 © Insurance Services Office, Inc., 2012 ,v 'm lilakM�.gawdTNWsimi i - REVIEWED & APPRMM 8r. Risk Management Spetlalis[ POLICY NUMBER: LA21 CGLZ04TP71C. COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be primary contrary: and would not seek contribution from any other Primary And Noncontributory Insurance insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 ��• R6kMcuganmtDWvn RE EwED 6 APPR Br. ��zsmm— Risk Management5peaebst POLICY NUMBER:LA21CGLZ04TP71C. COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization for whom you are performing operations during the policy period when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and any other person or organization you are required to add as an additional insured under the contract or agreement described above. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 2. 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 All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Risk MougemendD. X" Re eE &APPRWM BY. Rnk Management Spedyist 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. C. With respect to the insurance afforded to these 2. Available under the applicable Limits of Insurance additional insureds, the following is added to shown in the Declarations; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the most we Limits of Insurance shown in the Declarations. will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or CG 2010 0413 © Insurance Services Office, Inc., 2012 P"M>wmer _ fkwmta Rbk Management Spec t COMMERCIAL GENERAL LIABILITY POLICY NUMBER: LA21 CGLZ04TP71C. CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization when you and such person or organization have agreed in writing in a contract or agreement that you will waive any right of recovery against such person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above 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". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 e � Rhk MmwAPPR t DiD SY: NEVIEWED 6 APPROVm aY: A w,r" ZW44,,, Risk Management Specialist POLICY NUMB ER:LA2ICGLZ04TP71C. COMMERCIAL GENERAL LIABILITY NPC 711 08 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL AGGREGATE LIMIT PER PROJECT WITH AN OVERALL GENERAL AGGREGATE CAP This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: All Projects Overall General Aggregate Cap: $5,000,000 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally a. Insureds; obligated to pay as damages caused by "occur- b. Claims made or "suits" brought; or rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents c. Persons or organizations making claims or under COVERAGE C (SECTION 1), which can be bringing "suits'. attributed only to ongoing operations at a single 3. Any payments made under COVERAGE A for designated construction project shown in the Schedule above: damages or under COVERAGE C for medical expenses shall reduce the Designated Con- 1, A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- that designated construction project. Such ignated construction project, and that limit is payments shall not reduce the General Ag- equal to the amount of the General Aggregate gregate Limit shown in the Declarations nor Limit shown in the Declarations. Subject to shall they reduce any other Designated Con - the application of the General Aggregate Limit struction Project General Aggregate Limit for to each of your projects, the maximum any other designated construction project amount we will pay under the General Aggre- shown in the Schedule above. gate Limit for all claims arising from all projects is the Overall General Aggregate Cap 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Ex- pense continue to apply. However, instead of 2. The Designated Construction Project General being subject to the General Aggregate Limit Aggregate Limit is the most we will pay for the shown in the Declarations, such limits will be sum of all damages under COVERAGE A, subject to the applicable Designated Con - except damages because of "bodily injury" or struction Project General Aggregate Limit. "property damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C regard- less of the number of: NPC 711 08 11 Risk Mn rnatDMs1m RwEwED 6 APPRt Sr. ®' Rhk Management SpetlNst B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which cannot be attributed only to ongoing operations at a sin- gle designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Construction Project General Aggre- gate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or 'property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Construction Project General Aggregate Limit. Page 2 of 2 D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contract- ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated. Rick A1nr�agemnitD'nirian raEvieum & APPROVm Sr. ��' Risk Management5penalist WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 rr, 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 pren6um for this endorsement shall be otherwise due. Person or Organization ANY PERSON / ORG WHEN REQUIRED BY WRITTEN CONTRACT 3 % of the total California Workers' Compensation premium Schedule Job Description ALL CA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The InfomsYon below is required only when this endorsement is Issued subsequent to preparation of the policy.) Endorsement Effective 06/03/2022 PolicyNo.WVE 5030354 07 Endorsement No. Insured CROSSTOWN ELECTRICAL & DATA ( Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST WC 99 06 34 (Ed. 8-00) Countersignetl By--/�-�— INS Reo 01, `4 µ RenE:uv.Eo & APPROVED BY A, Risk Management Specialist ;i Policy No.: 2005675448 Effective: 11/05/2021 (12:01 A.M.) Integon National Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED COVERAGE If you pay the premium for this Blanket Additional Insured Endorsement, we agree with you that any person or organization with whom you have executed a written agreement prior to any loss is added as an additional insured with respect to such liability coverage as Is afforded by the policy, but this endorsement applies to such additional Insured only as a person or organization liable for your operations and then only to the extent of that liability. This endorsement does not apply to acts, omissions, products, work, or operations of the additional insured. Regardless of the provisions of paragraph A. of the Other Insurance section of this policy, if the person or organization with whom you have executed a written agreement has other insurance under which it is the named insured and that insurance also applies, then this endorsement is primary to, and non-contributory with, that other insurance when the written contract or agreement between you and that person or organization, signed and executed by you before the bodily Injury or property damage occurs and in effect during the policy period, requires this endorsement to be primary and non-contributory. In no way does this endorsement waive the Other Insurance section of the policy, nor make this policy primary to third parties hired by the insured to perform work for the insured or on the insured's behalf. yy.~��{' flCN' E�1i10),• 6APPp/Q,J®aN Awyu Odf ' Risk Management Specialist Integon National Insurance Company This Endorsement Applies Only If Form Number 10379 (01012014) Appears on the Declarations Page. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION All the provisions of this Policy apply except as modified by this endorsement. Policy No.: 2005675448 Effective: 11105/2021 This endorsement is issued to: CROSSTOWN ELECTRICAL & DATA GENERAL PROVISIONS OUR RIGHT TO RECOVER PAYMENT section will not apply to: CITY OF SANTA ANA 20 CIVIC CENTER PLAZA, M-43 SANTA ANA, CA. 92701 � �I 62 t'�16 a RIekMOugemmtDMeinn REVIEWme6-A,P.P.RQJ®BY: AeairuZ► Wig' Ruk Management Specialist 01 Azad, Azadeh _N -Ug-o• �_�;i -0 From: CTrax <certificate-request@ctrax.jdidata.com> Sent: Tuesday, September 20, 2022 9:46 AM To: certrequest@mcraeinsurance.insure; Azad, Azadeh; aheermance@crosstowndata.com; Rodriguez, Cesar; Castaneda, Ruben; shalea@crosstowndata.com Subject: Internal Notice of Compliance NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Crosstown Electrical & Data, Inc. Name: Project A-2022-157-01 Number: Project Agreement With Crosstown Electircal & Data, Inc., To Provide On -Call Name: Construction Services For The City Of Santa Ana 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: TYPE OF INSURANCE POLICY NUMBER EXPIRATION DATE FILE NAME DATECOI AUTOMOBILE LIABILITY 2005675448 11/05/2022 06/30/2022 COI-Crosstown.pdf Builder's Risk & Pollution Liability BUILDER'S RISK WAIVER 09/13/2023 09/20/2022 Waiver Request - Santa Ana 9-13- 22.pdf CITY OF SANTA GENERAL LIABILITY LA22CGLZ04TP7IC 09/03/2023 09/02/2022 ANA - JOB # 4812- 22.pdf Builder's Risk & Pollution Liability POLLUTION/ ENVIRONMENTAL LIABILITY WAIVER 09/13/2023 09/20/2022 Waiver Request - Santa Ana 9-I3- 22.pdf — -- —.I Bmlder's Risk & Pollution Liability �erRequest- PROFESSIONAL LIABILITY WAIVER 09/13/2023 09/20/2022 Santa Ana 9-13- 22.pdf TYPE OF INSURANCE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 9/20/2022 12:45 PM POLICY NUMBER EXPIRATION COI DATE FILE NAME DATE Crosstown Electrical WVE503035407 06/03/2023 06/20/2022 & Data, Inc. COI Exp 9-3-22 RMD06222022.pdf ACOR" CERTIFICATE OF LIABILITY INSURANCE 16.� DATE(MM/DD/YYYY) 1 06/03/2025 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: Mancela Aguirre HONE (PA/C./C. No. EAE: (714)779-6999 FAX , No): (714)779-6903 McRae Associates Insurance Services 1265 N. Manassero St Suite 303 Anaheim, CA 92807 E-MAIL maricela@mcraeinsurance. insure INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Travelers Property Casualty Company of America 25674 INSURED INSURER B : TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 25674 INSURERC: GREAT AMERICAN INSURANCE COMPANY 16691 CROSSTOWN ELECTRICAL & DATA, INC. 5454 DIAZ ST. INSURER D : St Paul Surplus Lines Insurance Company 30481 Irwindale, CA 91706 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 00001315-0 REVISION NUMBER: 750 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL I SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y DT22-CO-7W503833-TCT-25 06/03/2025 06/03/2026 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 3OO OOO X MED EXP (Any one person) $ 5,000 Deductible $10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4000000 PRO - POLICY � ECT El LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY Y Y 810-7W449049-25-26-G 06/03/2025 06/03/2026 COMBIB 'aa acccideDtsINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED X X AUTOS ONLY AUTOS ONLY C X UMBRELLA LIAB X OCCUR Y Y TUE257205207 06/03/2025 06/03/2026 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ 0 $ A Y UB-7W504031-25-26-G 06/03/2025 06/03/2026 X STATUTE EORH AND EMPLOYERS' LIABILITY AND EMPLOYERS' YERS' LIABTIONILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N E.L. EACH ACCIDENT $ 1,000,000 N N I A E.L. DISEASE- EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 A 2nd Tier Umb. Policy Y Y EX-B4831416-25-NF 06/03/2025 06/0312026 Each Occ/ Gene Agg $5,000,000 D Prof. & Poll. Liab. Y Y ZCE-16P95095 10/10/2024 10/10/2025 Each Occ/ Gen Agg $2 mill/ $4 mill DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: ATMS AND COMMUNICATION SYSTEMS, ON CALL REPAIR SERVICES, JOB#4775-22 THE CITY OF SANTA ANA ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE -MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. continued on ACORD 101 Additional Remarks Schedule APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 3:16 pm, Jun 10, 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. DigitallyPisi dby 20 CIVIC CENTER PLAZA M-30 Tu Tran ,,my SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE Date: 2025.06,10 Nguyen 15:16:45-07'00' (MAG) © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by MAG on 06/03/2025 at 08:54AM AGENCY CUSTOMER ID: LOC #: ACCOR" ® ADDITIONAL REMARKS SCHEDULE Page 2 of AGENCY McRae Associates Insurance Services NAMED INSURED CROSSTOWN ELECTRICAL & DATA, INC. POLICY NUMBER N/A CARRIER Multiple Carriers NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (continued from Description of Operations) * SHOULD ANY OF THE ABOVE -DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by MAG on June 03, 2025 at 08:54AM Policy Number: 810-7W449049-25-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION 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. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in 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 H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS 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. C. 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 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 busi- ness. 2. The following replaces Paragraph b. in B.5., 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 CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO 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". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: 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. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY 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 LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. 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. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. 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. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or 'loss" ap- plies only when the "accident" or 'loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". 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: The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for 'loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: 810-7W449049-25-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.S., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part S. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non- contributory. CA T4 99 02 16 6 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: DT22 CO -7W 503833 T'CT-25 COMMERCIAL GENERAL LIABILITY ISSUE DATE:05/30/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - DESIGNATED ADDITIONAL INSUREDS - PRIMARY WITH RESPECT TO CERTAIN OTHERINSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS "As required by written contract" PROVISIONS The following is added to Paragraph 4.a., Primary Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance afforded under this Coverage Part to anv additional insured shown in the Schedule Of Designated Additional Insureds is primary to any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance. CG D4 26 02 19 ® 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number: DT22-CO-7W503833-TCT-25 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided underthe following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 04 19 © 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 Policy Number: DT22-CO-7W503833-TCT-25 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 this 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 coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured — Unnamed Subsidiaries C. Incidental Medical Malpractice B. Blanket Additional Insured — Governmental D. Blanket Waiver Of Subrogation Entities — Permits Or Authorizations Relating To E. Contractual Liability — Railroads Operations F. Damage To Premises Rented To You PROVISIONS a. An organization other than a partnership, joint A. WHO IS AN INSURED — UNNAMED venture or limited liability company; or SUBSIDIARIES b. A trust; The following is added to SECTION II — WHO IS as indicated in its name or the documents that AN INSURED: govern its structure. Any of your subsidiaries, other than a partnership, B. BLANKET ADDITIONAL INSURED — joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR not shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONS Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: a. Before you maintained an ownership interest of more than 50% in such subsidiary; or The following is added to SECTION II — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury", "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II — Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products -completed operations hazard". CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE 1. The following replaces Paragraph b. of the definition of "occurrence" in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury' arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician or paramedic; 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, 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 II — Who Is An Insured. D. BLANKET WAIVER OF SUBROGATION 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 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 execution of the contract or agreement. E. CONTRACTUAL LIABILITY— RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: c. Any easement or license agreement; Page 2 of 3 © 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is deleted. F. DAMAGE TO PREMISES RENTED TO YOU The following replaces the definition of "premises damage" in the DEFINITIONS Section: "Premises damage" means "property damage" to: a. Any premises while rented to you or temporarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Policy Number: DT22-CO-7W503833-TCT-25 COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words 'you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and "our" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under Section II - Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V - Definitions. SECTION I - COVERAGES COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit' seeking those damages. However, we will have no duty to defend the insured against any "suit' seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any 'occurrence" and settle any claim or "suit' that may result. But: (1) The amount we will pay for damages is limited as described in Section III - Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. (1) The "bodily injury" or "property damage" is caused by an 'occurrence" that takes place in the "coverage territory"; (2) The "bodily injury" or "property damage" occurs during the policy period; and (3) Prior to the policy period, no insured listed under Paragraph 1. of Section II - Who Is An Insured and no "employee" authorized by you to give or receive notice of an "occurrence" or claim knew that the "bodily injury" or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. c. "Bodily injury" or "property damage" which occurs during the policy period and was not, prior to the policy period, known to have occurred by any insured listed under Paragraph 1, of Section II - Who Is An Insured or any "employee" authorized by you to give or receive notice of an 'occurrence" or claim, includes any continuation, change or resumption of that "bodily injury" or "property damage" after the end of the policy period. d. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section II - Who Is An Insured or any "employee" authorized by you to give or receive notice of an 'occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; No other obligation or liability to pay sums or (2) Receives a written or verbal demand or perform acts or services is covered unless claim for damages because of the "bodily explicitly provided for under Supplementary injury" or "property damage"; or Payments. (3) Becomes aware by any other means that b. This insurance applies to "bodily injury" and "bodily injury" or "property damage" has "property damage" only if: occurred or has begun to occur. CG T1 00 02 19 © 2017 The Travelers Indemnity Company . All rights reserved. Page 1 of 21 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 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 insurance of all insurers. 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. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. C. 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. 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 laws or regulations. 7. 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. 8. Transfer Of Rights Of 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 our request, 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 specific 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 © 2017 The Travelers Indemnity Company . All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. AW WORKERS COMPENSATION TRAVELERS J AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — POLICY NUMBER: UB-7W504031-25-26-G 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 As required by written contract 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 Policy No. UB-7W504031-25-26-G Endorsement No. Insured 06/03/2025 Premium Insurance Company Countersigned by Travelers Property Casualty Company DATE OF ISSUE: - - ST ASSIGN: Page 1 of 1 7TE,(MMIDDfYYYY) ACORO° CERTIFICATE OF LIABILITY INSURANCE27/2025 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: Veronica Carrillo McRae Associates Insurance Services IA N Ell, (714)779-6999 a/c No (714)779-6903 1265 N. Manassero St Suite 303 E-MAIL ADDRESS: veronica.c@mcraeinsurance.insure Anaheim, CA 92807 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Travelers Property Casualty Company of America 25674 INSURED INSURER B: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 25674 CROSSTOWN ELECTRICAL & DATA, INC. INSURERC: GREAT AMERICAN INSURANCE COMPANY 16691 5454 DIAZ ST. INSURER D: St Paul Surplus Lines Insurance Company 30481 Irwindale, CA 91706 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00001315-0 REVISION NUMBER: 916 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/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y DT22-CO-7W503833-TCT-25 06/03/2025 06/03/2026 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE J OCCUR PREM AGE SESOEa occuRENTErrDence $ 300,000 X Deductible $10,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY jECT RO- LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y 810-7W449049-25-26-G 06/03/2025 06/03/2026 EOa aMBI ccideDtsINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Per accident `` X UMBRELLA LAB X OCCUR Y Y TUE257205207 06/03/2025 06/03/2026 EACH OCCURRENCE $ 5,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ 0 $ A AND EMPS YERS'LSA IONILIT Y U B-7W504031-25-26-G 06/03/2025 06/03/2026 X STATUTE OERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/" E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? FN-] 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 A 2nd Tier Umb. Policy Y Y EX-B4831416-25-NF 06/03/2025 06/03/2026 Each Occ/Gene Agg $5,000,000 D Prof. & Poll. Liab. Y Y ZCE-16P95095 10/10/2025 10/10/2026 Each Occ/Gen Agg $10 mill/$10 mill DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: ATMS AND COMMUNICATION SYSTEMS, ON CALL REPAIR SERVICES, JOB#4775-22 THE CITY OF SANTA ANA ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE-MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY& NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. (continued on ACORD 101 Additional Remarks Schedule) CERTIFICATE HOLDER APPROVED CANCELLATION By Tu Tran Nguyen at 9:26 am,Oct 28,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN CITY OF SANTA ANA D,g,tailysigned ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA M-30 Tu Tran byTuTran Nguyen SANTA ANA, CA 92702 Nguyen 09Zbs0zo.;o.08 AUTHORIZED REPRESENTATIVE (vcc) @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by VCC on 10/27/2025 at 03:08PM AGENCY CUSTOMER ID: LOC#: ,a`oRo ADDITIONAL REMARKS SCHEDULE Page 2 of AGENCY NAMED INSURED McRae Associates Insurance Services CROSSTOWN ELECTRICAL& DATA, INC. POLICY NUMBER N/A CARRIER NAIC CODE Multiple Carriers EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (continued from Description of Operations) SHOULD ANY OF THE ABOVE-DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,A 30 DAY WRITTEN NOTICE WILL BE ISSUED. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by VCC on October 27,2025 at 03:08PM Policy Number: 810-7W449049-25-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION 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. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT C. EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE—INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies as an "insured" An Insured, of SECTION II —COVERED AUTOS under the Who Is An Insured provision contained LIABILITY COVERAGE: in Section II. Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The following is added to Paragraph A.1., 50% or more ownership interest and that is not Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission, while performing duties related to the conduct of your busi- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1., 2. The following replaces Paragraph b. in B.5., Who Is An Insured, of SECTION II — COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that is signed and ered "autos"you own: executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow; and during the policy period, to be named as an addi- (2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name, with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION II —COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED (iii) in may, at our discretion, participate LIMITS in defending the "insured" against, or in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE— INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to 'loss" to one or ted or authorized insurer outside the more airbags in a covered "auto" you own that in- United States of America, its territories flate due to a cause other than a cause of 'loss" and possessions, Puerto Rico and Can- set forth in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance. b. The airbags are not covered under any war- G. WAIVER OF DEDUCTIBLE—GLASS ranty; and The following is added to Paragraph D., Deducti- c. The airbags were not intentionally inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss". No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. The following is added to Paragraph A.2.a., of H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF SECTION IV—BUSINESS AUTO CONDITIONS: USE—INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or 'loss" ap- graph AA.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or "loss" is known TION III—PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership); $750 for any one "accident". (c) A member (if you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager(if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization); or SECTION III — PHYSICAL DAMAGE COVER- (e) Any "employee" authorized by you to give no- AGE: tice of the "accident" or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.5., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS: The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for 'loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or"loss", provided that the "accident" or"loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. SECTION IV— BUSINESS AUTO CONDITIONS: Page 4 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission. POLICY NUMBER: 810-7W449049-25-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2. The following is added to Paragraph B.5., Other 1. The following is added to Paragraph c. in A.1., Insurance of SECTION IV — BUSINESS AUTO Who Is An Insured, of SECTION II — COVERED CONDITIONS: AUTOS LIABILITY COVERAGE: Regardless of the provisions of paragraph a. and This includes any person or organization who you paragraph d. of this part 5. Other Insurance, this are required under a written contract or insurance is primary to and non-contributory with agreement, that is signed by you before the applicable other insurance under which an "bodily injury" or "property damage" occurs and additional insured person or organization is a that is in effect during the policy period, to name named insured when a written contract or as an additional insured for Covered Autos agreement with you, that is signed by you before Liability Coverage, but only for damages to which the "bodily injury" or "property damage" occurs this insurance applies and only to the extent of and that is in effect during the policy period, that person's or organization's liability for the requires this insurance to be primary and non- conduct of another"insured". contributory. CA T4 99 02 16 u 2016 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL GENERAL LIABILITY POLICY NUMBER: DT22-CO-aw 503A33TOT-25 ISSUE DATE:05/30/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - DESIGNATED ADDITIONAL INSUREDS - PRIMARY WITH RESPECT TO CERTAIN OTHERINSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS "As required by written contract" PROVISIONS Designated Additional Insureds is primary to any of The following is added to Paragraph 4.a., Primary the other insurance, whether primary, excess, Insurance, of SECTION IV — COMMERCIAL contingent or on any other basis, that is available to GENERAL LIABILITY CONDITIONS: such additional insured which covers such additional The insurance afforded under this Coverage Part to insured as a named insured, and we will not share with that other insurance. any additional insured shown In the schedule Of CG D4 26 02 19 m 2017 The Travelers Indemnity company.All rights reserved. Page 1 of t Includes copyrighted material of Insurance Services Office,Inc.with its permission. Policy Number: DT22-CO-7W503833-TCT-25 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products-Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS (1) Any "bodily injury", "property damage" or The following is added to SECTION II —WHO IS AN "personal injury" arising out of the providing, INSURED: or failure to provide, any professional Any person or organization that you agree in a architectural, engineering or surveying written contract or agreement to include as an services, including: additional insured on this Coverage Part is an (a) The preparing, approving, or failing to insured, but only: prepare or approve, maps, shop a. With respect to liability for "bodily injury" or drawings, opinions, reports, surveys, "property damage" that occurs, or for "personal field orders or change orders, or the injury" caused by an offense that is committed, preparing, approving, or failing to subsequent to the signing of that contract or prepare or approve, drawings and agreement and while that part of the contract or specifications; and agreement is in effect; and (b) Supervisory, inspection, architectural or b. If, and only to the extent that, such injury or engineering activities. damage is caused by acts or omissions of you or your subcontractor in the performance of "your (2) Any "bodily injury" or "property damage" work" to which the written contract or agreement caused by "your work" and included in the applies. Such person or organization does not "products-completed operations hazard" qualify as an additional insured with respect to unless the written contract or agreement the independent acts or omissions of such specifically requires you to provide such person or organization. coverage for that additional insured during The insurance provided to such additional insured is the policy period. subject to the following provisions: c. The additional insured must comply with the a. If the Limits of Insurance of this Coverage Part following duties: shown in the Declarations exceed the minimum limits required by the written contract or (1) Give us written notice as soon as practicable agreement, the insurance provided to the of an "occurrence" or an offense which may additional insured will be limited to such result in a claim. To the extent possible, such minimum required limits. For the purposes of notice should include: determining whether this limitation applies, the (a) How, when and where the "occurrence" minimum limits required by the written contract or or offense took place; agreement will be considered to include the minimum limits of any Umbrella or Excess (b) The names and addresses of any injured liability coverage required for the additional persons and witnesses; and insured by that written contract or agreement. (c) The nature and location of any injury or This provision will not increase the limits of damage arising out of the "occurrence" insurance described in Section III — Limits Of or offense. Insurance. b. The insurance provided to such additional (2) If a claim is made or"suit" is brought against insured does not apply to: the additional insured: CG D2 46 04 19 ©2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the (4) Tender the defense and indemnity of any claim or"suit" and the date received; and claim or "suit" to any provider of other (b) Notify us as soon as practicable and see insurance which would cover such additional to it that we receive written notice of the insured for a loss we cover. However, this claim or"suit" as soon as practicable. condition does not affect whether the insurance provided to such additional (3) Immediately send us copies of all legal insured is primary to other insurance papers received in connection with the claim available to such additional insured which or "suit', cooperate with us in the covers that person or organization as a investigation or settlement of the claim or named insured as described in Paragraph 4., defense against the "suit', and otherwise Other Insurance, of Section IV—Commercial comply with all policy conditions. General Liability Conditions. Page 2 of 2 ©2018 The Travelers Indemnity Company.All rights reserved. CG D2 46 04 19 Policy Number: DT22-CO-7W503833-TCT-25 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 this 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 coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured —Unnamed Subsidiaries C. Incidental Medical Malpractice B. Blanket Additional Insured — Governmental D. Blanket Waiver Of Subrogation Entities — Permits Or Authorizations Relating To E. Contractual Liability—Railroads Operations F. Damage To Premises Rented To You PROVISIONS a. An organization other than a partnership, joint A. WHO IS AN INSURED — UNNAMED venture or limited liability company; or SUBSIDIARIES b. A trust; The following is added to SECTION II —WHO IS as indicated in its name or the documents that AN INSURED: govern its structure. Any of your subsidiaries, other than a partnership, B. BLANKET ADDITIONAL INSURED — joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR not shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONS Declarations is a Named Insured if: a. You are the sole owner of, or maintain an The following is added to SECTION II — WHO IS ownership interest of more than 50% in, such AN INSURED: subsidiary on the first day of the policy period; Any governmental entity that has issued a permit and or authorization with respect to operations b. Such subsidiary is not an insured under performed by you or on your behalf and that you similar other insurance. are required by any ordinance, law, building code or written contract or agreement to include as an No such subsidiary is an insured for"bodily injury' additional insured on this Coverage Part is an or "property damage" that occurred, or "personal insured, but only with respect to liability for"bodily and advertising injury" caused by an offense injury", "property damage" or "personal and committed: advertising injury" arising out of such operations. a. Before you maintained an ownership interest The insurance provided to such governmental of more than 50% in such subsidiary; or entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury", "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II—Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products-completed operations hazard". CG D3 16 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE pharmaceuticals committed by, or with the 1. The following replaces Paragraph b. of the knowledge or consent of,the insured. definition of "occurrence" in the 5. The following is added to the DEFINITIONS DEFINITIONS Section: Section: b. An act or omission committed in providing "Incidental medical services" means: or failing to provide "incidental medical services", first aid or "Good Samaritan a. Medical, surgical, dental, laboratory, x-ray services" to a person, unless you are in or nursing service or treatment, advice or the business or occupation of providing instruction, or the related furnishing of professional health care services. food or beverages; or 2. The following replaces the last paragraph of b. The furnishing or dispensing of drugs or Paragraph 2.a.(1) of SECTION II — WHO IS medical, dental, or surgical supplies or AN INSURED: appliances. Unless you are in the business or occupation 6. The following is added to Paragraph 4.b., of providing professional health care services, Excess Insurance, of SECTION IV — Paragraphs (1)(a), (b), (c) and (d) above do COMMERCIAL GENERAL LIABILITY not apply to "bodily injury" arising out of CONDITIONS: providing or failing to provide: This insurance is excess over any valid and (a) "Incidental medical services" by any of collectible other insurance, whether primary, your "employees" who is a nurse, nurse excess, contingent or on any other basis, that assistant, emergency medical technician is available to any of your "employees" for or paramedic; or "bodily injury" that arises out of providing or (b) First aid or "Good Samaritan services" by failing to provide "incidental medical services" any of your "employees" or "volunteer to any person to the extent not subject to workers", other than an employed or Paragraph 2.a.(1) of Section II — Who Is An volunteer doctor. Any such "employees" Insured. or "volunteer workers" providing or failing D. BLANKET WAIVER OF SUBROGATION to provide first aid or "Good Samaritan services" during their work hours for you The following is added to Paragraph 8., Transfer will be deemed to be acting within the Of Rights Of Recovery Against Others To Us, scope of their employment by you or of SECTION IV — COMMERCIAL GENERAL performing duties related to the conduct LIABILITY CONDITIONS: of your business. If the insured has agreed in a contract or 3. The following replaces the last sentence of agreement to waive that insured's right of Paragraph 5. of SECTION III — LIMITS OF recovery against any person or organization, we INSURANCE: waive our right of recovery against such person or For the purposes of determining the organization, but only for payments we make applicable Each Occurrence Limit, all related because of: acts or omissions committed in providing or a. "Bodily injury" or "property damage" that failing to provide "incidental medical occurs; or services", first aid or "Good Samaritan services"to any one person will be deemed to b. "Personal and advertising injury" caused by be one"occurrence". an offense that is committed; 4. The following exclusion is added to subsequent to the execution of the contract or Paragraph 2., Exclusions, of SECTION I — agreement. COVERAGES — COVERAGE A — BODILY E. CONTRACTUAL LIABILITY—RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY: 1. The following replaces Paragraph c. of the Sale Of Pharmaceuticals definition of "insured contract" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or c. Any easement or license agreement; ordinance relating to the sale of Page 2 of 3 ©2017 The Travelers Indemnity Company.All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured a. Any premises while rented to you or contract' in the DEFINITIONS Section is temporarily occupied by you with permission deleted. of the owner; or F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such The following replaces the definition of"premises premises is rented to you, if you rent such damage" in the DEFINITIONS Section: premises for a period of seven or fewer "P remises damage "property property damage"to: consecutive days. CG D3 16 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Policy Number: DT22-CO-7W503833-TCT-25 COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read (1) The "bodily injury" or "property damage" is the entire policy carefully to determine rights, duties and caused by an "occurrence" that takes place what is and is not covered. in the "coverage territory'; Throughout this policy the words "you" and "your" refer (2) The "bodily injury" or "property damage" to the Named Insured shown in the Declarations, and occurs during the policy period; and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and (3) Prior to the policy period, no insured listed "our" refer to the company providing this insurance. under Paragraph 1. of Section II — Who Is The word "insured" means any person or organization An Insured and no "employee" authorized qualifying as such under Section II — Who Is An by you to give or receive notice of an " Insured. occurrence" or claim knew that the "bodily injury" or "property damage" had occurred, Other words and phrases that appear in quotation in whole or in part. If such a listed insured marks have special meaning. Refer to Section V — or authorized "employee" knew, prior to the Definitions. policy period, that the "bodily injury" or "property damage" occurred, then any SECTION I—COVERAGES continuation, change or resumption of such COVERAGE A — BODILY INJURY AND PROPERTY "bodily injury" or "property damage" during DAMAGE LIABILITY or after the policy period will be deemed to have been known prior to the policy period. 1. Insuring Agreement c. "Bodily injury" or "property damage" which a. We will pay those sums that the insured occurs during the policy period and was not, becomes legally obligated to pay as damages prior to the policy period, known to have because of"bodily injury" or "property damage" occurred by any insured listed under Paragraph to which this insurance applies. We will have 1. of Section II — Who Is An Insured or any the right and duty to defend the insured against "employee" authorized by you to give or receive any "suit" seeking those damages. However, notice of an "occurrence" or claim, includes any we will have no duty to defend the insured continuation, change or resumption of that against any "suit" seeking damages for "bodily "bodily injury" or "property damage" after the injury" or "property damage" to which this end of the policy period. insurance does not apply. We may, at our discretion, investigate any "occurrence" and d. "Bodily injury" or "property damage" will be settle any claim or "suit"that may result. But: deemed to have been known to have occurred at the earliest time when any insured listed (1) The amount we will pay for damages is under Paragraph 1. of Section II — Who Is An limited as described in Section III — Limits Insured or any "employee" authorized by you to Of Insurance; and give or receive notice of an "occurrence" or (2) Our right and duty to defend end when we claim: have used up the applicable limit of (1) Reports all, or any part, of the "bodily insurance in the payment of judgments or injury" or "property damage" to us or any settlements under Coverages A or B or other insurer; medical expenses under Coverage C. No other obligation or liability to pay sums or (2) Receives a written or verbal demand or perform acts or services is covered unless claim for damages because of the "bodily explicitly provided for under Supplementary injury" or"property damage"; or Payments. (3) Becomes aware by any other means that b. This insurance applies to "bodily injury" and "bodily injury" or "property damage" has "property damage" only if: occurred or has begun to occur. CG T1 00 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 21 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY c. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares, we will follow this method also. b. Those statements are based upon Under this approach each insurer contributes representations you made to us; and equal amounts until it has paid its applicable c. We have issued this policy in reliance upon limit of insurance or none of the loss remains, your representations. whichever comes first. The unintentional omission of, or unintentional error If any of the other insurance does not permit in, any information provided by you which we relied contribution by equal shares, we will contribute upon in issuing this policy will not prejudice your by limits. Under this method, each insurer's rights under this insurance. However, this provision share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of premium or to exercise our rights of cancellation or insurance of all insurers. nonrenewal in accordance with applicable insurance d. Primary And Non-Contributory Insurance If laws or regulations. Required By Written Contract 7. Separation Of Insureds If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an any rights or duties specifically assigned in this insured under this Coverage Part must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies: contributory basis, this insurance is primary to a. As if each Named Insured were the only other insurance that is available to such insured Named Insured; and which covers such insured as a named insured, and we will not share with that other insurance, b. Separately to each insured against whom claim is made or"suit" is brought. provided that: (1) The "bodily injury" or "property damage" for 8• Transfer Of Rights Of Recovery Against Others which coverage is sought occurs; and To Us (2) The "personal and advertising injury" for If the insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Part, offense that is committed; those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, subsequent to the signing of that contract or the insured will bring "suit" or transfer those rights agreement by you. to us and help us enforce them. S. Premium Audit 9. When We Do Not Renew a. We will compute all premiums for this Coverage If we decide not to renew this Coverage Part, we will Part in accordance with our rules and rates. mail or deliver to the first Named Insured shown in b. Premium shown in this Coverage Part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only. At not less than 30 days before the expiration date. the close of each audit period we will compute If notice is mailed, proof of mailing will be sufficient the earned premium for that period and send proof of notice. notice to the first Named Insured. The due date SECTION V—DEFINITIONS for audit and retrospective premiums is the date 1 "Advertisement" means a notice that is broadcast or shown as the due date on the bill. If the sum of published to the general public or specific market the advance and audit premiums paid for the segments about your goods, products or services policy period is greater than the earned for the purpose of attracting customers or premium, we will return the excess to the first Named Insured. supporters. For the purposes of this definition: c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding websites, only that part of a website that is about your goods, products or services 6. Representations for the purposes of attracting customers or By accepting this policy, you agree: supporters is considered an advertisement. Page 16 of 21 ©2017 The Travelers Indemnity Company.All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office,Inc.with its permission. AVIl► WORKERS COMPENSATION TRAVELERS J AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76( A)— POLICY NUMBER: UB-7W504031-25-26-G 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 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 Policy No. UB-7VV504031-25-26-G Endorsement No. Insured 06/03/2025 Premium Insurance Company Countersigned by Trevelers Property Casualty Company DATE OF ISSUE: - - ST ASSIGN: Page 1 of 1 ACORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 0 (MMID026 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: Maricela Aguirre McRae Associates Insurance Services a/c"N Ell, (714)779-6999 A/C No: (714)779-6903 1265 N. Manassero St Suite 303 E-MAIL ADDRESS: maricela@mcraeinsurance.insure Anaheim, CA 92807 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Travelers Property Casualty Company of America 25674 INSURED INSURER B: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 25674 CROSSTOWN ELECTRICAL & DATA, INC. INSURERC: GREAT AMERICAN INSURANCE COMPANY 16691 5454 DIAZ ST. INSURER D: St Paul Surplus Lines Insurance Company 30481 Irwindale, CA 91706 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00001315-0 REVISION NUMBER: 1083 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.LIMITS SHOWN ARE INCLUSIVE OF AMOUNTS REQUESTED BY THE CERTIFICATE HOLDER AND MAY NOT REFLECT POLICY LIMIT AMOUNTS IN EXCESS OF THOSE REQUESTED.*Not Applicable in WY INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y DT22-CO-7W503833-TCT-26 06/03/2026 06/03/2027 EACH OCCURRENCE $ 2,000,000 Am CLAIMS-MADE � OCCUR PREM SESOEa occurrDence $ 300,000 X Deductible $10,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY� PEA LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y 810-7W449049-26-26-G 06/03/2026 06/03/2027 Ea acccidenINED SINGLE LIMIT $ 11000,000 X ANY AUTO BODI LY I NJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident `` X UMBRELLA LIAB X OCCUR Y Y TUE257205208 06/03/2026 06/03/2027 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ 0 $ A AND EMPLOYE YERS'LSA IONILIT Y UB-7W504031-26-26-G 06/03/2026 06/03/2027 X STATUTE EERPER H AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEM BER EXCLUDED? FN—] 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 A 2nd Tier Umb. Policy Y Y EX-B4831416-26-NF 06/03/2026 06/03/2027 Each Occ/Gene Agg $5,000,000 D Prof. & Poll. Liab. Y Y ZCE-16P95095 10/10/2025 10/10/2026 Each Occ/Gen Agg $10 mill/$10 mill DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: PROJECT NAME: CONDUIT VERIFICATION AT EDINGER/GRAND -PROJECT#211280-000-SAN -CROSSTOWN -01 / PROJECT LOCATION: EDINGER/GRAND IN SANTA ANA, CA/JOB#4781-22 THE CITY OF SANTA ANA AND DKS,ALONG WITH THEIR OFFICERS, OFFICIALS,AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE-MENTIONED POLICIES PER ATTACHED (continued on ACORD 101 Additional Remarks Schedule) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN CITY OF SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. 305 4TH STREET SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE APPROVED - (MAG) By Tu Tran Nguyen at 10:22 am,Jun 01,2026 ACORD 25 1988-2025 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by MAG on 05/26/2026 at 11:25AM AGENCY CUSTOMER ID: LOC#: ,a`oRo ADDITIONAL REMARKS SCHEDULE Page 2 of AGENCY NAMED INSURED McRae Associates Insurance Services CROSSTOWN ELECTRICAL& DATA, INC. POLICY NUMBER N/A CARRIER NAIC CODE Multiple Carriers EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (continued from Description of Operations) ENDORSEMENT(S).COVERAGE IS PRIMARY&NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT,PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES,IF REQUIRED BY WRITTEN CONTRACT. SHOULD ANY OF THE ABOVE-DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,A 30 DAY WRITTEN NOTICE WILL BE ISSUED. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by MAG on May 26,2026 at 11:25AM DATE(MM/DDNYYY) ACORO° CERTIFICATE OF LIABILITY INSURANCEF05/26/2026 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: Maricela Aguirre McRae Associates Insurance Services (A N Ext: (714)779-6999 FAX "o: (714)779-6903 1265 N. Manassero St Suite 303 E-MAIL ADDRESS: maricela@mcraeinsurance.insure Anaheim, CA 92807 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Atlantic Specialty Insurance Com an 27154 INSURED INSURER B CROSSTOWN ELECTRICAL& DATA, INC. INSURERC: 5454 DIAZ ST. INSURER D Irwindale, CA 91706 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00001315-250603083707 REVISION NUMBER: 1 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/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES DAMAGE TO PREMISES Ea occurrence) ccurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 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 UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Prop & Inland Marine 710039414 05/10/2025 06/03/2026 Build/Prop $1,4 3,849/$300,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 1" _ MAG ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by MAG on 06/03/2025 at 08:41AM Policy Number: 810-7W449049-26-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION 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. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT C. EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE—INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies as an "insured" An Insured, of SECTION II —COVERED AUTOS under the Who Is An Insured provision contained LIABILITY COVERAGE: in Section II. Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The following is added to Paragraph A.1., 50% or more ownership interest and that is not Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission, while performing duties related to the conduct of your busi- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1., 2. The following replaces Paragraph b. in B.5., Who Is An Insured, of SECTION II — COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that is signed and ered "autos"you own: executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow; and during the policy period, to be named as an addi- (2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name, with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION II —COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED (iii) in may, at our discretion, participate LIMITS in defending the "insured" against, or in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE— INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to 'loss" to one or ted or authorized insurer outside the more airbags in a covered "auto" you own that in- United States of America, its territories flate due to a cause other than a cause of 'loss" and possessions, Puerto Rico and Can- set forth in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance. b. The airbags are not covered under any war- G. WAIVER OF DEDUCTIBLE—GLASS ranty; and The following is added to Paragraph D., Deducti- c. The airbags were not intentionally inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss". No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. The following is added to Paragraph A.2.a., of H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF SECTION IV—BUSINESS AUTO CONDITIONS: USE—INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or 'loss" ap- graph AA.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or "loss" is known TION III—PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership); $750 for any one "accident". (c) A member (if you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager(if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization); or SECTION III — PHYSICAL DAMAGE COVER- (e) Any "employee" authorized by you to give no- AGE: tice of the "accident" or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.5., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS: The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for 'loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or"loss", provided that the "accident" or"loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. SECTION IV— BUSINESS AUTO CONDITIONS: Page 4 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission. POLICY NUMBER: 810-7W449049-26-26-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2. The following is added to Paragraph B.5., Other 1. The following is added to Paragraph c. in A.1., Insurance of SECTION IV — BUSINESS AUTO Who Is An Insured, of SECTION II — COVERED CONDITIONS: AUTOS LIABILITY COVERAGE: Regardless of the provisions of paragraph a. and This includes any person or organization who you paragraph d. of this part 5. Other Insurance, this are required under a written contract or insurance is primary to and non-contributory with agreement, that is signed by you before the applicable other insurance under which an "bodily injury" or "property damage" occurs and additional insured person or organization is a that is in effect during the policy period, to name named insured when a written contract or as an additional insured for Covered Autos agreement with you, that is signed by you before Liability Coverage, but only for damages to which the "bodily injury" or "property damage" occurs this insurance applies and only to the extent of and that is in effect during the policy period, that person's or organization's liability for the requires this insurance to be primary and non- conduct of another"insured". contributory. CA T4 99 02 16 u 2016 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL GENERAL LIABILITY POLICY NUMBER: DT22-CO-aw 503A33TOT-26 ISSUE DATE:05/30/2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - DESIGNATED ADDITIONAL INSUREDS - PRIMARY WITH RESPECT TO CERTAIN OTHERINSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS "As required by written contract" PROVISIONS Designated Additional Insureds is primary to any of The following is added to Paragraph 4.a., Primary the other insurance, whether primary, excess, Insurance, of SECTION IV — COMMERCIAL contingent or on any other basis, that is available to GENERAL LIABILITY CONDITIONS: such additional insured which covers such additional The insurance afforded under this Coverage Part to insured as a named insured, and we will not share with that other insurance. any additional insured shown In the schedule Of CG D4 26 02 19 m 2017 The Travelers Indemnity company.All rights reserved. Page 1 of t Includes copyrighted material of Insurance Services Office,Inc.with its permission. Policy Number:DT22-CO-7W503833-TCT-26 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products-Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS (1) Any "bodily injury", "property damage" or The following is added to SECTION II —WHO IS AN "personal injury" arising out of the providing, INSURED: or failure to provide, any professional Any person or organization that you agree in a architectural, engineering or surveying written contract or agreement to include as an services, including: additional insured on this Coverage Part is an (a) The preparing, approving, or failing to insured, but only: prepare or approve, maps, shop a. With respect to liability for "bodily injury" or drawings, opinions, reports, surveys, "property damage" that occurs, or for "personal field orders or change orders, or the injury" caused by an offense that is committed, preparing, approving, or failing to subsequent to the signing of that contract or prepare or approve, drawings and agreement and while that part of the contract or specifications; and agreement is in effect; and (b) Supervisory, inspection, architectural or b. If, and only to the extent that, such injury or engineering activities. damage is caused by acts or omissions of you or your subcontractor in the performance of "your (2) Any "bodily injury" or "property damage" work" to which the written contract or agreement caused by "your work" and included in the applies. Such person or organization does not "products-completed operations hazard" qualify as an additional insured with respect to unless the written contract or agreement the independent acts or omissions of such specifically requires you to provide such person or organization. coverage for that additional insured during The insurance provided to such additional insured is the policy period. subject to the following provisions: c. The additional insured must comply with the a. If the Limits of Insurance of this Coverage Part following duties: shown in the Declarations exceed the minimum limits required by the written contract or (1) Give us written notice as soon as practicable agreement, the insurance provided to the of an "occurrence" or an offense which may additional insured will be limited to such result in a claim. To the extent possible, such minimum required limits. For the purposes of notice should include: determining whether this limitation applies, the (a) How, when and where the "occurrence" minimum limits required by the written contract or or offense took place; agreement will be considered to include the minimum limits of any Umbrella or Excess (b) The names and addresses of any injured liability coverage required for the additional persons and witnesses; and insured by that written contract or agreement. (c) The nature and location of any injury or This provision will not increase the limits of damage arising out of the "occurrence" insurance described in Section III — Limits Of or offense. Insurance. b. The insurance provided to such additional (2) If a claim is made or"suit" is brought against insured does not apply to: the additional insured: CG D2 46 04 19 ©2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the (4) Tender the defense and indemnity of any claim or"suit" and the date received; and claim or "suit" to any provider of other (b) Notify us as soon as practicable and see insurance which would cover such additional to it that we receive written notice of the insured for a loss we cover. However, this claim or"suit" as soon as practicable. condition does not affect whether the insurance provided to such additional (3) Immediately send us copies of all legal insured is primary to other insurance papers received in connection with the claim available to such additional insured which or "suit', cooperate with us in the covers that person or organization as a investigation or settlement of the claim or named insured as described in Paragraph 4., defense against the "suit', and otherwise Other Insurance, of Section IV—Commercial comply with all policy conditions. General Liability Conditions. Page 2 of 2 ©2018 The Travelers Indemnity Company.All rights reserved. CG D2 46 04 19 Policy Number:DT22-CO-7W503833-TCT-26 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 this 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 coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured —Unnamed Subsidiaries C. Incidental Medical Malpractice B. Blanket Additional Insured — Governmental D. Blanket Waiver Of Subrogation Entities — Permits Or Authorizations Relating To E. Contractual Liability—Railroads Operations F. Damage To Premises Rented To You PROVISIONS a. An organization other than a partnership, joint A. WHO IS AN INSURED — UNNAMED venture or limited liability company; or SUBSIDIARIES b. A trust; The following is added to SECTION II —WHO IS as indicated in its name or the documents that AN INSURED: govern its structure. Any of your subsidiaries, other than a partnership, B. BLANKET ADDITIONAL INSURED — joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR not shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONS Declarations is a Named Insured if: a. You are the sole owner of, or maintain an The following is added to SECTION 11 — WHO IS ownership interest of more than 50% in, such AN INSURED: subsidiary on the first day of the policy period; Any governmental entity that has issued a permit and or authorization with respect to operations b. Such subsidiary is not an insured under performed by you or on your behalf and that you similar other insurance. are required by any ordinance, law, building code or written contract or agreement to include as an No such subsidiary is an insured for"bodily injury' additional insured on this Coverage Part is an or "property damage" that occurred, or "personal insured, but only with respect to liability for"bodily and advertising injury" caused by an offense injury", "property damage" or "personal and committed: advertising injury" arising out of such operations. a. Before you maintained an ownership interest The insurance provided to such governmental of more than 50% in such subsidiary; or entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury", "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II—Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products-completed operations hazard". CG D3 16 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE pharmaceuticals committed by, or with the 1. The following replaces Paragraph b. of the knowledge or consent of,the insured. definition of "occurrence" in the 5. The following is added to the DEFINITIONS DEFINITIONS Section: Section: b. An act or omission committed in providing "Incidental medical services" means: or failing to provide "incidental medical services", first aid or "Good Samaritan a. Medical, surgical, dental, laboratory, x-ray services" to a person, unless you are in or nursing service or treatment, advice or the business or occupation of providing instruction, or the related furnishing of professional health care services. food or beverages; or 2. The following replaces the last paragraph of b. The furnishing or dispensing of drugs or Paragraph 2.a.(1) of SECTION II — WHO IS medical, dental, or surgical supplies or AN INSURED: appliances. Unless you are in the business or occupation 6. The following is added to Paragraph 4.b., of providing professional health care services, Excess Insurance, of SECTION IV — Paragraphs (1)(a), (b), (c) and (d) above do COMMERCIAL GENERAL LIABILITY not apply to "bodily injury" arising out of CONDITIONS: providing or failing to provide: This insurance is excess over any valid and (a) "Incidental medical services" by any of collectible other insurance, whether primary, your "employees" who is a nurse, nurse excess, contingent or on any other basis, that assistant, emergency medical technician is available to any of your "employees" for or paramedic; or "bodily injury" that arises out of providing or (b) First aid or "Good Samaritan services" by failing to provide "incidental medical services" any of your "employees" or "volunteer to any person to the extent not subject to workers", other than an employed or Paragraph 2.a.(1) of Section II — Who Is An volunteer doctor. Any such "employees" Insured. or "volunteer workers" providing or failing D. BLANKET WAIVER OF SUBROGATION to provide first aid or "Good Samaritan services" during their work hours for you The following is added to Paragraph 8., Transfer will be deemed to be acting within the Of Rights Of Recovery Against Others To Us, scope of their employment by you or of SECTION IV — COMMERCIAL GENERAL performing duties related to the conduct LIABILITY CONDITIONS: of your business. If the insured has agreed in a contract or 3. The following replaces the last sentence of agreement to waive that insured's right of Paragraph 5. of SECTION III — LIMITS OF recovery against any person or organization, we INSURANCE: waive our right of recovery against such person or For the purposes of determining the organization, but only for payments we make applicable Each Occurrence Limit, all related because of: acts or omissions committed in providing or a. "Bodily injury" or "property damage" that failing to provide "incidental medical occurs; or services", first aid or "Good Samaritan services"to any one person will be deemed to b. "Personal and advertising injury" caused by be one"occurrence". an offense that is committed; 4. The following exclusion is added to subsequent to the execution of the contract or Paragraph 2., Exclusions, of SECTION I — agreement. COVERAGES — COVERAGE A — BODILY E. CONTRACTUAL LIABILITY—RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY: 1. The following replaces Paragraph c. of the Sale Of Pharmaceuticals definition of "insured contract" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or c. Any easement or license agreement; ordinance relating to the sale of Page 2 of 3 ©2017 The Travelers Indemnity Company.All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured a. Any premises while rented to you or contract' in the DEFINITIONS Section is temporarily occupied by you with permission deleted. of the owner; or F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such The following replaces the definition of"premises premises is rented to you, if you rent such damage" in the DEFINITIONS Section: premises for a period of seven or fewer "P remises damage "property property damage"to: consecutive days. CG D3 16 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Policy Number: DT22-CO-7W503833-TCT-26 COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read (1) The "bodily injury" or "property damage" is the entire policy carefully to determine rights, duties and caused by an "occurrence" that takes place what is and is not covered. in the "coverage territory'; Throughout this policy the words "you" and "your" refer (2) The "bodily injury" or "property damage" to the Named Insured shown in the Declarations, and occurs during the policy period; and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and (3) Prior to the policy period, no insured listed "our" refer to the company providing this insurance. under Paragraph 1. of Section II — Who Is The word "insured" means any person or organization An Insured and no "employee" authorized qualifying as such under Section II — Who Is An by you to give or receive notice of an " Insured. occurrence" or claim knew that the "bodily injury" or "property damage" had occurred, Other words and phrases that appear in quotation in whole or in part. If such a listed insured marks have special meaning. Refer to Section V — or authorized "employee" knew, prior to the Definitions. policy period, that the "bodily injury" or "property damage" occurred, then any SECTION I—COVERAGES continuation, change or resumption of such COVERAGE A — BODILY INJURY AND PROPERTY "bodily injury" or "property damage" during DAMAGE LIABILITY or after the policy period will be deemed to have been known prior to the policy period. 1. Insuring Agreement c. "Bodily injury" or "property damage" which a. We will pay those sums that the insured occurs during the policy period and was not, becomes legally obligated to pay as damages prior to the policy period, known to have because of"bodily injury" or "property damage" occurred by any insured listed under Paragraph to which this insurance applies. We will have 1. of Section II — Who Is An Insured or any the right and duty to defend the insured against "employee" authorized by you to give or receive any "suit" seeking those damages. However, notice of an "occurrence" or claim, includes any we will have no duty to defend the insured continuation, change or resumption of that against any "suit" seeking damages for "bodily "bodily injury" or "property damage" after the injury" or "property damage" to which this end of the policy period. insurance does not apply. We may, at our discretion, investigate any "occurrence" and d. "Bodily injury" or "property damage" will be settle any claim or "suit"that may result. But: deemed to have been known to have occurred at the earliest time when any insured listed (1) The amount we will pay for damages is under Paragraph 1. of Section II — Who Is An limited as described in Section III — Limits Insured or any "employee" authorized by you to Of Insurance; and give or receive notice of an "occurrence" or (2) Our right and duty to defend end when we claim: have used up the applicable limit of (1) Reports all, or any part, of the "bodily insurance in the payment of judgments or injury" or "property damage" to us or any settlements under Coverages A or B or other insurer; medical expenses under Coverage C. No other obligation or liability to pay sums or (2) Receives a written or verbal demand or perform acts or services is covered unless claim for damages because of the "bodily explicitly provided for under Supplementary injury" or"property damage"; or Payments. (3) Becomes aware by any other means that b. This insurance applies to "bodily injury" and "bodily injury" or "property damage" has "property damage" only if: occurred or has begun to occur. CG T1 00 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 21 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY c. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares, we will follow this method also. b. Those statements are based upon Under this approach each insurer contributes representations you made to us; and equal amounts until it has paid its applicable c. We have issued this policy in reliance upon limit of insurance or none of the loss remains, your representations. whichever comes first. The unintentional omission of, or unintentional error If any of the other insurance does not permit in, any information provided by you which we relied contribution by equal shares, we will contribute upon in issuing this policy will not prejudice your by limits. Under this method, each insurer's rights under this insurance. However, this provision share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of premium or to exercise our rights of cancellation or insurance of all insurers. nonrenewal in accordance with applicable insurance d. Primary And Non-Contributory Insurance If laws or regulations. Required By Written Contract 7. Separation Of Insureds If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an any rights or duties specifically assigned in this insured under this Coverage Part must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies: contributory basis, this insurance is primary to a. As if each Named Insured were the only other insurance that is available to such insured Named Insured; and which covers such insured as a named insured, and we will not share with that other insurance, b. Separately to each insured against whom claim is made or"suit" is brought. provided that: (1) The "bodily injury" or "property damage" for 8• Transfer Of Rights Of Recovery Against Others which coverage is sought occurs; and To Us (2) The "personal and advertising injury" for If the insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Part, offense that is committed; those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, subsequent to the signing of that contract or the insured will bring "suit" or transfer those rights agreement by you. to us and help us enforce them. S. Premium Audit 9. When We Do Not Renew a. We will compute all premiums for this Coverage If we decide not to renew this Coverage Part, we will Part in accordance with our rules and rates. mail or deliver to the first Named Insured shown in b. Premium shown in this Coverage Part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only. At not less than 30 days before the expiration date. the close of each audit period we will compute If notice is mailed, proof of mailing will be sufficient the earned premium for that period and send proof of notice. notice to the first Named Insured. The due date SECTION V—DEFINITIONS for audit and retrospective premiums is the date 1 "Advertisement" means a notice that is broadcast or shown as the due date on the bill. If the sum of published to the general public or specific market the advance and audit premiums paid for the segments about your goods, products or services policy period is greater than the earned for the purpose of attracting customers or premium, we will return the excess to the first Named Insured. supporters. For the purposes of this definition: c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding websites, only that part of a website that is about your goods, products or services 6. Representations for the purposes of attracting customers or By accepting this policy, you agree: supporters is considered an advertisement. Page 16 of 21 ©2017 The Travelers Indemnity Company.All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office,Inc.with its permission. AVIl► WORKERS COMPENSATION TRAVELERS J AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76( A)— POLICY NUMBER: UB-7W504031-26-26-G 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 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 Policy No. UB-7VV504031-26-26-G Endorsement No. Insured 06/03/2026 Premium Insurance Company Countersigned by Trevelers Property Casualty Company DATE OF ISSUE: - - ST ASSIGN: Page 1 of 1