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HomeMy WebLinkAboutAKM CONSULTING ENGINEERS (2)INSURANCE NOT REQUIRED A-2020-076-06A fl /1prldJx� WORK MAY PROCEED CITY CLERK DATE: MAYOR Valerie Amezcua q MAYOR PRO TEM /. Jessie LoMAY a 20LJqqqq pez COUNCILMEMBERS Phil Bacerra Johnathan Ryan Hernandez David Penaloza Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza . P.O. Box 1988 Santa Ana, California 92702 w .santa-ana.ora April 10, 2023 AKM Consulting Engineers 553 Wald Irvine, CA 92618 Attn: Emin Kayiran, CPII Director of Construction Management Re: Extension of Agreement for On -Call Water Resources Construction Management and Inspection Services Agreement No. A-2020-076-06 CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by AKM Consulting Engineers, and the City of Santa Ana, dated April 21, 2020, the time period of the Agreement is hereby extended for an additional two-year period, from April 21, 2023 through April 20,2025. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sin1ncerely, N�-/~ Nabil Saba, P.E. Executive Director, Public Works Agency CITY OF SANTA ANA 6 Ridge City Manager .I ATTEST Uell ,r/ Jennifer L. Hall City Clerk APPROVED AS TO FORM AKM CONSULTINP-E1 ZINEER; i don Salvatierra Emin Ka 1r II Deputy City Attorney Director of Construction Management SANTA ANA CITY COUNCIL Veene Amazya Jeaen 1u . TM, VW PMn 8.n V."p PM1A aacem JOM1naNan Ryln XOmaMaz D.M Penabza M,y Mayor Pm Tanz W.M D Wu I W.2 WaN4 W.M5 WaM6 vimeza,a(&san bsarolooazf@Hnbana om ¢M1an®aanbaren,o byezPWi,IDeaMa-aneam PMum®aanlaana am LndaMmaoaea®eanbina am 4PSnabu®sanW-ana 0m Mazariego, Diana From: CTrax < Certificate- request@ ctrax.jdidata.com> Sent: Tuesday, September 20, 2022 10:57 AM To: Polezhaev, Katerina Subject: Internal Notice of Compliance NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor AKM Consulting Engineers, Inc. Name: Project A-2020-076-06 Number: Project Agreement To Provide On -Call Water Resources Construction Name: Management And Inspection Services The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: TYPE OF INSURANCE AUTOMOBILE LIABILITY GENERAL LIABILITY PROFESSIONAL LIABILITY WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 9/20/2022 1:57 PM POLICY NUMBER EXPIRATION DATE COI DATE FILE NAME 57SBWLUS719 09/20/2023 09/06/2022 CERT- 1073296498.pdf 57SBWLUS719 09/20/2023 09/06/2022 CERT- 1073296498.pdf 105344511 09/20/2023 09/06/2022 CERT- 1073296498.pdf 57WEGZS0250 09/20/2023 09/06/2022 CERT- 1073296498.pdf 1 NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor AKM Consulting Engineers, Inc. Name: Project A-2020-076-06A Number: Project Extension of Agreement for On-Call Water Resources Construction Name: Management and Inspection Services Agreement No. A-2020-076-06 The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: POLICY EXPIRATION TYPE OF INSURANCE COI DATE FILE NAME NUMBER DATE AKM COI for City of Santa AUTOMOBILE LIABILITY 575BWLU8719 09/20/2024 10/10/2023 Ana for On-Call Construction Mgmt.pdf AKM COI for City of Santa GENERAL LIABILITY 575BWLU8719 09/20/2024 10/10/2023 Ana for On-Call Construction Mgmt.pdf AKM COI for City of Santa PROFESSIONAL LIABILITY INCLUDES 105344511 09/20/2024 10/10/2023 Ana for On-Call CYBER LIABILITY Construction Mgmt.pdf AKM COI for City of Santa WORKERS COMPENSATION AND 57WEGZS0250 09/20/2024 10/10/2023 Ana for On-Call EMPLOYERS' LIABILITY Construction Mgmt.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 1/10/2024 12:31 PM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 9/8/2024 AssuredPartners Design Professionals Insurance Services,LLC 3697 Mt.Diablo Blvd.,Suite 230 Lafayette CA 94549 Maurice Thornton 510-272-1476 DesignProCerts@AssuredPartners.com License#:6003745 Travelers Casualty and Surety Co of America 31194 AKMCONS-01 Hartford Casualty Insurance Company 29424AKMConsultingEngineers,Inc. 553 Wald Street Irvine CA 92618-4627 Hartford Underwriters Insurance Company 30104 457903049 C X 2,000,000 X 1,000,000 10,000 2,000,000 4,000,000 X Y Y 57SBWBE3FCJ 9/20/2024 9/20/2025 4,000,000 C 2,000,000 X X Y Y 57SBWBE3FCJ 9/20/2024 9/20/2025 C X X 3,000,000Y57SBWBE3FCJ9/20/2024Y 9/20/2025 3,000,000 X 10,000 B X N Y 57WEGZS0250 9/20/2024 9/20/2025 1,000,000 1,000,000 1,000,000 A Professional Liability 105344511 9/20/2024 9/20/2025 Per Claim Aggregate Limit $2,000,000 $4,000,000 Insured owns no company vehicles;therefore,hired/non-owned auto is the maximum coverage that applies. The Umbrella Policy is follow form to its underlying Policies:General Liability/Auto Liability/Employers Liability. RE:On-Call Construction Management Services.The City of Santa Ana,its officers,officials,employees,and volunteers are named as additional Insured for General Liability and Auto Liability as required per written contract.General and Auto Liability are Primary/Non-Contributory per policy form wording.A Severability of Interests Clause applies to General Liability per policy form.Insurance coverage includes waiver of subrogation per the attached endorsement(s).CANCELLATION:30 day notice will be sent to the certificate holder. 30 Day Notice of Cancellation City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana,CA 92702 Form SL 00 00 10 18 Page 17 of 22 © 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) (2) Premises Rented To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (3) Tenant Liability That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (4) Aircraft, Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g.of Section B. Exclusions. (5) Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion k.of Section B. Exclusions. (6) When You Are Added As An Additional Insured To Other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that insurance; or (7) When You Add Others As An Additional Insured To This Insurance That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (a)and (b)do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under this Coverage Part to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1)The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2)The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all 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. Policy # 57SBWBE3FCJ Form SL 00 00 10 18 Page 18 of 22 © 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) 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. 7. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, 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. This condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. F. LIABILITY AND MEDICAL EXPENSES 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 purpose of this definition: a.Notices that are published include material placed on the Internet or on similar electronic means of communication; and b.Regarding web sites, only that part of a web site that is about your goods, products or services for the purpose of attracting customers or supporters is considered an advertisement. 2."Advertising idea" means any idea for an "advertisement". 3."Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4."Auto" means: a.A land motor vehicle, trailer or semi-trailer designed for travel on public roads, including any attached machinery or equipment; or b.Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance or motor vehicle registration law where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 5."Bodily injury" means physical: a.Injury; b.Sickness; or c.Disease sustained by a person and, if arising out of the above, mental anguish or death at any time. 6."Coverage territory" means: a.The United States of America (including its territories and possessions), Puerto Rico and Canada; b.International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in a. above; c.All other parts of the world if the injury or damage arises out of: (1)Goods or products made or sold by you in the territory described in a. above; (2)The activities of a person whose home is in the territory described in a.above, but is away for a short time on your business; or THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SL 30 26 10 18 Page 1 of 3 © 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) HIRED AUTO AND NON-OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. A. Amended Coverage: The following is added to Section A. COVERAGES: Coverage is extended to "bodily injury" and "property damage" arising out of the use of a "hired auto" or "non-owned auto". B.The following changes are made to Section B. EXCLUSIONS: 1.Exclusion g. Aircraft, Auto Or Watercraft does not apply to a "hired auto" or a "non-owned auto". 2.Exclusion e. Employer’s Liability does not apply to "bodily injury" to domestic "employees" not entitled to workers’ compensation benefits or to liability assumed by the insured under an "insured contract". 3.Exclusion f. Pollution is deleted and replaced by the following: (1)"Bodily injury" or "property damage" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": (a)That are, or that are contained in any property that is: (i)Being transported or towed by, handled, or handled for movement into, onto or from, the covered "auto"; (ii)Otherwise in the course of transit by or on behalf of the "insured"; or (iii)Being stored, disposed of, treated or processed in or upon the covered "auto". (b)Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the insured for movement into or onto the covered "auto"; or (c)After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered, disposed of or abandoned by the insured. Paragraph (a)above does not apply to fuels, lubricants, fluids, exhaust gases or other similar "pollutants" that are needed for or result from the normal electrical, hydraulic or mechanical functioning of the covered "auto" or its parts, if: (i)The "pollutants" escape, seep, migrate, or are discharged or released directly from an "auto" part designed by its manufacturer to hold, store, receive, or dispose of such "pollutants"; and (ii)The "bodily injury" and "property damage" does not arise out of the operation of any equipment listed in Paragraphs 15.f.(2) and 15.f.(3) of the definition of "mobile equipment". Paragraphs (b)and (c)above do not apply to accidents that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (i)The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (ii)The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage as a result of the maintenance or use of a covered "auto". 4.The following exclusion is added: Fellow employee Coverage does not apply to "bodily injury" to any fellow "employee" of the insured arising out of the operation of an "auto" owned by the insured in the course of the fellow "employee’s" employment. Policy # 57SBWBE3FCJ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SL 30 26 10 18 Page 2 of 3 © 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) 5.The following exclusion is added: Care, Custody Or Control Coverage does not apply to "property damage" involving property owned or transported by the insured or in the insured’s care, custody or control. C.With respect to "hired auto" and "non-owned auto" coverage, Section C. WHO IS AN INSURED is deleted and replaced by the following: 1.The following are insureds: a.You. b.Your "employee" while using with your permission: (1)An "auto" you hire or borrow; or (2)An "auto" you don’t own, hire or borrow in your business or personal affairs; or (3)An "auto" hired or rented by your "employee" on your behalf and at your direction. c.Anyone else while using a "hired auto" or "non-owned auto" with your permission except: (1)The owner or anyone else from whom you hire or borrow an "auto". (2)Someone using an auto while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (3)Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from an "auto". (4)A partner (if you are a partnership), or a member (if you are a limited liability company) for an "auto" owned by him or her or a member of his or her household. d.Anyone liable for the conduct of an insured described above but only to the extent of that liability. D.With respect to the operation of a "hired auto" or "non-owned auto" covered by this endorsement, the following changes are made to Section E. LIABILITY AND MEDICAL EXPENSES CONDITIONS: 1.The following condition is added: Other Insurance a.Except for any liability assumed under an "insured contract" the insurance provided by this endorsement is excess over any other collectible insurance. However, if your business is the selling, servicing, repairing, parking or storage of "autos", the insurance provided by this endorsement is primary when covered "bodily injury" or "property damage" arises out of the operation of a customer’s "auto" by you or your "employee". b.When this endorsement and any other endorsement, coverage part, or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our endorsement bears to the total of the limits of all the endorsements, coverage parts, and policies covering on the same basis. 2.The following condition is added: Two Or More Coverage Parts, Endorsements, Or Policies Issued By Us If this endorsement and any other endorsement, coverage part or policy issued to you by us or any company affiliated with us apply to the same accident, the aggregate maximum Limit of Insurance under all the endorsements, coverage parts, or policies shall not exceed the highest applicable Limit of Insurance under any one endorsement, coverage part, or policy. This condition does not apply to any endorsement, coverage part, or policy issued by us or an affiliated company specifically to apply as excess insurance over this endorsement. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SL 30 26 10 18 Page 3 of 3 © 2018, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) 3.The following condition is added: Financial Responsibility Laws a.With respect to a “hired auto” or “non-owned auto” to which this insurance applies, when this endorsement is certified as proof of financial responsibility for the future under the provisions of any motor vehicle financial responsibility law, the insurance provided by this endorsement for "bodily injury" liability and "property damage" liability will comply with the provisions of the law to the extent of the coverage and limits of insurance required by that law. b.With respect to a “hired auto" or “non-owned auto” to which this insurance applies, we will provide any liability, uninsured motorists, underinsured motorists, no-fault or other coverage required by any motor vehicle law. We will provide the required limits for those coverages. E.The following changes are made to Section F. LIABILITY AND MEDICAL EXPENSES DEFINITIONS : 1.The following definition is added: "Hired auto" means any "auto" you lease, hire, rent or borrow. This does not include any auto you lease, hire, rent or borrow from any of your "employees", your partners (if you are a partnership), members (if you are a limited liability company),, or your "executive officers" or members of their households. This does not include a long-term leased "auto" that you insure as an owned "auto" under any other auto liability insurance policy or a temporary substitute for an "auto" you own that is out of service because of its breakdown, repair, servicing or destruction. 2.The following definition is added: "Non-owned auto" means any "auto" you do not own, lease, hire, rent or borrow which is used in connection with your business. This includes: a."Autos" owned by your "employees" your partners (if you are a partnership), members (if you are a limited liability company), or your "executive officers", or members of their households, but only while used in your business or your personal affairs. b.Customer’s "auto" that is in your care, custody or control for service. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SL 30 32 06 21 Page 1 of 3 © 2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) BLANKET ADDITIONAL INSURED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. A.The following is added to Section C.WHO IS AN INSURED: Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s)or organization(s)identified in Paragraphs a.through f.below are additional insureds when you have agreed,in a written contract or written agreement,or when required by a written permit issued by a state or governmental agency or subdivision or political subdivision that such person or organization be added as an additional insured on your Coverage Part,provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. However,no such person or organization is an additional insured under this provision if such person or organization is included as an additional insured by any other endorsement issued by us and made a part of this Coverage Part. The insurance afforded to such additional insured will not be broader than that which you are required by the contract, agreement, or permit to provide for such additional insured. The insurance afforded to such additional insured only applies to the extent permitted by law. The limits of insurance that apply to additional insureds are described in Section D.LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE.How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E.LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS. a.Vendors Any person(s)or organization(s)(referred to below as vendor),but only with respect to "bodily injury"or "property damage"arising out of "your products"which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury"or "property damage" included within the "products-completed operations hazard". (1)The insurance afforded to the vendor is subject to the following additional exclusions: This insurance does not apply to: (a)"Bodily injury"or "property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement.This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b)Any express warranty unauthorized by you; (c)Any physical or chemical change in the product made intentionally by the vendor; (d)Repackaging,except when unpacked solely for the purpose of inspection,demonstration,testing,or the substitution of parts under instructions from the manufacturer,and then repackaged in the original container; (e)Any failure to make such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products; (f)Demonstration,installation,servicing or repair operations,except such operations performed at the vendor's premises in connection with the sale of the product; 57SBWBE3FCJCityofSantaAna THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SL 30 32 06 21 Page 2 of 3 © 2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) (g)Products which,after distribution or sale by you,have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h)"Bodily injury"or "property damage"arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf.However,this exclusion does not apply to: (i)The exceptions contained in Paragraphs (d) or (f); or (ii)Such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products. (2)This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b.Lessors Of Equipment (1)Any person or organization from whom you lease equipment;but only with respect to their liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by your maintenance, operation or use of equipment leased to you by such person or organization. (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to any "occurrence" which takes place after you cease to lease that equipment. c.Lessors Of Land Or Premises (1)Any person or organization from whom you lease land or premises,but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. (2)With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a)Any "occurrence"which takes place after you cease to lease that land or be a tenant in that premises; or (b)Structural alterations,new construction or demolition operations performed by or on behalf of such person or organization. d.Architects, Engineers Or Surveyors (1)Any architect,engineer,or surveyor,but only with respect to liability for "bodily injury","property damage" or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (a)In connection with your premises; (b)In the performance of your ongoing operations performed by you or on your behalf; or (c)In connection with "your work"and included within the "products-completed operations hazard",but only if: (i)The written contract,written agreement or permit requires you to provide such coverage to such additional insured; and (ii)This Coverage Part provides coverage for "bodily injury"or "property damage"included within the "products-completed operations hazard". (2)With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: This insurance does not apply to "bodily injury","property damage"or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services, including: (i)The preparing,approving,or failure to prepare or approve,maps,shop drawings,opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (ii)Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring,employment,training or monitoring of others by an insured,if the “bodily injury”,“property THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form SL 30 32 06 21 Page 3 of 3 © 2021, The Hartford (May include copyrighted material of Insurance Services Office, Inc., with its permission) damage”,or “personal and advertising injury”arises out of the rendering of or the failure to render any professional service. e.State Or Governmental Agency Or Subdivision Or Political Subdivision Issuing Permit (1)Any state or governmental agency or subdivision or political subdivision,but only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit. (2)With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a)"Bodily injury","property damage"or "personal and advertising injury"arising out of operations performed for the federal government, state or municipality; or (b)"Bodily injury" or "property damage" included within the "products-completed operations hazard". f.Any Other Party (1)Any other person or organization who is not in one of the categories or classes listed above in Paragraphs a.through e.above,but only with respect to liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (a)In the performance of your ongoing operations performed by you or on your behalf; (b)In connection with your premises owned by or rented to you; or (c)In connection with "your work"and included within the "products-completed operations hazard",but only if: (i)The written contract,written agreement or permit requires you to provide such coverage to such additional insured; and (ii)This Coverage Part provides coverage for "bodily injury"or "property damage"included within the "products-completed operations hazard". (2)With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: This insurance does not apply to "bodily injury","property damage"or "personal and advertising injury" arising out of the rendering of,or the failure to render,any professional architectural,engineering or surveying services, including: (a)The preparing,approving,or failure to prepare or approve,maps,shop drawings,opinions,reports, surveys, field orders, change orders, designs or drawings and specifications; or (b)Supervisory, surveying, inspection, architectural or engineering activities. This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision,hiring, employment,training or monitoring of others by an insured,if the “bodily injury”,“property damage”,or “personal and advertising injury”arises out of the rendering of or the failure to render any professional service described in Paragraphs f.(2)(a) or f.(2)(b) above. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative (1) Printed in U.S.A.Form WC 04 03 06 Policy Expiration Date: WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Endorsement Number:Policy Number: Effective Date: Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights from us 57WEGZS0250 09/20/2024 AKM Consulting Engineers,Inc. 553 Wald Street Irvine,CA 92618-4627 09/20/2025 EXTENSION SCHEDULE OF UNDERLYING INSURANCE Form SU 00 03 10 18 Page 1 of 4 Process Date:06/29/2024 © 2018, The Hartford Policy Expiration Date:09/20/2025 (May include copyrighted material of Insurance Services Office, Inc., with its permission) This extension schedule forms a part of the Supplemental Policy. An "X" marked in a box indicates the corresponding coverage is provided in the “underlying insurance”. Please note the Maintenance Of Underlying Insurance condition in the Umbrella Liability Supplemental Policy. A.(X) Business Liability Carrier, Policy Number and Policy Period: Hartford Underwriters Insurance Company 57 SBW BE3FCJ 09/20/2024 To 09/20/2025 Type of Coverage Applicable Limits (X) Liability and Medical Expenses $2,000,000 Per Occurrence (X) Personal and Advertising Injury $2,000,000 Per Person/Organization (X) Products/Completed Operations Aggregate $4,000,000 Aggregate (X) General Aggregate $4,000,000 Aggregate (X) Damages To Premises Rented To You $1,000,000 Any One Premises (X) Hired Auto and Non-Owned Auto Liability B.( ) Liquor Liability Carrier, Policy Number and Policy Period: Type of Coverage Applicable Limits Liquor Liability EXTENSION SCHEDULE OF UNDERLYING INSURANCE (Continued) POLICY NUMBER: 57 SBW BE3FCJ Form SU 00 03 10 18 Page 2 of 4 Process Date:06/29/2024 © 2018, The Hartford Policy Expiration Date:09/20/2025 (May include copyrighted material of Insurance Services Office, Inc., with its permission) C.( ) Comprehensive Automobile Liability Carrier, Policy Number and Policy Period: Type of Coverage ( ) Owned Autos ( ) Non-Owned Autos ( ) Hired Autos Applicable Limits Bodily Injury Liability Each Person Each Accident Property Damage Liability Each Accident Bodily Injury and Property Damage Liability Combined Each Person Each Accident Type of Coverage ( ) Uninsured Motorist ( ) Underinsured Motorist Applicable Limits Each Accident Each Occurrence Each Person Each Accident EXTENSION SCHEDULE OF UNDERLYING INSURANCE (Continued) POLICY NUMBER: 57 SBW BE3FCJ *In any jurisdiction where the amount of Employers Liability Coverage afforded by the underlying insurer is by law unlimited, the limit stated does not apply and the policy of which this extension schedule forms a part shall afford no insurance with respect to Employers Liability in such jurisdiction. Form SU 00 03 10 18 Page 3 of 4 Process Date:06/29/2024 © 2018, The Hartford Policy Expiration Date:09/20/2025 (May include copyrighted material of Insurance Services Office, Inc., with its permission) D.(X) Employer’s Liability Carrier, Policy Number and Policy Period: HARTFORD CASUALTY INSURANCE COMPANY 57WEGZS0250 09/20/2024 To 09/20/2025 Type of Coverage Applicable Limits Employers Liability $1,000,000 Each Accident* $1,000,000 Each Employee by Disease* $1,000,000 Total Policy by Disease* EXTENSION SCHEDULE OF UNDERLYING INSURANCE (Continued) POLICY NUMBER: 57 SBW BE3FCJ *In any jurisdiction where the amount of Employers Liability Coverage afforded by the underlying insurer is by law unlimited, the limit stated does not apply and the policy of which this extension schedule forms a part shall afford no insurance with respect to Employers Liability in such jurisdiction. Form SU 00 03 10 18 Page 4 of 4 Process Date:06/29/2024 © 2018, The Hartford Policy Expiration Date:09/20/2025 (May include copyrighted material of Insurance Services Office, Inc., with its permission) E.( ) Foreign Liability Carrier, Policy Number and Policy Period: Type of Coverage Applicable Limits ( ) Foreign Commercial General Liability ( ) Liability and Medical Expenses Per Occurrence ( ) Personal And Advertising Injury Per Person/Organization ( ) Products/Completed Operations Aggregate Aggregate ( ) General Aggregate Aggregate ( ) Damages To Premises Rented To You Any One Premises ( ) Foreign Contingent Auto Liability Each Accident ( ) Foreign Employers Liability Each Accident* Each Employee by Disease* Total Policy by Disease*