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HomeMy WebLinkAboutWILLDAN ENGINEERING (8)INSURANCE ON FILE WORK MAY PROCEED JNTIJNTI INSURANCE. EXPIRES I p�� `\)F� `RK rr""rr MAYOR Valens Amezwa MAYOR PRO TEM Jessie Lopez COUNCILMEMBERS Phil Became Johnathan Ryan Hernandez David Penaloza Thai Viet Phan Benjamin Vazquez MAY 2 2 2023 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 w seta-ana. pro April 10, 2023 Willdan Engineering 2401 East Katella Avenue, Suite 300 Anaheim, CA 92806 Attn: Chris Baca, RCI, CESSWI Director of Construction Management and Public Works Observation A-2020-076-02A Re: Extension of Agreement for On -Call Water Resources Construction Management and Inspection Services Agreement No. A-2020-076-02 CITY MANAGER Kristine Ridge CITY ATTORNEY Soma R. Carvalho CITY CLERK Jennifer L. Hell Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by Willdan Engineering, 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. Sincerely, `, a7:1 J�f y Nabil Saba, P.E. l�-/'� Executive Director, Public Works Agency CITY OF SANTA ANA Krist�Ridge City Manager APPROVED AS TO FORM on Salvatierra Deputy City Altomey ATTEST t f Jennifer L. Hall M City Clerk WILL AAj ENGINEERING I antes s u oz President SANTA ANA CITY COUNCIL vYwv Meim 1M it TNi 1. P. vu 11 weans 0.v P.. I.Y,OI fty PT TY,:, WY ] Wy r ,,.e muwMu+Yi949 "W&PPill 011✓MYn4xa Vr9 To: azamoraPwilldan.com; Fernandez, Armando <AFernandez(a)santa-ana"ore>; EchenPwilldan"com: nfo(@Iockton.com Gabriel, Jason <JGabriel(dsanta-ana.ore>; Burrola, Melissa <mburrola(@ Santa-ana.ore> Subject: Internal Notice of Compliance U NOTICE OF COMPLIANCE I1%11\1 I PRI\I InI. I-\(1I \DUI\(IkDE%%IIH AGREEMEN I TO THE CLERK OF HIE(OF NCIL Contractor Willdan Engineering Name: Project A-2020-076-02 Number: Project Agreement To Provide On -Call Water Resources Name: Construction 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 POLICY NUMBER EXPIRATION COI INSURANCE DATE DATE ARCH&ENG PROF 03135950 11/09/2023 10/27/2022 AUTOMOBILE LIABILITY GENERAL LIABILITY WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Thank you, 8107T01965A2243G 11/09/2023 10/27/2022 FILE NAME WILLD01 -City of Santa Ana - 18919988.pdf Willdan COI 1109 2023.pdf P6307TO16289TIL22 11/09/2023 10/27/2022 previewliabilityholdecpdf UB7T02108A2243G 11/09/2023 10/27/2022 previewliabilityholder.pdf City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 11/18/2022 7:12 PM ACC)RD0® CERTIFICATE OF LIABILITY INSURANCE DA7E(MM1D➢PMY) 11/9/2025 11/8/2024 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 pollcy(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 endorsoment(s). PRODUCER Lockton Insurance Brokers,LLC NAM ACT CA License#01399399 PHONE FAX AIC No): 777 S.Figueroa Street,52nd fl. E-MAIL Los Angeles CA 90017 ADDRESS: 213-689-0065 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Property Casualty Company of America 25674 INSURED Willdan Engineering INSURER B;Allied World Surplus Lines Insurance Company 24319 1508060 13191 Crossroads Parkway North, INSURER C Suite 405 INSURER D City of Industry,CA 91746 INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: 21138329 REVISION NUMBER: XXXXXXX 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 I ADDL SUER POLICY EFF POLICY EXP TYPE OF INSURANCE LTR D POLICY NUMBER (MMIDDIYYYYI IMMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY A � Y Y P-630-A1178471-TIL-24 11/9I2024 11/9/2025 EACH OCCURRENCE $ 1,()00000 CLAIMS-MADE F OCCUR DAMAGE TO RENTED $ 1000000 PREMISES Ea occurrenea X Emp.Benefits Liab. MED EXP(Any one person) $ 15,000 X Con(r.Liab.Incl. PERSONAL&AOV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY IK JEC FX]LOG PRODDOTS-COMPIOPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y 810-Al 161741-24-43-G 11/9/2024 11/9/2025 COMBINED SINGLE LIMIT Ea accldent 1 000 000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXX OWNED SCHEDULED BODILY INJURY Per accident $ XXXXXXX AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accldent $ XXXXXXX $ XXXXXXX UMBRELLA LIAR OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESSLIAB CLAIMS-MADE AGGREGATE $ XXXXXXX DED I I RETENTION$ $ XXXXXXX A AND EMP3COMPENSATIONYERS'LIILIT YIN Y UB-8Y032268-24-43-G 11/9/2024 11/9/2025 X STATUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOWPARTNEWFXECUTIVE E.L.EACH ACCIDENT -$ 1,000,000 OFFICER/MEMBER EXCLU➢ED7 ❑N N 1 A --- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000 B Arc1EDg.Prof, N Y 0313-5950 11/9/2024 11/9/2025 Per Claim:$2,000,000 Aggregate:$2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE;2025(CB)On-Call Water Resources Construction Management and Inspection Services Agreement No,A-2020-076-02.City of Santa Ana,its officers,officials,employees and volunteers arc included as Additional Insureds in accordance with the policy provisions of the General Liability,and Atdomobile Liability policies.A Waiver of Subrogation is granted in favor of City of Santa Ana, its offtccrs,officials,employees and volunteers in accordance with the policy provisions of the General,Auto and.Professional LinElity and Workers'Compensation policy. CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 21138329 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Narisa Casuga,Engineering Aide 215 S Center Street AUTHORIZED REPRESENTATIVE Santa Ana,CA 92703 ACORD 25(2016103) The ACORD name and logo are registered n APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 CONTINUATION DESCRIPTION or OPERATIONSILOCATIONSNEHICLESfEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS(Use only If more space Is required) General Liability,and Automobile Liability evidenced herein are Primary and Non-Contributory to other insurance available to an Additional Insured,but only in accordance with the policy's provisions. Should any of the above described policies be cancelled before the expiration date thereof,the policy provisions will govern how notice of cancellation may be delivered to certificate holders in accordance with the policy provisions of each policy. APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 -10 ACORD 25(2016103) Certificate Holder TD:21138329 Attachment Code:D604165 Master ID: 1508060,Certificate ID:21139329 Policy P-630-Al178471-TIL-24 COMMERCIAL GENERAL LIABILITY Effective11/9/2024 to 11/9/2025 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 LIABILITYCOVERAGE PART PROVISIONS (1)Any"bodily injury", "property damage" ?he 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 services, including contract or agreement to include as an additional (a)The preparing, approving, or failing to insured on this Coverage Part is an insured, but only prepare or approve, maps, shop a.With respect to liability for"bodily injury"or drawings, opinions, reports, surveys,field "property damage"that occurs, or for"persona orders or change orders, or the injury"caused by an offense that is committed, preparing, approving, or failing to prepare subsequent to the signing of that contract or or approve, drawings and specifications; agreement and while that part of the contract or 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 the unless the written contract or agreement independent acts or omissions of such person or specifically requires you to provide such organization coverage for that additional insured during the The insurance provided to such additional insured is 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 willbe limited to such minimum result in a claim. To the extent possible, such required limits. For the purposes of determining notice should include: whether this limitation applies, the minimum limits (a) How,when and where the "occurrence"or required by the written contract or agreement will offense took place; be considered to include the minimum limits of any Umbrella or Excess liability coverage (b)The names and addresses of any injured required for the additiona insured by that written persons and witnesses; and contract or agreement. This provision will not (c)The nature and location of any injury or increase the limits of insurance described in damage arising out of the"occurrence" Section III—Limits Of Insurance aroffense. b.The insurance provided to such additiona insured (2) If a claim is made or "suit"is brought against does not apply to the additionalinsured: APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 CG D2 46 04 19 6 2018 The Travelers Indemnity Compary.All rights reserved Page 1 of 2 Attachment Code:D604165 Master ID: 1508066,Certificate ID:21138329 Policy P-630-Al 178471-TIL-24 COMMERCIALGENERALLIABILITY Effective 111912024to 11/9/2025 (a) Immediately record the specifics of the (4)Tender the defy se and Ind��nnit o claim or°sulk"and the date received; and claimsourt' o any prove er o Other (b) Notify us as soon as practicable and see insurance which would coversuch additional to it that we receive written notice ofthe insured for a loss we cover. However, this claim or"suit" as soon as practicable condition does not affect whetherthe insurance provided to such additional insured (3) Immediately send us copies of all lea is primary to other insurance available to such pa als rgcpiged In connect) n with ie Maim suet , cooperate wi#�i us in a additionalinsured which covers that person or or organization as a named insured as described in Paragraph 4., Other Insurance, of Section investigation or settlement of the claim or IV--Commercial General Liability Conditions. defense against the"suit", and otherwise comply with all policy condition3 APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 CG D2 46 0419 Attachment Code:D604165 Master ID: 1508060,Certificate ID:21 I39329 Policy P-630-A1178471-TIL-24 COMMERCIAL GENERAL LIABILITY 1•f ective 11/9/2024 to 11/9/2025 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 fallow 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 limit c. We have issued this policy in reliance upon 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 rights by limits. Linder this method, each insurer's under this insurance. However,this provision does share is based on the ratio of its applicable limit not affect our right to collect additional premium or to of insurance to the total applicable limits of exercise our rights of cancellation or nonrenewal in insurance of all insurers. accordance with applicable insurance laws or d. Primary And Non-Contributory Insurance If 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 noncontributory basis,this insurance is primary to other insurance insurance applies: that is available to such insured which covers a. As if each Named Insured were the only such insured as a named insured, and we will not Named Insured; and share with that other insurance, provided that: b. Separately to each insured against whom (1)The "bodily injury"or"property damage" claim is made or"suit"is brought. for which coverage is sought occurs; and 8• Transfer Of Rights Of Recovery Against Others (2)The "personal and advertising injury"for To Us which coverage is sought is caused by an If the insured has rights to recover all or part of any offense that is committed; payment we have made under this Coverage Part, subsequent to the signing of that contract or those rights are transferred to us. The insured must do nothing after loss to impair them.At our request, agreement by you. the insured will bring "suit"or transfer those rights to 5. Premium Audit us and help us enforce them. a.We will compute all premiums for this Coverage 9.When We Do Not Renew Part in accordance with our rules and rates. If we decide not to renew this Coverage Part, we will b. Premium shown in this Coverage Part as mail or deliver to the first Named Insured shown in advance premium is a deposit premium only. At the Declarations written notice of the nonrenewal not the close of each audit period we will compute the earned premium for that period and send notice less than 30 days before the expiration date. to the first Named Insured. The due date for audit If notice is mailed, proof of mailing will be sufficient and retrospective premiums is the date shown as proof of notice. the due date on the bill. If the sum of the advance SECTION V—DEFINITIONS and audit premiums paid for the policy period is 1. "Advertisement" means a notice that is broadcast or greater than the earned premium, we will return published to the general public or specific market the excess to the first Named Insured. segments about your goods, products or services c. The first Named Insured must keep records of for the purpose of attracting customers or the information we need for premium supporters. For the purposes of this definition: computation, and send us copies at such times a. Notices that are published include material as we may request. placed on the Internet or on similar electronic R. Rnnrpcwnta4innc 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 Page 16 of 21 ©2017 The Travelers Indemnity Company.All rights reserved.CG APPROVED Inrhides rnnvrin m htPd afnrial of Insiiranrp Services OfF P By Cynthia Mora at 9:12 am, Nov 19, 2024 Attachment Code:D639778 Master ID: 1508060,Certificate ID:21138329 Policy P--630-AI_ 78471-TIT,-24 COMMERCIAL GENERAL LIABILITY Effective 11/9/2024 to 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 limit c We have issued this policy in reliance upon of insurance or none of the loss remains, your representations. whichever comes first. If any of the other insurance does not permit The unintentional omission of, or unintentional error contribution by equal shares, we will contribute in, any information provided by you which we relied by limits. Under this method, each insurer's upon in issuing this policy will not prejudice your rights share is based on the ratio of its applicable limit under this insurance. However,this provision does of insurance to the total applicable limits of not affect our right to collect additional premium or to insurance of all insurers. exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or d. Primary And Non-Contributory Insurance If 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 noncontributory basis, this insurance is primary to other insurance insurance applies: that is available to such insured which covers a. As if each Named Insured were the only such insured as a named insured, and we will not Named Insured; and share with that other Insurance, provided that: b. Separately to each insured against whom (1)The"bodily injury"or"property damage" claim is made or"suit"is brought. for which coverage is sought occurs; and 8.Transfer Of Rights Of Recovery Against Others (2)The"personal and advertising injury"for To Us which coverage is sought is caused by an If the insured has rights to recover all or part of any offense that is committed; payment we have made under this Coverage Part, subsequent to the signing of that contract or those rights are transferred to us. The insured must agreement by you. do nothing after loss to impair them.At our request, 5. Premium Audit the insured will bring"suit"or transfer those rights to us and help us enforce them. a. We will compute all premiums for this Coverage 9 When We Do Not Renew Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as If we decide not to renew this Coverage Part,we will advance premium is a deposit premium only. At mail or deliver to the first Named Insured shown in the close of each audit period we will compute the the Declarations written notice of the nonrenewal not earned premium for that period and send notice less than 30 days before the expiration date. to the first Named Insured.The due date for audit If notice is mailed, proof of mailing will be sufficient and retrospective premiums is the date shown as proof of notice. the due date on the bill. If the sum of the advance SECTION V—DEFINITIONS and audit premiums paid for the policy period is 1. "Advertisement" means a notice that is broadcast or greater than the earned premium, we will return published to the general public or specific market the excess to the first Named Insured. segments about your goods, products or services c. The first Named Insured must keep records of for the purpose of attracting customers or the information we need for premium supporters. For the purposes of this definition: computation, and send us copies at such times a. Notices that are published include material as we may request. placed on the Internet or on similar electronic 6. Representations means of communication; and By accepting this policy, you agree: 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 O 2017 The Travelers Indemnity Company.All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Cfe APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 AttacFm� �YocepD06 5�97A6I pte Ip: 1111Q60,Certificate ID:21139329 TIL- 4 Effective 11/9/2024 to 11/9/2025 COMMERCIAL GENERAL LIABILITY occupational therapist or occupational that is available to any of your"employees" therapy assistant, physical therapist or for"bodily injury"that arises out of providing speech-language pathologist; or or failing to provide "incidental medical (b) First aid or "Good Samaritan services" services" to any person to the extent not by any of your"employees"or"volunteer subject to Paragraph 2.a.(1) of Section II — workers", other than an employed or Who Is An Insured. volunteer doctor.Any such "employees" K. MEDICAL PAYMENTS—INCREASED LIMIT or"volunteer workers" providing or failing The following replaces Paragraph 7. of to provide first aid or "Good Samaritan SECTION III—LIMITS OF INSURANCE: services"during their work hours for you will be deemed to be acting within the 7. Subject to Paragraph 5.above, the Medical scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of"bodily injury"sustained by any 3. The following replaces the last sentence of one person, and will be the higher of: Paragraph 5. of SECTION III—LIMITS OF a. $10,000; or INSURANCE: For the purposes of determining the b. The amount shown in the Declarations of applicable Each Occurrence Limit, all related this Coverage Part for Medical Expense acts or omissions committed in providing or Limit, failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or "Good Samaritan CONDITION—PROFESSIONAL LIABILITY services"to any one person will be deemed The following is added to Paragraph 4.b., to be one"occurrence". g g p Excess Insurance, of SECTION IV — 4. The following exclusion is added to COMMERCIAL GENERAL LIABILITY Paragraph 2., Exclusions, of SECTION I — CONDITIONS: COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE This insurance is excess over any of the other LIABILITY: insurance, whether primary, excess, contingent Sale Of Pharmaceuticals or on any other basis, that is Professional Liability or similar coverage, to the extent the "Bodily injury" or"property damage"arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale ofpharm M. BLANKET WAIVER OF SUBROGATION — knowle knowledge or co committed by, e with the WHEN REQUIRED BY WRITTEN CONTRACT knowledge or consent of the insured. S. The following is added to the DEFINITIONS OR AGREEMENT Section: The following is added to Paragraph 8., Transfer "Incidental medical services"means: Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS: ray or nursing service or treatment, If the insured has agreed in a written contract or advice or instruction, or the related agreement to waive that insured's right of furnishing of food or beverages; or recovery against any person or organization,we b. The furnishing or dispensing of drugs or waive our right of recovery against such person medical, dental, or surgical supplies or or organization, but only for payments we make appliances. because of: 6. The following is added to Paragraph 4.b., a. "Bodily injury" or "property damage" that Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY occurs; or CONDITIONS: b. "Personal and advertising injury"caused by This insurance is excess over any valid and an offense that is committed; collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement. CG D3 79 02 19 ©2017 The Travelers IndomnityCorrpany.All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Offi APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 Attachment Code:D603994 Master ID: 1508060,Certificate ID:21138329 POLICYNUMBER: P-630-A1178471-TIL-24 ISSUE DATE: 10-21-24 EFFECTIVE: 11/9/2024 - 11/9/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY, AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above,we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 L T4 05 0519 02019 The Travelers Indemnity Company.All rights reserved. Page 'I of 1 Attachment Code:D603995 Master ID: 1508060,Certificate ID:21138329 POLICY NUMBER: 810--A1161741-24--43-G COMMERCIAL AUTO Effective 11/9/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2fo.IloTwhineg is added to Paragraph B.S.,Other 'I. The following is added to Paragraph A.t.c., Who Insurance of SECTION IV—BUSINESS AUTO 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 paragraph d. of this part 5.Other Insurance,this you insurance Is primary to and non-contributory with are required under a written contract or applicable other insurance under which an agreement between you and that person or additional insured person or organization is the organization,that is signed by you before the first named insured when the written contract or "bodily injury"or"property damage" occurs and agreement between you and that person or that is in effect during the policy period, to name organization,that is signed by you before the as an additional Insured for Covered Autos "bodily injury"or"property damage"occurs and Liability Coverage, but only for damages to which that is in effect during the policy period, requires this insurance applies and only to the extent of this insurance to be primary and non-contributory. that person's or organization's liability for the APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 CA T4 74 02 16 ©2016 The Travelers Indemnity Company.All rights reserved. Page 'I of 1 Includes copyrighted material or Insurance Services Office,Inc.with its permission. AttacBUSINENe AUTO EXTENSION ENDO&MENT ENODO&MEN�cale iA:21138329 POLICY NUMBER: 810-A1161741-24--43-G COMMERCIAL AUTO Effective 11/9/2024 You agree to maintain all required or (2) In or on your covered"auto". compulsory insurance in any such coup- 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 compulsory insurance requirements will No deductibles apply to this Personal Property 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 A.4.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 AA.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 : Transfer Of Rights Of Recovery Against The following is added to Paragraph AA., Cover- 5. Others To Us age Extensions, of SECTION III—PHYSICAL DAMAGE COVERAGE: We waive any right of recovery we may have against any person or organization to the ex- Personal Property 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 such contract. The waiver applies only to the person or organization designated in such contract. CA T3 53 02 15 DD 2015 The Travelers Indemnity Company.All rights APPROVED Includes copyrighted material of Insurance Services Office,Inc By Cynthia Mora at 9:12 am, Nov 19, 2024 Attachment Code:D603996 Master ID: 1508060,Certificate ID:21138329 POLTCY NUMBER: 810-A1161741-24-43-G Effective 11/9/2029 ISSUE DATE: 10/21/24 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 IL T4 05 0519 ©2019 The Travelers Indemnity Company.All rights reserved. Page 1 Of 1 Attachment Code:D616078 Master ID: 1508060,Certificate ID:21138329 TRAVELERS WORKERS COMPENSATION ONE TOWER SQUARE AND HARTFORb CT 06183 EMPLOYERS LIABILITY POLICY 18 ENDORSEMENT WC 00 03 13(00) - POLICY NUMBER: UB-8X032268-24-43--G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named In the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. INCLUDING: ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT, EXECUTED PRIOR TO TOSS TO FURNISH THIS WAIVER. APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. DATE OF ISSUE: 10-21-24 ST ASSIGN: PAGE 1 OF Attachment Code:D656443 Master ID: 1509060,Certificate ID:21138329 WORKERS COMPENSATION TRAVELERS AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTF'ORD CT 06183 ENDORSEMENT WC 99 06 R3 (00) - POLICY NUMBER: UB-8Yo32268-24-43-c NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX—CONDITIONS : Notice Of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you,we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organization before the cancellation is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete,we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation. SCHEDULE Name and Address of Designated Persons or Organizations: Number of Days Notice ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN 30 , BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDIN G THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED ZNSURRD RECEIVES NOTICE FROM US OF THE CANCELLATION 0 F THIS POLICY,AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEM ENT. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRIT TEN REQUEST FROM YOU TO US. All other terms and conditions of this policy remain unchanged. 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 11/9/2024 Policy No. UB-8Y03226B-24-43-G Endorsement No. Insurance Company Countersigned by Travelers Property Casualty Company of America Page 1 O DATE OF ISSUE: 10-21-24 ST ASSIGN: APPROVED p 2013 The Travelers Indemnity Company.All rights reserved. By Cynthia Mora at 9:12 am, Nov 19, 2024 Attachment Code:D604007 Master ID: 1508060,Certificate ID:21138329 ENDORSEMENT NO. AMEND SUBROGATION CLAUSE; WAIVER OF SUBROGATION FOR CLIENTS AND THIRD PARTIES This Endorsement, effective at 12:01 a.m. on November 9, 2024, forms part of Policy No. 0313-5950 Issued to Willdan Group, Inc. Issued by Allied World Surplus Lines Insurance Company In consideration of the premium charged, it is hereby agreed that Section Vill. CONDITIONS, Subsection N. is deleted in its entirety and replaced as follows: N. SUBROGATION In the event of any payment under this Policy, the Company shall be subrogatod to all the Insured's rights of recovery against any person or organization and the Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured shall do nothing to prejudice such rights. The Company agrees to waive its right of subrogation against any client of the Insured or any other person or entity for a Claim which is covered by this Policy where the Insured agreed to waive any such rights in writing prior to the date the Wrongful Act giving rise to such Claim first occurred. Any recoveries shall be applied first to subrogation expenses, second to Damages and Defense Expenses paid by the Company, and third in satisfaction of the Policy Deductible shown in Item 4. of the Declarations. Any additional amounts recovered shall be paid to the First Named Insured. All other terms, conditions and limitations of this Policy shall remain unchanged. ' t1 Authorized Representative AE 00062 (08/21) APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024 Attachment Code:D604005 Master ID: 1508060,Certificate ID;21138329 ENDORSEMENT NO. ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE NAMED INSURED LIMITED TO E-MAIL NOTIFICATION This Endorsement, effective at 12:01 a.m. on November 9, 2024, forms part of Policy No. 0313-5950 Issued to Willdan Engineering Issued by Allied World Surplus Lines Insurance Company In consideration of the premium charged, it is hereby agreed that: In the event that the Company cancels this Policy for any reason other than nonpayment of premium, and 1. the cancellation effective date is prior to this P oiic 's expiration date; 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this Policy is canceled (hereinafter, the "Certificate Holder(s)"); and has provided to the Company, either directly or through its broker of record,the email address of the contact at such entity; and 3. the Company receives this information after the First Named Insured receives notice of cancellation of this Policy and prior to this Policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Company; the Company will provide advice of cancellation (the "Advice")via e-mail to such Certificate Holders not later than thirty(30)days before the effective date of cancellation. Proof of the Company emailing the Advice, using the information provided by the First Named Insured, will serve as proof that the Company has fully satisfied its obligations under this Endorsement. This Endorsement does not affect, in any way, coverage provided under this Policy or the cancellation of this Policy or the effective date thereof, nor shall this Endorsement invest any rights in any entity not insured under this Policy. Any failure on the insurer's part to deliver the Advice will not impose liability of any kind upon the Insurer or invalidate the cancellation. Any Certificate Holder is not an Insured or a Loss Payee under this Policy. No coverage will be available under this Policy for any Claim brought by or against any Certificate Holder. All other terms,conditions and limitations of this Policy shall remain unchanged. Authorized Representative AE 00025 00 (03/21) APPROVED By Cynthia Mora at 9:12 am, Nov 19, 2024