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HomeMy WebLinkAboutTAIT ENVIRONMENTAL SERVICES (2) N-2025-252-01 0_`1A0i 2 b MAYOR ' H'r L`i' Lit r CITY MANAGER Valerie Amezcua G,t JUL 0 8 2026 ,V.4`e, f , Alvaro Nuliez MAYOR PRO TEM u -al i- ;;„','" CITY ATTORNEY David Penaloza .,: , Sonia R.Carvalho COUNCILMEMBERS * I'!IL� * CITY CLERK Phil Bacerra . o o Jennifer L.Hall Johnathan Ryan Hernandez c. Jessie Lopez '- r. 0v�, Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA 0: PWp-I CITY MANAGER'S OFFICE I'M•lol lv1Ol (bZ) 20 Civic Center Plaza.P.O.Box 1988 Santa Ana,California 92702 www.santa-ana.orq • June 23,2026 Tait Environmental Services, Inc 701 N.Parkcenter Dr. Santa Ana,CA 92705 Attn: Erin Langford,Vice President Re: Extension of Agreement No.N-2025-252 to Provide Under round Storage Tank Maintenance,Repair and Testing Pursuant to Section 3("Term")of the above-referenced Agreement,entered into by Tait Environmental Services,Inc., and the City of Santa Ana,which commenced on September 1,2025,the parties hereby exercise their option to extend the term of the Agreement for an additional one(1)year,through June 30,2027.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, odolfo Rosas, P.E. . Acting Executive Director, Public Works Agency ATTEST CITY OF SANT ANA /_ - nif-er t 9'.I K ° Alvaro Nunez City Cie i,'s City Manager APPROVED AS TO FORM TAIT ENVIRONMENTAL SERVICES L fe Nellesen By:Erin Langford Assistant City Attorney Title:Vice President,CA SANTA ANA CITY COUNCIL Valerie Amezcua David Penaloza Thai Viet Phan Benjamin Vazquez Jessie Lopez Phil Bacerra Johnalhan Ryan Hernandez Mayor Mayor Pro Tern•Ward 6 Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 vamezcua(o sente•ene.orq dnenalozaWaanla-ana.orq lohan(5sanla•ana.orq bvazquez(hsanla-ena,orq jessielooezc5lsanla-ana orq pbacerraesanla-ana orq jrva n hem ande z(Blsanla-ana.orq A`COBZO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDUYYY) 06128/2025 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(fes)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain polieles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LUNTAOT NAME. Accounts Team Scott&McCauley Insurance Agency 'HONE (949)503.1953 FAX 2 Ritz Carlton Drive Ai;,,No,ExN: (A/0,No): Suite 204 ADDRESS, COIQsminsuranueagency.00m — INSURER(S)AFFORDING COVERAGE _ NAIC N Dana Point CA 92629 INSURER A: AXIS Surplus Insurance Company 26620 INSURED INSURER B: The Continental Insurance Company 35289 Tait&Associates,Inc Valley -R 701 Parkcenter Dr INSURERC: Vll y Forge Insurance Company 20508 INSURER o; Colony Insurance Company 39093 INSURER E Santa CA 92705 INSURER F: — COVERAGES CERTIFICATE NUMBER: TAIT MSTER 25.2E REVISION NUMBER: THIS IS TO CERTIFYTHATTHE 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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE.POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, rev AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED ppB��Ypp PAID 7..CLAIMS. LTR TYPE OF INSURANCE ADM WhiR JN§p YYV0. POLICY NUMBER (MMIDDryYYY) IMMIDOnYYY} LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE § 2,000,000 CLAIMS-WOE. OCCUR DAMAGE t0 RENTED 25,000 /1i PREMISES lEa occurrence) s MED EXP(Anyone person) § 5,000 A Y Y SP002747-08-2025 09101/2026 09/01/2026 PERSONAL 8AOV INJURY $ 2,000,000 OEM.AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2,000,000 I POLICY I XI JERC E LOC PRODUCTS-COMPIOP AGO s 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANY AUTO (Ea stee ) $ 1,000,DOD _ BODILY INJURY(Per person} $ B — OWNED SCHEDULED Y Y 7034395486 -- - AUTOS ONLY AUTOS 09/(11/2025 D919v2Dz6 BODILY INJURY(Per accident) $ — HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY {par see/lane $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE § 5,000,000 A X EXCESS LIAR CLAIMS-MADE Y Y SX002746-08.2025 3901/2025 09/01/2026 AGGREGATE § 5,000,000 DED RETENTION S WORKERS COMPENSATION § AND EMPLOYERS LIABILITY YIN X:STATUTE EaFI- G OFFICER/MEMBER ANY EXCIUO �ECUTIVE N/A Y 7034395505 EL.EACIIACCIDENT 1,000,000 (Mandatory In NH) 09/01/2025 09/0112026 5 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,descabe under DESCRIPTION OF OPERATIONS Wow E.L.DISEASE-POLICY LIMIT $ 1,000,000 Professional LlabfConlractors Pollution Profess/Poll Ea Claim 2,000,000 AID Excess Liability SP002747-082025/EX04295007 09/01/2025 09/01/2026 Ea Claim/Aggregate 4,000,000 X 5M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACM 101,Addelanal Remarks Schedule,may be attached If more apace Is required) —'"- The City of Santa Ana,Its officers,employees,agents,volunteers,and representatives are Included as additional Insured on General Liability per the altaehed.Insurance Is Primary and Non-Contributory.Waiver of Subrogation applies on General Liability per the attached,30 days Notice of Cancellation for non-payment of premium. Tu Tra n ty,;;h I ed br Nguyen°r,fr3°o ' APPROVED CERTIFICATE HOLDER _ CANCELLATION By Tu Trott Nguyen at S:15 arn,Sep..02,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn Heidi Chou 215 S Center St M-85 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 �,L r y/ (r91988.2015 ACORD CORPORATION. All rights reserved, ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Endorsement No. Effective Date: 11 d$2-@12 01.a.m.Standard Time at the address of the Named Insured Policy Number 6 i insured Name:____________tf 1 Ws issuing Company:AXIS Surplus Insurance Company Additional(Return)Premium:}ao If the Endorsement Effective Date is Monk,then the effective data of this Endorsement Is the Inception Date of the Policy. ADDITIONAL INSURED/PRIMARY COVERAGE INCLUDING COMPLETED OPERATIONS (CGL&CONTRACTORS POLLUTION COVERAGE) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the Specialty Package Policy. In consideration of the premium charged,it Is agreed that: SECfION III--WHO 15 AN INSURED Is amended to include as an Additional Insured the person or organization shown in the schedule below as respects Coverages A,B and 0, but only for liability arising out of Your Work or Covered Operations performed by you or on your behalf for that Additional Insured and not due to any actual or alleged independent liability of said Additional Insured. This endorsement does not apply to Bodily Injury.Property Damage or Loss arising out of the sole negligence or willful conduct of,or for defects in design furnished by the Additional Insured. As respects the coverage afforded the Additional Insured,this Insurance is primary and non-contributory where a written contract or written agreement in effect prior to any related Claim requires you to provide such coverage. When this insurance is primary and non-contributory,our obligations are not affected by any other insurance carried directly by such additional insured whether it is primary or excess coverage. However,regardless of the provisions above: We will not extend any Insurance coverage to the additional Insured person or organization: (1) That is not provided to you in this Policy;or (2) That is broader coverage than you are required to provide to the additional Insured person or organization In the written contract or written agreement. This endorsement does not increase the Company's Limits of Insurance as specified in the Declarations of the Policy. SCHEDULE OF ADDITIONAL INSUREDS As required by written contract in effect prior to any related Claim SPP 0024(Ed.06 12) Page 1 of 1 Endorsement No. 7 Effective Date: 09/01/2025 @12:01 a.m.Standard Time at the address of the Named Insured Policy Number;SP002747-08-2025 Insured Name: Tait&Associates,Inc. Issuing Company:AXIS Surplus Insurance Company Additional(Return)Premium:Q lithe Endorsement Effective Date Is blank,then the effective date of this Endorsement Is the Inception Dote of the Policy. NAMED INSURED EXTENSION • THIS ENDORSEMENT MODIFIES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided by the Specialty Package Policy In consideration of the premium charged, It is agreed that the entitles in the following schedule are Included as Named Insureds in Item 1.of the Declarations.The First Named Insured designated In Item 1.of the Declarations shall remain unchanged, SCHEDULE Tait Environmental Services,Inc. DRA Tait Environmental Management DBA Tait Environmental Systems DBA Tait Electric DBA Tait Range Services Havill Engineering TAr'r Parkcenter Associates,LLC Environmental Services Properties,lie The Telt Family Trust The K.Richard Tait and Kathryn A.Tait Living Trust Thomas F.Tait Family Trust RC Trade Center Associates,LLC Yellow Roof Development,LLC 2130 Orangewood,LLC 20214th Street,LLC Willow Springs Investments,a California general partnership Whitewater Group LLC FIT Land Partners,LLC Holm Development,LLC Tait Land,Inc. Tait Development,LW Kenneth R.Tait,an Individual Thomas F.Telt,an Individual • Kenneth E.Tait,an Individual Trevor Tait,an Individual Victoria and Trevor Telt Family Trust Tait CP,LLC HT Land Partners 200,LLC • FIT Land Partners 300,LLC HT Mineral Partners,U.0 TRT Development 200,LLC The Daniel W Hinson Famlly Trust Tait Orcutt,LLC SPP 0054(Ed,1210) Page 1 of 2 Endorsement No. 8 Effective Date: 09/01/2028, @12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP002747-08.2025 Insured Name:Tait&Associates, Inc. Issuing Company:AXIS Surplus Insurance Company Additional(Return)Premium;$0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy. ENDORSEMENT-NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS THIS ENDORSEMENT MODIFIES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the SPECIALTY PACKAGE POLICY. In consideration of the premium charged,it is agreed that in the event you or we cancel this Policy prior to the expiration date,we will endeavor to provide a thirty (30)day notice of such cancellation to certificate holders,provided that: 1, you are under an existing contractual obligation to notify such certificate holders when this Policy Is cancelled;and 2. you have provided the following to us,either directly or indirectly,through your broker of record: a. The name of the entity shown on the certificate;and b. The address of such entity where notification may be mailed. We shall not provide a thirty (30)day notice if the cancellation is due to nonpayment of premium to us or to a finance company authorized to cancel the Policy. Such notice of cancellation will be provided via mall to the certificate holders. Proof that we have mailed the notice of cancellation, using the information provided by you, will serve as proof that we have fully satisfied our obligations under this endorsement, Such notice of cancellation is provided an an Informational basis and solely to assist you In meeting your contractual notice requirements to such parties. Our failure to provide such advance notice to the certificate holders)will not extend any Policy cancellation date, negate any cancellation of the Policy, or grant,alter, or extend any rights or obligations under this Policy and we shall have no liability for failure to provide the notice herein. All other terms and conditions of the Policy shall apply and remain unchanged. SPP 0063(Ed.0117) Page 1 of 1 Endorsement No. 11 Effective Date: 0Q/01/2025©12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP002747-08.2025 Insured Name: Tait&Associates, Inc. Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium:�0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT ENDORSEMENT (GENERAL LIABILITY COVERAGE) THIS ENDORSEMENT MODIFIES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies the Specialty Package Policy. Schedule of Designated Projects: As required by written contract In effect prior to any related Claim A. Subject to paragraph E. below, for all damages under Coverage A, except damages because of Bodily Injury or Property Damage included In the Products-Completed Operations Hazard, to which this Insurance applies and which can be attributed only to a single designated project shown In the Schedule above("Designated Project"): 1. A separate Designated Project General Aggregate Limit applies to each Designated Project, and that limit Is equal to the amount of the General Aggregate Limit shown In the Declarations, This Designated Project General Aggregate Limit applies on a primary non- contributory basis where required by written contract In effect prior to any associated claim, 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all such damages and Loss,regardless of the number of: a. Insureds; b. Claims made or Suits brought; or c. Persons or organizations making Claims or bringing Suits, 3. Any payments made for such damages shall reduce the Designated Project General Aggregate Limit for that designated project. Such payments shall not reduce the General Aggregate Limit shown In the Declarations nor shall they reduce any other Designated Project General Aggregate Limit for any other Designated Project shown in the Schedule above, 4, The limits shown In the Declarations for Each Occurrence and for Damage to Premises Rented to You continue to apply to a Designated Project. However, Instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Aggregate Limit. SPP 0107(Ed.05 16) Page 1 of 2 B. For all sums which the Insured becomes legally obligated to pay as damages under Coverage A to which this insurance applies and which cannot be attributed only to a single Designated Project shown In the Schedule above: 1. Any payments made for such damages 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 Designated Project General Aggregate Limit, C. When coverage for liability arising out of the Products-Completed Operations Hazard Is • provided, any payments for damages because of Bodily Injury or Property Damage Included In the Products-Completed Operations Hazard will reduce the Products-Completed Operations Aggregate Limit, and shall not reduce the General Aggregate Limit or the Designated Project General Aggregate Limit. D. The provisions of SECTION IV — LIMITS OF INSURANCE AND DEDUCTIBLE not otherwise modified by this endorsement shell continue to apply as stipulated. E. Regardless of the number of locations or projects and any other circumstance or payments made under this Policy, including payments made for Claims covered under the General Aggregate,the Products Completed Operations Aggregate or any Pollution Aggregate as applicable, the total amount we will pay under this Insurance policy for any and all project(s) designated within this endorsement shall be no more than the Designated Construction Project General Aggregate Limit shown below: Designated Construction Project General Aggregate Limit: $10,000.000 In the event that no dollar amount Is shown next to the Designated Construction Project General Aggregate Limit above, the Designated Construction Project General Aggregate Limit shall be $10,000,000. All other terms and conditions of this Policy remain unchanged. SPP 0107{Ed.OS 16) Page 2 of 2 Endorsement No. 12 Effective Date: 09/01/2025 @12:01 a.m.Standard Time at the address of the Named Insured Policy Number:SP002747.08.2025 Insured Name:Tait&Associates, Inc. Issuing Company:AXIS Surplus insurance Company Additional(Return)Premium:Q If the Endorsement Effective Date Is blank,then the effective date of this Endorsement Is the Inception Date of the Policy. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION This endorsement modifies Insurance provided under the following: SPECIALTY PACKAGE POLICY The following Is added to SECTION VI, COMMON CONDITIONS, Paragraph 9, Other Insurance, It supersedes any provision to the contrary: Primary and Noncontributory Insurance 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 (2) You have agreed In writing in a contractor agreement that this Insurance would be primary and would not seek contribution from any other Insurance available to the additional Insured. Includes copyrighted material of Insurance Services Office, Inc with its permission CG 20 01 04 13 SPP 200104(04 14) Page 1 of 1 Endorsement No, ra Effective Date: 0 .OTr tif:@12:D1 a,m.Standard Time at the address of the Named Insured Policy Number: irt`f'D 74. S 0?f Insured Name:,,ri'aif,&s sstje(dtes s__'c1 Issuing Company:AXIS Surplus Insurance Company Additional(Return) Premium:Pi if the Endorsement Effective Dote Is blank then the effective date of tills Endorsement Is the Inception pate of the Polley. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: SPECIALTY PACKAGE POLICY SCHEDULE Name Of Additional Insured Person(s) Or Organizationfs) Location(s)Of Covered Operations "r (S� SbJ% ID f lfit a S IJIx. � �o f5- k �1 S 1 Ida) u Information required to complete this Schedule, if not shown above,will be shown In the Declarations. A. Section III — Who Is An insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for Bodily injury, Property This insurance does not apply to Bodily injury or Damage or Personal And Advertising injury Property Damage occurring after: caused, in whole or in part,by: 1, All work, including materials, parts or 1. Your acts or omissions;or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs)to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the locatlon(s) location of the covered operations has been designated above. completed;or However: 2. That portion of Your Work out of which the Injury or damage arises has been put to its 1. The Insurance afforded to such additional intended use by any person or organization Insured only applies to the extent permitted by other than another contractor or subcontractor law;and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional Insured. Includes copyrighted material of insurance Services Office,Inc with Its permission CG 20 10 04 13 SPP 201013(0214) Page 1 of 2 C. With respect to the insurance afforded to these whichever is less. additional Insureds, the following Is added to This endorsement shall not increase the Section IV—Limits Of Insurance: applicable Limits of Insurance shown In the If coverage provided to the additional insured Is Declarations. 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; Includes copyrighted material of Insurance Services Office,Inc with Its permission CC20100413 SPP 201013(0214) Page 2 of 2 Endorsement No. gi Effective Date: 64 14 @12 01 a.m.Standard Time at the address of the Named Insured Policy Number: 2 7"$"' b__ Insured Name:jraite?Asso$I tes$ Issuing Company:AXIS Surplus Insurance Company Additional(Return) Premium:td rf the Endorsement Effective Date is Nook,then the effective dote of this Endorsement Is the Inception Date of the Poncy. ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT This endorsement modifies Insurance provided under the following: SPECIALTY PACKAGE POLICY SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): Information required to comdete this Schedule if not shown above, will be shown In the Declarations, A. Section ill — Who Is An Insured is amended to B. With respect to the Insurance afforded to these include as an additional insured the person(s) or additional insureds, this Insurance does not apply organization(s) shown in the Schedule, but only to any "occurrence" which takes place after the with respect to liability for Bodily injury or equipment lease expires. Property Damage or Personal And Advertising C. With respect to the insurance afforded to these Injury caused, in whole or in part, by your additional insureds, the following is added to maintenance, operation or use of equipment Section IV—Limits Of insurance: leased to you by such person(s) or If coverage provided to the additional insured is organization(s). required by a contract or agreement, the most we However: will pay on behalf of the additional insured Is the 1. The Insurance afforded to such additional amount of insurance: insured only applies to the extent permitted by 1. Required by the contract or agreement;or law;and 2. Available under the applicable Limits of 2. If coverage provided to the additional insured is Insurance shown in the Declarations; required by a contract or agreement, the whichever is less. insurance afforded to such additional insured will not be broader than that which you are This endorsement shall not increase the required by the contract or agreement to applicable Limits of Insurance shown in the provide for such additional Insured. Declarations. Includes copyrighted material of Insurance Services Office,Inc with Its permission CG20200413 SNP 202813(04 14) Page 1 of 1 Endorsement No. Effective Date: OS 0 @12:01 a.m.Standard Time at the address of the Named Insured Palley Number:e .., d2l47-ado Insured Name:]taj A �`Lia rdi Issuing Company:AXIS Sur lus Insurance Company Additional(Return) Premium: if the Endorsement Effective Date Is blank,then the effective dote of this rfndorsemeat is the inception Date of the Policy. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies Insurance provided under the following: SPECIALTY PACKAGE POLICY SCHEDULE Name Of Person Or Organization FactralrattlalOWIMMESTRAIA Information required to complete this Schedule,If not shown above,will be shown in the Declarations. The following Is added to Paragraph 12. Subrogation of Section VI—Common 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. Includes copyrighted material of Insurance Services Office,Inc with its permission CG 24 04 05 09 5PP 2404 09(04 14) Page 1 of 1 ',, Policy: 7034395486 CNA63359XX CNA (Ed. 04/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS EXTENDED COVERAGE ENDORSEMENT - BUSINESS AUTO PLUS - This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE 4. An "employee" of yours is an "insured" while operating an "auto" hired or rented A. Who Is An Insured under a contract or agreement in that The following is added to Section II, Paragraph "employee's" name, with your permission, A.1.,Who Is An Insured: while performing duties related to the conduct of your business. 1. a. Any incorporated entity of which the "Policy,"as used in this provision A. Who Is An Named stoInsck oned owns a majorityc ioof the Insured, includes those policies that were in voting stock on the date of inception of this Coverage Form; provided that, force on the inception date of this Coverage Form but: b. The insurance afforded by this provision A.1. does not apply to any 1. Which are no longer in force; or such entity that is an "insured" under 2. Whose limits have been exhausted, any other liability "policy" providing "auto"coverage. B. Bail Bonds and Loss of Earnings 2. Any organization you newly acquire or form, Section 11, Paragraphs A.2. (2) and A.2. (4) other than a limited liability company, are revised as follows: partnership or joint venture, and over which 1. In a.(2), the limit for the cost of bail bonds is you maintain majority ownership interest. changed from $2,000 to$5,000; and The insurance afforded by this provision 2. In a.(4), the limit for the loss of earnings is A.2.: changed from $250 to$500 a day. a. Is effective on the acquisition or C. Fellow Employee formation date, and is afforded only until the end of the policy period of this Section II, Paragraph B.5 does not apply. Coverage Form,or the next anniversary Such coverage as is afforded by this provision of its inception date, whichever is C. is excess over any other collectible earlier. insurance. b. Does not apply to: II. PHYSICAL DAMAGE COVERAGE (1) "Bodily injury" or"property damage" A. Glass Breakage— Hitting A Bird Or Animal — caused by an "accident" that Falling Objects Or Missiles occurred before you acquired or formed the organization; or The following is added to Section III, (2) Any such organization that is an Paragraph A.3.: "insured" under any other liability With respect to any covered "auto," any "policy"providing "auto" coverage. deductible shown in the Declarations will not 3. Any person or organization that you are apply to glass breakage if such glass is required by a written contract to name as repaired, in a manner acceptable to us, rather an additional insured is an "insured" but than replaced. only with respect to their legal liability for B. Transportation Expenses acts or omissions of a person,who qualifies Section III, Paragraph A.4.a. is revised, with Ans an "insured"edandunder whomS Liabilityn II —CoverageWh Is respect to transportation expense incurred by Insured and for you, to provide: is afforded under this policy. If required by written contract, this insurance will be a. $60 per day, in lieu of$20; subject to primary and non-contributory to insurance b. $1,800 maximum, in lieu of$600. on which the additional insured is a Named Insured. C. Loss of Use Expenses CNA63359XX Copyright,CNA Corporation,2000 Page 1 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission. Policy:7034395406 CNA CNA ) (Ed,d,04/1 04l12 Section IIi, Paragraph A.4.b. is revised, with c, Physical Damage Coverage on a covered respect to loss of use expenses incurred by "auto" also applies to "loss" to any you,to provide: permanently Installed electronic equipment a, $1,000 maximum, In lieu of$600. including Its antennas and other accessories, D. Hired "Autos" d, A $100 per occurrence deductible applies The following Is added to Section IiI. to the coverage provided by this provision. Paragraph A.: G. Diminution In Value 6. Hired"Autos" The following is added to Section III, If Physical Damage coverage is provided under Paragraph B.0.: this policy, and such coverage does not extend Subject to the following, the "diminution in to Hired Autos,then Physical Damage coverage value"exclusion does not apply to: is extended to: a. Any covered "auto"you lease,hire, rent a. Any covered "auto" of the private or borrow without a driver;and passenger type you lease, hire, rent or borrow, without a driver for a period of b. My covered "auto" hired or rented by 30 days or less,while performing duties your"employee"without a driver, under related to the conduct of your business; a contract in that Individual and "employee's" name, with your b. Any covered "auto" of the private permission, while performing duties passenger type hired or rented by your related to the conduct of your business. "employee"without a driver for a period c. The most we will pay for any one of 30 days or less, under a contract in "accident" or "loss" is the actual cash that individual "employee's" name, with value, cost of repair, cost of your permission, while performing replacement or $75,000, whichever is duties related to the conduct of your - less, minus a $500 deductible for each business. covered auto. No deductible applies to "loss"caused by fire or lightning. c. Such coverage as Is provided by this provision Is limited to a "diminution in d. The physical damage coverage as Is value" loss arising directly out of provided by this provision is equal to accidental damage and not as a result the physical damage coverage(s) of the failure to make repairs; faulty or provided on your owned "autos." incomplete maintenance or repairs; or the Installation of substandard parts. a. Such physical damage coverage for d. The most we will pay for "loss" to a hired"autos"will: covered "auto" in any one accident is (1) include loss of use, provided It is the lesser of: the consequence of an "accident" (1) $5,000; or for which the Named Insured is (2) 20% of the "auto's" actual cash legally liable, and as a result of value(ACV), which a monetary loss Is sustained by the leasing or rental concern. III. Drive Other Car Coverage Executive Officers (2) Such coverage as is provided by The following is added to Sections II and Ill: this provision will be subject to a 1. Any "auto" limit of$760 per"accident," you don't own, hire or borrow is a covered "auto" for Liability Coverage while • E. Airbag Coverage being used by, and for Physical Damage The following is added to Section III, Coverage while in the care, custody or control Paragraph B,3,; of,any of your"executive officers, except: The accidental discharge of an airbag shall not a. An "auto" owned by that "executive officer" be considered mechanical breakdown, or a member of that person's household; or F. Electronic Equipment b. An "auto" used by that "executive officer" while working in a business of selling, Section ill, Paragraphs B.4.c and B,4,d. are servicing,repairing or parking"autos." deleted and replaced by the following: CNA63359XX Copyright,CNA Corporation,MOO, Page 2 of 3 (Ed.04/12) Includes copyrighted material of the Insurance Services Office used with Its permission, Policy: 7034395486 CNA63359XX CNA (Ed. 04/12) Such Liability and/or Physical Damage We waive any right of recovery we may have, Coverage as is afforded by this provision. because of payments we make for injury or Equal to thegreatest of those damage, against any person or organization for (1) qwhom or which you are required by written coverages afforded any covered "auto" contract or agreement to obtain this waiver from and us. (2) Excess over any other collectible This injury or damage must arise out of your Insurance. activities under a contract with that person or 2. For purposes of this provision, "executive organization, officer" means a person holding any of the You must agree to that requirement prior to an officer positions created by your charter, "accident"or"loss," constitution, by-laws or any other similar governing document, and, while a resident of C. Concealment, Misrepresentation or Fraud the same household, includes that person's The following Is added to Section IV, spouse. Paragraph 8.2.: Such "executive officers" are "insureds" while Your failure to disclose all hazards existing on the using a covered "auto" described in this date of Inception of this Coverage Form shall not provision. prejudice you with respect to the coverage afforded IV. BUSINESS AUTO CONDITIONS provided such failure or omission is not intentional. A. Duties In The Event Of Accident, Claim, Suit D. Other Insurance Or Loss The following Is added to Section IV, The following is added to Section IV, Paragraph 8.5.: Paragraph A.2,a.: Regardless of the provisions of Paragraphs 5.a. (4) Your "employees" may know of an and 5.d. above, the coverage provided by this "accident" or "loss." This will not mean policy shall be on a primary non-contributory that you have such knowledge, unless basis. This provision Is applicable only when such "accident" or "loss" is known to required by a written contract. That written you or if you are not an individual, to contract must have been entered into prior to any of your executive officers or "Accident"or"Loss," partners or your Insurance manager. E. Policy Period, Coverage Territory The following is added to Section IV, Section IV, Paragraph B. 7.(5).(a). Is revised Paragraph A.2.b.: to provide: (6) Your "employees" may know of a. 45 days of coverage in lieu of 30 days, documents received concerning a claim or "suit." This will not mean that you V. DEFINITIONS have such knowledge, unless receipt of Section V. Paragraph C. is deleted and replaced such documents is known to you or If by the following: you are not an Individual, to any of your executive officers or partners or your "Bodily injury" means bodily Injury, sickness or insurance manager. disease sustained by a person, including mental anguish, mental injury or death resulting from any of B. Transfer Of Rights Of Recovery Against these. Others To Us The following is added to Section IV, Paragraph A.S. Transfer Of Rights Of Recovery Against Others To Us: CNA63359XX copyright,CNA Corporation,2000, Page 3 of 3 (Ed,04/12) Includes copyrighted material of the Insurance Services Office used with Its permission, CNA Waiver Of Subrogation (Workers Compensation Policy) 1.1 •.I," I '.','ir•lt i,;f31:ti111' ;IL' r' 1, :I I ;'t%1 II 1 1; 1 ;I I, I This endorsement changes the policy to which it is attached. It is agreed that Part One-Workers'Compensation Insurance G.Recovery From Others and Part Two-Employers'Liability Insurance H.Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations.(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE-Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure.The amount is Blanket Waiver of Subrogation Percentage Charge%. All other terms and conditions of the policy remain unchanged. This endorsement,which forms a part of and is for attachment to the policy issued by the designated Insurers,takes effect on the Policy Effective date of said policy at the hour stated in said policy,unless another effective date(the Endorsement Effective Date)is shown below,and expires concurrently with said policy unless another expiration date is shown below. Form No:G-19160-B(1 I-1997) Endorsement Effective Date:9/1/25 Endorsement Expiration Date:9/1/25 Policy Na:7034395505/7(134395522 Endorsement No: I Policy Effective Date:9l1l25 C)Copyright CNA All Rights Reserved. CNA ..„ 1 ,17-.7...s,,--t,:-.,,zv„57775TE.y t .- _, ifT �:1 , . A cr N ,T ,Y .§� �•3 i- O 4 il �?� a D J ��N t� , , s k',,,, 4: r 4 . ,.. `t" .,,,,,# : It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance,and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium,then notice of cancellation will be provided to such Certificate Holders at least 30 days in advance of the date cancellation is effective. If notice is mailed,then proof of mailing to the last known mailing address of the Certificate Holder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation,or impose any liability or obligation upon us or the Agent of Record. Fonn No:CC6802I A(02-2013) I Policy No:70343955051 7034395522 Policy Effective Date:9/1/25 Policy Page: 1 of 1 ©CNA All Rights Reserved.