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HomeMy WebLinkAboutBENDER ROSENTHAL, INC-2016City of Santa Ana ' <- t Clerk of the Council coTc office u:� Only 0 AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement an2ugl OEC 12 kti 9. 50 amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements C� r S A I have been satisfied prior to signing the termination form. E K Qi COUNCIL AN Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with No. �/ — d was completed on M 3 and final payment has been made. (List all amendments. Use space below it needed.) Department: Phone/Ext.:�� �3 Signature: Date: Rw,sed: 10-13-16 INSURANCE NOT ON FILE A-2016-286 WORK MAY PRAT PROCEED® CLERK OF COUNCILAGREEMENT TO PROVIDE RIGHT-OF-WAY PROPERTY DATE: ! I' i ~f APPRAISAL SERVICES ON AN ON -CALL BASIS THIS AGREEMENT is made and entered into this 4th day of October, 2016 by and between Bender Rosenthal, Inc. ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. On August 3, 2016, the City issued Request for Proposal No. 16-091, by which it sought consultants to furnish right-of-way property appraisal services on an on -call basis. B. Consultant submitted a responsive proposal that was among those selected by the City. Consultant represents that it is able and willing to provide the services described in the scope of work that was included in RFP No. 16-091 and attached herein as Exhibit A. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES On an as -needed basis, and at the sole discretion of City, Consultant shall furnish the services that are described in Exhibit A to this Agreement. Consultant's proposal is incorporated by reference as though fully set forth herein. 2. COMPENSATION a. City neither warrants nor guarantees any minimum or maximum compensation to Consultant under this Agreement. Consultant shall be paid only for actual services performed under this Agreement at the rates and charges identified in Exhibit B. The total sum to be expended under this Agreement, including any extension period, shall not exceed $200,000. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work that fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. TERM This Agreement shall commence on the date stated above and continue through October 3, 2019, unless terminated earlier in accordance with Section 16, below. The term of this Agreement may be extended for a single (2) two-year period upon a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. 2 C. Workers' Compensation Insurance. In accordance with the California Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for workers' compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. (iv) Consultant shall supply City with a fully executed additional insured endorsement. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. INDEMNIFICATION Consultant agrees to and shall indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligence or willful misconduct of the Consultant or its, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Consultant's indemnification obligations in this section shall survive expiration of this Agreement. Notwithstanding the foregoing, to the extent Consultant's Services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend, indemnify, and hold harmless City, its officers, agents, representatives, and employees against any and all liability or losses, including costs and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright, alleged or contained in the work product or documents provided or used by Consultant under this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. IL CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with the performance of services specified under this Agreement. M 12. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714-647-6956 With courtesy copies to: To Consultant: Executive Director Public Works Agency City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 Bender Rosenthal, Inc. 4400 Auburn Blvd., Suite 102 Sacramento, CA 95841 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant regarding the subject matter therein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 15. WAIVER No waiver of a breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right, or remedy. No waiver of any breach, failure, right, or remedy shall be deemed a waiver of any other breach, failure, right, or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 16. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, City may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 17. NONDISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or in connection with any activities under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 18. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of in connection with or by reason of this Agreement. 19. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement, 20, MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Marra D. Huizar Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALH0 City Attorney John V. Fink Assistant City Attorney AL: Fred Mou avipour, Execuiive Director Public W ks Agency CITY OF SANTA AN David Cavazos City Manager CONSULTANT: Name:( Title: fir` C� lwc-.ti'v�,1— EXHIBIT A CITY OF SANTA ANA RFP NO,: 16.091 ON -CALL RIGHT OF WAY PROPERTYAPPRAISAL SERVICES SCOPE OF WORT{ Yntrodiietlon and Background: The City of Santa Ana is issuing this Request for Proposals (RFP) to qualified Right of Way Property Appraisal firms to provide property appraisal services for the City of Santa Ana Public Works Agency on an as -needed basis, From the proposals received, it is the City's goal to select up to two firms, The City will enter into separate agreement with each firm for a not to exceed amount of $200,000, Work will be assigned by Contract Task Orders (CTO). As tasks are identified, they will be distributed among the firms based upon their ability to perform the required work within the project schedule and budget constraints. Minimum Qualifications: Consultant qualifications must demonstrate the minimum qualifications as established in the California Department of Transportation (Caltrans) Right of Way Manual which can be accessed at; http://www.dot.on.gov/hq/row/rowmardmanual/index.htii, Description of Work - Consultants under contract with the City of Santa Ana will provide support and services to City of Santa Ana staff or their designee on arr as -needed basis. The Consultants shall be thoroughly familiar with the Statement of Work prior to submitting a response to this Request for Proposal (RFP), • The Consultant shall perform work to produce a high quality, professional and complete work product. • Consultant must have experience with State and Federally funded projects, All work shall be performed in conformance with all applicable regulations, policies, procedures and standards. • "Work may include, but not be limited to, Etc following: onsiw review of the project area; review of existing records; conducting research and performing analysis; information gathering; negotiations; development of strategies. • The Consultant shall carry out the instructions received from the City and shall cooperate with the City and other agencies. + The Consultant has total responsibility for the accuracy and completeness of the work produced, The work will be reviewed by the City for conformity with the requirements of the Agreernent, Reviews by the City may NOT include a detailed review for the accuracy of items suhmitted. The responsibility for accuracy and completeness of such items remains solely that of the Consultant. • The Consultant shall be responsible for coordination and supervision of all work performed by its sub - consultants. The Consnhant shall review all work performed by its sub -consultants and the responsibility for accuracy and completeness of work performed remains solely that of Consultant. CITY OF SANTA ANA RFP NO.: 16-091 ON -CALL, RIGHT OF WAY PROPERTY APPRAISAL SERVICES The Consultant shall have a Quality Assurance/Quality Control (QA/QC) plan in effect during the entire time work is performed under the Agreement, The QA/QC plan is intended to ensure that the appraisals, reaps, reports, plans, studies, estimates, agreements and other documents submitted under assigned Scope of Work are complete, accurate, checked, and proofread to meet professional standard practice requirements, and to monitor work for conformance with the appropriate standards and policies, Additionally, all electronic files shall conform to the City's file naming system. • The Consultant shall diligently work on each assignment and complete each task in accordance with the schedule and accoimnodate the City's needs. • The Consultant's work will be subject to inspection and audit by City, County, State and Federal representatives. • Project files including copies of all correspondences, reports, documents, and electronic files shall be submitted to the City when requested and electronically updated monthly, The schedule and/or status report may require updating more frequently. • All work, including reports, analysis, data, and intellectual properties developed during the life of the Agreement shall become the properties of the City. • The Consultant will receive written notification of the award of the contract. Upon on such notification, the Consultant will proceed with the services required by the Agreement. Lem e of E.0rk: Consultant shall prepare appraisal services that include full and ,partial acquisition. for residential property; commercial property; industrial property; easements; special use or zoned property; and review appraisals. Appraisal Services shall be in accordance with federal, state, and local regulations, policies, procedures and standards. Consultant must make every effort to meet with the property owner prior to preparation of the report. Appraiser shall perform the following tasks: • Prepare appraisal report in accordance with the State of California Laws and the Uniform Standards of Professional Appraisal Practice (USPAP) • Research records, inspect the site and communicate with the property owner in preparation of the appraisal report. This might require multiple attempts for site visit and inspection • Prepare Real Estate Appraisal reports for full and partial acquisition • Prepare Appraisal Summary Statements to accompany City's Offer Package + Prepare Valuation of City's Landscape Setback Easement requirements • Prepare detailed appraisal report necessaiy for condemnation + Coordinate with Fixtures and Equipment Appraisers • Coordinate with Business Goodwill Appraisers • Communicate with property owners in writing and as required to obtain adequate information to prepare the report • Prepare all necessary correspondence, letters and reports • Provide effective communication with engineers, planners, attorneys, and City staff • Comply with federal, state and local regulations CITY OF SANTA ANA RFP NO,: 16.091 ON -CALL RIGHT OF WAY PROPERTY APPRAISAL SERVICES • Create files and maintain all records • Provide condemnation consultations as necessary • Attend meetings/public hearings and conduct presentations • Provide expert witness testimony as required for condemnation proceedings • Coordinate and review of Phase I and Phase II Environmental Studies • Review appraisal reports prepared by other consultants as required by the City and prepare review summary • Prepare Review Appraisal Reports (Required For Federally Funded Prcj eats) + Coordinate, direct and obtain Review Appraisals in accordance with the Uniform Relocation Assistance and Real Property Acquisition Policies Act (Uniform Act) and Caltrans guidelines Examine all appraisals and corresponding reports • Seek any corrections or revisions deemed appropriate • Prepare Dual Appraisal Report as required for federally funded projects under Caltrans Guidelines • Real estate appraisers must be certified and a Member of the Appraisal Institute, Consultant Responsibilities: Consultant Audit and Review Process: Prior to awarding the contract, the selected Consultant shall be subject to an audit or review by Caftans' Audits and Investigations (A&I), other state audit organizations, or the federal government. The selected Consultant shall complete Exhibit 10-K — Consultant Certification. Contract Costs and Financial, in the Appendix of this RFP as Attachment 4. City Responsibilities: The City will provide information in its possession relevant to preparation of required information in RFP, The City will provide only the staff assistance and docu mentatim specifically referred., to herein. Special Requirements (Attachment 4): Compliance with Requirements of Funding Agency: o Consultant Audit and Review Process (Caltrans funded contract) o This project is funded through, Federal and Measure M2 and shall comply with all requirements of Caltrans and OCTA The attached forms must be completed in their entirety and submitted with your proposal: • LAPM Exhibit I0-II ; Fee Proposal • LAPM Exhibit 10-1: Notice to Proposers, DBE Information • LAPM Fxhibit 10-K: Consultant Certification of Contact Costs and Financial management System • LAPM Exhibit 10-01: Consultant Proposal DBE Commitment o This project will be financed by federal finds. Consultant shall meet all required federal requirements included in this request for proposal. Consultants are advised that, as required by federal law, the City of Santa Ana is implementing the new Race Conscious Disadvantaged Business Enterprise (DBE) Program. The DBE goal for this contract is 4.0%. 7� 4400 Auburn Boulevard, Suite 102 EP] BENDSacramento, CA 95841 n ain: 916,978.4900 -fat: 916.978A904 ROSENTHAL, INC. www.benderrosenthal.com COMMERCIAL VALUATION AND RIGHT OF WAY SERVICES 2016 BILLING RATES Cydney Bender Reents, MAI David Wma, MAI, ARA Bob Morrison, PE, CA Real Estate Broker Designated Members of the Appraisal Institute (MAI/SRA) Senior Project Manager Quality Control Auditor Senior Appraiser Relocation Specialist Senior Acquisition Agent Acquisition Agent Appraiser Other Associated Professional Staff Researchers Administrative/Production $275/hr.* $275/hr.* $250/hr.* $250/hr.* $190/hr, $175/hr. $150/hr. $145/hr. $145nrr. $130/hr, $130/hr, $ 95/hr. $ 85/hr. $ 70/hr. *NOTE: For court or briefing preparation, depositions, any pre-trial conferences, court appearances, and related activities, the hourly rate is $450. A RV CERTIFICATE OF LIABILITY INSURANCE ATE(MMtD 7D"YY„' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements). PRODUCER Bill Douglas Kouris Insurance Agency,lnc NAME CT 10345 Danichris Way PHONE 916-236.5641 916-685.9571 ExtipL A/c N° Elk Grave CA 95757 EMAINo. ADDREss: bdkinsurance@gmall.com INSURERIS1AFF2RDIN000VERAGE NAiC#_- INSURER A:Houston Casualty Company ._ a237d INSURED BenderRosenthal, inc. INSURERB;Columbia Insurance Company 4400 Auburn Boulevard, Suite 102 1NSURER C.:Sentinel Insurance Company, Limited 111000 Sacramento CA 95841 INSURER 0, Granite State Insurance Company 13102_._..._........_. INSURER E : Mercer Insurance Company INSURER F GUVEKALahB GhK11HUAIE NUMBER' RFVIRIntd NIIMRFR- 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. KKK---._.__.__.___,..w....,_.• A47DL Sit 6R _.�.._ POLICY EFF ...._Pot-' IG'V EXP-.._.,_.____.._...__,,.,_.,...:......:.._.....,...................-..........._..... ............. ..... LTR TYPEOFINSURANCE POLICYNUMSER MMIDD M 1DD/YYYY LIMITS C ✓ COMMERCIAL GENERAL LIABILITY CLAIMS MADE �✓ occuR 57 SBA TX3133 07/21/2016 071211201E EACHOCCURRENCE ?..FiEti.�'1��.tE845�!!!LaRS�,_•.....5.... $2,000,000 _.:.:............:...... 300J 000 _ ..�._........_.__.._....._. ........................_..................._............ --- — MED EXP.SAr_kY on@.L h) .... $10,000 PERSONAL& ADV INJURY $2,000,000 _,_,•___.._............ ._...___.._._..__.._._._...,... GEN'L ✓ AGGREGATE LIMIT APPLIES PER: POLICY PRO- D JECT LOC GENERAL AGGREGATE _. _ .w ..._... PRODUCTS-COMPIOPAGG $4,000,000 __..____....,._... $4,000,000 $ OTHER AUTOMOBILE LIABILITY ANYAUTO ✓ t L/ �LT! I LE LIMIT —_ _J__._...... BODILYINJURY(Perperson) $1 000 000 $ B OWNED yr SCHEDULED AUTOSONLY AUTOS ✓ AiURTOSONLY ✓ ANON-OWNEDMOS ONLY 71APR351846 D611412017 0611412018 BODILY ) PROPERTY�TwiAGE """" ..1{P j cddent.._..._.....__.......... _ .5-_____._ _ $"""""' _._....... $ E UM13RELLALIAS ✓ OCCUR ✓ I ✓ 27305298 1212016 07/1212018 EACH OCCURRENCE $4r000,000 yI EXCESSLIAB CLAIMlyMADE GL, Auto and WC form r AGGREGATE $4,000,000 DED F_TiRETENTION $ $ D WORKERS COMPENSATION AND EMPLOY RS'LiABILIITY YiN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERWEMBEREXCLUOEb? [NJ (MandatoryinNN) NIA ✓ WC019397574 i06/0112017 0810112016 ✓ STA __ .FJ;.._,,,•.,,__, E.L.EACHACCIDENT E.DISEASE-EAEMPLOYEE A.L.---• ._„_•___ _ 1 O0O OOO $ ,_ i _ $1,000,000_................ If yyeess� describe under DESCRIPTIONOFOPERATIONStelow --- E.LDISEASE -POLICY LIMIT _ .....-._.:. $1,000,000 H716-108786 A Professional Liabili tY Q Q Deductible 15 000 , 113012016 11l3012017 $2,000,000 Per Occurrent: $2,000,000 Aggregate CLAIMS MADE ( Retro Date 11/30/99 DESCRIPTION OF OPERATIONS 1 LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schaduto, may be attached irmors apace to required) General Liability Policy excludes claims arising out of the performance of professional services. 30 Days Notice of Cancellation (10 Days for Non -Payment of Premium) Job: On -Call Right of Way Property Appraisal Services BUSINESS LIABILITY ADDITIONAL INSURED: City of Santa Ana, its officers, employees, agents, volunteers, and representatives and any other person named in the written contract between the Named Insured and the Certificate Holder. orkers' Compensation Additional Insured, 30 Day Cancellation WC990917, and Waiver of Subrogation WC04 361. REVIEWED BY: EUNICE HEREDIA, (PG OF of Santa Ana ivic Center Plaza (M-30) lox 1988 a Ana, CA 92702.1988 Ly, MLy@santa-ana.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CORPORATION, All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web Software. wvnv.FormsBoas:com (c) Impressive Publishing 800.208-1077 Insured: Bender Rosenthal, Inc. Insurer: The Hartford Sentinel Insurance Company, Limited Policy Number: 57SBATX3133 Policy Effective Date: 07/21/2017 Additional Insured: City of Santa Ana, its officers, employees, agents, volunteers, and representatives EXCERPTS FROM: Hartford Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through £ below are additional insureds when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract, or agreement or permit. A person or organization is an additional insured under this provision only for that period of tune required by the contract, agreement or permit. F. Any Other Party (1) Any other person or organization who is not an insured under 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; (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 or written agreement 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 operation hazard. (2) With respect to the insurance afforded to these additional insureds, 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; inspection, or engineering REVIEWED BY: EUNICE HEREDIA (PG), 0 ) E.5 Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" is brought E.7.b.(7). (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 seep contribution from the other insurance. E.S.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. REVIEWED BY: EUNICE HEREDIA (PGI OF EXCERPTS FROM CA 0001(0310) COLUMBIA AUTO COVERAGE Insured: Bender• Rosenthal, Inc. Policy Number: 71APR351846 Policy Effective Dates: 06/14/2017 Additional Insured: City of Santa Ana, its officers, employees, agents, volunteers, and representatives Additional Insured: SECTION 11 — LIABILITY COVERAGE 1. WHO IS AN INSURED: The following are "insureds" c. Anyone liable for the conduct of an "insured ... but only to the extent of that liability. Primary Insurance: SECTION IV — COMMERCIAL AUTO CONDITIONS B. General Conditions — 5. Other Insurance a. For any covered "auto" you own; this Coverage Form provides primary insurance. For any covered "auto" you don't own, the insurance provide by this Coverage Form is excess over any other collectible insurance. c. Regardless of the provisions of paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability assumed under an "insured contract". Cross Liability Clause: SECTION V — DEFINITIONS G. "Insured" means any person or organization qualifying as an insured in the Who is An Insured provision of the applicable coverage. Except with respect to the Limited of Insurance, the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or "suit" is brought. EXCERPTS FROM COLUMBIA COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT 15. WAIVER OF SUBROGATION — We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. ""'JA EUMCE HEREDIA (PG OF Insured: Bender Rosenthal, Inc. Insurer: Mercer Insurance Company Policy Number: 27305293 Policy Effective Date: 07/12/2017 Additional Insured: City of Santa Ana, its officers, employees, agents, volunteers, and representatives EXCERPTS FROM: Mercer Form CE70 07 0712 EXCESS LIABILITY COVERAGE FORM Section H. WHO IS AN INSURED Any person qualifying as such under "underlying General Liability, Commercial Auto, and Workers' Compensation insurance." REVIEWED BY: EUNICE HEREDIA (PG5'OF CALIFORNIA CANCELLATION ENDORSEMENT GRANITE STATE INSURANCE COMPANY Insured: Bender Rosenthal, Inc. Insurer: Granite State insurance Company, an AIG company Policy Number: WC 019-39-7574 Policy Effective Date: 06/01/2017 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. This endorsement, effective 12:01 AM 06/01/2017 forms a part of Policy No. WC 019-39-7574 Issued to BENDER ROSENTHAL, INC. By: GRANITE STATE INSURANCE COMPANY We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work, you perform for such person or organization. The additional premium for this endorsement shall be 2.00% of the total estimated workers' compensation premium for this policy. WC 04 03 61 Countersigned b (Ed. 11/90) Authorized Representative 1A REVIEWED BY: EUNICE FIEREDA (Po 6OF CALIFORNIA CANCELLATION ENDORSEMENT GRANITE STATE INSURANCE COMPANY Insured: Bender Rosenthal, Inc. Policy Number: WC 019-39-7574 Policy Effective Dates: 06/01/2017 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. This endorsement effective 12:01 AM 06/01/2017 forms a part of Policy No. WC 019-39-7574 Issued to BENDER ROSENTHAL, INC. By GRANITE STATE INSURANCE COMPANY This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the information Page. The cancellation condition in Part Six (Conditions)of the policy is replaced by these conditions: Cancellation 1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancellation is to take effect. 2. We may cancel this policy for one or more of the following reasons: a) Non-payment of premium; b) Failure to report payroll; c) Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued by us; d) Failure to pay any addition premium resulting from an audit of payroll required by the terms of this policy or any previous policy issued by us; e) Material misrepresentation made by you or your agent; 0 Failure to cooperated with us in the investigation of a claim; REVIEWED BY: EUNIGE tVEREDIR PG ` OF ) CALIFORNIA CANCELLATION ENDORSEMENT GRANITE STATE INSURANCE COMPANY Insured: Bender Rosenthal, Inc. Policy Number: WC019-39-7574 Policy Effective Dates: 06/01/2017 g) Failure to pay additional premium resulting from a retrospective adjustment of premium required by the terms of this policy or any previous policy issued by us; h) Failure to comply with Federal or State safety orders; i) Failure to comply with written recommendations of our designated loss control representatives; j) The occurrence of a material change in the ownership of your business; k) The occurrence of any change in your business or operations that materially increases the hazard for frequency or severity of loss; 1) The occurrence of any change in your business or operation that requires additional or different classification for premium calculation; in) The occurrence of any change in your business or operation which contemplates an activity excluded by our reinsurance treaties; 3. If we cancel your policy for any of the reasons listed in (a) through (g), we will give you 10 days advance written notice, stating when the cancellation is to take effect. Mailing that notice to you at your mailing address shown in Item I of the information page will be sufficient to prove notice. If we cancel your policy for any reasons listed in (h) through (in), we will give you 30 days advance written notice; however, we agree that in the event of cancellation and reissuance of a policy effective upon a material change in ownership or operations, notice will not be provided. 4. The policy period will end on the day and hour stated in the cancellation notice. WC 99 00 17 Countersigned by (Ed. 01/01) Authorized Representative REVIEWED BY: EUNICE HEREDIA (PG )F .AC D CERTIFICATE OF LIABILITY INSURANCE RATE(MM1out(YYY} li* . 1112912017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NA 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). [C. ACT PRODUCER B111 Douglas Kourls Insurance Agency,inc r_ gL_ 10345 Danichrls Way PH. 916.28f-564 F c Na,9I6-665.9577 Elk Grove CA 95767 INSURED Bender Rosenthal, Inc. INS R;aIolumia insurance company 21812 4400 Auburn Boulevard, Suite 102 Sacramento CA 95841 �entinel Insurance Company, Limited 11000 _ %8gRenait3ran to State Insurance Company{.... 23stiE1 .+ lasyg p c Mercer Insurance Company m.. 14470 w COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSION8 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. .. _ ... ,_..w.... -- IN$RT...•.,,.,.• ..__ _m.........., ....•..__. _..,..At1iiL11CNtt ,.._......... p ICYEFP..,..ISi.1�1-i'��(R.. LT 1 TYPEAPiNBURANCE .Oki YN MtrER.. _., _ ..,... _ .,..,. LIMITS C ✓ COMMERCIAL eEN9RALLIABILITY � OCCUR 57 SBA TX3133 0712112017 07/21/201a n�>s2,000,000 �ERACH IOCCURRENCE 0,00 0aCLAIMS•MADE tr .. ..� ...... ., _ MEDEXPiAnyonepsnwn� ......:0,000,,...._ _._........_._ ._ PERSONALRAgV!NAJ 2,000,000 -» GCNLAGGR GATELgIMITAPPLIESPErZ 0 q#NRRALAGGREOATE $4,000,000 ✓ POLICYU JgC'T too PRgDt CTS CAMPlQPAGO $4,000,OOa . AUTOMOBILE LIABILITY .. ✓ ✓ - _ _.1204 I 9 $1,aoa,aoa ANYAUTO BODILY INJURY(Porporsnn) $ B OWNED CHEDULED AUTOS ONLY C�O•S D ✓ AUT0090MY N 71APR36184B 8t14/20i7 08/1412p18 BODILY INJURY (Par ncddent) �'�a��d ��AIrfA60 - ....... .............. 5 $ AUTOSO t�Y _ ... ... .... ..,_. S E UMBROLLAI.IAB ✓ OCCUR ✓ . ✓ 73R2 7/1212017 07/12/2018 EACHbOcul}RENCE $3,000,000 ✓ EXCESSLU1a CLAIMS MADE M. GL, AlltO and WC form AGeREOATE •., ... 5,000r000 DED R TENTIONS $- D WORKERS COMPENSATION C 9397974 0610112017 06/0112010 ✓ 8 PTLJ[E R AND EMPLQYERW UABILnY ANYPROPRIETOy PpARTNERIOXECUTIVE YIN OFPICERIMEM0gEREXCLU0E0? N NIA EL EACH ACCIDENT $1,aba,�00 • • {MandatarylnNN) EL DISEASE• EA;EMPLOYEP $110Otl,00D if yes, desaibo unstol000,000 DESCRIPTION OF ERAT ON 0,L, Dl$U ASE. POLI LIMIT .. '•"' µ ' ,.•., $ 000,000 A Professional LlabEliry ®t r 71 • 10662 Deductible 15,000 1/3012017 11/3012018 2,000,000 Per Occurrenc 2,000,000Aggregate CLAIMS MADE Retro pate 11/30199 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHIOLEBACORD 101, Additional Romarlis Schedule, maybe attachad if more space Is required) 30 Days Notice of Cancellation (10 Days for don•Payment of Premium) Jab: On -Call Right of Way property Appraisal Services BUSINESS LIABILITY AD ITIONAt, INSURED: City of Santa Ana, Its officers employees, agents, volunteers, and representatives and any other, person named In the written contract between the Named insured ana the Certificate Holder. Workers' Compensation Additional Insured, 30 Day Cancellation WC990017, and Waiver of Subrogation W 40361. REVIEWED BY, EUNICE HEREDiA (PG • OF_ City of Santa Ana 20 Civic Center Plaza (M-30) PO Box 1988 Santa Ana, CA 92702.1088 Letica Lopez, 1Llopez5 oQsanta-ana.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHH�ORRIIZZEEDREPRESENTATI�VVE 211 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Produced using Forma Ross Wob Software. wwwYormsaoss,00m (0) Improsshro Publishing 000.200.1977 Insured: Bender Rosenthal, Inc, Insurer: The Hartford Sentinel Insurance Company, Limited Policy Number: 57SBATX3133 Policy 'Effective Date: 07/21/2017 Additional Insured: City of Santa Ana, its officers, employees, agents, volunteers, and representatives EXCERPTS FROM: Hartford Forni SS 00 08 04 OS BUSINESS LIABILITY COVERAGE FORM C. WHO IS AN INSURED G. 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, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract, or agreement or 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. F. Any Other Party (1) Any other person or organization who is not an insured under 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; (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 or written agreement 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 operation hazard. (2) With respect to the insurance afforded to these additional insureds, 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; inspection, or engineering REVIEWED BY: EUNICE NEREDIA (PG F ) E.5 Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" is brought E.7.b.(7). (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 fiom the other insurance. E.8.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. REVIEWED BY: EUNICE HEREDIA (PG 3OF ) EXCERPTS FROM CA 0001(0310) COLUMBIA AUTO COVERAGE Insured: Bender Rosenthal, Inc. Policy Number: 71APR351846 Policy Effective Dates: 06/14/2017 Additional Insured: City of Santa Ana, its officers, employees, agents, volunteers, and representatives Additional Insured: SECTION II — LIABILITY COVERAGE 1. WHO IS AN INSURED: The following are "insureds" c. Anyone liable for the conduct of an "insured ... but only to the extent of that liability. Primary Insurance: SECTION IV — COMMERCIAL AUTO CONDITIONS B. General Conditions — 5. Other Insurance a. For any covered "auto" you own; this Coverage Form provides primary insurance. For any covered "auto" you don't own, the insurance provide by this Coverage Form is excess over any other collectible insurance. c. Regardless of the provisions of paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability assumed under an "insured contract". Cross Liability Clause: SECTION V — DEFINITIONS G. "Insured" means any person or organization qualifying as an insured in the Who is An Insured provision of the applicable coverage. Except with respect to the Limited of Insurance, the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or "suit" is brought. EXCERPTS FROM COLUMBIA COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT 15. WAIVER OF SUBROGATION — We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. REVIEWED BY: EUNICE HEREDIA (PG q0F ) Insured: Bender Rosenthal, Inc, Insurer: Mercer Insurance Company Policy Number: 27305298 Policy Effective Date: 07/12/2017 Additional Insured: City of Santa Ana, its officers, employees, agents, volunteers, and representatives EXCERPTS FROM: Mercer Form CE70 07 0712 EXCESS LIABILITY COVERAGE FORM Section II. WHO IS AN INSURED Any person qualifying as such under "underlying General Liability, Commercial Auto, and Workers' Compensation insurance." REVIEWED BY: EUNICE HEREDIA (PG'SoF ) BLANIaET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT GRANITE STATE INSURANCE COMPANY Insured: Bender Rosenthal, Inc. Insurer: Granite State Insurance Company, an A.IG company Policy Number: WC 019-39-7574 Policy Effective Date: 06/01/2,017 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. This endorsement, effective 12:01 AIVI 06/01/2017 forms a part of Policy No. WC 019-39-7574 Issued to BENDER R.OSENTHAL, INC. By; GRANITE STATE INSURANCE COMPANY We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00% o of the total estimated workers$ compensation premium for this policy. WC 04 03 61 Countersigned by (Ed.11/90) Authorized Representative REViEWEQ BY: EUNtCE NEREDIA (PG � 4P �) CALIFORNIA CANCELLATION ENDORSEMENT GRANITE STATE INSURANCE COMPANY Insured: Bender Rosenthal, Inc. Policy Number: WC 019-39-7574 Policy Effective Dates: 06/01/2017 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. This endorsement effective 12:01 AM 06/01/2017 forms a. part of Policy No. WC 019-39-7574 Issued to BENDER ROSENTHAL, INC. By GRANITE STATE INSURANCE COMPANY This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the information Page. The cancellation condition in Part Six (Conditions)of the policy is replaced by these conditions: Cancellation 1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancellation is to take effect. 2. We may cancel this policy for one or more of the following reasons: a) Non-payment of premium; b) Failure to report payroll; c) Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued by us; d) Failure to pay any addition premium resulting from an audit of payroll required by the terms of this policy or any previous policy issued by us; e) Material misrepresentation made by you or your agent; f) Failure to cooperated with us in the investigation of a claim; REVIEWED BY:VA EUNICE HEREDIA (PG70F D j CALIFORNIA CANCELLATION ENDORSEMENT GRANITE STATE INSURANCE COMPANY Insured: Bender Rosenthal, Inc, Policy Number: WC 019-39-7574 Policy Effective Dates; 06/01/2017 g) Failure to pay additional premium resulting from a retrospective adjustment of premium required by the terms of this policy or any previous policy issued by us; h) Failure to comply with Federal or State safety orders; i) Failure to comply with written recommendations of our designated loss control representatives; j) The occurrence of a material change in the ownership of your business; k) The occurrence of any change in your business or operations that materially increases the hazard for fi•equency or severity of loss; 1) The occurrence of any change in your business or operation that requires additional or different classification for premium calculation; m) The occurrence of any change in your business or operation which contemplates an activity excluded by our reinsurance treaties; 3. If we cancel your policy for any of the reasons listed in (a) through (g), we will give you 10 days advance written notice, stating when the cancellation is to take effect. Mailing that notice to you at your mailing address shown in Item l of the information page will be sufficient to prove notice, If we cancel your policy for any reasons listed in (h) through (m), we will give you 30 days advance written notice; however, we agree that in the event of cancellation and reinsuance of a policy effective upon a material change in ownership or operations, notice will not be provided. 4. The policy period will end on the day and hour stated in the cancellation notice, r0, WC 99 0017 Countersigned b / (Ed. 01/01) Authorized Representative REVIEWED BY: EUNICE HEREDIA (PG OF AC R" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDlYYYY) 1 0812212018 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Bill Douglas Kourls Insurance Agency,inc NAME: CONTACT _ 10345 Danichr)s Way PHONE 916-236-5641 lac Nor916.685-9571 Elk Grove CA 95757 FA n'L.ea. bdkinsurance0amail.com INSURED Bender Rosenthal, Inc, 2825 Watt Avenue, Suite 200 Sacramento CA 95821 INSURER A,Houston Casualty Company I42374 „,grr.F...Travelers Property Casualty Co of America 125B74 COVERAGES CERTIFICATE NUMBER: RFVIRIAN NIIMRPR, 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. INBR ----_.. -- __-._--- AObt 9U8R _.._-.._......._ _..__..... _ _ —POLICY EfFPOLICY EXP---"'---"_. .._.._ ............. .. LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDfyyyyl LIMITS B I/ COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE S1,000,000 ✓ 630-9K104459-TIL-18 6/0112018 OW0112019 CLAIMSWADE OCCUR .pAM'1OES.(Eoocc_DIfpR4o)..__ $100,000 A1ED C-XP (Any ona parson) $ 5,000 J PERSONAL 6 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE s2,000,000 PRO- POLICY a JECT LOC ..-..._.. .. PRODUCTS-COMPIOP AGG s2,000,000 $ OTHER: AUTOMOBILE LIABILITY ✓ t/ COMBINED SINGLE LIMIT S 1 000 000 ANY AUTO BODILY INJURY (Per person) S OWNED ✓ SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par accident) S B HIRED NO N-0WNED ✓ ✓ BA-9K106686-18-14 6/0112018 06/01/2019 PROPERTY DAMAGE-� ERTYE S AUTOS ONLY AUTOS ONLY (per B UMBRELLA LIAR ✓ OCCUR ✓ ✓ EX-9K117560-18-14 6/0112018 06/01/2019 EACH OCCURRENCE $ 5,000,000 AG_G_REGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE GL, Auto and WC form T ' DED RETENTIONS I$ B WORKERS COMPENSATION $/ UB-9K107321-18-14 610112018 06/01/2019 ✓ PEREOT RH- AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,000 DFC ERPRIETOREXRTNCLUED9ECUTIVE a NIA E.L. DISEASE - EA EMPLOYEE S1,000,000 (Mandatory In NH) If es, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT S 1,000,000 H717-110662 A�Pcfim-SMADE slonal Liabilit Y Q O Deductible 15,000 113012017 11/30/2018 $2,000,000 Per regateOccurrenc 52,000,000 Aggregale Retro Date 11130/99 DESCRIPTION OF OPERATIONS/ LOCATIONS VEHICLES (ACORD tat, Addlllonal Remarks Schedule, maybe attached If more space Is rectulred) 30 Days Notice of Cancellation/10 Days for Non -Payment IL02700912 Job: On -Call Right of Way Appraisal Services Per Written Contract, Project Per Written Contract COMMERCIAL GENERAL LIABILITY BLANKET ADDITIONAL INSURED/PRIMARYINON-CONTRIBUTORYIWAIVER OF SUBROGATIONIHOLD HARM LESSNNSUREDS-SUBCONTRACTOR, OUR WORK PER PROJECT OR LOCATION: CGD2460805 Per Written Contract COMMERCIAL AUTO BLANKET ADDITIONAL INSURED/PRIMARYIWAIVER OF SUBROGATIONIEMPLOYEES AS INSUREDS: CAT3530216 Per Written Contract. WORKERS' COMPENSATION WAIVER OF SUBROGATION: WC990376(A)-001 Per Written Contract UMBRELLA: Any Person Qualifying as such under underlying General Liability, Commercial Auto, and Workers' Com ` nsation Insurance. Additional Insured: City of Santa Ana, Its officers, employees, agents, volunteers, a d.renresentatiVAR ' REVIEWED BY: EUNICE HEREDIA (PG City of Santa Ana 20 Civic Center Plaza M-30 PO Box 1988 Santa Ana, CA 92702-1988 Letica Lopez, Lfopez5@santa-ana.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 19OB-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Produced using Forma Boas Web Software, www.Formal3os3.com (c) Impressive Publishing 800.200-1977 =I'm 6309K104459TIL18 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional Insured on this Cover- age Part, but: a) Only with respect to liability for "bodily Injury", "property damage" or "personal injury"; and b) if, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional Insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional Insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of Insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and 11. Supervisory, Inspection, architectural or engineering activities. CG D2 46 08 05 c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring Insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional Insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that Is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional Insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional Insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other Insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional Insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should Include: © 2005 The St. Paul Travelers Companies, Inc. Page i of 2 REVIEWED BY: EUNICE HEREDIA (PG� OF I� ) 630OK104459TIL18 COMMERCIAL GENERAL LIABILITY 1. How, when and where the "occurrence" or offense took place; 11. The names and addresses of any injured persons and witnesses; and Ill. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: 1. Immediately record the specifics of the claim or "suit" and the date received; and 11. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional Insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional Insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to* "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal Injury" Is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement Is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2005 The St. Paul Travelers Companies, IT. CC D2 40 08 05 REVIEWED BY:41, EUNICE HEREDIA (PG IOF �� ) BA9K1066861814 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE -- This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HiRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following Is added to Paragraph A.1., Who Is An insured, of SECTION Il — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE. — LOSS OF USE — INCREASED LIMIT 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this Insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained In Section 11. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION [I'— COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow, and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 02015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Olflce, Inc. with Its permission. REVIEWED BY: EUNICE HEREDIA (PG OF (� ) BA9K1066861814 COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (I). You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION 11— COVERED AUTOS tions. LIABILITY COVERAGE: Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs, (iii) may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED in defending the "insured" against, or in LIMITS in the settlement of, any claim or 1. The following replaces Paragraph A.2,a.(2), "suit". of SECTION 11 — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C„ Limits Of insurance, of SECTION 11 — COVERED AUTOS of SECTION 11 — COVERED AUTOS LIABIL- LIABILITY COVERAGE. ITY COVERAGE: (4) All reasonable expenses Incurred by the (v) We will reimburse the "insured" for "Insured" at our request, including actual the reasonable expenses incurred with our consent for your Investiga- loss of earnings up to $500 a day be- tion of such claims and your defense cause of time off from work. of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and Included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION 11 — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to make such payments ends when we (5) Anywhere in the world, except any country or have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "Insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ® 2016 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of insurance Services Office, Inc. with Its permission, REVIEWED BY: EUNICE HEREDIA (PG F ) BA9K1066861814 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you compiled with the compulsory in- surance requirements. (d) it is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION Ill — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence In Para- graph A.4.a., Transportation Expenses, of SECTION ill — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION Ill — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III -- PHYSICAL DAMAGE COVERAGE: Exclusion 3.a, does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.'l.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (a) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION 1V — BUSINESS AUTO CONDI- TIONS: S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "foss" arises out of operations contemplated by CA T3 53 02 15 02015 The Travelers indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. REVIEWED BY: EUNICE HEREDIA (PG 6OF I ( ) BA9K1 06686181 � COMMERCIAL AUTO such contract, The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph 13.2., Con. lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal, SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 A 2015 The Travelers indemnity Compa ny. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. REVIEWED BY: EUNICE HEREDIA (PG OFi I ) BA9K1066861814 6309K104459TIL18 THiS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT -RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the Cancellation Com- mon Policy Condition are replaced by the follow- ing: 2. All Policies In Effect For 60 Days Or Less If this policy has been in effect for 60 days or less, and is not a renewal of a policy we have previously Issued, we may cancel this policy by mailing or delivering to the first Named In- sured, at the mailing address shown in the policy, and to the producer of record, advance written notice of cancellation, stating the rea- son for cancellation, at least: a. 10 days before the effective date of can- cellation If we cancel for: (1) Nonpayment of premium; or (2) Discovery of fraud by: (a) Any insured or his or her repre- sentative in obtaining this insur- ance; or (b) You or your representative in pursuing a claim under this pol- icy. .b. 30 days before the effective date of can- cellation if we cancel for any other rea- son. 3. All Policies In Effect For More Than 60 Days a. If this policy has been in effect for more than 60 days, or is a renewal of a policy we issued, we may cancel this policy only upon the oc- currence, after the effective date of the policy, of one or more of the following: (1) Nonpayment of premium, including pay- ment due on a prior policy we issued and due during the current policy term cover- ing the same risks. (2) Discovery of fraud or material misrepre- sentation by: (a) Any insured or his or her representa- tive In obtaining this insurance; or (b) You or your representative in pursu- ing a claim under this policy. (3) A judgment by a court or an administra- tive tribunal that you have violated a Cali- fornia or Federal law, having as one of its necessary elements an act which materi- ally increases any of the risks insured against. (4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your repre- sentative, which materially increase any of the risks insured against. (5) Failure by you or your representative to implement reasonable loss control re- quirements, agreed to by you as a con& tion of policy Issuance, or which were conditions precedent to our use of a par- ticular rate or rating plan, if that failure IL 02 70 09 12 © Insurance Services Office, Inc., 2012 Page 1 of 3 REVIEWED BY: EUNICE HEREDIA (PG F PI ) BA9K1066861814 63OK104459TIL18 materially increases any of the risks in- sured against. (6) A determination by the Commissioner of Insurance that the: (a) Loss of, or changes in, our reinsur- ance covering all • or part of the risk would threaten our financial Integrity or solvency; or (b) Continuation of the policy coverage would: (1) Place us in violation of California law or the laws of the state where we are domiciled; or (ii) Threaten our solvency. (7) A change by you or your representative in the activities or property of the commer- cial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, in- creased or changed risk is included in the policy. b. We will mail or deliver advance written notice of cancellation, stating the reason for cancel- lation, to the first Named Insured, at the mail- Ing address shown in the policy, and to the producer of record, at least: (1). 10 days before the effective date of can- cellation if we cancel for nonpayment of premium or discovery of fraud; or (2) 30 days before the effective date of can- cellation if we cancel for any other reason listed In Paragraph 3.a. B. The following provision is added to the Cancella- tion Common Policy Condition: 7. Residential Property This provision applies to coverage on real property which is used predominantly for residential purposes and consisting of not more than four dwelling units, and to cover- age on tenants' household personal property in a residential unit, if such coverage is writ- ten under one of the following: Commercial Property Coverage Part Farm Coverage Part — Farm Property -- Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. if such coverage has been in effect for 60 days or less, and is not a renewal of cov- erage we previously issued, we may can- cel this coverage for any reason, except as provided in b. and c. below. Page 2 of 3 b. We may not cancel this policy solely be- cause the first Named Insured has: (1) Accepted an offer of earthquake cov- erage; or (2) Cancelled or did not renew a policy issued by the California Earthquake Authority (CEA) that included an earthquake policy premium sur- charge. However, we shall cancel this policy if the first Named Insured has accepted a new Fr renewal policy issued by the CEA that includes an earthquake policy premium surcharge but fails to pay the earthquake policy premium surcharge authorized by the CEA. c. We may not cancel such coverage solely because corrosive soil conditions exist on the premises. This restriction (c.) applies only if coverage is subject to one of the following, which exclude loss or damage caused by or resulting from corrosive soil conditions: (1) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Para- graph D. Covered Causes Of Loss — Speclal. C. The following is added and supersedes any pro- visions to the contrary: , Nonrenewal 1. Subject to the provisions of Paragraphs C.2. and C.3. below, if we elect not to renew this policy, we will mail or deliver written notice, stating the reason for nonrenewal, to the first Named Insured shown in the Declarations, and to the producer of record, at least 60 days, but not more than 120 days, before the expiration or anniversary date. We will mail or deliver our notice to the first Named insured, and to the producer of re- cord, at the mailing address shown in the pol- icy. 2. Residential Property This provision applies to coverage on real property used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household property contained in a residential unit, if such coverage is written under one of the following: © Insurance Services Office, Inc., 2012 IL 02 70 09 12 REVIEWED BY: EUNICE HEREDIA (P 22 OF J ( ) BA9K1066861814 63OK104459TIL18 Commercial Property Coverage Part to the changes in our reinsurance po- Farm Coverage Part — Farm Property — Farm sition. Dwellings, Appurtenant Structures And c. We will not refuse to renew such cover - Household Personal Property Coverage Form age solely because the first Named In- a. We may elect not to renew such cover- sured has cancelled or did not renew a policy, Issued by the California Earth- age for any reason, except as provided In quake Authority, that included an earth- b., c. and d. below. quake policy premium surcharge. b. We will not refuse to renew such cover- d. We will not refuse to renew such cover- age solely because the first Named In- age solely because corrosive soil condi- sured has accepted an offer of earth- tions exist on the premises. This restric- quake coverage. tion (d.) applies only if coverage is sub - However, the following applies only to in- ject to one of the following, which exclude surers who are associate participating in- loss or damage caused by or resulting surers as established by Cal. Ins. Code from corrosive soil conditions: Section 10089.16. We may elect not to after the first {1) Commercial Properly Coverage Part renew such coverage Named Insured has accepted an offer of Causes Of Loss Special Form; or earthquake coverage, if one or more of (2) Farm Coverage Part — Causes Of the following reasons applies: Loss Form -- Farm Property, Para- (1) The nonrenewal is based on sound graph D. Covered Causes Of Loss — underwriting principles that relate to Special, the coverages provided by this policy 3. We are not required to send notice of nonre- and that are consistent with the ap- newal in the following situations: proved rating plan and related docu- ments filed with the Department of a. If the transfer or renewal of a policy, with - Insurance as required by existing law; out any changes in terms, conditions or rates, is between us and a member of our (2) The Commissioner of Insurance finds insurance group. that the exposure to potential losses will threaten our solvency or place us b. If the policy has been extended for 90 in a hazardous condition. A hazard- days or less, provided that notice has ous condition includes, but is not lim- been given in accordance with Paragraph ited to, a condition in which we make C.1. claims payments for losses resulting c. If you have obtained replacement cover - from an earthquake that occurred age, or if the first Named Insured has within the preceding two years and agreed, in writing, within 60 days of the that required a reduction In policy- termination of the policy, to obtain that holder surplus of at least 25% for coverage. payment of those claims; or d. if the policy is for a period of no more (3) We have: than 60 days and you are notified at the (a) Lost or experienced a substantial time of issuance that it will not be re - reduction in the availability or newed. scope of reinsurance coverage; e. If the first Named Insured requests a or change in the terms or conditions or risks (b) Experienced a substantial in- covered by the policy within 60 days of crease in the premium charged the end of the policy period. for reinsurance coverage of our f. If we have made a written offer to the first residential property insurance Named Insured, in accordance with the policies; and timeframes shown in Paragraph CA., to the Commissioner has approved a renew the policy under changed terms or plan for the nonrenewals that is fair conditions or at an increased premium and equitable, and that is responsive rate, when the increase exceeds 25%. iL 02 70 0912 © Insurance Services Office, Inc., 2012 Page 3 of 3 REVIEWED BY: EUNICE HEREDIA (PG100 ) TRAVELERS J k WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB-9K107321-18-14-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization .lob Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. End ementfftNo1 Insured reitt Insurance Company Countersigned DATE OF ISSUE: 06-14-18 ST ASSIGN: Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (PG I(OFC% ) •� ® DATE(MMIDDNM) !!`r© CERTIFICATE OF LIABILITY INSURANCE 06/1812019 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsements . PRODUCER Bill Douglas KDuria insurance Agency,lnc NAME: 10345 Danichris Way PHO E 918-*36-5641 916-685-9571 Elk Grove CA 95757 ! M19L . bdklnsurance0amall.com a INSURER A • Houston Casualty Company 142374 INSURED Bender Rosenthal, Inc. •• INSURER B: ravelers Property Casualty Co of America 26674 2625 Watt Avenue, Suffe 200 INSURERCs Sacramento CA 95821 INSURER Dt INSURER E : INSURER P t r nVFRAr.FS r:PRTIPN".ATF NI IMRFR� Ranlacas cart dated n510112019 RFVIRIn1J NIIMRf"R. 4 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. INsh /io0t. sbaR PQLIC EFF P6Licr RRP L TYPE OFINSURANCE INSO wvD POLICY NUMBER MMMDNYYY1 LIMITS B JCOMMERCIAL0ENERALLIABILITY CLAIMS-MADE ✓ OCCUR z/V/EACH 630-OK104459-TIL-19 6/0112019 06/0112020 OCCURRENCE -6AIUAOE'ro"1 TFb--- P.REM.IS6S (I:a uccunenco) S1,000,000 •---_---- S100,000--- ----------- MEDEXP(Anyone (son), $5,000 PERSONAL aADVINJURY $1,000,000 GEN1AOeA£G TELIMITAPPLIESPER: POLICYlJ JECTPRO. Ej LOC _GENE_RALAOGREGATE _ PRODUCTS-COMPIOPAGG _S2,000,o_oo__ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY k �/ M I DS LELMI $1,000,000 BODILY INJURY (Per pamon) �/ ANY AUTO S B OWNED SCHEDULED __ AUTOS ONLY AUTOS ✓ HIJRTosONLY ✓ NON-OWNED ON-OWAUTOS N D IBA-9K106686-19-14 1)61011201g 0610112020 BODILY INJURY (Per accident) S PR RTy� nainGE s - EACH OCCURRENCE S 5,000,000 06IF0112019 0610112020 B UMBRELLALIAB OCCUR ✓ ✓ EX-91(117560-19-14 V EXCESS LIAO CLAIMS.MAOE f GL, Auto and WC form AGGREGATE $5,000,000 — — DED RETENTIONS _ _ 16101120111 06/0112020 OTH- ✓ 7ATUTE 9& s B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YiN OFCEWAEMORIPAR UDEEXECUTIVE D (Mandatory In NH) NIA LI UB-91<107321-19-14 E.L EACH ACCIDENT $1,000,000 E.LDISEASE- EAEMPLOYEE S1,000,000 Usa describe under RIPTION OF OPERATIONS below I E.L. DISEASE -POLICY LIMIT I S1,000,000 A �CLAIMSMADE Professional Lleblllty QQ H718-112596 Deductible 15,000 11130/2,018 11113012019 0 Per 12,000 ooDAggrsgaleenc E10 Retro Date 11130/99 DESCRIPTION OF OPERATIONS 1 LOCCof WaypAnONB (VEHICLES (ACOROO t01, Additional Rumurka aehedule. may bo ottouhod I f mora space Is requlrod) Days for Non -Payment IL02700912 30 Days Notice of Job: On -Call Cotract, Project For ritten Contract INSUREDIPRtrhARritten COMMERCIALIght GENEIRAL L A131LpraTY BLANKET ADDITIONAL Y1NON•CONTR[BUTORYfWAIVER OF SUBROGATIONIHOLD HARMLESSIINSUREDS-SUBCONTRACTOR, OUR WORK PER PROJECT OR LOCATION: CGD2460805 Per Written Contract COMMERCIAL AUTO BLANKET ADDITIONAL INSUREDIPRIMARY/WAIVER OF SUBROGATIONIEMPLOYEES AS INSUREDS: CAT3530216 Per Written Contract. WORKERS' COMPENSATION WAIVER OF SUBROGATION: WC990376(A)-001 For Written Contract UMBRELLA. Any Person Qualifying as such under underlying General Liability, Commercial Auto, and Workers' Compensatlon insurance. Additional Insured: City of Santa Ana, Its officers, employees, agents, volunteers, and representatives CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE 01988.2015 ACORD CORPORATIO All righ! resew d. The ACORD name and logo are registered marks of ACORD Produced uslna Forma Bose Web Software, www.FormaBosa,com tat Imoreselve Publlshlna 800-208.1971 F KCVI'CVVCLJD1; IAA+ 15k M nag ant Ivlsion BA-9K106666.19-14-G Y-630.9K104459-TIL-19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT -RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LiQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the Cancellation Com- mon Policy Condition are replaced by the follow- ing: 2. All Policies in Effect For 60 Days Or Less if this policy has been in effect for 60 days or less, and is not a renewal of a policy we have previously issued, we may cancel this policy by malling or dellvering to the first Named in- sured, at the mailing address shown in the policy, and to the producer of record, advance written notice of cancellation, stating the rea- son for cancellation, at least: a. 10 days before the effective date of can- cellation if we cancel for: (1) Nonpayment of premium; or (2) Discovery of fraud by: (a) Any insured or his or her repre- sentative in obtaining this insur- ance; or (b) You or your representative in pursuing a claim under this pol- icy. b. 30 days before the effective date of can- cellation if we cancel for any other rea- son. 3. All Policies In Effect For More Than 60 Days a. If this policy has been in effect for more than 60 days, or is a renewal of a policy we issued, we may cancel this policy only upon the oc- currence, after the effective date of the policy, of one or more of the following: (1) Nonpayment of premium, including pay- ment due on a prior policy we issued and due during the current policy term cover- ing the same risks. (2) Discovery of fraud or material misrepre- sentation by: (a) Any insured or his or her representa- tive in obtaining this insurance; or (b) You or your representative in pursu- ing a claim under this policy. (3) A judgment by a court or an administra- tive tribunal that you have violated a Call- fornia or Federal law, having as one of its necessary elements an act which materi- ally increases any of the risks insured against. (4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your repre- sentative, which materially Increase any of the risks insured against. (5) Failure by you or your representative to implement reasonable loss control re- quirements, agreed to by you as a condi- tion of policy issuance, or which were conditions precedent to our use of a par- ticular rate or rating plan, if that failure IL 02 70 09 12 © Insurance Services Office, Inc., 2012 Tage 1n 3 K111I BA-91<106666-19-14-G y.630-9K1044697109 materially increases any of the risks in- sured against. (6) A determination by the Commissioner of Insurance that the: (a) Loss of, or changes in, our reinsur- ance covering all � or part of the risk would threaten our financial integrity or solvency; or (b) Continuation of the policy coverage would: (1) Place us in violation of California law or the laws of the state where we are domiciled; or (11) Threaten our solvency. (7) A change by you or your representative in the activities or property of the commer- cial or industrial enterprise, which results In a materially added, increased or changed risk, unless the added, in- creased or changed risk is included in the policy. b. We will mail or deliver advance written notice of cancellation, stating the reason for cancel- lation, to the first Named Insured, at the mail- ing address shown in the policy, and to the producer of record, at least: (1) 10 days before the effective date of can- cellation If we cancel for nonpayment of premium or discovery of fraud; or (2) 30 days before the effective date of can- cellation if we cancel for any other reason listed in Paragraph 3.a. B. The following provision is added to the Cancella- tion Common Policy Condition: 7. Residential property This provision applies to coverage on real property which Is used predominantly for residential purposes and consisting of not more than four dwelling units, and to cover- age on tenants' household personal property in a residential unit, if such coverage Is writ- ten under one of the following: Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. if such coverage has been in effect for 60 days or less, and is not a renewal of cov- erage we previously issued, we may can- cel this coverage for any reason, except as provided in b, and c, below. Page 2 of 3 b. We may not cancel this policy solely be- cause the first Named Insured has: (1) Accepted an offer of earthquake cov- erage; or (2) Cancelled or did not renew a policy issued by the California Earthquake Authority (CEA) that included an earthquake policy premium sur- charge. However, we shall cancel this policy if the first Named Insured has accepted a new or renewal policy issued by the CEA that includes an earthquake policy premium surcharge but fails to pay the earthquake policy premium surcharge authorized by the CEA. c. We may not cancel such coverage solely because corrosive soil conditions exist on the premises. This restriction (c.) applies only if coverage is subject to one of the following, which exclude loss or damage caused by or resulting from corrosive soil conditions: (1) Commercial Property Coverage Part -- Causes Of Loss -- Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Para- graph D. Covered Causes Of Loss — Special. C. The following is added and supersedes any pro- visions to the contrary: Nonrenewal 1. Subject to the provisions of Paragraphs C.2. and C.3. below, if we elect not to renew this policy, we will mail or deliver written notice, stating the reason for nonrenewal, to the first Named Insured shown in the Declarations, and to the producer of record, at least 60 days, but not more than 120 days, before the expiration or anniversary date. We will mail or deliver our notice to the first Named Insured, and to the producer of re- cord, at the mailing address shown in the pol- icy. 2. Residential Property This provision applies to coverage on real property used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household property contained In a residential unit, if such coverage is written under one of the following: © Insurance Services Office, Inc., 2012 IL 02 70 08 12 /1 11 1g I BA-9K106666-19.14-G Y-630-9K104459-TIL-19 Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. We may elect not to renew such cover- age for any reason, except as provided in b., c. and d. below. b. We will not refuse to renew such cover- age solely because the first Named In- sured has accepted an offer of earth- quake coverage. However, the following applies only to in- surers who are associate participating in- surers as established by Cal. Ins. Code Section 10089,16, We may elect not to renew such coverage after the first Named Insured has accepted an offer of earthquake coverage, if one or more of the following reasons applies; (1) The nonrenewal is based on sound underwriting principles that relate to the coverages provided by this policy and that are consistent with the ap- proved rating plan and related docu- ments filed with the Department of Insurance as required by existing law; (2) The Commissioner of Insurance finds that the exposure to potential losses will threaten our solvency or place us in a hazardous condition. A hazard- ous condition includes, but is not lim- ited to, a condition in which we make claims payments for losses resulting from an earthquake that occurred within the preceding two years and that required a reduction in policy- holder surplus of at least 25% for payment of those claims; or (3) We have: IL02700912 (a) Lost or experienced a substantial reduction in the availability or scope of reinsurance coverage; or (b) Experienced a substantial in- crease in the premium charged for reinsurance coverage of our residential property insurance policies; and the Commissioner has approved a plan for the nonrenewals that is fair and equitable, and that is responsive to the changes in our reinsurance po- sition. c. We will not refuse to renew such cover- age solely because the first Named In- sured has cancelled or did not renew a policy, issued by the California Earth- quake Authority, that included an earth- quake policy premium surcharge, d. We will not refuse to renew such cover- age solely because corrosive soil condi- tions exist on the premises. This restric- tion (d.) applies only if coverage is sub- ject to one of the following, which exclude loss or damage caused by or resulting from corrosive soil conditions; (1) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Para- graph D. Covered Causes Of Loss — Special. 3. We are not required to send notice of nonre- newal in the following situations: a. If the transfer or renewal of a policy, with- out any changes in terms, conditions or rates, is between us and a member of our insurance group. b. If the policy has been extended for 90 days or less, provided that notice has been given in accordance with Paragraph C.1. c, If you have obtained replacement cover- age, or If the first Named Insured has agreed, in writing, within 60 days of the termination of the policy, to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are notified at the time of issuance that it will not be re- newed. e. If the first Named Insured requests a change in the terms or conditions or risks covered by the policy within 60 days of the end of the policy period. f. If we have made a written offer to the first Named insured, in accordance with the timeframes shown in Paragraph C.1., to renew the policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25%. m Insurance Services Office, Inc., 2012 Page" of 3I I 1 I Y-630-9K1044 59JIL-19 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO iS AN INSURED -- (Section II) is amended to include any person or organization that you agree In a "written contract requiring Insurance" to Include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only to the extent that, the Injury or damage Is caused by acts or omissions of you or your subcontractor In the performance of "your work" to which the "written contract requiring Insurance" applies. The person or organization does not qualify as an additional Insured with respect to the Independent acts or omissions of such person or organization. 2. The Insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring Insurance", the In- surance provided to the additional Insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described In Section III — Limits Of Insurance. b) The insurance provided to the additional In- sured does not apply to "bodily Injury", "prop- erty damage" or "personal Injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or falling to prepare or ap- prove, drawings and specifications; and 11. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional Insured, and then the Insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The Insurance provided to the additional insured by this endorsement Is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that Is available to the additional Insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this Insurance apply on a primary basis or a primary and non-contributory basis, this Insurance is primary to 'other insurance" available to the additional Insured which covers that person or organization as a named Insured for such loss, and we will not share with that "other Insurance". But the Insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that Is available to the addl- tional insured when that person or organization is an additional insured under such 'other insur- ance". 4. As a condition of coverage provided to the additional Insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should Include: CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 YE30-9 K 104 459-T 1L-19 COMMERCIAL GENERAL LIABILITY i. How, when and where the 'occurrence" or offense took place; It. The names and addresses of any Injured persons and witnesses; and III. The nature and location of any Injury or damage arising out of the "occurrence" or offense. b) If a claim Is made or "suit" Is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and II. Notify us as soon as practicable. The additional Insured must see to It that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must Immediately send us copies of all legal papers received In connection with the claim or "suit", cooperate with us In the Investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional Insured must tender the de- fense and indemnity of any claim or "suit' to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to -"other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition Is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are requlred to Include a person or organization as an additional In- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal Injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 Y-630-9K104459•TIW9 (2) The total of all deductible and self -insured amounts under that "other Insurance", We will share the remaining loss, if any, with any "other insurance" that is not described in this Excess insur- ance provision. c. Method Of Sharing If all of the "other Insurance" permits contribution by equal shares, we will follow this method also. Under this approach each provider of insurance contributes equal amounts until It has paid its applicable limit of Insurance or none of the loss remains, which- ever comes first. If any of the "other insurance" does not permit contribution by equal shares, we will contribute by limits. Under this method, the share of each provider of insurance is based on the ratio of Its applicable limit of insur- ance to the total applicable limits of Insurance of all providers of insur- ance. 2. The following definition is added to SECTION V — DEFINITIONS: "Other insurance": a. Means Insurance, or the funding of losses, that is provided by, through or on behalf of: (1) Another insurance company; (2) Us or any of our affiliated Insurance companies, except when the Non cumulation of Each Occurrence Limit section of Paragraph 5. of LIMITS OF INSURANCE (Section III) or the Non cumulation of Personal and Advertis- ing Injury limit sections of Paragraph 4. of LIMITS OF INSURANCE (Sec- tion 111) applies; COMMERCIAL GENERAL LIABILITY Insurance shown on the Declarations of this Coverage Part. R. UNINTENTIONAL OMISSION 1. The following is added to Paragraph 6. Rep- resentations of SECTION iV — COMMER- CIAL GENERAL LIABILITY CONDITIONS: The unintentional omisslon of, or uninten- tional error in, any information provided by you which we relied upon In issuing this policy shall not prejudice your rights under this in- surance, 2. This Provision R. does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accor- dance with applicable insurance laws or regu- lations, S. WAIVER OF TRANSFER OF RIGHTS OF RE- COVERY AGAINST OTHERS TO US WHEN REQUIRED BY CONTRACT The following Is added to Paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION 1V -- COMMERCIAL GENERAL LI- ABILITY CONDITIONS: We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage", "personal Injury" or "advertising injury" arising out of: 1. Premises owned by you, temporarily occu- pied by you with permission of the owner, or leased or rented to you; 2. Ongoing operations performed by you, or on your behalf, under a contract or agreement with that person or organization; 3. "Your work"; or (3) Any risk retention group; (4) Any self -Insurance method or pro- gram, other than any funded by you and over which this Coverage Part T. applies; or (5) Any similar risk transfer or risk man- agement'method. b. Does not include umbrella insurance, or excess Insurance, that you bought spe- cifically to apply in excess of the Limits of 4. "Your products". We waive these rights only where you have agreed to do so as part of a "written contract re- quiring insurance" entered Into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense or "advertising Injury" offense is committed. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily Injury" in the DEFINITIONS Section: "Bodily Injury" means bodily injury, mental an- guish, mental Injury, shock, fright, disability, hu- miliation, sickness or disease sustained by a per- CG D4 15 05 OS (Rev. 10-00) 0 2008 The Travelers Companies, Inc. IJ-1 Page 7 of 8 BA-9K1066e6-19-14-G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any Injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS [NSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO -- LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 1 Both day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that Is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section 11, C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION 11 — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 02015 The Travelers Indemnity Company, All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with Its permission. Page 1 of 4 0 ('0j � WW106666-19.14-G COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (1). You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set - tie any such claim or "suit" and keep The following is added to Paragraph A,1., Who Is us advised of all proceedings and ac- An Insured, of SECTION It — COVERED AUTOS tions. LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- (11) Neither you nor any other involved ing a covered "auto" you don't own, hire or borrow "insured" will make any settlement in your business or your personal affairs. without our consent. E. SUPPLEMENTARY PAYMENTS — INCREASED (fit) We may, at our discretion, participate in defending the "insured" against, or LIMITS in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION Ii -- COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds, only up to the limit described in Para - 2. The fallowing replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION Il -- COVERED AUTOS LIABIL- ON II -- COVERED AUTOS SECTIONLIABIL iTY COVERAGE: COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE -- INDEMNITY BASiS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of insurance, of graph B.7., Policy Period, Coverage Territory, SECTION If — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to make such payments ends when we (5) Anywhere in the world, except any country or have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This Insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada, members of their households. Page 2 of 4 0 2016 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. I I BA-W106686.19-14-G You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law, Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, Its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III -- PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.16., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident'. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES -- INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION [I[ -- PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for 'loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty: and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A,2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or 'loss" ap- plies only when the "accident" or 'loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV -- BUSINESS AUTO CONDI- TIONS: S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident' or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4' Includes copyrighted material of Insurance Services Office, Inc. with Its permisslon. I l 8A-eK1056es-19.14-0 COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated In such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS; The unintentional omission of, or unintentional error In, any Information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 02016 The Travelers Indemnity Compa ny. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance services Offloe, [no. with Its permission, TRAVELERS TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99'03 76 ( A) - 001 POLICY NUMBER: Us-9K407321.19-14-C WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an Injury covered by this policy, We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 2.00 % of the .California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS ,AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement Is Issued subsequent to preparation of the policy) Endorsement Effective Policy No. �; � End ment No,� Insured Bander Rosenthal, r Inc. Insurance Company Countersigned DATE OF ISSUE: 06-14-18 ST ASSIGN: Page 1 of 1 n I