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HomeMy WebLinkAboutContract 1916 • (0 SECTION 1300 CONTRACT THIS CONTRACT, by and between the CITY OF CATHEDRAL CITY, a municipal corporation, herein referred to as "City", and Matich Corporation, herein referred to as, "Contractor". WITNESSETH: In consideration of their mutual covenants, the parties hereto agree as follows: 1. Contractor shall furnish all necessary labor, material, equipment, transportation and services for Bid No. B21-01E, Whitewater Neighborhood Street Improvements Phase II (C08833) and Whispering Palms Neighborhood Street Rehab. (C08831) (the "Work") in the City of Cathedral City, California. The Work shall be done in strict conformity with this Contract, approved Change Orders, the Invitation to Bid dated March 1 , 2021, Instructions to Bidders, permits issued by the City or other agencies, the General and Specific Project Requirements, Standard Specifications, Plans, Referenced Specifications, the General Conditions, Supplementary Conditions the Contractor's Bid dated March 23, 2021, and any addenda thereto (the "Contract Documents") all of which shall be considered a part hereof as though fully set herein. 2. Contractor will comply with all Federal, State, County, and City of Cathedral City laws, regulations and policies, which are, as amended from time to time, incorporated herein by reference. 3. All work shall be done in a workman like manner and to the satisfaction of the City Engineer. 4. Time is of the essence in Contractor's performance of the Work for this Contract. Contractor agrees to diligently pursue the performance and completion of the Work in every detail to the satisfaction of the City. Contractor shall commence work after the issuance of a written Notice to Proceed and agrees to have all work completed within 45 working days from the date of Notification to Proceed. 5. In consideration of said Work, City agrees to pay Contractor such sums as shall be approved by the City Engineer at lump sums and/or unit prices stated in the Contractor's Bid. The total compensation to Contractor for all Work shall not exceed ONE MILLION FOUR HUNDRED SEVENTY-FIVE THOUSAND THREE HUNDRED EIGHTEEN AND 00/100 ($1,475,318.00). All payments shall be subject to approval by the City Engineer and shall be in accordance with the terms, conditions, and procedures provided in the Contract Documents. 6. The Contractor shall not knowingly pay less than the higher of the Federal minimum wage rate or the general prevailing rate for per diem wages, as determined by the State of California Department of Industrial Relations and referred to in the Invitation to Bid, to any workman employed for the work to be performed under this contract; and the Contractor shall forfeit as a penalty to the City the sum of Twenty-Five Dollars ($25.00) for each calendar day, or fraction thereof, for such workman paid by him or by any subcontractor under him in violation of this provision (Sections 1770-1777, Labor Agreement 1300-1 Code of California). 7. Concurrently with the execution of this Contract, Contractor shall furnish bonds of a surety satisfactory to City, as provided in the Contract Documents, the cost of which shall be paid by Contractor. 8. Contractor agrees to indemnify, hold harmless, release and defend (even if the allegations are false, fraudulent or groundless), to the maximum extent permitted by law, the City, its City Council and each member thereof, and its officers, employees, commission members and representatives, from any and all liability, loss, suits, claims, damages, costs, judgments and expenses (including attorney's fees and costs of litigation) which in whole or in part are claimed to result from or to arise out of the usage or operation, including the malfunctioning of, or, any injury caused by, any product purchased herein; or any acts, errors or omissions (including, without limitation, professional negligence) of Contractor, its employees, representatives, subcontractors, or agents in connection with the performance of this Contract. This agreement to indemnify includes, but is not limited to, personal injury (including death at any time) and damage to property (including, but without limitation, contract or tort or patent, copyright, trade secret or trademark infringement) sustained by any person or persons (including, but not limited to, companies, or corporations, Contractor and its employees or agents, and members of the general public. 9. Except as otherwise required, Contractor shall concurrently with the execution of this Contract, furnish the City satisfactory evidence of insurance of the kinds and in the amounts provided in the Contract Documents. This insurance shall be kept in full force and effect by Contractor during this entire contract and all premiums thereon shall be promptly paid by it. Each policy shall further state that it cannot be canceled without 30 days unconditional written notice to the City and shall name the City as an additional insured. Contractor shall furnish evidence of having in effect and shall maintain Workers Compensation Insurance coverage of not less than the statutory amount or otherwise show a certificate of self-insurance, in accordance with the Workers Compensation laws of the State of California. Failure to maintain the required amounts and types of coverage throughout the duration of this Contract shall constitute a material breach of this Contract. 10. Contractor shall forfeit as a penalty to City $25.00 for each laborer, workman, or mechanic employed in the execution of this Contract by said Contractor, or any subcontractor under it, upon any of the work herein mentioned, for each calendar day during which such laborer, workman, or mechanic is required or permitted to work at other than a rate of pay provided by law for more than 8 hours in any one calendar day and 40 hours in any one calendar week, in violation of the provisions of Sections 1810-1815 of the Labor Code of the State of California. 11. In accepting this Contract, Contractor certifies that in the conduct of its business it does not deny the right of any individual to seek, obtain and hold employment without discrimination because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and veteran status as provided in the California Fair Employment Practice Act (Government Code Sections 12900, et seq.) Contractor agrees that a Agreement 1300-2 finding by the State Fair Employment Practices Commission that Contractor has engaged during the term of this Contract in any unlawful employment practice shall be deemed a breach of this Contract and Contractor shall pay to City $500.00 liquidated damages for each such breach committed under this Contract. 12. Contractor also agrees that for contracts in excess of $30,000 that apprentices will be employed without discrimination in an approved program in a ratio established in the apprenticeship standards of the craft involved (Sections 1777.5 and 1777.6, Labor Code of California). Contractors who willfully fail to comply will be denied the right to bid on public projects for a period of six months in addition to other penalties provided by law. 13. This Contract shall not be assignable by Contractor without the written consent of City. 14. Contractor shall notify the City Engineer (in writing) forthwith when the Contract is deemed completed. 15. In accepting this Contract, Contractor certifies that no member or officer of the firm or corporation is an officer or employee of the City except to the extent permitted by law. 16. Contractor certifies that it is the holder of any necessary California State Contractor's License and authorized to undertake the Work. Contractor must, at Contractor's sole expense, obtain all necessary permits and licenses required for the Work, and give all necessary notices and pay all fees and taxes required by law, including, without limitation, any business license tax imposed by City. Contractor represents and declares to Agency that it has all licenses, permits, qualifications and approvals of whatever nature which are legally required to practice its profession. 17. The City, or its authorized auditors or representatives, shall have access to and the right to audit and reproduce any of the Contractor records to the extent the City deems necessary to insure it is receiving all money to which it is entitled under the contract and/or is paying only the amounts to which Contractor is properly entitled under the Contract or for other purposes relating to the Contract. 18. The Contractor shall maintain and preserve all such records for a period of at least three years after termination of the Contract. 19. The Contractor shall maintain all such records in the City of Cathedral City. If not, the Contractor shall, upon request, promptly deliver the records to the City or reimburse the City for all reasonable and extra costs incurred in conducting the audit at a location other than at City offices including, but not limited to, such additional (out of the City) expenses for personnel, salaries, private auditors, travel, lodging, meals and overhead. 20. In entering into this Contract or a contract with a subcontractor to supply goods, services, or materials pursuant to this Contract, Contractor and any or subcontractor is deemed to have offered and agreed to assign to City all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 Agreement 1300-3 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2, commencing with Section 16700 of Part 2 of Division 7 of the California Business and Professions Code), arising from purchases of goods, services, or materials for the Contract. This assignment will be deemed made and will become effective at the time City tenders final payment to Contractor, without further acknowledgement by the Parties. Agreement 1300-4 IN WITNESS WHEREOF, the parties have executed this Contract as of the dates stated below. "CITY" CITY OF CATHEDRAL CITY, a California municipal corporation By: 1.-Lv' 04 IL}.21)21 Cha es P. McClendon, City Manager ATTEST: .1. . I AA: Dated: D1 Lf. 202) Tracey R. 4►-rtinez, MC, City I APPROVED AS To 'M: Dated: 0 V ZO ZO Z f Eric Vail, ity Attorney "CONTRACTOR" Dated: 1-tirtit/ Bya�v�. Name: immix a 0A 173- Title: i »4. • Dated: By: Name: Title: [CONTRACTOR SIGNATURES MUST BE NOTARIZED. IF CONTRACTOR IS A CORPORATION OR LIMITED LIABILITY COMPANY, TWO SIGNATURES MUST BE PROVIDED.] Agreement 1300-5 IN WITNESS WHEREOF, the parties have executed this Contract as of the dates stated below. "CITY" CITY OF CATHEDRAL CITY, a California municipal corporation By: Dated: Charles P. McClendon, City Manager ATTEST: Dated: Tracey R. Martinez, CMC, City Clerk APPROVED AS TO FORM: Dated: Eric Vail, City Attorney "CONTRACTOR" Dated: April 26. 2021 By: Name: Mi..- Title: /Man-1 4 Dated: April 26, 2021 By: ii ALL Name: ake R-a.- Title: • .•- u< .• l [CONTRACTOR SIGNATURES MUST BE NOTARIZED. IF CONTRACTOR IS A CORPORATION OR LIMITED LIABILITY COMPANY, TWO SIGNATURES MUST BE PROVIDED.] Agreement ]300-5 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of San Bernardino } On April 26, 2021 before me, I11R ji� IQV Lr) iWL tAii iC (Here insert name and title of the o cer) personally appeared Jason G. Jones who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s-) is re subscribed to the within instrument and acknowledged to me that 1D-he/they executed the same in Co er/their authorized capacity(ies), and that by I& er/their signature(s) on the instrument the person(s-), or the entity upon behalf of which the person(sj acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ?+ ANGELICA JIMOV WITNE my han• and official seal.sr `'� eV , . * �i: NotaryPublic-California ' ".. �• Riverside County / ' ". % Commission#2200821 A . t �' ""'m, My Comm.Expires Jun 9,2021 Notary Public SI:flair" (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed.should be completed and attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. he/she/they, is/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. CI Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact + Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document,number of pages and date. 0 . Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). www.NotaryClasses.com 800-873-9865 • Securely attach this document to the signed document with a staple. . . CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity , of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California 1 }1 County of San Bernardino . On April 26, 2021 before me, APO CPO j )\/, '110 R7; i(' fosertan.mle of thtie o cer i j personally appeared Jake Reade , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s)Oare subscribed to the within instrument and acknowledged to me that 4D-he/they executed the same in OD? er/their authorized capacity(ies), and that by er/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Il I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ..,,.,•,..„4 ANGELICA JIMOV WITNE m Id fl(21 official seal. 1 NotaRry Pubidlicalniftornia .j \ - c' 1.' Commission#2200821 - ',r.'s• My Comm.Expires Jun 9,2021 Notary Public Sig ture v 1uv(Notary Public Seal) • _ • INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her 1 Number of Pages Document Date commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. he/she/they, is Awe)or circling the correct forms.Failure to correctly indicate this 0 Individual (s) information may lead to rejection of document recording. El Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of 0 Partner(s) • the county clerk. El Attorney-in-Fact 4. Additional information is not required but could help to ensure this ID Trustee(s) acknowledgment is not misused or attached to a different document. • Indicate title or type of attached document,number of pages and date. 0 Other -,) Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). www.NotaryClasses.corn 800-873-9865 • Securely attach this document to the signed document with a staple. ,_ _ ' I Executed in Duplicate Bond No. 24252267 Premium: $9,737.00 SECTION 1310 FAITHFUL PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: THAT the City of Cathedral City, a municipal corporation, hereinafter designated the City, has, on , 2021, awarded to Matich Corporation hereinafter designated as the Principal, a Contract for Bid No. B21-01E, Whitewater Neighborhood Street Improvements, Phase II (C08833) and Whispering Palms Neighborhood Street Rehab. (C08831), and WHEREAS, said Principal is required under the terms of said Contract to furnish a bond for the faithful performance of said Contract: NOW, THEREFORE, we, the Principal, and Liberty Mutual Insurance Company , as Surety, are held and firmly bound unto the City in the just and full amount of ( $1,475,318.00 _) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if said Principal, his or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and abide by, and well and truly keep and faithfully perform the covenants, conditions, and agreements in the said contract and any alterations made as therein provided, on his or their part to be kept and performed, at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless, the City, its officers and agents as therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and virtue. It is acknowledged that the Contract provides for one-year guarantee period, during which time this bond remains in full force and effort. And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the Contract or to the work to be performed thereunder or the specifications accompanying the same shall, in any way, affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration, or addition to the terms of the Contract or to the work or to the specifications. Said Surety hereby waives the provisions of Sections 2819 and 2845 of the Civil Code of the State of California. THE REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK Faithful Performance Bond 1310-1 IN WITNESS WHEREOF, the Principal and Surety have executed this instrument under their seals this 23rd day of April , 2021, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. Matich Corporation Principal (Seal) / Signature for Principal .', a • C n 3 ov - Title of Signatory - V Liberty Mutual insurance Company Surety (Seal) Signature r Surety Reece Joel Diaz,Attorney-in-Fact Title of Signatory 790 The City Drive South, Suite 200, Orange, CA 92868 Address of Surety (714)634-5719 Phone#of Surety Mike Forman Contact Person For Surety Faithful Performance Bond 1310-2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 ..<r.r ., :,<;.a!::4 s;ri,r"i:«s«....i.<.nf!-, >.<.rNnr.nNr..-+�<.,<!s\<!;:c'4.( ::e.:...ace!sit/•:.•!G\<s.<!.<!re's.ca\¢!s\e s.:•:..rlr:<.<;e!a;<.n{..\N.:e/ A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Orange On APR l before me, Heather Rose Saltarelli,Notary Public Date Here Insert Name and Title of the Officer personally appeared __- Reece Joel Diaz Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. HEATHER ROSE SALTARELLI WITNESS my hand and official seal. Notary Public-California�`� Orange County /� /�' ,'{'�'o Commission!t 2248219 Signature UUP , My Comm.Expires Jul 27, 2022 Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _ Document Date. Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: -__ __. Signer's Name: Corporate Officer — Title(s): Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual X Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 4Y 4\�'<\V �;4r ti+/G\d -bGYfb4'YG✓ - _ b YG Y a:..1 ©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 ' This Power of Attorney limits the acts of those named herein,and they have no authority to sr bind the Company except in the manner and to the extent herein stated. sit r�, '- Liberty Liberty Mutual Insurance Company r� ' Mutual® The Ohio Casualty Insurance Company Certificate No:8205053-977460 / West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Heather Saltarelli;James Schaller:Jeri Apodaca;Kim Luu:Leigh McDonough;Maria Guise;Michael D.Parizino;Natalie Trofimoff,Rachelle Rheault;Reece Joel Diaz; Rhonda C.Abel all of the city of Newport Beach state of CA each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IIN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 18th day of March , 2021 . Liberty Mutual Insurance Company V\NStJR o' INS0p trisub The Ohio Casualty Insurance Company A,2OOPPOk1.'14m Q 2`owPO/7,OTF�y� ,SI,CPP +c, West American Insurance Company 1912 0 0 1919 o , '' 1991 dU�� ..0 � MPa3 iU O a .? 4GNS .da ! al 8j) * ):C4' 'NI * ),.‘k M * 0 By: ,a 12 David M.Carey,Assistant Secretary a C CO State of PENNSYLVANIA ss •-C = 2County of MONTGOMERY o E On this 18th day of March , 2021 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance u ami o Tu Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such, being authorized so to do,execute the foregoing instrument for the purposes''-'-7-- m > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. > IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. Oa c•( tl 0 CIS a)O P S Q�4y MON F rF.. Commonwealth of Pennsylvania-Notary Seal T= tp off' Q<�, Teresa Pastella,NotaryPublic a)', �' z• 9 Montgomery County O N OF My commission expires March 26,2025 B �O N C co g Commission number 1126044 y 4eaPastelIa, Member,PennsylvaniaAssocatonofNotaries Notary Public Q O ca N qRv 1,00- v . This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual ccoo E.- Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a co ARTICLE IV—OFFICERS:Section 12.Power of Attorney. o o o Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the-0 m a President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety a,C° >TO c any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall -a o have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such Q a) z 0instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the (15 provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. LL Q ARTICLE XIII—Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of APR 2 3, n21 V tNSUR 08 INse,,p Cv.. 14sia PGUwPOR4roym ,PcOaPO�ro yn aPOR4r y0x1912 n oU 1919 991v� . c. �'S'�Z 4, o o ...95''40 NU` ..dt. D Z0��F/AMPsa aa$* /01ANPy By:Renee C.Llewel n Assistant a,7 * �a Hyl * *� --*7- Llewellyn, Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02/21 } Executed in Duplicate Bond No. 24252267 Premium: Included in Performance Bond SECTION 1320 PAYMENT BOND ( KNOW ALL MEN BY THESE PRESENTS: THAT the City of Cathedral City, a municipal corporation, hereinafter designated the City, has, on___ 2021, awarded to Matich Corporation hereinafter designated as the Principal, a Contract for Bid No. B21-01E, Whitewater Neighborhood Street Improvements, Phase II (C8833) and Whispering Palms Neighborhood Street Rehab. (C08831), and WHEREAS, said Principal is required to furnish a bond in connection and with said Contract, providing that if said Principal, or any of it or its subcontractors shall fail to pay for any materials, provisions, or other supplies used in, upon, for, or about the performance of the work contracted to be done, or for any work or labor done thereon of any kind, the Surety of this bond will pay the same to the extent hereinafter set forth: NOW, THEREFORE, we, the Principal, and Liberty Mutual Insurance Company as Surety, are held and firmly bound unto the City in the just and full amount of ( $1,475,318.00 ), executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if said Principal, it or its heirs, executors, administrators, successors, or assigns, shall fail to pay for any materials, provisions, or other supplies used in, upon, for, or about the performance of the work contracted to be done, or for any work or labor thereon of any kind or for amount due under the Unemployment Insurance Act with respect to such work or labor, or for any amounts due, or to be withheld pursuant to Sections 18806 of the Revenue and Taxation Code of the State of California with respect to such work or labor, then said surety will pay the same in or to an amount not exceeding the amount hereinabove set forth, and also will pay in case suit is brought upon this bond, such reasonable attorney's fees to the City as shall be fixed by the court. This bond shall insure to the benefit of any and all persons, companies, and corporations named in Section 3181 of the Civil Code of the State of California so as to give a right of action to them or their assigns in any suit brought upon this bond. And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or addition of the terms of the Contract or to the work to be performed thereunder or the specifications accompanying the same shall, in any way, affect its obligations of this bond, and it does hereby waive notice of any change, extension of time, alteration, or addition to the terms of the contract or to the work or to the specifications. Said Surety hereby waives the provisions of Sections 2819 and 2845 of the Civil Code of the State of California. THE REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK Payment Bond 13204 . IN WITNESS WHEREOF, the Principal and Surety have executed this instrument under their seals this 23rd day of April _ , 2021, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. Matich Corporation Principal (Seal) i I Signature for Prin al f4v\ & . oi—es \/► VrescL �r-E-- Title of Signatory Liberty Mutual Insurance Company Surety (Seal) Signature Surety Reece Joel Diaz, Attorney-in-Fact Title of Signatory 790 The City Drive South, Suite 200,Orange, CA 92868 Address of Surety (714)634-5719 Phone#of Surety Mike Forman Contact Person For Surety I Payment Braid 1320-2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVILDE CO § 1189 •.tl�4Nr �..,�...s.Nwf.Al,Tt T<!ri<.T<.►.f.A<rw.wf.f.NTt,T .rte te v:ev:t"s:t!L.tai..t�::NrC:oN1.<ess<,Qt,...A. :t.•i<A,..vs<. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Orange On APR r _ before me, Heather Rose Saltarelli,Notary Public Date Here Insert Name and Title of the Officer personally appeared Reece Joel Diaz Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. HEATHER ROSE SALTARELLI -�j,Q r� ' •' Notary Public-California Signature f(1 Vw f:2"014t0149)-j2e rOrange County Commission#2248119 Signature of Notary Public i•�n.urw`. My Comm.Expires Jul 27,2022 Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: Corporate Officer — Title(s): Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual x Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: _ �]Csui.., GSiL >'t, G Y N<Y v4.••--G ei 4�a G�vG-V 4.,4,,' - Y V ' r ✓ - a 'S�tr'SaCiS_G.S.lCiY ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 w„ ' This Power of Attorney limits the acts of those named herein,and they have no authority to n bind the Company except in the manner and to the extent herein stated. 1`4% Liberty Liberty Mutual Insurance Company Oil Mutual® The Ohio Casualty Insurance Company Certificate No:8205053-977460 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Heather Saltarelli:James Schaller;Jeri Apodaca;Kim Luu;Leigh McDonough;Maria Guise;Michael D.Parizino;Natalie Trofimoff;Rachelle Rheault;Reece Joel Diaz; Rhonda C.Abel all of the city of Newport Beach state of CA each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 18th day of March , 2021 . Liberty Mutual Insurance Company %NStj .0 INso \NSU, The Ohio Casualty Insurance Company /JP`09-"P4j,940 yJ c0101°R4,%. cYs�P,,oaPOR4, "Pc-, West American Insurance Company 3 Fo rn Q 3 Fo Ct 2 Fo m 1912 0 1919 1991 0 ":71., /� a) Y 9f, 4'y t .1-,Z� PW O 6 I,IN7 N O dJl S4 eHuS da �NAmps�,Aa3 vs RN°IANP da • U 9zi * t,� �h'1 * 0 'M * 0 By: .- c - co — David M.Carey,Assistant Secretary 0-D :� to State of PENNSYLVANIA ss _ = 1t2 m County of MONTGOMERY o E, On this 18th day of March , 2021 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o=n o m Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such, being authorized so to do,execute the foregoing instrument for the purposes 0 > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. > IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. tY ¢O c.c @O N 9P PAS2. 1O FN6oNw ' Commonwealth of Pennsylvania-Notary Seal ((" F 8 Mn commission expires March 28,2025 By: O N C co ��P Commission number 1126044 w, syLJQ' , Member,Pennsylvania Association of Notaries eresa Pastella,Notary Public Q O cco 4qy 1305v '6,D co This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual cn 45 3 co E.E Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a c- ARTICLE IV-OFFICERS:Section 12.Power of Attorney.8 alo Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the-a o 72 President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety coC° co c any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall-o 3 have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such O at Z c.) instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the co provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. 0ti a ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. D c ' /I I IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of to 11� 1NSUR ��Y INStj \NSUR ,.....,,,,p0&,;%. ......,Y-.JPcoaPOR,q;Cti2, c 20°aPOR,,,, C. �f / 21912 o 0 21919 1991�� o .....7c.441-4.1"-- );•,k '�s,`_ d�9s'TACMU`��.e' �Z��NAMPSa„., 'l RNDIANP D3 By: C.�'�'�7� 6)7 * 0 ,y1 * P.‘..4 �d s'41 * ,fid Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02/21 SECTION 1330 WORKERS' COMPENSATION INSURANCE CERTIFICATE In accordance with California Labor Code Section 1861 , prior to commencement of work on the Contract, the Contractor shall sign and file with the City the following certification: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract." Signature V/Gt P ssPe,vr Title Aeg/L Z(D, Zi Date Workers'Compensation Insurance 1330-1 SECTION 1340 LIABILITY AND INSURANCE REQUIREMENTS 1.0 INDEMNIFICATION Contractor shall defend, indemnify and hold harmless the City, City Council and each member thereof, and every officer, employee and agent of City, from any claim, demand, damage, liability, loss, cost or expense (including, without limitation, attorney's fees and costs) arising from any intentional, reckless, negligent, or otherwise wrongful acts, errors or omissions of the Contractor, or any of the Contractor" employees, or any of its subcontractors arising out of work under this Contract. The City does not, and shall not, waive any rights that it may have against Contractor, any of the Contractor's employees, or any of its subcontractors under this Section because of the acceptance by the City, or the deposit with the City, of any insurance policy or certificate required pursuant to this Contract. The hold harmless, indemnification and duty to defend provisions of this Section shall apply regardless of whether or not said insurance policies are determined to be applicable to the claim, demand, damage, liability, loss, cost or expense described herein. The City will not be liable for any accident, loss, or damage to the work prior to its completion and acceptance. 2.0 INSURANCE REQUIREMENTS 2.1 General After award of Contract, the Contractor shall promptly obtain, at its own expense, all the insurance required by Paragraph 1340-2.0, INSURANCE REQUIREMENTS, and shall submit coverage verification for review and approval by the City upon execution of the Contract. The Notice to Proceed with the Work under this Contract will not be issued, and the Contractor shall not commence work, until such insurance has been approved by the City. The Contractor shall not allow any subcontractors to commence work on its subcontract until all similar insurance required of the subcontractor has been obtained and verified by Contractor. Such insurance shall remain in full force and effect at all times during the prosecution of the Work and until the final completion and acceptance thereof. The Notice to Proceed does not relieve the Contractor of the duty to obtain such insurance as required by Paragraph 1340-2.0 INSURANCE REQUIREMENTS. 2.2 Commercial General Liability Policy The Contractor shall take out and maintain during the life of the Contract, a Commercial General Liability Policy, on an occurrence basis, with a minimum limit of not less than One Million Dollars ($1,000,000) combined single limit for bodily injury and property damage for any one occurrence and a Two Million Liability&Insurance Requirements 1340-1 Dollar ($2,000,000) annual project aggregate, for all of the following: a. Premises Operations, including Explosion, Collapse and Underground (X, C, and U) Coverage. b. Completed Operations/Products, including X, C, and U Coverage. c. Independent Contractors. d. Blanket Contractual. e. Deductible shall not exceed One Thousand Dollars ($1,000). 2.3 Commercial Business Auto Policy The Contractor shall take out and maintain during the life of this Contract a Commercial Business Auto Policy, on an occurrence basis, with a minimum amount of not less than One Million Dollars ($1,000,000) combined single limit for bodily injury and property damage, providing at least all of the following coverage: a. Coverage shall be applicable to any and all leased, owned, hired, or non-owned vehicles used in pursuit of any of the activities associated with this Contract. b. Any and all mobile equipment, including cranes, which is not covered under said Commercial Business Auto Policy shall have said coverage provided for under the Commercial General Liability Policy. c. Deductible shall not exceed One Thousand Dollars ($1 ,000). 2.4 Workers' Compensation Insurance The Contractor shall take out and maintain during the life of the Contract, Worker's Compensation and Employers' Liability insurance providing coverage for any and all employees of Contractor: a. The required policy shall provide coverage for Workers' Compensation (Coverage A). b. This policy shall provide coverage for One Million Dollars ($1,000,000) Employers' Liability (Coverage B). 2.5 Endorsements All of the following endorsements are required to be made a part of the policies described in this Section hereof: a. "The City, City employees and officers, the City Engineer, its consultants, elected officials, agents, and sub-consultants are hereby added as Liability &Insurance Requirements 1340-2 additional insured insofar as Work done under this Contract is concerned." b. "This policy shall be considered primary insurance as respects any other valid and collectible insurance, including self-insured retention, the City may possess, and any other insurance the City does possess shall be considered excess insurance only." c. "This insurance shall act for each insured, and additional insured, as though a separate policy had been written for each. This, however, will not act to increase the limit of liability of the insuring company. d. "Thirty (30) days prior written notice of cancellation shall be given to the City. Such notice shall be sent to: Tami E. Scott, Administrative Services Director City of Cathedral City 68-700 Avenida Lalo Guerrero Cathedral City, CA 92234 2.6 Change in Terms The Contractor shall provide immediate written notice to the City of any change in terms and conditions and/or reduction in the coverage of any nature to the insurance policies. The notice shall be sent to the location identified in Paragraph 1340-2.6.d, Endorsements. The Contractor shall be obligated to pay any extra premium for maintaining the insurance requirements specified herein. Liability&Insurance Requirements 1340-3 ACORDCERTIFICATE OF LIABILITY INSURANCE DATE(MM/ AE(MM/ DTYYYY) 021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Alliant Insurance Services, Inc. PHONE Alexis Berlanga FAX 1301 Dove Street, Suite 200 INC.No.Extl:949-660-5965 (A/C,No): Newport Beach CA 92660-2436 ADDRESS: aberlanga@alliant.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Executive Risk Indemnity Inc 35181 INSURED INSURER B:Federal Insurance Company 20281 Matich Corporation 1596 Harry Shepard Blvd. INSURER C:Great American Insurance Compa 16691 San Bernardino CA 92408 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:972409340 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRLTYPE OF INSURANCE INSD DDL SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDDIYYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY 54303169 7/1/2020 7/1/2021 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $100,000 MED EXP(Any one person) $5,000 _ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X ECT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: Deductible $5,000 B AUTOMOBILE LIABILITY 54303168 7/1/2020 7/1/2021 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) _ X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) _ C UMBRELLA LIAB X OCCUR TUE405725714 7/1/2020 7/1/2021 EACH OCCURRENCE $25,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $25,000,000 DED RETENTION$ $ g WORKERS COMPENSATION 54303170 7/1/2020 7/1/2021 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Contract#621-01E,Matich Job#21-014,Whitewater Neighborhood Street Improvements Phase II(C08833)and Whispering Palms Neighborhood Street Rehab.(C08831). City of Cathedral City,City employees and officers,the City Engineer,its consultants,elected officials,agents,and sub-consultants are named as Additional Insured per attached endorsements on Primary and Non-Contributory basis.Thirty(30)Days Notice of Cancellation/Non-Renewal—Ten(10)Days Notice For Non-Payment of Premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Cathedral City 68-700 Avenida Lalo Guerrero Cathedral City CA 92234 AUTHORIZED REPRESENTATIVE I . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Policy No.: 54303169 COMMERCIAL GENERAL LIABILITY CG 20 38 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured: additional insureds, the following additional 1. Any person or organization for whom you are exclusions apply: performing operations when you and such This insurance does not apply to: person or organization have agreed in writing 1. "Bodily injury", "property damage" or "personal in a contract or agreement that such person or and advertising injury" arising out of the organization be added as an additional insured rendering of, or the failure to render, any on your policy; and professional architectural, engineering or 2. Any other person or organization you are surveying services, including: required to add as an additional insured under a. The preparing, approving, or failing to the contract or agreement described in prepare or approve, maps, shop drawings, Paragraph 1. above. opinions, reports, surveys, field orders, Such person(s) or organization(s) is an additional change orders or drawings and insured only with respect to liability for "bodily specifications; or injury", "property damage" or "personal and b. Supervisory, inspection, architectural or advertising injury"caused, in whole or in part, by: engineering activities. a. Your acts or omissions; or This exclusion applies even if the claims against b. The acts or omissions of those acting on any insured allege negligence or other wrongdoing your behalf; in the supervision, hiring, employment, training or in the performance of your ongoing operations for monitoring of others by that insured, if the the additional insured. "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused However, the insurance afforded to such the "personal and advertising injury", involved the additional insured described above: rendering of, or the failure to render, any a. Only applies to the extent permitted by law; professional architectural, engineering or and surveying services. b. Will not be broader than that which you are 2. "Bodily injury" or "property damage" occurring required by the contract or agreement to after: provide for such additional insured. a. All work, including materials, parts or A person's or organization's status as an equipment furnished in connection with additional insured under this endorsement ends such work, on the project (other than when your operations for the person or service, maintenance or repairs) to be organization described in Paragraph 1. above are performed by or on behalf of the additional completed. insured(s) at the location of the covered operations has been completed; or CG 20 38 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 2 b. That portion of"your work" out of which the 2. Available under the applicable Limits of injury or damage arises has been put to its Insurance shown in the Declarations; intended use by any person or organization whichever is less. other than another contractor or subcontractor engaged in performing This endorsement shall not increase the operations for a principal as a part of the applicable Limits of Insurance shown in the same project. Declarations. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III—Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 38 04 13 POLICY NUMBER: 54303169 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Where required by written contract All locations where required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 • C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: 54303169 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Where required by written contract, but only when All locations where required by written contract. coverage for completed operations is specifically required by that contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III— Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 ❑❑LI❑ ❑❑M-❑❑L54303169 COMMERCIAL GENERAL LIABILITY 10-02-2461 (Ed. 7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE FOR SCHEDULED ADDITIONAL INSURED his endorse ent odi ies insurance ro ided under the ollowin ❑❑MML__ A _LlEGA❑❑A❑®❑ ❑❑❑L_A A SCHEDULE Additional Insured: Location Of Covered Operations: Where required by written contract. All Locations. no entry a ears abo e in or ation required to co❑Bete this endorse ent will be shown in the eclarations as a licable to this endorse ent. With resect only to the Additional nsured and at the location ❑❑ ❑olered a Lerations shown in the ❑chedule-the .ollowin❑ is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS Lara ra h 4. Other Insurance and su ersedes any LIoision to the contraryl Primary And Noncontributory Insurance [his insurance is 0'i❑ary to and will not see contribution ToLi any other insurance a ailable to the Additional nsured with resect to the location ❑❑❑oLered ❑❑erations shown in the ❑ched ule under this Lolicy D-oCided that (1) Che Additional nsured is a nal ed insured under such other insurance and (2) Lou hale a reed in writini in a contract or a"reel ent that this insurance would be Lri_ary and would not see❑contribution To❑ any other insurance aLeilable to the Additional nsured. 10-02-2461 (Ed. 7-15) ncludes colyriChted aterial o_nsurance ❑erIces ❑Lce❑Ttc.= Page 1 of 1 with its Ler❑ission. POLICY NUMBER: 54303169 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All of your designated construction project where required by written contract. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by "occur- damages or under Coverage C for medical rences" under Section I—Coverage A, and for all expenses shall reduce the Designated Con- medical expenses caused by accidents under struction Project General Aggregate Limit for Section I — Coverage C, which can be attributed that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General Ag- construction project shown in the Schedule gregate Limit shown in the Declarations nor above: shall they reduce any other Designated Con- 1. A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- any other designated construction project ignated construction project, and that limit is shown in the Schedule above. equal to the amount of the General Aggregate 4. The limits shown in the Declarations for Each Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, ex- General Aggregate Limit shown in the Decla- cept damages because of "bodily injury" or rations, such limits will be subject to the appli "property damage" included in the "products- cable Designated Construction Project Gen completed operations hazard", and for medi- eral Aggregate Limit. cal expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 2 0 B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "occur- "products-completed operations hazard" is pro- rences" under Section I—Coverage A, and for all vided, any payments for damages because of medical expenses caused by accidents under "bodily injury" or "property damage" included in Section I — Coverage C, which cannot be attrib- the "products-completed operations hazard" will uted only to ongoing operations at a single des- reduce the Products-completed Operations Ag- ignated construction project shown in the Sched- gregate Limit, and not reduce the General Ag- ule above: gregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed, or abandoned under the General Aggregate Limit or the and then restarted, or if the authorized contract- Products-completed Operations Aggregate ing parties deviate from plans, blueprints, de- Limit, whichever is applicable; and signs, specifications or timetables, the project will 2. Such payments shall not reduce any Desig- still be deemed to be the same construction pro- nated Construction Project General Aggre- ject. gate Limit. E. The provisions of Section III — Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 ©Insurance Services Office, Inc., 2008 CG 25 03 05 09 0 t L Policy No.: 54303169 b. Those statements are based upon a. Copyrighted "advertisement"; or representations you made to us; and b. Registered collective mark, registered service c. We have issued this policy in reliance upon mark or other registered trademarked name, your representations. slogan, symbol or title. 7. Separation Of Insureds 3. "Asbestos" means asbestos in any form, including Except with respect to the Limits of Insurance, and its presence or use in any alloy, by-product, any rights or duties specifically assigned in this compound or other material or waste. Waste Coverage Part to the first Named Insured, this includes materials to be recycled, reconditioned or insurance applies: reclaimed. a. As if each Named Insured were the only 4. "Auto" means: Named Insured; and a. A land motor vehicle, trailer or semitrailer b. Separately to each insured against whom designed for travel on public roads, including claim is made or"suit" is brought. any attached machinery or equipment; or 8. Transfer Or Waiver Of Rights Of Recovery b. Any other land vehicle that is subject to a Against Others To Us compulsory or financial responsibility law or We will waive the right of recovery we would other motor vehicle insurance law where it is otherwise have had against another person or licensed or principally garaged. organization, for loss to which this insurance However, "auto" does not include "mobile applies, provided the insured has waived their equipment". rights of recovery against such person or 5."Bodily injury" means physical: organization in a contract or agreement that is a. Injury; executed before such loss. To the extent that the insured's rights to recover b. Sickness; or all or part of any payment made under this c. Disease; Coverage Part have not been waived, those rights sustained by a person, including resulting death, are transferred to us. The insured must do nothing humiliation, mental anguish, mental injury or shock after loss to impair them. At our request, the at anytime. All such loss shall be deemed to insured will bring "suit" or transfer those rights to g occur at the time of the physical injury, sickness or us and help us enforce them. disease that caused it. This condition does not apply to Coverage C. 6. "Coverage territory"means: 9. When We Do Not Renew a. The United States of America (including its If we decide not to renew this Coverage Part, we territories and possessions), Puerto Rico and will mail or deliver to the first Named Insured Canada; shown in the Declarations written notice of the b. International waters or airspace, but only if the nonrenewal not less than 30 days before the injury or damage occurs in the course of travel expiration date. or transportation between any places included If notice is mailed, proof of mailing will be sufficient in Paragraph a. above; or proof of notice. c. All other parts of the world if the injury or SECTION V—DEFINITIONS damage arises out of: 1. "Advertisement" means an electronic, oral, written (1) Goods or products made or sold by you in or other notice, about goods, products or services, the territory described in Paragraph a. designed for the specific purpose of attracting the above; general public or a specific market segment to use (2) The activities of a person whose home is in such goods, products or services. the territory described in Paragraph a. "Advertisement" does not include any e-mail above, but is away for a short time on your address, Internet domain name or other electronic business; or address or metalanguage. (3) "Advertising injury" or "personal injury" 2. "Advertising injury" means injury, other than offenses that take place through the "bodily injury", "property damage" or "personal Internet or similar electronic means of injury", sustained by a person or organization and communication caused by an offense of infringing, in that particular part of your "advertisement" about your goods, products or services, upon their: Form 10-02-1800 (Rev. 09- Includes copyrighted material of ISO Properties, Inc., with Page 13 of 17 17) its permission Auto Policy No.: 54303168 COMMERCIAL AUTOMOBILE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM borrow in your business or your personal This endorsement modifies the Business Auto Coverage Form. affairs. 1. EXTENDED CANCELLATION CONDITION C. Lessors as Insureds Paragraph A.2.b.—CANCELLATION -of the Paragraph A.1.—WHO IS AN INSURED—of COMMON POLICY CONDITIONS form IL 00 17 is SECTION II—LIABILITY COVERAGE is deleted and replaced with the following: amended to add the following: b. 60 days before the effective date of cancellation if e. The lessor of a covered"auto"while the we cancel for any other reason. "auto" is leased to you under a written 2. BROAD FORM INSURED agreement if: A. Subsidiaries and Newly Acquired or Formed (1) The agreement requires you to Organizations As Insureds provide direct primary insurance for The Named Insured shown in the Declarations is the lessor; and amended to include: (2) The "auto" is leased without a driver. 1. Any legally incorporated subsidiary in which Such leased "auto"will be considered a you own more than 50%of the voting stock on covered "auto"you own and not a covered the effective date of the Coverage Form. "auto"you hire. However, the Named Insured does not include However, the lessor is an "insured"only any subsidiary that is an "insured" under any for"bodily injury"or"property damage" other automobile policy or would be an resulting from the acts or omissions by: "insured" under such a policy but for its 1. You; termination or the exhaustion of its Limit of 2. Any of your"employees"or agents; Insurance. or 2. Any organization that is acquired or formed by 3. Any person, except the lessor or you and over which you maintain majority any"employee" or agent of the ownership. However, the Named Insured lessor, operating an "auto"with the does not include any newly formed or acquired permission of any of 1. and/or 2. organization: above. (a)That is an"insured" under any other D. Persons And Organizations As Insureds automobile policy; Under A Written Insured Contract (b)That has exhausted its Limit of Insurance Paragraph A.1 —WHO IS AN INSURED—of under any other policy; or SECTION II—LIABILITY COVERAGE is (c) 180 days or more after its acquisition or amended to add the following: formation by you, unless you have given f. Any person or organization with respect to us written notice of the acquisition or the operation, maintenance or use of a formation. covered "auto", provided that you and Coverage does not apply to"bodily injury"or such person or organization have agreed "property damage"that results from an "accident" under an express provision in a written that occurred before you formed or acquired the "insured contract",written agreement or a organization. written permit issued to you by a B. Employees as Insureds governmental or public authority to add Paragraph A.1.—WHO IS AN INSURED—of such person or organization to this policy SECTION II—LIABILITY COVERAGE is amended to as an"insured". add the following: However, such person or organization is d. Any"employee"of yours while using a an "insured" only: covered "auto"you don't own, hire or Form: 16-02-0292 (Rev. 11-16) Page 1 of 3 "Includes copyrighted material of Insurance Services Office, Inc.with its permission" (1) with respect to the operation, d. Rental Expense maintenance or use of a covered We will pay the following expenses that you or "auto"; and any of your"employees" are legally obligated (2) for"bodily injury" or"property damage" to pay because of a written contract or caused by an "accident"which takes agreement entered into for use of a rental place after: vehicle in the conduct of your business: (a) You executed the "insured MAXIMUM WE WILL PAY FOR ANY ONE contract" or written agreement; or CONTRACT OR AGREEMENT: (b) The permit has been issued to 1. $2,500 for loss of income incurred by the you. rental agency during the period of time that 3. FELLOW EMPLOYEE COVERAGE vehicle is out of use because of actual EXCLUSION B.S. - FELLOW EMPLOYEE—of damage to, or"loss"of, that vehicle, including SECTION II— LIABILITY COVERAGE does not apply. 4. PHYSICAL DAMAGE—ADDITIONAL TEMPORARY income lost due to absence of that vehicle for TRANSPORTATION EXPENSE COVERAGE use as a replacement; Paragraph A.4.a.—TRANSPORTATION EXPENSES 2. $2,500 for decrease in trade-in value of the —of SECTION III— PHYSICAL DAMAGE rental vehicle because of actual damage to COVERAGE is amended to provide a limit of$50 per that vehicle arising out of a covered "loss"; and day for temporary transportation expense, subject to a 3. $2,500 for administrative expenses incurred maximum limit of$1,000. by the rental agency, as stated in the contract 5. AUTO LOAN/LEASE GAP COVERAGE or agreement. Paragraph A. 4. —COVERAGE EXTENSIONS - of 4. S7,500 maximum total amount for paragraphs SECTION III— PHYSICAL DAMAGE COVERAGE is 1., 2. and 3. combined. amended to add the following: 7. EXTRA EXPENSE—BROADENED COVERAGE c. Unpaid Loan or Lease Amounts Paragraph A.4. —COVERAGE EXTENSIONS—of In the event of a total "loss"to a covered "auto", we will SECTION III —PHYSICAL DAMAGE COVERAGE pay any unpaid amount due on the loan or lease for a is amended to add the following: covered "auto" minus: e. Recovery Expense 1. The amount paid under the Physical Damage We will pay for the expense of returning a Coverage Section of the policy; and stolen covered "auto" to you. 2. Any: 8. AIRBAG COVERAGE a. Overdue loan/lease payments at the time of Paragraph B.3.a. - EXCLUSIONS—of SECTION the "loss"; III— PHYSICAL DAMAGE COVERAGE does not b. Financial penalties imposed under a lease for apply to the accidental or unintended discharge of excessive use, abnormal wear and tear or an airbag. Coverage is excess over any other high mileage; collectible insurance or warranty specifically c. Security deposits not returned by the lessor: designed to provide this coverage. d. Costs for extended warranties, Credit Life 9. AUDIO, VISUAL AND DATA ELECTRONIC Insurance, Health, Accident or Disability EQUIPMENT - BROADENED COVERAGE Insurance purchased with the loan or lease; Paragraph C.1.b. —LIMIT OF INSURANCE- of and SECTION III - PHYSICAL DAMAGE is deleted e. Carry-over balances from previous loans or and replaced with the following: leases. b. $2,000 is the most we will pay for"loss" in any We will pay for any unpaid amount due on the loan or one "accident"to all electronic equipment that • lease if caused by: reproduces, receives or transmits audio, visual 1. Other than Collision Coverage only if the or data signals which, at the time of"loss", is: Declarations indicate that Comprehensive (1) Permanently installed in or upon the Coverage is provided for any covered "auto"; covered "auto" in a housing, opening or 2. Specified Causes of Loss Coverage only if the other location that is not normally used by Declarations indicate that Specified Causes of the "auto" manufacturer for the installation Loss Coverage is provided for any covered "auto"; of such equipment; or (2) Removable from a permanently installed 3. Collision Coverage only if the Declarations indicate housing unit as described in Paragraph that Collision Coverage is provided for any covered "auto. 2.a. above or is an integral part of that 6. RENTAL AGENCY EXPENSE equipment; or Paragraph A. 4. —COVERAGE EXTENSIONS—of (3) An integral part of such equipment. SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: 10. GLASS REPAIR—WAIVER OF DEDUCTIBLE Form: 16-02-0292 (Rev. 11-16) Page 2 of 3 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" Under Paragraph D. - DEDUCTIBLE—of their rights of recovery against such person or SECTION III—PHYSICAL DAMAGE COVERAGE organization under a contract or agreement the following is added: that is entered into before such"loss". No deductible applies to glass damage if the glass To the extent that the"insured's" rights to is repaired rather than replaced. recover damages for all or part of any 11.TWO OR MORE DEDUCTIBLES payment made under this insurance has not Paragraph D.- DEDUCTIBLE—of SECTION III— been waived, those rights are transferred to PHYSICAL DAMAGE COVERAGE is amended to us.That person or organization must do add the following: everything necessary to secure our rights and If this Coverage Form and any other Coverage must do nothing after"accident"or"loss"to Form or policy issued to you by us that is not an impair them.At our request, the insured will automobile policy or Coverage Form applies to the bring suit or transfer those rights to us and same"accident", the following applies: help us enforce them. 1. If the deductible under this Business Auto Coverage Form is the smaller(or smallest) 14. UNINTENTIONAL FAILURE TO DISCLOSE deductible, it will be waived; or HAZARDS 2. If the deductible under this Business Auto Paragraph B.2.—CONCEALMENT, Coverage Form is not the smaller(or smallest) MISREPRESENTATION or FRAUD of SECTION deductible, it will be reduced by the amount of IV—BUSINESS AUTO CONDITIONS- is deleted the smaller(or smallest)deductible. and replaced with the following: If you unintentionally fail to disclose any hazards 12.AMENDED DUTIES IN THE EVENT OF existing at the inception date of your policy, we will ACCIDENT, CLAIM, SUIT OR LOSS not void coverage under this Coverage Form Paragraph A.2.a.- DUTIES IN THE EVENT OF because of such failure. AN ACCIDENT, CLAIM, SUIT OR LOSS of SECTION IV- BUSINESS AUTO CONDITIONS is 15. AUTOS RENTED BY EMPLOYEES deleted and replaced with the following: Paragraph B.S. -OTHER INSURANCE of a. In the event of"accident", claim, "suit"or SECTION IV—BUSINESS AUTO CONDITIONS- "loss", you must promptly notify us when the is amended to add the following: "accident" is known to: e. Any"auto" hired or rented by your"employee" (1) You or your authorized representative, if on your behalf and at your direction will be you are an individual; considered an "auto"you hire. If an (2) A partner, or any authorized "employee's" personal insurance also applies representative, if you are a partnership; on an excess basis to a covered "auto" hired (3) A member, if you are a limited liability or rented by your"employee"on your behalf company; or and at your direction, this insurance will be (4) An executive officer, insurance manager, primary to the"employee's" personal or authorized representative, if you are an insurance. organization other than a partnership or 16. HIRED AUTO—COVERAGE TERRITORY limited liability company. Paragraph B.7.b.(5). - POLICY PERIOD, Knowledge of an "accident", claim, "suit"or COVERAGE TERRITORY of SECTION IV— "loss"by other persons does not imply that the BUSINESS AUTO CONDITIONS is deleted and persons listed above have such knowledge. replaced with the following: Notice to us should include: (5)A covered "auto"of the private passenger (1) How,when and where the "accident" or type is leased, hired, rented or borrowed "loss"occurred; without a driver for a period of 45 days or (2) The"insured's" name and address; and less; and (3) To the extent possible, the names and 17. RESULTANT MENTAL ANGUISH COVERAGE addresses of any injured persons or Paragraph C. of-SECTION V—DEFINITIONS is witnesses. 13. WAIVER OF SUBROGATION deleted and replaced by the following: Paragraph A.S.-TRANSFER OF RIGHTS OF "Bodily injury" means bodily injury, sickness or RECOVERY AGAINST OTHERS TO US of disease sustained by any person, including SECTION IV—BUSINESS AUTO CONDITIONS is mental anguish or death as a result of the"bodily deleted and replaced with the following: injury"sustained by that person. 5. We will waive the right of recovery we would otherwise have against another person or organization for"loss"to which this insurance applies, provided the"insured" has waived Form: 16-02-0292 (Rev. 11-16) Page 3 of 3 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" ❑❑I ull❑ ❑❑M❑❑❑C 54303168 COMMERCIAL AUTO 16-02-0316 Ed. 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY LIABILITY INSURANCE _his endorse❑ent ❑odiles insurance ro ided under the ollowin ❑❑❑®❑❑❑A❑❑❑ ❑❑❑❑❑A❑❑ ❑,-' M With res ect to co era-e DoLded by this endorse-entLthe EroEsions o❑the ❑oera❑e Lor, &Ay unless ❑odi ied by the endorse El ent. lihis endorse ent chanes the [blicy efectiCe on the inceLion date oche Colicy unless another date is indicated below. Named Insured: Matich Corporation Endorsement Effective Date: 7/1/2020 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization as where required by written contract prior to loss. n or ation required to co❑Clete this chedule i not shown abo e will be shown in the eclarations. ❑he bllowiniE is added to le- CI ❑[Other InsuranceLo❑[fe- E. ❑[General Conditions❑under [lection m ❑[Business Auto Conditions e. ❑e❑ardless o❑the ❑-odsions o❑❑araDaIh .a. throuDh d. aboe❑[Dr any liability arisin❑ out o the ownershi- -aintenance❑use❑rentalieaseLiloan hire or borrowin by an insured-2°7a coffered _auto_ or which an insured is contractually obli'eted to Ero de LriJ ary insurance co_erale to a client❑this ❑oerae ❑or❑ will be Cri'C ary and nonrcontributory with resect to the ❑ersons or ❑reni ations in the schedule-reerdless oithe a ailability or e istence o other collectible insurance under any other o era e ❑or❑ or ❑olicy that alIlies on a [Hillary basis. 16-02-0316 Ed. 10 14 Page 1 of 1 POLICY NUMBER: #54303168 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Matich Corporation Endorsement Effective Date: 7/1/2020 SCHEDULE Name Of Person(s) Or Organization(s): Any person or ogranization as where required per written contract prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 Policy Number: 54303168 COMMERCIAL AUTO CA99441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LOSS PAYABLE CLAUSE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. We will pay, as interest may appear, you and the Cancellation ends this agreement as to the loss loss payee named in the policy for "loss" to a payee's interest. If we cancel the policy, we will covered "auto". mail you and the loss payee the same advance B. The insurance covers the interest of the loss notice. payee unless the "loss" results from conversion, D. If we make any payments to the loss payee, we secretion or embezzlement on your part. will obtain his or her rights against any other party. C. We may cancel the policy as allowed by the Cancellation Common Policy Condition. CA 99 44 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 99 03 04 (Ed. 7-08) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA This endorseL ent chances the policy to which it is attached errectiCe on the inceltion date ()Tithe policy unless a di-erent date is indicated below. he Jollowin-"attachin clause" need to be co-7eted only when this endorse:ent is issued subsequent to se-:aration 0_the olicy.❑ This endorseTentLeErectiLe on 07/01/2020 at -- -1A. M. standard tiCellorls a Tart oil 7A- Federal Insurance Company Colicy To. 54303170 o-the SAM - _DA',, _-MIA::- issued to Matich Corporation ba.n.2, With Authori ed -e resentatiie We hale the right to recoLer our CayTents roil anyone liable Ger an in Ury col_ered by this -olicy. We will not enLorce our ri_ht ar ainst the Gerson or orraniLation na ed in the Lchedule. :he additional Crer iur Cor the blanLet wailer oCeered by this endorseL ent shall be _Lr- T o:_total LaliLornia Frei iur ,ichedule Person or ❑rLaniCation Cob Tescrirtion Where required by written contract. Where required by written contract. W❑ ❑❑❑❑❑❑Dud. ELME