Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
Contract - Manhole Adjusting, Inc. - 2017-01-10 •
PUBLIC WORKS AGREEMENT
#311 Manhole Surface Repairs— Phase 3
This agreement (hereafter "AGREEMENT") is made and entered into this
i0114 day of Xkt`J , 201_1, by and between the Costa Mesa Sanitary
District, a sanitary district (hereafter "DISTRICT"), and Manhole Adjusting, Inc., a
California corporation (hereafter"CONTRACTOR").
1. Scope of the Work. CONTRACTOR agrees to furnish to DISTRICT all
labor, materials, tools, equipment, services, and incidental and customary work
necessary to fully and adequately perform the services described in Exhibit "A,"
attached hereto and incorporated by reference. The services described in Exhibit "A"
shall be referred to as the "PROJECT." The PROJECT shall be subject to, and
performed in accordance with, this AGREEMENT, the attached exhibits, and all
applicable local, state, and federal laws, rules, and regulations.
2. The Contract Sum. DISTRICT agrees_es to pay and
agrees s to
P Y CONTRACTOR
g accept in full payment for all work
P Y agreed to herein the sum of: Twenty
Thousand Five Hundred Dollars ($20,500.00).
3. Time of Performance and Liquidated Damages. Time is of the essence
of this AGREEMENT. The work shall commence within five (5) days of DISTRICT
issuing a "Notice to Proceed" and shall be completed within Twenty Five (25) working
days thereafter. CONTRACTOR shall forfeit as liquidated damages the amount of Two
Hundred Fifty Dollars ($250) per calendar day to compensate DISTRICT for the loss of
use of the public facility. The parties agree that liquidated damages only measure the
damage to the public caused by loss of use or untimely completion of a public facility
and that actual damages may also be recovered in addition to liquidated damages.
DISTRICT may deduct liquidated damages and actual damages from payments owed to
CONTRACTOR.
4. Extra Work and Change Orders. At any time during the term of this
AGREEMENT, DISTRICT may request that CONTRACTOR perform EXTRA WORK.
"EXTRA WORK" means any work that is necessary for the proper completion of the
PROJECT but which the parties did not reasonably anticipate would be necessary at
the time of execution of this AGREEMENT or work outside of this AGREEMENT that is
requested by DISTRICT. CONTRACTOR shall not perform, nor be compensated for,
EXTRA WORK without a written change order that is authorized and signed by
DISTRICT. The written change order requirement cannot be waived.
1
PWK 30U 12 10
If CONTRACTOR encounters conditions that require EXTRA WORK,
CONTRACTOR must notify DISTRICT in writing in a written change order request
within fifteen (15) days of encountering said conditions. The failure to submit a written
change order request shall constitute a waiver of CONTRACTOR's claim for additional
time or compensation for EXTRA WORK. The written change order requirement cannot
be waived.
The following formula shall be used to measure CONTRACTOR's damages or
EXTRA WORK. CONTRACTOR shall be limited to the following:
Direct costs Mark-up
Labor 20%
Materials 15%
Equipment Rental 15%
Other Items 15%
Subcontracted work 10% (first$5000)
Subcontracted work 5% (work in excess of first
$5000)
Specialty Subcontracting 5% (Provided at least three
(required by EXTRA WORK) competitive bids are
obtained and contractor
selected the lowest bidder)
Excluded from recovery shall be "Eichleay damages" including, but not limited to,
home office overhead, insurance and bonding costs, lost bonding capacity, lost profits,
and lost interest.
CONTRACTOR acknowledges that CONTRACTOR's recovery for damages or
EXTRA WORK is limited as provided in this paragraph.
CONTRACTOR's
Initials Je-
5. Contractor's Performance and Qualifications. CONTRACTOR shall
----------------
perform all services required under this AGREEMENT in a skillful and competent
manner, consistent with the standards generally recognized as being employed by
persons and professionals in the same discipline in the State of California.
CONTRACTOR represents and maintains that it is skilled in the calling necessary to
perform the PROJECT. CONTRACTOR warrants that all employees and
subcontractors have sufficient skill and experience to perform the services assigned to
them. CONTRACTOR represents that it, its employees, and subcontractors have all of
the licenses, permits, qualifications, and approvals that are legally required to perform
the PROJECT, including a City Business License, and that such licenses and approvals
shall be maintained throughout the term of this AGREEMENT. CONTRACTOR agrees
that CONTRACTOR has the contractor's license required to do this job, and any other
2
PWK 30U 12 10
contractor's license requested by DISTRICT, and that CONTRACTOR's License No is:
398443.
6. Bidding. This paragraph only applies if this AGREEMENT was awarded
following a competitive bid. If CONTRACTOR submitted a subcontractors list,
CONTRACTOR may only substitute a listed subcontractor by complying with the
Subletting and Subcontracting Fair Practices Act. (See Public Contract Code §§ 4100
et seq.) CONTRACTOR cannot perform work using a subcontractor who is debarred.
CONTRACTOR hereby assigns unfair business practices claims (Clayton Act and
Cartwright Act) to the DISTRICT. CONTRACTOR declares by signing this
AGREEMENT that CONTRACTOR did not collude to obtain this job. (Public Contract
Code § 7106.)
7. Prevailing Wages. This is a Public Work. (Labor Code § 1781.) This job,
if over One Thousand Dollars ($1,000.00) in value and not exempt, requires compliance
with the prevailing wage law. (Labor Code §§ 1720 et seq.) As such, DISTRICT will
ascertain the prevailing wages to be paid on this job from the Director of Industrial
Relations. Said amounts are listed at http://www.dir.ca.gov/dlsr/pwd/index.htm.
CONTRACTOR understands that CONTRACTOR is required to pay prevailing wages,
unless exempt, and is required to maintain prevailing wage records and comply with
statutory requirements relating to certified copies of payroll records. (Labor Code §
1776.) CONTRACTOR shall defend, indemnify, and hold DISTRICT, its elected
officials, officers, employees, and agents free and harmless from any claim or liability
arising out of any failure or alleged failure to comply with the prevailing wage laws.
CONTRACTOR recognizes that state law makes eight (8) hours a legal day's
work, and any worker workingin of
excess that time must be paid overtime. (Labor
Code
Statutoryprovisions§ 1810.) sions for
p penalties for failure to comply with wage and
hour laws will be enforced. (Labor Code 1775,
§§ 1813.)
CONTRACTOR must comply with statutory requirements relating to the
employment of apprentices. (Labor Code § 1777.5.)
8. Workers' Compensation. CONTRACTOR must secure the payment of
workers' compensation to its employees. (Labor Code § 1860; Civil Code § 3400.) By
signing this AGREEMENT, CONTRACTOR acknowledges the following: •
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.
3
PK 30U 12 10
W
9. Progress Payments. Progress payments may be authorized if this job
will take in excess of thirty (30) days. DISTRICT agrees to promptly make progress
payments on undisputed and properly submitted payment requests within thirty (30)
calendar days and to comply with the provisions of Public Contract Code Section
20104.50.
If this AGREEMENT is for at least Five Thousand Dollars ($5,000.00) and
progress payments are made, DISTRICT will retain five percent (5%) of the total
contract amount until sixty (60) days after the notice of completion is filed. (Public
Contract Code §§ 7107, 9203.) CONTRACTOR may substitute securities in lieu of
retention pursuant to Public Contracts Code Section 22300.
10. Insurance.
A. Time for Compliance. CONTRACTOR shall not commence work
under this AGREEMENT until it has provided evidence satisfactory to DISTRICT that it
has secured all insurance required under this Section. In addition, CONTRACTOR shall
not allow any subcontractor to commence work on any subcontract until it has provided
evidence satisfactory to DISTRICT that the subcontractor has secured all insurance
required under this Section.
B. Minimum Requirements. CONTRACTOR shall, at its expense,
procure and maintain for the duration of the AGREEMENT insurance against claims for
injuries to persons or damage to property which may arise from or in connection with
the performance of the AGREEMENT by CONTRACTOR, its agents, representatives,
employees, or subcontractors. CONTRACTOR shall also require all of its
subcontractors to procure and d maintain the same insurance for the duration of the
AGREEMENT. Such insurance shall meet at least the following minimum levels of
coverage:
i. Minimum Scope of Insurance. Coverage shall be at least
as broad as the latest version of the following: (1) General Liability: Insurance Services
Office Commercial General Liability coverage (occurrence form CG 0001); (2)
Automobile Liability: Insurance Services Office Business Auto Coverage form number
CA 0001, code 1 (any auto); and (3) Workers' Compensation and Employer's Liability:
Workers' Compensation insurance as required by the State of California and Employer's
Liability Insurance.
ii. Minimum Limits of Insurance. CONTRACTOR shall
maintain limits no less than: (1) General Liability: One Million Dollars ($1,000,000.00)
per occurrence for bodily injury, personal injury, and property damage. If Commercial
General Liability Insurance or other form with general aggregate limit is used, either the
general aggregate limit shall apply separately to this AGREEMENT/location or the
general aggregate limit shall be twice the required occurrence limit; (2) Automobile
4
PWK 30U 12 10
Liability: One Million Dollars ($1,000,000.00) per accident for bodily injury and property
damage; and (3) Workers' Compensation and Employer's Liability: Workers'
Compensation limits as required by the Labor Code of the State of California.
Employer's Liability limits of One Million Dollars (51,000,000.00) per accident for bodily
injury or disease.
C. insurance Endorsements. The insurance policies shall contain
the following provisions, and a separate endorsement stating to add the following
provisions to the insurance policies shall be submitted and approved by DISTRICT:
i. General Liability. The general liability policy shall be
endorsed to state that: (1) DISTRICT, its directors, officials, officers, employees,
agents, and volunteers shall be covered as additional insureds with respect to the work
or operations performed by or on behalf of CONTRACTOR, including materials, parts,
or equipment furnished in connection with such work; and (2) the insurance coverage
shall be primary insurance as respects DISTRICT, its directors, officials, officers,
employees, agents, and volunteers, or if excess, shall stand in an unbroken chain of
coverage excess of CONTRACTOR's scheduled underlying coverage. Any insurance
or self-insurance maintained by DISTRICT, its directors, officials, officers, employees,
agents, and volunteers shall be excess of CONTRACTOR's insurance and shall not be
called upon to contribute with it in any way.
ii. Automobile Liability. The automobile liability policy shall
be endorsed to state that: (1) DISTRICT, its directors, officials, officers, employees,
agents, Y
g , and volunteers shall be covered as additional insureds with respect to the
ownership, operation, maintenance, use, loading, or unloading of any auto owned,
leased, hired, or
borrowed byCONTRACTOR OR or for which CONTRACTOR is
responsible; and (2) the insurance coverage shall be primary insurance as respects
DISTRICT, its directors, officials, officers, employees, agents, and volunteers, or if
excess, shall stand in an unbroken chain of coverage excess of CONTRACTOR's
scheduled underlying coverage. Any insurance or self-insurance maintained by
DISTRICT, its directors, officials, officers, employees, agents, and volunteers shall be
excess of CONTRACTOR's insurance and shall not be called upon to contribute with it
in any way.
iii. Workers' Compensation and Employer's Liability
Coverage. The insurer shall agree to waive all rights of subrogation against DISTRICT,
its directors, officials, officers, employees, agents, and volunteers for losses paid under
the terms of the insurance policy which arise from work performed by CONTRACTOR.
iv. All Coverages. Each insurance policy required by this
AGREEMENT shall be endorsed to state that: (A) coverage shall not be suspended,
voided, reduced, or canceled except after thirty (30) days prior written notice by certified
mail, return receipt requested, has been given to DISTRICT; and (B) any failure to
comply with reporting or other provisions of the policies, including breaches of
5
PWK 30U 12 10
warranties, shall not affect coverage provided to DISTRICT, its directors, officials,
officers, employees, agents, and volunteers.
D. Separation of Insureds; No Special Limitations. All insurance
required by this Section shall contain standard separation of insureds provisions. In
addition, such insurance shall not contain any special limitations on the scope of
protection afforded to DISTRICT, its directors, officials, officers, employees, agents, and
volunteers.
E. Deductibles and Self-Insured Retentions. An
deductibles s or
self-insured retentions must be declared to and approved by DISTRICT.
CONTRACTOR shall guarantee that, at the option of DISTRICT, either: (1) the insurer
shall reduce or eliminate such deductiblesself-insured or self insured retentions as respects
DISTRICT, its directors, officials, officers, employees, agents, and volunteers, or (2)
CONTRACTOR shall procure a bond guaranteeing payment of losses and related
investigation costs, claims, and administrative and defense expenses.
F. Acceptability of Insurers. Insurance is to be placed with insurers
with a current A.M. Best's rating of no less than A:VIII, licensed to do business in
California, and satisfactory to DISTRICT.
G. Verification of Coverage. CONTRACTOR shall furnish DISTRICT
with original certificates of insurance and endorsements effecting coverage required by
this AGREEMENT on forms satisfactory to DISTRICT. The certificates and
endorsements for each insurance policy shall be signed by a person authorized by that
insurer to bind coverage on its behalf and shall be on forms provided by DISTRICT if
requested. All certificates and endorsements must be received and approved by
DISTRICT before work commences. DISTRICT reserves the right to require complete,
certified copies of all required insurance policies, at any time.
11. Indemnification. CONTRACTOR shall defend, indemnify, and hold the
DISTRICT, its officials, officers, employees, and agents free and harmless from any and
all claims, demands, causes of action, expenses, liabilities, losses, damages, and
injuries to property or persons, including wrongful death, where the same arise out of,
pertain to, relate to, are a consequence of, or are in any way attributable to, in whole or
in part, the performance of this AGREEMENT by CONTRACTOR or by any individual or
entity for which CONTRACTOR is legally liable, including, but not limited to, officers,
agents, employees, or subcontractors of CONTRACTOR, save and except that caused
by DISTRICT's sole or active negligence or willful misconduct.
12. Bonds. If this PROJECT is over Twenty-Five Thousand Dollars
($25,000.00), CONTRACTOR must post a payment (labor and materials) bond and a
faithful performance bond on DISTRICT's forms. (Civil Code § 9550.) No work shall be
6
PWi<30U 12 10
performed until all insurance and bonds required by this AGREEMENT are on file and
this AGREEMENT has been properly executed.
13. Warranty. CONTRACTOR shall perform, at its own cost and expense
and without reimbursement from DISTRICT, any services necessary to correct errors or
omissions which are caused by CONTRACTOR's failure to comply with the standard of
care provided for herein. CONTRACTOR shall guarantee work done on the PROJECT
for a one-year (1) period commencing on the date of substantial completion.
CONTRACTOR shall warrant that all services provided and equipment installed shall
perform in a workmanlike manner and be fit for itsarticular purpose.
ose.
P P
14. Termination. DISTRICT reserves the right to terminate this
AGREEMENT
9
at any time, with or without cause. CONTRACTOR will be entitled to
payment for work performed up until receipt of the notice of termination unless
CONTRACTOR was in default in CONTRACTOR's performance.
Any employee of CONTRACTOR or its subcontractors who is determined by
DISTRICT to be uncooperative, incompetent, a threat to the adequate or timely
completion of the PROJECT, or a threat to the safety of persons or property, or any
employee who fails or refuses to perform PROJECT in a manner acceptable to
DISTRICT, shall be promptly removed from the PROJECT by the CONTRACTOR and
shall not be re-employed to perform any of the PROJECT.
15. Miscellaneous. DISTRICT acknowledges that if it provides
CONTRACTOR with locations of underground pipelines and DISTRICT is incorrect and
those utilities must be relocated, DISTRICT will pay for those relocation costs in
accordance with statutory requirements. (Government Code §4215.)
CONTRACTOR agrees to provide DISTRICT with notice of any hazardous
materials or subsurface or latent physical site conditions if encountered if this work
involves excavations deeper than four feet (4'). If this work exceeds Twenty-Five
Thousand Dollars (S25,000.00) and the excavations exceed five feet (5'),
CONTRACTOR must provide a detailed trenching plan. (Public Contracts Code § 7104;
Labor Code § 6705.)
DISTRICT shall give CONTRACTOR timely notice of third-party claims.
For claims that are less than Three Hundred Seventy-Five Thousand Dollars
($375,000.00), the provisions of Public Contracts Code Sections 20104 et seq. (Article
1.5— Resolution of Construction Claims) shall be followed.
CONTRACTOR is and shall at all times remain as to DISTRICT an independent
contractor. No employee benefits shall be available to CONTRACTOR in connection
7
PWK 30U 12 10
I
with the performance of this AGREEMENT. Except for the fees paid to CONTRACTOR
as provided in this AGREEMENT, DISTRICT shall not pay salaries, wages, or other
compensation to CONTRACTOR for performing any services hereunder for DISTRICT.
DISTRICT shall not be liable for compensation or indemnification to CONTRACTOR for
injury or sickness arising out of performing any services hereunder.
This AGREEMENT shall be interpreted in accordance with the laws of the State
of California. Any action brought between the parties shall be commenced in the
superior or federal district court with jurisdiction over the DISTRICT.
This AGREEMENT and the attachments hereto shall contain the entire
agreement between the parties. This AGREEMENT cannot be modified except in a
writing signed by both parties. In the event of inconsistency between this AGREEMENT
and any attachment hereto, this AGREEMENT shall control in all respects.
CONTRACTOR shall provide DISTRICT with drawings of the construction in its
"as built" condition.
COSTA MESA SANITARY DISTRICT CONTRACTOR
Approved by: Reviewed and Accepted by:
General Manager Name: JOH CO!.
Approved as to Content: Signatu -: ` y�
it"
Title: P• SIDENT
Rob H mers
District Engineer
Approved as to Form:
64---/t.‘
Harper& Burns LLP
District Counsel
8
PWK 30U 12 10
MANHOLE ADJUSTING INC FROM: ABEL RUIZ
° 9500 BEVERLY ROAD UTILITY ADJUSTING DIVISION
'., IIS PICO RIVERA,CA 90660-2135 (323)558-8000,FAX(323)558-8055
General Engineering Lic 398443
DIR NO.:1000004104
BID PROPOSAL abelruizmainc@earthlink.net
TO: Mr.Rob Hamers
COMPANY: CMSD-Dist.Engineer
FACSIMILE: rhamers@robhamers.com
Date: 12/20/2016
Project: SEWER MANHOLE SURFACE REPAIRS(8311)-PHASE 3 BID DATE: 12/20/2016
Owner: CITY OF COSTA MESA BID TIME: 10:30AM
ITEM DESCRIPTION Qty Max Depth(s) Unit Price UNIT TOTALS
Adjust 24"diameter Manhole(EXCLUDES
N/A FRAME&COVER):R/R frame Cover 25 6"SECTION $ 820.00 $ 20,500.00
CONSIDERATIONS:
WORK HOURS:9:00AM TO 3:30PM,MONDAY TO FRIDAY ON ARTERIAL LOCATIONS AND 7:00AM TO 3:30PM ON
RESIDENTIAL LOCATIONS.
We exclude:Permits,Traffic Control Plans&approvals,Detours,AC sawcutting,PCC Sawcutting,
PCC center gutter around manhole,Precast Concrete Cone adjustment,any customed made pre-cast concrete section
other than precast concrete grading rings(if needed),any traffic loop damaged(not clearly marked at each location).
'BID TOTAL: I $ 20,500.00
MANHOLE PRICES EXCLUDE ANY LINING APPLICATION UNLESS NOTED.
PRICES BASED UPON ONE(1)MOVE IN.
Please contact us if there is any transmission problem at(323)558-8000.
Approved by:
Name&Signature Date Company Name
Y:\MANHOLE\BIDS\2016\COSTA_MESA_PRO1311_SEWER MH PH3_122016_proposal
Printed on:12/19/2016_6:18 PM
•
• �....IN MANHADJ-01 BSHIELDS
'4`,,.�R� CERTIFICATE OF LIABILITY INSURANCE DATE
TE(MM o i
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 License#OK07568 CONTACT Bonnie Shields
NAME;.___._ -._--- ---------------
Busby-Stone Insurance Services,LLC PHONE — FAX
9201 Camino Media Suite 250 lac,No, ):(661)665 9150 (ACC,No_1__
P.O.Box 22620E "6$3.bshields©busbystone.com
Bakersfield,CA 93311
INSURERM AFFORDING COVERAGE NAIL 1
NSURERA:TravelersProperttsCasualty Co of America _25674
INSURED INSURER B:Travelers Casualty_&Surety Co
Manhole Adjusting Inc. INSURER c:
9500 Beverly Road INSURER D
Pico Rivera,CA 90660-2135
INSURER E:
';INSURER F:
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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR' TYPE OF INSURANCE 'ADDL'SUBR.- - -- POLICY NUMBER POUCY EFF POLICY EXP UMITS
/MM/DD/YYYYI
A '
X COMMERCIAL GENERAL LIABILITY 1,000 OOO
X :DAMAGE TO RENTED
CLAIMS-MADE X OCCUR C04E966229-TCT-16 04/30/2016 04/30/2017,TREMISEB(Ea suTencel +� 300,000
r __ EACH OCCURRENCE __
MED EXP one person) 5,000
,-
' 1,000,000
PERSONAL 8 ADV INJURY 1
GEN'L AGGREGATE LIMIT APPLIES PER: .GENERAL AGGREGATE $ 2,000,000
I
POLICY X JECT LOC _ r.PRODUCTS-_COMP/OP AGG -$ 2,000000
OTHER j $ _Included
B
AUTOMOBILE LIABILITYI COMBINED SINGLE LIMIT 1,000,000,
X ANYOWAUTOED SCHEDULED '6104E97743A-TCT-16 04/30/2016;04/30/2017 BODILY INJURY(Perperson) $
AUTOS ONLY ;AUTOS BODILY INJURYSPer accident) $
II---
HIRED -OW EPROPERTY----
_,AUTOS ONLY ._I AUTOS ONNLY e ,DAMAGE $
X ,,Auto with Comp&r x '.$1,000 Deductible
r ,Col $
UMBRELLA LIAR �._._. OCCUR
_-_, i EACH OCCURRENCE $
' EXCESS LLAB CLAIMS-MADE
—i__ - ,AGGREGATE-- --------. $.__.___.. ---------
1' 1
DED RETENTION$ U64E660616-16 04/30/2016 5
WORKERS COMPENSATION PER 0TH-
AND EMPLOYERS LIABILITY Y/N X._:$TATUTE ER .
04/30/2017 1 000 000
A Ali
CER/M EIMgOE XCLUDED XECUTIVE N/A ,,_E.L EACH ACCIDENT --___ Y$____,._
(Mandatoryin NH) 1,000,000
_E__L._DISEASE-EA EMPLOYEE.$___-__
I If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ '
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES()WORD 101,Additional Remarks Schedule, be enriched I re mois required)
Adjust and Surface Repair twenty five(25)Sewer Manholes,Project No.311,Phase,MAI's Job No.MP17-14033
Costa Mesa Sanitary District along with their elected officials,officers,employees and agents are named as additional insured per attached endorsement.
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.
AUTHORIZED REPRESENTATIVE
Costa Mesa Sanitary District
628 W.19th St.
Acosta Mesa.CA 92627 ���� ////
ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Policy No.: CO4E966229-TCT-16
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 c) The insurance provided to the additional in-
to include any person or organization that you sured does not apply to "bodily Injury" or
agree in a "written contract requiring insurance" "property damage" caused by "your work"
to include as an additional insured on this Cover- and included in the "products-completed op-
age Part, but: erations hazard" unless the "written contract
a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you
"property damage"or"personal injury"; and to provide such coverage for that additional
insured, and then the insurance provided to
b) If, and only to the extent that, the injury or the additional insured applies only to such
damage is caused by acts or omissions of "bodily injury" or "property damage" that oc-
you or your subcontractor in the performance curs before the end of the period of time for
of "your work" to which the "written contract which the "written contract requiring insurance" nsur-
requiring applies. The person or ante" requires you to provide such coverage
organization does not qualify as an additional or the end of the policy period, whichever is
insured with respect to the independent acts earlier.
or omissions of such person or organization.
3. The insurance provided to the additional insured
2, The insuranceP rovided to the additional insured
by this endorsement is excess over any valid and
by this endorsement is limited as follows:
collectible "other insurance", whether primary,
a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is
this Coverage Part shown in the Declarations available to the additional insured for a loss we
exceed the limits of liability required by the cover under this endorsement. However, if the
"written contract requiring insurance", the in- "written contract requiring insurance" specifically
surance provided to the additional insured requires that this insurance apply on a primary
shall be limited to the limits of liability re- basis or a primary and non-contributory basis,
quired by that "written contract requiring in- this insurance is primary to "other insurance"
surance". This endorsement shall not in- available to the additional insured which covers
crease the limits of insurance described in that person or organization as a named insured
Section III—Limits Of Insurance. for such loss, and we will not share with that
b) The insurance provided to the additional in- "other insurance". But the insurance provided to
does not apply "bodily injury", "prop- the additional insured by this endorsement still is
suredpP y yry ' excess over any valid and collectible "other in-
erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or
of the rendering of, or failure to render, any on any other basis, that is available to the addi-
professional architectural, engineering or sur- tional insured when that
veying services, including: person or organization is
an additional insured under such "other insur-
i. The preparing, approving, or failing to ance".
prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the
ings, opinions, reports, surveys, field or- additional insured by this endorsement:
ders or change orders, or the preparing,
approving, or failing to prepare or ap- a) The additional insured must give us written
prove, drawings and specifications;and notice as soon as practicable of an "occur-
ii. Supervisory, Inspection, architectural or rence" or an offense which may result in a
engineering activities. claim. To the extent possible, such notice
should include:
CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
I. How, when and where the "occurrence" any provider of"other insurance"which would
or offense took place; cover the additional insured for a loss we
ii. The names and addresses of any injured cover under this endorsement. However, this
persons and witnesses; and condition does not affect whether the insur-
ance provided to the additional insured by
iii. The nature and location of any injury or this endorsement is primary to "other insur-
damage arising out of the"occurrence"or ance" available to the additional insured
offense. which covers that person or organization as a
b) If a claim is made or"suit" is brought against named insured as described in paragraph 3.
the additional insured, the additional insured above.
must: 5. The following definition is added to SECTION V,
i. Immediately record the specifics of the —DEFINITIONS:
claim or"suit and the date received;and "Written contract requiring insurance" means
ii. Notify us as soon as practicable. that part of any written contract or agreement
The additional insured must see to it that we under which you are required to include a
receive written notice of the claim or"suit as person or organization as an additional in-
soon as practicable. sured on this Coverage Part, provided that
the "bodily injury"and "property damage"oc-
c) The additional insured must immediately curs and the"personal injury" is caused by an
send us copies of all legal papers received in offense committed:
connection with the claim or"suit", cooperate a. After the signing and execution of the
with us in the investigation or settlement of
the claim or defense against the "suit", and contract or agreement by you;
otherwise comply with all policy conditions. b. While that part of the contract or
d) The additional insured must tender the de- agreement is in effect;and
fense and indemnity of any claim or"suit"to 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