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Contract - Newport Floor Covering - 2012-09-17 PUBLIC WORKS AGREEMENT DISTRICT YARD FLOOR REPAIR This agreement (hereafter "AGREEMENT") is made and entered into this 17th day of September, 2012, by and between the Costa Mesa Sanitary District, a sanitary district (hereafter "DISTRICT"), and Newport Floor Covering, a 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 to pay and CONTRACTOR agrees to accept in full payment for all work agreed to herein the sum of: thirteen thousand five hundred eighty Dollars ($13,580.00). 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 six (6) working days thereafter. CONTRACTOR shall forfeit as liquidated damages the amount of five hundred Dollars ($500) 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 08 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. CONTRAC ' ' Initials 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 08 f - - -- contractor's license requested by DISTRICT, and that CONTRACTOR's License No is: 614587. 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 qt 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 working in excess of that time must be paid overtime. (Labor Code § 1810.) Statutory provisions for 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 PWK 30U 12 08 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 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 Liability: One Million Dollars ($1,000,000.00) per accident for bodily injury and property 4 PWK 30U 12 08 . 1 - 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 ($1,000,000.00) 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, jts directors, officials, officers, employees, agents, 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 by CONTRACTOR 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 warranties, shall not affect coverage provided to DISTRICT, its directors, officials, officers, employees, agents, and volunteers. 5 PWK 30U 12 08 • 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. Any deductibles 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 deductibles 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 on DISTRICT's form. (Civil Code § 9550.) No work shall be performed until all insurance and bonds required by this AGREEMENT are on file and this AGREEMENT has been properly executed. • 6 PWK 30U 12 08 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. 14. Termination. DISTRICT reserves the right to terminate this AGREEMENT 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 ($25,000.00) 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 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. 7 PWK 30U 12 08 . 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 CONSULTANT Approved by: Reviewed and Accepted by . 9,6- = oDic. 06,0/41 , 4 ,c. General Manager Name .. Sign _� Title: •' 071 Approved as to Form: • Harper& Burns LLP Associate District Counsel 8 PWK 30U 12 08 • EXHIBIT A CONTRACT / PROPOSAL S.C.L. #C-15-218912 3500 EAST COAST HWY ORONA NEWPORT FLOOR COVERING, INC. 949//675-1636R,CA 92625 \iU,I 01' "Since 1959"•Carpeting•Window Coverings•Vinyl•Tile•Stone•Wood FAX 949/675.6124 NewportFloorCoronaDe1Mar.can Emoii asancheztcrosdca.gov Dane 8/77/2012 Rev 9/6/12 Owner or Contractor Costa Mesa Sanitation District phone 949-645-8400 Address 628 W. 19th St, Job Location 174 W.Wilson, Costa Mesa Cty Costa Mesa, CA 92627 Phone fax 949-650-2253 • WE HEREBY PROPOSE TO FURNISH AND INSTALL THE FOLLOWING ITEMS,SUBJECT TO TERMS AND CONDITIONS SPECIFIED HkREIN Furnish and install flooring as follows: Quality. Dal Tile - .1 1,930.00 Style: City View 12°x 24° Floor tile Color: Harbour Mist Arms- Hallways., Entry&closets Grout and seal in all areas 1,t 50.uU s• •, r_.1 • 11 • ►• Demo existing wood floor, a ■ : .- •....•. • 91111. 1St •_.0• a •.' .1•.•.• • • TOTAL OF CONTRACT ,13,580.00 SALES TAX RECD DATE / / V M A CK# LESS DEPOSIT 50% RECD DATE / / V M A CK# BALANCE DUE ON COMPLETION APPROXIMATE DATE OF INSTALLATION: TERMS: . Payment upon completion unless otherwise specified In writing.Finance charges of'I Y%per month shall be added if payment is not made within ten(10) days after completion,which is an annual percentage rate of eighteen(18%)percent charged on all past due accounts.Seller reserves the right to lien Buyer's property if payment is not made according to the conditions contained herein.The prices set forth in this contract shall be binding only If this contract Is e>teouted by both parties within thirty(30)days of the date setforth above. The above proposal is made subject to the conditions and NOTICE printed on the reverse aide and made a part hereof and the Buyer in accepting same acknowledges that he has said conditions and accepts the same unconditionally. NEWPORT FLOO C RIN ,INC. Customer's Signature,owner-contractor,or their authorized agent By Office Approval:This order is subject to company acceptance at ita office Ace P CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDM/W) `-� 10/18/2012 THIS CERTIFICATE ISI 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 ASTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE ORjPRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the ce tIflcato holder is an ADDITIONAL INSURED,the policy(les)must belendorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions I f 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 r 'CONTACT . V WINE SERGI&CO LL PHONE -------225 SMITH RD E-M Na.E:,o, (888);828-3686 1(Arc,NO): ST CHARLES,IL 601.4 ARDnESS; INSURERISI AFFORDING COVERAGE NAIC d --_.. ._ .__ _ NSURER A. Citizens Ins Co of America 31534 INSURED INSURER 0- NEWPORT FLOOR CO ERING,INC — T&S CLEANING SERV CES INC INSURER c I . 3500 EAST COAST HIGHWAY NSURF.R 0: _.__. _INSURER E: CORONA DEL MAR CA 92625 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- NOTWITHS.IANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTf 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 CONDI PIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSJ 1A�SR WVD� POLICY NUMBER 11 POLICY YYYY)!I(POLICY/Y8T I LIMITS- _ - ----------- LTR TYPE OF INSURANCE GENERAL LIABILITY I i EACH OCCURRENCE S 1,000,000 X I COMMERCIAL GENER LIABILITY I X 'f X ' r GA MA E* -- PREMISES{Ep_occurla ece ) ,I s 300,000 A CLAIMS•MADE 117 OCCUR ' OBC 9396563 00 1 12/15/2011 . 12/15/2012 I MED EXP(____Any one person I$10,000 • PERSONAL 8ADV INJURY _(s 1,000,000 GENERAL AGGREGATE j$2;000,000 --__ n GEN'LAGGREGATELIMITtPPUES OC '�PRODUCTS•COMP/OP I S 2,000,000 PRO- _- – .- r .. -_....._ POLICY•X I JF;; S-. AUTOMOBILE LIABILITY ff COMBINED SINGLE UMIT ■ ANY AUTO X II a aceWann 1,000,000 ALL OANED SCHEDULED , I8001LY INJURY(Par person! I'S A AUTO AUF X I I OBC 9396563 00 12/15/2011 12/15/2012 I --- ------ I AUTOS AUTOS ! BODILY INJURY(Par aacitlonq $ OS I I AUTO-0VNJED I PROPERTY DAMAGE •LPerecddonl _ I s CE_____.. .'I$ X UMBRELLA LIAB '__-! __.,,, I x +OCCUR f�( I x I I EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB 7I i ... _ _ cLAIMS•MAOe OBC 9396563 00 . 12/15/2011 12/15/2012 AGGREGATE s 1,000,000 -.'BETE -. YfN I _... ... 1. DEC I RETENTICN$ I $ WORKERS COMPENSATION! I I VC STATU• OTH-! AND EMPLOYERS'LIABILIT`� _I ,_ LIQBYJ.IMITS1. I..EB..!___________..______...__ ANY I'ROPRIETOR/PARTNEIr'EXECU FIVE 1r--: E,L EACH ACCDENT OFFICE/MEMBER EXCLUDE, 1:N/A II _-___ __ $ --- (Mendaloty in NH) I E L DISEASE-EA EMPLOYEE 3 Byes,describe under ' .._.._ OPSI:eiI'IonrwoFFA1111tisted¢,•r I -EL.DISEASE.POLICY LIMII $ -� , f I DESCRIPTION OF OPERATIONS ILDCATIONS f VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space lslrequlred) Certificate Holder is an Additional Insured pursuant to the terms and conditions of form:BP0450.Additional Insured is primary and noncontributory to the extend provided by form 391-1586.Waiver of subrogation as provided by 391-1586. i CERTIFICATE HOLDER I CANCELLATION Costa Mesa Sanitary District 6281A1. 19th St I 1^Oy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa CA 9262 THE EXPIRATION! DATE THEREOF, NOTICE WILL BE DELIVERED IN ' ACCORDANCE WITH THE POLICY PROVISIONS. IO AUTHORIZED REPRESENTATIVE I :4715f ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks lof ACORD a.•.'- Hanover Insurance Group.. TH S ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY SUPPLEMENTARY ENDORSEMENT This endorsement odifies insurance provided under the following: BUSINESSOWN RS COVERAGE FORM I. Additional Insured by Contract,Agreement or Permit construction or demolition operations Under SECTION II - LIABILITY, C. Who Is An Insured, performed by or on behalf of the Paragraph 4.is added as follows: manager or lessor;or a. Any person or organization for whom you are (5) To "bodily injury", "property damage" or performing operations when you and such person "personal and advertising injury" arising out or organization have agreed in writing in a of the rendering of or the failure to render any contract) agreement or permit that such person or professional services. This includes but is not organization n be added as an additional insured on limited to any professional services as an your poicy. Such person or organization is an architect or engineer arising out of any addition I insured only with respect to liability for construction agreement or activities under "bodily injury", "property damage" or "personal which any insured or anyone acting:on any and adv rtising injury"caused,in whole or in part, insured's behalf provides'or provided service, by: advice, expertise or work. Construction includes, but is not limited to, the plan, (1) You acts or omissions; or conception, design,build, construct,assembly, (2) The acts or omissions of those acting on your development, safety, erection, formation, beh If, reconstruct, rehabilitation, repair, or any but only(with respect to: improvement made to real property. Construction also includes the hiring, (3) "Yot,r work" for the additional insured(s)at the supervision or management of any of these location designated in the contract, activities. However, this exclusion does not agreement or permit;or apply to liability arising out of an insured's (4) Premises presence at a jobsite that was not caused by ( ) you own, rent, lease, control or professional activities listed in the above occtpy. paragraph. This inst,rance applies on a primary basis if that is required by the written contract, agreement or c. Additional insured coverage provided by this permit. provision will not be broader than coverage provided to any other insured. b. This provision does not apply: d. All other insuring agreements, exclusions, and (1) Un*s the written contract or written conditions of the policy apply. agreement has been executed or permit has been issued prior to the "bodily injury", II. Additional Insured by Contract,Agreement or Permit- "property damage" or "personal and Primary and Non-contributory advQrtising injury"; The following is added to SECTION III - COMMON (2) To any person or organization included as an POLICY CONDITIONS: insured by an endorsement issued by us and M. Other Insurance made part of this Policy; (3) To airy lessor of equipment: 1. Additional Insureds If you agree in a written contract, written (a) After the equipment lease expires; or agreement or permit that the insurance (b) f the "bodily injury", "property damage" provided to any person or organization pr "personal and advertising injury" included as an Additional Insured under rises out of the sole negligence of the SECTION II - LIABILITY, Part C - Who is An lessor; Insured, is primary and non-contributory, the (4) To any: following applies: (a) owners or other interests from whom If other valid and collectible insurance is land has been leased which takes place available to the Additional Insured for a loss after the lease for that land expires; or we cover under SECTION II - LIABILITY, Part (b) Managers or lessors of premises if: A.Coverages, Paragraph 1.,Business Liability our obligations are limited as follows: ('t) The occurrence takes place after you cease to be a tenant in that premises; a. Primary Insurance or tr The "bodily injury", This insurance is primary to other ( ) y j y', "property insurance that is available to the damage" or "personal and advertising injury" arises out of Additional Insured which covers the structural alterations, new Additional Insured as a Named Insured. 391-1586 02 11 Includes copyrighted material of Insurance Services Offices, Inc. with its permission Page 1 of 2 ■ We will not seek contribution from any (1) The total amount that all such other other insurance available to the insurance would pay for the loss in the Additional Insured except: I absence of this insurance;and (1) For the sole negligence of the (2)The total of all deductible and self-insured Additional Insured; (2) When the Additional Insured is an amounts under all that other insurance. Additional Insured under another i We will share the remaining loss, if any, with primary liability policy; or any other insurance that is not described in (3) When b.(2)below applies. this Excess Insurance provision and was not tf this insurance is primary, our bought specifically to apply in excess of the obligations are not affected unless Limits of Insurance shown in the Declarations any of the other insurance is also of this Coverage Part. primary. Then, we will share with all c. Method Of Sharing that other insurance by the method described in b.(3)below. If all of the other insurance permits contribution by b. Excess Insurance equal shares, we will follow this method also. Under this approach each insurer contributes This insurance is excess over: equal amounts until it has paid its applicable limit (1) Any of the other insurance, whether of insurance or none of the loss remains, primary, excess,contingent or on any Whichever comes first. other basis: If any of the other insurance does not permit (a) That is Fire, Extended Coverage, contribution by equal shares,we will contribute by Builder's Risk, Installation Risk limits. Under this method, each insurer's share is or similar coverage for "your based on the ratio of its applicable limit of work"; insurance to the total applicable limits of (b) That is Fire insurance for insurance of all insurers. premises rented to the Additional Ill. Aggregate Limit of Insurance(Per Project) Insured or temporarily occupied by the Additional Insured with a. For purposes of the coverage provided by this permission of the owner; endorsement, D. Liability and Medical Expenses Limits of Insurance under Section II - Liability is (c) That is insurance purchased by emended by adding the following: the Additional Insured to cover The General Aggregate Limit under D. Liability the Additional Insured s liability and Medical Expenses Limits of Insurance applies as a tenant for "property separately to each of "your projects" or each damage" to premises rented to location listed in the Declarations. the Additional Insured or temporarily occupied by the b. For purposes of the coverage provided by this Additional Insured with endorsement F. Liability And Medical Expenses Definitions under Section II-Liability is amended permission of the owner; or by adding the following: (di) If the loss arises out of the maintenance or use of aircraft, a "Your project"means: "autos" or watercraft to the i. Any premises,site or location at, on,or in extent not subject to Exclusion g. which "your work" is not yet completed; of SECTION II - LIABILITY, Part . and A. Coverages, 1. Business Liability. : ii. Does not include any location listed in the When this insurance is excess, we will have I Declarations. no d U ty under SECTION II - LIABILITY,Part A. IV. Blanket Waiver of Subrogation Covelrages,1.Business Liability to defend the Paragraph K. Transfer Of Rights Of Recovery Against insured against any "suit"if any other insurer Others o Us in Section III-Common Policy Conditions is has q duty to defend the insured against that amended by the addition of the following: "suit'. If no other insurer defends, we will We will waive any right of recovery we may have against unde ake to do so, but we will be entitled to any person or organization when you have agreed in a the i sured's rights against all those other written contract, permit or agreement to waive any rights insurers. of recovery against such person or organization because When this insurance is excess over other of payments we make for injury or damage arising out of insurance, we will pay only our share of the your ongoing operations or "your work" done under a amount of the loss, if any, that exceeds the coniractiwith that person or organization and included in sum of: the "products-completed operations hazard". 391-1586 02 11 Includes copyrighted material of Insurance Services Offices, Inc.,with its permission Page 2 of 2 II me OBC 9396563 00 4Hanover Insurance Croup_ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS • This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE' Name Of Person Or Organization: Costa Mesa Sanitary District 628 W.19th St Costa Mesa CA 9262G 'Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. The following is added to Paragraph C. Who Is An Insured in Section II - Liability: 4. Any person or organization shown in the Schedule is also an insured, but only with re- spect to liability arising out of your ongoing op- erations performed for that insured. BP 04 50 07 02 ISO Properties, Inc., 2001 Page 1 of 1 A CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/16/2012 PRODUCER (310)798-69.00 FAX: (310)798-6151 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Kinter-Buchanan Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License Number: 040872 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE'COVERAGE AFFORDED BY THE POLICIES BELOW. 111 Pier Ave. , Suite 100 Hermosa Beach CA 90254 INSURERS AFFORDING COVERAGE NAIC# ------ - -------- INSURED ._-- INSURER A:Hartford Ins Co of the Mdwst 37478 — — NEWPORT FLOOR COVERING, INC. INSURER B: DBA: CARPET ONE INSURER C: 3500 E COAST HWY INSURER a CORONA DEL MAR CA 92625 INSURER E: COVERAGES THE POLICIES OF INSURAN!E LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERMIOR 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 OFSUCH POLICIES.AGGREGATELIM TS-SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iNsFi.Awn. POCICYEFFECTIVE PLICY EXPIRATION _LI• N ;• r IN - POLICY NUMBER OATSfMMIA D TE(MM/DDIYYYYI LIMITS GENERAL IJABILITY _EACH OCCURRENCE $ -DAMAGSTOTRENTED COMMERCIAL GE ERAL LIABILITY PRFMISE$(Es ocdurrence)_ $ CLAIMS MAD' I I OCCUR MED EXP(Any one person)- $ -- I - --- - - ----- PERSONAL 8 ADV INJURY $ -- - GENERAL AGGREGATE S GE 'L AGGREGATE LIM T APPLIES PER. I PRO- PRODUCTS-COMPtOPAGG $ POLICY i JECS I 1-oc AUTOMOBILE LIABILITYI COMBINED SINGLE LIMIT ._..,-, ANY AUTO (Ea accident) $ ALL OWNED AUTO I BODILY INJURY SCHEDULED AUTO (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY dent $ (Per accident) - _...__- --- PROPERTY DAMAGE (Per acddenp 'GA.AGE LIABILITY AUTO ONLY-EA ACCIDENT E ANY AUTO -- --"—- OTHER THAN EA ACC $ AUTO ONLY: - AGO $ EXCESS I UMBRELLA LIA DUTY EACH OCCURRENCE __ S IOCCUR I—I CLAIMS MADE AGGREGATE q DEDUCTIBLE .$ RETENTION $ $ A WORKERS COMPENSATION I WCSTATU_ OTH- AND EMPLOYERS'UABILITY Y/N X TORY_LIMITS. ER,. _ ANY PROPRIETOR/PARTNE ECUTIVE� E-L. 1.r. -EACH ACCIDENT $ 000 r 000 OFFICER/MEMBER EXCLUDED? ._..__ ..._,... (Mandatory•In NH) 72WECRY6093 4/1/2012 4/1/2013 E.L DISEASE•EA EMPLOYE a-$ 1,000.,000_ If yes,describe under — _.._._ _.._..-... SPECIAL PROVISIONS below EL.DISEASE-POLICY LIMIT $ 1 000,000 OTHER DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Evidence of Coverage License # 218912 Job location:174 W. Wilson, Costa Mesa, CA Waiver of Subrogation to follow. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,TH€ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Costa Mesa 5a 1 to ry District NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 628 W. 19th S . IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Costa Mesa, CAI 92627 REPRESENTATIVES., AUTHORIZED REPRESENTATIVE Patricia Buchanan/KBI �� 'j ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200901).01 The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -, CALIFORNIA I Policy Number: 72 WEC RY6093 Endorsement Number: 02 Effective Date: IL 0/16/12 Effective hour is the same as stated on the Information Page of the policy. Namedlnsured ndAddress: NEWPORT FLOOR COVERING, INC. 3500 E COAST HWY CORONA DEL MAR, CA 92625 We have the right to recover our payments from anyone liable for any injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must rnaint in payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. I The additional ilremium for this endorsement shall be 2 % lof the California workers' compensation premium otherwthe due on such remuneration. SCHEDULE Person or Organization Job Description BIG-D CONSTRUCTION CORP. _ 404 WEST 400 SOUTH SALT LAKE CITY, UT 84100 COSTA MESA S4WITARY DISTRICT FURNISH AND INSTALL FLOORING 628 W 19TH ST COSTA MESA C1 92627 Countersigned by I Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 11/16/12 Policy Expiration Date: 04/01/13 A C 0„p DATE(MMIDDtYyyy) CERTIFICATE OF LIABILITY INSURANCE 10/18/2012 THIS CERTIFICATE IS'ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES QT 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, RODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the ■olicy(ies)must be endorsed. If SUBROGATION IS WAIVED,sU Jectito the tarns and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not corder rights to the c'ertiflcate holder In Ile of such endorsement(s). _ PRODUCER Lori Greek-+ arabedian Insurance Agency Inc N 1;--Bonnie Crvrich State Farm Insurance PHONE.EIJ.94_9 tom_ FAX No}.94958.4400 29811 Santa Margarita Parkway(Suite 400) E-MAIL. bonnie_(s�lgginauranee:com ri-.Q • Rancho San a Margarita, Ca 92688 INSURER(S)AFFOROINOCOVERAps NAIQN INSURER ate Farm Mutual:Aytomobilo•InsuranceCompany age$ . INSURED Newport Ficior Covering, Inc INSURERS: 3300 E. Coast Highway INSURER C: Corona Del Mar, Ca 92625 INSURER 0: — INSURER 11: COVERAGES INSURER F: CERTIFICATE NUMBER: REVISION NUMBER: THIS;IS TO CERTIFY THAT THE.POLICIES OF INSURANCE LISTED EELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE,POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREME=NT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE'IS$$UED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONQITtONS OF SUCH POLICIES.LIMITS SHOVWrt+I MAY HAVE BEEN REDUCED BY PAID CLAIMS. NarR ADD/SLtBR I:TR: TYPE OF INSU ,NCp I INS VNn' POLICY NuneuER PDOCK eFe Miley P -.. 'GENERAL LIABILITY — fMt1VDt?IYYYYt (Nr1.vD4rYYYY1 UMiT9. EACH OCCURRENCE Y • _•, QOMMP_RCIAL GENERA LIABILITY IAj1L7O RENI8L1•" '-" CIAIMS•MADE PREMISES Ea cf:z.(n) S OCCUR MEO EXP(Any env person) S PERSONAL&ADV INJURY S GENERAL AGGREGATE $ GEEN'L AGGFEGATE LIMIT AP'L_IES PER: - - 1'OLICY 7,78: f 1 Loc pa ODUCT9-COMP/OPAda 9 AUTOMOBILE L1A81UTY d Y Ell 072-3730.F18-75 07t18171312 12/18/2012 �'M9EHE0 SINGLE ut417--- =o x. ANY AL TO IEeaeddnntL,. $ 1,000.000 x.<AN OV�4'7ED ggC��H{EDU�ED BODILY INJURY(PET person) i -'- AUTOS UTO.OwLSD BODILY INJURY(Par AcdderlU 3 —x HIRED AUTOS X NON.? PROPERTY DAMAGE S 75-1314 10118/2012 03/18/2013 -UP-1-8---`4`11"3 .. UMBRELLA LIAe h1I OCCUR L�� E EXCESS LL,s L EACH OCCURRENCE S ,.- I CLAIMS+MADE AGGREGATE .S _ DED REFENTION�6 .,. IMORKER8 COMPENSA11ON I I _ f AND EMPLOYERS'LIABILITY 1N�,Y UMIX- I l ANY P,ROPIRETOR/PARTIVER/EXBCUTIvE YIN I TORY UMIJ&I 1 E OFFICE/MELOER EXCLUDED? ( j N/A E^L.EACH ACCIDENT, g (Manditnry Et NH) if Yes,delaicn,agar £L.DISEASE-EA EMPLOYEE 3 OESCREPT7QLLOF OPERATIONS balmy ( r - EL DISEASE-POLICY LIMIT S DESCRJPTION OF OPERATIONS,LOOATIONB I VEHICLES (Attach ACORO 101,Adel I.,p, Remarks Schsdefe,N Mora:mice le reg4Ilec) • CERTIFICATE HOLDER 1 C•NCELLATION , Costa Mesa Sanitary 71strict SHOULD ANY OF THE ABOVE DESCRIBED pOLic(ES BE CANCELLED BEFORE 628 W.99th Street THE ExPt-•T1061 10• - THEREOF, NOTICE WILL BE DELIVERED IN ACCORDA•' Ej WUI11T1i 2 potiCY PROVISIONS. Costa Mesa, Ca 92626 AUTHOR, D. :-RE$D TA�° ACORD 25(2010/45) S,r" ( :8- • 'ACORD CORPORATION./ All rights reserved. The ACORD name and logo are registers.'mar of ACORD 1001486 132849.7 03-01- 2012 10/18/2012 5:40PM [Job No. 9166] I�j0001 j., -vww .m�a4d�rw�v-mTry CITY 017 NEWPORT BEACH BUSINESS TAX CERTIFICATE Tiliti"P:1;�Pr\1'\iF.\T GXPIRFS: 11/30/2012 ACCOUNT NUMBER: BT00002035 OWNER/PRINCIPAL NAME: SERVICE ADDRESS: NEWPORT FLOOR COVERING INC NEWPORT FLOOR COVERING IN 3500 COAST HWY E U1\'NERSHIP'I'l'PL: • CORONA DEL MAR, CA 92625 CORPORATION • BUSINESS CATEGORY TAX INCLUDES PAYMENT FOR: FLOOR COVERING STORES, RUGS, C 4 EMPLOYEES • SFL I_ CR V PGRAIIT- 024137915 D;1'I'B OF ISSUE: 03/01/1960 PRINT DATE: 12/15/2011 r z. i wvs a € THIS DOCUMENT HAS A TRUE DEFENSA?"_,WATERMARK AND:VISIQLE FlBERSDISCERNIBLE FROtA SIDES :.`' I:EEP FOR YOUR RECORD NOT TRANSFERABLE CITY OFLAGU�IA BEACH Pose IN cosricuBOTH ovs PLACe 817SINESS TAX RECEIPT ACCOUNT:NUMBER BUSINESS LICENS1r CERTIFICATE AT BUSINESS LOCATION 4 21311'4 ACCT.NO. 213114 The 1 14 fret a<ap<ndon named<Mve i,ba<by gaeeM b«m,o eng+tT rt.an nn a rrensc>,in de Ctrl'OF UGVNA REACH,CAUFORNtA.1k bu PATE PAID: 01!052012 treda cuing p,ofonon<eninnioe or nn,w ,�des:r;b's.cm,a R,r m<t«�e imm:n<,. n�,rk<n,<i,prn•5 w,m Aar.na m<n�n�md°ert:<ena rte,r"n PAYMENT: $172.00 be poa 1 in."('"i+ouadac<a m a<.oroval boon,i oai,on.or a,rind b.I.r.'rare o,Nis mgeseeani•e.if not axeaw4 from wniata eepv.<d ionnian Ie it.eiev. BUSINESS TAX DATE PAID: 01/05/2012 BUSINESS LOCATION IN LACUNA BEACH RATE CODE: 100 RATE CODE: 100 �._ JW0 E COAST 11µ'F 0009177 Nk.1, 1, 1 �`. BALANCE 50.00 Ow?,'FRHEMOR NEWPORT FLOOR.COVERING'.I'.0 kCPIRATI2012 F: I?l312012 CORPORATION: ✓_ ' TAXES Y BU IN NESS TAX ORDINANCE ANC 1 'r THE CITY BUSINESS TAX ORDNANCE BUSINESS NAME; NE-WI'ORTFLOORCOVERING�INC ,S.t,r CITY OF LAGUNA MAILING ADDRESS: 3500 1.;COAST hl\VY ;>. c BEACH CITY AND STATE: CORONA DEL MAR.CA 92625 240(1./;} ;,, NON-REFUNDABLE,> "" . •. •- e . i_•'A D REFLECTS'FLUORESCENT.HIERS'UNDER UV-UGH TS,"'=' CITY OF COSTA MESA BUSINESS LICENSE NOT TRANSFERABLE a. THIS BUSINESS LICENSE TAX CERTIFICATE DOES NOT GUARANTEE COMPLIANCE.WITH STATE OR FEDERAL LICENSING REQUIREMENTS. Issuance of this certificate indicates that the person,firm,or corporation named below has paid the applicable business tax,pursuant to Title 9,Chapter 1,of the:,Costa Mesa Municipal Codeiifor the business,enterprise,trade,calling, profession,exhibition,or occupation described below.Issuance of'this'Certificate is not an endorsement,nor certification of compliance with other ordinances or laws. Business I.icense Tax Certificate No. BL007268 Business Name: NEWPORT'FLOOR COVERINGS INC. Business Location: Principal's Name: TLRPS7RA.,STEVE President Contractor License=: 168844 C61 Standard Industrial Class Code: 1799'Special Trade Contractor Expiration Date: 06/30/20 13 TO BE POSTED IN A PLACE VISIBLE TO THE PUBLIC-THIS IS YOUR CURRENT TAX CERTIFICATE ,::`. .4- ^": ." <.:«-... :.�W+z``t�1 F'�4 vkr � t .`��Frr •l�r"}, ,�^