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HomeMy WebLinkAboutUNITED STORM WATER, INC. (4)�Q INSWANCE ON FILE J WORK MAY PROCEED UIJTIL INSURANCE EXPIRES CLERKO� �� -_- DATE �Ct )6' SECOND AMENDMENT TO AGREEMENT TO PROVIDE SPILL Z $`r RESPONSE AND STORM DRAIN FACILITY CLEANING SERVICES A-2020-158-06 THIS SECOND AMENDMENT to the above -referenced agreement is entered into on August 3, 2020, by and between United Storm - Water, Inc. ("Consultant'), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECTTALS A. The parties entered into Agreement No. A-2017-157, dated June 20, 2017, by which Consultant agreed to provide spill response and storm drain facility cleaning services ("Agreement'). The original term of the Agreement was for two years and has been extended for two, additional one-year periods, ending June 19, 2021. B. The primary purpose of the Agreement is for spill response and storm drain facility cleaning services, though related services are also provided under the Agreement for hazardous waste pickup and disposal. C. On April 21, 2020, the parties entered into First Amendment No.-A-2020-079, by which the Agreement was amended to expand the scope of services and adjust the amount to be expended under the Agreement. D. The parties now wish to further amend the Agreement to expand the scope of services and adjust the amount to be expended under the Agreement. The Parties therefore agree: 1. Section 1, Scope of Services, is amended to include COVID-I9=Sanitizahon Services, as further described in Exhibit A. 2. Section 2, Compensation, is amended to increase the not -to -exceed expenditure under the Agreement from $300,000 to $900,000 for the one-year term ending on June 19, 2021. 3. Except as modified by this Second Amendment, and all prior amendments, all terms and conditions of the Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the Agreement on the date and year first written above. ATTEST CITY OF SANTA ANA aisy Gomez Kristine Ridge Clerk of the Council City Manager Pagel of 2 APPROVED AS TO FORM Sonia R. Carvalho City Attorney By: 7�'. ] in M. Funk Assistant City Attorney RECOMMENDED FOR APPROVAL Nabil Saba, PE Executive Director Public Works Agency Page 2 of 2 CONSULTANT Name: Robert Pina Title: Secretary EXHIBIT 1 SCOPE Or' SERVICES A. COVID-19 SANITIZATION SERVICES 1. Contractor shall provide COVID-19 Sanitization Services on porous and non -porous surfaces throughout the public right-of-way and at City -owned facilities including, but not limited to: a. Sidewalks, asphalt, curb & gutter; b. Bus shelters; c. Park facilities; d. Santa Ana Regional Transportation Center (SARTC); e. City Hall; f. Libraries: g. Senior Centers; h. Street furniture; i. Signs; j. Waste receptacles; k, Other surfaces/locations identified by the City, 2. Methods to provide COVID-19 Sanitization Services shall include, but are not limited to: a. Pressure washing surfaces with disinfection solutions; b. Hand-wiping/scrubbing surfaces with disinfection solutions; c. Using a hand-held sprayer with disinfection solutions; d. Other methods suggested by Contractor and approved by the City. 3. Contractor shall manifest, transport, and dispose of all waste and wastewater generated from providing COVID-19 Sanitization Services to the satisfaction of the California Department of Toxic Substance Control (DTSC), the United States Department of Transportation (DOT), the United States Environmental Protection Agency (USEPA), the permitted disposal facilities receiving the waste or wastewater, and any other applicable Federal, State, or local regulations. No waste or wastewater generated from providing COV1D-19 Sanitization Services shall be transported to the City's Corporate Yard for disposal. 4. Contractor shall only use disinfection solutions from Waterline Technologies, Inc. —Santa Ana Branch to provide COVID-19 Sanitization Services: a. Contractor shall consult with Waterline Technologies, Inc. — Santa Ana Branch regarding appropriate disinfection solution concentrations to use on various surfaces; b. Contractor shall consult with Waterline Technologies, Inc. — Santa Ana Branch regarding safe application and training on proper use of disinfection solutions; c. Contractor shall be responsible for scheduling routine pickups and/or deliveries of disinfection solutions from Waterline Technologies, Inc. — Santa Ana Branch; Page I of 2 EXHIBIT 1 d. Contractor shall procure disinfection solutions from Waterline Technologies, Inc. — Santa Ana Branch at the wilt prices listed in Attachment A to this Scope of Services. The total amount of solutions used will vary on an "as -needed" basis, 5. Contractor shall ensure all employees are supplied with and use adequate Personal Protective Equipment (PPE) while providing COVID-I9 Sanitization Services. 6. Contractor shall establish a safe perimeter to ensure the public is not impacted while providing COVID-19 Sanitization Services. 7. Contractor shall immediately notify the City if any of its employees conducting COVID-19 Sanitization Services test positive for COVID-1.9 and shall take all necessary precautions, as recommended by the Orange County Health Care Agency, to mitigate the spread of COVID-19 to City Staff and the public. 8. Contractor shall implement Best Management Practices (BMPs) to ensure no disinfection solutions or wastewater are discharged into the City's stormdrain system and there are no negative environmental impacts associated with COVID-19 Sanitization Services. Contractor shall immediately notify the City in the event any disinfection solutions or wastewater are discharged into the City's stoimdrain system. 9. Contractor shall document all COVID-19 Sanitization Services and send the City a weekly update, including photos and dates, of every location disinfected and sanitized. Page 2 of 2 ATTACHMENT A U WATERLINE TECHN010GIES, INC. SWIMMING POOL EQUIPMENT A CHEMICALS BILLTO: 8902 SANTA ANA BRANCH 620 SAN T IAGO STREET SANTA ANA. CA 92701 714.564.9100 ATTENTION: RAMON MENJIVAR RAMONM @ UNITEDSTORMWATER.COM UNITED STORMWATER, INC. (626) 890-7104 14000 VALLEY BLVD. CITY OF INDUSTRY CA 91746 RATE SHEET QUOTE EXPIRES ON 12/31/2020 RATE SBEET IF 1590671 ORDER DATE 7f-74/2020 10:44:16 SHIP TO: 8902 ATTENTION: RAMON MENJIVAR RAMONMQ UNITEDSTORM WATER.COM UNITED STORMWATER, INC. (626) 890-7104 14000 VALLEY BLVD. CITY OF INDUSTRY CA 91746 1 I0-2004 330 1.02 ,i.i6.60 UN179111YPOCFILORITE SOLUTIONS Vendor: 1767 Pang :5.25% HYPOCHLORITE SOLUTION S.PACKINGGROUPIII - 13ULK 5.25°! LIQUID-NSFCERTIFIEDTO NSr/ANSI 60 - MUL 200ma/L - PER GALLON 3 10.2030 330 0.99 326.70 UN1791 MIXEDim,olcFII.ORITE. SOLUTIONS Vendor.1698 Ilan 0 : 20UPPM 8, PG III FILTERED SODIU161 I IYPOCI ILORITE 12.5%BULK - NSIF CERTIFIED TO NSF/ANSI 60 - MUL 84 me/L- PER GALLON - 200 PPM 4 10.2031 330 1.06 349.80 UN 1791 MIXED I IYPOCI ILORITL SOLUTIONS Vendor:1698 Pan a : 600PPM 8. PG III FILTERED SODIUM IIYPOCHLORITE 12.5%BULK - NSF CERTIFIr:D TO NSF/ANSI 60 - MUL 84 niWL- PER GALLON - 600 PPM 5 TOTEOUT 1 800.00 800.00 330 GALLON TOTE DEPOSIT -OUT Vendor. 1781 (NONTAXABLE) DC DELIVERYCHARGE Vendor. 1698 Pang : DELIVERY CHARGE - NONTAXABLE 75.00 75.00 All items arc in neenNanec w ill, plans and q cciftcuti. ,t. Bbt,line TechteA vies dull not be respeosiblefurtnisinoToelo%nsoh,wxifieations dt,nukinga rcatmuble, e0on. 3lalvdal quoted shall M verified by the pute6Tser us to,vaubm,ing m speei0tuticete Iouku quantities. Walerline 1-hnologics dull Ium be obligated so honosor acnpl any pnn:ltuse alder based nn the quoulion. and w,Hnmer tH oblivion an the pan of lFm,tine'le honlogice shall aria unless and Pmil all of she folleneing conditions love Men calisfud: 1. *1 quote is timely and tmcotditionallY acccptd in %citing by pcn,Mciire cuslumv,vilhin Ien I FYI Jars of I. quotation.'-. All terms of IM "neuion Use, x'mpted.ejiNut nnutiflonians or change. 3. Wuledine Tcehnnlagics vtisacs itself in the to and absolute disaminn. mgalding the endit%wnhimss orlltc pmspeetivc elowno. 4.1% is Ilse seep leAbility ufOte PunluarIoc.r.ilyso, iew do- itents listed fur accuutry and applieminn. 5. Little. se iad in writing. the Buds lined alloc arc sbua ihanvill be dti,, W. Signature: 2CV110' V M (Senior Project Manager) Date 7/2812020 TBERREY lberreya,waterlinelech.com ACORO® CERTIFICATE OF LIABILITY INSURANCE `� DATE(AVAVYYYD 1 1 /312020 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(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 Bolton 8 Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 www.boltonco.com 0008309 CONTACT NAME: PHONE 626 799-7000 1FAx Ne: 62 583-2117 i1AIL ADDRESS, INSUREINS) AFFORDING COVERAGE NAIC0 INSURERA: Greenwich Insurance Company 22322 INSURED United Storm Water, Inc. 14000 East Valley Blvd. City of Industry CA 91746 INSURERS: XL Insurance America Inc. 24554 INSURERC: XLSpecialty Insurance Company 37885 INSURERD: Indian Harbor Insurance Company 36M INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: 53408109 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 WHCH 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 Lra TYPEOFINSURANC6 POLICYNUMBEq POLIC-_ M"DrYYYYYY UP MWDOr LIMITS A c """r""--uAeIL" ✓ GEC3001234 12/31/2019 12/31/2020 EACHOCCURRENCE S1000000 CLAIMS -MADE F/I OCCUR PREMISES IES m $100 000 MED EMP (A, ore ) $5000 PERSONAL S ADV INJURY $1.000.01)(1) AGGREGATE LIMIT APPLIES PER POLICY E'CT 1_J LOC GENERALAGGREGATE 52,000,000 GEML PRODUCTS -COMPMP AGG S2000WO S OTHER: B D "-MOSILELIABILITY ANY AlnO AECO048938/ AECO048939 12/312019 12131/2020 COMBINED SINGLE LIMIT S1000 W0 BODILY INJURY (Par �) S DIVINE ONLY �SCH�ULEpAURCIS BODILY INJURY (Per ecaantl S --- HIRED NON O MED AUTOS ONLY ✓ AUTOS ONLY PROPERTY DAMAGE 1 S S C "'tlL1aRELUA Luc accuR UECO048940 12/3112019 12/31/2020 EACHMCURRENCE S15000000 ✓ EXCESS LIA6_ C":NADE AGGREGATE 515000000 OED ✓.I RETENTIONS 10,000 S C'" DEMPLOYE EMPLOYERS'LIABILITY AxbexpwvERs•Luwurr r)x OF CEOPRIETERE%CLER ECUTNE � N)A WEC3001235 12/31/2019 12/31/2020 ✓ PS.ETA� &H- E.L EACH ACCIDENT $100D000 EL DISEASE -EA EMPLOYEE S fMendatmy In NH) If yes, descnt,e urWw DESCRIPTION OF OPERATIONS WI. E.L. DISEASE -POLICY LIMIT $1000000 D Pollution Liability PECO048963 121312019 12131/2020 $15,D0o,000 Each Claim I $25,000 Dad. D Professional Liao -Claims Made PECO048963 I 12131/2019 121312020 $15,000,000 Each Claim 1$25,000 Dad. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AGGRO 101, A611dwe1 Remarks Schedule, may M etuNed B mane Space H nequ"d) GL Additional Insured applies per CG20100413 8 CG20370413 attached, only if required by written contract/agreement. GL Primary 8 Non -Contributory Wording applies par XIL4240605 attached. Re: Agreement #A-2017-157 in City of Santa Ana. Excess Policy follows form. Additional Insured(s): City of Santa Ana, its officers, agents, volunteers and employees. CERTIFICATE HOLDER CANCELLATION Re: Agreement #A-2017-157 Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92702 REVIEWED & APPROVED By Ri MANAGEMENT DIVISION AUTHOR DREPRESEMATIVE Cassandra Rosales n Ub CUCU IH 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2018/03) ACORD name a{nd� tnoT' o are registered marks of ACORD 53409/09 1 UNITPIgI-Oi ( 19-20 All Li. G•d' T.HAI 3�.-A rji"{ -TI (PM I Page : cf S _ _ , POLICY NUMBER: GEC3001234 COMMERCIAL GENERAL LIABILITY CG 2010 0413 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) Locations Of Covered Operations Any person or organization where required by written All Locations as required per written contract. contract provided that such contract was executed prior to the date of loss. 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring after: 1. 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 2. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 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 2010 0413 53408109 I pNI4 -01 1 19-29 All Line. REVIVED & APPROVED Py Ri MANAGEMENT DIVISION All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Services Office, Inc., 2012 Ti 2R (PM I PA,. ] "e 5 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or I) & APPROVED 1GEMENT Divisioti 08 2020 2. Available under the applicable Limits Insurance shown in the Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown in Declarations. Of the the Page 2 of 2 [�AL�—��A-0AansnnRf�m[(c��e�'3ervices Office, Inc., 2012 CG 20 10 0413 53408209 1 gM1T -o: Al 1 3S-20 l c3na8 lii lid OZd'i:il:. PM [P ) I Page 3 of s POLICY NUMBER: GEC3001234 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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 Any person or organization where required by written contract provided that such contract was executed prior o the date of loss. All Locations as required per 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 Include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described In the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 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 & APPROVED 1crMENT Dj10N 00 2020 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional Insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown In the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. MM LAMBERT O Insurance Services Office, Inc., 2012 Page 1 of 1 53408109 1 WITP 01. 1 19-20 A11 L.0 I Cory xoap"Cale" 1 113/202C 2:21:21 Y IPni I Pege 4 of 5 ENDORSEMENT# This endorsement, effective 12:01 a.m.,i2t3v2oig , farms a part of Policy NO.GEC3001234 issued to United Pumping Service, Inc. by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART It is agreed that to the extent that Insurance is afforded to any Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract. All other terms and conditions of this policy remain unchanged. QED & APPROVED MANAGEMENT DIVISION XIL 424 0605 f— SAMANTHA08 2020 2005, XL America, I�g j M. LAMBERT 534ne101 I MITPN1-al 1 19 20 All L fts I mry xoapedalee 1 1/3/2020 2:2:: i) M (PST) I Page 5 of S DIIIWII,lpd byF andne R. Francine R. Villareal Wlareel Date:2D21 0I.I51 o:13A3-00'( A'ca'R& CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIVYYV) `-'� 1/91/2021 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 Bolton &Com an 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 CONTACT NAME: AHC"N E,,. 626799-7000 ac No: 626 583-2117 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: Greenwich Insurance Company 22322 www.boltonco.com 0008309 INSURED United Storm Water, Inc' 14000 East ValleywsuRERc: Blvd. INSURER B: XL Insurance America Inc. 24554 Indian Harbor Insurance Company 36940 INSURER D: City of Industry A 91746 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 59652633 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. ILTR LTR OF INSURANCE ADDLTYPE I=SUp POLICYNUMBER MMIDDY� MO/U�YEXP YYY LIMITS I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE MOCCUR ✓ GEC3001234 12/31/2020 12131/2021 EACH OCCURRENCE $1000000 PAMAGE TO RENTED REMISES Ea occurrence $ 100 000 MED EXP (Any one person) $ 5 000 PERSONAL & ADV INJURY $ 1 000 000 AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 GEN'L POLICY EjEp7 0LOC PRODUCTS-COMPIOPAGG $2000000 $ OTHER: B AUTOMOBILE LIABILITY AECO048938 I AECO048939 12/31/2020 12/31/2021 OMBINEDISINGLE LIMIT 31000000 BODILY INJURY (Par person) $ ANYAUTO 1�/ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Peraccident) $ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY PROPERTYDAMAGE Per accident $ C UMBRELLA LIAB OCCUR UECO048940 12131/2020 12/31/2021 EACH OCCURRENCE $15 000 000 H AGGREGATE $15 000 000 ✓ EXCESS LIAB CLAIMS -MADE DED ✓ RETENTION 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFICERIMEMB REXCLUDED9ECUTIVE � NIA WEC3001235 12l31/2020 12/31/2021 ,/ STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $j 00 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT I $1000000 C Pollution Liability PECO048963 12/31/2020 12/31/2021 $16,000,000 Occ/Aggregate ! $25,000 Ded. C Professional Liab - Claims Made PECO048963 12/31/2020 12/31/2021 $15,000,000 Each Claim/Agg ! $25,000 Ded. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: Agreement #A-2017-157, A-2020-079 (1st Amendment), A-2020-158-06 (2nd Amendment), and A-2020-158-29 (3rd Amendment) In City of Santa Ana. GL Additional Insured applies per CG20101219 & CG20371219 attached, only If required by written contract/agreement. GL Primaryy & Non -Contributory Wording applies per XIL4240606 attached. Excess Policy follows form. Additional Insured(s): City of Santa Ana, its officers, agents, volunteers and employees. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 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 Cassandra Rosales ©1988-2015 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD .� PlekMannipenent DMa[rnt REVIEWED & APPROVm BY: t F4Awt4.e P,, V4,-44aP Risk Mnnagemcnt PoSBlyn 59652633 1 UNITPUM-01 1 20-21 All Linea I Cory Hoepedalea 1 1/11/2021 3:53:53 PM (PST) I Page 1 of 5 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional Insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 59652633 1 UNITPUM-01 120-21 All Linee I Cory Ho9pedalee 1 1/11/2021 3:53:53 PM (PST) I Page 3 of 5 not increase the „ ,aa FiskMWQgMeAv1V1s4m [R`Ev1EWED&pA�P?Rovm8V: '. i' f �NiY/4✓eP. Fes. U.,�iMEfi� �1 Risk Management Analyst ENDORSEMENT# This endorsement, effective 12:01 a.m.,12/31/2020 , forms a part of Policy No.cec3001234 issued to United Pumping Service, Inc. by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART It is agreed that to the extent that insurance is afforded to any Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract. All other terms and conditions of this policy remain unchanged. XIL 424 0605 ©, 2005, XL America, Inc. 59652633 1 ilN1TPOM-01 1 20-21 All Lines I Cory Hospedalee 1 1/11/2021 3:53:53 PM (PST) I Page 5 of 5 sy Risk marogenienlDmalon. p+% rREoEWED 6 APPROVED BY' 8I "L� r'AAfY.K+¢ �, VausaAf� Risk Management Analyst „�