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HomeMy WebLinkAboutALL AMERICAN ASPHALTINSURANCE AY PROCEED �O wuL INSURANCE EXPIRES N-2021-055 R_ �121 _�i,: Of COUNCIL LICENSE AGREEMENT This LICENSE AGREEMENT ("Agreement") is dated as of March 17, 2021, and entered into by and between the CITY OF SANTA ANA, a charter city and municipal corporation existing under the Constitution and laws of the State of California ("City"), and All American Asphalt ("Licensee"). RECITALS A. The City is the owner of that certain real property located in the City of Santa Ana, County of Orange, California, more specifically identified as the southwest corner of Bristol St. and St. Andrew Pl. (APNs 408-332-01), as depicted on Exhibit A ("License Area"). B. Licensee desires to use the License Area for purposes of storing vehicles, materials, and other construction equipment and stockpile during the License period ("Permitted Uses"). C. The City has agreed to grant Licensee a license to use the License Area, on the terms and conditions set forth in this Agreement. NOW THEREFORE, for and in consideration of the mutual covenants and agreements herein contained and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as follows: 1. License. The City hereby grants to Licensee a nonexclusive license for the right to enter and use the License Area beginning on March 17, 2021, for the Permitted Uses described in Recital B, upon the terms and conditions set forth herein ("License"), subject to Licensee's performance of all of its obligations under this Agreement. This License shall remain in effect until May 17, 2021, unless extended in writing by the Executive Director of the Public Works Agency, or his or her designee. The License may be terminated by City upon thirty (30) days written notice. This Agreement is intended and shall be construed only as a revocable license to use the License Area and not as a lease or grant of any possessory or other interest. 2. Restoration and Clean Up' At its sole cost, Licensee shall, after use of the License Area, restore the License Area to its original condition in which it existed immediately prior to the Agreement, leave the License Area in a neat and clean condition to the sole satisfaction of the City, free of trash and debris, and remove all property and materials of Licensee. Licensee shall cause the License Area to be cleaned, with such work to be completed no later than the times specified in the License as stated in paragraph 1 above, and the License shall be extended to such time for the limited purpose of allowing the cleaning work to be completed. 3. Compliance with Laws. Licensee shall cause all activities of Licensee under this Agreement and all activities on the License Area to be performed in compliance with all applicable federal, state, and local laws, ordinances, and regulations, and permits. 4. Licensee shall include, implement, and maintain but not be limited to the following Best Management Practices (BMPs) at the License Area: a) Waste management and Materials Pollution Control BMPs shall be implemented to prevent the contamination of stormwater by construction wastes and materials. b) Tracking control (TC) BMPs to control off -site sediment tracking shall be implemented and maintained. Page I of 5 c) Sediment control (SE) BMPs shall be implemented at all locations along the site perimeter, at all operational storm drain inlets and at all non -active slopes, as appropriate, d) Pollution prevention practices shall be implemented, e) Non-stormwater management measures to prevent illicit discharges and control stormwater pollution sources. f) Erosion Control BMPs shall be implemented, as appropriate. g) Wind erosion control BMPs (dust control) shall be implemented, as appropriate. h) Non-stormwater BMPs shall be implemented to reduce or prevent the contamination of stormwater from construction activities. i) Fence and Green Screen For specific guidance reference, reference the Construction Runoff Guidance Manual (Orange County Stormwater Program, December 2012) (https://media.ocgov.eom/ ov/pw/watersheds/documents/bmn/constructionactivities asp] or the California Stormwater Quality Association (CASQA) Stormwater BMP Handbook for Construction. 5. Damage. In the event that Licensee damages any portion of the License Area or the improvements or equipment therein, Licensee shall immediately repair the damage at Licensee's sole cost. Alternatively, the City may, at its election, repair the damage in which case Licensee shall reimburse the City for its cost within fifteen (15) days of receipt of written demand from City. G. Licensee Parties. Licensee, together with its employees, subcontractors, agents, representatives, and all persons entering the License Area, by or through or at the direction of Licensee, are collectively referred to herein as the "Licensee Parties." Licensee shall be responsible for the Licensee Parties and shall cause the Licensee Parties to comply with the terms of this Agreement. 7. Fee. As consideration for this Agreement, Licensee shall pay City a total license fee of $5,540. Licensee shall pay this amount upon full execution of this Agreement. Licensee shall pay the monthly fee of $2,770, or a pro -rated portion thereof, for any extension of the Agreement pursuant to Section 1. 8. AS -IS Condition. City makes no representation or warranty of any kind as to the condition of the License Area or any other matter relating to Licensee's use of the License Area. Licensee hereby disclaims and waives any and all objections to the physical and other characteristics and conditions of the License Area. Licensee acknowledges and agrees that the use of the License Area will be on the basis of Licensee's own investigation of the condition of the License Area. The license to use the License Area shall be granted on an "AS -IS," "WITH ALL FAULTS" basis, without representation or warranty expressed or implied by City, or by operation of law. City expressly disclaims, which Licensee hereby acknowledges and accepts, any implied warranty of condition or fitness for a particular purpose or use. Licensee's use of the License Area shall be subject to the License Area being in a usable and safe condition at the time of Licensee's use and Licensee shall be responsible for determining whether the License Area Is in such condition. In connection therewith, in the event that the License Area or access thereto is damaged or obstructed or the use by Licensee is otherwise impaired, prevented or limited, City shall have no obligation or duty to repair the damage or rectify the condition to make the License Area usable or safe. 9. Insurance. Licensee shall secure or cause its agents or contractors performing any entry onto the License Area to secure, prior to commencing any activities under this Agreement, and maintain or cause to be maintained during the term of this Agreement, insurance coverage as follows: a. Commercial General Liability Insurance. Licensee shall maintain commercial general liability insurance which shall include, but not be limited to, protection against claims arising from bodily Page 2 of 5 and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Licensee Parties use of the License Area, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence and $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Worker's Compensation Insurance as required by California law. C. Comprehensive Automobile Liability Coverage, including as applicable owned, non - owned, and hired autos, in an amount of not less than $1,000,000 per occurrence, combined single limit, written in an occurrence form. 10. Indemnity. Licensee shall indemnify, defend, and hold harmless City, and its respective agents, representatives, employees, subsidiaries and affiliates ("Covered Parties") from and against any and all actions, suits, claims, demands, judgments, losses, expenses, or liabilities, injuries and damages to persons and property, including death, arising out of or related to Licensee's use of the License Area, the entry by any Licensee Party on the License Area or surrounding property, or Licensee's breach or default in the performance of any of its obligations under this Agreement; provided, however, that Licensee will not be obligated to indemnify the Covered Parties from any claims arising solely from the gross negligence or willful misconduct of a Covered Party. If any action or proceeding Is brought against any Covered Party by reason of any such claim, Licensee, upon receipt of written notice from Covered Party, shall defend the same at Licensee's expense with legal counsel reasonably acceptable to Covered Party. Payment shall not be a condition precedent to recovery under any indemnification in this Agreement, and a finding of liability or an obligation to indemnify shall not be a condition precedent to the duty to defend. The provisions of this Section 10 shall survive the termination or expiration of this Agreement. II. Miscellaneous. 11.1 Entire Agreement. Waiver and Amendments. This Agreement incorporates all of the terms and conditions mentioned herein, or incidental hereto, and supersedes all negotiations and previous agreements between the parties with respect to the subject matter of this Agreement. All waivers of the provisions of this Agreement must be in writing and signed by the appropriate authorities of the party to be charged. Any amendment or modification to this Agreement must be in writing and executed by the appropriate authorities of the City and Licensee, 11.2 Severability. If any term, provision, covenant, or condition of this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions of the Agreement shall continue in full force and effect, unless and to the extent the rights and obligations of one or both parties has been materially altered or abridged by such holding. 11.3 No Assignment. Licensee shall not assign or transfer or otherwise convey any interest in this Agreement to any party without the express prior written consent of City, which consent may be withheld in City's sole and absolute discretion. 11.4 Applicable Law. This Agreement shall be construed and enforced in accordance with the internal laws of the State of California. Page 3 of 5 N-2021-055 11.5 Litigation Expenses. If either party to this Agreement commences an action against the other party to this Agreement arising out of or in connection with this Agreement, the prevailing party shall be entitled to recover reasonable attorneys' fees, expert witness fees, costs of investigation, and costs of suit from the losing party. 11.6 Authority. The persons executing this Agreement on behalf of the parties hereto represent and warrant to the other party that they are duly authorized to execute and deliver this Agreement on behalf of such party, and by so executing this Agreement, said party is formally bound to the provisions of this Agreement. 11.7 Notices. Any notices, requests, or approvals given under this Agreement from one party to another shall be in writing and shall be personally delivered or deposited with the United States Postal Service for mailing, postage prepaid, by certified mail, return receipt requested, to the addresses of the other party as stated in this section, and shall be deemed to have been received at the time of personal delivery or three (3) days after the deposit for mailing. Notices shall be sent to: If to Licensor: All American Asphalt Attn: Jim McGee 400 E. 61" Street Corona, CA 92879 If to City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 11.8 Execution in Counterpart. This Agreement may be executed in several counterparts, and all so executed shall constitute one agreement binding on both of the parties hereto, notwithstanding that both parties are not signatories to the original or the same counterpart. IN WITNESS WHEREOF, City and Licensee have entered into this Agreement as of the day and year first written above. CITY OF SANTA ANA Kristine Ridge City Manager ATTEST Daisy Gon ez Clerk of tile Council LICENSEE By: Its: &JV-bL c� J. CC,ilio-,7 Vr' Page 4 of 5 APPROVED AS TO FORM SONIA R. CARVALHO City Attorney !g, � L J n M. Funk Senior Assistant City Attorney FOR APPROVAL ,,JV94�. Nabil Saba Executive Director Public Works Agency Page 5 of 5 o-, OVA 'I W Saint Andrew PI' W Saint Andrew �f � to '•' l e i + + x r F IR IMA '.----------- i i Francine R. 't os�rary,y�m eyaann,ka. emai Villareal - duExonarn isaoss.mm A� " CERTIFICATE OF LIABILITY INSURANCE DAT MMIDD2n1YY) 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()es) 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 Ed wood Partners Insurance Center P.O. Box San Ramonon,, CA 94583 CONTACT NAME: Certificates Department PNNNo Er : 925-244-7700 we No: 925901-0671 C ADDRESS: EPICcerts@epicbrokem.com INSURERS AFFORDING COVERAGE NAIL ry INSURERA: Arch Specialty Insurance Company 21199 w .epicbrokers.com CA LICENSE #OB29370 INSURED All American Asphalt P.O. Box 2229 INSURER B: Zurich American Insurance Company 16535 INSURER C: Great American Insurance Company 16691 NsuRERD: Corona CA 92878 NSURERE: NSURERF: COVERAGES CERTIFICATE NUMBER: switi KR2 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. ILTH TYPE OF INSURANCE ADDLSUBR POLICYNUMBER POLICY EFF MMIDDANYY POLICY EXP MMIDDIYYYY LIMITS A ✓ COMMERCIAL GENERALLIASILITY CLAIMS -MADE OCCUR ✓ DPC1005856-04 8/1/2020 8/1/2021 EACH OCCURRENCE $1,000,000 AMA ET RE E PREMISES Ea occurrence $100,000 MED EXP (Any one person) $ PERSONAL a ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPUES PER: POLICY Z JECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2000,000 $ B AUTOMOBILELIABIDTY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY BAP6571088-08 8/1/2020 8/1/2021 (Eaaccident)BIKESINGLE LIMIT $2000,000 r/ BODILY INJURY (Per person) $ acident BODILY INJURY (Perc) $ ✓ PROPERTY DAMAGE Peraccident _ $ 8 C UMBRELLA DAB EXCESS UAB OCCUR CLAIMS -MADE TUE347483600 8/1/2020 8/1/2021 EACH OCCURRENCE $5,000,000 ✓ M AGGREGATE $5,000,000 DED ✓ RETENTION$10,000 Following -Form $ B WORKERSCOMPENSATION EMPLOYERS' LIABILITY Y I N ANYPROPRIETORIPARTNERIEXECUIVE OFFICERIMEMBEREXCLUDED7 ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC593205707 8/1/2020 8/112021 ✓ STATUTE I I 'ER'AND E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $10000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AAA Job #1 B-69081 RE: Bristol Street Protected Bike Lanes from Edinger Avenue to First Street CML-5063(183) I Certificate Holder is Additional Insured if Required by Written Contract Excluding Workers Compensation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division, 4th Floor ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Ad Risk Marwge nad.Dhision Certificates Department agyp,° REVIEWED& APPROVED SY. ©1988-2015 ACORD C 8, . ., f IMIO�w P_ Vi.:t""t ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management Analyst 59791982 120 1011 Standard with $5mm XS I Seta Ho 1100120214: 14 08 PM (PST) I P., I of I I E I PI I JC PO Box 5003 San Ramon, CA 94583 Phone: 925.244.7700 Fax: 925.901-0244 Email: EPICcerts@epicbrokers.com CERTIFICATE HOLDER: City of Santa Ana Risk Management Division, 4th Floor 20 Civic Center Plaza Santa Ana CA 92701 To: Whom it may concern Regarding: Notice of Cancellation Date Issued: 1/20/2021 Named Insured(s): All American Asphalt Policy Number(s): DPC1005856-04 BAP5571088-06 WC593205707 TUE347483600 Should the above described policy be cancelled before the expiration date thereof, we will mail 30 days written notice to the above referenced Certificate Holder; except, 10 days notice for non-payment of premium. Sincerely, Z)4-- Dan Ryan, Managing Principal epicbrokers.com edgewood partners insurance center �. RE&Mwuganen{Div[eian rR�eneNm& Ar'axo/v�® ar. �. Risk Managem nt Maryst 59791892120 [011 Standard with $5mm XS I Sna H.1 1==] 4 14:08 PM (PST) I Page 2 of I I COMMERCIAL GENERAL LIABILITY CG 20 10 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): Location(s) Of Covered Operations Any person or organization where the Named Any location where required by written contract or Insured has agreed to add as an additional insured agreement, provided the contract or agreement is by written contract or agreement, provided the executed prior to any "occurrence" or offense. contract or agreement is executed prior to any ,.occurrence" or offense 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: Your acts or omissions; or 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: 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. 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: 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 2. 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 subcontract �,RukMougalren[Dideian Rene&m & APPRovm av: CG 20 10 04 13 © Insurance Services Office, Inc., 2012 a fa c. u A V (LHuI �Risk Management MalySt 59991882120 [01( Standard wlth $5m XS I Seta Ho 11/3N20214. 14'. 08 PM (PST) I Page 3 of 11 performing operations for a principal as a part of the same project. 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: All other terms and conditions of this policy remain unchanged. Endorsement Number: t. 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. This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: DPC1005856-04 Named Insured: All American Asphalt Endorsement Effective Date: 08/01/2020 REFERENCE: AAA Job #18-69081 RE: Bristol Street Protected Bike Lanes from Edinger Avenue to First Street CML-5063(183) I CG20100413 SCHEDULE: City of Santa Ana. © Insurance Services Office, Inc., 2012 59791882120 [01] Standard mffi SSmm XS I Seta Ho 1 112020214. 14'O9 PM (PST) I Page 4 or 11 tcMFUR*isek� ® COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization where the Named Insured All locations where required by contract. has agreed to add as an additional insured by written contract or agreement, provided the contract or agreement is executed prior to any "occurrence" or offense 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: 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 CG 20 37 04 13 additional insured. 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. © Insurance Services Office, Inc., 2012 ca.., RLkMowgonm[DMdm REVe&m6APPRwm9r: Risk Management Malys[ 59991882120[01] Standard-d 85mm XSI Sna Ho11 nM0214: 14:08PM(PST) I Pege5of II All other terms and conditions of this Policy remain unchanged. Endorsement Number: This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: DPCIO05856-04 Named Insured: All American Asphalt Endorsement Effective Date: 08f01/2020 REFERENCE: FYU71q�1�1�� AAA Job #18-69081 RE: Bristol Street Protected Bike Lanes from City of Santa Ana. Edinger Avenue to First Street CML-5063(183) / CG 20 37 04 13 © Insurance Services Office, Inc., 2012 on Risk Mw%m=1l D1*[on o RaAEwED&APPRcrADBY: 1 a' F�IH.L:K �. ViUH4t1 Risk Management Analyst 59791882120 I0[1 Standard wdN $5mm XS I Sem Ho 11/20/20214:14: 08 PM (PST) l Page 6 or I I COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (1) The additional insured is a Named Condition and supersedes any provision to the Insured under such other insurance; contrary: and Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: All other terms and conditions of this policy remain unchanged. REFERENCE: AAA Job #18-6908 / RE: Bristol Street Protected Bike Lanes from Edinger Avenue to First Street CML-5063(183) / Endorsement Number: (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. SCHEDULE: City of Santa Ana. This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: DPC1005856-04 Named Insured: All American Asphalt Endorsement Effective Date: 08/01/2020 CG 20 01 04 13 © Insurance Services Office, Inc., 2012 ,q'% a 'c, RleieMougemmt so By.. +7 REV1EWm SAPPR�O/V�@BV�: F,FPLi Z V:�ctir ti t Risk Management Analyst 59791882120 [01] Standard with Mini $S I Sera Ho I [W2021 4.14:08 PM (PST) I Page 7 or I I COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Any person or organization where the waiver of our right to recover is permitted by law and is required by written contract or agreement, provided the contract or agreement is executed prior to any occurrence or offense The following is added to Paragraph 8. Transfer for injury or damage arising out of your ongoing Of Rights Of Recovery Against Others To Us operations or "your work' done under a contract of Section IV — Conditions: with that person or organization and included in the "products -completed operations We waive any right of recovery we may have hazard". This waiver applies only to the person against the person or organization shown in the or organization shown in the Schedule above. Schedule above because of payments we make All other terms and conditions of this policy remain unchanged. Endorsement Number: This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: DPC1005856-04 Named Insured:All American Asphalt Endorsement Effective Date: 08/01/2020 REFERENCE: SCHEDULE: AAA Job #18-6908 / RE: Bristol Street Protected Bike Lanes from City of Santa Ana. Edinger Avenue to First Street CML-5063(183) / CKevzWK1146161 © Insurance Services Office, Inc., 2008 _ Pbk Marug*nadDMs[an RENEWED S APPRW®BY: Risk Management Analyst 59791882120 [01] Sla dwd with S5mm XS I Seta Ho 1 1/2020214'. 14'08 PM (PST) I Page 8 of I I POLICY NUMBER: BAP5571088-08 1/20/2021 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds' for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: All American Asphalt Endorsement Effective Date: 08/01/2020 SCHEDULE Name Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS ON A PRIMARY, NON-CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "Insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 SCHEDULE: City of Santa Ana, O Insurance Services Office, Inc., 2011 59791882120[01] Star,d with SSMMXS I Sda Ho 11/20/202141408 PM(PST) I Page9 of 11 Page 1 of 1 '�� a Risk Manogmtatt D[Asim RENEwm & APPROVE) Br. func:.se �. V:C1.rnrfl `� Risk Management Malyst 1/20/2021 POLICY NUMBER: BAP55710e8-08 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: All American Asphalt Endorsement Effective Date: 08/01/2020 SCHEDULE Name(s) Of Person(s) Or Organization(s): ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the SCHEDULE: person(s) or organization(s) shown in the Schedule, City of Santa Ana. but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 _ E RLAMmagemed D[Wabn h� REmE&m&APPRWm8y: low' Risk Management Malys[ 59791882120 [01[ Standard with $5mm XS I Seta Ilo I In6n021 4 14 08 PM (PST) I Pa,, 10 of I I WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHTTO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (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 maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0 .00 % of the California workers' compensation pre- mium otherwise due on such remuneration. Schedule Person or Organization Job Description ALL PERSONS AND/OR ALL CA OPERATIONS ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION SCHEDULE: REFERENCE: AAA Job #18-6908 / RE: Bristol Street Protected Bike City of Santa Ana. Lanes from Edinger Avenue to First Street CML-5063 (183) / Policy Number: WC593205707 Named Insured: All American Asphalt All American Asphalt Endorsement Effective Date: 08/01/2020 o RwkM9YgOnlntDMelon WC 252 (4$4) �/ ReaEWEn 6 APPROVm Sr: WC 040306(Ed. 4-84) Risk Managemen[Anatyst 19791882120[0p Siwdnrd with S5m XSISae Ho 1 IR0120214.14. 03 PM (PST) Pa,,IIdI