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HomeMy WebLinkAboutCOLICH & SON'S LPINSURANCE NOT ON FILE N-2022-089 WORK MAY NOT PROCEED CLERK OF COUNCIL DATE d /n�-r- �rv�n���__ ' LICENSE AGREEMENT WITH COLICH & SON'S L.P. l !Jlm ©,I�'4/�/ This LICENSE AGREEMENT ("Agreement") is dated as of March 25. 2022, and entered into by oand 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 Colich & Son's L.P. ("Licensee"). cr o RECITALS rr rl 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 2115 S Bristol St (APN 015-194-42), as depicted in 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 28, 2022, for the Permitted Uses described in Recital B, upon the terms and conditions set forth herein ("License's, subject to Licensee's performance of all of its obligations under this Agreement. This License shall remain in effect until October 28, 2022, 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. fj 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) [httns://media.oca0--- /eov{pw/watersheds/documents/bmn/conshuctionactivities 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. 6. 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 Forty -Five Thousand Five Hundred Forty -Nine Dollars and Zero Cents ($45,549.00). Licensee shall pay this amount upon full execution of this Agreement. Licensee shall pay the monthly fee of Six Thousand Five Hundred Seven Dollars and Zero Cents ($6,507.00), or a p.ro-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: Page 2 of 5 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 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. 11, 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 Severabilitv. 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 bill 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 ally 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 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: Colich & Son's, LT Attn: Steve Tamer 547 West 140" Street Gardena, CA 90248 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 hr Cauntg art. 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. [signature page to follow] Page 4 of 5 IN WITNESS WHEREOF, City and Licensee have entered into this Agreement as of the day and year first written above. CITY OF SANTA ANA ATTEST Kristine Ridge Daisy Gomez City Manager Clerk of the Council APPROVED AS TO FORM LICENSEE Sonia R. Carvalho City Attorney By: Btwtronierra Name: Deputy City Attorney Title:Ich _ RECOMMENDED FOR APPROVAL Vice Prealdent of Operatlom Corelm Inc., General Partner Nabil Saba Executive Director Public Works Agency Page 5 of 5 TITH"ll W Saint GertrUde,PI vi ■` W Saint Gertrude PI AAA �'L•. , Af 't: �Ir Y 4 � i t Y l � • Ii ..1"F 3' 6. «i -' P, wx 121 ,ice_ NAP 1 t'I ♦r j'I �' , r: i rE ov,� '*` / Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! Ebuf;!3133/15/17!21;41;69! Upsj!Qjfstpo .18(11( COLI&SO-01DMORALES DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/23/2021 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). CONTACT License # 0757776 PRODUCER NAME: PHONEFAX Riverside, CA - HUB International Insurance Services Inc. (951) 788-8500(951) 788-8502 (A/C, No, Ext):(A/C, No): PO Box 5345 E-MAIL Riverside, CA 92517 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Executive Risk Indemnity35181 INSURER A : INSURED Federal Insurance Company20281 INSURER B : INSURER C : Colich & Sons, LP 547 West 140th Street INSURER D : Gardena, CA 90248 INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 2,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR X 543101856/1/20216/1/2022 $ PREMISES (Ea occurrence) X 5,000 MED EXP (Any one person)$ 2,000,000 PERSONAL & ADV INJURY$ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 4,000,000 XX POLICYLOC PRODUCTS - COMP/OP AGG$ JECT Per Proj Gen Agg per contract X OTHER:$ COMBINED SINGLE LIMIT 2,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO 543101846/1/20216/1/2022 BODILY INJURY (Per person)$ X OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ UMBRELLA LIABOCCUR EACH OCCURRENCE$ EXCESS LIABCLAIMS-MADE AGGREGATE$ DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION B X STATUTEER AND EMPLOYERS' LIABILITY Y / N 543101866/1/20216/1/2022 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 18-6616 - Flower Street Sewer. City of Santa Ana, its officers, employees, agents and representatives are included as Additional Insureds where required by an executed written contract as respects General Liability and Auto Liability per attached endorsements. This Insurance shall apply as Primary and Non-Contributory where required by an executed written contract as respects General Liability and Auto Liability per attached endorsements. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division, 4th Floor 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COLI&SO-01DMORALES AGENCY CUSTOMER ID: 1 LOC #: Page of 11 ADDITIONAL REMARKS SCHEDULE License # 0757776 AGENCYNAMED INSURED Colich & Sons, LP Riverside, CA - HUB International Insurance Services Inc. 547 West 140th Street Gardena, CA 90248 POLICY NUMBER Gardena SEE PAGE 1 CARRIERNAIC CODE SEE PAGE 1SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 25Certificate of Liability Insurance FORM NUMBER:FORM TITLE: Cancellation: * Should the policy(ies) be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non-payment of premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation date. ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY 10-02-2461 (E d.7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE FOR SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Additional Insured: Location Of Covered Operations: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect only to the Additional Insured and at the Location Of Covered Operations shown in the Schedule, the following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4.Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Additional Insured with respect to the Location Of Covered Operations shown in the Schedule under this policy provided that: (1)The Additional Insured is a named insured under such other insurance; and (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. 10-02-2461 (EPage d.7-15) Includes copyrighted material of Insurance Services Office, Inc.,1of1 with its permission. COMMERCIAL AUTO 16-02-0316Ed. 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY LIABILITY INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO 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. Endorsement Effective Date: SCHEDULE Name(s)Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Item 5. – “Other Insurance” of Item B. – “General Conditions” under Section IV – “Business Auto Conditions”: e.Regardless of the provisions of Paragraph 5.a. through d. above, for any liability arising out of the ownership, maintenance, use, rental, lease, loan, hire or borrowing by an ”insured” of a covered “auto” for which an “insured” is contractually obligated to provide primary insurance coverage to a client, this Coverage Form will be primary and non-contributory with respect to the Persons or Organizations in the schedule, regardless of the availability or existence of other collectible insurance under any other Coverage Form or policy that applies on a primary basis. 16-02-0316Ed. 10 14Page 1of 1 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/30/2022 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). CONTACT PRODUCER (AVC) Donna Esquivel NAME: IOA Insurance Services FAX PHONE 130Vantis, Suite 250 (949) 297-5962 (A/C, No): (A/C, No, Ext): Aliso Viejo, CA 92656 E-MAIL donna.esquivel@ioausa.com ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # www.ioausa.comCA License #0E67768 INSURER A :RLI Insurance Company13056 INSURED INSURER B : Landmark Surveying Solutions, Inc. INSURER C : 7231 Boulder Avenue, Suite #538 INSURER D : Highland CA 92346 INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: 67483025 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY APSB00014253/13/20223/13/2023 EACH OCCURRENCE$ 444 1,000,000 DAMAGE TO RENTED Scheduled AI Endt CLAIMS-MADEOCCUR$ 4 1,000,000 PREMISES (Ea occurrence) #PPB3130212 MED EXP (Any one person)$ 4 Prim/NonCon10,000 Professional Services PERSONAL & ADV INJURY$ 4 Wvr of Subr1,000,000 performed by the Insured 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ are Excluded PRO- 44 POLICYLOCPRODUCTS - COMP/OP AGG$ 2,000,000 JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ APSA00012243/13/20223/13/2023 1,000,000 (Ea accident) 44 Designated Insured Endt ANY AUTO BODILY INJURY (Per person)$ 4 #CA20481013; Prim/NonCon OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS and Blkt Wvr of Subr NON-OWNED HIREDPROPERTY DAMAGE $ 44 (Per accident) AUTOS ONLYAUTOS ONLY included on pg 2 of Form $ 4 Prim/NonCon 4 Wvr of Subr#PPA3000313 UMBRELLA LIAB APSE00012903/13/20223/13/2023 EACH OCCURRENCE$ 4 OCCUR 5,000,000 Excludes Professional EXCESS LIAB 4 CLAIMS-MADEAGGREGATE$ 5,000,000 Liability; Follow Form $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION APSW00013543/13/20223/13/2023 4 4 STATUTEER AND EMPLOYERS' LIABILITY Y / N Waiver of Subrogation ANYP ROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ 1,000,000 N / A OFFICER/MEMBER EXCLUDED?YEndt #WC0403060484 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ 1,000,000 If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below 1,000,000 AProfessional LiabilityRDP00464123/13/20223/13/2023$1,000,000 Each Claim Claims-Made$2,000,000 Annual Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an Additional Insured with respect to General Liability (GL) and Automobile Liability when required by contract with the Insured, but only to the extent provided within the Endorsements noted above. GL includes Separation of Insureds and Contractual Liability per limitations in the BusinessOwners' Coverage form. A Workers’ Compensation Waiver is included for the person or organization named in the Schedule that are parties to a written contract, but only to the extent provided within the Endorsement noted above. Coverage is subject to all policy terms, conditions, limitations and exclusions. 30 Day Notice of Cancellation / 10 Days for Non-Payment in accordance with policy provisions. CERTIFICATE HOLDERCANCELLATION Flower Street Sewer Main Improvements Santa Ana, CA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Colich & Sons, LP; City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 547W. 140th Street ACCORDANCE WITH THE POLICY PROVISIONS. Gardena CA 90248 AUTHORIZED REPRESENTATIVE (AVC) Alicia K. Igram © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD 78594136!}!4033.34!HM-!BVUP-!FYDFTT-!XD!'!QM!}!)BWD*!Epoob!Ftrvjwfm!}!404103133!5;3:;22!QN!)QEU*!}!Qbhf!2!pg!6 PSB0001425 Landmark Surveying Solutions, Inc. Colich & Sons, LP; City of Santa Ana 78594136!}!4033.34!HM-!BVUP-!FYDFTT-!XD!'!QM!}!)BWD*!Epoob!Ftrvjwfm!}!404103133!5;3:;22!QN!)QEU*!}!Qbhf!3!pg!6 PSA0001224 Landmark Surveying Solutions, Inc. 3/13/2022 Colich & Sons, LP; City of Santa Ana 78594136!}!4033.34!HM-!BVUP-!FYDFTT-!XD!'!QM!}!)BWD*!Epoob!Ftrvjwfm!}!404103133!5;3:;22!QN!)QEU*!}!Qbhf!4!pg!6 78594136!}!4033.34!HM-!BVUP-!FYDFTT-!XD!'!QM!}!)BWD*!Epoob!Ftrvjwfm!}!404103133!5;3:;22!QN!)QEU*!}!Qbhf!5!pg!6 Colich & Sons, LP; City of Santa Ana 3/13/2022PSW0001354 Landmark Surveying Solutions, Inc. 78594136!}!4033.34!HM-!BVUP-!FYDFTT-!XD!'!QM!}!)BWD*!Epoob!Ftrvjwfm!}!404103133!5;3:;22!QN!)QEU*!}!Qbhf!6!pg!6 Ejhjubmmz!tjhofe!cz!Upsj!Qjfstpo! Ebuf;!3133/17/1:!1:;31;27! Upsj!Qjfstpo .18(11( COLI&SO-01BMARIN DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/31/2022 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). CONTACT License # 0757776 PRODUCER NAME: PHONEFAX HUB International Insurance Services Inc. (951) 788-8500(951) 788-8502 (A/C, No, Ext):(A/C, No): PO Box 5345 E-MAIL Riverside, CA 92517 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Executive Risk Indemnity35181 INSURER A : INSURED Federal Insurance Company20281 INSURER B : INSURER C : Colich & Sons, LP 547 West 140th Street INSURER D : Gardena, CA 90248 INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD (MM/DD/YYYY)(MM/DD/YYYY) 2,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR X 543101856/1/20226/1/2023 $ X PREMISES (Ea occurrence) 5,000 MED EXP (Any one person)$ 2,000,000 PERSONAL & ADV INJURY$ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 4,000,000 XX POLICYLOC PRODUCTS - COMP/OP AGG$ JECT Per Proj Gen Agg per contract X OTHER:$ COMBINED SINGLE LIMIT 2,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO 543101846/1/20226/1/2023 BODILY INJURY (Per person)$ X OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE$ EXCESS LIAB CLAIMS-MADE AGGREGATE$ DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION B X STATUTEER AND EMPLOYERS' LIABILITY Y / N 543101866/1/20226/1/2023 1,000,000 X ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Project No. 18-6616; Flower Street Sewer Main Improvements. City of Santa Ana, its officers, employees, agents and representatives are included as Additional Insureds where required by an executed written contract as respects General Liability and Auto Liability per attached endorsements. This Insurance shall apply as Primary and Non-Contributory where required by an executed written contract as respects General Liability and Auto Liability per attached endorsements. Waiver of Subrogation applies where required by an executed written contract as respects WorkersÓ Compensation per attached endorsement. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COLI&SO-01BMARIN AGENCY CUSTOMER ID: 1 LOC #: Page of 11 ADDITIONAL REMARKS SCHEDULE License # 0757776 AGENCYNAMED INSURED Colich & Sons, LP HUB International Insurance Services Inc. 547 West 140th Street Gardena, CA 90248 POLICY NUMBER Gardena SEE PAGE 1 CARRIERNAIC CODE SEE PAGE 1SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 25Certificate of Liability Insurance FORM NUMBER:FORM TITLE: Cancellation: * Should the policy(ies) be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non-payment of premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation date. ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIA L GENERAL LIABILITY 10-02-2461 (Ed.7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE FOR SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Additional Insured: Location Of Covered Operations: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect only to the Additional Insured and at the Location Of Covered Operations shown in the Schedule, the following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4.Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Additional Insured with respect to the Location Of Covered Operations shown in the Schedule under this policy provided that: (1)The Additional Insured is a named insured under such other insurance; and (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. 10-02-2461 (EPage d.7-15) Includes copyrighted material of Insurance Services Office, Inc.,1of1 with its permission. COMMERCIAL AUTO 16-02-0316Ed. 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY LIABILITY INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO 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. Endorsement Effective Date: SCHEDULE Name(s)Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Item 5. Î Ð Other Insurance Ñ of Item B. Î Ð General Conditions Ñ under Section IV Î Ð Business Auto Conditions Ñ: e.Regardless of the provisions of Paragraph 5.a. through d. above, for any liability arising out of the ownership, maintenance, use, rental, lease, loan, hire or borrowing by an ÑinsuredÑ of a covered ÐautoÑ for which an ÐinsuredÑ is contractually obligated to provide primary insurance coverage to a client, this Coverage Form will be primary and non-contributory with respect to the Persons or Organizations in the schedule, regardless of the availability or existence of other collectible insurance under any other Coverage Form or policy that applies on a primary basis. 16-02-0316Ed. 10 14Page 1of 1 EBUF!)NN0EE0ZZZZ* DFSUJGJDBUF!PG!MJBCJMJUZ!JOTVSBODF 404103133 UIJT!DFSUJGJDBUF!JT!JTTVFE!BT!B!NBUUFS!PG!JOGPSNBUJPO!POMZ!BOE!DPOGFST!OP!SJHIUT!VQPO!UIF!DFSUJGJDBUF!IPMEFS/!UIJT DFSUJGJDBUF!EPFT!OPU!BGGJSNBUJWFMZ!PS!OFHBUJWFMZ!BNFOE-!FYUFOE!PS!BMUFS!UIF!DPWFSBHF!BGGPSEFE!CZ!UIF!QPMJDJFT CFMPX/!!UIJT!DFSUJGJDBUF!PG!JOTVSBODF!EPFT!OPU!DPOTUJUVUF!B!DPOUSBDU!CFUXFFO!UIF!JTTVJOH!JOTVSFS)T*-!BVUIPSJ\[FE SFQSFTFOUBUJWF!PS!QSPEVDFS-!BOE!UIF!DFSUJGJDBUF!IPMEFS/ JNQPSUBOU;!!Jg!uif!dfsujgjdbuf!ipmefs!jt!bo!BEEJUJPOBM!JOTVSFE-!uif!qpmjdz)jft*!nvtu!ibwf!BEEJUJPOBM!JOTVSFE!qspwjtjpot!ps!cf!foepstfe/ Jg!TVCSPHBUJPO!JT!XBJWFE-!tvckfdu!up!uif!ufsnt!boe!dpoejujpot!pg!uif!qpmjdz-!dfsubjo!qpmjdjft!nbz!sfrvjsf!bo!foepstfnfou/!!B!tubufnfou!po uijt!dfsujgjdbuf!epft!opu!dpogfs!sjhiut!up!uif!dfsujgjdbuf!ipmefs!jo!mjfv!pg!tvdi!foepstfnfou)t*/ DPOUBDU QSPEVDFS )BWD*!Epoob!Ftrvjwfm OBNF; JPB!Jotvsbodf!Tfswjdft GBY QIPOF 241!Wboujt-!Tvjuf!361 ):5:*!3:8.6:73 )B0D-!Op*; )B0D-!Op-!Fyu*; Bmjtp!Wjfkp-!DB!!:3767 F.NBJM epoob/ftrvjwfmAjpbvtb/dpn BEESFTT; JOTVSFS)T*!BGGPSEJOH!DPWFSBHFOBJD!$ xxx/jpbvtb/dpnDB!Mjdfotf!$1F78879 JOTVSFS!B!;SMJ!Jotvsbodf!Dpnqboz24167 JOTVSFE JOTVSFS!C!; Mboenbsl!Tvswfzjoh!Tpmvujpot-!Jod/ JOTVSFS!D!; 8342!Cpvmefs!Bwfovf-!Tvjuf!$649 JOTVSFS!E!; Ijhimboe!DB!!:3457 JOTVSFS!F!; JOTVSFS!G!; DPWFSBHFTDFSUJGJDBUF!OVNCFS;SFWJTJPO!OVNCFS; 78594136 UIJT!JT!UP!DFSUJGZ!UIBU!UIF!QPMJDJFT!PG!JOTVSBODF!MJTUFE!CFMPX!IBWF!CFFO!JTTVFE!UP!UIF!JOTVSFE!OBNFE!BCPWF!GPS!UIF!QPMJDZ!QFSJPE JOEJDBUFE/!!OPUXJUITUBOEJOH!BOZ!SFRVJSFNFOU-!UFSN!PS!DPOEJUJPO!PG!BOZ!DPOUSBDU!PS!PUIFS!EPDVNFOU!XJUI!SFTQFDU!UP!XIJDI!UIJT DFSUJGJDBUF!NBZ!CF!JTTVFE!PS!NBZ!QFSUBJO-!UIF!JOTVSBODF!BGGPSEFE!CZ!UIF!QPMJDJFT!EFTDSJCFE!IFSFJO!JT!TVCKFDU!UP!BMM!UIF!UFSNT- FYDMVTJPOT!BOE!DPOEJUJPOT!PG!TVDI!QPMJDJFT/!MJNJUT!TIPXO!NBZ!IBWF!CFFO!SFEVDFE!CZ!QBJE!DMBJNT/ BEEMTVCS QPMJDZ!FGGQPMJDZ!FYQ JOTS UZQF!PG!JOTVSBODFMJNJUT QPMJDZ!OVNCFS MUS)NN0EE0ZZZZ*)NN0EE0ZZZZ* JOTEXWE DPNNFSDJBM!HFOFSBM!MJBCJMJUZ BQTC1112536402403133402403134 FBDI!PDDVSSFODF% 444 2-111-111 EBNBHF!UP!SFOUFE Tdifevmfe!BJ!Foeu DMBJNT.NBEFPDDVS% 4 2-111-111 QSFNJTFT!)Fb!pddvssfodf* $QQC4241323 NFE!FYQ!)Boz!pof!qfstpo*% 4 Qsjn0OpoDpo21-111 Qspgfttjpobm!Tfswjdft QFSTPOBM!'!BEW!JOKVSZ% 4 Xws!pg!Tvcs2-111-111 qfsgpsnfe!cz!uif!Jotvsfe 3-111-111 HFO(M!BHHSFHBUF!MJNJU!BQQMJFT!QFS;HFOFSBM!BHHSFHBUF% bsf!Fydmvefe QSP. 44 QPMJDZMPDQSPEVDUT!.!DPNQ0PQ!BHH% 3-111-111 KFDU % PUIFS; DPNCJOFE!TJOHMF!MJNJU BVUPNPCJMF!MJBCJMJUZ% BQTB1112335402403133402403134 2-111-111 )Fb!bddjefou* 44 Eftjhobufe!Jotvsfe!Foeu BOZ!BVUP CPEJMZ!JOKVSZ!)Qfs!qfstpo*% 4 $DB31592124<!Qsjn0OpoDpo PXOFETDIFEVMFE CPEJMZ!JOKVSZ!)Qfs!bddjefou*% BVUPT!POMZBVUPT boe!Cmlu!Xws!pg!Tvcs OPO.PXOFE IJSFEQSPQFSUZ!EBNBHF % 44 )Qfs!bddjefou* BVUPT!POMZBVUPT!POMZ jodmvefe!po!qh!3!pg!Gpsn % 4 Qsjn0OpoDpoXws!pg!Tvcs 4$QQB4111424 VNCSFMMB!MJBC BQTF11123:1402403133402403134 FBDI!PDDVSSFODF% 4 PDDVS 6-111-111 Fydmveft!Qspgfttjpobm FYDFTT!MJBC 4 DMBJNT.NBEFBHHSFHBUF% 6-111-111 Mjbcjmjuz<!Gpmmpx!Gpsn % EFESFUFOUJPO% QFSPUI. 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Ebuf;!3133/17/1:!1:;31;27! Upsj!Qjfstpo .18(11( COLI&SO-01BMARIN DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/31/2022 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). CONTACT License # 0757776 PRODUCER NAME: PHONEFAX HUB International Insurance Services Inc. (951) 788-8500(951) 788-8502 (A/C, No, Ext):(A/C, No): PO Box 5345 E-MAIL Riverside, CA 92517 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Executive Risk Indemnity35181 INSURER A : INSURED Federal Insurance Company20281 INSURER B : INSURER C : Colich & Sons, LP 547 West 140th Street INSURER D : Gardena, CA 90248 INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD (MM/DD/YYYY)(MM/DD/YYYY) 2,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR X 543101856/1/20226/1/2023 $ X PREMISES (Ea occurrence) 5,000 MED EXP (Any one person)$ 2,000,000 PERSONAL & ADV INJURY$ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 4,000,000 XX POLICYLOC PRODUCTS - COMP/OP AGG$ JECT Per Proj Gen Agg per contract X OTHER:$ COMBINED SINGLE LIMIT 2,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) X ANY AUTO 543101846/1/20226/1/2023 BODILY INJURY (Per person)$ X OWNEDSCHEDULED AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED (Per accident)$ AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE$ EXCESS LIAB CLAIMS-MADE AGGREGATE$ DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION B X STATUTEER AND EMPLOYERS' LIABILITY Y / N 543101866/1/20226/1/2023 1,000,000 X ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Project No. 18-6616; Flower Street Sewer Main Improvements. City of Santa Ana, its officers, employees, agents and representatives are included as Additional Insureds where required by an executed written contract as respects General Liability and Auto Liability per attached endorsements. This Insurance shall apply as Primary and Non-Contributory where required by an executed written contract as respects General Liability and Auto Liability per attached endorsements. Waiver of Subrogation applies where required by an executed written contract as respects WorkersÓ Compensation per attached endorsement. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COLI&SO-01BMARIN AGENCY CUSTOMER ID: 1 LOC #: Page of 11 ADDITIONAL REMARKS SCHEDULE License # 0757776 AGENCYNAMED INSURED Colich & Sons, LP HUB International Insurance Services Inc. 547 West 140th Street Gardena, CA 90248 POLICY NUMBER Gardena SEE PAGE 1 CARRIERNAIC CODE SEE PAGE 1SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 25Certificate of Liability Insurance FORM NUMBER:FORM TITLE: Cancellation: * Should the policy(ies) be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non-payment of premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation date. ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIA L GENERAL LIABILITY 10-02-2461 (Ed.7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE FOR SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Additional Insured: Location Of Covered Operations: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect only to the Additional Insured and at the Location Of Covered Operations shown in the Schedule, the following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4.Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Additional Insured with respect to the Location Of Covered Operations shown in the Schedule under this policy provided that: (1)The Additional Insured is a named insured under such other insurance; and (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. 10-02-2461 (EPage d.7-15) Includes copyrighted material of Insurance Services Office, Inc.,1of1 with its permission. COMMERCIAL AUTO 16-02-0316Ed. 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY LIABILITY INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO 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. Endorsement Effective Date: SCHEDULE Name(s)Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Item 5. Î Ð Other Insurance Ñ of Item B. 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