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HomeMy WebLinkAboutCLINICAL LABORATORY OF SAN BERNADINO, INC.iNSURANCt ON FILE ;hfARK MAY PPOCEI.i UN11L INSURANCE EXPIRES C)". CLERK OF COUNU DATE: A-2022-112 c.a FIRST AMENDMENT TO AGREEiAIENT WITH THE CLINICAL LABORATORY OF SAN c.e N BERNARDINO. INC., TO PROVIDE WATER QUALITY SAMPLING AND TESTING ® SERVICES THIS FIRST AMENDMENT to the above -referenced agreement is entered into June 21, 2022, by and between Clinical Laboratory of San Bernardino, 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"). o'•PwA(� RECITALS A. The parties entered into Agreement No. A-2020-154 ("Agreement") dated July 21, 2020, to retain Consultant to provide water quality sampling and testing services for the Water Resources Division of the Public Works Agency. B. The Agreement is current and in -effect through July 20, 2023. C. The parties now wish to amend the Agreement to increase the compensation to fund additional testing under the Agreement. The Parties therefore agree: Section 2(a), Compensation, is amended to increase the total annual sum to be expended under the term of the Agreement, including any extension periods, by $53,000 for a total annual amount of $130,000. 2. Except as modified by this First Amendment, all terns and conditions of the Agreement, shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above. ATTEST DAISY EZ Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney CITY OF SANTA ANA -251- fV , •tt KRISTINE RIDGE City Manager CLINICAL LABORATORY OF SAN BERNARDINO, INC.: By t Bralvatierra Steven Martinez Deputy City Attorney Laboratory Director [signatures continued on next page] Pagel of 2 RECOMMENDED FOR APPROVAL Nabil Saba Executive Director Public Works Agency Page 2 of 2 as Francine H. Villareal Villareal ^`� CERTIFICATE OF LIABILITY INSURANCE DATE /22/rrv0 2/7' 0' 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 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 Wood Gutmann & Bogart Insurance Brokers CONTACT NAME: Candace Cordova PHONE FA Na - 714-824-8389 x A/C No: License 0679263 15901 Red Hill Ave., Suite 100 ADoRess: ccordova@wgbib.com Tustin CA 92780 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Continental Casual CO INSURED CUNI-2 Clinical Laboratory of San Bernardino, Inc. INSURERS : American Cas CO of Reading PA 20427 INSURERC: Continental Insurance Company Geo-Monitor, Inc. PO Box 329 San Bernardino CA 92402 INSURER D : Hartford Underwriters Ins Cc INSURER E: United Financial Casualty Co 11770 INSURER F Cf1VFRA(:FC rcorrvnwrc .rr,.....-... ...__-_---. "- ' ...... ­c. KeVI51UIN NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOOL SUER LTR TYPE OF INSURANCE POLICY NUMBER MMIDDY EFF MMMDNYY LIMITS B GENERAL LIABILITY Y 6072997663 2/1/2022 2/1/2023 EACH OCCURRENCE x $ L000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,000 CLAIMS-MADElxl OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FXI PRO- X1 LOC GENERAL AGGREGATE $2.000,000 PRODUCTS -COMPIOP AGE $2,000.000 E AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED 005831362 4/3/2022 4/3/2023 COMBINED SINGLE LIMIT Ea accident 1 0 0# BODILY INJURY (Per person) $ IX BODILY INJURY (Per accident) $ PROPERTY DAMAGE C X UMBRELLA LVIB LIAB ELITOOCSC�Partlent CUE6Wfi281162 2l1/2022 2lt/2023 EACH OCCURRENCEEXCESS $5,000,000 AGGREGATE $5,000,000 DED X RETENTION$10000 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETO WPARTNEWEXECUTIVE OFPCEWMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under NIA 72WECAE9PU9 2/1/2022 2/1/2023 X WG siATU- OTH- $ E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 A DESCRIPTION OF OPERATIONS below Environmental Professional Liabil Claims Made Coverage Deductible: $100.000 EEH276170923 V1/2022 211/2023 E.L. DISEASE- POLICY LIMIT $1.000,000 Per Claim 3.000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: All Operations usual to the insured's operations subject to the policy terms and conditions City of Santa Ana, its officers, officials, employees and volunteers are named as additional insured on the General contract subject to the terms and conditions of the policy. Liability per attached as required by written Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation per form to follow from carrier. Primary and Non -Contributory applies on the General Liability per attached . See Attached... CFRTIFICATF M(V nFG 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 AUTHORRE EPRESENTATIVE Santa Ana CA 92702 PJA M#n igIaa..wwt �dDl w s`,%g+ REVIEWED&APPRON®BY: ©1988-2010 ACORD Cl`` F4wc.�( R. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD®' =�� Risk Management Analyst AGENCY CUSTOMER ID: CLINI-2 LOC #: A� VKL! ADDITIONAL REMARKS SCHEDULE Pagel of , AGENCY NAMED INSURED Wood Gutmann & Bogart Insurance Brokers Clinical Laboratory of San Bernardino, Inc. Geo-Monitor, Inc. POLICY NUMBER PO Box 329 San Bernardino CA 92402 CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE of Subrogation applies to the Workers' Compensation and General Liability, per attached A mowganou um mn REVIEZED&APPRweDBr. ACORD 101 (2008/01) © 2008 ACORD C g-t-u1li01FD1i F� �� The ACORD name and logo are registered marks of ACORD 'm' Risk Management Analyst CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this Coverage Part; including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. bodily injury, property damage, or personal and advertising injury to the extent caused by: 1. the Named Insured's acts or omissions; or 2. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations specified in the written contract; or B. bodily injury or property damage to the extent caused by your work specified in the written contract and included in the products -completed operations hazard, and only if 1. the written contract requires the Named Insured to provide the additional insured such coverage; and 2. this coverage part provides such coverage. IL Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. acts or omissions of the additional insured, or of anyone acting on the additional insured's behalf; or B. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or C. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to insurance on which the additional insured is a named insured. _ V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: CNA75081XX (1-15) F Page 1 of 2 Endorse TRANSPORTATION INSURANCE COMPANY Effect Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with REVIEWED & APPROVE] BY. F,�AR. Uc[trda Rkk Management Analyst CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage - Limited Liability Endorsement The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 4 does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. The bodily injury or property damage; or 2. The offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75081XX (1-15) Page 2 of 2 TRANSPORTATION INSURANCE COMPANY Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Includes copyrighted material or Insurance Services Office, Inc., with �n,aarl REMEwED S APPROVED BY. Risk Klanagement Analyst CNA CNA PARAMOUNT Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WHOM THE CONTRACT OR AGREEMENT TO WAIVE SUCH CONTRACT OR AGREEMENT: NAMED INSURED HAS AGREED IN WRITING IN A RIGHTS OF RECOVERY, BUT ONLY IF SUCH 1. IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; AND 2. WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY GIVING RISE TO THE CLAIM. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer may have against such person or organization because of payments arising out of the Named Insured's ongoing operations or your work included hazard. All other terms and conditions of the Policy remain unchanged. Insurer waives any right of recovery the the Insurer makes for injury or damage in the products -completed operations This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75008XX (10-16) Page 1 of 1 AMERICAN CASUALTY CO OF READING,PA Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. REmEwm 6 pAPPROVED By: [ r 4^W;,1 L P, V&"Ai Risk Management Analyst Copynghl CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 72 WEC AE9FU9 Endorsement Number: Effective Date: 02/01/22 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: CLINICAL LABORATORY OF SAN BERNARDINO, INC. PO BOX 329 SAN BERNARDINO CA 92402 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 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by xVkMaa gmwd Dhi.1. Form WC 04 03 06 (1) Printed in U.S.A. REv�wmeArrRov®6y. Process Date: 12/28/21 Polic E �. F�K P,. WZV� "t y ® Rnk Management Malyst CNA CNA PARAMOUNT Primary and Noncontributory - Other Insurance Condition Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is understood and agreed that the condition entitled Other Insurance is amended to add the following: Primary And Noncontributory Insurance Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. the additional insured is a named insured under such other insurance; and b, the Named Insured has 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. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA74987XX (1-15) Policy No: Page 1 of 1 Endorseme AMERICAN CASUALTY CO OF READING,PA Effective DI Insured Name: CLINICAL LABORATORY OF SAN BERNARDINO, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance services office, Inc., with its R&kM fine P. II:.favAl Rzk Management Analyst