Loading...
HomeMy WebLinkAboutUNIVERSAL ENGINEERING SCIENCES, LLCINSURANCE ON FILE A-2023-194-29 WORK MAY PROCEED UNTIL INSURANCE EXPIRES DSI011 Z1 AGREEMENT TO PROVIDE ON -CALL ENVIRONMENTAL AND CITY CLERK PLANNING SERVICES RELATED TO CEQA AND NEPA DATE: DEC 17 2024 THIS AGREEMENT is made and entered into this 28th day of October, 2024 by and between Universal Engineering Sciences, LLC, a California corporation ("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"). pro.nctnt vrUartAk[YO RECITALS A. On August 17, 2023, the City issued Request for Qualification No. 23-142, by which it sought Consultants to provide on -call environmental, technical, and planning services for the Planning and Building Agency of the City of Santa Ana. The scope of work may include any and all work efforts related to the analysis of a proposed project for compliance with the California Environmental Quality Act (CEQA) and National Environmental Policy Act (NEPA). This may include preparation of required technical studies, peer review of technical studies prepared by others, preparation of Initial Studies, Negative Declarations, Mitigated Negative Declarations, Environmental Impact Reports, Environmental Assessments, Environmental Impact Statements, and staffing services on an as -needed basis. B. Consultant submitted a responsive proposal that was among those selected by the City. Consultant represents that it is able and willing to provide the services described in the scope of work that was included in RFQ No. 23-142 and attached as Exhibit A. C. Consultant has been selected as one of thirty-five (35) vendors which qualified for this engagement. Only those consultants approved by the City Council on November 7, 2023, shall be eligible to be engaged by the City for these services. D. hi undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contracting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES a. On an as -needed basis, and at the sole discretion of the City, Consultants shall perform the services that are described in Exhibit A, attached and incorporated by reference as though fully set forth herein. Consultant's proposal is incorporated by reference as though fully set forth herein. When the need for services arise, City may initiate services through use of a letter agreement, executed by the Executive Director of the Planning and Building Agency and the Consultant. Work by the Consultant may not proceed absent a previously engaged or fully executed consultant agreement and letter agreement for a specific project. Page 1 of 10 2. COMPENSATION a. City neither warrants nor guarantees any minimum or maximum compensation to Consultant under this Agreement. Consultant shall be paid only for actual services performed under this Agreement at the rates and charges identified in Exhibit B. Consultant is one of thirty-five (35) Consultants selected to provide environmental and planning services on an as needed basis under RFQ No. 23-142. The total compensation for services provided by all Consultants selected under RFQ No. 23- 142 is a collective amount not to exceed four million nine hundred fifty thousand ($4,950,000.00) during the term of the Agreement, including any extension periods. b. Where applicable, City shall recognize and pay for any outstanding invoices for work performed by any of the thirty-five (35) selected vendors for building safety consultant services performed by the Consultant for work previously performed for the City. G. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals and Scope of Work, which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above through November 7, 2028, unless terminated earlier in accordance with Section 16, below. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Page 2 of 10 Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Minimum Scope and Limit of Insurance 1. Commercial General Liability (CGL): Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: ISO Form Number CA 00 01 covering any auto (Code 1), or if Consultant has no owned autos, hired, (Code 8) and non -owned autos (Code 9), with a limit no less than $1,000,000 per accident for bodily injury and property damage. 3. Workers' Compensation: as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. 4. Professional Liability (Errors and Omissions): insurance appropriate to the Consultant's profession, with limit no less than $1,000,000 per occurrence or claim, $2,000,000 aggregate. 5. Broader Coverage: if the Consultant maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. b. Other Insurance Provisions Additional Insured Status: The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, or equipment furnished in connection with such work or operations. General liability coverage can be provided in the form of an endorsement to the Consultant's insurance (at least as Page 3 of 10 broad as ISO Form CG 20 10 11 85 or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 2037 if a later edition is used). 2. Primary Coverage: For any claims related to this contract, the Consultant's insurance coverage shall be primary coverage at least as broad as ISO CG 20 01 04 13 as respects the City, its officers, officials, employees, and volunteers. Any insurance or self- insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Consultant's insurance and shall not contribute with it. 3. Notice of Cancellation: Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the City. 4. Waiver of Subrogation: Consultant hereby grants to City a waiver of any right to subrogation that any insurer of said Consultant may acquire against the City by virtue of the payment of any loss under such insurance. Consultant agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Self -Insured Retentions: Self -insured retentions must be declared to and approved by the City. The City may require the Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self -insured retention may be satisfied by either the named insured or City. 6. Acceptability of Insurers: Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City. 7. Claims Made Policies (applicable only to professional liability): i. The Retroactive Date must be shown, and must be before the date of the contract or the beginning of contract work. ii. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. iii. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a Retroactive Date prior to the contract effective date, the Consultant must purchase "extended reporting" coverage for a minimum of five (5) years after completion of work. Page 4 of 10 8. Verification of Coverage: Consultant shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Consultant's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. 9. Subcontractors: Consultant shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Consultant shall ensure that City is an additional insured on insurance required from subcontractors. 10. Special Risks or Circumstances: City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. 7. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant or its Consultants, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. Page 5 of 10 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend, indemnify and hold harmless the City, its officers, agents, representatives, and employees against any and all liability, including costs, and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 12. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: Page 6 of 10 To City: City Clerk City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 Executive Director Planning and Building Agency City of Santa Ana 20 Civic Center Plaza (M-20) P.O. Box 1988 Santa Ana, CA 92702 Email: PBAAdmin@santa-ana.org To Consultant: Universal Engineering Services, LLC 16 Technology Drive Suite 139 Irvine, CA 92618 949-788-4900 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to Page 7 of 10 this Agreement performed by City personnel or by other consultants retained by City. 15. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 16. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 17. NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 18. JURISDICTION -VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 19. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and Page 8 of 10 in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA ALVARO NUNEZ .1( City Manager APPROVED AS TO FORM CONSULTANT lz 0\ : W .• City Attorney Ity: *-olo MELISSA M. CROSTHWAITE Senior Assistant City Attorney FOR APPROVAL .,-� :� g- MINH THAI Executive Director Planning and Building Agency Kurt Schlyer Principal Planner CEQA/NEPA Page 9 of 10 Exhibit A Scope of Services Consultants will be expected to provide experienced and knowledgeable professional staff familiar with federal, state and local regulations including the Santa Ana Municipal Code and General Plan and the CEQA and NEPA. The Consultants' Project Manager and staff shall be responsive and maintain excellent working relationships with project applicant, property owners, developers and City staff. Consultants shall be committed to provide adequate staffing levels at all times in order to adhere to established schedules. All consultants shall provide services under the direction of City staff. Services may include attendance at appropriate City Council, City Commissions, and neighborhood meetings. A. Environmental Services Services include, but are not limited to preparation of documents, distribution and filing of environmental noticing, preparation of studies and technical reports as required by the CEQA and NEPA including, but not limited to, the following as amended and updated from time to time: • Initial Study • Notice of Preparation • Notice of Availability • Notice of Determination • Categorical Exemption • Negative Declaration • Mitigated Negative Declaration • Environmental Impact Report (Program, Focused, Master, Staged) • EIR Addendum, Supplemental EIR, Subsequent EIR • Mitigation and Monitoring Program • Response to Comments • Statement of Overriding Considerations • NEPA compliance documents B. Technical Studies As necessary, prepare any technical studies needed to complete the environmental review or for development projects or City projects as -needed, including but not limited to: • Air Quality Study • Biological Resource Assessment • Cultural Resource Study • Environmental Site Assessments • Economic/Market Study • Geological/Soil Study • Greenhouse Gas Assessment • Health Risk Assessment • Historical Resource Assessment • Hydrology/Water Quality Study • Noise Impact Study • Parking Study • Water Supply Assessment • Mineral Resource Study • Utility/Sewer Study • Traffic Study C. Staffing Services The Planning Division is also seeking qualified professional individuals, firms, or multi -disciplinary teams with experience in current, historic preservation, environmental justice, and advanced planning to assist with processing development project applications, counter services and planning efforts on an as -needed basis. Page 10 of 10 FEE SCHEDULE HOURS, RATES, AND COST ASSUMPTIONS UES agrees to provide the purchased services at the costs, rates, and fees as set forth in this Fee Schedule in response to this RFQual. No other costs, rates, or fees shall be payable to UES for implementation of this SOQ. The hourly rates provided shall apply for a 12-month period commencing with the execution of the Agree- ment between the City of Santa Ana and UES. SCHEDULEGENERAL DF FEES DESCRIPTION RATE/FEE Principal II $205 / hour Senior Project Manager 1 $175 / hour Senior Project Engineer 11 $175 / hour Project Archaeologist $155 / hour Project Engineer 1 $145 / hour Project Environmental Planner / Biologist / Archaeologist / Environmental Scientist $145 / hour Senior Environmental Planner / Biologist / Archaeologist / Environmental Scientist $135 / hour Geologist II $135 / hour Geologist 1 $125 / hour Senior Technical Writer 11 $85 / hour Senior CAD/GIS Technician II $150 / hour Project Administrator II $105 / hour Project Administrator I $100 / hour Senior Project Administrator II $75 / hour Senior Clerical Staff 11 $75 / hour Administrative Staff $60 / hour Document Production Staff $55 / hour Universal Engineering Sciences 115 A� & CERTIFICATE OF LIABILITY INSURANCE DATE(Mlll 2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Edgewood Partners Insurance Agency 3780 Mansell Rd. Suite 370 Alpharetta GA 30022 CONTACT Greylin COI Specialist PHONE FAx - 7706705324 tA11, No : 770 670 5324 EAooliEss: uescerts re tin .com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Endurance American Specialty Ins Cc 41718 INSURED UNIVENG Universal Engineering Sciences, LLC 4205 Vineland Road INSURER B: Evanston Insurance Company 35378 INSURER c: Landmark American Insurance Company33138 INSURER D: Greenwich Insurance Company 22322 Orlando, FL 32811 INSURER E: AB en Specialty Insurance Company10717 INSURER,: Convex Insurance UK Limited COVERAGES CERTIFICATE NUMBER: 1682760137 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL BUSH -MMPOLICYNUMBER POLICY EFF MMDD POUCYEXP MMIDDIYYYY LIMITS D X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR V Y RGC3002099 5/1/2024 5/1/2025 EACH OCCURRENCE $2,000,000 UAMAGE TO RE ED PREMISES Ea omunence $300,000 X MED EXP (Any one peon) $10,000 Contractual Liab PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY Lfl PECT FX I LOC GENERAL AGGREGATE $4.000,000 PRODUCTS -COMPIOP AGG $4,000,000 Em Ioyee Benefits $1,000,000 OTHER: D A AUTOMOBILE LIABILITY ANY AUTO V V RXT3003325 EXT30030240901 5/1/2024 5/1l2024 5/1/2025 5/1/2025 COMBINED SINGLE LIMIT Ea accident)$2,000,000 X BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS Per accident 8001LV INJURY ( ) $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X PROPERTYDAMAGE Per accident $ Excess Auto $2,000,000 B C UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE 1' Y MKLV2EUE101855 LHAS00397 5/1/2024 511/2024 5/1/2025 5/l/2025 EACH OCCURRENCE $7,000,000 X AGGREGATE $7,000,000 DED X RETENTION$ $ D WORKERS COMPENSATION AND EMPLOYERTLIABILTY YIN ANYPROPRIETOR/PARTNER/EXECUOVE OFFICERIMEMBER EXCLUDED? N/A Y RWC3002100 5/1/2024 5/1/2025 1PER ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000.000 (Mandatory in NH) It yes, describe under E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below I I E F Excess GL Professional Debg9 incl. Pollution Lieb CXOIONE24 B0146LDUSA2405257 5/1/2024 5/1/2024 5/1/2025 5/1/2025 Per Om./A re ate 9 Per Claim Aggregate $,000,000 $1000,000 $1,.000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACOR0101, Additional Remarks Schedule, maybe attached if more space is required) APPROVED By Cynthia Mora at 11:17 am, Dec 05, 2024 City of Santa Ana Planning and Building Agency 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: RAC9438325 XII 401 1007 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NAMED INSURED ENDORSEMENT With respect to coverage provided by this endorsement, the provisions of the Coverage Form(s) apply unless modified by the endorsement. NAMED INSURED of the policy declarations page is amended to include the following: Obsidian Group Holdings, LLC Universal Engineering Sciences, Inc. Universal Engineering Sciences, LLC Universal Engineering Inspection, LLC Nova Geotechnical and Inspection Services, LLC Nova Geotechnical and Inspection Services - Northern Nevada LLC Nova Geotechnical and Inspection Services - So Cal (a California corporation) IQC Southwest, LLC GFA International, Inc. Contour Engineering, LLC Obsidian Group Acquisitions, Inc. Nova Geotechnical and Inspection Services, LLC, dba Universal Engineering Sciences (Las Vegas) Nova Geotechnical and Inspection Services — Northern Nevada LLC, dba Universal Engineering Sciences (Reno) Nova Geotechnical and Inspection Services — SO CAL dba Universal Engineering Sciences (Irvine, CA) GFA International, Inc. dba Universal Engineering Sciences IQC — Southwest — So Cal Universal Engineering Sciences GEOServices, LLC Alpha Testing, LLC Alpha Acquisition Dan Brown and Associates, PC Speedie and Associates, Inc. Geotechnology, LLC GSI Engineering, LLC GPR Testing and Inspection L.L.C. Summit Engineering, Laboratory & Testing, PC APPROVED McGinley & Associates, Inc. Construction Testing & Engineering Inc. I By Cynthia Mora at 11:17 am, Dec 05, 2024 XII 401 1007 © 2007, XL America, Inc. Page 1 of 4 CTE South, Inc. River City Geoprofessionals, Inc. dba Wallace -Kuhl & Associates River City Geoprofessionals, Inc. River City Geoprofessionals, Inc. d/b/a Universal Engineering Sciences Aries Consultants Inc Centurion Consultants Inc Rock Engineering & Testing Laboratory, LLC Carmichael Engineering, Inc. Faulkner Engineering Services Inc. Faulkner Engineering Services LLC GRUBBS, HOSKYN, BARTON & WYATT, INC. GRUBBS, HOSKYN, BARTON, & WYATT, LLC Riner Engineering, Inc. Geo Solutions, LLC Biome Consulting Group, LLC InControl Technologies LLC UES Professional Solutions 18, LLC (rename of Contour Engineering, LLC) UES Professional Solutions 19, LLC (rename of GEOServices, LLC) UES Professional Solutions 44, LLC (rename of Alpha Testing, LLC) UES Professional Solutions 29, Inc. (rename of Summit Engineering, Laboratory & Testing, Inc.) UES Professional Solutions 45, LLC (rename of Rock Engineering and Testing Laboratory, LLC) UES Professional Solutions 63, LLC (rename of Riner Engineering, Inc.) UES Professional Solutions 30, LLC (Nova Geotechnical and Inspection Services, LLC ) UES Professional Solutions 64, LLC (InControl Technologies LLC) All other terms and conditions remain the same. (Authorized Representative) APPROVED By Cynthia Mora at 11:17 am, Dec 05, 2024 XII 401 1007 © 2007, XL America, Inc. Page 2 of 4 ENDORSEMENT# This endorsement, effective 12:01 a.m., 05-01-2024 forms a part of Policy No. RGC3002099 issued to Obsidian Group Holdings, LLC by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NAMED INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM It is agreed that NAMED INSURED of the policy declarations page, is amended to include the following: Obsidian Group Holdings, LLC Universal Engineering Sciences, Inc. Universal Engineering Sciences, LLC Universal Engineering Inspection, LLC Nova Geotechnical and Inspection Services, LLC Nova Geotechnical and Inspection Services - Northern Nevada LLC Nova Geotechnical and Inspection Services - So Cal (a California corporation) IOC Southwest, LLC GFA International, Inc. Contour Engineering, LLC Obsidian Group Acquisitions, Inc. Nova Geotechnical and Inspection Services, LLC, dba Universal Engineering Sciences (Las Vegas) Nova Geotechnical and Inspection Services — Northern Nevada LLC, dba Universal Engineering Sciences (Reno) Nova Geotechnical and Inspection Services — SO CAL dba Universal Engineering Sciences (Irvine, CA) GFA International, Inc. dba Universal Engineering Sciences XIL 404 0605 ©, 2005, XL America, Inc. 1 APPROVED By Cynthia Mora at 11:17 am, Dec 05, 2024 IQC — Southwest — So Cal Universal Engineering Sciences GEOServices, LLC Alpha Testing, LLC Alpha Acquisition Dan Brown and Associates, PC Speedie and Associates, Inc. Geotechnology, LLC GSI Engineering, LLC GPR Testing and Inspection L.L.C. Summit Engineering, Laboratory & Testing, PC McGinley & Associates, Inc. Construction Testing & Engineering Inc. CTE South, Inc. River City Geoprofessionals, Inc. dba Wallace -Kuhl & Associates River City Geoprofessionals, Inc. River City Geoprofessionals, Inc. d/b/a Universal Engineering Sciences Aries Consultants Inc Centurion Consultants Inc Rock Engineering & Testing Laboratory, LLC Carmichael Engineering, Inc. Faulkner Engineering Services Inc. Faulkner Engineering Services LLC GRUBBS, HOSKYN, BARTON & WYATT, INC. GRUBBS, HOSKYN, BARTON, & WYATT, LLC Riner Engineering, Inc. Geo Solutions, LLC Biome Consulting Group, LLC InControl Technologies LLC UES Professional Solutions 18, LLC (rename of Contour Engineering, LLC) LIES Professional Solutions 19, LLC (rename of GEOServices, LLC) LIES Professional Solutions 44, LLC (rename of Alpha Testing, LLC) LIES Professional Solutions 29, Inc. (rename of Summit Engineering, Laboratory & Testing, Inc.) LIES Professional Solutions 45, LLC (rename of Rock Engineering and Testing Laboratory, LLC) LIES Professional Solutions 63, LLC (rename of Riner Engineering, Inc.) LIES Professional Solutions 30, LLC (Nova Geotechnical and Inspection Services, LLC ) LIES Professional Solutions 64, LLC (InControl Technologies LLC) All other terms and conditions remain unchanged. XI L 404 0605 ©, 2005, XL America, Inc. APPROVED By Cynthia Mora at 11:17 am, Dec 05, 2024 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY SCHEDULE OF NAMED INSUREDS AND LOCATIONS Item 1 of the Information Page is amended to include: Named Insured Obsidian Group Holdings, LLC Universal Engineering Sciences, Inc Universal Engineering Sciences, LLC Universal Engineering Inspection, LLC Nova Geotechnical and Inspection Services, LLC Nova Geotechnical and Inspection Services - Northern Nevada LLC Nova Geotechnical and Inspection Services - So Cal (a California corporation) IQC Southwest, LLC GFA International. Inc. Contour Engineering, LLC Obsidian Group Acquisitions, Inc. Nova Geotechnical and Inspection Services, LLC, dba Universal Engineering Sciences (Las Vegas) Nova Geotechnical and Inspection Services — Northern Nevada LLC, dba Universal Engineering Sciences (Reno) Nova Geotechnical and Inspection Services — SO CAL dba Universal Engineering Sciences (Irvine, CA) GFA International, Inc. dba Universal Engineering Sciences IQC — Southwest — So Cal Universal Engineering Sciences GEOServices, LLC Location FEIN WC 99 00 15 State Unemployment # This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 5/1/2024 Policy No. RWC3002100 Endorsement No. 1 Insured Obsidian Group Holdings, LLC Insurance Company APPROVED l Greenwich Insurance Company WC 99 00 15 Countersigned by I By Cynthia Mora at 11:17 am, Dec 05, 2024 Ed. 0314 © 2014 X.L. America, Inc. All Rights Reserved. Page 1 of 3 May not be copied without permission Alpha Testing, LLC Alpha Acquisition Dan Brown and Associates, PC Speedie and Associates, Inc. Geotechnology, LLC GSI Engineering, LLC GPR Testing and Inspection L.L.C. Summit Engineering, Laboratory & Testing, PC McGinley & Associates, Inc. Construction Testing & Engineering Inc. CTE South, Inc. River City Geoprofessionals, Inc. dba Wallace -Kuhl & Associates River City Geoprofessionals, Inc. River City Geoprofessionals, Inc. d/b/a Universal Engineering Sciences Aries Consultants Inc Centurion Consultants Inc Rock Engineering & Testing Laboratory, LLC Carmichael Engineering, Inc. Faulkner Engineering Services Inc. Faulkner Engineering Services LLC GRUBBS, HOSKYN, BARTON & WYATT, INC. GRUBBS,HOSKYN,BARTON,& WYATT, LLC Riner Engineering, Inc. Geo Solutions, LLC Biome Consulting Group, LLC InControl Technologies LLC UES Professional Solutions 18, LLC (rename of Contour Engineering, LLC) LIES Professional Solutions 19, LLC (rename of GEOServices, LLC) LIES Professional Solutions 44, LLC (rename of Alpha Testing, LLC) UES Professional Solutions 29, Inc. (rename of Summit Engineering, Laboratory & Testing, Inc.) This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 5/1/2024 Insured Obsidian Group Holdings, LLC Insurance Company Greenwich Insurance Company WC 99 00 15 Ed. 0314 Policy No. RWC3002100 Endorsement No. 1 APPROVED Countersigned b By Cynthia Mora at 11:17 am, Dec 05, 2024 © 2014 X.L. America, Inc. All Rights Reserved. May not be copied without permission Page 2 of 3 UES Professional Solutions 45, LLC (rename of Rock Engineering and Testing Laboratory, LLC) UES Professional Solutions 63, LLC (rename of Riner Engineering, Inc.) UES Professional Solutions 30, LLC (Nova Geotechnical and Inspection Services, LLC ) UES Professional Solutions 64, LLC (InControl Technologies LLC) All other terms and conditions of this policy remain the same. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 5/1/2024 Insured Obsidian Group Holdings, LLC Insurance Company Greenwich Insurance Company WC 99 00 15 Ed. 0314 Policy No. RWC3002100 Endorsement No. 1 APPROVED Countersigned b By Cynthia Mora at 11:17 am, Dec 05, 2024 © 2014 X.L. America, Inc. All Rights Reserved. May not be copied without permission Page 3 of 3 ENDORSEMENT# This endorsement, effective 12:01 a.m., 05/01/2024, forms a part of Policy No. RAC9438325 issued to Obsidian Group Holdings, LLC by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Schedule Additional Insured(s) Work Any person or organization for whom you have All works agreed under contract or agreement to provide insurance. COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" the person or organization listed in the Schedule above, but only with respect to liability for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of: 1. You, while using a covered "auto"; or 2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission; in the performance of your work as described in the Schedule above. In no event shall any person or organization listed in the Schedule become an "insured" pursuant to this Endorsement if such person or organization is solely negligent. IT IS FURTHER AGREED THAT IN NO EVENT SHALL ANY CONTRACT OR AGREEMENT ALTER THE CONDITIONS, COVERAGES OR EXCLUSIONS SET FORTH IN THIS POLICY. All other terms and conditions of this policy remain unchanged. APPROVED By Cynthia Mora at 11:17 am, Dec 05, 2024 XIC 414 1013 © 2013 X.L. America, Inc. All Rights Reserved. Page 1 of 1 May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: RAC9438325 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION 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. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 POLICY NUMBER: RAC9438325 COMMERCIAL AUTO CA 04 44 10 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: Obsidian Group Holdings, LLC Endorsement Effective Date: May 1, 2024 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization where required by written contract provided that such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 POLICY NUMBER: RGC3002099 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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) I Location(s) Of Covered Operations Any person or organization where required by written All Locations as required per written contract. contract provided that such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 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: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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 subcontractor engaged in performing operations for a principal as a part of the same project. APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable limits of insurance. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 POLICY NUMBER: RGC3002099 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization where required by written contract provided that such contract was executed prior to the date of loss. All Locations as required per written contract., Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: RGC3002099 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 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 LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition 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 an additional insured under your 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. APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: RGC3002099 COMMERCIAL GENERAL LIABILITY CG 24 53 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 CG 24 53 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by written agreement signed prior to loss. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Insured RWC3002100 Obsidian Group Holdings, lLC Insurance Company Countersigned by_ Greenwich Insurance Company WC 00 0313 (Ed. 4-84) Endorsement No. Premium Included APPROVED By Cynthia Mora at 11:18 am, Dec 05, 2024 0 1983 National Council on Compensation Insurance. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO 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 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Where required by written agreement signed prior to loss All California Operations. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Policy No. RWC3002100 Insurance Company Endorsement No. Obsidian Group Holdings, LLC Greenwich Insurance Compa APPROVED Countersigned By By Cynthia Mora at 11:18 am, Dec 05, 2024 WC 04 03 06 Page 1 of 1 (Ed. 04-84) Copyright 1984 Workers' Compensation Insurance Rating Bureau of California. All Rights Reserved.