Loading...
HomeMy WebLinkAboutBACKFLOW APPARATUS & VALVE, CO. (3)INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES Off -L1 12S CITY CLERK DATE: JAN 13 2025 N-2025-002 AGREEMENT WITH BACKFLOW APPARATUS & VALVE, CO., TO PROVIDE TESTING AND INSPECTION OF BACKFLOW PREVENTION SERVICES O� pww CA "�T,HIS AGREEMENT is made and entered into on this 21�' day of October, 2024 by and between Q4Wt 4A"nanAeL6dPackflow Apparatus & Valve, Co., a California corporation ("Contractor"), 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"). RECITALS A. The City desires to retain a contractor having special skill and knowledge in the field of testing and inspecting backflow prevention devices and assemblies for the Public Works Agency, B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting 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 Contractor shall perform the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in Exhibit A, attached hereto and incorporated herein by this reference. 2. COMPENSATION a. City agrees to pay, and the Contractor agrees to accept as total payment for its services under this Agreement, the rates and charges identified in Exhibit A. The total sum to be expended under the term of this Agreement, including any extension period(s), shall not exceed Fifty Thousand Dollars and Zero Cents ($50,000). b. Payment by City shall be made within 45 days (forty-five) 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 which may reasonable be expected by City. 3. TERM Page 1 of 9 This Agreement shall commence on the date first written above and terminate on October 20, 2026 unless terminated earlier in accordance with Section 16, below. 4. PREVAILING WAGES Contractor is aware of the requirements of California Labor Code Section 1720, et seq„ and 1770, et seq., as well as California Code of Regulations, Title 8, Section 1600, et seq„ ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects, If the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless form any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws, 5. INDEPENDENT CONTRACTOR Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services, Contractor 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, 6. 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 Contractor tinder this Agreement ("Documents & Data"). Contractor 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. Contractor represents and warrants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data which were provided to Contractor 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. 7. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall procure and Page 2 of 9 maintain for the duration of the agreement, the following insurance coverages: MINIMUM SCOPE AND LIMIT OF INSURANCE Contractor shall maintain limits of insurance coverage in the following minimum amounts and shall be at least as broad as: 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 CO 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. Automobile Liability (AL) Insurance Services Office Form CA 00 01 covering Code 1 (any auto), or if Contractor has no owned autos, hired (Code 8) and non -owned (Code 9), with combined single limits of $1,000,000. In the event Contractor does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance with existing limits, which can be lower than $1,000,000. Workers' Compensation (W/C): as required by the State of California, with statutory limits, and Employer's Liability Insurance with limit ot no less than $1,000,000 per accident, per employee, per policy for bodily injury or disease. This requirement can be waived if Contractor has no employees. If Contractor maintains broader coverage and/or higher limits than the minimums shown above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions: I. CGL and AL policies: City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, equipment, and personnel furnished in connection with such work or operations, 2. All required insurance policies: Insurance company(ies) agrees to waive all rights of subrogation against City, its City Council, Its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Contractor for City, 3, All required insurance policies: For any claims related to this Contract, Contractor's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. 4. Each insurance policy required herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non -renewed by the Page 3 of 9 carrier, or materially changed except after thirty (30) days prior written notice has been given to City. Ten (10) days prior written shall be provided to City for policy cancellation or non -renewal due to non-payrrient. 5. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention; Diana Lazariego, 20 Civic Center Plaza M-85, Santa Ana, CA 92701. The name and location of event should be included in the Description of Operations section of each certificate. Self -Insured Retentions Self -insured retentions must be declared to and approved by the City, City may require Contractor 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. Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the state of California with a current A.M. Best rating of no less than A:VCI, unless otherwise acceptable to City. Verification of Coverage Contractor shall furnish 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 Contractor's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. Claims Made Policies If any of the required policies provide coverage on a claims -made basis: 1. The retroactive date must be shown and must be before the date of the contract or the beginning of work. 2. Insurance must be maintained and evidence of insurance must be provided for at least three (3) years after completion of work. 3. 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, Contractor must purchase "extended reporting" coverage for a minimum of three (3) years after completion of work. Subcontractors Contractor shall require and verify that all sub -contractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that City is an additional insured on insurance required from sub -contractors. 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. Page 4 of 9 8. INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, 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 Contractor, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section I 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 Contractor 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 Contractor'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 out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Contractor shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Contractor to the City pursuant to this Agreement. 10. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor 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 Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor 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. Contractor 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 Contractor under this Agreement. 11, CONFIDENTIALITY Page 5 of 9 If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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 Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 13. NON-DISCRIMINATION Contractor 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 veteranstatus, 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. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, 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 Contractor. 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 Contractor 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 is not embodied herein. 15. ASSIGNMENT Page 6 of 9 Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor 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 this Agreement performed by City personnel or by other contractors retained by City, 16. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor 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 Contractor to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor 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, 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. 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 Contractor 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. Contractor shall notify the City immediately and 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. Page 7 of 9 20. 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: To City: Clerk if the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies for Nabil Saba, Executive Director, Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, California 92702' Fax: 714.647-5635 To Contractor: Robert Purzycki, Vice President Backflow Apparatus & Valve Company 20435 South Susana Rd, Long Beach, CA 90810-1136 Fax: (310) 639-0721 info@bavco.com 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. Page 8 of 9 21. 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: APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: _ Kyle Nalesen Assistant City Attorney RECOMMENDED FOR APPROVAL: ��-Iy'(hA- Nabil Saba Executive Director Public Works Agency CITY OF ANTA A AN !uflez City Manager BACKFLOW APPARATUS & VALVE CO. Vice President Page 9 of 9 -3AVC0 ®AOKPLOW APPARNru6 a VALVE CO. EXHIBITA 8/15/24 City of Santa Aria c/o Diana Mazariego Proposed Contract BackflowTesting/ Parts / Misc. Items Calibration of Backflow Test Gauges $95.00 Service / Repair of Backflow Test Gauges $150.00 plus parts Testing of Backflow Assemblies $80,OO each Hourly Labor Rate $80,00 per hour- per technician Robert Purzycki Vice President 1 Q� YOUR BACKFL(OW PRQDUCTS C•.ONNEC'TI C�7N 20435 South Susana Rd., Long Beach, CA 90810-1136 • (310) 639.5231 • FAX (310) 639-0721 • Info@bavoo,com • www.bavoo.com ACORO® CERTIFICATE OF LIABILITY INSURANCE 111 DATE IMMIDDIYYYY) 1 11/21/2024 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 SIP Insurance Services -Orange 750 The City Drive South, 450 Orange CA 92868 CONTACT Heidi Farman! PHONE FA1c 951 365-3850 ac No626-564-6565 Eo "alEss: heldiflMsipbrokers.corn INSURERS AFFORDING COVERAGE NAIC# INSURER A: Travelers Property Casualty Company of America 25674 LicenseM 0 93299 INSURED BACXAPP-01 BackfloW Apparatus & Valve CO. 20435 S. Susana Road INSURER B: The Travelers Indemnity Company of Connecticut 25682 INSURERC: INSUO: Long Beach CA 90810 INSURRERER E INSURER F : COVERAGES CERTIFICATE NUMBER: 504427579 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. INSR LTft TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF IMIDDIYYYY POLICY UP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY V Y 6308,1664090 10/31/2024 10/31/2025 EACH OCCURRENCE $1,000,000 CLAIMS -MADE I —XI OCCUR DAMA ETORENTED PREMISES RENT $300,000 MED UP (Any one erson) $ 5,000 PERSONAL B ADV INJURY $1,000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000.000 POLICY [fl JE� F-1 LOG PRODUCTS-COMP/OPAGG $2.000,000 $ OTHER: B Y Y BA7N173419 10/31/2024 10/31/2025 COMBINED SINGLE LIMIT Ea ascidenlANYAUTO $1.000,000 BODILY INJURY(Per person) $OWNED SCHEDU LEDAUTOS ONLY POMOBILELIABILITY BODILY INJURY (Per accitlentAUTOS ) $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Par accident $ A X UMBRELLA LIAR X OCCUR CUP9J209005 10/31/2024 10/31/2025 EACHOCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y/N Y UB-3R155740 8/27/2024 8/27/2025 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 ANYPROPRIETORIPARTNERIEXECUTIVE ❑ OFFICER/MEMBEREXCLUDED] NIA E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) U yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 A Property 6308,1664090 10/31/2024 10/31/2025 Bus Personal Property Included DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached it more space is required) Subject to all policy terms, exclusions and conditions. RE: COSA Agreement N-2020-153; City of Santa Ana and its officers, employees, agents, volunteers and representatives all for nonprofessional related exposures are an Additional Insured with respects to the General Liability and Auto Liability if required by written contract. General Liability Additional Insured, Primary and Non -Contributory and Waiver of Subrogation endorsements attached. Auto Liability Additional Insured and Waiver of Subrogation endorsement attached. Attached Workers Compensation Waiver of Subrogation endorsement applies if required by written contract.'PLEASE NOTE COPYRIGHT LAWS APPLY TO THE ACORD FORM PROHIBITING US FROM MODIFYING THE CANCELLATION CLAUSE. HOWEVER, PER S I P INSURANCE SERVICES PROCEDURES WILL NOTIFY YOU WITHIN 30 DAYS IF SAID POLICY CANCELS. Except 10 Days APPROVED CERTIFICATE HOLDER CANCELLATION By Cynthia Mora at 2.48 pm, Dec 04, 20 SHOULDANY OFT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Water Resources Division 215 S Center Street AUTHOB ZED REPRESENTATIVE Santa Ana CA 92703 ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BA7N173419 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II, C. EMPLOYEE HIRED AUTO The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI. NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Includes copyrighted material of Insurance[By PPROVED Cynthia Mora at 2:48 pm, Dec 04, 2024 COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION 11 — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (III) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (tv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners If you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ® 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material or Insurance Services Office, Inc, with its permission. APPROVED By Cynthia Mora at 2.48 pm, Dec 04, 2024 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE —GLASS The fallowing is added to Paragraph D., Deducti- ble, of SECTION If — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced- H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS : S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 02 15 ® 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance SeFBy PPROVED Cynthia Mora at 2:48 pm, Dec 04, 2024 COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: APPROVED By Cynthia Mora at 2:48 pm, Dec 04, 2024 Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: 630BJ664090 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR MANUFACTURERS AND WHOLESALERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured —Unnamed Subsidiaries B. Who Is An Insured — Employees And Volunteer Workers — Bodily Injury To Co -Employees And Cc -Volunteer Workers C. Who Is An Insured — Newly Acquired Or Formed Limited Liability Companies D. Blanket Additional Insured — Broad Form Vendors E. Blanket Additional Insured— Controlling Interest F. Blanket Additional Insured — Mortgagees, Assignees, Successors Or Receivers G. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Premises PROVISIONS A. WHO IS AN INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION II — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership or joint venture, that is not shown as a Named Insured in the Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: H. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Operations I. Blanket Additional Insured — Grantors Of Franchises J. Incidental Medical Malpractice K. Medical Payments — Increased Limit L. Blanket Waiver Of Subrogation M. Contractual Liability —Railroads a. Before you maintained an ownership interest of more than 50% in such subsidiary; or b. After the date, if any, during the policy period that you no longer maintain an ownership interest of more than 50% in such subsidiary. For purposes of Paragraph 1. of Section II — Who Is An Insured, each such subsidiary will be deemed to be designated in the Declarations as: a. A limited liability company; b. An organization other than a partnership, joint venture or limited liability company; or c. A trust; as indicated in its name or the documents that govem its structure. CG D4 58 02 19 ® 2017 The Travelers Indemnity C Includes copyrighted material of Insurance APPROVED By Cynthia Mora at 2.48 pm, Dec 04, 2024 COMMERCIAL GENERAL LIABILITY B. WHO IS AN INSURED — EMPLOYEES AND a. A limited liability company; VOLUNTEER WORKERS — BODILY INJURY TO CO -EMPLOYEES AND CO -VOLUNTEER b. An organization, other than a partnership, WORKERS joint venture or limited liability company; The following is added to Paragraph 2.a.(1) of or SECTION II — WHO IS AN INSURED: c. AVust; Paragraphs (1)(a), (b) and (c) above do not apply as indicated in its name or the documents to "bodily injury" to a co -"employee" while in the that govern its structure. course of the co -"employee's" employment by you D. BLANKET ADDITIONAL INSURED — BROAD or performing duties related to the conduct o f your FORM VENDORS business, or to "bodily injury" to your other "volunteer workers" while performing duties The following is added to SECTION II — WHO IS related to the conduct of your business. AN INSURED: C. WHO IS AN INSURED — NEWLY ACQUIRED Any person or organization that is a vendor and OR FORMED LIMITED LIABILITY COMPANIES that you have agreed in a written contract or The following replaces Paragraph 3, of SECTION agreement to include as an additional insured on II— WHO IS AN INSURED: this Coverage Part is an insured, but only with respect to liability for "bodily injury" or "property 3. Any organization you newly acquire or form, damage" that: other than a partnership or joint venture, and a. Occurs subsequent to the signing of that of which you are the sole owner or in which contract or agreement; and you maintain an ownership interest of more than 50%, will qualify as a Named Insured if b. Arises out of "your products" that are there is no other similar insurance available to distributed or sold in the regular course of that organization. However: such vendor's business. a. Coverage under this provision is afforded The insurance provided to such vendor is subject only: to the following provisions: (1) Until the 180th day after you acquire a. The limits of insurance provided to such or form the organization or the end of vendor will be the minimum limits that you the policy period, whichever is earlier, agreed to provide in the written contract or if you do not report such organization agreement, or the limits shown in the in writing to us within 180 days after Declarations, whichever are less. you acquire or form it; or b. The insurance provided to such vendor does (2) Until the end of the policy period, not apply to: when that date is later than 180 days (1) Any express warranty not authorized by after you acquire or form such you or any distribution or sale for a organization, if you report such b purpose not authorized 6y you; organization in writing to us within 180 days after you acquire or form it; (2) Any change in "your products" made by b. Coverage A does not apply to "bodily such vendor; injury" or "property damage" that occurred (3) Repackaging, unless unpacked solely for before you acquired or formed the the purpose of inspection, demonstration, organization; and testing, or the substitution of parts under c. Coverage B does not apply to "personal instructions from the manufacturer, and and advertising injury" arising out of an then repackaged in the original container; offense committed before you acquired or (4) Any failure to make such inspections, formed the organization. adjustments, tests or servicing as For the purposes of Paragraph 1. of Section II vendors agree to perform or normally — Who Is An Insured, each such organization undertake to perform in the regular will be deemed to be designated in the course of business, in connection with the Declarations as: distribution or sale of "your products"; Page 2 of 5 V 2017 The Travelers Indemnity Company. All rights reserved. CG D4 58 02 19 Includes copyrighted material of Insurance APPROVED By Cynthia Mora at 2.48 pm, Dec 04, 2024 (5) Demonstration, installation, servicing or repair operations, except such operations performed at such vendor's premises in connection with the sale of "your products'; or (6) "Your products" that, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or on behalf of such vendor. Coverage under thi s provision does not apply to: a. Any person or organization from whom you have acquired "your products", or any ingredient, part or container entering into, accompanying or containing such products; or b. Any vendor for which coverage as an additional insured specifically is scheduled by endorsement. E. BLANKET ADDITIONAL INSURED - CONTROLLING INTEREST 1. The following is added to SECTION 11-WHO IS AN INSURED: Any person or organization that has financial control of you is an insured with respect to liability for "bodily injury', "property damage" or "personal and advertising injury" that arises out of: a. Such financial control; or b. Such person's or organization's ownership, maintenance or use of premises leased to or occupied by you. The insurance provided to such person or organization does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. 2. The following is added to Paragraph 4. of SECTION 11- WHO IS AN INSURED: This paragraph does not apply to any premises owner, manager or lessor that has financial control of you. F. BLANKET ADDITIONAL INSURED - MORTGAGEES, ASSIGNEES, SUCCESSORS OR RECEIVERS The following is added to SECTION 11 - WHO IS AN INSURED: Any person or organization that is a mortgagee, assignee, successor or receiver and that you have agreed in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to its COMMERCIAL GENERAL LIABILITY liability as mortgagee, assignee, successor or receiver for "bodily Injury", "property damage" or "personal and advertising injury" that: a. Is "bodily injury' or "property damage" that occurs, or is "personal and advertising injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement; and b. Arises out of the ownership, maintenance or use of the premises for which that mortgagee, assignee, successor or receiver is required under that contract or agreement to be included as an additional insured on this Coverage Part. The insurance provided to such mortgagee, assignee, successor or receiver is subject to the following provisions: a. The limits of insurance provided to such mortgagee, assignee, successor or receiver will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. b. The insurance provided to such person or organization does not apply to: (1) Any "bodily injury' or "property damage" that occurs, or any "personal and advertising injury' caused by an offense that is committed, after such contract or agreement is no longer in effect; or (2) Any "bodily injury', "property damage" or "personal and advertising injury" arising out of any structural alterations, new construction or demolition operations performed by or on behalf of such mortgagee, assignee, successor or receiver. G. BLANKET ADDITIONAL INSURED - GOVERNMENTAL ENTITIES - PERMITS OR AUTHORIZATIONS RELATING TO PREMISES The following is added to SECTION II - WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to premises owned or occupied by, or rented or loaned to, you and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of the existence, ownership, use, maintenance, repair, construction, erection or removal of any of the following for which that governmental entity has CIS D4 56 02 19 ® 2017 The Travelers Indemnity Co m n . All ri hits reserved. Pace 3 of 5 Includes copyrighted material of Insurance APPROVED By Cynthia Mora at 2.48 pm, Dec 04, 2024 COMMERCIAL GENERAL LIABILITY issued such permit or authorization: advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, elevators, street banners or decorations. H BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIES — PERMITS OR AUTHORIZATIONS RELATING TO OPER- ATIONS The following is added to SECTION II — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liabi lity for "bodily injury'. "property damage" or "personal and advertising injury" arising out of such operations. The Insurance provided to such governmental entity does not apply to: a. Any "bodily injury', "property damage" or "personal and advertising injury" arising out of operations performed for the governmental entity; or b. Any "bodily injury' or "property damage" included in the "products -completed operations hazard". I. BLANKET ADDITIONAL INSURED — GRANTORS OF FRANCHISES The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that grants a franchise to you is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of your operations in the franchise granted by that person or organization. If a written contract or agreement exists between you and such additional insured, the limits of insurance provided to such insured will be the minimum limits that you agreed to provide in the written contract or agreement, or the limits shown in the Declarations, whichever are less. J. INCIDENTAL MEDICAL MALPRACTICE services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION 11 — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician, paramedic, athletic trainer, audiologist, dietician, nutritionist, occupational therapist or occupational therapy assistant, physical therapist or speech - language pathologist: or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". 4. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE. LIABILITY: 1. The following replaces Paragraph b. of the Sale Of Pharmaceuticals definition of "occurrence" in the "Bodily injury' or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or b. An act or omission committed in providing ordinance relating to the sale of or failing to provide "incidental medical pharmaceuticals committed ins or with the knowledge or consent of, the insured. Page 4 of 5 ® 2017 The Travelers Indemnity Company. All rights reserved. CG D4 58 02 19 Includes copyrighted material of Insurance APPROVED By Cynthia Mora at 2:48 pm, Dec 04, 2024 5. 6. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. K. MEDICAL PAYMENTS —INCREASED LIMIT The following replaces Paragraph 7. of SECTION III — LIMITS OF INSURANCE: 7. Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person, and will be the higher of: COMMERCIAL GENERAL LIABILITY a. $10,000; or b. The amount shown in the Declarations of this Coverage Part for Medical Expense Limit. L. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the execution of the contract or agreement. M. CONTRACTUAL LIABILITY —RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is deleted. APPROVED By Cynthia Mora at 2:48 pm, Dec 04, 2024 CIS D4 58 02 19 0 2017 The Travelers Indemnity Company. All rights reserved. Page 5 of 5 Includes copydghted material of Insurance services Office, Inc. with its permission POLICY NUMBER: 630BJ664090 COMMERCIAL GENERAL LIABILITY 4. Other Insurance (ii) That is insurance for "premises If valid and collectible other insurance is available to damage'; the insured for a loss we cover under Coverages A (iii) If the loss arises out of the or B of this Coverage Part, our obligations are maintenance or use of aircraft, limited as described in Paragraphs a. and b. below. "autos" or watercraft to the extent As used anywhere in this Coverage Part, other not subject to any exclusion in this insurance means insurance, or the funding of Coverage Part that applies to losses, that is provided by, through or on behalf of: aircraft, "autos" or watercraft (i) Another insurance company; (iv) That is insurance available to a premises owner, manager or (ii) Us or an of our affiliated insurance companies, Y P lessor that qualifies as an insured except when the Non cumulation of Each under Paragraph 4. of Section II — Occurrence Limit provision of Paragraph 5. of Who Is An Insured, except when Section III — Limits Of Insurance or the Non Paragraph d. below applies; or cumulation of Personal and Advertising Injury (v) That is insurance available to an Limit provision of Paragraph 4, of Section III — equipment lessor that qualifies as Limits of Insurance applies because the an insured under Paragraph of Amendment — Non Cumulation Of Each Section II —Who Is An Insured, Occurrence Limit Of Liability And Non except when Paragraph d. below Cumulation Of Personal And Advertising Injury applies. Limit endorsement is included in this policy; (b) Any of the other insurance, whether (ill) Any risk retention group; or primary, excess, contingent or on any (iv) Any self-insurance method or program, in other basis, that is available to the which case the insured will be deemed to be insured when the insured is an the provider of other insurance, additional insured, or is any other Other insurance does not include umbrella insured that does not qualify as a insurance, or excess insurance, that was bought named insured, under such other specifically to apply in excess of the Limits of insurance. Insurance shown in the Declarations of this (2) When this insurance is excess, we will Coverage Part. have no duty under Coverages A or B to As used anywhere in this Coverage Part other defend the insured against any "suit" if any insurer means a provider of other insurance. As other insurer has a duty to defend the used in Paragraph c. below, insurer means a insured against that "suit". If no other provider of insurance. insurer defends, we will undertake to do so, but we will be entitled to the insured's rights a. Primary Insurance against all those other insurers. This insurance is primary except when (3) When this insurance is excess over other Paragraph b, below applies. If this insurance is insurance, we will pay only our share of the primary, our obligations are not affected unless amount of the loss, If any, that exceeds the any of the other insurance is also primary. sum of: Then, we will share with all that other insurance (a) The total amount that all such other by the method described in Paragraph c. below, insurance would pay for the loss in the except when Paragraph d. below applies. absence of this insurance; and b. Excess Insurance (b) The total of all deductible and self - insured amounts under all that other (1) This insurance is excess over: insurance. (a) Any of the other insurance, whether (4) We will share the remaining loss, if any, primary, excess, contingent or on any with any other insurance that is not other basis: described in this Excess Insurance That e, (i) That is Fire, Extended Coverage, Provision and was not bought specifically to Builders Risk, Installation Risk apply in excess of the Limits of Insurance shown in the Declarations of this Coverage similar coverage for "your work"; Part. CG T1 00 02 19 ® 2017 The Travelers Indemnity Com h n. . Pa a 15 of 21 Includes copyrighted material or Insurance 5e APPROVED By Cynthia Mora at 2.48 pm, Dec 04, 2024 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares, we will follow this method also. b. Those statements are based upon Under this approach each insurer contributes representations you made to us; and equal amounts until it has paid its applicable c. We have issued this policy in reliance upon limit of insurance or none of the loss remains, your representations. whichever comes first. The unintentional omission of, or unintentional error If any of the other insurance does not permit in, an information provided b Y You which relied Y contribution b equal shares, we will contribute Y � is upon in issuing this policy will not prejudice your i by limits. Under this method, each insurer's rights under this insurance. However, this provision share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of premium or to exercise our rights of cancellation or insurance of all insurers. nonrenewal in accordance with applicable insurance d. Primary And Non -Contributory Insurance If laws or regulations. Required By Written Contract 7, Separation Of Insureds If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an arty rights or duties specifically assigned in this insured under this Coverage Part must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies: contributory basis, this insurance is primary to a. As If each Named Insured were the only other insurance that is available to such insured Named Insured; and which covers such insured as a named insured, and we will not share with that other insurance, b. Separately to each insured against whom claim provided that: is made or "suit" is brought. (1) The "bodily injury" or "property damage" for 8. Transfer Of Rights Of Recovery Against Others which coverage is sought occurs; and To Us (2) The "personal and advertising injury" for If the insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Part, offense that is committed; those rights are transferred to us. The insured must subsequent to the signing of that contract or do nothing after loss to impair them. At our request, agreement by you. the insured will bring "suit" or transfer those rights to us and help us enforce then. S. Premium Audit 9. When We Do Not Renew a, will compute all premiums for this Coverage If we decide not to renew this Coverage Part, we will Pa Partin accordance with our rules and rates. mail or deliver to the first Named Insured shown in b. Premium shown in this Coverage Part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only. At not less than 30 daysbefore the expiration date. the close of each audit we will compute If notice is mailed, proof of mailing will be sufficient at period and send the earned premium for that that proof of notice. notice to the first Named Insured. The due date for audit and retrospective premiums is the date SECTION V — DEFINITIONS shown as the due date on the bill. If the sum of 1. "Advertisement" means a notice that is broadcast or the advance and audit premiums paid for the published to the general public or specific market policy period is greater than the earned segments about your goods, products or services premium, we will return the excess to the first for the purpose of attracting customers or Named Insured. supporters. For the purposes of this definition: c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding websites, only that part of a website 6. Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 ® 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Sere' APPROVED By Cynthia Mora at 2:48 pm, Dec 04, 2024 R �I I)ELCpCAIW WORKERS COMPENSATION r I A ERS AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB-3R155740-24-14-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR ALL OPERATIONS WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. APPROVED By Cynthia Mora at 2:48 pm, Dec 04, 2024 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 08/27/2024 Policy No. Endorsement No. Insured Backfiow Apparatus & Valve Co. Premium Insurance Company Countersigned by DATE OF ISSUE: 09-18-24 ST ASSIGN: Page 1 of 1 710/17/2025 E(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 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 CONTACT NAME: Heidi Farman) SIP Insurance Services-Orange PHONE g51 365-3850 FAX No:626-564-6565 790 The City Drive South, Ste 210 A/C No Ext: ( ) (Aic Orange CA 92868 ADDE-MRESS: heidif@sipbrokers.com INSURER(S)AFFORDING COVERAGE NAIC# License#:OM93299 INSURERA:Travelers Property Casualty Company of America 25674 INSURED BACKAPP-01 INSURERB:The Travelers Indemnity Company of Connecticut 25682 Backflow Apparatus&Valve Co. 20435 S. Susana Road INSURERC: Long Beach CA 90810 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1429036460 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y Y 6308J664090 10/31/2025 10/31/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $300,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY� ECT C LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y BA7N173419 10/31/2025 10/31/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLA LAB X OCCUR CUP9J209005 10/31/2025 10/31/2026 EACH OCCURRENCE $5,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ A WORKERS COMPENSATION Y UB-3R155740-25-14-G 8/27/2025 8/27/2026 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Property 6308J664090 10/31/2025 10/31/2026 Bus Personal Property Included DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Subject to all policy terms,exclusions and conditions. RE: COSA Agreement N-2020-153;City of Santa Ana and its officers,employees,agents,volunteers and representatives all for nonprofessional related exposures are an Additional Insured with respects to the General Liability and Auto Liability if required by written contract.General Liability Additional Insured, Primary and Non-Contributory and Waiver of Subrogation endorsements attached.Auto Liability Additional Insured and Waiver of Subrogation endorsement attached.Attached Workers Compensation Waiver of Subrogation endorsement applies if required by written contract.'PLEASE NOTE COPYRIGHT LAWS APPLY TO THE ACORD FORM PROHIBITING US FROM MODIFYING THE CANCELLATION CLAUSE. HOWEVER, PER S I P INSURANCE SERVICES PROCEDURES WILL NOTIFY YOU WITHIN 30 DAYS IF SAID POLICY CANCELS. Except 10 Days Notice of Cancellation For Non-Payment Of Premium. CERTIFICATE HOLDER APPROVED CANCELLATION By Tu Tran Nguyen at 9:57 am,Oct 23,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN DigitalnyNigredby ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana Tu Tran Attn: Water Resources Division Date:2025.10.23 215 S Center Street Nguyen 0957.44-07'00' AUTHORIZED REPRESENTATIVE Santa Ana CA 92703 C� // �� @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BA71\1173419 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT C. EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE—INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies as an "insured" An Insured, of SECTION II —COVERED AUTOS under the Who Is An Insured provision contained LIABILITY COVERAGE: in Section II. Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The following is added to Paragraph A.1., 50% or more ownership interest and that is not Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission, while performing duties related to the conduct of your busi- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1., 2. The following replaces Paragraph b. in B.S., Who Is An Insured, of SECTION II — COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization.who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that is signed and ered "autos"you own: executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow; and during the policy period, to be named as an addi- (2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name, with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered"auto". (1) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured"against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION II —COVERED AUTOS tions. LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- (ii) Neither you nor any other involved ing a covered "auto"you don't own, hire or borrow "insured" will make any settlement in your business or your personal affairs. without our consent. E. SUPPLEMENTARY PAYMENTS — INCREASED (iii)We may, at our discretion, participate LIMITS in defending the "insured" against, or in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II —COVERED AUTOS LIABIL- ITY COVERAGE: (iv)We will reimburse the "insured" for sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE—INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with compulsory insurance requirements will No deductibles apply to this Personal Property not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to "loss" to one or ted or authorized insurer outside the more airbags in a covered "auto"you own that in- United States of America, its territories flate due to a cause other than a cause of 'loss" and possessions, Puerto Rico and Can- set forth in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance. b. The airbags are not covered under any war- G. WAIVER OF DEDUCTIBLE—GLASS ranty; and The following is added to Paragraph D., Deducti- c. The airbags were not intentionally inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one 'loss". No deductible for a covered "auto' will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF The following is added to Paragraph A.2.a., of SECTION IV—BUSINESS AUTO CONDITIONS: USE—INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or 'loss" ap- graph AA.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or 'loss" is known TION III—PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership); $750 for any one "accident'. (c) A member (if you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager (if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization); or SECTION III — PHYSICAL DAMAGE COVER- (e) Any "employee" authorized by you to give no- AGE: tice of the"accident'or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.S., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto'of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS : The following is added to Paragraph AA., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for 'loss" to wearing ap- signed and executed prior to any "accident' parel and other personal property which is: or'loss", provided that the "accident' or'loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. SECTION IV—BUSINESS AUTO CONDITIONS: Page 4 of 4 ©2015 The Travelers Indemnity Compa ny.All rights reserved CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. POLICY NUMBER: 6308J664090 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR MANUFACTURERS AND WHOLESALERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights,duties,and what is and is not covered. A. Who Is An Insured—Unnamed Subsidiaries H. Blanket Additional Insured — Governmental B. Who Is An Insured — Employees And Volunteer Entities — Permits Or Authorizations Relating To Workers — Bodily Injury To Co-Employees And Operations Co-Volunteer Workers I. Blanket Additional Insured — Grantors Of Franchises C. Who Is An Insured — Newly Acquired Or Formed Limited Liability Companies J. Incidental Medical Malpractice D. Blanket Additional Insured—Broad Form Vendors K. Medical Payments —Increased Limit E. Blanket Additional Insured—Controlling Interest L. Blanket Waiver Of Subrogation F. Blanket Additional Insured—Mortgagees, M. Contractual Liability—Railroads Assignees, Successors Or Receivers G. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Premises PROVISIONS A. WHO IS AN INSURED — UNNAMED a. Before you maintained an ownership interest SUBSIDIARIES of more than 50% in such subsidiary; or The following is added to SECTION II —WHO IS b. After the date, if any, during the policy period AN INSURED: that you no longer maintain an ownership Any of your subsidiaries, other than a partnership interest of more than 50% in such subsidiary. or joint venture, that is not shown as a Named For purposes of Paragraph 1. of Section II—Who Insured in the Declarations is a Named Insured if: Is An Insured, each such subsidiary will be a. You are the sole owner of, or maintain an deemed to be designated in the Declarations as: ownership interest of more than 50% in, such subsidiary on the first day of the policy period; a. A limited liability company; and b. An organization other than a partnership, g p p,joint b. Such subsidiary is not an insured under venture or limited liability company; or similar other insurance. No such subsidiary is an insured for"bodily injury" c. A trust; or "property damage" that occurred, or "personal as indicated in its name or the documents that and advertising injury" caused by an offense govern its structure. committed: CG D4 58 02 19 ®2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 5 Includes copyrighted material of Insurance Services Office,Inc.with its permission COMMERCIAL GENERAL LIABILITY B. WHO IS AN INSURED — EMPLOYEES AND a. A limited liability company; VOLUNTEER WORKERS—BODILY INJURY TO b. An organization, other than a partnership, CO-EMPLOYEES AND CO-VOLUNTEER joint venture or limited liability company; WORKERS or The following is added to Paragraph 2.a.(1) of SECTION II—WHO IS AN INSURED: c. A trust; Paragraphs (1)(a), (b) and (c) above do not apply as indicated in its name or the documents to "bodily injury" to a co-"employee" while in the that govern its structure. course of the co-"employee's" employment by you D. BLANKET ADDITIONAL INSURED — BROAD or performing duties related to the conduct o f your FORM VENDORS business, or to "bodily injury" to your other "volunteer workers" while performing duties The following is added to SECTION II —WHO IS related to the conduct of your business. AN INSURED: C. WHO IS AN INSURED — NEWLY ACQUIRED Any person or organization that is a vendor and OR FORMED LIMITED LIABILITY COMPANIES that you have agreed in a written contract or The following replaces Paragraph 3. of SECTION agreement to include as an additional insured on II—WHO IS AN INSURED: this Coverage Part is an insured, but only with respect to liability for "bodily injury" or "property 3. Any organization you newly acquire or form, damage" that: other than a partnership or joint venture, and a. Occurs subsequent to the signing of that of which you are the sole owner or in which contract or agreement;and you maintain an ownership interest of more than 50%, will qualify as a Named Insured if b. Arises out of "your products" that are there is no other similar insurance available to distributed or sold in the regular course of that organization. However: such vendor's business. a. Coverage under this provision is afforded The insurance provided to such vendor is subject only: to the following provisions: (1) Until the 180th day after you acquire a. The limits of insurance provided to such or form the organization or the end of vendor will be the minimum limits that you the policy period, whichever is earlier, agreed to provide in the written contract or if you do not report such organization agreement, or the limits shown in the in writing to us within 180 days after Declarations,whichever are less. you acquire or form it; or b. The insurance provided to such vendor does (2) Until the end of the policy period, not apply to: when that date is later than 180 days after you acquire or form such (1) Any express warranty not authorized by organization, if you report such You or any distribution or sale for a organization in writing to us within purpose not authorized by you; 180 days after you acquire or form it; (2) Any change in "your products" made by b. Coverage A does not apply to "bodily such vendor; injury"or"property damage" that occurred (3) Repackaging, unless unpacked solely for before you acquired or formed the the purpose of inspection, demonstration, organization; and testing, or the substitution of parts under c. Coverage B does not apply to "personal instructions from the manufacturer, and and advertising injury" arising out of an then repackaged in the original container; offense committed before you acquired or (4) Any failure to make such inspections, formed the organization. adjustments, tests or servicing as For the purposes of Paragraph 1. of Section II vendors agree to perform or normally —Who Is An Insured, each such organization undertake to perform in the regular will be deemed to be designated in the course of business, in connection with the Declarations as: distribution or sale of"your products"; Page 2 of 5 ©2017 The Travelers Indemnity Company.All rights reserved. CIS D4 58 02 19 Includes copyrighted material of Insurance Services Office,Inc.with its permission COMMERCIAL GENERAL LIABILITY (5) Demonstration, installation, servicing or liability as mortgagee, assignee, successor or repair operations, except such operations receiver for "bodily injury", "property damage" or performed at such vendor's premises in "personal and advertising injury"that: connection with the sale of "your a. Is "bodily injury" or "property damage" that products';or occurs, or is "personal and advertising injury" (6) "Your products" that, after distribution or caused by an offense that is committed, sale by you, have been labeled or subsequent to the signing of that contract or relabeled or used as a container, part or agreement; and ingredient of any other thing or substance b. Arises out of the ownership, maintenance or by or on behalf of such vendor. use of the premises for which that mortgagee, Coverage under this provision does not apply to: assignee, successor or receiver is required a. Any person or organization from whom you under that contract or agreement to be have acquired "your products", or any included as an additional insured on this ingredient, part or container entering into, Coverage Part. accompanying or containing such products; The insurance provided to such mortgagee, or assignee, successor or receiver is subject to the b. Any vendor for which coverage as an following provisions: additional insured specifically is scheduled by a. The limits of insurance provided to such endorsement. mortgagee, assignee, successor or receiver E. BLANKET ADDITIONAL INSURED — will be the minimum limits that you agreed to CONTROLLING INTEREST provide in the written contract or agreement, or the limits shown in the Declarations, 1. The following is added to SECTION II —WHO whichever are less. IS AN INSURED: b. The insurance provided to such person or Any person or organization that has financial organization does not apply to: control of you is an insured with respect to liability for "bodily injury", "property damage" (1) Any "bodily injury or "property damage" �� �� that occurs, or any "personal and or personal and advertising injury that arises advertising injury" caused by an offense out of: that is committed, after such contract or a. Such financial control; or agreement is no longer in effect;or b. Such person's or organization's (2) Any "bodily injury", "property damage" or ownership, maintenance or use of "personal and advertising injury" arising premises leased to or occupied by you. out of any structural alterations, new The insurance provided to such person or construction or demolition operations organization does not apply to structural performed by or on behalf of such alterations, new construction or demolition mortgagee, assignee, successor or operations performed by or on behalf of such receiver. person or organization. G. BLANKET ADDITIONAL INSURED — 2. The following is added to Paragraph 4. of GOVERNMENTAL ENTITIES — PERMITS OR SECTION II—WHO IS AN INSURED: AUTHORIZATIONS RELATING TO PREMISES This paragraph does not apply to any The following is added to SECTION II —WHO IS premises owner, manager or lessor that has AN INSURED: financial control of you. Any governmental entity that has issued a permit F. BLANKET ADDITIONAL INSURED — or authorization with respect to premises owned MORTGAGEES, ASSIGNEES, SUCCESSORS or occupied by, or rented or loaned to, you and OR RECEIVERS that you are required by any ordinance, law, The following is added to SECTION II —WHO IS building code or written contract or agreement to AN INSURED: include as an additional insured on this Coverage Part is an insured, but only with respect to liability Any person or organization that is a mortgagee, for "bodily injury", "property damage" or"personal assignee, successor or receiver and that you and advertising injury" arising out of the have agreed in a written contract or agreement to existence, ownership, use, maintenance, repair, include as an additional insured on this Coverage construction, erection or removal of any of the Part is an insured, but only with respect to its following for which that governmental entity has CG D4 58 02 19 m 2017 The Travelers Indemnity Company.All rights reserved. Page 3 of 5 Includes copyrighted material of Insurance Services Office,Inc.with its permission COMMERCIAL GENERAL LIABILITY issued such permit or authorization: advertising services", first aid or "Good Samaritan signs, awnings, canopies, cellar entrances, coal services" to a person, unless you are in holes, driveways, manholes, marquees, hoist the business or occupation of providing away openings, sidewalk vaults, elevators, street professional health care services. banners or decorations. 2. The following replaces the last paragraph of H BLANKET ADDITIONAL INSURED — Paragraph 2.a.(1) of SECTION II — WHO IS GOVERNMENTAL ENTITIES — PERMITS OR AN INSURED: AUTHORIZATIONS RELATING TO OPER- Unless you are in the business or occupation ATIONS of providing professional health care services, The following is added to SECTION II —WHO IS Paragraphs (1)(a), (b), (c) and (d) above do AN INSURED: not apply to "bodily injury" arising out of Any governmental entity that has issued a permit providing or failing to provide: or authorization with respect to operations (a) "Incidental medical services" by any of performed by you or on your behalf and that you your "employees" who is a nurse, nurse are required by any ordinance, law, building code assistant, emergency medical technician, or written contract or agreement to include as an paramedic, athletic trainer, audiologist, additional insured on this Coverage Part is an dietician, nutritionist, occupational insured, but only with respect to liabi lity for"bodily injury", "property damage" or "personal and therapist or occupational therapy advertising injury" arising out of such operations. assistant, physical therapist or speech- The insurance provided to such governmental language pathologist; or entity does not apply to: (b) First aid or "Good Samaritan services" by a. Any "bodily injury", "property damage" or any of your "employees" or "volunteer "personal and advertising injury" arising out of workers", other than an employed or operations performed for the governmental volunteer doctor. Any such "employees" entity;or or "volunteer workers" providing or failing to provide first aid or "Good Samaritan b. Any "bodily injury' or property damage services" during their work hours for you included in the "products -completed will be deemed to be acting within the operations hazard". scope of their employment by you or I. BLANKET ADDITIONAL INSURED — performing duties related to the conduct GRANTORS OF FRANCHISES of your business. The following is added to SECTION II —WHO IS 3, The following replaces the last sentence of AN INSURED: Paragraph 5. of SECTION III — LIMITS OF Any person or organization that grants a franchise INSURANCE: to you is an insured, but only with respect to For the purposes of determining the liability for "bodily injury", "property damage" or applicable Each Occurrence Limit, all related personal and advertising injury arising out of acts or omissions committed in providing or your operations in the franchise granted by that failing to provide "incidental medical person or organization. services", first aid or "Good Samaritan If a written contract or agreement exists between services"to any one person will be deemed to you and such additional insured, the limits of be one "occurrence". insurance provided to such insured will be the 4. The following exclusion is added to minimum limits that you agreed to provide in the Paragraph 2., Exclusions, of SECTION 1 — written contract or agreement, or the limits shown COVERAGES — COVERAGE A — BODILY in the Declarations,whichever are less. INJURY AND PROPERTY DAMAGE J. INCIDENTAL MEDICAL MALPRACTICE LIABILITY: 1. The following replaces Paragraph b. of the Sale Of Pharmaceuticals definition of "occurrence" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or b. An act or omission committed in providing ordinance relating to the sale of pharmaceuticals committed by, or with the or failing to provide "incidental medical knowledge or consent of,the insured. Page 4 of 5 p 2017 The Travelers Indemnity Company.All rights reserved. CG D4 58 02 19 Includes copyrighted material of Insurance Services Office,Inc.with its permission COMMERCIAL GENERAL LIABILITY S. The following is added to the DEFINITIONS a. $10,000;or Section: b. The amount shown in the Declarations of "Incidental medical services" means: this Coverage Part for Medical Expense a. Medical, surgical, dental, laboratory, x-ray Limit. or nursing service or treatment, advice or L. BLANKET WAIVER OF SUBROGATION instruction, or the related furnishing of The following Is added to Paragraph 8., Transfer food or beverages;or g 9 p Of Rights Of Recovery Against Others To Us, b. The furnishing or dispensing of drugs or of SECTION IV — COMMERCIAL GENERAL medical, dental, or surgical supplies or LIABILITY CONDITIONS: appliances. If the insured has agreed in a contract or 6. The following is added to Paragraph 4.b., agreement to waive that insured's right of Excess Insurance, of SECTION IV — recovery against any person or organization, we COMMERCIAL GENERAL LIABILITY waive our right of recovery against such person or CONDITIONS: organization, but only for payments we make This insurance is excess over any valid and because of: collectible other insurance, whether primary, a. "Bodily injury" or "property damage" that excess,contingent or on any other basis, that is available to any of your "employees" for occurs;or "bodily injury" that arises out of providing or b. "Personal and advertising injury" caused by failing to provide "incidental medical services" an offense that is committed; to any person to the extent not subject to subsequent to the execution of the contract or Paragraph 2.a.(1) of Section II — Who Is An agreement. Insured. M K. MEDICAL PAYMENTS—INCREASED LIMIT M. CONTRACTUAL LIABILITY—RAILROADS 1. The following replaces Paragraph c. of the The following replaces Paragraph 7. of SECTION definition of "insured contract" in the III—LIMITS OF INSURANCE: DEFINITIONS Section: 7. Subject to Paragraph S. above, the Medical c. Any easement or license agreement; Expense Limit is the most we will pay under Coverage C for all medical expenses 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is because of bodily injury sustained by any deleted. one person, and will be the higher of: CG D4 58 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 5 of 5 Includes copyrighted material of Insurance Services Office,Inc.with its permission POLICY NUMBER: 6308J664090 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing a. The statements in the Declarations are If all of the other insurance permits contribution accurate and complete; by equal shares,we will follow this method also. b. Those statements are based upon Under this approach each insurer contributes representations you made to us;and equal amounts until it has paid its applicable c. We have issued this policy in reliance upon limit of insurance or none of the loss remains, your representations. whichever comes first. The unintentional omission of, or unintentional error If any of the other insurance does not permit in, any information provided by you which we relied contribution by equal shares, we will contribute upon in issuing this policy will not prejudice your by limits. Under this method, each insurer's rights under this insurance. However, this provision share is based on the ratio of its applicable limit does not affect our right to collect additional of insurance to the total applicable limits of premium or to exercise our rights of cancellation or insurance of all insurers. nonrenewal in accordance with applicable insurance d. Primary And Non-Contributory Insurance If laws or regulations. Required By Written Contract 7. Separation Of Insureds If you specifically agree in a written contract or Except with respect to the Limits of Insurance, and agreement that the insurance afforded to an any rights or duties specifically assigned in this insured under this Coverage Part must apply on Coverage Part to the first Named Insured, this a primary basis, or a primary and non- insurance applies: contributory basis, this insurance is primary to a. As if each Named Insured were the only other insurance that is available to such insured Named Insured;and which covers such insured as a named insured, and we will not share with that other insurance, b. Separately to each insured against whom claim provided that: is made or"suit"is brought. (1) The "bodily injury"or"property damage"for 8• Transfer Of Rights Of Recovery Against Others which coverage is sought occurs;and To Us (2) The "personal and advertising injury" for If the insured has rights to recover all or part of any which coverage is sought is caused by an payment we have made under this Coverage Part, offense that is committed; those rights are transferred to us.The insured must subsequent to the signing of that contract or do nothing after loss to impair them.At our request, agreement by you. the insured will bring "suit" or transfer those rights to us and help us enforce them. S. Premium Audit 9. When We Do Not Renew a. We will compute all premiums for this Coverage If we decide not to renew this Coverage Part,we will Part in accordance with our rules and rates. mail or deliver to the first Named Insured shown in b. Premium shown in this Coverage Part as the Declarations written notice of the nonrenewal advance premium is a deposit premium only.At not less than 30 days before the expiration date. the close of each audit period we will compute If notice is mailed, proof of mailing will be sufficient the earned premium for that period and send proof of notice. notice to the first Named Insured.The due date for audit and retrospective premiums is the date SECTION V—DEFINITIONS shown as the due date on the bill. If the sum of 1. "Advertisement" means a notice that is broadcast or the advance and audit premiums paid for the published to the general public or specific market policy period is greater than the earned segments about your goods, products or services premium, we will return the excess to the first for the purpose of attracting customers or Named Insured. supporters. For the purposes of this definition: c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication;and as we may request. b. Regarding websites, only that part of a website 6. Representations that is about your goods, products or services By accepting this policy,you agree: for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 m 2017 The Travelers Indemnity Company.All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office.Inc.with its permission. TRAVELERS, WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76( A)- 001 POLICY NUMBER: UB-3R155740-25-14-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2.DD % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 08/27/2025 Policy No. Endorsement No. Insured Backflow Apparatus &Valve Co. Premium Insurance Company Countersigned by DATE OF ISSUE:08-12-2025 ST ASSIGN: Page 1 of 1