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Home My WebLink AboutADVANCED TRANSPORTATION CONCEPTS GROUP, INC. 2 - 2007 "-' -..I AGREEMENT TERMINATION Wlll SEP -9 AM 9: 3t1 Please complete this form when the attached agreement is no longer III effect. CITY [, \ fJ"NA Return form to the Deputy Clerk of the Council (M-30). Call647-5~Eir-ypuhave ~estions. - -. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- Theagreementwith ~m&d. ~~--Irzt~ ~:i. $4AI~J --k, No. #-';'007- OO~ was completed on IZ/"t-'/ (17 and final payment has been made. Date: rrJJA ~A'}~ ql~l f) K ~ Department: Signature: Revised 08-28-06 City of Santa Ana Clerk of the Council ::1SURANCL cY~ 'ILE WORK MAY PPOCEED UNTil INSIIRANCEEXPIRES N-2007-004 /0-J.f-07 CUERK OF COUNCIL ~~~~(~)J. ~~"^ CONSULT ANT AGREEMENT THIS AGREEMENT, made and entered into this IS,I; day of December, 2006 by and between Advanced Transportation Concepts Group, Ine" a California corporation (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corpormion organized and existing under the Constitution and laws of the State of California (hereinafter "City"). REClT ALS A. The City desires to retain a consultant having special skill and knowledge in the field or teclmo[ogy integration to oversee the coordination, testing and integration of the advanced traffic control system and 2070 traffic controllers and to assist in grant applications. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the per/onnance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be perfonned in compliance with such standards as may reasonably be expected from a professional consulting fiml in the lield. 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: J. SCOPE OF SERVICES Consultant shall perlurm those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $10,000.00 during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing \-vork performed, subject to City accounting procedures. Payment need not be made lor work which fails to meet the standards of performance set forth in the Recitals which may reasonably bc expected by City. 3. TERM This Agreement shall commence on the date lirst set forth above and terminate on expenditure ur allocated funds, unless terminated earlier in accordance with Sediun 12, belo\v. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreemcnt, be construed to be an indcpendent contractor and not an cmployee of the City. This Agreemcnt is not intended nor shall it bc construed to create an employcr-employec relationship, a joint vcnture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, thc services to bc provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANO: Prior to undertaking perfonnance of work under this Agrccmcnt, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limitcd to protection against claims arising from bodily and pcrsonal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrcnce. Consultant shall supply City with a fully executcd additional insured endorsement in substantially the form attached hereto as Exhibit R upon execution of this Agreement and shall be approved in form by the City Attorney. b. Busincss automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 pcr occurrence. Such insurance shall include covcrage for owned, hired and non-owned automobiles. c. \'lorker's Compensation Insurance. In accordance with the provisions ofSectiun 3300 of the Lahor Code, Consultant, if Consultant has any employees, is required to be insmed against liability for workcr's compensation or to unde11ake sell'insurance. Prior to commencing the performance of the work undcr this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. Professional liability (errors and omissions) insurance, \vith a combined single limit of not less than $1,000,000 per claim. 2 e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and ellect lor the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and sball be approved in form by the City ^ttorney. (iii) Certificates and policies sball state that tbe policies shall not be canceled or reduced in covcrage or changed in any other material aspect without thirty (:10) days prior writtcn noticc to the City. f. If Consultant fails or retuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof tbat insurance has been procured and is in forcc and paid for, the City shall bave the rigbt, at the City's election, to forthwitb terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold hannless tbe City, its officers, agcnts, employees, consultants, special counsel, alId representati yes ham liability: (I) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including hcaltb, and claims for property damage, which may arise trom tbe direct or indirect operation~ of the Consultant or its contractors, subcontractors, agents, cmployees, or other persons acting on their bebalf which relates to the services dcscribcd in section I of this Agreement; and (2) from any claim tbat personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of tbe terms of or effects arising from this Agreement. This indemnity and bold bannless agreement applies to all claims for damages, just compensation, restitution, judicial or cquitablc relief suffered. or alleged to bave heen sul1ered, by reason of the events referred to in this Section or by reason ofthc tcrms of. or etfects, arisiug from this Agreement. Tbe Consultant rurther agrees to indemnify, hold barmless, and pay all costs for the defense ofthe City, including fees and costs lor special counsel to be selected by tbe City, regarding any action by a tbird 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 ariscs by rcason of the terms of, or elIeets arising Irom this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own infonnation of 3 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. Conlidential information disclosed to either party by any subsidiary and/or agent of the other pm1y is covered by this Agreement. The foregoing ohligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly availahle source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSJ<: Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with perfomlance of services specified under this Agreement. 9. 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 tirst class or certified mail, postage prepaid, or sent by tclefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Conncil City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 telefacsimile (714) 647-6956 With conrtesy copies to: Executive Director of the Public Works Agency Traffic Engineering Section City of Santa Ana 20 Civic Center Plaza (M-43) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-5616 and City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) PO. Box 1988 Santa Ana, California 92702 tclelacsimile (714) 647-6515 4 To Consultant; Advanced Transportation Concepts Group, fnc. John Thai 14 Sorenson Irvine. California 92602 telefacsimile (714) 210-9161 A party may change its address by giving notice in "Titing to the other party. Thereaner, 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 aftcr it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth abovc. If sent by telefacsimile, communication shall be el1ective or deemed to have been given twenty-four (24) hours aller the time sct forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. for purposes of calculating these time frames, weekends, fcderal, state, County or City holidays shall be excluded. IO, EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement hetween the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms or this Agreement and any attachments hereto, the terms or this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obI igate Consultant nor the City. Fach party to this Agreement acknowledges that no representations, inducements, prumises or agreements, orally or otheruiise, have been made by any party, or anyone acting un behalf of any party. which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consul1ant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent oflhe 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 ^greement performed by City personnel or by other consultants retained by City. 12. TERMINATION This Agreement may be terminated hy the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to rceeive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: 5 a. As a condition of such pa}TI1cnt, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the properly ofthc City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as thc City deems appropriate. b. Payment need not be made for work which Jails to mcct the standard of per/ormance spccified in the Recitals of this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because 0 f race, color. creed, religion, sex, marital status, sexual orientation. age, national origin, ancestry, or disability, as defined and prohibited by applicable law. in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14, JLJRISDICTION - VENUE This Agreement has been executed and delivered in the Stale of Cali fomi a and the validity, interpretation, performance, and enforcement of any of the elauses of this Agrecmcnt shall be determined and governed by the laws ofthe State ofCalifomia. 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. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits. approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and 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. 16. MISCELLANEOUS PROVISIONS a. Felch undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective pal1ies to each of the terms of this Agreement, a11d shall indemnify City fully, including reasonable costs a11d attorney's fees, for any injuries or damages to City in the event thaI such authority or powcr is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hercto shall be incorporated as if fully set forth in the body of this Agreement. II II 6 IN WITNESS WHEREOF, the panies hercto have executed this Agreement the date and year first above written. ATTEST:) ~// / . .. -. L _ // .-'>- / .' - '. ,/ ',. --f::~ ?~t L- ''-I::-"C' _-<'-~. _ .. PATRICIA LffEAG - 6 Clerk of the Council CITY OF SANTA ANA ~ rf;..cAO f-' DAVID N. REA M 't.-- City Manager APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney Bv: .t; -' ,. Laura 'Sheedy Assistant City Attorney RECOMMENDED FOR OVAL: CONSULTANT -rJ:;;. JAM .S G. ROSS Exc5lbtivc Director of the Pul'1ie Works Agency I . IJ Tax ID# J~. O~rO'l-rl 7 ~ Advanced Transportation Concepts Group 14 Sorenson, Irvine, CA 92602 November 27, 2006 Mr. T.C. Sutaria City Traffic Engineer City of Santa Ana Public Warks Department 20 Civic Center Plaza Santa Ana, CA 91702 He: On-Call Consulting Services for Grant Application, Design and Integration of tbe A TMS Dear Mr. Sutaria: Thank YOLl for this opportunity to submit a proposal to assist the City of Santa Ana with lTS integration as the City's on-call ITS design and integration firm. The City has implemented the A TMS project as pal1 of a Downtuwn demonstration project to field test adaptive lraffk control capabilities using 2070 controllers. We believe there are significant systems integration issues lurking ahead such as reliable controller communications, CCTV design and integralion, and systems evaluation that Advanced Transportation Concepts Group (ATCG) has the expertise to guide and assist the City. These tasks may include: 1. Review and inventory of City infrastructure, 2. Continue controller communications integration, 3. Assist with integrating CCTVs, 4. Assist with testing and integrating ATMS, 5. Assist with testing and integrating 2070 traffic control firmware, 6. Documenting project results and firulings for City's future reference, and 7. Assist with preparing grant application. As the on-call ITS firm, A TCG proposes to work on-call basis at the rate of $IOO/hr (not- to-exceed $10.000) for ITS cunsulling services. We believe this is the most cost effective method for the City as YOLl are only billed for the consulting hours rem.lereu. We arc prepared to meet the Cily's insurance and other contractual requirements within 30 days of a NTP. If YOll have other questions regarding this proposal, please fed frce to call me at 714-210- 9161. Respectfully yours. John Thai, P.E. r,:';V... ~.~, t. '.,. EXHIBIT Il ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIARIUTY POLICY Insurance Company _ This endorsement modifies such insurance as is al10rded hy the provisions of Policy # relating to the following: I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers. employees. agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured, 2, With respect to claims arising out of the operations ami uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. Ihe inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of' Santa Ana, 20 Civic Center Plaza, Santa Ana, California 9270 I. (Completion of the following, including countersignature, is required to make this endorsement effective.) EfJeetive Policy # Issued to , this endorsement form as a part of Named Insured Countersigned hy Authorized Representative 8 AVII1IKAL INSURANCE COMPANY i::':':, A STOCK COMPAi'JY t>: OlCfl:incallcd"lhO:(\llnp<my") (fIJ-.. . , \. f " '" , 1 PROF~5~IONAL LIABILITY POLICY ",;. IlECLARATIONS 'ICLAIMS.MA DE FORM) Policy No.: E0000003889-02 RcnewallRewrite of: E0000003889-01 r "Named Insured'~~nd M~llij]g Address ----.J ADV ANCEll TRANSPORT A nON CONCEPTS GROUP,INC. 14 SORENSON IRVINE, CA 92602 .::::::?}; ::: :;~~~~:~:!~~:; ;~:;: :~~;~j ~:~: r;~~i1~~~i:~~~:;:i :.~ =.;:.::.: ~)... ,-N,',' ...,.. ,..::?~...':~"'" .;}/" ".' >, -: ~;:~:. :)~::}:::::::::;:;:~;~~~~;:;:i;:~~~h,. ,';Y -.-.... '.', ._;.:N :::;~. ;;::~ .:.;.. .<:;;;~. ~~:: '~:;:" "POLlCY PERIOD": r>om 10104/2006 to 10/04I2oi\i::li''''J2.&/AS's.;,,:4,;,,~li4j;dd';;'br'h''Nld "J1" ",,'" I,,~j, .;.;.: . ..,._<;:.:.,:.:.;:~:.. . - - ," -<.:...;.:.:.;.;:::-~ - ,";':';', .~: :::., _ _,' " .>:: :x, In consideration of the payment ofpremiuoo, ill relia~~ tJPOll';i#~~~~~~~i~~~~~~I=;'~~~~~e,t?, ~ subjci~o all oft]u: f h. 1 h C . h tl "N" d I '''''d'' ., II . ........ .. .......w.... ., .. terms 0 t IS po lL'j, t C ompllny agrees WIt Ie 1 ~e n~~~f a~,:,',? O)~f'; "--":~}i~;~::~:;::::~::'/:::';li"'''- t!;" g Item!: "Named Insured's" BllSines~:tL m \,::~;~~~~t~~:;:;-:-~~::::"._,,<;':C";:';:'<f-:?~~::t:::~r:;::;.... {?~' Traffic Engineering Consulting Service~:nt' John n. Trai, E:&*::;i~f:-'~:;ir<~::~4:;.~;;-"'~'"" ;{f'" {';~::l;:~~~:}:; Limits of Liability 'l;th..~'~L",..::,~~Jn>' /ij;.] .~ f~ $1,000,000 Each "Clii@~".::;~""7}~T.~TE TAX f,~ $ i#.;-~ $2.000,000 Agg"gatc.."",;;,..:,J.... )$'rA~WI,,!@l'EE;~ 1_ '""p'.., I1TOTNHwE ..4$'1 .,'-??"f.. ! ~ .. ...,.;::;::;tr~;~J~h;~B~~~~~:~~~;;;~:;;;;~tb:::::::;f?~' "- $5,000 Per Claim (including ":~'m"cxpeti5~'I;;:j N- ~CCfl-OOL\ Item II: Itcmlll: Deductible: Item IV: .. ... . '.',-,',:.~;.-. .. A;~lif'J'll!~i:~\1~1!:'B1IiJtj~~"~l ' $0.00 . Terrorism Premiuri( ~---,- $7,500.00 Total Premium ~".:.;.;. ,...... .:~....,.,. Item V: Item VI Furms attached at inception: See Schedule of Forms AI 00 180398 NOTICE Except to suchaldent as may oU;erwise 0>.: prlWidM heHwl, the coverage of thf$ policy is limIted \Jeneraily ro liability for only those claims that are lirst made against the insured whits poli~)' is >, force. f"ea.e rev1~w the policy GarefuHy and discuss the covei3ge thereunder with your in$lJranc~ agent or broker A SIGl\ED COPY OF THE "NAMED INSlJRED'S" APPLICATION FOR THIS POLICY IS MADE A PART HERHJF.. AT INCEPTION This pulicy is not binding unless countersigned by AdIniral Insurance Company or it'g Authorized Representative. Co~mtersiglledOn: __~ IO/05g906_____ At Seattle, "y"'A By: o S.C~ AlllllUriLcd Representative rW?f\?Qf)1m A(;!-=:'JT ropy ( ) , ~f ...~ J~ 22,2007 11;)2 Arc Group 7148384170 11:"b!.ll.....VI ((IMM~IO..'IJ\; ml_jr~"'J" ',IIYH^,III,IIH~11\'" ~J,-11111'1111~llle'l: AII\JI,t.ll f H\^I~(,I'I)III^III)N l'l\,jRI')-JS(JN IIIVIIJI,(A'j)liI)l Commercial Auto Insurance Coverage Summary rhis is your revised Renewal Declarations Page PROOREIJIVE' t:r.HMIFIlCMI PoII~,ftumbet: IJUm01.l 1J~1I~IWfiU.~ b.,.: '11lIJ'~J--liweCMualtyl".Il1lnnre(lI. ~""'I,I '11 ,'II~(, Po.~y 11)11Ul1 1)11 ~l :'urJI, I.YI.II..'(~11 r<tlJ(' I "I ~ plogrU$lvuom lMiMS~l"Iit~ Mllll' II""ONII'.. d,v, ~ hdl" I') ," 'J"rf. prln: ll"IIV dll(lIfli;\1<, '~11,"rk II". 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I~ql ~lfJfIJ1) '1Iq;lt~rtIJ(l"l).JII~oDI ((17m, II "I 1I.l11~'cI i(l',IJlr~l (l1l},l..ild:i,lll 'VI'" P. .' f<)'jY>f,1~irlfl uullin'! ot tOUerl1lgt "'.,''''"" I","'. II,II!IIIIII'! udl~I" l~nrlilV Ilfi~IY dlld f'l1I1\{\_IIY!l:1fi109,.I,,,,,I''hly Iltur-'I~"IJ(llrlffl'II;''';;l~d Mu[~~r~1 1111I"~uo~d ~,~'!Ir'I!~,I,.fllu,I;'l"I,~ 1~'Ol"'.II~ Mrdl(,lll',l,\TI('flt'. . ( '\II~II,\tll\Il'.'~~ WI' ~(hrrllJlp 111'- "'Il'".~1 ^UIl'. '..,-,II",l<ln ~~ ~d,~d".It, ot '=lIvrl~d ^'~fI'i :11I,'~I\'~'lli:ll,jlil~T\.t')Ilw'. II\ldll'l hlf."Y dllU Pr".~rll, ;)lln'\'J~ 11"hild~ 11"~I',,'It!, N'Il1PV1/ill~Aurn I',l""~ry II' O'lI~I' Ilnrl.lv IlIillY .1IIlII>JOjWIIY Il~II~I~~ li.bilily 'iuDtlltalp_ollcyprl!",iuDl ',dIIIII1I1IJ 'v~hill~ ^'{,('~'.fIl!'~t I t,~ r~~l JlIlalUmonthp611rypfflmillflT NIIIlIlll'llllllllployt''-'''(fJ 1(1) "',I,~',I.' \l,IIII:I,WO\llllliJim'u',i"!lk,lllnl\ .~ i; i~'~',:i:i6~ 1'.\( II. P':":",'!lrI_1 ,\I~U.(,~lli l:,~.h ,( i ~jl'"!' ,f:rpdi~,! ,~~,wo ;"'~~'II~~:;'n ,. I '1IIi' <11 ~"hlhl~ I,'v: d_.J~,H,'" III"iltill~ll"I'!IIo>~'.Lhhj'llhll' '.l,{:(l(J,~II(1 (L)mniol'li ,.i'I~~' b"~1 iI.OUll,i)(m ,1;11r1~!ir'l'fJ,ifl(llc ."lll - $""'.011 1 ~(, $1,t6UO o , ) Page 6 1'",,,,,,,, )1.Ii18 1~,1 :j) ll~ 165 'h bl "IJII('r 11 JAN 22,2007 11:53 ATC Group 7148384110 Page 1 STATE COMPENSATION INSURANCE FUND STATUTORY ACCOUNTING PRINCIPLES BILL RECEIVABLE lB01464-06 RENEWAL SG HOM' O."CE ENDORSEMENT AllREEMIiNT SAN FRANCISCO EFFECTIVI!: OCTOBER 1. 2006 AT 12.01 All EFFECTIV[ DATES ARE AT 12:01 AM PACifIC STANDARD TIME OR TIfE TIME INDICATED AT PACIFIC STANDARD TIME A.M. PAGE 1 or 1 ADVANCED TRNSPRTTN CNCPTS GRP, INe II SORENSON IRVINE, CA 92602 ANY CONTRADICTION BETWEEN THE POLlCY AND TillS ENDORSEHlNT WILL BE CONTROLLED BY THIS LNDORSEKENT. IT IS AGREEu THAT THIS tNDORSEHENT AMENDS SECTION D. Of PART rIVE Of' 'j'BE POLICY. YOUR POLICY HAS 8~EN WRITTEN ON QUARTERLY ADJUSTMENT PER rOil. YOU WILL PAY AlL PREKlUH WHEN DUE. PAYROLL REPORTS AND PREMIUM Allf:: DUE WITtHN 10 DAYS (IEN) ^fTER THE L.sT DAY Of THE REPORTING PERIOD. PAYMENT OF OUTSTANDING PREMIUM JS DUE WITHIN 10 DArs (Tf.N) fROM THE BILL DATE. NOTHING IN THIS ENDOAS!':MENT CONTAINED SHALL BE HELD TO VARY, AL nR. WAIVE Oft EXTEND ANY' OF THE TERMS, CONDITIONS, AGREEMENTS, OR liMitATIONS OF THIS pOLlCr OTH~M THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL at' HEW TO VARY, ALTER. WAIVE OR LIMIT THE TEAMS, CONDITIONS. AGREEMENTS OR LIMITATIONS OF THIS ENDORSEM!NT. COUNTERSIGNED AND ISSU€D AT SAhli FI'lANCISCO: ~EP"ESENTATIV S~PTEHBER 26, 2006 (j/lvf!fl-- PRE51DFNT 2089 , / ) JAN 22,2007 11:'2 ATC Group H4B3B4170 Page 2 ~~1.(;o"J"" "". gl.. ~ IIlSU.'~lnC('," ~NEWAL ".",.o,,'_",,',JO'.",t<.,"",' FFECTIVE DATE: 0~/Q112006 POlicy Number: BOPll664662 PrIor Policy: 9884662 B~lIng Type: DIRECT BILL ". ._~.,--- ..----.-..".. .""._-~- Co.eroge Is Provided In GOLDEN EAGLE INSURANCE CORPORATION Named Insurld and Mailing Add'8roS: ADVANcED TRANSPORTATION CONCEPTS GROUP INC 14 SORENSON IRVINE CA 92602-9405 Agent: CYBER INSURANCE SERVICES INC 13150 7TH STFL 2 CHINO CA 9mo Auon' Co": 4295370 Agent Pho...: (909)-590.1010 COMMERCIAL PROTECTOR COVERAGE FORM OECLARA TIONS BU9INESSOWNERS COVERAGE FORM DECLARATIONS n return lor Iho paymelll 01 premium, and 5ubject to all the terrns Of thi9 policy, we agree with }IOIJ 10 pro~lde the ~sLn~"". as tOlated "this poliCY, POLICY PERIOD: from: 09f01no06 To: OQfQ1J2fl07 8112:01 AM Standard Time at your mailing aCldres9 Shuwn above FDRM DF BUSINESS; CORPORATION BUSINESS DESCRIPTION: ENGINEERS OR ARCHITECTS CONSUL rlNG- NOT ENGAGED DESCRIPTION OF PREMISES Prem. Bldg, locallon No. No OCCUPMCY, ConstructionfFire Prowctlon 00' 001 '4 SORENSON IRVINE CA 92602-"05 ENGINEERS OR ARCHITECTS CONSUL TING- NOT ENGAGED FRAME PRoPERTY COVERAGE Prom Bldg No. No 001 00' DEDUCTIBLE: Colterag8 Limits of InsumllCI\ BUSINESS PERSONAL PROPERTY S 500 In Arw Ono Occurrence $ 11.025 AUTOfoAATIC INCREASE: Building Co\'elagE>> Sttsll8e IncreMed AnnuAlly. Personal PrUf)srty coverage Shall Be Increased 4% Annually. MORTGAGE HOLDERS; NONE ( . ) JAN 22,2007 ]1:52 ATC Group RENEWAL 7H8384170 Page 3 1~;\ , .4.....______.._,~...."... " COMMERCIAL P~OTECTOR COVERAGE FORM DECLARATIONS ICunlinl/8d) Bl/81NESSOWNEIls COVERAGE FORM DECLA~AnONS LIABILITY AND MEDICAL PAYMENTS COVERAGE bcept lor Fire legal Lltibility. each paid claIm lor 1M fOllowin" coverages redllt6$lhe amount ot insur80l~8 wo pr{J\'illo dunng I applicllble aJlnual panod, Please ,'e'or 10 Peragr8ph 0,4. 01 the Section II lIABILITY of thB COMMERCIAL PROTECT' COVERAGE FORM (BUSINESS OWNERS COVERAGE FORM) Covorage L.imils OllllSUrtlf1ce LIABILITY AND MEDICAL EXPENSES MEDICAL EXPENSES DAMAGE TO PREMISES RENTED TO YOU $ 1,000 I (JOc Per Or.:clJr~lf1. $ 5. 000 Ptlf Person $ 50,OOOArlyOnOFlre Of ElI:p!osion AGGREGATE LIMITS BODILY INJURY OR PROPERTY OAMAGE UI>IOER PRODUCTSICOMPLETED OPERATIONSHAlARD $ 2,000,000 ALl OTHER INJURY OR DAMAGE (INClUDING MEDICAl EXPENSES) $ 2,000,000 FORMS AND ENDORSEMENTS APPLlCABU TD THIS POlICY, IAp~lcable reirill!:. and ~nOOIiIlml!r1ls 8r~ omitted II enClWn In ._Iicl CovafaQ* P.rtlCovorage f'OIm DecllltllD!llI) FOUll Number 17-22 17.5 1/..96 4"15 ...162 "-192 '4-20. .. 206CA ..-207 BPoV09 BP0155 SPO.,7 SP0419 BPo.30 BP0493 BP0501 BP051, BPOSt3 BP056' BP0576 BPoln BP1702 GECP0121 1).59 PREMIUM .060. - 0604 - 060. - 060. - 060. . 060. - 0('\04 . 0105 0305 - 0197 0105 . 0702 - 0702 - 0702 .0702 . 0702 .. 0102 . 0102 - 050' 1102 - 1102 , 0702 - 010, - 069. DlJscrlptlon EXCLUSION - LEAD WELFARE & PENSION fUND ERISA CO"'PLIANCE CONDITION EXCLUSION - ASBESTOS COMMERCiAL PROTECTOR COVERAGE FORM LIMITED EXCLUSION OF ACTS OF TERRORISM WAR LIABILITY EXCLUSION PERSONAl AND ADVERTISING INJURY LIABILITY ENDORSEMENT EXClUSION. SiliCA EXCLUSION-VIOLATION OF STATUTES BUSINESSOWNERS COMMON POLICY CONDITIONS CALIFORNIA CHANGES EMPLOYMENT -RELATED PRACTICES EXCLUSION AMENDMENT-LIQUOR LIABILITY EXCLUSION PROTECTIVE SAFEGUARDS 'rOTAL POLLUTION EXCLUSION CALCULATION OF PREMIUM EXClUSION OF WAR, MlllTARY ACTION AND TERRORISM WAR OR TERRORISM EXCLUSION (LIABILITY ENDORSEMENT) CONDITIONAL EXCLUSION Of' TERRORISM lIMITEo FUNGI OR BACTERIA COVERAGE FUNGI OR BACTERIA EXCLUSION CONDOMINIUM COMMERCiAl UNIT -OWNERS COVERAGE STANDARD FIRE POLICY DECLARATIONS EXTENSION T wrorism Risk Insurance Ac1 012002 ana 2005 ClMIrage s 1. 00 JA~~2Z,2007 11:52 ATe Group 71483811 10 Page 1 ~EWAL COMMERCIAL PROTECTOR COVERAGE FO BUmNESSOWNER8 COVE T ~ltJl:I Polic Premium 50100W' untlJJ'Signed: Bvn__ --;:-.:~ ::;::.:-::::;:~..!1-:-2t2:--P 0_ """ - - -/ ^""',. ~ t'/ /1 .1/ lll~ludlll oopyr\gnlllld mattrlal or IrtllJranclt ~er~6t,~ ,Inc. wtltlltt permlu DPV'~hi, Irtll\,lIl1nce SerlllCCla O"ltll Inc 1S182,196J, 19!14, Hllill'l. o.tolssu"d 07/3112008 , , ',\ CHECKLIST FOR PROCESSING AGREEMENTs AND AMENDMENTS 7-' .." '-"1 .' HI 8: q:. ( , TO: CLERK OF THE COUNCIL OFFICE FROM: DEPT.: ?u1?L\<- wa>\iZ-\"--'i AG;rsivG'( MAIL STOP: 1-'\- '-t? EXT: %\'2. CONTACT PERSON: \11"-'+\ ...,G;-v'-{E:W THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: AGREEMENT NUMBER (if amendment): A I N AMENDMENT NUMBER (if applicable): COUNCIL APPROVAL DATE: wI"" o 1ST o 2ND o 3RD o AMOUNT: DOVER $tOOOo )(UNDER $10,000 l'JIWE or. CONSULT A~JT:_.t<!?V,,~J;Eb .~~"'S.E'i'?~I.~JPI,L_"""IJCl5 fL'2__S~EL,;r '" y__ iERM OF AGREEMENT: EFFECTIVE DATE: \'Z.rIS Iz.o-ob__TERMINATION DATE'______ INSURANCE REQUIRED: 0 NO DYES If yes, ~ ATTACHED 0 IN PROGRESS o AUTO 0 CGL (Commercial General Liability) o PROFESSIONAL LIABILITY 0 WORKERS COMPENSATION (INS. APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) SIGNATURES REQUIRED: o VENDOR o CITY ATTORNEY o AGENCY (UNDER $10,000) P: OTHER - C-ll'{ MI"-AJ'" '4-5~ COMMENTS: FOR CLERK OFFICE USE ONLY: ~PROCESS o DO NOT PROCESS D MISSING SIGNATURES o NEEDS COUNCIL APPROVAL o OTHER - ~r &/f~ ~ ?h:J ADDITIONAL REMARKS: riP- "/-0 7 ACORD, INSURANCE BINDER N - ;2007 - oOLf I DATE [MMlDOfYY) 10/4/2007 SUB CODE. SHOWN ON THE REVERSE SIDE OF THIS FORM. BINDER # &0000003889-03 EFFECT~ T ~PIRATlON DATE TIME - DATE I TIME - - C--10/4/200~_12: O-=- ~ l;:J ~~2008 J~12N~~~ X 'THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY I PER EXPIRING POLlCY#- E0000003889-U2 DE~PT'ON OF OPERATIONSIVEHICLESIPROPERTY (Including Location) Named In~ured's Busi~ess: Traffic Engineering consulting Services of John H. Thai, PE THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS PRODUCER l&NJo,Ex~ (94~ 756-0271 COMPANY '.j-'", Allian": Insur.ance Services, Inc. ~1-,1ir"l 11 Ll~ensp #OC3686~ ~. 1,301 DoveStree, t, Newport Beach CODe: AGENCY - - CUSTOMER 10: INSURED Advanced Transportation Concepts Group, Inc. 14 Sorenson suite 200 CA 92660-2436 I I rv.:irne CA 92602 TYPE OF INSURANCE PROPERTY COVERAGE/FORMS DEDUCTIBLE LIMITS COINS % AMOUNT COVERAGES CAUSES OF LOSS Il BASIC [-I BROAD [ J SPEC GENERAL. LIABILITY I COMIAERCIAL GENERAL L1AB!UTY ~ CLAIMS MADE L I OCCUR ~CH OCCURRENCE ~IRE DAMAGE (Anyone fire) MED ~P (Any ?ne person1 PERSONAL & ADy INJURY S $ . . RETRO DATE FOR CLAIMS MADE GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT $ BODILY INJURY (Per person~s ~DIL Y INJURY (Per aCCident) $_ PROPERTY DAMAGE $ --- MEDICAL PAYMENTS $ PERSONAL INJURY PROT S UNINSURED MOTORIST $ AUTOMOBILE LIABILITY ANY AUTO r~ AcL OWNED AUTOS SCHEDULED AUTOS HoRED AUTOS , NO!'. OWNED AUTOS AUTO PHYSICAL. DAMAGE DEDUCTIBLE ALL VEHICLES SCHEDULED VEHIC'~ES ACTUAL CASH VALUE STATED AMOUNT OTHER AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EACH ACCIDENT AGGREGATE EACH OCCURRENCE $ . ~ COLLISION OTHER THAN COL GARAGE L1ABIL.ITY ANY AUTO EXCESS LIABILITY I UMBREL~A FORM OTHER THAN UMB~ELLA ;::ORM RETRO DATE FOR CLAIMS MADE AGGREGATE $ SELF-INSURED RETENTION $ ~ STATUTORY L1M~TS _ E L EACH ACCIDENT $ E L DISEASE EA EMPLOYEE $ E L DISEASE. POLICY W.W $ FEES TAXES $ E::>TIMATED TOTAL PREI\IIUM $ 6, 050.78 WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY SPECIAL CONDITIONSI OTHER COVERAGES Archi~ects & Engineers Professional Liability. Claims Made coverage sub:ect to policy conditions, terms & exclusions. $l,OUU,OOO Each Claim & Aggregate Limit. NAME & ADDRESS Evidence of coverage APfOltOVl:!t:) AS TO P'OR.M MORTGAGEE LO::;S PAYEE LOAN# ADDITIONAL INSURE:J ACORD 75-S (11981 LM. LPW~1g9alJ1l1D14107 1'\"7 tyl-',>elrj~nlE' ""~ (Y auru Stili Shl,;":uy at Cit Altorne NOTE: IMPORTANT STATE INFORMATION ON REVERSE SIDE AUTHORIZED REPRESENTATIVE \< J. \) LF PWv1.9.9a '" 10/4107 ~ 17biUs""rlatr"... @ACORDCORPORATION 1993 ~F ,,' U 1 CONDITIONS This Company binds the kind(s) of insurance stipulated on the reverse side. The Insurance is subject to the terms, conditions and limitations of the policy ties) in current use by the Company. This binder may be cancelled by the Insured by surrender of this binder or by written notice to the Company stating when cancellation will be effective. This binder may be cancelled by the Company by notice to the Insured in accordance with the policy conditions This binder IS cancelled when replaced by a policy If this binder is not replaced by a policy, the Company is entitled to charge a premium for the binder according to the Rules and Rates in use by the Company Applicable in California When this form is used to provide insurance in the amount of one million dollars ($1,000,000) or more, the title of the form is changed from "Insurance Binder" to "Cover Note" Applicable in Delaware The mortgagee or Obligee of any mortgage or other instrument given for the purpose of creating a lien on real property shall accept as eVidence of insurance a written binder issued by an authorized insurer or its agent if the binder includes or is accompanied by: the name and address of the borrower; the name and address of the lender as loss payee; a description of the insured real property; a provision that the binder may not be canceled within the term of the binder unless the lender and the insured borrower receive written notice of the cancel- lation at least ten (10) days prior to the cancellation; except in the case of a renewal of a policy subsequent to the closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount of Insurance coverage. Chapter 21 Title 25 Paragraph 2119 Applicable in Florida Except for Auto Insurance coverage, no notice of cancellation or nonrenewal of a binder is required unless the duration of the binder exceeds 60 days, For auto insurance, the insurer must give 5 days prior notice, unless the binder is replaced by a policy or another binder in the same company. Applicable in Nevada Any person who refuses to accept a binder which provides coverage of less than $1,000,000.00 when proof IS required, (A) Shall be fined not more than $500.00, and (8) is liable to the party presenting the binder as proof of insurance for actual damages sustained therefrom. ACORD 15-5 (1/98) L ' l.fJ'W ..1 ',1 !I~ 0.' "1)I~.'n7 "17 \,y 1.1<,,,r"'I~.r''''' PF..01 1~,1 LF.'i..1~!-l~o,,1'-IIJ!n, 8"'r'l'J~ert~?tllP . OtT 24,2001 12:22 ATC Group j11t(){;}IPi~IVt t"OMMrRri^1 ponox')fllt) (ll\JUANP, OH 44tOl N,)IYI~d i"~,lllt!d ADVAN<E TIIAN>I'OIIIAlION 141n1UNlON If\VINI, (A q;"nl 1148384170 Page 1 PROORE.HIVE' COMMcNCIlft POliCY numb." 0133'001.) UndtrwrittfR by: Progresliive bf-lfQU Ins Company A\lq\l:'II.O.l007 Pnhr~ )torlod Oct 12.1LAJ"'. ()II I) /!lOr. r.lq.:l"ll progresslve.tom Ontine Senl'itc Mjlk~ Ilil~nlt'rll'- : ~I",'k nl111f111 ,i; tlv:tl. 1'1'1'11 polICY dcxumcnl~.1lI (lw(k HII' ~~I.JIIJ', 1',1,] tl.MIll Commercial Auto Insurance Coverage Summary This is your Renewal Declarations Page IlIO..,5-2116 fill (LI',1i JI 1\\:1 ~~'I\ll,,' .1II ill I., Ill", WI v,( I' )11 hwll' i\ll.lf 'I d;\f .,wI-,'l I hi'. IIt,nrw,,1 IIp.r!,)'','HII';'\', PMIP I';, ..ffpl'lv~ (\Ill~ If tltl: 1"lllillllll'l dllll.l\.illl dUl' to l\:I'l.!W YUJ,J! Pl\i1lY I~ r~l(;lV(;d OJ ~)I)~ltlr~'llkNI n'l Ollobcl n, lOtH Yrulf (f1VI~r,lIW brqm', on ()t1ohN n, JOO! <1t 1 U)l ~,m Ihis p.,ll!CY l."Xpif~'; l\n Ol.l\.l\'ll.'! );, )008 fit 1):01 .un VOlil ,I1",UlrJl\ll~ PO,H.Y dtld .1I1V puli( V I'IHIOIL,l'rrll'nl', ((~Ill:'\ll\ ,) [\Ill (l~r!i1rl,wnn n! ym.l' (;)V€'h'q~ 111~ pi dll.'~ lil1111~ ';huwlI (IJI ;m JU\() IlldV rllA \JI~ I.l'HlllllII.:U with the limll!.lor the ~ijml.:' loverage nn Ll~mhrr ,llllll, \Jnlr."t. Thr. poliry \omr.XT .1I',flW'. Ttll;' ~,LK~lIlq .11 limit'., 1'11.' rrllliY ,nnn,i(t I~ klnn ,\1/1) (IH/IlI'I). ih;o. (LI111Iill'1,,, 11'1IIdin~:.t by \lllr\b 143:, Ill.jOGl, /B'i2(^ l09/O!")\. '17r:,7 (tBlIle,), 4W,!(A (III/C'I, ~~Rlc'\ (1110'), l))R 107101), IlqR (tHin,). I.I'KI (Il!l(l~), IR'J I WI/1\,) ""d 62.< 11011'l/l Ir'(\lnt:ll1(!1I1':lI((1':lt'1I(IJm\,ltjrlnIYjJf.'I';J(lII~lil'i4..1I1. Outline of coverage VU',,(,llllbl)l1 11':lhl'llry 1I'IO't,>li'i 1\lldrly 1111111'1 ,md f'lOrPllv l)'lmJ~r lriJbllity 1IIlIp<,lllf'rtl\Indrlin'lIJlf'd MOlllli',l IJr\in~,urr.d MolU',~1 Propcrty I)JrT\l!Jf Mrd'\.,ii 11'-lYllwnt'. 1,()tnrrr'hl~"',I~ ',i'.' 0:.1 11('(\\,IiI' 01 ClIWWI'I AUli)L, l_ollr~IUI1 ~I:'~ ljl.ht'd\li~ 01 CU\l~r~d ^lJjtJ'~ I IIII'd Aulo l,iul)iliIV I'll (llht~l', Rl,tf,ly !r\lllIV .1'111 P,n,II,It:'lly [ldllldt!~"lldlJlli\y , , 1l"plr.YI~l Ni1"\OWliNI AIIHll \,ihlhly \1'1 ()1h..I'; ;)LOlny lJ\jUlY dill.! rlU~~llY [ldllldl,lL' I ii:lbllilY 5ubtotol policy premium r L1lrtmnl,1 Vllhlih' A';~,II',~(m"llll~ ~('I", lotal12 month poticy premi"m Numbcl 0\ r"ploycC\ (0. \III \.)t"lM~'l (!'Ul'"n,"1 l~M', Ikd,..lohfr' P"."I1I1L1I11 }i,',',' ~ 1.000,OO,O,~:,Ufflb!I~~~ ;,lflglc Irll111 "I ,noo,onn 1.f.lrllhilll~U ',itlqlf! hrllil kc]cClr.d \,'"noo ~r:ld' f.Il't~.lln I /'~ )k 'Kl 1,',:'1'1 u11',111IhIY,!rr',.., dt:'dlll.'lihl~ 38) lir1ll1 olliabihlV Ir',~, c1rnumoln g':f 'i i,OOO,COO I.UI1lb!m:~ ~lI1gk'lirTllt hl $' ,(lOO,OOI) ((")rTlhif'l~d r,lnqlr< li'l;\! 51,43).00 I hll SU,Ul; 51,414.10 n l,"lI..~".1 'APPROVED 'AS ~TO ~ ~~~~/ - aUla ~tl1t Sheedy Assistant City Atldl1~ , OCT 24,2001 12:23 ATC Group 1148384170 Rated drivers OliN 111^i I DANNY N[ ml.N XDAN THAI Auto coverage schedule 2005 Konda A<<ord ttybrid VIN IHMC N'u"n\COH9~,6 Liability li,'llllll) IIMJlllMllI MI:.jl".JY Pn'nliurn l(\'l"i 1\)', PH CunllJ '.m",1 ~nllJW,WI"f (oIIJW.lll/l"l Phymal Uamaqe tJ,dlll'hhlP 1'''1''11\1,1111 Ill'(ju-Ul~' 1'1"'111"'" PremiunI 'II,OOU '11.7 \1.0110 rl~, Premium discounts ,-"lilY ~ldlt~J An....'ilJrd (;'lr,1qinq lip (1.1(11:' \31,0011 Yir,lii IlJPII}(\OI-'i Pdld in hill i.\lld Hr:rK'wdl Additional Insured information ArlrllllM,liln<;IJrrrl ow Of IRVINE 1 r IVIi '-LNII IIIIIVINL. C^ '!iolJ Company officers fA. Lp...... Prcs'dcnt I JIl~ 11~~~ l'll.l~/Q\l1 .-' L7~ .;./<1-_-:';;.... 'f747.-,..l.~....pr. 5eClctalV f'd)(~ "111111,,'1 ll~(IIll(,\()I., AUVA,N(IIt{AN'.lt'f'IiI"IION f',JIf\!.' \II.' k,ldiu' ~~ 0 '\w. Tl~.ll $1,Zn Page 1 ~ ~ .,- ~- ~=== ~~ .,- .- uii 8- :::5E 8=== 8 . g ..- -- ~~ u= ~= ..... === '- .- g~ ...~ ~- ~ ....- .~ ~~ ~ii ,;(_0"'" , ;;m; Q. -_: STATE COMPENSATION INSURANCE FUND IN REPLY REFER TO: SEPTEMBER 14, 2007 1801464-07 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 Dear Policyholder Thank you for choosing us as your workers' compensation insurance carrier. This package contains your renewal documents as listed on the following page. please keep these together. - Our goal is to provide you with fast, efficient, and the most convenient service possible. We truly appreciate your business. If you have any questions about the information in this mailing, please contact your broker of record or your local State Compensation Insurance Fund off ice. State compensation Insurance Fund 1275 Market Street. San Francisco, CA 94103-1410 Mailing Address: P.O. Box 420807. San Francisco. CA 94142-0807 STATE COMPENSATION INSURANCE FUND IN REPL Y REFER TO: 1801464-07 WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY I NSURANCE POll CY STATE COMPENSATION INSURANCE FUND Forms and Endorsements Applicable List Policy FORM NUMBER FORM DESCRIPTION 10963A 10217 10217 10217 10217 10610 ANNUAL RATING ENDORSEMENT 2089 -ENDORSEMENT AGREEMENT- STATUTORY ACCOUNTING PRINCIPLES - BILL RECEIVABLE 2437 -ENDORSEMENT AGREEMENT- MEDICAL PROVIDER NETWORK ENDORSEMENT 2558 -ENDORSEMENT AGREEMENT- TERRORISM RISK INSURANCE EXTENSION ACT WC 00 01 13 3015 -ENDORSEMENT AGREEMENT- EXECUTIVE OFFICERS - MINIMUM/MAXIMUM LIMITS POLICY HOLDER NOTICE - 1275 Market Street. San Francisco, CA 94103-1410 Mailing Address: P.O. Box 420807. San Francisco. CA 94142-0807 '. STATE HOME OFFICE SAN FRANCISCO I ANNUAL RATING ENDORSEMENT COMPENSATION IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING INSURANCE FUND IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW. HERE ARE YOUR NEW RATES FOR THE PERIOD INDICATED. IF YOUR NAME OR ADDRESS SHOULD BE CORRECTED OR IF INSURANCE IS NOT NEEDED FOR NEXT YEAR. PLEASE TELL US. CONTINUOUS POLICY 1801464-07 IMPORT ANT THIS IS NOT A BILL SEND NO MONEY UNLESS STATEMENT IS ENCLDSED THE RATING PERIOD BEGINS AND ENDS AT 12:01AM PACIFIC STANDARD TIME RATING PERIOD 10-01-07 TO 10-01-08 ADVANCED TRNSPRTTN CNCPTS 14 SORENSON IRVINE, CALIF 92602 GRP, INC DEPOSIT PREMIUM MINIMUM PREMIUM PREMIUM ADJUSTMENT PERIOD $477.00 $200.00 QUARTERLY R SG NAME OF EMPLOYER- ADVANCED TRANSPORTATION CONCEPTS GRP, IN (A CORPORATION) CODE NO. PRINCIPAL WORK AND RATES EFFECTIVE FROM 10-01-07 TO 10-01-08 PREMIUM BASIS INTERIM BASE BILLING RATE RATE* 8601-1 ENGINEERS--CONSULTING--MECHANICAL. CIVIL, ELECTRICAL AND MINING ENGINEERS AND ARCHITECTS 57833 1.25 1.25 ********BUREAU NOTE INFORMATION******** FEIN 330850211 APPRO\! co.' /\ ~ TO FORM . 14'/ (./ ,~ c-;:>" _',~~'_._~:;1 -' i .....;l y Attorney TOTAL ESTIMATED ANNUAL PREMIUM $723 COUNTERSIGNED AND ISSUED AT SAN FRANCISCO SEPTEMBER 14, 2007 POLICY L PAGE 1 OF 3 selF FORM 10963A (REV. 03-07) (OVER PLEASE) STATE HOME OFFICE SAN FRANCISCO I ANNUAL RATING ENDORSEMENT COMPENSATION IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING INSURANCE FUND IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW. IMPORTANT HERE ARE YOUR NEW RATES FOR THE PERIOD INDICATED. IF YOUR NAME OR ADDRESS SHOULD BE CORRECTED OR IF INSURANCE IS NOT NEEDED FOR NEXT YEAR, PLEASE TELL US. CONTINUOUS POLICY 1801464-07 THIS IS NOT A BILL SEND NO MONEY UNLESS STATEMENT IS ENCLOSED THE RATING PERIOD BEGINS AND ENDS AT 12:01AM PACIFIC STANDARD TIME RATING PERIOD 10-01-07 TO 10-01-08 * INTERIM BILLING RATES WILL BE USED ON PAYROLL REPORTS. THEY TAKE INTO ACCOUNT RATING PLAN CREDITS (OR DEBITS) WHICH WILL APPLY AT FINAL BILLING AND AN ESTIMATE OF YOUR PREMIUM DISCOUNT AS DETAILED BELOW. RATING PLAN CREDITS (DEBITS) EFFECTIVE FROM 10-01-07 TO 10-01-08 RATING PLAN MODIFIER 1.00000 ESTIMATED PREMIUM DISCOUNT MODIFIER 1.00000 COMPOSITE FACTOR APPLIED TO BASE RATES TO DERIVE INTERIM BILLING RATES 1 . 00000 ********************************************************************************* * * * PREMIUM DISCOUNT SCHEDULE EFFECTIVE FROM 10-01-07 TO 10-01-08 * * ESTIMATED MODIFIED PREMIUM IS DISCOUNTED ACCORDING TO THE FOLLOWING SCHEDULE: * * FIRST ABOVE * * $5,000 $5.000 * * 0.0% 14.7% * * * ********************************************************************************* THE ESTIMATED PREMIUM DISCOUNT IS BASED ON AN ESTIMATE OF YOUR PAYROLL. ACTUAL PREMIUM DISCOUNT APPLIED AT FINAL BILLING WILL BE BASED ON THE ACTUAL PAYROLL REPORTED ON YOUR POLICY AND SUBJECT TO AUDIT. OUNTERSIGNED AND ISSUED AT SAN FRANCISCO SEPTEMBER 14, 2007 POLICY L PAGE 2 OF 3 selF FOAM 10963A (REV. 03-07) (OVER PLEASEf '. STATE HOME OFFICE SAN FRANCISCO I ANNUAL RATING ENDORSEMENT COMPENSATION IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING INSURANCE FUND IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW. CONTINUOUS POLICY 1801464-07 IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT YOUR LOCAL STATE FUND OFFICE BELOW: CSC - POLICY AT FAIRFIELD 5251 BUSINESS CENTER DRIVE FAIRFIELD . CA 94585 (877) 405-4545 Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions agreements or limitations of the Policy other than as herein stated. When countersigned by a duly authorized officer or representative of the State Compensation Insurance Fund. these declarations shall be valid and form part of the Policy. r~ AUTHORIZED REPRESENTATIVE ~(~~- PRESIDENT COUNTERSIGNED AND ISSUED AT SAN FRANCISCO SEPTEMBER 14, 2007 POLICY L PAGE 3 OF 3 selF FORM 10963A (REV. 03-07) STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ENDORSEMENT AGREEMENT STATUTORY ACCOUNTING PRINCIPLES BILL RECEIVABLE 1801464-07 RENEWAL SG EFFECTIVE OCTOBER 1, 2007 AT 12.01 A.M. PAGE 1 OF 1 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT. IT IS AGREED THAT THIS ENDORSEMENT AMENDS SECTION D. OF PART FIVE OF THE POLICY. YOUR POLICY HAS BEEN WRITTEN ON QUARTERLY ADJUSTMENT PERIOD. YOU WILL PAY ALL PREMIUM WHEN DUE. PAYROLL REPORTS AND PREMIUM ARE DUE WITHIN 10 DAYS (TEN) AFTER THE LAST DAY OF THE REPORTING PERIOD. PAYMENT OF OUTSTANDING PREMIUM IS DUE WITHIN 10 DAYS (TEN) FROM THE BILL DATE. - NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY , ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~EPRESENTATIV selF FORM 10217 IREV.3-07) SEPTEMBER 14, 2007 ~(~~ 2089 PRESIDENT OLD DP 2 t ' STATE COMPENSATION INSURANCE I=UND ENDORSEMENT AGREEMENT MEDICAL PROVIDER NETWORK HOME OFFICE SAN FRANCISCO 1801464-07 RENEWAL SG EFFECTIVE ALL EFFECTIVE DATES ARE AT 12,01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME OCTOBER 1, 2007 AT 12.01 A.M. PAGE 1 OF 3 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT. THE SlATE COMPENSATION INSURANCE FUND MEDICAL PROVIDER NETWORK IS ESTABLISHED IN ACCORDANCE WITH CALIFORNIA LABOR CODE 4600 ET SEQ AND APPROVED BY THE CALIFORNIA DIVISION OF WORKERS' COMPENSATION ADMINISTRATIVE DIRECTOR. THE INTENT OF THE 2004 LEGISLATION REQUIRING THE ESTABLISHMENT OF THE MEDICAL PROVIDER NETWORK IS INCREASED EMPLOYER CONTROL OVER THE COSTS OF TREATING EMPLOYEE WORK RELATED INJURIES AND DISEASE. PART FOUR OF THE POLICY, YOUR DUTIES IF INJURY OCCURS, IS AMENDED AS FOLLOWS: IT IS AGREED THAT THE POLICYHOLDER SHALL REFER ALL WORK RELATED INJURIES OR DISEASE TO THE STATE COMPENSATION INSURANCE FUND MEDICAL PROVIDER NETWORK AT THE TIME OF AN OCCUPATIONAL INJURY OR UPON KNOWLEDGE OF AN OCCUPATIONAL INJURY OR DISEASE. IT IS FURTHER AGREED THAT WHEN AN EMPLOYEE NOTIFIES THE POLICYHOLDER OF AN OCCUPATIONAL INJURY OR FILES A CLAIM FOR WORKERS' COMPENSATION WITH THE POLICYHOLDER, THE POLICY- HOLDER SHALL ARRANGE AN INITIAL MEDICAL EVALUATION AND BEGIN TREATMENT WITHIN THE MEDICAL PROVIDER NETWORK. THE POLICYHOLDER SHALL NOTIFY THE EMPLOYEE OF HIS OR HER RIGHT CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 6:::EPRESENTATIV selF FORM 10217 IREV.J-07l SEPTEMBER 14, 2007 ~~~~- PRESIDENT 2437 OLD DP 217 STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ENDORSEMENT AGREEMENT MEDICAL PROVIDER NETWORK 1801464-07 RENEWAL SG EFFECTIVE OCTOBER 1, 2007 AT 12.01 A.M. PAGE 2 OF 3 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 CONTINUED. TO BE TREATED BY A PHYSICIAN OF HIS OR HER CHOICE FROM WITHIN THE MEDICAL PROVIDER NETWORK AFTER THE FIRST VISIT. THE POLICYHOLDER SHALL NOTIFY EMPLOYEE OF THE METHOD BY WHICH THE LIST OF PARTICIPATING PROVIDERS MAY BE ACCESSED BY EMPLOYEES. IT IS FURTHER AGREED THAT IF AN INJURED EMPLOYEE DISPUTES EITHER THE DIAGNOSIS OR THE TREATMENT PRESCRIBED BY THE TREATING PHYSICIAN, THE EMPLOYEE MAY SEEK THE OPINION OF ANOTHER PHYSICIAN WITHIN THE MEDICAL PROVIDER NETWORK. IF THE INJURED EMPLOYEE DISPUTES THE DIAGNOSIS OR TREATMENT PRESCRIBED BY THE SECOND PHYSICIAN, THE EMPLOYEE MAY SEEK THE OPINION OF A THIRD PHYSICIAN WITHIN THE MEDICAL PROVIDER NETWORK. IT IS FURTHER AGREED THAT THIS ENDORSEMENT IN NO WAY AFFECTS THE RIGHTS OF AN INJURED WORKER TO PREDESIGNATE A PHYSICIAN. AN EMPLOYEE MUST FILE WRITTEN NOTICE OF THE PREDESIGNATION WITH THE EMPLOYER PRIOR TO THE DATE OF INJURY. THE NOTICE MUST INCLUDE THE PHYSICIAN'S SIGNATURE OF AGREEMENT TO THE PREDESIGNATION, AND THE FOLLOWING CONDITIONS MUST APPLY: THE PHYSICIAN IS THE EMPLOYEE'S REGULAR PHYSICIAN. THE PHYSICIAN IS THE EMPLOYEE'S PRIMARY CARE PROVIDER WHO HAS PREVIOUSLY DIRECTED THE MEDICAL TREATMENT OF THE CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~EPRESENTATIV selF FORM 10217 (REV.3-07) SEPTEMBER 14, 2007 ~(~~- 2437 PRESIDENT OLD DP 217 STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ENDORSEMENT AGREEMENT MEDICAL PROVIDER NETWORK 1801464-07 RENEWAL SG ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME EFFECTIVE OCTOBER 1, 2007 AT 12.01 A.M. PAGE 3 OF 3 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 CONTINUED. EMPLOYEE AND RETAINS RECORDS OF THE TREATMENT AND MEDICAL HISTORY. THE EMPLOYER PROVIDES THE STAFF WITH NONOCCUPATIONAL GROUP HEALTH COVERAGE IN A HEALTH-CARE SERVICE PLAN (SUCH AS AN HMO/PPO PROGRAM) . OR THE EMPLOYER PROVIDES NONOCCUPATIONAL HEALTH COVERAGE IN A GROUP HEALTH PLAN OR A GROUP HEALTH INSURANCE POLICY. PER LABOR CODE 4616.7. - NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: Q:::::EPRESENTATIV serF FORM 10217 (REV.3-07) SEPTEMBER 14, 2007 ~(.~~- PRESIDENT 2437 OLD DP 217 STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE EXTENSION ACT WC 00 01 13 1801464-07 RENEWAL SG EFFECTIVE OCTOBER 1, 2007 AT 12.01 A.M. TO OCTOBER 1, 2008 AT 12.01 A.M. PAGE 1 OF 5 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 THIS ENDORSEMENT ADDRESSES THE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT OF 2002 AS AMENDED AND EXTENDED BY THE TERRORISM RISK INSURANCE EXTENSION ACT OF 2005. DEFINITIONS THE DEFINITIONS PROVIDED IN THIS ENDORSEMENT ARE BASED ON THE DEFINITIONS IN THE ACT AND ARE INTENDED TO HAVE THE SAME MEANING. IF WORDS OR PHRASES NOT DEFINED IN THIS ENDORSEMENT ARE DEFINED IN THE ACT, THE DEFINITIONS IN THE ACT WILL APPLY. "ACT" MEANS THE TERRORISM RISK INSURANCE ACT OF 2002, WHICH TOOK EFFECT ON NOVEMBER 26, 2002, AND ANY AMENDMENTS RESULTING FROM THE TERRORISM RISK INSURANCE EXTENSION ACT OF 2005. "ACT OF TERRORISM" MEANS ANY ACT THAT IS CERTIFIED BY THE SECRETARY OF THE TREASURY, IN CONCURRENCE WITH THE SECRETARY OF STATE, AND THE ATTORNEY GENERAL OF THE UNITED STATES AS MEETING ALL OF THE FOLLOWING REQUIREMENTS: A. THE ACT IS AN ACT OF TERRORISM. B. THE ACT IS VIOLENT OR DANGEROUS TO HUMAN LIFE, PROPERTY OR INFRASTRUCTURE. CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~EPRESENTATIV selF FORM 10217 (REV.3.07) SEPTEMBER 14, 2007 ~~~- 2558 PRESIDENT OLD DP 217 STATE COMPENSATION INSUAANCE FUND ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE EXTENSION ACT WC 00 01 13 1801464-07 RENEWAL SG HOME OFFICE SAN FRANCISCO EFFECTIVE ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME OCTOBER 1, 2007 AT 12.01 A.M. TO OCTOBER 1, 2008 AT 12.01 A.M. PAGE 2 OF 5 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 CONTINUED. C. THE ACT RESULTED IN DAMAGE WITHIN THE UNITED STATES, OR OUTSIDE OF THE UNITED STATES IN THE CASE OF UNITED STATES MISSIONS OR CERTAIN AIR CARRIERS OR VESSELS. D. THE ACT HAS BEEN COMMITTED BY AN INDIVIDUAL OR INDIVIDUALS ACTING ON BEHALF OF ANY FOREIGN PERSON OR FOREIGN INTEREST, AS PART OF AN EFFORT TO COERCE THE CIVILIAN POPULATION OF THE UNITED STATES OR TO INFLUENCE THE POLICY OR AFFECT THE CONDUCT OF THE UNITED STATES GOVERNMENT BY COERCION. "INSURED TERRORISM OR WAR LOSS" MEANS ANY LOSS RESULTING FROM AN ACT OF TERRORISM (INCLUDING AN ACT OF WAR, IN THE CASE OF WORKERS COMPENSATION) THAT IS COVERED BY PRIMARY OR EXCESS PROPERTY AND CASUALTY INSURANCE ISSUED BY AN INSURER IF THE LOSS OCCURS IN THE UNITED STATES OR AT UNITED STATES MISSIONS OR TO CERTAIN AIR CARRIERS OR VESSELS. "INSURER DEDUCTIBLE" MEANS: A. FOR THE PERIOD BEGINNING ON NOVEMBER 26, 2002 AND ENDING ON DECEMBER 31, 2002, AN AMOUNT EQUAL TO 1% OF OUR DIRECT EARNED PREMIUMS, AS PROVIDED IN THE ACT, OVER THE CALENDAR YEAR IMMEDIATELY PRECEDING NOVEMBER 26, 2002. CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED, NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT, COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~EPRESENTATlV selF FOAM 10217 (REV.J-G71 SEPTEMBER 14, 2007 ~{:~J6 PRESIDENT 2558 OLD DP 217 STATE COMPENSATION IN SUAANCE FUND HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12,01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE EXTENSION ACT WC 00 01 13 1801464-07 RENEWAL SG EFFECTIVE OCTOBER 1, 2007 AT 12.01 A.M. TO OCTOBER 1, 2008 AT 12.01 A.M. PAGE 3 OF 5 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 CONTINUED. B. FOR THE PERIOD BEGINNING ON JANUARY 1, 2003 AND ENDING ON DECEMBER 31, 2003, AN AMOUNT EQUAL TO 7% OF OUR DIRECT EARNED PREMIUMS, AS PROVTDED IN THE ACT, OVER THE CALENDAR YEAR IMMEDIATELY PRECEDING JANUARY 1, 2003. C. FOR THE PERIOD BEGINNING JANUARY I, 2004 AND ENDING ON DECEMBER 31, 2004, AN AMOUNT EQUAL TO 10% OF OUR DIRECT EARNED PREMIUMS, AS PROVIDED IN THE ACT, OVER THE CALENDAR YEAR IMMEDIATELY PRECEDING JANUARY 1, 2004. - D. FOR THE PERIOD BEGINNING ON JANUARY 1, 2005 AND ENDING ON DECEMBER 31, 2005, AN AMOUNT EQUAL TO 15% OF OUR DIRECT EARNED PREMIUMS, AS PROVIDED IN THE ACT, OVER THE CALENDAR YEAR IMMEDIATELY PRECEDING JANUARY 1, 2005. E. FOR THE PERIOD BEGINNING ON JANUARY 1, 2006 AND ENDING ON DECEMBER 31, 2006, AN AMOUNT EQUAL TO 17.5% OF OUR DIRECT EARNED PREMIUMS, AS PROVIDED IN THE ACT, OVER THE CALENDAR YEAR IMMEDIATELY PRECEDING JANUARY 1, 2006. CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO, ~EPRESENTATIV selF FORM 10217 (REV.3-07l SEPTEMBER 14, 2007 ~~~,.- 2558 PRESIDENT OLD DP 217 STATE COMPENSATION INSURANCE F=UND ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE EXTENSION ACT WC 00 01 13 1801464-07 RENEWAL SG HOME OFFICE SAN FRANCISCO EFFECTIVE ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME OCTOBER 1, 2007 AT 12.01 A.M. TO OCTOBER 1, 2008 AT 12.01 A.M. PAGE 4 OF 5 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 CONTINUED. F. FOR THE PERIOD BEGINNING JANUARY 1, 2007 AND ENDING ON DECEMBER 31, 2007, AN AMOUNT EQUAL TO 20% OF OUR DIRECT EARNED PREMIUMS, AS PROVIDED IN THE ACT, OVER THE CALENDAR YEAR IMMEDIATELY PRECEDING JANUARY 1. 2007. LIMITATION OF LIABILITY - THE ACT MAY LIMIT OUR LIABILITY TO YOU UNDER THIS POLICY. IF ANNUAL AGGREGATE INSURED TERRORISM OR WAR LOSSES OF ALL INSURERS EXCEED $100,000,000,000 DURING THE APPLICABLE PERIOD PROVIDED IN THE ACT, AND IF WE HAVE MET OUR INSURER DEDUCTIBLE, THE AMOUNT WE WILL PAY FOR INSURED TERRORISM OR WAR LOSSES UNDER THIS POLICY WILL BE LIMITED BY THE ACT, AS DETERMINED BY THE SECRETARY OF THE TREASURY. POLICYHOLDER DISCLOSURE NOTICE - - 1. INSURED TERRORISM OR WAR LOSSES WOULD BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT UNDER A FORMULA ESTABLISHED BY THE ACT. UNDER THIS FORMULA, THE UNITED STATES GOVERNMENT WOULD PAY 90% FOR PROGRAM YEAR 4 AND 85% FOR PROGRAM YEAR 5 OF OUR INSURED TERRORISM OR WAR LOSSES EXCEEDING OUR INSURER DEDUCTIBLE. CONTINUED NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: Q:::::EPRESENTATlV selF FORM 10217 (REV.3.07) SEPTEMBER 14, 2007 ~{~~- PRESIDENT 2558 OLD DP 217 ", ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE EXTENSION ACT WC 00 01 13 STATE CO....PENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME 1801464-07 RENEWAL SG EFFECTIVE OCTOBER 1, 2007 AT 12.01 A.M. TO OCTOBER 1, 2008 AT 12.01 A.M. PAGE 5 OF 5 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 CONTINUED. 2. THE PREMIUM CHARGED FOR THE COVERAGE THIS POLICY PROVIDES FOR INSURED TERRORISM OR WAR LOSSES IS INCLUDED IN THE AMOUNT SHOWN IN ITEM 4 OF THE INFORMATION PAGE OR IN THE SCHEDULE IN THE FOREIGN TERRORISM PREMIUM ENDORSEMENT (WC 00 04 22), ATTACHED TO THIS POLICY. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT, COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~EPRESENTATIV selF FORM 10217 (REV.3-Q7) SEPTEMBER 14, 2007 ~(~~ 2558 PRESIDENT OLD DP 217 STATE COMPENSATION INSURANCE FUND ENDORSEMENT AGREEMENT EXECUTIVE OFFICERS MINIMUM/MAXIMUM LIMITS 1801464-07 RENEWAL SG HOME OFFICE SAN FRANCISCO EFFECTIVE ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME OCTOBER 1, 2007 AT 12.01 A.M. PAGE 1 OF 1 ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CA 92602 ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT. IT IS AGREED THAT UNLESS OTHERWISE EXCLUDED BY ENDORSEMENT THE ACTUAL REMUNERATION EARNED BY EACH EXECUTIVE OFFICER DURING THE POLICY PERIOD SHALL BE USED AS THE BASIS OF PREMIUM, SUBJECT TO THE MINIMUM AMOUNT OF $ 33,800 PER ANNUM AND THE MAXIMUM AMOUNT OF $ 89,700 PER ANNUM AS SPECIFIED IN THE CALIFORNIA WORKERS' COMPENSATION UNIFORM STATISTICAL REPORTING PLAN, FOR WORKERS' COMPENSATION INSURANCE IN EFFECT DURING THE POLICY PERIOD. - NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHAll BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: a::::EPRESENTATIV selF FORM 10217 (REV.J-07) SEPTEMBER 14, 2007 ~-C~~ PRESIDENT 3015 OLD DP 217 1801464-07 Dear Policyholder: These endorsements amend and are part of your policy. Please Keep them with your documents for future reference. If you have any questions concerning these endorsements, Please contact your local State Fund office. OIATc COMPENSATION INSURANCE FUND POLICYHOLDER NOTICE YOUR RIGHT TO RATING AND DIVIDEND INFORMA TJON PN 04 99 018 (Ed. 03-03) Page 1 of 2 POLICY NO. 1801464-07 NR SG ADVANCED TRNSPRTTN CNCPTS GRP, INC 14 SORENSON IRVINE, CALiF 92602 1. RATING AND CLAIMS INFORMATION. Pursuant to Section 11752.6 of the California Insurance Code. upon written request, you are entitled to information relating to loss experience, claims. class- ification assignments. and policy contracts, as well as rating plans, rating systems. manual rules, or other information impacting your premium that is maintained in the records of the Workers' Compen- sation Insurance Rating Sureau of California ("WCIRS"), a rating organization licensed by the California Insurance Commissioner. Requests for policyholder information should be forwarded to: WCIRS. 525 Market Street, Suite 800, San Francisco, California 94105-2716, Attention: Custodian of Records. The Custodian of Records can be reached by telephone at 1-888-229-2472, and the fax number is 415-778-7272. Pursuant to Sections 3761 and 3762 of the California Labor Code. you are also entitled to receive information in our claim files that affects your premium. 2. POLICYHOLDER OMBUDSMAN. Pursuant to California Insurance Code Sections 11752.6 (g) and (h) (1), a policyholder ombudsman is available at the WCIRS to assist you in obtaining and evaluating the information referenced above. The ombudsman may advise you on any dispute with us, the WCIRS, or on an appeal to the Insurance Commissioner pursuant to Section 11737 of the Insurance Code. The address of the policyholder ombudsman is WCIRS, 525 Market Street, Suite 800, San Francisco, California 94105-2716. Attention: Policyholder Ombudsman. The policyholder ombudsman can be reached by telephone at 415-777-0777 and by fax at 415-778-7007. 3. CALIFORNIA DEPARTMENT OF INSURANCE. Information and assistance on policy questions can be obtained from the Department of Insurance Consumer HOTLINE, 1-800-927-HELP (4357). - 4. STATISTICAL REPORTING. For claims covered under this policy, we will estimate the ultimate cost of unsettled claims for statistical purposes eighteen months after the policy becomes effective and will report those estimates to the WCIRS no later than twenty months after the effective date of the policy. The cost of any settled claims will also be reported at that time. At twelve-month intervals thereafter, we will update and report to the WCIRS the estimated cost of any unsettled claims and the actual final cost of any claims settled in the interim. The amounts we report will be used by the WCIRS to compute your experience modification if you are eligible for experience rating. 5. DIVIDEND CALCULATION. If this is a participating policy (a policy on which a dividend may be paid), upon payment or non-payment of a dividend, we shall provide a written explanation to you that sets forth the basis of the dividend calculation. The explanation will be in clear, understandable language and will express the dividend as a dollar amount and as a percentage of the earned premium for the policy year on which the dividend is calculated. selF 10610 (Rev. 04-07) Page 2 of 2 POLICY NO. 1801464-07 NR SG 6. DISPUTING OUR ACTIONS. Pursuant to Insurance Code Section 1 1753.1 (bl. you may request, in writing, that we reconsider a change in a classification assignment that results in an increased pre- mium. You may also request, in writing, that we review the manner in which our rating system has been applied in connection with the insurance afforded or offered you pursuant to Insurance Code Section 11737 (fl. Written requests that we reconsider or review our actions should be forwarded to: State Compensation Insurance Fund, Attention: Manager, Customer Assistance Program, 5860 Owens Drive, Pleasanton, CA 94568, Telephone: (925) 460-6530, Fax: (925) 460-6633. 7. DISPUTING THE ACTIONS OF THE WCIRS. If you have been aggrieved by any decision, action, or omission to act of the WCIR8, you may request, in writing, that the WCIRS reconsider its decision, action, or omission to act pursuant to Insurance Code Section 11753.1 (a). You may also request. in writing, that the WCIRS review the manner in which its rating system has been applied in connection with the insurance afforded or offered you pursuant to Insurance Code Section 11737 (f). Written requests for reconsideration or requests for review regarding the actions of the WCIRS should be forwarded to: WCIRS, 525 Market Street, Suite 800, San Francisco, California 94105-2716, Attention: Complaints and Reconsiderations. The WCIRS's telephone number is 1-888-229-2472, and the fax number is 415-371-5204. 8. APPEAL TO THE INSURANCE COMMISSIONER. After you send your written request for policyholder information, reconsideration, or review of the manner in which the rating system has been applied in connection with the insurance afforded or offered you, we, or the WCIRS, have 30 days to provide you written notice indicating whether or not your written request will be reviewed. If we, or the WCIRS, agree to review your request, we, or the WCIRS, must conduct the review and issue a decision granting or rejecting your request within 60 days after sending you the written notice granting review. If we, or the WCIRS, decline to review your request. or if you are dissatisfied with the decision upon review, or if your request is rejected or not acted upon, you may appeal to the Insurance Commissioner pursuant to the provisions of Insurance Code Sections 11752.6(cl. 11753.1 (a) and (b), or 11737(f) and Title 10, California Code of Regulations, Section 2509.40 et seq. You must make your appeal within 30 days after we, or the WCIRS, send you the notice denying review of your request or the decision upon - review. If no written decision regarding your request for policyholder information, reconsideration, or review is sent. your appeal must be filed within 120 days after you sent your request to us, or the WCIRS. The filing address for all appeals to the Commissioner is: - Administrative Hearing Sureau California Department of Insurance 45 Fremont Street. 22nd Floor San Francisco, California 94105 The Insurance Commissioner will hold a hearing upon your appeal and may either affirm, modify, or reverse our action or that of the WCIRS. This notice does not change the policy to which it is attached.