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HomeMy WebLinkAboutSULLY-MILLER CONTRACTING COMPANY (2) INSURANCE NOT REQUIRED A,-2025-067-01 ,Y��'�t-}�i�/4 MIApYwPROCEED - T]/ {�J AGREEMENT �^1p� �n/��;�T (�i U F 7 CLERK L'+��7C�A�O F"Y !'1.rlJAl.f'11'rlr�.d�l'�{T FOR R�,�r i �T DATE: AUG 2 d 2025 SECURITY DEPOSIT IN LIEU UT Rl'arA;ENT.ION o:pwa L zi Dann This Escrow Agreelrrent is made and entered into this 16th day of July 2025,� between the CITY Ol+ SANTA ANA whose address is 20_�Ciyic Center Plaza, CA 927Q1 hereinafter called "OWNER", and SULLY-MILLER CONTRACTING COMPANY, whose address is 135 S. State College Blvd. # 400, Brea, CA 92821 lereinafter called "CONTRACTOR", and U.S. BANK NATIONAL ASSOCIATION whose address is 633 W, 5tl' Street 2 th Floor, Los Angeles, CA 90071 hereinafter called "ESCROW A(jENT" Section A. Oil or about March 19, 2025, the City, Contractor, and Escrow Agent entered into a Escrow Agreern6nt for Security Deposit in Lieu of Retention (A-2025-067), It has come to the attention of.the Pa,r�fies that the'listed Contract amount in that agreement was incorrect.Accordingly, the Parties now eatei i into (his new Agreement. The prior Agreement, A-2025-067, is hereby formally terminated and !' silpel 'ded by this new Agreement For th consideration hereinafter set forth, the OWNER,CONTRACTOR, and ESCROW AGENT agree as follows: i 1) Pursuant to Section 22300 of the Public Contract Code of the State of California, CONTRACTOR has the Option to deposit securities with ESCROW AGENT as a substitute for retention earnings required to be withheld by OWNER, pursuant to the Construction Contract entered into between the OWNER and CONTRACTOR for Bristol Street I oyements from Warner Avenue to Saint Andrew PlElce, Pro'ect o. 11-6741 & Bristol Street Phase 4 Water Main Improvements, Project No 19-6499 in the'amoitnt o f.$22,354,492.25 datcd March 4, 2025 (hereinafter referred to as the "Contract"). Alternatively, Girl written request of the; CONTRACTOR, the OWNER shall make payments of the retention earnings directly to (lie ESCROW AGENT. When the CONTRACTOR deposits the secrll'ities as a substitute for Contract earnings, the ESCROW AGENT shall notify the OWNER within 10 (lays of the deposit. The market value of the securities at the tine of the substitution shall be at least equal to the cash atnotint then required to be withheld as retention under the terms of the Contract between the OWNER and CONTRACTOR. Securities shall be held in the name of CITY OF SANTA ANA and shall designate the CONTRACTOR as the beneficial OWNER. 2) The OWNER shall make progress payments to the CONTRACTOR for those funds which otherwise would be withheld from progress payments pursuant to the Contract provisions, provided that the ESCROW AGENT'holds securities in the form and amount specified above, 3) When the OWNER makes payment of retentions earned directly to the ESCROW AGENT,the ESCROW AGENT shall hold them for the benefit of the CONTRACTOR until the time that the escrow created under this contract is terminated,The CONTRACTOR linay direct the investment of the payments into securities. All terms and conditions of this agreement and the rights and responsibilities of the parties shall be equally applicable and binding when the OWNER bays the ESCROW AGE NT directly, 4) CONTRACTOR shall be responsible for.paying all fees for the expenses incurred by ESCROW AGENT in administering the Escrow Accoilllt and all expenses of the OWNER, These expenses and payment terms shalt be determined by the OWNER, CONTRACTOR, and ESCROW AGENT. i 5) The interest earned on the securities or the money market accounts held in escrow and all interest canted on that interest shall be for the sole account of CONTRACTOR and shall be subject to withdrawal by � CONTRACTOR at any time and From time to time without notice to the OWNER. Page 1 er3 103,10704-Santa Ana,Bristol Street wutcr Improvement,doex G) CONTRACTOR shall have the right to withdraw all orally part of the principal in (lie Escrow Account only by written notice to ESCROW AGENT accompanied by written authorization from the OWNER to the ESCROW AGENT that OWNER consents to the witltdrarval of the amosislt sought to be withdrawn by CONTRACTOR. 7) The OWNER shall haven right to draw upon the securities in the event of default by the CONTRACTOR. Upon seven days' written notice to [lie ESCROW AGENT from (lie OWNER of(lie default,the ESCROW AGENT shall immediately convert the securities to cash and shall distribute the cash as instructed by the OWNER. 8) Upon receipt of written notification from the OWNER Certifying that the Contract is final and complete, and that the CONTRACTOR has complied with all requirements and procedures applicable to the Contract, ESCROW AGENT shall release to CONTRACTOR all securities and interest oil deposit less escrow fees and charges of the Escrow Account. The escrow shall be closed immediately upon disbursement of all moneys and securities on deposit and payments of fees and charges. 9) ESCROW AGENT shall rely on the written notifications from the OWNER and the CONTRACTOR pursuant to Sections (5) to (8), inclusive, of this Agreement and the OWNER and CONTRACTOR shall hold ESCROW AGENT harmless from ESCROW AGENT's release and disbursement of the securities and interest as set forth above. 10)The names of the persons who are authorized to give written notice or to receive written notice on behalf of the OWNER and on behalf of CONTRACTOR in connection with the foregoing, and exemplars of their respective signatures are as follows: On behalf of OWNER: On behalf of CONTRACTOR: Executive Director of Finance and Management ServicQs Chief Financial Officer Title Title Alexander Trinidad Jac Won Naine Name Alexander Trin7da�Aug8,2025 M25:52 PDT) Signature Signa ure _ Address: Address; 20 Civic Center Plaza, Santa Ana, CA 92701 135 S. State College Blvd., ##400 Brea, CA 92821 On behalf of ESCROW AGENT:. Vice President I Relationship Manager Title Ismael Diaz Name Si nature Page 2 of 3 10.14 l704-Sawa Ana.Bristol Street water lmprovenient.doex I 633 W. 5`1' Street, 241" Floor Los Angeles, CA 90071 At (lie tune the escrow account is opcned, the OWNER and CONTRACTOR shall deliver to the ESCROW AGENT a fully executed Counterpart of this Agreement. IN WITNESS WHEREOF, the parties have executed this Agreement by their proper officers on the date first set forth above. OWNER A"a CONTRACTOR AA,%ykpm + CtfJ1 Chief Financial Officer Title Title ]�A4,a� Jae Won Name Name Signature Signatt re On behalf of ESCROW AGENT: Vice President Relationship Manager i Title Ismael Diaz Name S i tiature / E E I I { Page 3 oF3 10340704-Santa Ana.Bristat SlMel water r111pr0vetncL11A0CX ATTEST: „rx CITY OF TA A I E L. ALL 'ALVARO NUNS City C City Manager APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: Kyle NAllesen Assistant City Attorney RECOMMENDED FOR APPROVAL: RUDY ROSAS, P.E. Acting Executive Director Public Works Agency CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDlYYYY) 3/1312025 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 polley(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 GUIMIAUr NAME: Liberty Mutual Insurance Co.Nat'l Ins Northeast PHONE FAX 500 IV 3rd St, Suite 300 EMAIL WC,No): Wausau,WI 54403 ADDRESS: CMeCertProduction Liber( Mutual,com INSURERS AFFORDING COVERAGE NAIC# www.LibertyMutual,cpm INSURER A: LibertyMutual Fire Insurance Cc.m an 23 335 INSURED INSURER B: LM Insurance Corporation 33600 SULLY-MILLER CONTRACTING COMPANY 135 S.State College Blvd. INSURERC: Suite 400 INSURER D: Brea CA 92821 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 84336107 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 I TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICYNUMBER MM1DD MM1DDPffYYI LIMITS A COMMERCIAL GENERAL LIABILITY �/ ✓ TB2-631-510805-025 4/1/2025 4/1/2026 EACH OCCURRENCE $2000000 D AGE TO RENTED CLAIMS-MADE �/ OCCUR PREMISES Ea occurrence $500 000 / Per Job Aggregate MED EXP(Any one person) $10 000 IncludesXCU PERSONAL&ADV INJURY $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY[Z]jECOT- LOC PRODUCTS-COMPIOPAGG $3000000 _ OTHER: $ A AUTOMOBILELIA01tTY ✓ AS2-631-510805-015 4/1/2025 4/1/2026 EasBcoideDtswGLELIMIT T$2,OOO,000ANY AUTO BODILY INJURY(Per parson)OWNE❑ SCHEDULED BODILY INJURY PeAUTOS ONLY AUTOS ( raccident)HIRED NON-OWNED PROPERT DDAMAGEAUTOS ONLY AUTOS ONLY Per accident $ UMBRELLALIAB HOCCUR EACH OCCURRENCE $ - EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ B WORKERS COMPENSATION WC5-631-5W805-035 4/1/2025 4/1/2026 AND EMPLOYERS'LIABILITY YIN Covers All States ✓ STATUTE ERH- ANYPROPRIETORIPARTNERIEXECUTIVE N E.L.EACH ACCIDENT $2 00O 000 OFF N NIA (Mandatory In NHI E.L.DISEASE-EA EMPLOYEE $ 0 If S lNunder E.L.DISEASE-POLICY LIMIT $2000000 DESCRIPTION OF OPERATIONS below A Automobile Physical Damage: AS2-631-514805-015 4/1/2025 4/1/2026 **All Medium,Heavy,Extra Heavy and Trailer Types Camp&Coll Deds:$1,500 **All Private Passengers, Pick Lips and Vans Camp&Call Deds:$500 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101,Addlllonal Remarks Schedule,maybe attached if more space Is required) RE:Project NO.11-6741 Bristol Street Improvements from Warner Avenue to Saint Andrew Place and Project No.:19-6499 Bristol Street(Phase 4) Water Main '*See Addendum" Digitally sign Tu Tra n'9TY Tram APPROVED N guye'niazs: .g7 sY Nguyen Tu Tran en at 9:24 am,Apr 07,2025 o4 3 Y 0424r1n-071aa CERTIFICATE HOLDER CANCELLATION Job10340704 City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Hall- Ross Annex ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Diane Beaudoin 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD R4336107 1 3-004090 1 4/25-4/26 - Sully Miller I .7Ulie Nelson 1 3/13/2025 9:59:32 Af4 (EDT) I Page 1 of 2 AGENCY CUSTOMER ID: 3-004090 LOC#: �'►�a® ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED LibertyMutual Insurance Co.Nat'l Ins Northeast SULLY-MILLER CONTRACTING COMPANY 135 S.State College Blvd. POLICY NUMBER Suite 400 Brea CA 92821 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:Certificate of Liability Insurance(03116) HOLDER: City of Santa Ana City Hall-Ross Annex ADDRESS:20 Civic Center Plaza Santa Ana CA 92701 RE: Project No. : 11-6741 Bristol Street Improvements from Warner Avenue to Saint Andrew Place / Project No. : 19-6499 Bristol Street (Phase 4) Water Main Improvements The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers is/are additional insured with regards to general liability and automobile liability, as their interest may appear, where required by written contract with respect to liability arising out of work or operations performed by or on behalf of the Permittee including materials, Coverage is primary and non-contributory. Waiver of Subrogation is included in favor of the certificate holder on general liability, workers compensation and automobile liability, and applies only to the specific jobs of the insured performed under written contract, and where applicable by law. 30-day Notice of Cancellation, except for 10-day Notice of Cancellation for nonpayment of premium. i i ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 84336107 1 3-00409C 1 4/25-4/26 - Sully Miller I Julie Nelson 1 3/13/2025 B:5B:32 AM (6DT) I Page 2 of 2 Page 1 of 2 ACC.,R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMt03/11/2025 DDNYYY) 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($), 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 Wits Certificate Center NAME: Willis Towers Watson Northeast, Inc. PHONE 1-877-995-7378 FAX 1-688-467-2378 e/o 26 Century Blvd atC No): P.O. Box 305191 MAIL ADDRESS: certificates@wtwco.com Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAIC# INSURERA: Liberty mutual Piro insurance Company 23035 INSURED INSURERB• Berkshire Hathaway Specialty Insurance Com 22276 Bully-Miller Contracting Company 135 S. State College Blvd., suite 400 INSURERC: Brea, CA 92821 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:W38104652 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. ILTR TYPE OF INSURANCE ADDLSUBR pOLICYNUMBER POLICY F POLICY EXP YYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _MMACLAIMS-MADE OCCUR G (RENTED PREMISESS Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENFRAI,AGGREGATE $ POLICY E jEO LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Me accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident $ AUTOS ONLY AUTOS ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per axident $ p UMBRELLALI'46 X OCCUR EACH OCCURRENCE $ 3,000,000 X =XCESgLIAB CLAIMS-MADE Y y TL2-631-510040-825 04/01/2025 04/01/2026 AGGREGATE $ 3,000,000 X DED RETENTION$0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN E.L.EACH ACCIDENT $ OFFICE IMEMB RlPARTNERIEXECUTIVE ❑ NIA OFFICERIMEMBEREXCLUDE07 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E,L,DISEASE-POLICY LIMIT $ H 1st Excess Liability y Y 47-XSF-302408-10 04/01/2025 04/O1/2026 Each Occurrence $5,000,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) APPROVED For Division Branch: 10340704 ByTu Tran Nguyan at9:24am,Apr07,2025 Excess policy is follow form over the General Liability, Automobile, and Employers Liability. Project No. 11-6741 Bristol Street Improvements from Warner Aire to St. Andrew Place and Project 16-6499 Bristol Street (Phase 4) Water Main. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana - City Hall - Ross Annex AUTHORIZED REPRESENTATIVE Attn: City Clerk 20 Civic Center Plaza Santa Ana, CA 92701 ©1988-2016ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD SR In: 274113627 —cx: 3EI70056 AGENCY CUSTOMER ID: LOG#: Ac" " ADDITIONAL REMARKS SCHEDULE Page 2 of z AGENCY NAMED INSURED ully-miller Contracting Company Willis Towers Watson Northeast, Inc. S 135 S. State College Blvd., Suite 400 POLICY NUMBER Brea, CA 92621 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE:See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE' Certificate of Liability Insurance The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers are included as Additional Insureds as respects to Umbrella/Excess Liability. Umbrella/Excess Liability policy shall be Primary and Non-Contributory with any other insurance in force for or which may be purchased by Additional Insureds. Waiver of Subrogation applies in favor of Additional Insureds with respects to Umbrella/Excess Liability. ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of'ACORD SR ID: 27418627 BATCH: 3870056 CERT. W30104652 A� CERTIFICATE OF LIABILITY INSURANCE o0410212025Dr1 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(tes)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 endorsoment(s). PRODUCER CONTACT MARSH USA,LLC. NAME: 1166 Avenue of the Americas PHONE FAx New York,NY 10036 a DHSS x ' Arc No): INSURERS AFFORDING COVERAGE NAIC# 01,1101472134-HRI-Prof:24-25 Nelson INSURER A: NQtIonal Flre 8 Marine Insurance Corapany 20079 INSURED INSURER B SULLY MILLER CONTRACTING COMPANY 136 S.STATE COLLEGE BLVD.,STE,400 INSURER C: BREA,CA 92821 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-012256014.00 REVISION NUMBER: o 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 SUER POLICY EFF POLICY EXP LTR POLICYNUMBER MWUD MMIDDfYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE DOCCUR DAMAGE TO RENTED E ISES Ea occurre ca $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ JECTPRO- POLICY F-1 LOC PRODUCTS-COMPlOPAGO $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED id P BODILY INJURY(Per accent AUTOS ONLY AUTOS ) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per eccldeni $ $ UMBRELLALIAB OCCUR EACHOCCURRENCE $ - EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND FMPLOYERV LIABILITY Y STATUTE ER ANYPROPRIETORIPARTNERIEXECUTIVE _N E.L.EACH ACCIDENT $ OFFICEWMEMBEREXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ U yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ A CONTRACTORS'PROFESSIONAL 42-CNP-33588"1 0710112024 07101/2025 EACH CLAIM IAGO 2,000,000 LIABILITY(CLAIMS MADE) SELF INSURED RETENTION 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Project No.:11-6741 Bristol Street Improvements from Warner Avenue to Salnt Andrew Place I Project No.:19-6499 Bristol Street(Phase 4)Water Main Job 10340704 APPROVED By Tu Tran Nguyen of 9:24 am,Apr OT,2025 CERTIFICATE HOLDER CANCELLATION City of Sanla Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza-City Hall,Ross Annex THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana,CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE of Marsh USA LLC O 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101472134 LOC#: New York ACCO ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA,LLC, SULLY-MILLER CONTRACTING COMPANY 1368,STATE COLLEGE BLVD.,STE.400 POLICY NUMBER BREA,CA 92821 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 2b FORM TITLE: Certificate of Liability Insurance Waiver of Subrogador Is included In favor of the certificate holder and applies only to the specBlo lobs of the Insured performed under wrillen contmot,and where applicable bylaw, City of Santa Ana is Loss Payee i i i i I ACORD 101 (2008101) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number TB2-631-510805-025 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED—OWNERS, LESSEES OR CONTRACTORS WITH PRODUCTS/COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name of Additional Insured Person(s) or Location of Covered Operations: Organization(s): The City of Santa Ana, its City Council, officers, Project No.: 11-6741 Bristol Street Improvements officials, employees, agents and volunteers are from Warner Avenue to Saint Andrew Place / covered as additional insured with respect to Project No.: 19-6499 Bristol Street(Phase 4)Water liability arising out of work or operations performed Main by or on behalf of the Permittee including materials, parts or equipment furnished in connection with such work or operations A. Section II—Who Is An Insured is amended to include as an additional insured: 1. Any person or organization where required by a"written contract"you have entered into where the contract requires the entity to be added as an additional insured under your Policy; and 2. The particular person or organization, if any, shown in the Schedule of this endorsement at the location(s) shown in the Schedule. B. The insurance provided to the additional insured is limited as follows.- 1. The person or organization is an additional insured only with respect to liability for"bodily injury", "property damage", or"personal and advertising injury"caused, in whole or in part, by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the"written contract'; or b. "Your work" that is specified in the "written contract" but only for "bodily injury" or"property damage" included in the"products-completed operations hazard", and only if.- (1) The"written contract" requires you to provide the additional insured such coverage; and (2) This Coverage Part provides such coverage. 2. If the"written contract"specifically requires you to provide additional insurance coverage via; a. The 10101 edition of CG2010(aka CG 20 10 10 01); b. The 10101 edition of CG2037 (aka CG 20 37 10 01); or c. The 11185 edition of CG2010(aka CG 20 10 11 85), then in Paragraph B.1.above,the words"caused, in whole or in part, by"are replaced by the words"arising out of`. LD 20 116 01 20 ©2020 Liberty Mutual Insurance Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. C2 -COLAS GROUP INTERNAL: Employees and partners who need to know. 3. We will not provide the additional insured any broader coverage or any higher limit of insurance than: a. The maximum permitted by law; b. That is required by the"written contract"; c. That is described in B.1. above; or d. That is afforded to you under this Policy, whichever is less. 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance of Section IV — Commercial General Liability Conditions, this insurance is excess over all other insurance available to the additional insured,whether on a primary,excess,contingent or any other basis. But if required by the"written contract" to be primary and non-contributory,this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 5. The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or "personal and advertising injury"arising out of: a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities; or b. Any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Coverage Part. C. Section IV—Commercial General Liability Conditions is amended as follows: 1. The Duties In The Event Of Occurrence, Offense, Claim Or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or"suit" under this insurance, and of any claim or"suit"that does result; (2) Except as provided in Paragraph 8.4. of this endorsement, make available any other insurance the additional insured has for a loss we cover under this Coverage Part; (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of any claim or"suit"; and (4) Tender the defense and indemnity of any claim or suit to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the "written contract" requires this insurance to be primary and non-contributory, this provision (4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or"suit". D. Only for the purpose of the insurance provided by this endorsement, Section V— Definitions is amended to add the following definition: LID 20 116 01 20 O 2020 Liberty Mutual Insurance Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. C2 - COLAS GROUP INTERNAL Employees and partners who need to know. "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, ,provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this Policy; and 2. Was executed prior to: a. The"bodily Injury"or"property damage"; or b. The offense that caused the"personal and advertising injury", for which the additional insured seeks coverage under this Coverage Part. All other terms and conditions of the Policy remain unchanged. LID 20 116 01 20 O 2020 Liberty Mutual Insurance Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. C2 -COLAS GROUP INTERNALS Employees and partners who need to know COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and ROUP INTERGGL2EW%J9s and partners who rOddaurimm Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: TB2-531-510805-025 COMMERCIAL GENERAL LIABILITY CG 24 04 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s)Or Organization(s): The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers are covered as additional insured with respect to liability arising out of work or operations performed by or on behalf of the Permittee including materials, parts or equipment furnished in connection with such work or operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s)shown in the Schedule above. CG 24 04 1219 ©insurance Services Office, Inc., 2018 Page 1 of 1 C2 - COLAS GROUP INTERNAL: Employees and partners who need to know. Policy Number T132..631-510805-025 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PROD UCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY—UMBRELLA COVERAGE FORM Schedule Name of Other Person(s)I Email Address or mailing address: Number Days Notice: Organ ization s City of Santa Ana 20 Civic Center Plaza 30 City Hall--Ross Annex Santa Ana, CA 92701 A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 05 11 Q 2011 Liberty Mutual Group of Companies.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. C2- COLAS GROUP INTERNAL Eniplovees and partners wl)o need to know. COVERAGE C—MEDICAL PAYMENTS d. Workers' Compensation And Similar Laws 1. Insuring Agreement To a person, whether or not an "employee" of a. We will pay medical expenses as described any insured, if benefits for the"bodily injury" are below for"bodily injury"caused by an accident: payable or must be provided under a workers' compensation or disability benefits law or a (1) On premises you own or rent; similar law. (2) On ways next to premises you own or rent; e. Athletics Activities or To a person injured while practicing, instructing (3) Because of your operations; or participating in any physical exercises or provided that: games, sports, or athletic contests. (a) The accident takes place in the f. Products-Completed Operations Hazard coverage territory and during the policy Included within the "products-completed period; operations hazard". (b) The expenses are incurred and reported g. Coverage A Exclusions to us within one year of the date of the a A. Excluded under Coverage accident;and g (c) The injured person submits to SUPPLEMENTARY PAYMENTS — COVERAGES A examination, at our expense, by AND B physicians of our choice as often as we 1. We will pay, with respect to any claim we reasonably require, investigate or settle, or any "suit" against an b. We will make these payments regardless of insured we defend: fault. These payments will not exceed the a. All expenses we incur, applicable limit of insurance. We will pay b. Up to $250 for cost of bail bonds required reasonable expenses for: because of accidents or traffic law violations (1) First aid administered at the time of an arising out of the use of any vehicle to which accident; the Bodily Injury Liability Coverage applies. We (2) Necessary medical, surgical, X-ray and do not have to furnish these bonds. dental services, including prosthetic c. The cost of bonds to release attachments, but devices; and only for bond amounts within the applicable (3) Necessary ambulance, hospital, limit of insurance. We do not have to furnish .professional nursing and funeral services. these bonds. 2. Exclusions d. All reasonable expenses incurred by the insured at our request to assist us in the We will not pay expenses for"bodily injury": investigation or defense of the claim or "suit", a. Any Insured including actual loss of earnings up to $250 a To any insured, except"volunteer workers". day because of time off from work, b. Hired Person e. All court costs taxed against the insured in the "suit". However, these payments do not include To a person hired to do work for or on behalf of attorneys' fees or attorneys' expenses taxed any insured or a tenant of any insured. against the insured. c. Injury On Normally Occupied Premises f. prejudgment interest awarded against the To a person injured on that part of premises insured on that part of the judgment we pay. If you own or rent that the person normally we make an offer to pay the applicable limit of occupies. insurance, we will not pay any prejudgment interest based on that period of time after the offer. Page 8 of 16 0 Insurance Services Office, Inc., 2012 CG 00 01 0413 g. All interest on the full amount of any judgment So long as the above conditions are met, attorneys' that accrues after entry of the judgment and fees incurred by us in the defense of that before we have paid, offered to pay, or indemnitee, necessary litigation expenses incurred deposited in court the part of the judgment that by us and necessary litigation expenses incurred is within the applicable limit of insurance. by the indemnitee at our request will be paid as These payments will not reduce the limits of Supplementary Payments. Notwithstanding the insurance. provisions of Paragraph 2.b.(2) of Section I — Coverage A— Bodily Injury And Property Damage 2. If we defend an insured against a "suit" and an Liability, such payments will not be deemed to be indemnitee of the insured is also named as a party damages for "bodily injury" and "property damage" to the"suit",we will defend that indemnitee if all of and will not reduce the limits of insurance. the following conditions are met: Our obligation to defend an insured's indemnitee a. The "suit" against the indemnitee seeks and to pay for attorneys' fees and necessary damages for which the insured has assumed litigation expenses as Supplementary Payments the liability of the indemnitee in a contract or ends when we have used up the applicable limit of agreement that is an"insured contract'; insurance in the payment of judgments or b. This insurance applies to such liability assumed settlements or the conditions set forth above, or by the insured; the terms of the agreement described in c. The obligation to defend, or the cost of the Paragraph f. above, are no longer met. defense of, that indemnitee, has also been SECTION II—WHO IS AN INSURED assumed by the insured in the same "insured 1. If you are designated in the Declarations as: contract"; a. An individual, you and your spouse are d. The allegations in the "suit"and the information insureds, but only with respect to the conduct of we know about the "occurrence" are such that a business of which you are the sole owner. no conflict appears to exist between the b. A partnership or joint venture, you are an interests of the insured and the interests of the insured. Your members, your partners, and indemnitee; their spouses are also insureds, but only with e. The indemnitee and the insured ask us to respect to the conduct of your business. conduct and control the defense of that c. A limited liability company, you are an insured. indemnitee against such suit and agree that Your members are also insureds, but only with we can assign the same counsel to defend the respect to the conduct of your business. Your insured and the indemnitee; and managers are insureds, but only with respect to f. The indemnitee: their duties as your managers. (1) Agrees in writing to: d. An organization other than a partnership, joint (a) Cooperate with us in the investigation, venture or limited liability company, you are an settlement or defense of the"suit"; insured. Your "executive officers" and directors (b) Immediately send us copies of any are insureds, but only with respect to their demands, notices, summonses or legal duties as your officers or directors. Your papers received in connection with the stockholders are also insureds, but only with "suit"; respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are {c) Notify any other insurer whose coverage also insureds, but only with respect to their is available to the indemnitee;and duties as trustees. (d) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee;and (2) Provides us with written authorization to: (a) Obtain records and other information related to the"suit';and (b) Conduct and control the defense of the indemnitee in such "suit". I CG 00 01 0413 C Insurance Services Office, Inc.,2012 Page 9 of 16 2. Each of the following is also an insured: c. Any person or organization having proper a. Your "volunteer workers" only while performing temporary custody of your property if you die, duties related to the conduct of your business, but only: or your "employees", other than either your (1) With respect to liability arising out of the "executive officers" (if you are an organization maintenance or use of that property; and other than a partnership, joint venture or limited (2) Until your legal representative has been liability company) or your managers (if you are appointed, a limited liability company), but only for acts within the scope of their employment by you or d. Your legal representative if you die, but only while performing duties related to the conduct with respect to duties as such. That of your business. However, none of these representative will have all your rights and "employees" or "volunteer workers" are duties under this Coverage Part. insureds for: 3. Any organization you newly acquire or form, other (1) "Bodily injury" or "personal and advertising than a partnership, joint venture or limited liability injury": company, and over which you maintain ownership or majority interest, will qualify as a Named Insured you are a partnership or joint venture), to (a) To you, to your partners or members (if if there is no other similar insurance available to your members (if you are a limited that organization. However: liability company), to a co-"employee" a. Coverage under this provision is afforded only while in the course of his or her until the 90th day after you acquire or form the employment or performing duties organization or the end of the policy period, related to the conduct of your business, whichever is earlier; or to your other "volunteer workers" b. Coverage A does not apply to "bodily injury" or while performing duties related to the "property damage" that occurred before you conduct of your business; acquired or formed the organization; and (b) To the spouse, child, parent, brother or c. Coverage B does not apply to "personal and sister of that co-"employee" or advertising injury" arising out of an offense "volunteer worker" as a consequence of committed before you acquired or formed the Paragraph (1)(a) above; organization. (c) For which there is any obligation to No person or organization is an insured with respect to share damages with or repay someone the conduct of any current or past partnership, joint else who must pay damages because of venture or limited liability company that is not shown the injury described in Paragraph (1)(a) as a Named Insured in the Declarations. or(b) above;or SECTION III—LIMITS OF INSURANCE (d) Arising out of his or her providing or 1. The Limits of Insurance shown in the Declarations failing to provide professional health and the rules below fix the most we will pay care services, regardless of the number of: (2) "Property damage"to property: a. Insureds; (a) Owned,occupied or used by; b. Claims made or"suits" brought;or (b) Rented to, in the care, custody or control c. Persons or organizations making claims or of, or over which physical control is bringing"suits". being exercised for any purpose by; you, any or your "employees", "volunteer 2. The General Aggregate Limit is the most we will pay for the sum of: workers", any partner or member (if you are a partnership or joint venture), or any a. Medical expenses under Coverage C; member (if you are a limited liability b. Damages under Coverage A,except damages company). because of "bodily injury" or "property damage" b. Any person (other than your "employee" or included in the "products-completed operations "volunteer worker"), or any organization while hazard"; and acting as your real estate manager. c. Damages under Coverage B. Page 10 of 16 0 Insurance Services Office, Inc.,2012 CG 00 01 0413 3. The Products-Completed Operations Aggregate (3) The nature and location of any injury or Limit is the most we will pay under Coverage A for damage arising out of the "occurrence" or damages because of "bodily injury' and "property offense. damage" included in the "products-completed b, If a claim is made or "suit" is brought against operations hazard". any insured,you must: 4. Subject to Paragraph 2. above, the Personal And (1) Immediately record the specifics of the Advertising Injury Limit is the most we will pay claim or"suit" and the date received; and under Coverage B for the sum of all damages because of all "personal and advertising injury' (2) Notify us as soon as practicable. sustained by any one person or organization. You must see to it that we receive written notice 5. Subject to Paragraph 2. or 3. above, whichever of the claim or"suit"as soon as practicable. applies, the Each Occurrence Limit is the most we c. You and any other involved insured must: will pay for the sum of: (1) Immediately send us copies of any a. Damages under Coverage A;and demands, notices, summonses or legal b. Medical expenses under Coverage C papers received in connection with the because of all "bodily injury" and "property claim or"suit"; damage'arising out of anyone"occurrence". (2) Authorize us to obtain records and other 6. Subject to Paragraph S. above, the Damage To information; Premises Rented To You Limit is the most we will (3) Cooperate with us in the investigation or pay under Coverage A for damages because of settlement of the claim or defense against "property damage" to any one premises, while the"suit"; and rented to you, or in the case of damage by fire, (4) Assist us, upon our request, in the while rented to you or temporarily occupied by you enforcement of any right against any person with permission of the owner. or organization which may be liable to the 7. Subject to Paragraph S. above, the Medical insured because of injury or damage to Expense Limit is the most we will pay under which this insurance may also apply. Coverage C for all medical expenses because of d. No insured will, except at that insured's own "bodily injury'sustained by anyone person. cost, voluntarily make a payment, assume any The Limits of Insurance of this Coverage Part apply obligation, or incur any expense, other than for separately to each consecutive annual period and to first aid,without our consent. any remaining period of less than 12 months, starting 3. Legal Action Against Us with the beginning of the policy period shown in the No person or organization has a right under this Declarations, unless the policy period is extended Coverage Part: after issuance for an additional period of less than 12 months. In that case, the additional period will be a. To join us as a party or otherwise bring us into deemed part of the last preceding period for purposes a"suit"asking for damages from an insured;or of determining the Limits of Insurance. b. To sue us on this Coverage Part unless all of SECTION IV-- COMMERCIAL GENERAL LIABILITY its terms have been fully complied with, CONDITIONS A person or organization may sue us to recover on 1. Bankruptcy an agreed settlement or on a final judgment Bankruptcy or insolvency of the insured or of the against an insured; but we will not be liable for insured's estate will not relieve us of our damages that are not payable under the terms of obligations under this Coverage Part. this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement 2. Duties In The Event Of Occurrence, Offense, means a settlement and release of liability signed Claim Or Suit by us, the insured and the claimant or the a. You must see to it that we are notified as soon claimant's legal representative. as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and CG 00 01 0413 ©Insurance Services Office, Inc.,2012 Page 11 of 16 4. Other Insurance (3) When this insurance is excess over other If other valid and collectible insurance is available insurance, we will pay only our share of the to the insured for a loss we cover under Coverages amount of the loss, if any, that exceeds the A or B of this Coverage Part, our obligations are sum of: limited as follows: (a) The total amount that all such other a. Primary Insurance insurance would pay for the loss in the This insurance is primary except when absence of this insurance; and Paragraph b. below applies. If this insurance is (b) The total of all deductible and primary, our obligations are not affected unless self-insured amounts under all that other any of the other insurance is also primary. insurance. Then, we will share with all that other insurance (4) We will share the remaining loss, if any, with by the method described in Paragraph c. any other insurance that is not described in below. this Excess Insurance provision and was not b. Excess Insurance bought specifically to apply in excess of the Limits of Insurance shown in the (1) This insurance is excess over: Declarations of this Coverage Part. (a) Any of the other insurance, whether c. Method Of Sharing primary, excess, contingent or on any other basis: If all of the other insurance permits contribution by equal shares, we will follow this method (i) That is Fire, Extended Coverage, also. Under this approach each insurer Builder's Risk, Installation Risk or contributes equal amounts until it has paid its similar coverage for"your work"; applicable limit of insurance or none of the loss (ii) That is Fire insurance for premises remains,whichever comes first. rented to you or temporarily If any of the other insurance does not permit occupied by you with permission of contribution by equal shares, we will contribute the owner; by limits: Under this method, each insurer's (iil) That is insurance purchased by you share is based on the ratio of its applicable limit to cover your liability as a tenant for of insurance to the total applicable limits of "property damage" to premises insurance of all insurers, rented to you or temporarily 5. Premium Audit occupied by you with permission of the owner; or a. We will compute all premiums for this Coverage Part in accordance with our rules (iv) If the loss arises out of the and rates. maintenance or use of aircraft, b. Premium shown in this Coverage Part as autos or watercraft to the extent not g subject to Exclusion g. of Section I— advance premium is a deposit premium only. At Coverage A -- Bodily Injury And the close of each audit period we will compute Property Damage Liability. the earned premium for that period and send notice to the first Named Insured. The due date (b) Any other primary insurance available to for audit and retrospective premiums is the date you covering liability for damages arising shown as the due date on the bill. If the sum of out of the premises or operations, or the the advance and audit premiums paid for the products and completed operations, for policy period is greater than the earned which you have been added as an premium, we will return the excess to the first additional insured. Named Insured. (2) When this insurance is excess,we will have c. The first Named Insured must keep records of no duty under Coverages A or B to defend the information we need for premium the insured against any "suit" if any other computation, and send us copies at such times insurer has a duty to defend the insured as we may request. against that "suit". If no other insurer 6. Representations defends, we will undertake to do so, but we p will be entitled to the insured's rights against By accepting this policy,you agree: all those other insurers. a. The statements in the Declarations are accurate and complete; Page 12 of 16 0 Insurance Services Office, Inc., 2012 CG 00 01 0413 b. Those statements are based upon However, "auto" does not include "mobile representations you made to us; and equipment". c. We have issued this policy in reliance upon 3. "Bodily injury" means bodily injury, sickness or your representations. disease sustained by a person, including death 7. Separation Of Insureds resulting from any of these at any time. Except with respect to the Limits of Insurance, and 4. "Coverage territory' means: any rights or duties specifically assigned in this a. The United States of America (including its Coverage Part to the first Named Insured, this territories and possessions), Puerto Rico and insurance applies: Canada; a. As if each Named Insured were the only b. International waters or airspace, but only if the Named Insured; and injury or damage occurs in the course of travel b. Separately to each insured against whom claim or transportation between any places included is made or"suit" is brought. in Paragraph a.above; or 8. Transfer Of Rights Of Recovery Against Others c. All other parts of the world if the injury or To Us damage arises out of: If the insured has rights to recover all or part of any (1) Goods or products made or sold by you in payment we have made under this Coverage Part, the territory described in Paragraph a. those rights are transferred to us. The insured above; must do nothing after loss to impair them. At our (2) The activities of a person whose home is in request, the insured will bring "suit" or transfer the territory described in Paragraph a. those rights to us and help us enforce them. above, but is away for a short time on your 9. When We Do Not Renew business; or If we decide not to renew this Coverage Part, we (3) "Personal and advertising injury" offenses will mail or deliver to the first Named Insured that take place through the Internet or shown in the Declarations written notice of the similar electronic means of communication; nonrenewal not less than 30 days before the provided the insured's responsibility to pay expiration date. damages is determined in a "suit"on the merits, in If notice is mailed, proof of mailing will be sufficient the territory described in Paragraph a. above or in proof of notice, a settlement we agree to. SECTION V—DEFINITIONS 5. "Employee" includes a "leased worker". "Employee" does not include a "temporary 1. "Advertisement" means a notice that is broadcast worker". or published to the general public or specific 6. ""Executive officer" means a person holding any of market segments about your goods, products or the officer positions created by your charter, services for the purpose of attracting customers or constitution, bylaws or any other similar governing supporters. For the purposes of this definition: document. a. Notices that are published include material 7, ""Hostile fire" means one which becomes placed on the Internet or on similar electronic uncontrollable or breaks out from where it was means of communication;and intended to be. b. Regarding web sites, only that part of a web 8, ""Impaired property" means tangible property, other site that is about your goods, products or than "your product" or "your work", that cannot be services for the purposes of attracting used or is less useful because: customers or supporters is considered an advertisement. a. It incorporates "your product" or "your work" 2. "Auto" means: that is known or thought to be defective, deficient, inadequate or dangerous; or a. A land motor vehicle, trailer or semitrailer b. You have failed to fulfill the terms of a contract designed for travel on public roads, including any attached machinery or equipment;or or agreement; b. Any other land vehicle that is subject to a if such property can be restored to use by the repair, replacement, adjustment or removal of compulsory or financial responsibility law or "your product" or "your work" or your fulfilling the other motor vehicle insurance law where it is terms of the contract or agreement. licensed or principally garaged. CG 00 01 0413 ©Insurance Services Office, Inc„2012 Page 13 of 16 i Policy Number: AS2-631-510805-015 Issued by: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED -NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE. FORM MOTOR CARRIERS COVERGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are"insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s)or Organizations(s): The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers are covered as additional insured with respect to liability arising out of work or operations performed by or on behalf of the Permittee including materials, parts or equipment furnished in connection with such work or operations Regarding Designated Contract or Project: 11-6741 Bristol Street Improvements from Warner Avenue to Saint Andrew Place 1 Project No.: 19-6499 Bristol Street (Phase 4) Water Main Each person or organization shown in the Schedule of this endorsement is an "insured"for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed priorto the"bodily injury"or"property damage",then this insurance will be primary and we will not seek contribution from such insurance. OUP INTERNACER4MS td ftnd partners Ou 120t ,,Li.eirtyA1Iutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: AS2-631-510805-015 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers are covered as additional insured with respect to liabiity arising out of work or operations performed by or on behalf of the Permittee including materials, parts orequipment furnished in connection with such work or operations Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Each person or organization shown in the Schedule is an"insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section Il — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph 0.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. 2OUP INTERt t2 'l *3s and partners who r@ddsorlatme.Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: AS2-631-510805-015 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s)Of Person(s) Or Organization(s): The City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers are covered as additional insured with respect to liabiity arising out of work or operations performed by or on behalf of the Permittee including materials, parts or equipment furnished in connection with such work or operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the"accident" or the "loss" under a contract with that person or organization. ROUP 1NTERQA10 1pKy*3s and partners who r@dd8urbcce.Services Office, Inc., 2011 Page 1 of 1 Policy Number AS2-631-510805-015 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PROD UCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY—UMBRELLA COVERAGE FORM Schedule Name of Other Person(s)1 Email Address or mailing address: Number Days Notice: Organ ization s City of Santa Ana 20 Civic Center Plaza 30 City Hall--Ross Annex Santa Ana,CA 92701 A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 0105 11 O 2011 Liberty Mutual Group of Companies.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. C2 - COLAS GROUP INTERNAL Employees and pailners who reed to know WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0% of the California workers' compensation premium otherwise due on such remuneration. Schedule [Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of$ 01 Person or Organization Job Description The City of Santa Ana, its City Council, officers, officials, Project No.:11-6741 Bristol Street Improvements from Warner employees, agents and volunteers are covered as additional Avenue to Saint Andrew Place / Project No.: 19-6499 Bristol insured with respect to liability arising out of work or operations Street(Phase 4)Water Main performed by or on behalf of the Permittee including materials, parts or equipment furnished in connection with such work or operations Issued by Co 2-Liberty Mutual Fire Insurance Company For attachment to Policy No. vVC5-631-510805-035 Effective Date 04/01/2025 Premium $ Issued to WC 04 03 06 R1 Page 1 of 1 Ed. 08/2013 C2 - COLAS GROUP INTERNAL: Employees and partners who need to know. NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. SCHEDULE Name of Other Person(s)1 Email Address or mailing address: Number Days Notice: Organization(s): City of Santa Ana 20 Civic Center Plaza 30 City Hall—Ross Annex Santa Ana, CA 92701 All other terms and conditions of this policy remain unchanged. Issued by For attachment to Policy No. WC5-631-510605-035 Effective Date 04/01/2025 Premium $ Issued to WC 99 20 75 Q 2016 Liberty Mutual Insurance Page 1 of 1 Ed. 12/01/2016 C2 -COLAS GROUP INTERNAL: Employees and partners who need to know. R. Subrogation and Transfer of Rights of Recovery If we make any payment under this policy, we shall be subrogated to all "insured's" rights against any person or entity, including the right to participate with an "insured" in the exercise of all "insured's" rights of recovery. You shall execute and deliver instruments and papers to us and do whatever else is necessary to secure such rights. With respect to a "protective indemnity claim", this includes a written transfer to us of any assignment(s) of rights obtained if an "insured" has elected not to pursue same in furtherance of its "protective indemnity claim". An "insured" shall do nothing to prejudice such rights as described in this paragraph, including, but not limited to, providing full cooperation as stated in Condition C.above. We shall not exercise any such rights against any persons, firms or corporations included in the definition of "insured" or against any other entities, except any "design professional", if prior to a "professional liability claim" or "pollution claim", a waiver of subrogation is contractually agreed to in writing by an "insured". With respect to any recovery obtained through subrogation, reimbursement shall be made as follows: 1. First, expenses incurred in obtaining such subrogation recovery shall be deducted from the recovery amount and allocated to the party that incurred such expense; 2. The remaining amount shall be allocated as follows: a. First, to any interest who has paid any amount in excess of the Limit of Insurance provided under this policy; b. Next,to us;and c. Then to any interest as are entitled to claim the remainder, if any. V Definitions A. "Bodily Injury" shall mean physical injury, sickness or disease, sustained by any person, including death resulting therefrom or mental anguish, emotional distress or shock,sustained by any person caused by a "pollution event" arising out of your "covered operations", "completed operations" or"transportation". "Bodily injury" shall extend to include medical monitoring, but only when such medical monitoring is a direct result of a "pollution event".to which Coverage Part C:Contractor's Pollution Liability applies. B. "Claim"shall mean: 2. Any"professional liability claim"; and 2. Any"pollution claim"; C. "Clean-up costs" shall mean the reasonable and necessary costs and expenses, including legal expenses and "restoration costs", that are incurred to investigate, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to or assess the effects of a "pollution event", but only to the extent: 1. Required by"environmental law";or 2. In the absence of any applicable "environmental law", recommended in writing by an "environmental professional". As used herein, "environmental law" means the federal, state, provincial, municipal or local laws that are applicable to "pollutants" or a "pollution event", of the territory that has authority and jurisdiction over the clean-up of a "pollution event", including, but not limited to,that particular territory's statutes, rules, ordinances, guidance documents, and governmental, judicial or administrative orders and directives. Page 10 CL-CNPC-001-03/2023 MEMORANDUM Risk Management Analyst To: Human Resources Department Date: March 10,2025 Sean Thomas, Principal Civil Engineer From: Public Works Agency RISK MANAGEMENT CERTIFICATE OF INSURANCE REVIEW PROJECT NO. 11-6741 & 19-6499 BRISTOL STREET IMPROVEMENTS AND PHASE 4 Subject: WATER MAIN IMPROVEMENTS (WARNER AVENUE TO SAINT ANDREW PLACE) The Public Works Agency's Construction Services Team has reviewed the scope of the project and can confirm that the contractor does not have a need to procure Builder's Risk Insurance, since the project does not contain a building element. Due to this exclusion for this project, we confirmed that Professional Liability Insurance(errors and omissions)is not required. Please feel fi•ee to contact me at 714-647-5655 if you have any questions.