Loading...
HomeMy WebLinkAboutCABIFORNIA INC. (SANTA ANA CITY HALL - EIGHT FLOOR BATHROOM RENOVATIONS) INSURANCE ON FILF WORK IOAY PROCLED UN I it_ISSdRr.I3CF EX11RC3 CITY CLERK CILLERK C CITY OF SANTA ANA DATE` OCT 2 12025 CONSTRUCTION CONTRACT PROJECT 25-6058 SANTA ANA CITY HALL-EIGHTH FLOOR BATHROOM RENOVATIONS This CONSTRUCTION CONTRACT is made and entered into this 5th day of September 2025 by and between the City of Santa Ana, California,a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "CITY"), and Cabifornia Inc. (hereinafter"CONTRACTOR"). WITNESSETH: The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows: I. CONTRACTOR agrees to perform all the work and furnish all the materials at its own cost and expense necessary to construct and complete in a good and workmanlike manner and to the satisfaction of the City Engineer of the CITY,the Santa Ana City Hall Eighth Floor Bathroom Renovations Project (hereinafter referred to as the "WORK OF IMPROVEMENT") identified in and in accordance with the Contract Documents prepared by the City's Public Works Agency and approved by the City Council. 2. The complete Construction Contract consists of the"Contract Documents" as defined by the Standard Specifications for Public Works Construction and which include the following: • Notice Inviting Bids • Information to Bidders • Bid Proposal • Bid Bond • Contract Form • Contract Bonds • General Provisions • Special Provisions • Technical Provisions and Project Plans • Community Workforce Agreement • Appendices In case of conflict between the Contract Documents, the precedence of documents shall be as established in the Standard Specifications for Public Works Construction, 3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete the WORK OF IMPROVEMENT the sum total amount not to exceed One Hundred Sixty-Nine Thousand Five Hundred Dollars and No Cents ($169,500.00), as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit"A." The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not expressly or by implication agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable. rev.09/01r2017 Page I of 3 4. CONTRACTOR agrees to complete the WORK OF IMPROVEMENT within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. 5. The CONTRACTOR will pay,and will require all subcontractors to pay,all employees on the WORK OF IMPROVEMENT a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. b. If applicable, the CONTRACTOR shall adhere to the CITY'S Community Workforce Agreement (CWA), a pre-hire collective bargaining agreement, which establishes the Labor relations policies and procedures for CONTRACTOR to follow in the crafts persons employed to complete the WORK OF IMPROVEMENT as more fully described in the CWA. The CWA may be found on the City's website at: http://www.santa-ana.org/pwa/documents/CWA.pdf 7. CONTRACTOR shall, after award of this Contract, furnish two bonds to be approved by the CITY, one in the amount of One Hundred Percent (100%) of the Contract price, to guarantee the faithful performance of the work(Performance Bond), and one in the amount of One Hundred Percent(100%) of the Contract price to guarantee payment of all claims for labor and materials furnished (Payment Bond). This Contract shall not become effective until such bonds are supplied to and approved by the CITY. 8. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond shall also be required as a condition of project acceptance. For projects up to Five Hundred Thousand Dollars($500,000),the Warranty Bond amount shall be the greater of Ten Thousand Dollars($10,000) or Twenty Percent (20%) of the final contract price. For projects above Five Hundred Thousand Dollars($500,000),the Warranty Bond amount shall be the greater of One Hundred Thousand Dollars ($100,000) or Ten Percent(10%)of the final contract price. 9. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions,to be approved by the CITY. 10. INDEMNIFICATION. To the fullest extent allowed by law, CONTRACTOR and its Subcontractors hereby agree to defend, indemnify, and hold harmless CITY, its City Council, boards and commissions, officers, agents, employees, representatives and volunteers (hereinafter collectively referred to as "Indemnitees"), through legal counsel acceptable to CITY, from and against any liability, claims, actions, costs, damages or losses, including reasonable costs and attorney's fees, for injury, including death to any person or damage to any property,arising directly or indirectly from, or in any manner relating to,any of the following: (i) Performance or nonperformance of the Work of Improvement by CONTRACTOR or its Subcontractors of any lower tier; (ii) Performance or nonperformance by CONTRACTOR or its Subcontractors of any lower tier, of any of the obligations under the Contract Documents; Page 2 of 3 (iii) The construction activities of CONTRACTOR or its Subcontractors of any lower tier, either on the project site or on other properties; (iv) The payment or nonpayment by CONTRACTOR of any of its Subcontractors of any lower tier, for Work of Improvement perfonned on or off the project site; and (v) Any personal injury, property damage or economic loss to third persons related to and arising from the performance or nonperformance by CONTRACTOR or its Subcontractors of any lower tier, of the Work of Improvement. (vi) The indemnity obligations of Subcontractors provided by this Section shall be included in all subcontract documents issued by CONTRACTOR. Nothing in the Contract Documents shall be construed to give rise to any implied right of indemnity in favor of CONTRACTOR against CITY or any other Indemnitee. IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: CITY OF SANTA`A�NA JENNIF LL r " ' ALVARO NUNEZ S City Cler City Manager APPROVED AS TO FORM: SONIA R. CARVALHO CONTRACTOR: City Attorney Cabifornia Inc. "I E NELLESEN NAME: Saeed Mohammadi Assistant City Attorney TITLE: President RECOMMENDED FOR APPROVAL: a61;-- LFO R PE Acting Executive Director Public Works Agency Page 3 of 3 CITY OF SANTA ANA . PROPOSAL' PROJECT NO.:25-6058 CITY HALL 8"0 FLOOR BATHROOM RENOVATIONS BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: CABIFORNIA Inc. REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Conti-act Documents in its entirety and hereby proposes to famish all material and do all the work required to complete the said work in accordance with said plans(if any)and the specifications for the unit price(g)or lump sum(s)set forth in the following schedule: Item Description Qty Unit Unit Price Amount City Hall 81"Floor Bathroom t L.S $ $ Itenovatioas 168,000.00 168 000.00 As-Built Plans 1 LS $ $ 1,800.00 1,500.00 TOTAL BASE BID $ 169,500.00 The lowest responsible bidder shall be selected based on the total base bid.The City reserves the right to award the Base laid,and any,all, or none of the add-alternate bid items(if any). The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the"25%"limit as stated in Section 7-3.5 of the Standard Specifications. The actual. amount for this.item will be dictated by the actual quantity used,and the Agency reserves the right to increase or decrease the quantity of this item accordingly. t This bid item is considered a Specialty Item per Section 3-2 of the Standard Specifications. TIME FOR COMPLETION OF IMPROVEMENTS AND LT UIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within eighty 80 working days after the commencement date stated in the Notice to Proceed. The liquidated damages amount,in lieu of the amount specified in Subsection 6-9 of the Standard Specifications,shall be$3,600 per calendar day. P-1 ofP-'18 CITY OF SANTA.ANA PROPOSAL PROJECT NO.:25-6058 CITY HALL 8T1 FLOOR BATHROOM RENOVATIONS Name of Firm CABIFORNIA Inc. Signature of BIDDER Title President. (Man individual,so state. -If a firm or co-partnership,state the firm name and give the names of all individual co-partners composing the firm, If a corporation,state legal name of earporation, and names of President, Secretary,Treasurer and Manager,thereof.) R2 of P-18 I ACC>R" CERTIFICATE OF LIABILITY INSURANCE P09/09/2025 ATE(MMIODIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER CONTACT EZ Insurance Services, Inc NAME: Alan Starc 2960 Harbor Blvd Suite b PH : (714)754-9037 FAX No: (714)754-9035 COSTA MESA, CA 92626 ADDRESS: Alan@ezlnsurance923.com License#- OEB6632 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Gotham insurance Company 25569 INSURED INSURERB: Nautilus Insurance Company 17370 CABIFORNIA INC. INSURER C: 26611 NACCOME DR INSURER D: MISSION VIEJO, CA 92691 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00029446.0 REVISION NUMBER: 22 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 MAYBE 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY) (MMiDDffYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y GL202500023595 07130/2025 07130/2026 EACH OCCURRENCE $ 1 0OO 000 CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence) $ 300,000 MED EXP(An one arson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JE'CT ❑ LOC PRODUCTS-COMPIOPAGO $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMDINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY per accident B X UMBRELLA LIAB OCCUR Y Y AN1356530 0713012025 0713012026 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1 000,000 DED I I RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- ANbEMPLOYERS'LIABILITY YIN STATUTE ER ANY PRO PRIETORIPARTNERIEXECUTIVE E,L,EACH ACCIDENT $ OFFICERIMEMBEREXCLUOE1 NIA (Mandatory in NH) EX,DISFASE-EA EMPLOYE $ If yyes,describe under OESGRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Tu T an %Digiruuysru�dby D.t ra2 Ngu APPROVED �a�e:xazs,l 13 - Ngu en n,:41:19-07' � -. ray T.Tran Nguyen at 7;40 am,Oct 43,2075. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) GENERAL LIABILITY POLICY HAS BLANKET Al, BLANKET WOS&BLANKET PNC ENDORSEMENTS.See Attached. City of Santa, its officers,empolyees, agents and representative are Additional Insureds with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non-Contributory. 30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of premium in accordance with policy provisions, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN RISK MANAGEMENT DIVISION ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA AUTI1Q2QD REPRESENTATIVE - 5ANTAANA, CA 92702 AAS ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by AAS on 0 9109/2 0 2 5 at 08:38AM CERTIFICATE OF LIABILITY INSURANCE D10/10/25Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Amir Darabi NAME:ME: A & S Insurance Management Center 310-699-9949 FAX (AIXNo; 310--807-8312 14252 Culver Dr. ADDRESS: amirQasinscenter.COm Suite A338 INSURERS AFFORDING COVERAGE NAIC# Irvine CA 92604 INSURERA:Kemper Auto Commercial INSURED INsuRERB;Westchester Insurance Company Cabifornia, Inc. INSURERC: 26611 Naccome Drive INSURER D: Mission Viejo, CA 92691 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EPP POLICY EXP LTR POLICY NUMBER MWDDNYYY MMIDD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&AOV INJURY $ GENERAL AGGREGATE $ GEN1 AGGREGATE LIMIT APPLIESPER: PRODUCTS-COMP/OP AGO $ POLICY r PRO- LOC $ AUTOMOBILE LIABILITY 50019255701 04/30/25 10/30/25 EOaacBad.nt) LELIMIr ANY AUTO BODILY INJURY(Par person) $ 1, 0 0 0, 0 0 0 A ALL OWNED SCHEDULEO X X BODILY INJURY(Per accident) $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Poraccide t UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEU RETENTION $ WORKERS COMPENSATION I WC STATU- I IOTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? El N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE: $ ES If es,describe under CRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D B Pollution Liability X G48744874 001 10/10/25 10/1.0/26 Ded $5,000 $lm/$2m DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers are to be covered as additional insureds are named as additional insured. Waiver of subrogation applies. CERTIFICATE HOLDER APPROVED_.____._. CANCELLATION By Tu Tran Nguyen at 7:44 am,Oct 13,2025. SHOULD ANY OF THE ABOVE OF-SCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 City Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE Amir Darabi -L7— ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i ACOR�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 09124/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Steve Almanza NAME: Steven Almanza Agency PHONE (562)861-0301 FAX (424)358-4847 AIC NO 22939 Hawthorne Blvd. Unit 311 E-MAIL Sal manza astevenal manza agency.com ADDRESS: Torrance,CA 90505 INSURERS AFFORDING COVERAGE NAIL# INSURER A INSURED INSURER B CABIFORNIA INC INSURER C DBA CABIFORNIA INSURER D: Clear Spring Property Casualty Company 15563 26611 Naccome Dr. INSURER E: Mission Viejo CA 92691 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMFDDfYYYY MMIDDfYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE ❑OCCUR DAMAGE (-RENTED PREMISESEa occurrence) $ MED EXP(Any one person) S PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO JECT LDC PRODUCTS-COMPIOP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per parson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) 5 HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Par accident $ 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER CTH- AND EMPLOYERS'LIABILITY Y f N STATUTE ER D ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,Q00.dD� OFFICERIMEMBER EXCLUDED? NIA. CWCO2822901 01/27/2025 01/27/2026 - (Mandatcry In NH) E.L.DISEASE-FA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER APPROVE® CANCELLATION By Tv Tran Nguyen at 7:40 am,Oct 13,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED R TAT Santa Ana CA 92701 O 1 2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.5%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any Person or Organization As Required by Written Contract. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 0 1/2 712 02 5 Policy No. CWCO2822901 Endorsement No. 1 Insured CABIFORNIA ING Premium $2,568 Insurance Company: Clear Spring Property and Casualty Company Countersigned by: AGENCY CUSTOMER ID: _ LOC#: A`COR O® ADDITIONAL REMARKS SCHEDULE Page 2 of AGENCY NAMED INSURED EZ Insurance Services, Inc CABIFORNIA INC. POLICY NUMBER NIA CARRIER NAIC CODE Multiple Carriers EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Vehicles Summary # Year Make Model VIN Fleet ID Co Vehicle# Locations Summary Loc# Description Address Location 1 General Contractor 26611 NACCOME DR MISSION VIEJO,CA 9269 Building 1 General Contractor ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD j Printed by AAS on September 09,2025 at 08:38AM INTERLINE IL 3133 0923 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART SCHEDULE Designated Person Or Organization: City of Santa Ana Risk Management Division 20 Civic Center plaza, Santa Ana,CA 92702 If we cancel this policy, we will endeavor to mail written notice of cancellation to the person or organization shown in the Schedule above at least 30 days (10 days for non-payment of premium) in advance of the effective date of cancellation. All other terms and conditions remain unchanged. IL 3133 0923 ©2023 Coaction Specialty Insurance Group, Inc. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL. GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract or agreement that such person or organization be 1. "Bodily injury", "property damage" or "personal added as an additional insured on your policy. and advertising injury" arising out of the Such person or organization is an additional rendering of, or the failure to render, any insured only with respect to liability for "bodily professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury"caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports, surveys, field orders, change orders or drawings and behalf; specifications; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims additional insured: against any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the supervision, hiring, and employment, training or monitoring of others by 2. Will not be broader than that which you are that insured, if the "occurrence" which caused required by the contract or agreement to the "bodily injury" or "property damage", or the provide for such additional insured. offense which caused the "personal and advertising injury", involved the rendering of or A person's or organization's status as an the failure to render any professional additional insured under this endorsement ends architectural, engineering or surveying when your operations for that additional insured services. are completed. CG 20 33 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 2 2. "Bodily injury" or "property damage" occurring C. With respect to the insurance afforded to these after: additional insureds, the following is added to a. All work, including materials, parts or section III— Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or b. That portion of "your work" out of which the 2• Available under the applicable limits of injury or damage arises has been put to its insurance; intended use by any person or organization whichever is less. other than another contractor or This endorsement shall not increase the subcontractor engaged in performing applicable limits of insurance. operations for a principal as a part of the same project. Page 2 of 2 ®Insurance Services Office, Inc., 2018 CG 20 33 12 19 I COMMERCIAL GENERAL LIABILITY CG20391219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT WITH YOU (COMPLETED OPERATIONS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to 2. Supervisory, inspection, architectural or include as an additional insured any person or engineering activities. organization for whom you have performed This exclusion applies even if the claims against operations when you and such person or any insured allege negligence or other wrongdoing organization have agreed in writing in a contract or in the supervision, hiring, employment, training or agreement that such person or organization be monitoring of others by that insured, if the added as an additional insured on your policy. "occurrence" which caused the "bodily injury" or Such person or organization is an additional "property damage" involved the rendering of or the insured only with respect to liability for "bodily failure to render any professional architectural, injury" or"property damage"caused, in whole or in part, by "your work" performed for that additional engineering or surveying services. insured and included in the "products-completed C. With respect to the insurance afforded to these operations hazard". additional insureds, the following is added to However, the insurance afforded to such Section III—Limits Of Insurance: additional insured: The most we will pay on behalf of the additional 1. Only applies to the extent permitted by law, insured is the amount of insurance: and 1. Required by the contract or agreement you have entered into with the additional insured; 2. Will not be broader than that which you are or required by the contract or agreement to provide for such additional insured. 2. Available under the applicable limits of B. With respect to the insurance afforded to these insurance; additional insureds, the following additional whichever is less. exclusion applies: This endorsement shall not increase the This insurance does not apply to: applicable limits of insurance. "Bodily injury" or "property damage" arising out of 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;or CG 20 39 12 19 c0 insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: GL202500023595 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations City of Santa Ana Risk Management Division 20 Civic Center Plaza 26611 Naccome Dr,Mission Viejo,CA 92691 Santa Ana,CA 92702 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II -- Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury" or damage or personal and advertising injury "property damage"occurring after: caused, in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 12 19 c O Insurance Services Office, Inc., 2018 Page 1 of 2 � C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable limits of insurance. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 ©Insurance Services Office, Inc., 2018 CG 20 10 12 19 i I POLICY NUMBER: GL202500023595 COMMERCIAL GENERAL LIABILITY GL 02261013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT - CAPPED (BLANKET) This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Each single designated construction project for which you are obligated, by written contract,to maintain general liability insurance with a separate per project general aggregate limit. The separate per project general aggregate limit must apply only to that construction project. The contract must be executed prior to the "occurrence"of the "bodily injury"or"property damage". Capper! Designated Construction Project(s) General Aggregate Limit: $5,000,000 Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. For all sums which the insured becomes legally obligated to pay as damages caused by"occurrences" under Section I—Coverage A and for all medical expenses caused by accidents under Section I—Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project(s) General Aggregate Limit applies to each designated construction project and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations of this policy. However, the separate Designated Construction Project(s) General Aggregate Limits(s) are subject to an overall Capped Designated Construction Project(s) General Aggregate Limit in the amount shown in the Schedule above. The Capped Designated Construction Project(s) General Aggregate Limit is the most we will pay for all damages and medical expenses included in the Designated Construction Project(s) General Aggregate Limit(s)for all construction projects combined. 2. The Designated Construction Project(s) General Aggregate Limit is the most we will pay for the sum of all damages under Section I—Coverage A, except damages because of"bodily injury" and "property damage" included in the "products-completed operations hazard"; and medical expenses under Section I — Coverage C, and it is the most we will pay regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits", GL 0226 1013 Includes copyrighted material of Insurance Services Office, Inc., with Page 1 of 2 its permission 3. Any payments made under Section I — Coverage A for damages or under Section I — Coverage C for medical expenses shall reduce the Designated Construction Project(s) General Aggregate Limit for that designated construction project and the Capped Designated Construction Project(s) General Aggregate Limit. Such payments for damages and medical expenses shall not reduce the General Aggregate Limit shown in the Declarations of the policy nor shall they reduce any other Designated Construction Project(s) General Aggregate Limit for any other designated construction project shown in the Schedule above. However, such payments for damages and medical expenses included in the Designated Construction Project(s) General Aggregate Limit for all construction projects combined will reduce the Capped Designated Construction Project(s)General Aggregate Limit. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expenses continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations of the policy, such limits will be subject to the applicable Designated Construction Project(s) General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by"occurrences"under Section I —Coverage A and for all medical expenses caused by accidents under Section I—Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Section I — Coverage A for damages or under Section I — Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products- Completed Operations Aggregate Limit,whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project(s)General Aggregate Limit. C. When coverage for liability arising out of the"products-completed operations hazard" is provided, any payments for damages because of"bodily injury"or"property damage" included in the "products-completed operations hazard"will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project(s)General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables,the construction project will still be deemed to be the same construction project. E. The provisions of Section III—Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. F. If this endorsement and a Designated Locations(s)General Aggregate Limit Endorsement(either capped or un-capped) issued by us or one of our affiliated companies applies to the same"occurrence", or would have applied to the same"occurrence" but for exhaustion of the applicable aggregate limit, this endorsement shall apply to that"occurrence" and not the Designated Location(s) General Aggregate Limit Endorsement. In no event shall the limits of both endorsements apply to the same'occurrence". All other terms and conditions of this policy remain unchanged. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with GL 0226 1013 0 its permission COMMERCIAL GENERAL LIABILITY CG 24 53 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. CG 24 53 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1 i KEMPERAuto Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 COMMERCIAL Alpharetta, GA30022 Underwritten by. Infinity Select Insurance Company Customer Service: (800)722-3391 Claims Service: (800)353-6737 ADDITIONAL NAMED INSURED ENDORSEMENT x Q = a; -I i 50019255701 10/30/2025 12:01 a.m. City of Santa Ana, its officers,employees, agents, -- .W- and Volunteers - 20 Civic Center Piz Cabifornia Inc Santa Arta, CA 92701 This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. - _ .— .Aic�tlitoiialltrs�fredm� = _ - City of Santa Ana, its officers, employees, agents, and Volunteers Part A- Liability Coverage, is changed as follows: The definition of insured is changed to include the additional insured named above. Adding an insured will not increase the limit of our liability.The insurance provided by this endorsement will be excess over any other valid and collectible insurance. All other parts of this Policy remain unchanged. i i ADDL INSURED COPY AMEND DATE: 1 0/0 912 02 5 50461AIS01 ENDORSEMENT:2-3 KEMPERAuto Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 COMMERCIAL Alpharetta, GA30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800)722-3391 Claims Service: (800)353-6737 WAIVER OF SUBROGATION 1 a�feee 50019255701 10/30/2025 12:01 a.m. City of Santa Ana, its officers, employees, agents, and Volunteers 20 Civic Center Piz Cabifornia Inc Santa Ana, CA 92701 This endorsement is attached to and forms a part of the listed policy.No changes will be effective prior to the time changes are requested. In return for your premium payment shown below,we agree that our rights of subrogation or rights of recovery under the policy will not apply against the following person or organization: City of Santa Ana, its officers,employees, agents, and Volunteers (name of person or organization) Additional premium in the amount of$25.00 will be retained by us regardless of any early termination of this endorsement or the policy. All other policy provisions remain unchanged. i i i ADDL INSURED COPY AMEND DATE: 1 010 912 02 5 50461SWF01 ENDORSEMENT:2-3 CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number Project No. 25-6058 Santa Ana City Hall- Eighth Floor Bathroom Change Order Number 1 Renovations To Cabifornia Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE:THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER. Unless otherwise stated,rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY EXTRA WORK AT AGREED PRICE 1. To compensate the contractor for costs associated with upgrades to original scoped out materials and additional scope of work per PCO#01 TOTAL AGREED PRICE=$16,904.94 age I We -•. CITY OF SANTA ANA PUBLIC WORKS AGENCY w' CONTRACT CHANGE ORDER Project Number Project No. 25-6058 Santa Ana City Hall-Eighth Floor Bathroom Change Order Number Renovations To Cabifornia Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE:THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER Unless otherwise staled,rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY The compensation both time and cost set forth in this change order comprises the total compensation due the Contractor, ail Subcontractors,and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTAL COST THIS CHANGE ORDER: DECREASE $ _______________ INCREASE 16,904.94 By reason of this order the CONTRACT TIME completion will be adjusted as follows: Five (5) Working Days We the undersigned contractor have given careful consideration to the change proposed and hereby agree,if this proposal is approved,that we will provide all equipment,furnish all materials,except as may otherwise be noted above,and perform all service necessary for the worts above specified,and will accept as full payment therefor the prices shown above. Accepted,Date 01/23/2026 Contractor Cabifornia Inc. By Saeed Mohammadi Title President 41 Approval recommended by r.i Date zo Z-� CTWG PO VC WORKS AGENCY TIVt:DIRECTOR Approved by 77pp Date "ta CITY MANAGER Attest: Date ;mod 111uvato CLERK Page 2 of 2