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HomeMy WebLinkAboutCLR DESIGN, INC. INSURANCE ON FILE WORK WY PROCEED IV-2025-290 �JPl1lL I;;SUf„;NCB EriE'i;�S CITY LERK DWE DEC 1 8 2075 flPwFi ty) 7anotkhOtl Avial;(Dz) AGREEMENT WITH CLR DESIGN, INC. FOR DESIGN SUPPORT SERVICES THIS AGREEMENT is made and entered into on this 17th day of October, 2025 by and between CLR Design, Inc., a Pennsylvania corporation,("Consultant"),and the City of Santa Ana,a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of design services to be provided for completion of the Giant Otter Project at the Santa Ana Zoo. B. Consultant represents that it is able and willing to provide such services to the City. D. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows; 1. SCOPE OF SERVICES Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in Scope of Services - Exhibit A, attached hereto and incorporated by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit A. The total amount to be expended during the term of this Agreement shall not exceed$18,920. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. City and Consultant agree that all payments due and owing under this Agreement shall be made through Automated Clearing House (ACH)transfers. Consultant agrees to execute the City's standard ACH Vendor Payment Authorization and provide required documentation. Upon verification of the data provided, the City will be authorized to deposit payments directly into Consultant's account(s) with financial institutions. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. Page 1 of 8 3. TERM This Agreement shall commence on the date first written above and shall end on December 31, 2025, unless terminated earlier in accordance with Section 16, below. The City shall have the option to extend this Agreement for one additional six(6) month term, exercisable upon a writing executed by the City Attorney and City Manager. 4. PREVAILING WAGES Consultant is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on"public works"and"maintenance"projects. If the services being performed are part of an applicable"public works"or"maintenance"project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Consultant agrees to fully comply with such Prevailing Wage Laws. Consultant shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 5. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes,which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. Page 2 of 8 7. INSURANCE Insurance requirements are attached hereto as Exhibit B. 8. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel,and representatives from liability: (1) for personal injury,damages,just compensation,restitution,judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and(2) from any claim that personal injury, damages,just compensation, restitution,judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages,just compensation,restitution,judicial or equitable relief suffered,or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution,judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding.Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8,the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent,trademark, or copyright infringement,including costs,contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 10. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents,proceedings, and activities related to this Agreement for a period of three Page 3 of 8 (3) years from the date of final payment to Consultant under this Agreement. 11. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information"shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that(a) has been disclosed in publicly available sources; (b) is,through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or(e) is independently developed by the Consultant without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE a. Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. b. No immediate family members of either the Mayor, City Council Member, or any appointed City Official, including appointed board and commission members, as defined under the City's Municipal Code, whose position with the City shall award or influence the award of this Agreement, or any competing contract or amendment thereof, shall be employed in any capacity by the Consultant or have any other direct or indirect financial benefit or interest in this Agreement. c. The section also prohibits the awarding of any agreement, contract, grant, or any amendment to those awards, to any former full-time employee for one-year from date of employee separation except for any CalPERS retiree as authorized by City Council resolution d. The Consultant must comply with all conflict of interest laws, ordinances, and regulations now in effect or hereafter to be enacted during the term of this Agreement. The Consultant warrants that it is not now aware of any facts which conflict with the prohibitions defined above. If the Consultant hereafter becomes aware of any facts that might reasonably be expected to create a conflict of interest, it must immediately make full written disclosure of such facts to the City. Full written disclosure must include, but is not limited to, identification of all persons implicated and a complete description of all relevant circumstances. Failure to comply with the provisions of this paragraph will be a material breach of this Agreement. Page 4 of 8 c. Consultant covenants that none of its directors, officers, employees, or agents shall participate in selecting or administrating any subcontract supported(in whole or in part) by City funds stemming from the Agreement where the awarding of the subcontract has any direct or indirect financial benefit or interest to any individual, as defined in subsections (b) and (c) above. 13. NON-DISCRIMINATION Consultant shall not discriminate because of race,color,creed,religion,sex,marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto,the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to,the terms and conditions hereof, shall not bind or obligate Consultant or the City.Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. 15. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 16. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to Page 5 of 8 deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 17. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy.No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 18. JURISDICTION-VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 19. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 20. NOTICE Any notice,tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section,to the following persons: To City: City Clerk City of Santa Ana 20 Civic Center Plaza(M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Page 6 of 8 With courtesy copies to: Executive Director, Public Works Agency City of Santa Ana 20 Civic Center Plaza (1\4-23) P.O. Box 1988 Santa Ana, California 92702 To Consultant: CLR Design,Inc. Attn: Gregg Leicester 34921 Calle Del Sol Capistrano Beach, CA 92624 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four(24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 21. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [signature page to follow] Page 7 of 8 IN WITNESS WHEREOF,the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF NTA AN ennifer 11 '' �f` Alvaro Nunez City Cle City Manager APPROVED AS TO FORM: SONIA R. CARVALHO CONSULTANT: City Attorney By: Kyle�f llesen Zjregg Leicester Assistant City Attorney Principal RECOMMENDED FOR APPROVAL: Ro af osas, .E. Acting Executive Director Public Works Agency Page 8 of 8 E r D E S I G N EXHIBIT DESIGN - ARCHITECTURE LANDSCAPE ARCHITECTURE mark e.beauchamp,asla•gregoryj.dykstra,aia jon stefansson,asla• gregg b. leicester,asla September 9, 2025 Jonathon Aguirre, EIT Assistant Engineer City of Santa Ana -Public Works Agency 20 Civic Center Plaza Santa Ana, CA 92701 Sent via email Re: Giant Otter Project Final Services Proposal Dear Jonathon, We appreciate the opportunity to submit this proposal for the final work effort in support of the Giant Otter Project at the Santa Ana Zoo. • Work to be Completed: Site visits, OAC meeting attendance, construction-related correspondence, and project closeout. • Fees & Expenses: Based on the final work described above, we propose the following modifications to our fees and expenses: Consultant Scope Additional Fees this Amendment CLR Design Architecture, $18,920 Landscape Architecture,Exhibit Design,Project Management Subtotal $18,920 We look forward to continuing our work with you on this exciting project. Sincerely, Gr dspe cester La Architect, Principal cc: Kelsey Weber Karen Marshall t 215.564.0250 If 215.564.1154 www.Cirdesign.com 833 chestnut street,suite 1000 philadelphia,pa 19107 34921 calle del sol • Capistrano beach,ca 92651 EXHIBIT B Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require any subcontractors to obtain and maintain insurance as described below for the entire Term of this Agreement against claims for injuries to persons or damage to property which may arise from or in connection with services, products and materials supplied to City.Total cost of such insurance shall be borne by Consultant. MINIMUM SCOPE AND LIMIT OF INSURANCE 1. Commercial General Liability(CGL): Insurance Services Office Form CG 00 01covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal &advertising injury with limits no less than$1,000,000 per occurrence and $2,000,000 aggregate. Required policy limits can be met with primary and umbrella/excess insurance policies. 2. Automobile Liability(AL): Insurance Services Office Form CA 00 01 covering Code 1(any auto), with limits no less than $1,000,000 combined single limits. In the event Consultant does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance. 3. Workers'Compensation(WC):as required by the State of California,with Statutory Limits, and Employer's Liability Insurance with limit of no less than$1,000,000 per accident, policy or employee,for bodily injury or disease, Coverage is not required if Consultant has no employees and signs request to waive such insurance. 4. Professional Liability(PL):with limits no less than$1,000,000 per occurrence or claim, and $2,000,000 aggregate. If Consultant maintains broader coverage and/or higher limits than the minimum requirements for each line of coverage shown above,City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Consultant.Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions The above required insurance policies are to contain or be endorsed to contain the following provisions: 1. City, its City Council, its officers,officials, employees, agents, and volunteers are to be covered as additional insureds, under Consultant's CGL and AL policies,with respect to any liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, equipment, and personnel furnished in connection with such work or operations. 2. Consultant's Insurance company(ies) agrees to waive all rights of subrogation against City, its City Council, its officers,officials, employees, agents, and volunteers for losses paid under the terms of Consultant's CGL,AL, and WC policies which arise from work performed by Consultant under this Agreement. 3. For any claims related to this contract,Consultant's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials,employees, agents, or volunteers shall not contribute with it. 4. A severability of interest provision must apply for all the additional insureds, ensuring that Consultant's insurance shall apply separately to each insured against whom a claim is made or suit is brought,except with respect to the insurer's limits of liability. 5. Insurance policies required herein shall provide that coverage shall not be canceled,suspended, voided, reduced in coverage or in limits, non-renewed by the carrier,or materially changed except after thirty(30)days prior written notice has been given to City.Ten (10)days prior written notice shall be provided to City for policy cancellation or non-renewal due to non- payment of premium. 6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention:Jonathon Aguirre,20 Civic Center Plaza (M-11),Santa Ana,CA 92702.The name and location of project must be included in the Description of Operations section of each certificate. Self-Insured Retentions Self-insured retentions must be declared to and approved by the City.The City may require the Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations,claim administration, and defense expenses within the retention. Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the State of California with a current A.M. Best rating of no less than A:VII, unless otherwise acceptable to City. Verification of Coverage Consultant shall furnish City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements before work begins. However,failure to obtain the required documents prior to the work beginning shall not waive Consultant's obligation to provide them. City reserves the right to require complete,certified copies of all required insurance policies, including endorsements required by these specifications, at any time. Special Risks or Circumstances City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. Ac"® CERTIFICATE OF LIABILITY INSURANCE pATEIMMIDDIYYYYj 12/09/2025 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 bolder 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 endorsement(s). PRODUCER CONTACT Paul LUCCI NAME; Brown&Brown Insurance Services,Inc. PHONE (445)201-1625 FAX WC.No Ext: FAX NO: 107Audubon Rd E-MAIL aul.lucci bbrown,com ADDRESS: P INSURER(S)AFFORDING COVERAGE NAIC# Wakefield MA 018BO INSURER A: Travelers Property Casualty Company of America 25674 INSURED INSURER B: The Charter Oak Fire Insurance Company 25615 CLR Design,Inc INSURER C: The Standard Fire Insurance Company 19070 833 Chestnut St INSURER D: XL Specialty Insurance Company 37885 Suite 909 INSURER E: Philadelphia PA 19107 INSURER F: COVERAGES CERTIFICATE NUMBER: 25-26 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM,DDmYY MMJDDNY POLICY Y1 LIMITS X COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED- CLAIMS-MADE FX—I OCCUR PREMISES Eaoccuence $ 9,000,000 MED EXP fAny one person) $ 10,000 A Y Y 6802J979064 07/11/2025 07/1112026 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY 19 JECT LJ LOG PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y Y BA9R272273 07/11/2025 07/11/2026 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED Ix NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR $ 5,000,000 EACH OCCURRENCE A EXCESS LIAB CLAIMS-MADE CUP6736Y412 07/11/2025 07/11/2026 AGGREGATE $ 5,000,000 DIED X RETENTION $ 10,000 $ WORKERS COMPENSATION X STATUTE ORH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y!N E.L,EACH ACCIDENT $ 1,000.000 C OFFICER/MEMBER EXCLUDED? FR NIA Y UB7K189676 07/11l2025 07l1112026 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,OD0,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability Each Claim $4,000,000 D DPR5045978 07/11/2025 07/11/2026 Aggregate $4,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required) RE:City of Santa Ana Agreement#A-2D21-060. DIgiullysl ed City of Santa Ana,its officers,employees,agents and representatives are named as additional insured as respects general liability and auto liability for TU Tran hyTuTran Nguyen services provided by the named insured. Coverage is primary and non-contributory.30 days notice of cancellation applies. Additional Insured Nguyen D te:2025 2.09 endorsements attached.(CG T8 02 07 22&CG T8 03 07 22). Waiver of Subrogation applies to the General Liability(See endorsements CG T1 00 02 19, 14:570-0'00' Page 16,Paragraph a and CG D3 79 01 16,Page 5,Paragraph Q.),Sulo Liability and Workers Compensation. APPROVED CERTIFICATE HOLDER CANCELLATION 8y Tu?°ran Nguyen at 2.37 p 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 PROVIStONS. Attention: PWA 20 Civic Center Plaza,M-11 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 °_ O 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:080-2J979064 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II -- Who Is An Insured is amended to in- location designated and described in the schedule of chide as an additional insured the person(s) or or- this endorsement performed for that additional in- ganization(s) shown in the Schedule, but only with sured and included in the "products-completed opera- respect to liability for "bodily injury" or "property darn- tions hazard". age" caused, in whole or in part, by"your work" at the CG20370704 CG TS 02 07 25 © ISO Properties, Inc., 2004 DATE OF ISSUE: 05/30/2025 Page a. of 1 POLICY NUMBER:680-2J979064 COMMERCIAL GENERAL LIABILITY 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 Names of Additional Insured Person(s) or Organization(s): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part, provided that such written contract was signed by you before,and is in effect when, the"bodily injury"or"property damage"occurs or the"personal injury"or"advertising injury"offense is committed. Location of Covered Operations, Any project to which a written contract with the Additional Insured Person(s)or Organization(s) in the Schedule applies. (information required to complete this Schedule, if not shown above,,will be shown in the Declarations.) A. Section II y--Who Is An Insured is amended to in- This insurance does not apply to "bodily injury" or elude as an additional insured the person(s) or "property damage" occurring, or "personal injury" organizations) shown in the Schedule, but only or "advertising injury" arising out of an offense with respect to liability for"bodily injury", "property committed,after: damage", "personal injury" or "advertising injury" 1. All work, including materials, parts or equip- caused, in whole or in part, by: meat.furnished in connection with such work, 1. Your acts or omissions; or on the project (other than service, mainte- 2. The acts or omissions of those acting on your nance or repairs) to be performed by or on behalf; behalf of the additional insureds) at the loca- tion of the covered operations has been com- in the performance of your ongoing operations for pleted; or the additional insured(s) at the iocation(s) desig- nated above. 2. That portion of "your work" out of which the B. With respect to the insurance afforded to these injury or damage arises has been put to its In- tended use by any person or organization additional insureds, the following additional exclu- other than another contractor or subcontrac. sions apply: for engaged in performing operations for a principal as a part of the same project. CG D3 61 03 05 Copyright 2005 The St. Paul Travelers Companies, Inc.All rights reserved. CO T8 03 07 2 jncludes copyrighted material of Insurance Services Office, Inc,with its permission. DATE OF ISSUE* 05/30/2025 Page 1 of 1 COMMERCIAL GENERAL LIABILITY occupational therapist or occupational that is available to any of your "employees" therapy assistant, physical therapist or for "bodily injury" that arises out of providing speech-language pathologist; or or failing to provide "incidental medical (b) First aid or "Good Samaritan services" services" to any person to the extent not by any of your"employees" or "volunteer subject to Paragraph 2.a.(1) of Section Il — workers", other than an employed or Who Is An Insured. volunteer doctor. Any such "employees" K. MEDICAL PAYMENTS--INCREASED LIMIT or "volunteer workers" providing or failing to provide first aid or "Good Samaritan The following replaces Paragraph 7. of services" during their work hours for you SECTION III—LIMITS OF INSURANCE: will be deemed to be acting within the 7. Subject to Paragraph 5. above, the Medical scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of "bodily injury" sustained by any 3. The following replaces the last sentence of one person, and will be the higher of: Paragraph 5. of SECTION III — LIMITS OF a. $10,000; or INSURANCE: For the purposes of determining the b. The amount shown in the Declarations of applicable Each Occurrence Limit, all related this Coverage Part for Medical Expense acts or omissions committed in providing or Limit. failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or "Good Samaritan CONDITION—PROFESSIONAL LIABILITY services" to any one person will be deemed to be one"occurrence". The following is added to Paragraph 4.b., 4. The following exclusion is added to Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY Paragraph z., Exclusions, of SECTION I — CONDITIONS: COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE This insurance is excess over any of the other LIABILITY: insurance, whether primary, excess, contingent or on any other basis, that is Professional Sale Of Pharmaceuticals Liability or similar coverage, to the extent the "Bodily injury" or "property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of pharmaceuticals committed by, or with the M. BLANKET WAIVER OF SUBROGATION — knowledge or consent of the insured. WHEN REQUIRED BY WRITTEN CONTRACT 5. The following is added to the DEFINITIONS OR AGREEMENT Section: The following is added to Paragraph S., Transfer Of Rights Of Recovery Against Others To Us, Incidental medical services means: of SECTION IV -- COMMERCIAL GENERAL a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS: ray or nursing service or treatment, If the insured has agreed in a written contract or advice or instruction, or the related agreement to waive that insured's right of furnishing of food or beverages; or recovery against any person or organization, we b. The furnishing or dispensing of drugs or waive our right of recovery against such person medical, dental, or surgical supplies or or organization, but only for payments we make appliances, because of: 6. The following is added to Paragraph 4.b., a. "Bodily injury" or "property damage" that Excess Insurance, of SECTION IV — occurs; or COMMERCIAL GENERAL LIABILITY CONDITIONS: b. "Personal and advertising injury" caused by This insurance is excess over any valid and an offense that is committed; collectible other insurance, whether primary, subsequent to the signing of that contract or excess, contingent or on any other basis, agreement. CG D3 79 02 19 0 2017 The Travelers Indemnity Company,All rights reserved. Page 5 of 6 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARCHITECTS, ENGINEERS AND SURVEYORS COVERAGE XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured K. Additional Insured--Lessor Of Leased Equipment B. Incidental Medical Malpractice L. Additional Insured — State Or Political C. Reasonable Force — Bodily Injury Or Property Subdivisions—Permits Relating To Premises Damage M. Additional Insured — State Or Political D. Non-Owned Watercraft-- Increased To Up To 75 Subdivisions--Permits Relating To Operations feet N. Who Is An Insured — Newly Acquired Or Formed E. Aircraft Chartered With Crew Organizations F. Damage To Premises Rented To You O. Knowledge And Notice Of Occurrence Or Offense G. Malicious Prosecution — Exception To Knowing P. Unintentional Omission Violation Of Rights Of Another Exclusion Q. Waiver Of Transfer Of Rights Of Recovery H. Medical Payments— Increased Limit Against Others To Us When Required By Written 1. Increased Supplementary Payments Contract J. Additional Insured — Owner, Manager Or Lessor R. Amended Insured Contract Definition — Railroad Of Premises Easement PROVISIONS Unless you are in the business or occupation A. BROADENED NAMED INSURED of providing professional health care services, "occurrence" also means an act or omission 1. The following is added to SECTION II—WHO committed in providing or failing to provide IS AN INSURED: first aid or "Good Samaritan services" to a Any organization, other than a partnership or person. joint venture, over which you maintain 2, The following is added to the DEFINITIONS ownership or majority interest on the effective Section: date of the policy qualifies as a Named Insured. However, coverage for any such "Good Samaritan services" means any additional organization will cease as of the emergency medical services for which no date during the policy period that you no compensation is demanded or received. longer maintain ownership of, or majority 3. The following is added to Paragraph 2.a.(1) of interest in, such organization. SECTION II—WHO IS AN INSURED: B. INCIDENTAL MEDICAL MALPRACTICE Unless you are in the business or occupation 1. The following is added to the definition of of providing professional health care services, "occurrence" in the DEFINITIONS Section: Paragraphs (1)(a), (b), (c) and (d) above CG D3 79 01 16 0 2016 The Travelers indemnity Company.All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY does not apply to any "bodily injury" arising insured. This exclusion does not apply to out of any providing or failing to provide first "bodily injury" or "property damage" resulting aid or "Good Samaritan services" by any of from the use of reasonable force to protect your "employees", other than an employed any person or property. doctor. Any such "employees" providing or D. NON-OWNED WATERCRAFT — INCREASED failing to provide first aid or "Good Samaritan TO UP TO 75 FEET services" during their work hours for you will be deemed to be acting within the scope of 1. The following replaces Paragraph (2) of their employment by you or performing duties Exclusion g., Aircraft, Auto Or Watercraft, related to the conduct of your business. in Paragraph 2. of SECTION I — 4. The following exclusion is added to COVERAGES — COVERAGE A BODILY Paragraph 2., Exclusions, of SECTION I -- INJURY AND PROPERTY DAMAGE COVERAGES — COVERAGE A BODILY LIABILITY: INJURY AND PROPERTY DAMAGE (2) A watercraft you do not own that is: LIABILITY in COVERAGES: (a) Less than 75 feet long; and Sale of Pharmaceuticals (b) Not being used to carry any person or "Bodily injury" or "property damage" arising property for a charge; out of the willful violation of a penal statute or 2. The following is added to Paragraph 2. of ordinance relating to the sale of SECTION 11—WHO IS AN INSURED: pharmaceuticals committed by, or with the Any person or organization that, with your knowledge or consent of, the insured. express or implied consent, either uses or is S. The following is added to Paragraph S. of responsible for the use of a watercraft that SECTION III—LIMITS OF INSURANCE: you do not own that is: For the purposes of determining the (a) Less than 75 feet long; and applicable Each Occurrence Limit, all related (b) Not being used to carry any person or acts or omissions committed in the providing property for a charge; or failing to provide first aid or "Good Samaritan services"to any one person will be 3. The following is added to Paragraph 4.b., considered one"occurrence", Excess Insurance, of SECTION IV — 6. The following is added to Paragraph 4.b., COMMERCIAL GENERAL LIABILITY Excess Insurance, of SECTION IV — CONDITIONS: COMMERCIAL GENERAL LIABILITY This insurance is excess over any valid and CONDITIONS: collectible other insurance, whether primary, This insurance is excess over any valid and excess, contingent or on any other basis, that is available to the insured for "bodily injury" collectible other insurance, whether primary, that arises out of the use of a watercraft that excess, contingent or on any other basis, that you do not own that is: is available to any of your "employees" for "bodily injury" that arises out of providing or (a) Less than 75 feet long; and failing to provide first aid or "Good Samaritan (b) Not being used to carry any person or services" to any person to the extent not property for a charge. subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. E. AIRCRAFT CHARTERED WITH CREW C. REASONABLE FORCE — BODILY INJURY OR 1• The following is added to Exclusion g., PROPERTY DAMAGE Aircraft, Auto Or Watercraft, in Paragraph The following replaces Exclusion a., Expected Or 2. of SECTION I — COVERAGES — Intended Injury, in Paragraph 2. of SECTION I — COVERAGE A BODILY INJURY AND COVERAGES — COVERAGE A BODILY PROPERTY DAMAGE LIABILITY in COVERAGES: INJURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft a. Expected Or Intended injury Or Damage that is: "Bodily injury" or "property damage" expected or intended from the standpoint of the (a) Chartered with crew to any insured; Page 2 of 6 b 2016 The Travelers indemnity Company.All rights reserved. CG D3 79 01 16 COMMERCIAL GENERAL LIABILITY (b) Not owned by any insured; and 2. The following replaces Paragraph 6. of (c) Not being used to carry any person or SECTION III—LIMITS OF INSURANCE: property for a charge. Subject to 5. above, the Damage To 2. The following is added to Paragraph 4.b., Premises Rented To You Limit is the most we Excess Insurance, of SECTION IV — will pay under Coverage A for damages COMMERCIAL GENERAL LIABILITY because of "property damage" to any one CONDITIONS: premises while rented to you, or temporarily This insurance is excess over any valid and occupied by you with permission of the collectible other insurance, whether primary, owner, caused by fire; explosion; lightning; excess, contingent or on any other basis, that smoke resulting from such fire, explosion, or is available to the insured for use of an lightning; or water. The Damage To Premises aircraft that is: Rented To You Limit will apply to all damage proximately caused by the same (a) Chartered with crew to any insured; 'occurrence", whether such damage results (b) Not owned by any insured; and from: fire; explosion; lightning; smoke (c) Not being used to carry any person or resulting from such fire, explosion, or property for a charge. lightning; or water; or any combination of any of these. F. DAMAGE TO PREMISES RENTED TO YOU The Damage To Premises Rented To You 1. The following replaces the last paragraph of Limit will be the higher of: Paragraph 2., Exclusions, of SECTION I -- COVERAGES -� COVERAGE A BODILY a. $1,000,000; or INJURY AND PROPERTY DAMAGE b. The amount shown on the Declarations of LIABILITY in COVERAGES: this Coverage Part for Damage To Exclusions c. through n. do not apply to Premises Rented To You Limit. damage to premises while rented to you, or 3. The following replaces Paragraph a. of the temporarily occupied by you with permission definition of 'insured contract" in the of the owner, caused by: DEFINITIONS Section: a. Fire; a. A contract for a lease of premises, b. Explosion; However, that portion of the contract for a c. Lightning; lease of premises that indemnifies any person or organization for damage to d. Smoke resulting from such fire, explosion, premises while rented to you, or or lightning; or temporarily occupied by you with e. Water. permission of the owner, caused by: A separate limit of insurance applies to such (1) Fire; damage to premises as described in (2) Explosion; Paragraph 6, of Section III — Limits Of Insurance. This insurance does not apply to (3) Lightning; damage to premises while rented to you, or (4) Smoke resulting from such fire, temporarily occupied by you with permission explosion, or lightning; or of the owner, caused by; (5) Water, a. Rupture, bursting, or operation of is not an "insured contract`; pressure relief devices; 4. The following replaces Paragraph 4.b.(1)(b) b. Rupture or bursting due to expansion or of SECTION IV-- COMMERCIAL GENERAL swelling of the contents of any building or LIABILITY CONDITIONS: structure, caused by or resulting from water; or (b) That is insurance for premises rented to c. Explosion of steam boilers, steam pipes, you, or temporarily occupied by you with steam engines, or steam turbines. the permission of the owner; CG D3 79 01 16 0 2016 The Travelers indemnity Company.All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. MALICIOUS PROSECUTION — EXCEPTION TO insured, but only with respect to liability for "bodily KNOWING VIOLATION OF RIGHTS OF injury", "property damage", "personal injury" or ANOTHER EXCLUSION "advertising injury" that: The following is added to Exclusion a., Knowing a. Is "bodily injury" or"property damage" caused Violation Of Rights Of Another, in Paragraph 2, by an 'occurrence" that takes place, or of SECTION I — COVERAGES — COVERAGE B "personal injury" caused by an offense that is PERSONAL AND ADVERTISING INJURY committed, after you have signed that LIABILITY: contract: and This exclusion does not apply to "personal injury" b. Arises out of the ownership, maintenance or caused by malicious prosecution. use of that part of any premises leased to you H. MEDICAL PAYMENTS—INCREASED LIMIT under that written contract. The following replaces Paragraph 7. of SECTION The insurance provided to such premises owner, III—LIMITS OF INSURANCE: manager or lessor is subject to the following 7. Subject to S. above, the Medical Expense provisions: Limit is the most we will pay under Coverage a. The limits of insurance provided to such C. for all medical expenses because of premises owner, manager or lessor will be "bodily injury" sustained by any one person, the limits which you agreed to provide in the and will be the higher of: written contract, or the limits shown on the (a) $10,000; or Declarations of this Coverage Part, whichever are less. (b) The amount shown on the Declarations of this Coverage Part for Medical Expense b. The insurance provided to such premises Limit. owner, manager or lessor does not apply to: I. INCREASED SUPPLEMENTARY PAYMENTS (1) "Bodily injury" or "property damage" caused by an "occurrence" that takes 1. The following replaces Paragraph 1.b. of place, or "personal injury" caused by an SUPPLEMENTARY PAYMENTS -- offense that is committed, after you COVERAGES A AND B of SECTION I — cease to be a tenant in that premises: or COVERAGES: b. Up to $2,500 for cost of bail bonds (2) Structural alterations, new construction or demolition operations performed by or on required because of accidents or traffic behalf of such premises owner, manager law violations arising out of the use of any or lessor. vehicle to which the Bodily Injury Liability Coverage applies. We do not have to c. The insurance provided to such premises furnish these bonds. owner, manager or lessor is excess over any 2. The following replaces Paragraph 1.d. of valid and collectible other insurance available SUPPLEMENTARY PAYMENTS — to such premises owner, manager or lessor, COVERAGES A AND B of SECTION I — unless you have agreed in a written contract COVERAGES: for this insurance to apply on a primary or contributory basis. d. All a expenses incurred by the K. ADDITIONAL INSURED--LESSOR OF LEASED insuredred att our our request to assist us in the . EQUIPMENT investigation or defense of the claim or "suit", including actual loss of earnings up The following is added to SECTION II —WHO IS to $500 a day because of time off from AN INSURED: work. Any person or organization that is an equipment J. ADDITIONAL INSURED — OWNER, MANAGER lessor and that you have agreed in a written OR LESSOR OF PREMISES contract to name as an additional insured on this The following is added to SECTION II —WHO IS Coverage Part is an insured, but only with respect AN INSURED: to liability for "bodily injury", "property damage", Any person or organization that is a premises "personal injury" or"advertising injury"that: owner, manager or lessor and that you have a. Is "bodily injury" or"property damage" caused agreed in a written contract to name as an by an `occurrence" that takes place, or additional insured on this Coverage Part is an "personal injury" caused by an offense that is Page 4 of 6 02016 The Travelers Indemnity Company.All rights reserved. CG D3 79 0116 COMMERCIAL GENERAL LIABILITY committed, after you have signed that written M. ADDITIONAL INSURED — STATE OR contract; and POLITICAL SUBDIVISIONS — PERMITS b. Is caused, in whole or in part, by acts or RELATING TO OPERATIONS omissions of you or any person or The following is added to Paragraph 2, of organization performing operations on your SECTION II—WHO IS AN INSURED: behalf, in the maintenance, operation or use Any state or political subdivision that has issued a of equipment leased to you by such permit with respect to operations performed by equipment lessor. you or on your behalf is an insured, but only with The insurance provided to such equipment lessor respect to "bodily injury", "property damage", is subject to the following provisions: "personal injury" or "advertising injury" arising out of operations performed by you or on your behalf a. The limits of insurance provided to such for which that state or political subdivision has equipment lessor will be the limits which you issued such permit. However, no such state or agreed to provide in the written contract, or political subdivision is an insured for: the limits shown on the Declarations of this (1) "Bodily "property damage", Coverage Part,whichever are less; and injury",rY p pert Y g ", "personal injury" or "advertising injury" arising out of b. The insurance provided to such equipment operations performed for that state or political lessor does not apply: subdivision; or (1) To any "bodily injury" or "property (2) 'Bodily injury" or "property damage" included damage" caused by an "occurrence" that within the "products — completed operations takes place, or "personal injury" caused hazard". by an offense that is committed, after the N. WHO IS AN INSURED — NEWLY ACQUIRED equipment lease expires; or OR FORMED ORGANIZATIONS (2) if the equipment is leased with an The following replaces Paragraph 4.a. of operator. SECTION II—WHO IS AN INSURED: c. The insurance provided to such equipment a. Coverage under this provision is afforded lessor is excess over any valid and collectible only: other insurance available to such equipment (1) Until the 180th day after you acquire or lessor, unless you have agreed in a written form the organization or the end of the contract for this insurance to apply on a policy period, whichever is earlier, if you primary or contributory basis, do not report such organization in writing L. ADDITIONAL INSURED — STATE OR to us within 180 days after you acquire or POLITICAL SUBDIVISIONS — PERMITS form it; or RELATING T O PREMISES (2) Until the end of the policy period, when The following is added to Paragraph 2. of that date is later than 180 days after you SECTION 11—WHO IS AN INSURED: acquire or form such organizations, if you report such organization in writing to us Any state or political subdivision that has issued a within 180 days after you acquire or form permit in connection with premises owned or it. occupied by, or rented or loaned to, you, is an O. KNOWLEDGE AND NOTICE OF insured, but only with respect to "bodily injury", OCCURRENCE OR OFFENSE "property damage", "personal injury" or "advertising injury" arising out of the existence, The following is added to Paragraph 2., Duties In ownership, use, maintenance, repair, The Event of Occurrence, Offense, Claim Or construction, erection or removal of advertising Suit, of SECTION IV — COMMERCIAL signs, awnings, canopies, cellar entrances, coal GENERAL LIABILITY CONDITIONS: holes, driveways, manholes, marquees, hoist e. The following provisions apply to Paragraph away openings, sidewalk vaults, elevators, street a. above, but only for the purposes of the banners or decorations for which that state or insurance provided under this Coverage Part political subdivision has issued such permit. to you or any insured listed in Paragraph 1. or 2. of Section 11—Who is An Insured: CG D3 79 01 16 ©2016 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY (1) Notice to us of such "occurrence" or of an health insurer. This applies only if you offense must be given as soon as subsequently give notice to us of the practicable only after the "occurrence" or "occurrence" or offense as soon as offense is known to you (if you are an practicable after any of the persons individual), any of your partners or described in Paragraphs e. (1) or (2) members who is an individual (if you are a above discovers that the "occurrence" or partnership or joint venture), any of your offense may result in sums to which the managers who is an individual (if you are insurance provided under the Coverage a limited liability company), any of your Part may apply. trustees who is an individual (if you are P. UNINTENTIONAL OMISSION a trust), any of your"executive officers" or directors (if you are an organization other The following is added to Paragraph 6., than a partnership, joint venture, limited Representations, of SECTION IV -- liability company or trust), or any COMMERCIAL. GENERAL LIABILITY "employee" (such as an insurance, loss CONDITIONS: control or risk manager or administrator) The unintentional omission of, or unintentional authorized by you to give notice of an error in, any information provided by you which "occurrence"or offense, we relied upon in issuing this policy will not Knowledge by any other "employee" of an prejudice your rights under this insurance. "occurrence" or offense does not imply However, this provision does not affect our right that you also have such knowledge. to collect additional premium or to exercise our rights of cancellation or nonrenewal in (2) If you are a partnership, joint venture, accordance with applicable insurance laws or limited liability company or trust, and regulations. none of your partners, joint venture members, managers or trustees are Q. WAIVER OF TRANSFER OF RIGHTS OF individuals, notice to us of such RECOVERY AGAINST OTHERS TO U5 WHEN "occurrence" or offense must be given as REQUIRED BY WRITTEN CONTRACT soon as practicable only after the The following is added to Paragraph 8., Transfer "occurrence" or offense is known by: of Rights of Recovery Against Others to Us, of (a) Any individual who is: SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (i) A partner or member of any partnership or joint venture; We waive any right of recovery we may have against any person or organization because of (ii) A manager of any limited liability payments we make for injury or damage arising company; out of premises owned or occupied by or rented (iii)A trustee of any trust; or or loaned to you; ongoing operations performed (iv)An executive officer or director of by you or on your behalf, done under a written any other organization; contract with that person or organization; "your work"; or "your products". We waive this right that is your partner, joint venture where you have agreed to do so as part of a member, manager or trustee; or written contract signed by you prior to loss. (b) Any "employee" authorized by such R. AMENDED INSURED CONTRACT DEFINITION partnership, joint venture, limited —RAILROAD EASEMENT liability company, trust or other organization to give notice of an I• The following replaces Paragraph c. of the "occurrence" or offense. definition of "insured contract" in the DEFINITIONS Section: (3) Notice to us of such "occurrence" or offense will be deemed to be given as C. Any easement or license agreement; soon as practicable if it is given in good 2. Paragraph f.(1) of the definition of "insured faith as soon as practicable to your contract" in the DEFINITIONS Section is workers' compensation, accident, or deleted. Page 6 of 6 C 2016 The Travelers Indemnity Company.All rights reserved. CG D3 79 01 16 TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 00 03 13 (00)- 001 POLICY NUMBER: UB-7x189676-25-47-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DATE OF ISSUE: 05-27-25 STASSiGN: PAGE 1 OF COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following replaces Paragraph A.S., Transfer of required of you by a written contract executed Rights Of Recovery Against Others To Us, of the prior to any "accident" or"loss", provided that the CONDITIONS Section: "accident" or "loss" arises out of the operations S. Transfer Of Rights Of Recovery Against Oth- contemplated by such contract. The waiver ap- ers To Us plies only to the person or organization desig- We waive any right of recovery we may have nated in such contract, against any person or organization to the extent CA T3 40 02 15 ©2016 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following is added to Paragraph c. in A.1., Who between you and that person or organization, that is Is An Insured, of SECTION II — COVERED AUTOS signed by you before the "bodily injury" or "property LIABILITY COVERAGE in the BUSINESS AUTO damage" occurs and that is in effect during the policy COVERAGE FORM and Paragraph e. in A.1.,Who Is period, to name as an additional insured for Covered An Insured, of SECTION II — COVERED AUTOS Autos Liability Coverage, but only for damages to LIABILITY COVERAGE in the MOTOR CARRIER which this insurance applies and only to the extent of COVERAGE FORM, whichever Coverage Form is that person's or organization's liability for the conduct part of your policy: of another"insured". This includes any person or organization who you are required under a written contract or agreement CA T4 37 02 16 ©2016 The Travelers Indemnity Company.All rights reserved . Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission.