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HomeMy WebLinkAboutA'S CONSTRUCTION (BRUCE ANDERSON ENTERPRISES, INC.) INSURANCE ON FILE WORK WY PROCLED UNIO INS11F NC' F.Yi Dill. o DEC 18 2025 CITY OF SANTA ANA PWA(2) CONSTRUCTION CONTRACT OICM 6aln0(Dz) PROJECT26-2602 SANDPOINTE RESURFACING This CONSTRUCTION CONTRACT is made and entered into this 22 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 Bruce Anderson Enterprises, Inc., doing business as A's Construction(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 Sandpointe Resurfacing 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 and Sixty-Nine Thousand Dollars and No Cents ($169,000.00), 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. rcv.09i0112017 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. 6. 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.pd 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, fumish 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 performed 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 ANA r, IF L ALVARO NUNEZ City Cl k City Manager APPROVED AS TO FORM: SONIA R. CARVALHO CONTRACTOR: City Attorney A's Construction f fI By- KYLE NELLESEN ANDRES AGUILAR Assistant City Attorney CEO RECOMMENDED FOR APPROVAL: 'R6D0ff010STS, PE Acting Executive Director Public Works Agency Page 3 of 3 a DATE(MMlDD1YYYY)AC� CERTIFICATE OF LIABILITY INSURANCE 121212025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Bonnie Me for SHIS-Colossus-Alkeme Insurance PHONE 619 908 6351 FArAXX 1204 E Yorba Linda Blvd (A No): Placentia CA 92870 ADDRESS: bme for alkemeins.com INSURERS AFFORDING COVERAGE NAIC 1f INSURER A:National Fire&Marine Insurance Company 20079 INSURED BRUCAND-03 INSURER B:State Compensation Insurance Fund of California 35076 Bruce Anderson Enterprises, Inc, dba A's Construction 1662 West McFadden Ave msuRERc:Associated Industries Insurance Company, Inc. 23140 Santa Ana CA 92704 INSURER D:Ategrity Specialty Insurance Cornpanv 16427 INSURER E:Scottsdale Insurance Company 41297 INSURER F: COVERAGES CERTIFICATE NUMBER:1149131948 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MW�bmYY MMIDDIYYYY LIMITS C X COMMERCIALGENERALLIABILITY AES125773501 11/1812025 11/18/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADEFRI OCCUR DAMAGETORENTEO PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 POLICY ]JEOT LOG PRODUCTS-COMP/CPAGG $2,000,000 OTHER: 1 $ A AUTOMOBILE LIABILITY 72APS123295 1/10/2025 1/10/2026 COMI INRDSINGLELIMIT $1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED Ix SCHEDULED BODILY INJURY(Per sccldent) $ AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident E UMBRELLA LIAR X OCCUR CXS4067120 10/21/2025 11/18/2026 EAGH OCCURRENCE $2,000,000 X EXCESSLIAB CLAIMS-MADE AGGREGATE $2,000,000 ❑EO I X I RETENTION $ B WORKERSCOMPENSATION 9352130 1/1012025 1/10/2026 X STATUTE OTRH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETORIPARTNEPJEXECUTIVE TI NIA R.L.EACH ACCIDENT $1,000,000 OFFICE RIMEMBEREXCLUDED? (Mandatory In NH) R.L.DISEASE-RA EMPLOYEE $1,000,000 If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 O Pollution Llabilty G48784586 001 10/612025 10/6/2026 Each Condition 1,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) The City of Santa Ana,its officers,Officials,employees and volunteers are named as Additional Insureds applies per CG 2033 0413&CG 2037 0704 On a Primary and Non-Contributory basis per attached form NXGL009 0809 and waiver of subrogation applies per attached form CG 2404 0509 as respects to General Liability coverage per attached forms and are required by written contract with the named insured prior to an occurrence and subject to policy terms and conditions as respects to insureds operations. The City of Santa Ana,its officers,officials,employees and volunteers are named as Additional Insureds applies per attached form M58870817 and waiver of subrogation applies per attached form M5144a0607as respects to business auto liabillty coverage and are required by written contract with the named insured prior to an occurrence and subject to policy terms and conditions as respects to insureds operations. See Attached... CERTIFICATE HOLDER CANCELLATION APPROVED J Fran Nguyen.af 9 94•am�.Dec-03,2025 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. Public Works Agency-Parks, Fleet, &Facilities S Digitally signed 20 Civic Centre Plaza M-11 AUTHORIZED REPRESENTATIVE p� Nguyen Santa Ana CA 92701 �Q I V g t lyel l 09 to 24-090' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and-logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE AGENCY CUSTOMER ID: BRUCAND-03 _ LOC#: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED BHIS-Colossus-Alkeme Insurance Bruce Anderson Enterprises,Inc.dba As Construction 1662 West McFadden Ave POLICY NUMBER Santa Ana CA 92704 CARRIER NAIC COpE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL,REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 26 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Work Comp waiver of subrogation applies per attached form 10171 4-18 as respects to insureds operations. *30 days notice of cancellation except 10 days for non-payment of premium. Subject to all policy terms,conditions and exclusions. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN 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 'I• "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 against additional insured: any insured allege negligence or other wrongdoing 1. Only applies to the extent permitted by law; in the supervision, hiring, employment, training or and monitoring of others by that insured, if the 2. Will not be broader than that which you are "occurrence" which caused the "bodily injury' or required by the contract or agreement to "property damage", or the offense which caused provide for such additional insured. the "personal and advertising injury", involved the rendering of or the failure to render any A person's or organization's status as an professional architectural, engineering or additional insured under this endorsement ends surveying services. when your operations for that additional insured are completed. CG 20 33 04 13 ©insurance Services Office, Inc., 2012 Page 1 of 2 M-5887(0812017) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE—ADDITIONAL INSURED: City of Santa Ana,its City Council,officers,off Parks,Fleet,Facilities&Refuse 20 Civic Center Plaza,M-11 Santa Ana,CA 92701 A. In consideration of payment of the additional premium listed below, LIABILITY COVERAGE is extended to Include the additional insured named herein, provided that: 1) such insurance applies only to the ownership, maintenance or use of a covered"auto';and 2) such insurance applies only to acts or omissions by you,your agents or your"employees"while such covered auto is being used In your business; and 3) such insurance does not apply to the acts or omissions of the additional insured or any of the additional insured's agents or"employees"other than you;and 4) such insurance does not apply if the additional insured is subject to motor carrier insurance requirements and is not insured for hired"autos"under an"auto"liability insurance form that insures on a primary basis the owners of the"autos"and their agents and"employees"while the"autos"are being used exclusively In the additional insured's business and pursuant to operating rights granted to the additional insured by a public authority. B. The insurance afforded to such additional insured: 1) Applies only to the extent permitted by law; and 2) Will not be broader than that which you are required by a contract or agreement to provide for such additional insured. C. The most we will pay on behalf of the additional insured is the lesser of the amount of insurance: 1) That you are required by a contract or agreement to provide for such additional insured;or 2) That is available under the applicable Limits of Insurance shown in the Declarations. All other terms, conditions and agreements remain unchanged. Additional Premium: $ 11 Company Name Policy Number 72 APS 123295 National Fire&Marine Insurance Company Endorsement Effecilve 11/05/2025 3:06 PM Named Insured Countersigned by BRUCE ANDERSON ENTERPRISES INC (Authorized Representative) (The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy.) M-5887(0812017) 11/21/2025 POLICY NUMBER 72 APS 123295 M-5144a(01112007) WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: 11/0512025 3:0$PM Named Insured: BRUCE ANDERSON ENTERPRISES INC (Authorized Representative) SCHEDULE Name Of Person(s)Or Organization(s): City of Santa Ana,Its City Council,officers,off Parks,Fleet, Facilities&Refuse 20 Civic Center Plaza,M-11 Santa Ana,CA 92701 Additional Premium $ 11 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s)or organiza- tion(s)shown in the Schedule. We will retain the additional premium shown above, regardless of any early termi- nation of this endorsement or the policy. Includes copyrighted material of Insurance Services Office.Inc.with its permission, M-5144a(0612007) POLICY NUMBER:AES1257735 01 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 All persons or organizations where written contract Various with the Named Insured requires additional insured completed operations coverage. This form does not apply to your work on residential property. 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard". CG 20 37 07 04 01SO Properties, Inc., 2004 Page 1 of I El POLICY NUMBER:AES1257735 01 COMMERCIAL GENERAL LIABILITY NX GI_009 08 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTING INSURANCE (THIRD-PARTY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Third Party: All persons or organizations where required by written contract with the Named Insured (Absence of a specifically named Third Party above means that the provisions of this endorsement apply as required by written contractual agreement with any Third Party for whom you are performing work.) Paragraph 4. of SECTION IV: COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance: With respect to the Third Party shown above,this insurance is primary and non-contributing. Any and all other valid and collectable insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for loss covered by this policy, shall in no instance be considered as primary, co-insurance, or contributing insurance. Rather, any such other insurance shall be considered excess over and above the insurance provided by this policy. NX GL 009 08 09 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission POLICY NUMBER:AES1257735 01 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations where required b written contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions., We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or"your work" done under a contract with that person or organization and included in the"products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 ENDORSEMENT AGREEMENT STATE WAIVER OF SUBROGATION BLANKET BASIS 9352130-25 FUND RENEWAL SP HOME OFFICE B-73-18-68 SAN FRANCISCO EFFECTIVE JANUARY 10, 2025 AT 12. 01 A.M. PAGE 1 OF 1 ALLEFFEcriVE DATES ARE AND EXPIRING JANUARY 10, 2026 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME A'S CONSTRUCTION 1662 W MCFADDEN AVE SANTA ANA, CA 92704 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 OMER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION BLANKET WAIVER OF FOR WHOM THE NAMED INSURED SUBROGATION HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: �� JANUARY 13, 2025 2572 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO SCIF FORM 10217 (REV.4.2018) OLD DP 217