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HomeMy WebLinkAboutTAIT & ASSOCIATES, INC. F - A-2023-075-09A MAYOR f�� UZb .. CITY MANAGER Valerie Amezcua -a.is~ Alvaro Nunez MAYOR PRO TEM rl>- �,; CITY ATTORNEY David Penaloza MAY 11 2926 Sonia R.Carvalho COUNCILMEMBERS CITY CLERK Phil Bacerra , Jennifer L.Hall Johnathan Ryan Hernandez Jessie Lopez Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA o Pwwr t i-ivi s-l�x) PUBLIC WORKS AGENCY nA;GhfA�l D Y 20 Civic Center Plaza I PO Box 1988 Santa Ana,California 92702 www.santa-ana.org April 17, 2026 TAIT& Associates, Inc. Attn: Jacob Vandervis, VP& C.O.O. 701 Parkcenter Drive, Santa Ana, CA 92705 Re: Extension of Agreement No.A-2023-075-09 to provide on-call enzineering services Pursuant to Section 3 ("Term")of the above-referenced Agreement, entered into by TAIT&Associates, Inc. and the City of Santa Ana,which commenced on May 2,2023,the parties hereby exercise their option to extend the term of the Agreement for an additional one (1)year through May 1, 2027. Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely rr olfo Ro' , P.E. Acting Executive Director, Public Works Agency CITY SANT ATTEST = ` Alvaro Nunez nmi er L. a City Manager City Clerk APPROVED AS TO FORM CONSULTANT 4fe Nellesen By: David Sloan, PE Assistant City Attorney Title: Vice President - Director of Engineering SANTA ANA CITY COUNCIL Valerie Amezcua David Penaloza Thai Viet Phan Benjamin Vazquez Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez Mayor Mayor Pro Tem-Ward 6 Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 VamezWa(dl5anke-ana.ar0 dpenaIOZa,.nla=rp tphanpsanta-anaara hyaznuez0sanla-an8.orti Ie35ielopeZ(a>aanfa-anaArp phacerransanta-ana orp anherr_mandez(Osanlaana.orp CERTIFICATE OF LIABILITY INSURANCE DATE 0 911 1025 1912 0 2 5 THIS CERTIFICATE 1S 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 ACCOunts Team NAME: Scott&McCauley Insurance Agency PHONE (949)503-1953 FAX AIC No Ext: A1C,No 2 Ritz Carlton Drive E-MAIL COI@a sminsuranceagency.com ADDRESS: Suite 204 INSURER(S)AFFORDING COVERAGE NAIL tk Dana Point CA 92629 INSURER A: AXIS Surplus Insurance Company 26620 INSURED INSURER B: The Continental Insurance Company 35289 Tait&Associates,Inc INSURERC: Valley Forge Insurance Company 20508 701 Parkcenter Dr INSURER D: Colony insurance Company 39993 INSURER E: Santa CA 92705 INSURER F: COVERAGES CERTIFICATE NUMBER: TAlT MSTFR 25-26 REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TQTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSO WVD POLICY NUMBER MMIDDIYYYY) (MMIDDrffYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,OOC CLAIMS-MADE � OCCUR PREMISES Fa Occurrence $ 25,000 MED EXP(Any one person) S 5,000 A Y Y SP002747-08-2025 09/01/2025 09/0112026 PERSONAL&ADV INJURY s 2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER. GENERAL $AGGREGATE S 2,000,000 POLICY ❑X PRa.ECT ❑ LOC PROD 2,000,000 J OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT �. 1,000,000 Ea accident �( ANYAU70 BODILY INJURY(Per person) S B OWNED SCHEDULED Y Y 7034395486 0910112025 0910112C26 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIREO NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per aGGidertit UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE Y Y SX002748-08-2025 09/01/2025 09/01/2026 AGGREGATE $ 5,000.000 NDEO I I RETENTION S $ WORKERS COMPENSATION PER OTH YIN - AND EMPLOYERS'LIABILITY X STATUTE ER C ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S 1,000,O CO OFFICERIMEMBER EXCLUDED? NIA Y 7034395505 09/0112025 09101l2026 IMandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 Professional LiablContractors Pollutlon Profess/Poll Ea Claim 2,000,000 A/D Excess Liability SP002747-082025/EX04295007 09/0112025 09/01/2026 La Claim/Aggregate 4,000,000 X 51VI DESCRIPTION OF OPERATIONS 1 LOCATIONS r VEHICLES (ACORD 101,Addltional Remarks Schedule,maybe attached If more space is required) City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are additional insureds per written contract or agreement. The certificate holder is included as an Additional Insured as required by a written contract or agreement on the General Liability,Auto Liability,and Umbrella.Coverage is Primary&Non-Contributory when required by a written contract or agreement with the named insured.Blanket Waiver-of-Subrogation is granted in favor of the Additional Insured with respect to the General Liability,Auto Liability,and Workers'Compensation when required by written contract or agreement.Umbrella follows form over General liability,Auto liability,Employers liability,pollution and professional liability.Thirty(30)days' notice of cancellation with ten(10)days'notice for non-payment of premium is provided to the certificate holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Tu Tran ° 1rallysignedby THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN r�rran25.09,,2 ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana PWA-Facilities Nguyen �� Date:2925.9939 V g u ye n 082506-07W 20 Civic Center Plaza,M-ti AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 ©1988-2015ACORD CORPORATION. All rights reserved, ACORD 25(2018l03) APPROVEDare registered marks of ACORD By Tu Tran Nguyen at 8:24 am,Sep 29,2025 Endorsement No. 5 Effective Date: 09/01/2025@12:01 am.Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 Insured Name:Tait&Associates, Inc. Issuing Company:AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank,then the effective date of this Endorsement is the Inception Dote of the Policy. ADDITIONAL INSURED/PRIMARY COVERAGE INCLUDING COMPLETED OPERATIONS (CGL& CONTRACTORS POLLUTION COVERAGE) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the Specialty Package Policy. In consideration of the premium charged, it is agreed that: SECTION III—WHO IS AN INSURED is amended to include as an Additional Insured the person or organization shown in the schedule below as respects Coverages A, B and D, but only for liability arising out of Your Work or Covered Operations performed by you or on your behalf for that Additional Insured and not due to any actual or alleged independent liability of said Additional Insured. This endorsement does not apply to Bodily Injury. Property Damage or Loss arising out of the sole negligence or willful conduct of,or for defects in design furnished by the Additional Insured. As respects the coverage afforded the Additional Insured,this insurance is primary and non-contributory where a written contract or written agreement in effect prior to any related Claim requires you to provide such coverage. When this insurance is primary and non-contributory, our obligations are not affected by any other insurance carried directly by such additional insured whether it is primary or excess coverage. However, regardless of the provisions above: We will not extend any insurance coverage to the additional Insured person or organization: (1) That is not provided to you in this Policy;or (2) That is broader coverage than you are required to provide to the additional Insured person or organization in the written contract or written agreement. This endorsement does not increase the Company's Limits of Insurance as specified in the Declarations of the Policy. SCHEDULE OF ADDITIONAL INSUREDS As required by written contract in effect prior to any related Claim SPP 0024(Ed.06 12) Page 1 of 1 Endorsement No. 7 Effective Date: 09/01/2025 @12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 Insured Name: Tait&Associates, Inc. Issuing Company:AXIS Surplus Insurance Comlaany Additional (Return) Premium: $0 If the Endorsement Effective Date is blank,then the effective date of this Endorsement is the Inception Date of the Policy. NAMED INSURED EXTENSION THIS ENDORSEMENT MODIFIES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided by the Specialty Package Policy In consideration of the premium charged, it is agreed that the entities in the following schedule are included as Named Insureds in Item 1. of the Declarations. The First Named Insured designated in Item 1. of the Declarations shall remain unchanged. SCHEDULE Tait Environmental Services, Inc. DBA Tait Environmental Management DBA Tait Environmental Systems DBA Tait Electric DBA Tait Range Services Havill Engineering TAIT Parkcenter Associates,LLC Environmental Services Properties,LLC The Tait Family Trust The K.Richard Tait and Kathryn A.Tait Living Trust Thomas F.Tait Family Trust RC Trade Center Associates, LLC Yellow Roof Development, LLC 2130 Orangewood,LLC 2021 4th Street,LLC Willow Springs Investments,a California general partnership Whitewater Group LLC HT Land Partners, LLC Hoime Development, LLC Tait Land,Inc. Tait Development,LLC Kenneth R.Tait,an Individual Thomas F.Tait,an Individual Kenneth E.Tait,an Individual Trevor Tait,an Individual Victoria and Trevor Tait Family Trust Tait CP,LLC HT Land Partners 200,LLC HT Land Partners 300, LLC HT Mineral Partners, LLC TRT Development 200, LLC The Daniel W Hinson Family Trust Tait Orcutt, LLC SPP 0054(Ed.12 10) Page 1 of 2 Endorsement No. 8 Effective Date: 09/01/2025 @12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 insured Name: Tait&Associates, Inc. issuing Company: AXIS Surplus Insurance Compare Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy. ENDORSEMENT- NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS THIS ENDORSEMENT MODIFIES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the SPECIALTY PACKAGE POLICY. In consideration of the premium charged, it is agreed that in the event you or we cancel this Policy prior to the expiration date, we will endeavor to provide a thirty (30) day notice of such cancellation to certificate holders, provided that: 1. you are under an existing contractual obligation to notify such certificate holders when this Policy is cancelled; and 2. you have provided the following to us, either directly or indirectly, through your broker of record: a. The name of the entity shown on the certificate; and b. The address of such entity where notification may be mailed. We shall not provide a thirty (30) day notice if the cancellation is due to nonpayment of premium to us or to a finance company authorized to cancel the Policy. Such notice of cancellation will be provided via mail to the certificate holders. Proof that we have mailed the notice of cancellation, using the information provided by you, will serve as proof that we have fully satisfied our obligations under this endorsement. Such notice of cancellation is provided on an informational basis and solely to assist you in meeting your contractual notice requirements to such parties. Our failure to provide such advance notice to the certificate holder(s) will not extend any Policy cancellation date, negate any cancellation of the Policy, or grant, alter, or extend any rights or obligations under this Policy and we shall have no liability for failure to provide the notice herein. All other terms and conditions of the Policy shall apply and remain unchanged. SPP 0063(Ed,0117) Page 1 of 1 Endorsement No. 11 Effective Date: 09101/2025 @12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 Insured Name: Tait &Associates, Inc. Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT ENDORSEMENT (GENERAL LIABILITY COVERAGE) THIS ENDORSEMENT MODIFIES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the Specialty Package Policy. Schedule of Designated Projects: As required by written contract in effect prior to any related Claim A. Subject to paragraph E. below, for all damages under Coverage A, except damages because of Bodily Injury or Property Damage included in the Products-Completed Operations Hazard, to which this insurance applies and which can be attributed only to a single designated project shown in the Schedule above ("Designated Project"): 1. A separate Designated Project General Aggregate Limit applies to each Designated Project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. This Designated Project General Aggregate Limit applies on a primary non- contributory basis where required by written contract in effect prior to any associated claim. 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all such damages and Loss, regardless of the number of: a. Insureds; b. Claims made or Suits brought; or C. Persons or organizations making Claims or bringing Suits. 3. Any payments made for such damages shall reduce the Designated Project General Aggregate Limit for that designated project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Project General Aggregate Limit for any other Designated Project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence and for Damage to Premises Rented to You continue to apply to a Designated Project. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Aggregate Limit. SPP 0107(Ed.05 16) Page 1 of 2 B. For all sums which the insured becomes legally obligated to pay as damages under Coverage A to which this insurance applies and which cannot be attributed only to a single Designated Project shown in the Schedule above: 1. Any payments made for such damages 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 Project 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 shall not reduce the General Aggregate Limit or the Designated Project General Aggregate Limit. D. The provisions of SECTION IV — LIMITS OF INSURANCE AND DEDUCTIBLE not otherwise modified by this endorsement shall continue to apply as stipulated. E. Regardless of the number of locations or projects and any other circumstance or payments made under this Policy, including payments made for Claims covered under the General Aggregate, the Products Completed Operations Aggregate or any Pollution Aggregate as applicable, the total amount we will pay under this insurance policy for any and all project(s) designated within this endorsement shall be no more than the Designated Construction Project General Aggregate Limit shown below: Designated Construction Project General Aggregate Limit: $10,000,000 In the event that no dollar amount is shown next to the Designated Construction Project General Aggregate Limit above, the Designated Construction Project General Aggregate Limit shall be $10,000,000. All other terms and conditions of this Policy remain unchanged. SPP 0107(Ed.05 16) Page 2 of 2 Endorsement No. 12 Effective Date: 09/01/2025 @12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 Insured Name:Tait&Associates, Inc. Issuing Company:AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: SPECIALTY PACKAGE POLICY The following is added to SECTION VI, COMMON CONDITIONS, Paragraph 9, Other Insurance. It supersedes any provision to the contrary: Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your Policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Includes copyrighted material of Insurance Services Office, Inc with its permission CG 20 01 04 13 SPP 200104(04 14) Page 1 of 1 Endorsement No. 17 Effective Date: 09/01/2025@12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 Insured Name:Tait&Associates, Inc. Issuing Company:AXIS Surplus Insurance Company Additional (Return) Premium:$0 If the Endorsement Effective Date is blank,then the effective date of this Endorsement is the Inception Dote of the Policy. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: SPECIALTY PACKAGE POLICY SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations As required by written contract in effect prior to any related As required by written contract in effect prior to any Claim related Claim Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section HI — 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 organizatfon(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. Includes copyrighted material of Insurance Services Office, Inc with its permission CG 20 10 04 13 SPP 2010 13(02 14) Page 1 of 2 C. With respect to the insurance afforded to these whichever is less. additional insureds, the following is added to This endorsement shall not increase the Section IV— Limits Of Insurance: applicable Limits of Insurance shown in the If coverage provided to the additional insured is Declarations. required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; Includes copyrighted material of Insurance Services Office, Inc with its permission CG20100413 SPP 2010 13(02 14) Page 2 of 2 Endorsement No. 19 Effective Date: 09/01/2025@12:01 a.m.Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 Insured Name:Tait&Associates, Inc. Issuing Company:AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank,then the effective date of this Endorsement is the Inception Date of the Policy. ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT This endorsement modifies insurance provided under the following: SPECIALTY PACKAGE POLICY SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): As required by written contract in effect prior to any related Claim Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section III — 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, this insurance does not apply organization(s) shown in the Schedule, but only to any 'occurrence" which takes place after the with respect to liability for Bodily Injury or equipment lease expires. Property Damage or Personal And Advertising C. With respect to the insurance afforded to these Injury caused, in whole or in part, by your additional insureds, the following is added to maintenance, operation or use of equipment Section IV— Limits Of Insurance: leased to you by such person(s) or organization(s). If coverage provided to the additional insured is required by a contract or agreement, the most we However: will pay on behalf of the additional insured is the 1. The insurance afforded to such additional amount of insurance: insured only applies to the extent permitted by 1. Required by the contract or agreement; or law; and 2. If coverage provided to the additional insured is 2. Available under the applicable Limits of Insurance shown in the Declarations; required by a contract or agreement, the insurance afforded to such additional insured whichever is less, will not be broader than that which you are This endorsement shall not increase the required by the contract or agreement to applicable Limits of Insurance shown in the provide for such additional insured. Declarations. Includes copyrighted material of Insurance Services Office, Inc with its permission CG 20 28 04 13 SPP 2028 13(04 14) Page 1 of 1 Endorsement No. 26 Effective Date: 09/01/2025@12:01 a.m.Standard Time at the address of the Named Insured Policy Number: SP002747-08-2025 Insured Name:Tait&Associates, Inc. Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank,then the effective date of this Endorsement is the Inception Date of the Policy. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: SPECIALTY PACKAGE POLICY SCHEDULE Name Of Person Or Organization: As required by written contract in effect prior to any related Claim Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 12. Subrogation of Section VI—Common 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. Includes copyrighted material of Insurance Services Office, Inc with its permission CG 24 04 05 09 SPP 2404 09(04 14) Page 1 of 1 Policy: 7034395486 GNA63359XX CNA (Ed. 04112) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS EXTENDED COVERAGE ENDORSEMENT - BUSINESS AUTO PLUS - This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE 4. An "employee" of yours is an "insured" A. Who Is An Insured while operating an "auto" hired or rented under a contract or agreement in that The following is added to Section !I, Paragraph "employee's" name, with your permission, A.1., Who Is An Insured: while performing duties related to the 1. a. Any incorporated entity of which the conduct of your business. Named Insured owns a majority of the "Policy," as used in this provision A. Who Is An voting stock on the date of inception of Insured, includes those policies that were in this Coverage Form; provided that, force on the inception date of this Coverage b. The insurance afforded by this Farm but: provision A.1. does not apply to any 1. Which are no longer in force; or such entity that is an "insured" under 2. Whose limits have been exhausted. any other liability "policy" providing "auto"coverage. B. Bail Bonds and Loss of Earnings 2. Any organization you newly acquire or form, Section II, Paragraphs A.2. (2) and A.2. (4) other than a limited liability company, are revised as follows: partnership or joint venture, and over which 1. In a.(2), the limit for the cost of bail bonds is you maintain majority ownership interest. changed from $2,000 to $5,000; and The insurance afforded by this provision 2. In a.(4), the limit for the loss of earnings is A.2.. changed from $250 to $500 a day. a. Is effective on the acquisition or C. Fellow Employee formation date, and is afforded only until the end of the policy period of this Section 11, Paragraph B.5 does not apply. Coverage Form, or the next anniversary of its inception date, whichever is Such coverage as is afforded by this provision earlier. C. is excess over any other collectible insurance. b. Does not apply to: 11. PHYSICAL DAMAGE COVERAGE (1) "Bodily injury" or "property damage"caused by an "accident" that A Glass Breakage_ Hitting A Bird Or Animal —occurred before you acquired or Falling Objects Or Missiles formed the organization; or The following is added to Section III, (2) Any such organization that is an Paragraph A.3.: "insured" under any other liability With respect to any covered "auto," any "policy" providing "auto" coverage, deductible shown in the Declarations will not 3. Any person or organization that you are apply to glass breakage if such glass is required by a written contract to name as repaired, in a manner acceptable to us, rather an additional insured is an "insured" but than replaced. only with respect to their legal liability for B. Transportation Expenses acts or omissions of a person, who qualifies as an "insured" under Section II — Who Is Section 111, Paragraph A.4.a. is revised, with An Insured and for whom Liability Coverage respect to transportation expense incurred by is afforded under this policy. If required by you, to provide: written contract, this insurance will be a. $60 per day, in lieu of$20; subject to primary and non-contributory to insurance on which the additional insured is a Named b. $1,800 maximum, in lieu of$600. Insured. C. Loss of Use Expenses CNA63359XX copyright,CNA corporation,2000. Page 1 of 3 (Ed. 04112) Includes copyrighted material of the Insurance Services Office used with its permission. Policy: 7034395486 CNA63359XX CNA (Ed. 04I12) Section III, Paragraph A.4.16. is revised, with c. Physical Damage Coverage on a covered respect to loss of use expenses incurred by "auto" also applies to "loss" to any you, to provide: permanently installed electronic equipment a. $1,000 maximum, in lieu of$600. including its antennas and other accessories. D. Hired "Autos" d. A $100 per occurrence deductible applies The following is added to Section Ili. to the coverage provided by this provision. Paragraph A.: G. Diminution In Value 5. Hired "Autos" The following is added to Section III, If Physical Damage coverage is provided under Paragraph B.6.: this policy, and such coverage does not extend Subject to the following, the "diminution in to Hired Autos, then Physical Damage coverage value" exclusion does not apply to: is extended to: a. Any covered "auto" you lease, hire, rent a. Any covered "auto" of the private or borrow without a driver; and passenger type you lease, hire, rent or borrow, without a driver for a period of b. Any covered "auto" hired or rented by 30 days or less, while performing duties your "employee" without a driver, under related to the conduct of your business; a contract in that individual and "employee's" name, with your b. Any covered "auto" of the private permission, while performing duties related to the conduct of your business. passenger type hired or rented by your employee"without a driver for a period c. The most we will pay for any one of 30 days or less, under a contract in "accident" or "loss" is the actual cash that individual "employee's" name, with value, cost of repair, cost of your permission, while performing replacement or $75,000, whichever is duties related to the conduct of your less, minus a $500 deductible for each business. covered auto. No deductible applies to c. Such coverage as is provided by this '"loss" caused by fire or lightning. provision is limited to a "diminution in d. The physical damage coverage as is value" loss arising directly out of provided by this provision is equal to accidental damage and not as a result the physical damage coverage(s) of the failure to make repairs; faulty or provided on your owned "autos." incomplete maintenance or repairs; or the installation of substandard parts. e. Such physical damage coverage for d. The most we will pay for "loss" to a hired "autos"will: covered "auto" in any one accident is (1) Include loss of use, provided it is the lesser of: the consequence of an "accident" (1) $5,000; or for which the Named Insured is (2) 20% of the "auto's" actual cash legally liable, and as a result of value (ACV). which a monetary loss is sustained by the leasing or rental concern. Ill. Drive Other Car Coverage—Executive Officers (2) Such coverage as is provided by The following is added to Sections II and III: this provision will be subject to a 1. Any "auto" you don't own, hire or borrow is a limit of$750 per"accident." covered "auto" for Liability Coverage while E. Airbag Coverage being used by, and for Physical Damage Coverage while in the care, custody or control The following is added to Section III,Paragraph B.3.: of, any of your"executive officers," except: The accidental discharge of an airbag shall not a. An "auto" owned by that "executive officer" be considered mechanical breakdown, or a member of that person's household; or F. Electronic Equipment b. An "auto" used by that "executive officer" while working in a business of selling, Section Ill, Paragraphs B.4.c and BA.d. are servicing, repairing or parking "autos." deleted and replaced by the following: CNA63359XX Copyright,CNA Corporation,2000, Page 2 of 3 (Ed. 04/12) includes copyrighted material of the Insurance Services Office used with its permission. Policy: 7034395486 CNA63359XX CNA (Ed. 04112) Such Liability and/or Physical Damage We waive any right of recovery we may have, Coverage as is afforded by this provision. because of payments we make for injury or (1) Equal to the greatest of those damage, against any person or organization for coverages afforded any covered "auto", whom or which you are required by written and contract or agreement to obtain this waiver from us. (2) Excess over any other collectible This injury or damage must arise out of your insurance. activities under a contract with that person or 2. For purposes of this provision, "executive organization. officer" means a person holding any of the You must agree to that requirement prior to an officer positions created by your charter, "accident"or"loss." constitution, by-laws or any other similar governing document, and, while a resident of C. Concealment, Misrepresentation or Fraud the same household, includes that person's The following is added to Section IV, spouse. Paragraph 8.2.: Such "executive officers" are "insureds" while Your failure to disclose all hazards existing on the using a covered "auto" described in this date of inception of this Coverage Form shall not provision. prejudice you with respect to the coverage afforded IV. BUSINESS AUTO CONDITIONS provided such failure or omission is not intentional. A. Duties In The Event Of Accident, Claim, Suit D. Other Insurance Or Loss The following is added to Section IV, The following is added to Section IV, Paragraph B.S.: Paragraph A.2.a.: Regardless of the provisions of Paragraphs 5.a. (4) Your "employees" may know of an and 5.d. above, the coverage provided by this "accident" or "loss." This will not mean policy shall be on a primary non-contributory that you have such knowledge, unless basis. This provision is applicable only when such "accident" or "loss" is known to required by a written contract. That written you or if you are not an individual, to contract must have been entered into prior to any of your executive officers or "Accident"or"Loss." partners or your insurance manager. E. Policy Period, Coverage Territory The following is added to Section IV, Section IV, Paragraph B. 7.(5).(a), is revised Paragraph A.2.b.: to provide: (6) Your "employees" may know of documents received concerning a claim a. 45 days of coverage in lieu of 30 days. or "suit." This will not mean that you V. DEFINITIONS have such knowledge, unless receipt of such documents is known to you or if Section V. Paragraph C. is deleted and replaced you are not an individual, to any of your by the following: executive officers or partners or your "Bodily injury" means bodily injury, sickness or insurance manager. disease sustained by a person, including mental B. Transfer Of Rights Of Recovery Against anguish, mental injury or death resulting from any of Others To Us these. The following is added to Section IV, Paragraph A.5. Transfer Of Rights Of Recovery Against Others To Us: CNA63359XX Copyright,CNA Corporation,2000. Page 3 of 3 (Ed. 04/12) Includes copyrighted material of the Insurance Services office used with its permission. CNA Waiver Of Subrogation (Workers Compensation Policy) BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One-Workers'Compensation Insurance G. Recovery From Others and Part Two-Employers'Liability Insurance H.Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations.(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE-Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure.The amount is Blanket Waiver of Subrogation Percentage Charge%. All other terms and conditions of the policy remain unchanged. This endorsement,which forms a part of and is for attachment to the policy issued by the designated Insurers,takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date(the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No:G-19160-B(11-1997) Policy No:7034395505/7034395522 Endorsement Effective Date:9/1/25 Endorsement Expiration Date: 9/1/25 Policy Effective Date:9/1/25 Endorsement No: 1 ©Copyright CNA All Rights Reserved. CMA ' NOTICE OF CANCELLATION • CERTIFICATE HOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium,then notice of cancellation will be provided to such Certificate Holders at least 30 days in advance of the date cancellation is effective. If notice is mailed,then proof of mailing to the last known mailing address of the Certificate Holder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation,or impose any liability or obligation upon us or the Agent of Record. Form No: CC68021A(02-2013) 1 Policy No:7034395505 I 7034395522 Policy Effective Date:9/1/25 Policy Pa e: I of I ©CNA All Rights Reserved.