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HomeMy WebLinkAboutRJM DESIGN GROUP INC. 2A - 2014City of Santa A, a r t Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with (' J 114 COTC Office Use Only � Cie V No. � �b ��_ �� was completed on and final payment has been made. (List all amendments. Use space below if needed.) J 0/7 A)-7 63 2> Revised: 01-07-16 Department: G- i oe Phone/Ext.: Signature: -?74 " r✓�� / 1 6� Date: pp g` l.� Zj OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza M -36 • P.O. Box 1888 M -36 Santa Ana, Callfornma 92702 w.vw.san #a- ana,om June 3, 2015 Mr, Robert J. Mueting, Principal RIM Design Group 31591 Camino Capistrano San Juan Capistrano, CA 92675 Re: RJM Design Group Consultant Agreement "'Extension" Dear Mr. Mueting: A -2014- 223 -01 CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar Pursuant to Agreement No. A -2014 -223, entered between RJM Design Group and the City of Santa Ana, dated September 16, 2014, Section 5 "Term", the time period of said Agreement is hereby extended for an additional one (1) year period, through September 30, 2016. The insurance certificates are required to be extended and /or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. If you have any questions regarding this matter, please contact Jason Gabriel, Principal Civil Engineer, at 714- 647 -5664. Public Works Agency APPROVED AS TO FO12M: Sonia R.. C.,arvalho City Attorney d,S02 —�— V c San doval f Assistant City Attorney cc; Clerk of the Council CITY OF SANTA ANA David Cavazos ATTEST: Maria 1). Fluizar Clerk of the Council SANTA ANA CITY COUNCIL r� Miguel A. 6'ukdu Vincent F. Sarmiamo NU0,01e Mat= Angelica Amezcea P. David aanavide5 Roman Reyoa Sal Tina]em Mayor Mayot Pro Tem, Wartli ward Ward ! Wwd4 I Wards We'd6 MLu �s 1 .gg i VSermteniMAs�nta�r t i�r ASa�eria arra am 6AM— z,m:@sartea ma pa..kdmo- i@JAardmar -a.ae RRMnft@— SweAnA&M A_" INSURANOE NQT ON FILE WORK MAY NE PROCEED CLERK OF COUNCIL. MAYOR <.l Miguel A. Pido DATE; � 16' 6 MAYOR PRO TEM Vincent F. Sarmlento COUNCILMEMBERS Angelina Anezcua P. David Bensvides Michele Martinez Roman Reyna Sal Tinajero CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza M -36 • P.O. Box 1888 M -36 Santa Ana, Callfornma 92702 w.vw.san #a- ana,om June 3, 2015 Mr, Robert J. Mueting, Principal RIM Design Group 31591 Camino Capistrano San Juan Capistrano, CA 92675 Re: RJM Design Group Consultant Agreement "'Extension" Dear Mr. Mueting: A -2014- 223 -01 CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar Pursuant to Agreement No. A -2014 -223, entered between RJM Design Group and the City of Santa Ana, dated September 16, 2014, Section 5 "Term", the time period of said Agreement is hereby extended for an additional one (1) year period, through September 30, 2016. The insurance certificates are required to be extended and /or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. If you have any questions regarding this matter, please contact Jason Gabriel, Principal Civil Engineer, at 714- 647 -5664. Public Works Agency APPROVED AS TO FO12M: Sonia R.. C.,arvalho City Attorney d,S02 —�— V c San doval f Assistant City Attorney cc; Clerk of the Council CITY OF SANTA ANA David Cavazos ATTEST: Maria 1). Fluizar Clerk of the Council SANTA ANA CITY COUNCIL r� Miguel A. 6'ukdu Vincent F. Sarmiamo NU0,01e Mat= Angelica Amezcea P. David aanavide5 Roman Reyoa Sal Tina]em Mayor Mayot Pro Tem, Wartli ward Ward ! Wwd4 I Wards We'd6 MLu �s 1 .gg i VSermteniMAs�nta�r t i�r ASa�eria arra am 6AM— z,m:@sartea ma pa..kdmo- i@JAardmar -a.ae RRMnft@— SweAnA&M A_" A ,FLL CERTIFICATE OF LIABILITY INSURANCE DATE (MM,DDYYY) 9!312014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not senior rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT PHONE E d L714- 427 =6870 nab fie) 4- Deal% , Renton & Associates P, 0. Box 10550 Santa Ana CA 92711 -0559 MAIL _ .w„ _ IN9URER19}APF4ROINO COVERAGE mm _ NAICN _ 3865D390300 (3b12014 13012015 INSURER AI uP,y -eje ELEmpacty ,A'aSl1a Co ofA� INSURED INSURERB; (g L'a5U` f11yRi; urety Co Anne, 11V4 ENSURER C : RJM Design Group, Inc. INSURER 0; _- INSURER E � 31591 Camino Capistrano San Juan Capistrano CA 92675 _ , INSURER F: kEM19F9 (AE COVERAGES CERTIFICATE NUMBER: 160437120 REVISION NUMBERt 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, SEEN-REDUCED EXCLUSION'S AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ASR TYPEOFINSURANCE AUDI SI 4 EYYY POLICYNUMI MOUO VYP UNITS A GENERAL LIABILITY Y Y 3865D390300 (3b12014 13012015 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY kEM19F9 (AE MED E %P An one pamoo ,81,000,000 _ $10000 " CLAIMS -MADE OCCUR tJ PERSONAL &ADV INJURY 8200.000 Contractual Liability GENERALAGGREaTE _ $4,00,000 — GENLAGGREGATLUMMAPPUES PER; PRODUCTS- COMPfOP AGG $4,000,000 $ _ POLICY X 1 O' LOG A AUTOMOBILE LIABILITY ANY AUTO AUTOS OWNED SCHEDULED x_ HIRED AUTOS AU a5 NEO BA5D394305 !3012014 q( pI AN,r.7 � 3'!,z °' g xJ 13012015 dLDly} w„ -- DINED: - 1,000,000 BOOILY INJURY (per pare0n) _ 8 —�- 60011.Y INJURY (Per aCnidanlj $ ROn EftMTY AMAGE � —� UMBRELLA UAa EXCESS LIAR OCCUR CLAIMS -MADE i..tCfjA p,1L0 pssiBtan neY d b EACH OCCURRENCE $ AGGREGATE - $_-M ..- DED RETENTIONS $_ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNIUVEXECUTIVE YIN y UB413OT960 _ /30/2014 /30/2015 X WC STAN- IN -` ORY E.LEACHACClDEN, 81,0001000 OFFICERtMEMSER EXCLUDED? (Meruhrtmy ke NH) '- E.L. DISEASE. FA EMPLOYE $1000 iPCO E,C OISFAS£ - POLICY UMtr 81,006000 It de3Cr8e muter -9CRiPTiON OF OPERAT NS below B Professional Liability Claims Made 105991919 110/1/2014 ( 01112015 Per Claim $1,000,000 Annual Aggr. 82,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ADDED 1011, Additional Remarks Schedule, If more spaeo Is required) General Liability policy excludes Claims arising out of the performance of professional services, Re: On•Cali Services - City of Santa Ana, CA. The City of Santa Ana, Its officers, employees and representatives are Additional Insured as respects to General Liability coverage as required by written contract. Primary and Non - Contributory applies to General Liability as required by written contract. Waiver Of Subrogation for Work Comp is Included as required by written contract. See Attached.,. CERTIFICATE HOLDER CANCELLATION30 Da 110 Day Notice of Cancellation C9 998 &2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Attn: Marilyn Boothe ACCORDANCE WITH THE POLICY PROVISIONS. P.G. BOX 1988 Santa Ana, CA 92702 -1988 UTHORIBEC REPRESENTATIVE i C9 998 &2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC : ACCW0 ADDITIONAL REMARKS SCHEDULE Page L_ of 1 AGENCY NAMEDINSURED Dealey, Renton & Associates RJM Design Group, Inc, POLICY NUMBER °'— 31591 Camino Capistrano li San Juan Capistrano CA 92875 9ARM91t,.... NALCCODe. EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE _ Separation of Insureds - general liability Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this Insurance applies: a. As if each Named Insured were the only Named insured; and b, Separately to each insured against whom claim is made or suit Is brought. O aR IPp ,aa-V�p AS 5 SCpl KneY Assistant pity ACORD 101 (2008101) 02008 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD Aift TRAVELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 (00) — 001 POLICY NUMBER: UB413 OT960 TIAITERI)FUJI - 0 - -- ENDORSEMENT CALIFORNIA (BLANKET WAIVER) 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. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 3.00 % of the California workers' compensation premium otherwise due on such remuneration. Person or Organization ALL PERSONS OR ORGANIZATIONS THAT REQUIRES YOU TO OBTAIN EXECUTED THE CONTRACT BEFORE DATE OF ISSUE: 9 /3 /z 014 01710& Schedule Job Description THAT ARE PARTIE TO A CONTRACT THIS AGREEMENT, PROVIDED YOU THE LOSS. ST ASSIGN: ca APPROVED AS TO PORT% LISA E, sTORCK p Assistant City AttOrnev RJM Design Group, Inc. COMMERICAL GENERAL LIABILITY Policy Number: 68050390306 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section ll): Any person or organization that you agree in a "contract or agreement requiring insurance" to in- clude as an additional insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage' or "personal injury" caused, in whole or in part, by your acts or omis. sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera• tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products- campleted operations hazard ". Such person or organization does not quality as an additional insured for "bodily injury ", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: INSURANCE (Section Ili) for this Coverage Part. B. The following is added to Paragraph a, of 4. Other Insurance In COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply on a primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that Is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage Is sought occurs; and (2) The "personal injury' for which coverage is sought arises out of an offense committed; d. This Insurance does not apply on any basis to any person or organization for which cover- C. age as an additional insured specifically is added by another endorsement to this Cover- age Part. a. This insurance does not apply to the render- ing of or failure to render any "professional services ". f. The limits of insurance afforded to the addi- tional Insured shall be the limits which you agreed in that " oontract or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF after you have entered into that "contract or agreement requiring insurance ". But this insur- ance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the Insured when the insured is an additional insured under any other insurance. The following is added to Paragraph 8, Transfer Of Rights Of Recovery Against Others To Us In COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, under a"contract or agreement requiring Insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with such person or organization entered into by you before, and in effect when, the "bodily A,pil1�0'VEi3 As TO FORM CG 08 8`109 07 D 2007 The Trave ers companies, Inc. Page 1 of 2 Inc odes the copyrightad materiel of Insurance Services Orrice, Inc., with Its permission. , �;,..--- -- - -" - -- LISA E, S At orm,4 Assistant City � fr COMMERICAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- sonal injury' offense is committed. D. The following definition is added to DEFINITIONS (Section Y): "Contract or agreement. _requiring insurance" means that part of any contract or agreement un- der which you are required to include a person or organization as an additional insured on this Cov- Page 2 of 2 erage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal in- jury' is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period, TO FOAM RPggC?VED �5 LISA • SIORCK AttoMe" j V 2007 The Trove ers Companies, Inc. Assistant City Gr,, D8 8109 07 Inc Was the copyrighted material of Insurance Services office. Inc., with its permission. RJM Design Group, Inc A- 2009 -023 & A- 2.014- 223 -01 REVIEWED BY: o EUNICE HEREDIA (PG1 OF 5) ACCORa CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 9/15/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Dealey, Renton & Associates DRA License 0020739 P. O. Box 10550 CONTACT NAME: PHONE 714 -427 -6810 FAx 714- 427 -6818 (Air No Fxt)- E-MAIL INSURERS AFFORDING COVERAGE NAIC # Santa Ana CA 92711 -0550 INSURER A :Travelers Property Casualty Co of A 25674 9/30/2015 INSURED INSURERB:Travelers Casualty & Surety Co. Ame 31194 RJM Design Group, Inc. 31591 Camino Capistrano San Juan Capistrano CA 92675 INSURER C INSURER D INSURER E: $1,000,000 INSURER F MED EXP (Any one person) $10,000 COVERAGES CERTIFICATE NUMBER: 1207104895 REVISION NLJMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 6805D390306 9/30/2015 9/30/2016 EACH OCCURRENCE $2,000,000 CLAIMS -MADE FX OCCUR PREMISES S E( RENTED PREMI Ea occurrence ) $1,000,000 X MED EXP (Any one person) $10,000 Contractual Liability PERSONAL & ADV INJURY $2,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY E PEI° LOC PRODUCTS - COMP /OPAGG $4,000,000 $ OTHER: A AUTOMOBILE LIABILITY BA5D394305 9/30/2015 9/30/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB CLAIMS -MADE DED RETENTION $ __$___ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN y UB413OT960 9/30/2015 9/30/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT _ $1,000,000 ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Pro fessionalLiability Claims Made 105991919 10/1/2015 10/1/2016 Per Claim $1,000,000 Annual Aggr. $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) General Liability policy excludes claims arising out of the performance of professional services. Re: A- 2009 -023 and A- 2014 - 223 -01. The City of Santa Ana, its officers, employees and representatives are Additional Insured as respects to General Liability coverage as required by written contract. Primary and Non - Contributory applies to General Liability as required by written contract. Waiver of Subrogation for Work Comp is included as required by written contract. See Attached... l.CrcllrwAlc r7ULUMM I.AINI.CLLA I IUN JU Udy IVUU/ I Udy IUl IVUI Ir-dy UI I" ICIII City of Santa Ana Attn: Marilyn Boothe P.O. Box 1988 Santa Ana, CA 92702 -1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE RJM Design Group, Inc A-2009-023 & A-2014-223-01 REVIEWED BY: EUNICE FIEREDIA (PG2 OF 5) AGENCY CUSTOMER ID: LOC #: Page 1 of 1 AGENCY Dealey, Renton & Associates NAMED INSURED RJM Design Group, Inc. 31591 Camino Capistrano San Juan Capistrano CA 92675 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 1-5- FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Separation of Insureds - general liability Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or suit is brought. AL,UKU IV I tZUUZ5/U-I) 9 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RJM Design Group, Inc A-2003-023&A-2014-223-U1 REVIEWED BY: , EUN|CEHERED|A(PG3OF5) WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT VVC8SO3760O\--0O1 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA (BLANKET WAIVER) We have the right tD recover our payments from anyone liable for on injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. You must maintain oavru| records accurately S8gnygoUng the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 3.00 96 of the California workers' compensation premium otherwise due on such remuneration. Person orOrganization ALL PERSONS ORORGANIZATIONS THAT REQUIRES YOU TOOBTAIN EXECUTED THE CONTRACT BEFORE DATE C]F ISSUE: s/zs/zozs Schedule Job Description THAT ARE PxRTETOACONTRACT THIS AGREEMENT, PROVIDED YOU THE LOSS. 0T ASSIGN: cA RJM Design Gmup. Inc A-20}9'O28&A-2O14-223-01 REVIEWED BY RJN1 Design Group, Inc. Policy Number'. 6805D390306 ~ EUN|CEMEREDIA(PG4OF5) COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added tn WHO *S AN INSURED (Section 11): Any person or organization that you agree in m ^con(nect nr agreement requiring inounance' to in- o|udeas an additional insured on this Coverage Part, but only with respect hv liability for "bodily in- iury'', "property damage" or "personal injury" camaed, in whole orin part, by your acts uromin- o|onV or the nnto or omissions of those aoUng on your behalf: w. In the performance of your onQumq opera- tions; b. In connection with premises owned by or rented ho you; or o, In connection with "your work" and included within the "products-completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injun/' for which that per- son or organization has assumed liability in a con- tract or agreement. INSURANCE (Section U|) for this Coverage Part, B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV)/ However, if you specifically agree in a "contract ur agreement requiring insuronme'that the insurance provided to an additional insured under this Cov- erage Part must apply an o primary basis' or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such addi- tional insured as named inoured, and we will not share vAth the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs-, and (2) The "personal injury" for which coverage is sought arises out of an offense committed; The insurance provided to such additional insured |m limited osfollows: d. This insurance does not apply on any basis tV any person or organization for which cover- C. age as an additional insured specifically is added hy another endorsement h) this Cover- age Part, e' This insurance does not apply to the render- ing of or failure to render any "professional services"- t The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurmnne" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Pmrt, whichever are less, This endorsement does not increase the limits of insurance m(otod in the UK8|TS OF after You have entered into that "contract or agreement requiring insurance". But this insur- ance di|| is excess over valid and cuUepUb|e other insurance, whether primary, excess, contingent or om any other basis, that ivavailable to the insured when the insured is an additional insured under any other insurance. The following ie added toParagraph 8. Transfer 0f Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section K\/): We waive any rights of recovery we may have ogommt any person or organization because of payments we make for "bodily imjury'. ''property damaAe" or "personal injury" arising out of ''your work" performed by you, or on your behalf, under n "contract or agreement requiring inaunannn''with that person or organization. We waive these hghte only where you have agreed to do so as part nf the "contract Vr agreement requiring insur' ance" with such person or organization entered into by you before, and in effect when, the "bodily CGD$81V9V? t'cmo7 The Tm°vnm Companies, Inc. Page 1n[2 |nvu*es the copyrighted material m Insurance aor"ices Office, |nc..,#|mits permission. RJM Design Group, Inc A-2009-023 & A-2014-223-01 REVIEWED BY COMMERICAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- sonal injury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include a person or organization as an additional insured an this Cov- EUNICE HEREDIA (PG5 OF 5) erage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal in- jury" is caused by an offense committed: a. After you have entered into that contract or agreement', b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 -c) 2007 The Tra,/e ers Companies, Inc. CG D3 81 09 07 Inc udes the copyrighted material of Insurance Services Office, Inc., with its permission,