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HomeMy WebLinkAboutPENCO ENGINEERING, INC. 3 - 20150� City of Santa Ana i Clerk of the Council AGREEMENT TERMINATION FORM MI Q Er f Please complete this form in its entirety when the attached agreemen a amendments (if any) are no longer in effect. CITY - Note: If our agreement is rant related, lease ensure that all rant retention9r e 'h N iA A Y 9 9 r g 4t(erM C0UN ,', have been satisfied prior to signing the termination foam. Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with poNco / C No. ) �� i/��was completed on ( / and final payment has been made. (List all amendments. Use space below if needed.) ( y� Department: PyJs V I� — G/Cs14 Phone/Ext.: Signature: Date: ����� .6-7 ff8 21 C--Z, tl Revised: 10-18-16 INSURANCE(LC Ot� FILE WORK MAYNIT PROCEED CLERK OF COUN tL DATE, '6� CONSULTANT AGREEMENT CITY OF SANTA ANA A-2016-236 THIS AGREEMENT is made and entered into this 21st day of October, 2015 by and between PENCO Engineering, Inc. ("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. On June 24, 2015, the City issued Request for Proposal No. 15-045, by which it sought proposals �y £rom qualified firms for engineering, technical, and administrative support services to be �`1 v provided to the Public Works Agency on an as -needed basis. B. Consultant submitted a responsive proposal that was among those selected by the City. Consultant represents that it is able and willing to provide the services described in the scope of work that was included in RFP No. 15-045 as Attachment 1 and that is also attached to this Agreement as Exhibit A. C. 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 consulting 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 those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services-tbe rates and charges identified in Exhibit B. The t'otaI sum to be expended under this . Agreement shall not exceed $500,000 daring the tern, of this Agreement. Payment by City shall be made within forty-five of days (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work that fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on October 21, 2018, unless terminated earlier in accordance with Section IS, below. The term of this Agreement may be extended for one (1) two-year period upon a writing executed by the City Manager and the City Attorney. 4. 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. 5. 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 Stich use not within the purposes intended by this Agreement shall be, at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Consultant shall supply City with a fully executed additional insured endorsement in substantially the form attached as Exhibit C upon execution of this Agreement. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the California Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. C. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement, (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. (iv) Consultant shall supply City with a fully executed additional insured endorsement. f, If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination, Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 7. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, 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 or its contractors, subcontractors, agents, employees, or other persons acting on their 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 indennity 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. 8. 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. 9. 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 (3) years from the date of final payment to Consultant under this Agreement. 10. 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. 11. CONFLICT OF INTEREST CLAUSE 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. 12. 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 cormmunication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 With courtesy copies to: To Consultant: Fred Mousavipour Executive Director Public Works Agency City of Santa Ana 20 Civic Center Plaza M-36 P.O. Box 1988 Santa Ana, California 92702 Fax 714- 647-5622 PENCO Engineering, Inc. 16842 Von Barman Avenue, Suite 150 Irvine, CA 92606 Attn: Jeffrey M. Cooper 949-753-8111 (office) 949-753-0775 (fax) City Attorney's Office City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Fax 714- 647-6515 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. 13. EXCLUSIVITY AND AMI'aNDMENT This Agreement represents the complete and, exclusive statement between the City and Consultant regarding the subject matter therein, and supersedes any and all other agreements, oral or written, between the parties, hi 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 are not embodied herein. 14. 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 assigranent, 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. 15. TERMINATION This Agreement may be tenninated 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 deliver to the City all work product 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 that fails to meet the standard of performance specified in the Recitals of this Agreement, 16. NONDISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or in connection with any activities 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. 17. JIIRISDICTION - 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. 18. 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. 19. 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. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: SOMA R. CARVALHO City Attorney By: 7~ John M. Funk Assistant City Attorney AL: Public Works Agency CI��TYY OF SANTA ANA 0 David Cavazos City Manager CONSULTANT: Je ey M. C oper P CO Engineering, Inc. Tax ID# 33-D3&4z2-610 EXHIBIT A f..,..._.,m._ _ Appendix ATTACHMENTJ ._ SCOPE OF WORT CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR ENGINEEMNO, TWITNICAL AND ADMINISTRATIVIC SUPPORTSERVICES RFP NO.: 15.045 Introdnc02n. and Backmand The City of Santa Ana is located in the County Of Orange in Southern California, The) City encompasses 27.5 square miles and apopulation of over 325,000 people. The City of Santa Ana Public Works Agency is soliciting proposals for staff services firom consulting firms to assist in the Design, Construction Management, Project Management, Inspection, Oversight and delivery of Public Work services, In. the past the City has utilized used professional and administrative staff on as needed basis to meet the goals and objectives of the City in the delivery of quality, on time services, The staff services are an extension to the current workibrce and work in conjunction to better serve and complement the needs of the Public Works Agency. In summary, tho City of Santa Ana is soliciting; proposals from qualified firing to provide enrginoering, technical, and administrative support services for Public Works. This request 'for proposal (RFp) provides interested qualified firms with the information enabling them to submit a Service Bid Proposal and to .provide the services described heroin. Deserfution of Work: On as needed basis, the Consultant/s will provide the City with professional staff to perform engineering, technical and administrative tasks on the delivery Public Work Services, These tasks may include englneering design far: street rehabilitation and street widening projects plans and specifications. Underground utility design aid review for water, sower and storm drain plans and specifications, Next, Electrical and Mechanical consulting, review and design of plans and specifications for water Infrastructure OX, wells, pump stations, sewer lift stations). Also, landscaping and irrigation system design for public work projects, In addition, and including traffic signal design, road striping, survey services, contract management, project inspection and oversight, and admirdstrative support services. The list of positions the Consultant/s might treed to fill include the following; AuIal eering/Tee ntc 41 • Project Engineer • Senior Civil Engineer (PE License Required) + Assistant Engineer lI, (Civil, Electrical, Mechanical) City of Setnta Ana RFP 16-ph6 r Assistant Engineer 1, ( Civil, 'Electrical, Mechanical) + Engineering Aide + CADD- Designer r GIS Analyst + Land Surveyor (LS License Required) + Project Manager + Field Inspector (Construction) • Field inspector (Buildings) + Storm Water Coordinator • Plan Check Engineer tAdmutatrative • Senior Accounting Assistant • Accounting Assistant • Administrative Assistant • Contract Administrator After the City identifies the need for a position to be tilled, the selected consultant/s will be asked to provide resumes of the candidates for the position. The City reserves the right to .interview any of the candidates prior to making the selection, Registered Professional Engineers and Licensed Land Surveyors may be required to sing plans, specifications and contract legal documents. The City will accommodate the chosen candidate/s in a workstation with and provide related office supplies, and provide access to -the building (temporary identification cards), Consultant Responsibilities: ultant Audit and Tteview }?recess: Prior to awarding the contract, the selected Consultaut might be subject to an audit or review by Caltrans' Audits and Investigations (AM), other state audit organizations, or the federal government, The selected Consultant/s shall complete Exhibit 10-1( — Consultant Certification Contract Costs and Financial, in the Appendix of this RFP as Attachment 4. City ResDonsibillties& The City will provide information in its possession relevmlt to the preparation of the required itxforrnation in the UP, The City will provide only the staff assistance mid the documentation specifically in referred to herein. Fee Pro osal, include all forms and information as requested. The finding mcchanism for any of tine available positions might come from different frmding sources and would need to comply with the funding Agency requirements. Cary of Santa Ana RFP 15M045 In addition to Section IV,B,II (Submittal Requirements: Fee Proposal) fee schedule shall be structured as follows: • Cattrans funded projects, reference LAPM Exhibit 'IQ-H (sample cost proposal) included in Attachment 4, S eci i aegitlqments (Attachment 4): Corru fiance with Funding Agency: All services rendered under federal, state and other iron- local funding sources are subject to compliance with the regulatory funding agency. If Caitrans; This project is funded through XXXX and shall comply with till requirements of XXXX The attached forms must be completed in their entirety and submitted with your proposal: • LAPM Exhibit 10•Ht Sample Cost Proposal • LAPM Exhibit 10•.1; Notioe to Proposers, DBE information • LAPM Exhibit 10-01: Consultant Proposal DBE Commitment • LAPM .Exhibit 10-K: Consultant Certification of Contract Costs and Financial management System If CDB& This agreement will be funded through the U.S, Department of Housing and Urban Development, Community Development BIock Grant Program and as such is subject to the conditions of the Section 3 Contract Clause, Proposer shall comply with all requirements as thoy.pertain,to the use of these funds, Refor to Attachment 4, included in the Appendix of this RFP, If the project will be financed by federal Rinds all services rendered shall meet all required federal requirements included in this request for proposal. Consultants are advised that, as required by federal law, the City of Santa Ana is implementing the now Race Conscious Disadvantaged Business Enterprise (DBE) Program, T'he DBE goal for this contract is 9,60%. MY of Santa Ana RFP 15-045 EXHIBIT B unE Project Engineer Senior Civil Engineer (PE, License Required Assistant Engineer II Assistant Engineer I Engineering Aide CADD- Dasigner GIS- Analyst Land Surveyor (LS, License Required) Project Manager Field Inspector (Construction) Building Inspector (Buildings) Storm Water Coordinator Plan Check Engineer Senior Accounting Assistant Accounting Asslstant Administrative Assistant Contract Administrator BILLING RATEJIR $66-$98 $72-$97 $56-$69 $38-$55 $33-$48 $43-$58.50 $49-$78 $88-$102 $85-$114 $70-$80 $75-$85 $100-$,110 $100-$1j0 $IOD-$110 $100-$110 $70-$75 $75-$80 EXHIBIT C ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company This endorsement modifies such insurance as Is afforded by the provisions of Policy # relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective,) Effective this endorsement form as a part of Policy # Issued to Named Insured Countersigned by Authorized Representative A!•'E" CERTIFICATE OF LIABILITY INSURANCE °"TL(MMI°D/ YYYj 11 /20/2015 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(les) 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 endorsements . PRODUCER Dealey, Renton & Associates License 90020739 P. OBox 10550 Santa Ana CA 92711-0550 COACT PHONE FAX �Iialess _ INSURERRH AFFORDING COVERAGE NAIC N INSURER A :Travelers Casualt & Suret Co. Ame 31194 INSURED PENCO Enggmea meaning, Inc. 16842 Von Korman Avenue, Suite 150 INSURER a.American Automobile Ins, Co. 21840 INSURERC:Associated Indemnity Corp. — _ — Irvine CA 92606 INSURER D INSURER E - INSURER F: COVERAGES CERTIFICATE MI IMRPP- 1:$HH1 T hI H4 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 Or INSURANCE 50 WVD POLICY NUMBER pMIDDYEFF MMIDOIYYYY POLICY EXP MhiIDDIYVYY LIMITS C X I COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR XX Contractual AZC80905277 7/21/2015 7/21/2016 EACH OCCURRENCE $11000.000 — T.1A L- R<�'Y EN� PREMISESIEac,ccwence $1,000,000 X MED EXP(Any one endn) $10.000 X I BFPD. XCU PERSONAL B ADV INJURY $1.000,000 DEAL AGGREGATE LIMIT APPLIES PER: POLICY El PRCT LOC O- JE GENERAL AGGREGATE $2,000.000 PRODUCTS - COMP/OP AGG 62,000,000 OTHER: $ B AUTOMOBILE X LIABILITY ANYAUTO MZAR0312991 7/21/2015 7/21/2016 COMBINED $1,000AU0 BODILY INJURY(Per person) $ X ALLOWNED CHEOULED AU705 Oro S HIRED AUTOS N AUTOBWNC° BODILYINJURY(Paraccidenu $ PERTYD b Peramldan! $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVL- OrPICER/MEMBER EXCLUDED4 (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WZPBI028890 [7/21J2;015 7/21/2016 X PEAT TE OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1.000,000 E.L. DISEASE. POLICY LIMIT $1.0011000 A Professional Liability Claims Made 106119195 7/21/2016 Per Claim $1,000,000 Ann[ Aggr $2,000,000 REVIEWED DY. Et1NtCE k-3EREC)lA (F'G. ern=/ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddUlonai Remarks $cheduie, moy be attached It morn spaco le roqulred) General Liability policy excludes claims arising out of the performance of professional services. Independent Contractors Included as respects to General Liability. 30 Day Notice of Cancellation/10 Day notice for Non -Payment of Prom Re: On Call Engineering Services. Agreement numbers A-2008-218 and A-2015-236. City of Santa Ana, its officers, employees, agents, volunteers and representatives are additional insured as respects to General Liability as required by written contract. Primary and Non -Contributing coverage applies to GL as required by written contract. Waiver of Subrogation or Rights applies to Workers Compensation policy only as required by a written signed contract prior to any loss occurring. City of Santa Ana 20 Civic Center Plaza -Ross Annex (M-36) Santa Ana CA 92701 ACORD 25 (2014/011 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 I�QrL,vK_ �7YlCy1.P ©1 rho ACORD name and logo are registered marks of ACORD All riaht8 Workers' Compensation and Employers' Liability Insurance Policy Waiver of Our Right to Recover From Others Endorsement - California WC 04 03 06 If the following information is not complete, refer to the appropriate Schedule attached to the policy. Insured;PENC0 Engineering, Inc. Producer: Dealey, Renton & Associates Schedule Person or Organization City of Santa Ana 20 Civic Center Plaza -Ross Annex (M-36) Santa Ana CA 92701 Additional Premium % We have the right to recover our payments from any- one liable for an injury- covered by this policy. We will not enforce car right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under ❑ written contract that requires you to obtain this agreement from tis,) Iljaru;,.. J'hrn P Authorized RelimsentAiN e wcoaoaee Policy Number WZP81028890 Effective Date 11/20/2015 Job Description Any person or organization for which the Insured has completed a written agreement to provide this waiver You must maintain payroll records accurately segre- gating the remuneration of your employees while en- gaged in the work described in the Schedule. The additional premium for this endorsement shall be the percentage, as shown in the Schedule applicable to this endorsement, of the California workers' compensation premium otherwise clue on such remuneration. RFVIEVVED BY//j —A - EUNICE HEREDIA lPG 7 OF Iffi Penco Engineering, Inc. AZC80905277 EXCERPTS FROM: Fireman's Fund ABC MULTICOVER — AB 91 89 08 07 THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: AMERICAN BUSINESS COVERAGE 2. Blanket Additional Insured Section II — Liability Coverage, Part I. Who Is An Insured, Item 2, is amended to include: f. Any person or organization that you are required by a written insured contract to Include as an insured, subject to all of the following provisions; (1) Coverage is limited to their liability arising out of: (a) the ownership, maintenance or use of that part of the premises, or land owned by, rented to, or leased to you; or (b) your ongoing operations performed for that insured; or (e) that insured's financial control of you; or (d) the maintenance, operation or use by you of equipment leased to you by such person(s) or organization(s) 4. Blanket Waiver of Subrogation Section II — Liability Coverage, Part K. Liability and Medical Payments General Conditions, is amended to include: 6. Transfer or Rights of Recovery Against Others to us and Blanket Waiver of Subrogation b. If required by a written Insured contract, we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your operations or your work for that person or organization. 19, Common Policy Conditions (AB 00 09 A 01 87), Part H. Other Insurance, Item 2 is replaced with: 2. Coverage C — Liability If other valid and collectible insurance is available to any insured for a loss we cover under Coverage C of this Coverage Part our obligations are limited as follows: a. The insurance provided under this policy is primary if you are required by a written insured contract to include any person or organization as an insured, but only with respect to that insured's liability arising out of the ownership, maintenance, or use of that part of the premises owned by or rented to you, or your work for that insured by or for you. Any other insurance available to that person or organization Is excess and noncontributory with this insurance. EXCERPT FROM: PROPERTY/LIABILITY POLICY -- AB 90 00 12 93 II, K. 5. Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy 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. REviEWEDBY,G/1.v. 11fIA, . EUNicEHEREDiA(PcS(XtU) FleetCovertkR, Endorsemeni - CA 70 18 03 10 Policy Amendments) Commercial Business Auto Coverage Form - Motor Carrier Coverage Form A. Broadened Named Insured as an insured under any other automobile N- obility insurance policy whose limits of insur- Sectton CI - Liability Coverage, A, Coverago, t• ante have been exhausted or whose insurer 4Y'ho Is An Insurccl. the following is addc d. has become insolvent. Any organization you own or the inception of Ibis policy, or newly nequiro or inlet during the policy peeiocS, and over which you maintain during the policy period, nutjority ownership m• majority in- terest will qualify ,Is a Named Insured ir; (1) Tlaero is no other .similar insurance available to that organization: and (2) The first Nulled Insured shown in tlrc Deo- laradons of this policy has the responsibility orplacing insurance I'or that organization; and If The organization is ineorpmated or organized ❑odor the laws of the united Sums of Amer- ca. I lowevel (a) Coverago under this provision is anaided only until the next oeourrirg 12 month anniversary of the buginuing of tilt policy period shown in the Declarationu, nr tile; call of the policy Period, whichever is earlier; and (b) Cavcragc under this pnrovision does not apply to bodily injury of property damage that re- sults Boar an accident that occut'rud befloe you acquired or forncd the organization; and (e) No pardon of organiaation is an insured with respect to ally current or past partnership, w joint venrore that is not shown as It Named Insured in the Declarations; and (d) Coverage under A,(I), (2) and (3) above does not apply to any organization that is coverer( R. Rroadened Who Is an Insured I, Form CA0001 (if' attached to this policy), Section n - Liability Coverage, I. Who Is An Iniurcd, item b.(2) is deleted, and d. is added as follows: d. Your employee while using with your permission his owned auto, or an auto owned by a i mnher of his or her house- hold, in your business or your personal afhdrs, provided you do not own, hire or borrow that auto. 2. Form CAo(LO (if attached to this policy), Section 11 - Liability Coverage, I. Who N An Insured, item b.(2) is deleted, and f, is added as follows: C Your employee or agent while using with your permission his owned private pas- scnger type auto, or a private passenger type auto owned by a member of his or her household, in your business or per- eonal affairs, provided you do not own, hire, or borrow that into. C'. Additional Insured Coverage and Waiver at Subrogation I. Form CA0001 (if attached to this policy), Section 11 - Liability Coverage, 1. Who Is An Insured, the following is added as item c.; and form CA0020 (if tolached to this policy}. Section 11 • Liability Coverage, 1. Who Is An Insurod; the following is added as itcru g.: 'fats Form trust be outchad to CLwrge Lndorsea¢nl Mmi iesucd tiler the policy a w,jaea. Ulu of the Ft.unan's Food Insurance Cotapanles lie owned m the policy Secretary prcxidcnt CAN'S 3-le Page I or 7 REVIEWED BY: (/Gr_r/L(IN1c; 1IEt,eDia(carf0F/C7) Any person fir organization with respect to the operation, maintenance, or use, of a cov- eted pour, provided (hat you and such person or organisation have agreed under fill ex pressed provision in a written insmredcontrw or written agtecnicn(, ur a written permit is. sued to you by a govennncntal or public au- thority, to add such person, organization, or gowminental mpublic mdhorily to this pol- icy as all insured Ilowevcr, such person fir organizanon is an insured: (I) Only Willi respect to the operation. maintenance, or use, of a covered auto; sand f2) Only for bodily injury or properly dam- sn„e caused by an accident which take, place title]: fs) %'nu executed file insured Contract or written agreement; or fill The penuit has been issued to you. 2. Porno CA0001 (il' attached to this policy). Section IV - Business Auto Conditions, A. Loss Conditions, item 5.; and form CA0020 fif attached to this policy), Section V -Motor CarrierCoc itlons, A. t,ws Contfilions, item 6.: the following is added: Waiver of Subrogation If required by v a. Written insured contracl or written agreement executed prior to the neciel l; or b, Written poni;it issued to you by a gov- ernmental or public authority prior to the accident; we waive any right of recovery we may have against any poison m' organization named ill such contract, ag rvement or permit, bccauso of payments Nye make for injury or damage arising out of ('he ownership, oaaintenance or use or a covered onto. D. Auto Medical Payments - Increased Limit For each Covered auto described in the Deduct - lions no shown in file ScheLlule as having Anto Medical Payments Cove;agc. the Medical Pav- mcnts I.imii of Insurance for (hose solos k revised to the grcatm' of: I. .55.000: or 2. 'File limit shown in the Declarations F.., Ifired Auto Physical Damage Covcrapc and Loss of Usc Expenses Hired Auto Physics] Dntnnge Coverage If Physical Damago Coverage is provided by this policy oil your owned covered Ruins, the following applies: Any auto that you (case, hire, rent or borrow widxan it driver, will be covered under this policy tin' Physical Damage Covcragc. Ilowevor any such suto: I. Wit( be Covered only for the, scone Physical Damage Coverage [hat applies to your owned covered ccocos; 2. Will be subjee[ to the some applicable deductible shown in the Declarations that applies to your most similar owned covered auto. except ally Comprehensive Coverage deductible does not apply Ill loss causer) by fire or lightning: and 3. The most we will pay for coy one lass in any one aceidcnt is the lesser of the Following: Actual cash value or the damaged or smAcn prolrcrty as of the time of the loss as dowrtnined by its; or b. The cost of repairing or replacing the damaged or stolen property Willi othu' property of like kind and quality. To nddicon, we will pay costs and le-cs associated With such Covered loss only for a mnsilnum tines Period of seven clays beginning with the date of loss, subject to a maximum of 5500. I I owcver: I. If torn CA0o01 is attached to this policy, this covenage does not tlpply to uuus you leaAe, hire, rent or burrow from any of your employees, pummels fif you are a partnership), members (if you arc a limited liability cem- peny) or members of their households: and CArma a-lo Page 2 of I REVIEWED L'Y:a, g j E.UNICE HEREDIA {PG If form CA0020 is attached to this policy, this coverage does not apply to any private pas- senger type auto you base, hire, real or bor- row Thom any member of your 11011SCheld, any of your employees, Partners (if you are, a partnership), mcmbors (if you are a limited liability company), or agents or members of dteir households. Mired Auto Loss of Use Expenses Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A, Coverage, 4, Coverage Extensions, b. Loss of Use Rxpenvcs; and form CA0020 (if attached to this policy). Section IV - Physical Damage Coverage, A, Coverage, 4. Coverage F.xteneiuns, b. Loss or Use P",xpenses; in deleted andreplaced by the following: b. For [fired Auto Physical Damage, we will pay expenses for which as Insmradbenomca legally responsible to pay for loss of use of a vehicle canted or hired without it driver, under a written rental contract or agreement. We will Pay for loss of use expenses il'Cuscd by. ( I) Other than collision only if the Dacimxo- tions indicate that C'omprchensive Cov- erage is provided fear any covered auto; t2) specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss is provided for any cov- ered auto; or (1) Collision only ifthe Declinations indicate that Collision Coverage Is provided for any covered auto, flowever, tite most we will pay for any ex. penscs for loss of use is SI00 fill day. 10 a maximtnrt ol'SI,000. F. Coverage 'Territory - Hired Auto Pone CA 0001, (ifanached to this policy), Suction IV - Business Auto Conditions, B. General Condi- tions, 7. Policy Period, Coverage Tell is replaced by the following Conditions, 7. Policy Period, Coverage Territory, h.(S).(a); is replaced by the following: lal A covered auto of the private passenger type is leased, hired, ranted or borrowed without a driver for a period of 130 days or less: slid G. Communication Equipment Coverage I. perm CA 0001 of attached to this policy), Section III - Physical Damage Coverage, C. Limit of Insurance, Paragraph 2, is deleted and replaced by the following: ?. 51,500 is the ttrost see will pay for loss in any cote. accident to all electronic equip- ment that reproduces, receives or traus- mils audio, visual or data signals which, at tic limo of the loss, is: 2. Form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, Limits of I11SUIR ee, Paragraph 2, is deleted and replaced by the following: 1. S 1,500 is tine "last we will pay for loss in tiny one accident to all electronic equip- ment that reproduces, receives or trans- mits audio, visual ur daut signals which, at the tinm of the loss, is: H. Tapes, Records, CDs and DVD Coverage A. Collor Comprehensive Coverage, we will pay liar loss to tapes, records,, discs or other similar devices used with audio. visual or data oleo- home equipment. We will pay only if file utpes, records, discs or other similar audio, visual or [hall electronic devices: .. Arc your property, or that of a Plimily number: and 1 Are in it covered auto at the time of to loss. H. The most we will pay for loss is 5250. C. Physical Damage Coverage provisions, apply to this coverage, except that no deductible applies, (a)A covered auto of the private passenger type 1. Personal Effects Coverage is leased, hired[. rooted or borrowed without a driver i'or a period of 180 boys of less; cold From CA0001 of attached to this policy), section III - Physical Damage Coverage, A. Coverage, 4. Penn CA0020 (ifa(tachcd to this policy), Section Coverage Bxtcrtsions; and form CA0020 (if at- V - A9otor Carrier Condituns, B. General inched to this policy), Section IV - Physical CAMS s-+o a Psgc 3 of 7 REVI EWEn Y' �f r /!) EtJhl7CE HC::REDIA t'G OFto Damage Coverage, A. Coverage, 4. Coverage Ea- teaxians; item d. is added as follows: d Personal Effects Coverage We will pay up to 5500 for loss (or clothing items nr other personal effbets that are owned by an insured and are in all Owned auto at the time of a covered loss. Personal Effects do not include audio visual or electronic devices, money, giftoards. SCCru- ritics, jowclry, or tools. This coverage is excess over any other collec- fible insurance (I) We will pay only for those cxpenyes in- currcd by you that begin 2=4 hours after the covered loss. (2) We will cease paying for those expenses, regardless of the policy's expiration date. at the earlior of the following dates: (a) The number n1' (lays leasonably re- quired to repair or replace tine cov- ered auto. II' loss is caused by theft, this number of clays is added it) the number of days it takrs to locntc and return the covered auto to you; or (b) 45 clays Iron the date this coverage No deductible applies to this covcntge. begins. ,1. Ah-bog Coverage (3) Our payment is limited to the lesser of the following anl➢antiI I, Form CA0001 (it' attached to this policy), Section III - Physical Damage Coverage, 13. (a) Necessary and actual expenses in - Exclusions. 3.a.; and Fmm CA0020 (if al- curred by you; or Cached to this policy). Section IV - Physical Damage (:overage, B. Exclusions, 3.a.; the (b) SIJ00. following is Li (4) Tlus coverage does not apply while there However, mechanical breakdown does not tare Spam Ol reserve autos available to you mean the unintended discharge of an air -bag, for your operations. provided that any loss covered under this provision is excess over any other collectable (5) If loss results from the total theft of a insurance or wtuaxmty (designed to Cover such covered private passenger type auto of unintended dischargN. CA0020 is attached to this policy), or a K. Rental Rein laurscincrit covered private pussenger auto fir CA0001 is attached to this policy), we Forth C'AU001 (if attached to this policy), Section will pay under this coverage only that III - Physical Damage Coverage, A. Covcragc. 4. amount of your covered rental expenses Covcragc Estuosions; and form CA0020 (if at.- or additional n:ansporralion cxpeaecs utcbeef to this policy), Section IV - PhY-sical Dam- which tire not already provided for under age Coverage, A. Covcragc- 4. Coverage the Physical Dainage Coverage Uxtcn- Utensionat item c Is added as follows' sions. c. Rental Reintbnrsement or Transportation 1- E]tended Towing Coverage Espouses If loss occurs to a covered ;into described or designated in the Declarations or Schedule and covered for Physical Damnge Coverage, we will pay for rental e,vpenses frnr the rcnral of it similar replacement auto and additional transportation expenses. incurred by yolk. This payment applies in addition to the oth- euvise applicable amount of each coverage you It on the covered auto. No deductible applies ut this coverage, Howeam': I. Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 2. Towing. is replaced by th,: fol- lowing: 2. Fxtended Towing We will pay all to S750 per disableaury or towing and labor costs you orient. each time your co m,ed unto is disabled. However: CAT0183-10 Page A of 7 _E EVIEWED BY: / Y, € MCE HEREDIA (PG 7Ot- � Ft(...---------�--t, a. All labor must be performed on tho place• of disablement; and b. 11' the covered auto is of the private passenger type, no deductible ap- plies; and C. If the covered auto is not of the pri- vate passenger type, our obligation to pay will be reduced by to $250 deductible par disablement. d. 11'tha covered auto is not of the pri- vile passenger type and the disablc- mcmr results Prot', a loss covered under Section III - Physical Damage Coverage, A. Coverage, Paragraphs i, a., b., or c., there is no separate deductible for the Extended Towing Coveoulol. For' Pluposes of this coverage. disal le- mont means a breakdown of the covered onto including mechanical hreakdown, engine falhlre, or tiro blowout, where re- pairs cannot be made roadside and a tow is requimd to remove the auto rent the roadway and to suck additional services unit repair. 2. Form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, \ Coverage, 2. Towing - Private Pa.ssmagor Au- tos, is roplacad by Lite following: CA(eta 3-10 2. Extended Towing We will pay up to $750 per disablement for towing and labor costs you incur each time your eoveml auto is disabled. However: a, All labor roust be performed at the place of disablement; and b. If the covered auto is of the private Passenger type no deductible applies; and c. if' the covered [into is not of tilt private passenger type our obligation to pay will ba reduced by a S250 deductible per disahkanent. d. If the covered onto Is not of the prl- vale passenger type and the disalk- ment results rout a loss covered under Section III - Physical Damage Coverage, A. Coverage, Paragraphs 1, a., b- or c- thou is no separate deductible for the Emodcd Towing Covertoge. ~ For purposes of this cuvcrage, disable- ntcnt moans a breakdown of' the covered auto including mechanical brcakdown, engine failure, or tiro blowout. whole re- pairs cannot be made roadside and a tow is required to remove the auto from the roadway and to seek additional services and repair. [Vl. Cancellation - 120 Days Notice If' we cancel this Policy for ally reason other than nonpayment of premiuun, we will n1ni1 or deliver to the first Nmned Instn'ed at the last mailing ad- diess known to its, written notice of ctmccliation at least 120 days prior to the effective date of can- cellation. N. Snpplenrentary Payments - Increased Limits Snctinn If - Liability Coverage, 2. Cnvnrngc Ex- tensions, a. supplcmcntary Payments, iteurs (2) and H) are replaced by the following: (2) Up to 52,500 for the cost of bail bonds (im eluding bonds for related traffic law vio. lotions) required bCCuUSe of an accident we Covell. We do not have to fiu-nish these bonds. pt) All romonable expenses incurred by the insuredat our rcgtwst, inchtding sub%tnmiated Toss of ctarniugs up to $500 a day. because of time off flvm work. 0- Duties in Tile Event of Accident, Claim, Suit or Loss - Amended Foray CA0001 (if attached to this policy) Section IV - Business Auto Conditions, A. Loss Condi- tions, item 2. a.; and form CA0020 (if attached to this policy) Section V - Motor Carrier Conditions, ,V Lass Conditions, itc[n 2. a.: is replaced by the following• It, In the event of accident, claim, suit or loss, you must promptly notify us or our author- ized representative when it becomes known to: (1) Yoe, ifyou m'c an individual; Page i of 7 REVIEWED BY4f4-Z- 14,�7✓%l EUNICE FIEREDIA (I'G eJFjO) (21 Your parhtcr or nu:mbm. if' you are a partnership or joint venture: (3) Your member, ifyou are a limited liabil- ity eontpany: (J) Your executive rl'licer i( you arc an or- ganization other than a partnership- joint venture or limited liability company: ur (5) YOU] wfiotircd representative ur insur- ance InallagCr. Knowledge of ,in accident. claim, stilt or loss by o(hcr persons does not imply that the persons listed above have such knowledge. Notice Should include: (1) How, when and where tits accident at loss occurred; and (2) The insured'snatne and addro;s: and (3) To the extent possible, the names and address of any injurcd pmsor.s and witnesses. D. Unintentional Failure in Disclose Hazards Font C'A0001 (if attached to this policyl, Section IV - Business Auto Conditions, B. General Condi- tions, item 2.; and fury CA0020 (if attached to (his policy). Section V - Motor Carrier Cunditions, 13, General Conditions,, Bern 3.; the following is added: However, ifyou unintentionally fail to disclose tiny hazards existing at the inception date orthis policy, we will not deny Coverage tinder this Coverage Font because of such failure, This provision does not affect Our right to collect additional Imcnnitun or exercise our right of cancellation or non-rcnc- wal . Q. Fellow Employee Coverage Section 11 - Liability Coverage, 13. Exclmsions, 5. Fellow Employee. the fnhowing is added: However, this exclusion does not apply if the bodily injury resutrs front the ttse of n covered auto you own or hire, and provided that only cov- erage older this provision only appfics in excess ever any other collectible insurance. R. Limited Vleeico Coverage WARNING ALTO ACCIDENTS IN MEXICO ARE. SCB- JECT TO THE LAWS OF NIEXICO ONLY - NO'T TIM,' LAWS OF THE UNITED STATES 017 AMERIC'A, THE RC.PUSLIC: OF MF.X- ICO CONSIDERS .ANY AUTO ACCIDENT A CRIMINAL. OFFENSE AS WELL AS A CIVIL NIATI'I,-R. IN SOML CASES Tiff; COVERAGE PRO- VIDED HERE MAY NOT BE REC'OGNI7F.D I3Y THE ME1XICAN AUTl-IORff1F.S AND WE MAY NOT BE ALLOWED TO IMPLF.- AF,NT THIS COVERAOF AT ALL IN MEXICO. YOU SHOULD CONSIDER PUR- CHASING AUTO COVERAGE FROM A LICENSED MEXICAN INSURANCE COM- PANY BEFORE DRIVING IN MEXICO. THIS ENDORSEMENT DOES NOT APPLY TO ACCIDENTS OR LOSSES WHICH OC- CUR OUTSIDI.i OF 25 MIFFS FROM THE BORDER OP THE UNITED STATES OF ANIERICA. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, B. General Condi- tions, item 7.: and front CA0020 (if attached to this policy), Section V - Mntor Carrier Condi- tions. B. General Conditions, item 7.: tho follow- ing is added: The coverage territory is extended to include MCaico, hot Only: a. For accidents or losses cccur:'ing within 35 miles of the united States border; and b, For trips into Mexico ol' 10 clays or loss: and C. If the covered auto is principally garaged and principally used in the United States: and It If the, insured is it resident of the United Statcs. If it loss to a covered auto occurs in Mexico, are pay far such loss in the United States, 11the cov- ered auto must be ropairo.d in Mexico in order to be driven, we will not pay for mare than the actual cash value of such loss as determined by us at the nearest Ullood states point where The repairs can be made. CAN'63 to Page 6 of 7 REiVIENII'_fl BY �, v7—�.3,__�_t3uP110E HEfzEt)IA (PG qOF/0 ) Any insurance provided under this provision will be excess over any other collectible insurance. S. Extended Class Coverage Donn C'A0001 (if amaulud to this policy), Section III — Physical Damage C'ovcrage, A. Coveiaai , item 3.a.; au:d form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, itonr ).a.; is replaced by the follow- ing: n. Glass breakage. It glass must be replaced, the deductible will be ti100 ur the deductible shown, in the Declarations, whichevoi is lens. If glass can be repaired and is actually repareti rather (hat replaced, the deductible will be waived. You have the optirnn of having the glass repaired rather than replaced. T. Broadened Definition of Bodily Injury Fenn C'A0001 (if attnchod to this policy), Scalia, V - Definitions, item C.; and Farm CA0020 (Wat- (achcd to this policy). SECTION VI - DEFI- NITIONS, item C.; is replaced by the fallowing: CBodily Injury means bodily injury, sickness or disrr3e sustained by it person including death or nteuttl anguish resulting from any ol'thesc at any onto. Mental anguish moans any, type of nunral m: emotional illness or di- scasc. L'. Customer Lease or Loan Physical Damage C'over- age Extension Pone CA0001 (if attached to this policy), Section HI - Physical Damage Coverage, C. Limit of In- strof)M and form CA0020 (it' attached to this policy). Section IV - Physical Damage Coverage, C. Limits Qf In9nr-nneC; item S. is added as Bellows: i. If ,your covered owned suit) is: (1) Shown in the Schedule and designated as covered Inn Physical Damage C'ovcr- age: and 12) Shown in this polity as having it lass payee or ndditiunal-iusurud-lessor, and 0) Incurs a covered total loss; we will pay the gretatcr of (n) Tlic aetnol cash value, as determined by us, of the damaged or stolen propm'ty as of the time of the total loss: or (h) The outstanding indebtedresa under the initial Imance agreement for the covered safe and its cyvilnnent. As used hC'c, outstanding indebtednessmcans the amount YOU owc on the finance agree - Client 2t Clio time of total loss: W Less any amounts representing tuxes, ovoic(ue payments, penalties, interest, or charges resulting from overdue paymouts, additional mileage, exec:::; weal and sear, or leasc termination fees; and 00 Less any administrative costs or ovcnccaci. ices assessed by the lnance company who has leased the cooerml auto to you; and (tit) Less socurity dcposlna not returned by tin lessor; end (iv) Lens costs for extended waianties, Credit Lilo Insurance, Health, Accident or Dis- ability Insurance purchased with the loan or lase; and (v) Less carry-over halanccs from previous loans or leases. V. Two at- More Deductibles Seen()" III - Physical Damage Coverage, D. De- ductible, (he rllowing is added: It' another Firenan'.s Fund Insurance Company policy or coverage Poem that is not on automobile policy or coverage form applies to the same acci- dent or loss, the following applies: (1) If the deductible under this Business Auto Coverage Form is the lessor of (or leatsL) de- ductiblo, it will be waived. (2) If (hc deductible under this Business Auto Coverage Form is not the lesser, (or (cast) de- ductible, it will be rvduecd by the wnounl of the Icsscr (or [cast) dcductibtc. cnzC'a a-r r, Paige 7 oi' 7 FtGVICEUNICE FIEREDIA (PGA)OF10) PENCENG-01 GORDONS CERTIFICATE OF LIABILITY INSURANCE DATE 1 7115/215/2016 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 License 4 OE67768 CONTACT NAME: Victoria Godfrey IOA Insurance Services 3875 Hopyard Road PHONE 925 416-7862 FAX 925 416-7869 A/c No Ext : ( ) {A/C, No): ( ) EMAIL ADDRESS: Suite 240 Pleasanton, CA 94588 INSURER(S) AFFORDING COVERAGE NAIL # INSURE A: RLI Insurance Company 13056 INSURED INSURER B: Atlantic Specialty Insurance Company 27154 INSURERC; Penco Engineering, Inc. INSURER D 16842 Van Karman Avenue, Suite #150 Irvine, CA 92606 -- - - INSURER E . INSURER F : CUVtHAUL3 CERTIFICATE NIJMRFR- Qr=vletnnt nn tneacD. 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 rADDL!SUBR IINSD'WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X.� OCCUR - I IPSB0006402 07/21/2016 07/21/2017 EACH OCCURRENCES PREMiSEs_(EaoccLrronce)__ 1,000,000 — s 1,000,000 ..1,00 -- ... MEDEXP-(Any one, person) S 10,000 PERSONAL R ADV INJURY S 1,000,000 AGGREGATE LIMIT APPLIES PER: PRO- POLICYa JECTEl GEN'LL GENERAL AGGREGATE S 2,000,000 PRODUCTS-COMP/OPAGG —.. _ ._.. - a 2,000,000 _ . S OTHER: A AUTOMOBILE XANYAUTO X LIABILITY ALL OWNED SCHEDULED AUTOS --- AUTOS NON -OWNED HIRED AUTOS X AUTOS j PSA0002222 07/21/2016 I 07121/20171 COMBINED SINGLE LIMIT Ea acadenti S 1,000,000 BODILYINJURY(Perperson) -- --- I BODILY INJURY (Per accident) PROPERTY DAbtAGE -(Peraccldent) S S _.--._--------....._.... $ $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PSE0002785 07/21/2016 07/21/2017 EACH OCCURRENCE 8 1,000,000 AGGREGATE S 1,000,000 DED I X RETENTION $ S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A PSW0003626 07/21/2016 .. 07/21/2017 X PER OThI S I'ATUTE _ ER EL EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 1 E.L. DISEASE -POLICY LIMIT $ 1,000,000 B Professional Liab. DPL-6661-16 07/21/2016 07/21/2017 Per Claim 2,000,000 B Ded Per Claim $25k DPL-5661-16 07/21/2016 I 07/21/2017 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: On Call Engineering Services. Agreement numbers A-2008-218 and A-2015-236. City of Santa Ana, Its officers, employees, agents, volunteers and representatives are additional insured as respects to General Liability as required by written contract. Primary and Non -Contributing coverage applies to GL as required by written contract. Waiver of Subrogation or Rights applies to Workers Compensation policy only as required by a written signed contract prior to any loss occurring. r ( REVIEWED D B / � � r E t IA kBC, i f 1P- EKED (PG +, y l City of Santa Ana 20 Civic Center Plaza -Ross Annex (M-36) IYIrCL _A 11UN 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 V IUUS-ZU14 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD Policy Number: PSB0006402 RLI Insurance Company THIS ENDORSEMENT CHANCES THE POLICY, PLEASE READ IT CAREFULLY. RLIPack° FOR DESIGN PROFESSIONALS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II -.. LIABILITY 1. C. WHO IS AN INSURED is amended to Include as an additional insured any person or organization that you agree in a contract or agreement requiring Insurance to include as an additional insured on this policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or In part by you or those acting on your behalf: a, In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2, The Insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this policy. b. This insurance does not apply to the rendering of or failure to render any "professional services", c, This endorsement does not Increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance: 3, The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy 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 additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b, The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement, 4. The following is added to SECTION III K. 2. Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO ONLY TO SECTION Ii — LIABILITY) 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 and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" Occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED, p Page 1 of 1 F Policy Number: PGA0002222 This endorsement modifies insurance provided under the followIng: BUSINESS AUTO COVERAGE FORM A. Broad Form Named Insured The following is added to the SECTION U - LIABILITY Coverage, Paragraph AJ. Who Is An Insured Provision: Any business entity newly acquired orformed by you during the policy period, provided you own fifty percent (50%) or more, of the.business entity a nd the, business entity is not separately insured for Business Auto Coverage. Coverage is extended Lip to a maximum of one hundred eighty (180) days following the acquisition or formation of the business This provision does not apply to any person or organization for which coverage is excluded by endorsement, B. Employees As Insureds The following is added to the SECTION U - LIABILITY COVERAGE, Paragraph A.1.Who Is An /nooredPmvision: Any "employee' of yours isan"inuned^while, Lising acoyered "auto" you don't mmn' hire or boAnw in your business oryourpersonal affairs. C. BlanketAdditionial Insured The following is added to the SECTION U - LIABILITY COVERAGE, Paragraph A.1.Who ieAm Insured Provision: Any person nrorganization that you are uequir0d tO Include cis an additional insured on this coverage form in a contract nreQneementthat is executed by you before the "bodily injury" or "property damage" occurs is an "insured" for liability onvaoaQe, buL on|y for damages to which this insurance epp8oa and only to the extent 'chat person or or�ganizaUon qualifies ou an "insured" under the Who Is An Insured provision conhainod in SECTION || - LIABILITY COVERAGE. The. insurance provided to the additional insured will be on o primary and non-000tribulfor beuio.1to the additional inaunyd'u own business auto coverage, if you Iara required hodouo in a contract oragreement that is executed by you before the "bodily injury" or .1 property damage" Occurs. D. BlanketWaiverOfSubrogation The following is added to the SECTION K/ - BUSINESS AUTO COND|T|O0S, A. Lnea Conditions, !i Transfer Of Rights Of Recovery Against Others To Us: We�waive any right ofrecovery wnmay have against any person or organization kzthe extent required of YOU by a contract executed prior to any "accident" or ~loaa^, provided that the "accident" or '`|mso^ ahmou ou( cfthe operations contemplated by such cuntnsoL The wa,iver applies only to the person or organization designated {nsuch contract. E. Employee Hired Autos The, following in added to [lie SECTION U - LIABILITY COVERAGE' Paragraph /\.1. Who Is An Insured Provision: An "employee" of yours is an "Insured" while operating an "auhO" hired or rented under a contract or -agreement in that "employee's' name, with your permiunion, while performing duties related intheconduct ofyour business, 2. Changes In General Conditions: Paragraph �b. of the Other Insurance Condition in the BUSINESS AUTO CONDITIONS isdeleted and replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered ^auhzn^you own: (1) Any covered "amo" you |oaue' h|na, nanL nrborrow" and (2) Any covered "auto" hired or ranted by your^employee^under acontract inthat indiVICIu-Al e'o^neme�Withyour pennisykon, whiie performing duhes n�eLed to the conduct of your 6uoinena. Hmxaver. any ''euhz" that is |eaoed, kinad' rented or borrowed with adr|ver is not a covered "auto". F. Fellow Employee Coverage SECTION U-LX\EULrTY COVERAGE Exclusion E\5. do -en "lot apply if you have worker compensation inmuroncein-force covering all of your employees, G. Auto Loan Lease Gap-Coverage�_ SECTION III - PHYSICAL. DAK0AGECOVERAGE, C. Limit Of Insurance, is emended by the addition oithe following: In the event of at total '')oaa^ to a covered "auto" shown in the Schedule ofDeclarations, we will pay any unpaid amount due on the lease Or loan for n oovened"autO^. |eao: Policy Number: PSWO003626 WORKERS CumPL-N8ATO0AND EMPLOYERS UAB|L|TYINSURANCE POLICY YyGD4U30O (Ed.4-U^g WAIVER OF OUR RIGHT T{)RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this pdicy, We will not enforce our right against the person or organization named in the Schedu|e� (This agreement applies only tothe extent that you perform work under a written contract that requires you to obtain this agreement from us) You must maintain payroll records accurately segregating the rern uneration of your employees while engaged ill. tile wokdeaucibnd.in the Schedule, Tile additional premium For this endorsement shall be _2.% of the California workers' compensation prernium otherwise due onuuubremuneration, pu/vpvw,{)nywoizuUvn All persons ororganizations that are party to contract 'that nequine�syou toobtain this ogmnmcnt,pmvidodyou oxooutod thoonnhom before, the.loss, Schedule JvUovvt;,ipUm/ Jobs performed for any person or o rganization 'that you have agreed with inawritten contract toprovide this ogmomon'. This endorsernerit changes the policy In which It is attoched and is effedive or) the date issued unless oihewjsvxtjted, (The information below Is required an ly when this a riclorsann grit I" Issued SUbspquent to proparation of the pal icy.) snuomomo'emecu*, pm*ywu Endnrsennentwo. Insured Insurance cG=lpany RL| insurance Company Countersigned By @1998 by the Workers' Compenratlon Insurance Rating Bureou of California. All rights reserved. PENCENG-01 FRANCISC AGORA CERTIFICATE OF LIABILITY INSURANCE �DATE(�MM/DD/YYYY) 7/21/2017 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 License # OE67768 CONTACT Marie Benjamin NAME: IDA Insurance Services PHONE FAX 3875 Hopyard Road (A/c, No, Ext): (925) 660-3530 50030 (A/c, No): (925) 416-7869 Suite 240 noDRIL Marie. Benjamin@ioausa.com Pleasanton, CA 94588 . __ INSURER(S) AFFORDING. COVERAGE '.. NAIC # INSURER A:RLlInsurance _Company 13056 INSURED INSURER B;.Atlantic Specialty Insurance Company 27154.""„ Penco Engineering, Inc. 16842 Von Karman Avenue, Suite #150 Irvine, CA 92606 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR':" TYPE OF INSURANCE 'ADDLSUBR POLICY NUMBER POLICY EFF TR N D WV M DD YY POLICY EXP LIMITS MM D Y A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X ' OCCUR PSB0006402 07/21/2017 ' 07/21/2018 DAMAGE TO RENTED PREMISES (Ea occurrence)._. $ 1,000,000 MED" EXP (Any one person).... $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PPp LOC PRODUCTS - COMP/OP AGO $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO PSA0002222 07/21/2017 07/21/2018 BODILY INJURY (Per person) $ OWNED SCHEDULED ._ AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ OS ONLY NON-OWNED X ! AT XSONL ONLY POaednt}AMAGE (r c$ $ A UMBRELLA LIAB" X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS -MADE PSE0002785 07/21/2017', 07/21/2018 AGGREGATE $ _.... 1,000,000 j DED X RETENTION $ $ _.. .._. A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER OTH- STATUTE ', ER__.. YIN PSW0003626 07/21/2017 PROPRIETOR/PARTNER/EXECUTIVE 07/21/2018 E.L. EACH ACCIDENT $ 1,000,000 OFFICERWEMBER EXCN / A in NH) '.. 1,000,000 (Mandatory E.L. DISEASE - EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B ',Professional Liab. DPL700617 07/21/2017', 07/21/2018 Per Claim 2,000,000 B IDed Per Claim $25k DPL700617 07121/2017', 07/21/2018 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: On Call Engineering Services. Agreement numbers A-2008-218 and A-2015-236. City of Santa Ana, its officers, employees, agents, volunteers and representatives are additional insured as respects to General Liability as required by written contract. Primary and Non -Contributing coverage applies to GL as required by written contract. Waiver of Subrogation or Rights applies to Workers Compensation policy only as required by a written signed contract prior to any loss occurring. REVIEWED FSY: EUNIC:E HEREDIA (PG ( OF CERTIFICATE HOLDER CANCELLATION 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 PRESENTATIVE City of Santa Ana 20 Civic Center Plaza -Ross Annex M-36 ACORD 25 (2016/03) OO 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: P8BOOm64U2 RUInsurance Company Named Insured: 'PencoEngineering, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ' ---�_ _--e FOR - PROFESSIONALS -_' _-__'--~~. ~~~,~ BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSCOVERAGE FORM ' SECTION U-LIABILITY C. WHO IS AN INSURED is amended toinclude am an additional insured any person ororganization that you agree in e contract or agreement requiring insurance b»Include aoonadditional insured onthis po|ioy, but only with nnwpoot to |imbiUh/ for "bodily injury". "property damage" or "personal and advertising injury" ouuaad in whole or in part by you urthose acting onyour behalf: m. |nthe performance mfyour ongoing operations; h. |nconnection with premises owned byurrented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2. The insurance provided bothe additional insured by this endorsement iolimited mafollows: a. This insurance does not apply un any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this policy. b. This insurance does not apply buthe rendering of or failure to render any "professional c. This endorsement duao not (ncnamae any of the limits of insurance stated in D. Liability And Medical Expenses Limits ofInsurance, 3. The following is added to SECTION III H,2. Other Insurance - COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION U - LIABILITY) Huwover, if you specifically agree In m contract or agreement that the insurance provided to an additional insured under this policy 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 additional insured oea named ineured, and we will not mhena with that other inmunonoe, provided that: m. The "bodily injury" or "property damage" for which coverage Is sought occurs after you have entered into that contract o,agreement; or b. The "personal and advertising injury" for which coverage Is sought arises out of on offense committed after you have entered into that contract oragreement. 4. The following is added to SECTION |/X K. 2. Transfer wfRights ofRmc*vm | Others to Us - COMMON POLICY CONDITIONS (BUT APPLICABLE TO ONLY TO SECTION O - LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property dmmogp/' or "personal and advertising injury" arising out of "your work" performed by you, or on your behalf, under a contract or agreement with that person or organization, VVawaive these rights only vvhona you have ognaod to do so as pad of a contract or agreement with such person or organization entered into byyou before the "bodily injury" or"property damage" occurs, orthe "personal WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA WC 04 03 06 (Ed. 4.84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be ZO/o of the California workers' compensation premium otherwise due on such remuneration, Person or Organization Schedule Job Description All persons or organizations that are party to a contract that Jobs performed for any person or organization that you requires you to obtain this agreement, provided you executed have agreed with in a written contract to provide this the contract before the loss. agreement. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated, (The Information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No, PSWO003626 Endorsement No. Insured Insurance Company Penco Engineering, Inc. RLI Insurance Company Countersigned By 01998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. LREVIEWED BY., EUNICE HEIREDIA(IDG-30F,3) I