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CROSSTOWN ELECTRICAL & DATA, INC. (2)-2012
City of Santa ." .1a - Clerk of the Coy.. _il COTC Office Use Only AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect.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 Glzes ca:v L P.4 T/?. ,it"4. No. A-20/2-/77 was completed on 0 l36//7- and final payment has been made. (List all amendments. Use space below if needed.) Department: ic'7/4`.4 !T irff iC A - / 7_02_ Phone/Ext.: yS--62 G Signature: Date: ry f 2-c'// - Revised:01-07-16 MAYOR Mrquel A Pulidc iMAYOR PRO TEM Vicente S'amner,o COUNCILMEMBERS Angelica Amezcua P. David 8cmavides Michele Ma[tlnee Rorf3a11 ✓•iai nj uai 71ralero 1118UHANCE ON FILL WORK MAY PROCEED UNTIL INSURANCE EXPIRES PUBLIC WORKS AGENCY 20 Civic Center Plaza M-30' w P G Box 1988 M-36 Santa Ana, California 92702 i rAN 2iiua-aira.orcl June 30, 2016 Crosstown Electrical & Data, Inc. Attn: David P. Heermance 5463 Diaz Street Irwindale, CA 91706 A-2012-177-02 CITY MANAGER C3avid Cavazos C{tY ATTORiNEY 5Qrtie R Canvalhn cLeRi< olP THE COUNCit. Msnta D Nulzar Re: Agreement A-2012-177, "Service Agreement for Advanced Traffic Management System and Communication Maintenance and Repair Services' Extension Dear Mr. Heermance; Pursuant to Agreement A-2012-177 entered by Crosstown Electrical & Data, me, and the City of Santa Ana, dated August 20, 2012, and Extension Letter A-2012.177-01 dated June 18, 2015, Section 3 "Term," the time period of said Agreement is hereby extended for an additional one (1) year period, through June 30, 2017. 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 fall force and effect. If you have any questions, please contact Vinh Nguyen in the Public Works Agency at 714-647-5612. 'y ousavipour CLT • Or SANTA ANA ive Director David Cavazos Works Agency City Manager APPROVED AS FORM: ATTEST; Sonia R. Carvalho City AttSne, -t7✓ Maria D. Huizar / Clerk of the Council IJ stSandoval ,I el'Assistant City AtWincy CON" 1' T _. art7rawar- By: c: Clerk of the Council SANTA ANA Cl FY F;OiJNCH- AC`il CERTIFICATE OF LIABILITY INSURANCE Ill" DATE IMMIDOtYYYY) 06/01/2016 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(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 endorsement(s). PRODUCER LICENSE NO. 0637431 PATRICK MCRAE INSURANCE SERVICES 1290 N. HANCOCK ST., SUITE 210a ANAHEIM RILLS, CA 92807 coNrncNAME:r PATRICK MCRAE PHONE�u (714) 779-B999 ac, N.L714) 779-6903 DRESS: P.mcrae@sboglobal.net INSURERS AFFORDING COVERAGE NAIC# INSURERA; COLONY INSURANCE COMPANY 39993 X INSURED INSURERS: INSURANCE COMPANY OFTHE WEST 27847 INSURERC; CENTURY -NATIONAL INSURANCE CO. 26905 CROSSTOWN ELECTRICAL & DATA, INC. 5463 DIAZ STREET IRWINDALE CA 91706 INSURER O: TOPA INSURANCE COMPANY 18034 _ INSURERS: TOKIO MARINE SPECIALTY INSURANCECOI 23850 INSURER F: LA.I1AaFIA!l7I A:\ LIO IM!\ 11aI0 I 11P4:1ZI: A clTJL9r.l1ff1I1 ;rl - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE POLICY NUMBER MM pI pV EYY MMI�OIYYVY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MAGE ❑X OCCUR X XCU X X 103 GL 0014267-00 DEDUCTIBLE $5,000 PER OCCURENCE 06/03/201606/03/2017 EACH OCCURRENCE $ 1,000,000 ISA AGE r0_R_E_NTff T_ PREMISEs Fao.curan.a $ 100,000 MED EXP (Any ane pars.,) $ 5,000 X OCP PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY C11 PES 11 LOC GENERAL AGGREGATE $ 2,000,000 _ PRODUCTS-COMPIOP AGG $ 2,000,000 $ OTHER: C AUTOMOBILE X LIABILITY ANYAUTO X BAP0171987 - 11/05/201511/05/2016j°aas,dERNcLEUMIT $ 1,000,000_ BODILY INJ URY(Per parson) $ X ALL OOWNEDSCHEDULED HIRED AUTOS X NON -OWNED AUTOS aPe eODILYINJURY(Pereccldsm) $ - PROPERTY DAMAGE ecodenl $ - $ -E--UMBRELLA X UAB E%CESSLIAB _ x OCCUR CLAIM&MADE PUB542883 UNDERLYING LIMITS; GL; AL; EL POLIGIES 06/03/201606/03/2017 EACH OCCURRENCE $ 10,000,000 AGGREGATE _ $ 10,000,000 X OED RETENTIONS 0 $ B WORKERS COMPENSATI TV YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUQED9 a (Mandatory in NH) If OE SC RIP TION OF OPERATIONS below NIA x WVE 5030354-01 06103/201606/03/2017 X s RTUTE GERH.AND �_— 51, EACH ACCIDENT -- $ 1,000,000 E.L. DISEASE - EA EMPLOYEE _ $ 1,000,000 EL DISEASE - POLICY LIMIT $ 1,000,000 D PROPERTY & PC 6600295 790,840 BUILDING CONTRACTORS EQUIPMENT $1,000 DEDUCTIBLE COV. INCL. THEFT 04/10/2016 04/10/20 17 $385,790 BPP -$300,00061 WI EE $116,318 SCHEDULED EQ. $50,000 MISCELLANEOUS TOOLS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Additional Remarks Schedule, may be attached If more space Is re ulead THE CITY OF SANTA ANA, ITS DIRECTORS COM ISSIONERS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEESFSS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS, WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. "SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRUTEN NOTICE WILL BE ISSUED. i RE: PROJECT NAME: "SERVICE AGREEMENT FOR ADVANCED TRAFFIC MANAGEMENT SYSTEM AND COM ONICA_T N MAINTENANCE AND REPAIR SERVICES CROSSTOWN JOB 42413EVIEVVEO BY: - EUNICE HEREDiA (PG �OF} - , m___w__..� CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M-36 SANTA ANE, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE © 1988.2014 ACORD CORPORATION. All ri0hts rpsprved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 108 GL 0014267-00 06/03/2016 TO 06/03/2017 103 GL 0014267.00 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Orrganizatlon(s� Locatian(s) Of Covered Operations All persons or organizations as required by written contract As designated in written contract with the Named with the Named Insured Insured if not shown above, will shown in the Declarations. A. Section It — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf: in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. CG 20 10 07 04 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the Injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. 0ISO Properties, Inc., 2004 Page 1 of 1 r E`diEWFD BY: �i li^' =�1.i-"T{ -UN€GG HFRFDM (PG 2 -JF 4 I POLICY NUMBER: 103 GL 0014267.00 06/03/2016 TO 06/03/2017 103 GL 0014267-00 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizationsas required by written As designated In written contract with the Named contract with the Named Insured Insured Information required to complete this Schedule, if not shown . _---- -- ---------- _..._.... ...._..._._ _ above, will be shown in the Declarations. Section II — Who Is An Insured is amended to Include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, In whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products-oompleted operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 t;EVIcWED BY:PI % 'L-t0N)GE 4CREDIA(PG joFq !._ POLICY NUMBER: 103 GL 0014267-00 06/03/2016 TO 06/03/2017 103 GL 0014267.00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any rights of recovery we may have against any person or organization because of payments we make for injury or damage resulting from your ongoing operations or "your work" done under a contractwith that person or organization and included in the "products -completed operations hazard" if: a, you agreed to such waiver; b, the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies, ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U047.0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. l 1REVIE!YE2e EUhfICE HGREGIA {PG '(0, POLICY NUMBER: 103 GL 0014267-00 0610312016 TO 0 610 312 01 7 103 GL 0014267.00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY ANDNON-CONTRIBUTING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS,4. Other Insurance, and all subparts thereof, as contained in the policy is deleted in its entirety and replaced with the following condition as respects the Third Party shown below: 4. Otherinsurance a. With respect to the Third Party shown below, the insurance provided by this policy shall be primary and non-contributing insurance. Any and all other valid and collectible insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for a loss covered by this policy, shall in no instance be considered as primary, co-insurance, or contributing insurance. Rather, any such other in- surance shall be considered excess over and above the insurance provided by this policy. Third Party to whom this endorsement applies is: All persons or organizations as required by written contract with the Named Insured Absence of a specifically named Third Party above means that the provisions of this endorsement apply "as required by written contractual agreement with any Third Party for whom you are perform- ing work". ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. 0407-0707 Contains material O ISO Properties, Inc., 2000 with its permission. Pagel oft r POLICY NUMBER: 103 GL 0014267-00 06/03/2016 TO 06/03/2017 103 GL 0014267-00 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 9911WRIWE Designated Construction Projects: All projects during the policy period. If no entry appears above, information required to complete this endorsement will be shown in the Declare - tions as applicable to this endorsement.} A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" Under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I — COVERAGE C MEDICAL PAYMENTS, which can be attributed only to ongoing operations at a single designated con- struction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, except damages because of "bodily injury' or "property damage' included in the "products -completed operations hazard", and for medical expenses under SECTION I — COVERAGE C MEDICAL PAYMENTS regardless of the number of a, Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits", 3. Any payments made under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages or under SECTION I - COVERAGE C MEDICAL PAYMENTS shall reduce the Designated Construction Project General Aggregate Limit for that des- ignated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damages to Premises Rented to You and Medical Expense continue to apply, However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. 5. The most we will pay for the sum of all Designated Construction Project General Aggregate Limits combined and to which this insurance applies is $5,000,000, UCG2503-1013 Includes copyrighted material of Insurance Services Office, Inc., 1996 Page 1 of 2 with its permission, A IREVIEWED EY_ /��� t I;UNiCF NEF'EL7111 (Pt3����)� COMMERCIAL AUTO) CAM 612110 96 THIS ENDORSEMENT CDANGES TIIEPOCICY. PLEASE REAL) IT CAREITULLY. BLANUT ADDITIONAL INSURED ENDORSEMENT - PRIMARY This endorsernenT modifies instnnnce provided under the following: MOTOR CARRIER COVERAGE I*O WM BLISfINESS ALTO COVE;RACX FORM GrARACiF, COVERAGE FORM 1"RLICIERS COVERAGE FORM With respect to SECTION lI — LCAB LrFY COVERAGE nary, Who is,0.n Insured is mnended to include as an additional insured any persun(s) or organitu&on(i) wham you are realtured to add to this policy as an additional insured rmdera mitten agreement in effect ur6aanmirzg e(iocrive during the policy period. This insurance applies only to "bodily injury" and "property damage'*that mours gn4sequeor to execution ,7r the written agoob ant and subsequent to dte issunnce of Et uerrcliaale o6 Pnsun�e iadicitrutg such persmi(s) ur ory nizndun(s) as additional iivalcd{nF. The in:tna cc prtoided hereby to the Additional Insuend(s) is limited as failoeesr The coverage afforded hereby to such additional insured is limited to aerated lirbility speciiaca€I} resulting from the conduct or the Named Insured for which the additional inured was, hold liable. The ftmits ofitwumcc applicable to the duurunce afrorrled hereby are those epecifled in the vvriaen agreementar in the Declarations or Schedules of this(:ukic evHchet•ae is fess The limbs of iastuaneearaoieable to the lnsamnae a€iurded hueby, are net inches iae mrd out is adrblion to the limits of imumace Shown the Nclaratictts or Schedut¢a or this policy. Any coverage provided under clef & andurs;msnt Far any additional lnswed will never be broader than corertagc pmyided to any names. iruumd Any o0m poliev teems, condition., limitations, exclusiona_and definitinua upply at this etrebisetirent CAhl 612: 10 06 CEV7FWCD DY_ f al 0;N CE HER D1 L-yv- --;f----..�. COMbLUCIAL ABTA CIM 6120 09 06 TFA6 C'E' ORSVVIENT CHANGES'T14E POLICY. PLEASE READ PC CAREFILLY, BLANKET WAIVER OF SUBROGATION This endorsement madifies insummv pmvidcd tacky the M[mving; MOTOR CARRIER CO V`ER-Ad E FORA! BCISLNESS AUFO COVERAGE FORlvl GARAM. C OVER AOF FORM TRUCKERS COV'EMOE FORM We agree to w6vc any and ah subrogation ctehns or righty of recovery against arty pcmon(s) or orgaul'd4 oon(s) if there is an executed written agreeIDent with that person(a) or organizatioa§(a�, which requires a Waiver of Subrogation Clause, from the Named hratred, except for losses. w=hich are duo in whole or tart to the negligence or errors and umissioats of such person(s) or organization(s). CAM 67'-.0 09 06 I CiE�llc 1VED 6Y: , r CUr IG E HEREDIA (PG F 7� WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET 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). The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION ALL CALIFORNIA OPERATIONS, FOR WHOM THIS WAIVER IS REQUIRED. Policy Number: WVE 5030354 01 Insured: Crosstown Electrical & Data Inc Endorsement Effective: 6/3/2016 Coverage Provided by: Insurance Company of the West Issue Date: 5/27/2016 Countersigned by: f WC 99 06 34 1 (Ed. 8-00) REVIEWED BY, (r EUNICE HEREDIA (PGqu) AC"RV CERTIFICATE OF LIABILITY INSURANCE PATE (MM/DD/YYYY) 11/03/2016 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 NO. 0637431 PATRICK MCRAE INSURANCE SERVICES 1290 N. HANCOCK ST., SUITE 210 ANAHEIM HILLS, CA 92807 CONTACT NAME: PATRICK MCRAE PHONE# -FAx 4 779-6903 - IA/C,-No-E: (714 - 779-6999 ._..._ .................-----—�A/C,. No): (714) ----------.... E-MAILADDRESS: p.mcrae@sbcglobal.net INSURER(S)AFFORDINGCOVERAGE -- — NAIC# - - - COLONY INSURANCE COMPANY 39993 103 GL 0014267-00 DEDUCTIBLE $5,000 PER OCCURENCE INSURED _iNSURERA: INSURERB: INSURANCE COMPANY OF THE WEST 27847 CROSSTOWN ELECTRICAL & DATA, INC. 5463 DIAZ STREET IRWINDALE CA 91706 INSURERC:CENTURY-NATIONAL INSURANCE CO. 26905 INSURERD: TOPA INSURANCE COMPANY 18034 INSURER E: TOKIO MARINE SPECIALTY INSURANCE CO 23850 INSURER F: OCP _ _ 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP ( MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR XCU X X 103 GL 0014267-00 DEDUCTIBLE $5,000 PER OCCURENCE 06/03/2016 ( 06/03/2017 EACH OCCURRENCE Is 1,000,000 �� DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ 5,000 LX OCP _ _ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL POLICY 7 PEO- LOC HOTHER: AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG ............. — $ 2,000,000 — — -- $ C AUTOMOBILE LIABILITY X X BAP0171987 1 1 /05/2016 1 1 /05/2017 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ X ALL OWNED XSCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS , X._ AUTOS (Per accident BODILY LY INJURY $ _) PROPERTY DAMAGE Per accident)$ - E X rX � X � UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE DED - DI RETENTION $ 0 PUB542883 UNDERLYING LIMITS: GL; AL; EL POLICIES 06/03/2016 06/03/2017 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 - $ - B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PRO PRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDE❑Y D? (Mandatory in NH) If yes, describe under--- DESCRIPTION OF OPERATIONS below N I A x WVE 5030354-01 06/03/2016 06/03/2017 X I STATUTE ERH- — EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 _ E.L. DISEASE - POLICY LIMIT — $ 1,000,000 D PROPERTY & PC 6600295 $790,849 BUILDING CONTRACTORS $1,000 DEDUCTIBLE 04/10/2016 04/10/2017 $385,780 BPP - $300,000 BI WI EE $116,318 SCHEDULED EQ. EQUIPMENT COV. INCL. THEFT $50,000 MISCELLANEOUS TOOLS DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) THE CITY OF SANTA ANA, ITS DIRECTORS, COMMISSIONERS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS , ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT, * SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED, RE: PROJECT NAME: "SERVICE AGREEMENT FOR ADVANCED TRAFFIC MANAGEMENT SYSTEM AND COMMUNICATIONMAINTENANCE AND REPAIR SERVICES." CROSSTOWN JOB #2413. ---- — — M _ .. REVIEWED BY: EUNICE HEREDIA (PG I OF ) CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M-36 SANTA ANA, CA 92702 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 19Stl-Z094 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 103 GL 0014267-00 06/03/2016 TO 06/03/2017 103 GL 0014267-00 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DDD OR CONTRACTORSSCHEDULED ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations All persons or organizations as required by written contract As designated in written contract with the Named with the Named Insured Insured Information required to complete this Schedule, if not shown above, will shown in the Declarations. A. Section II — Who Is An Insured is amended to B include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. CG 20 10 07 04 With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after; 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of 'your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. © ISO Properties, Inc., 2004 Page 1 of 1 REVlIE7Wl BY: EUNICE HEREDIA (tac of POLICY NUMBER: 1o3GL0014207-0n 06/03/2016 TO 06/03/2017 1036IL0014207-00 COMMERCIAL GENERAL LIABILITY CG2U37V7O4 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section U — Who Is An Insured is amended to include as an additional insured the (a) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "prod ucts-completed operations hazard". CG 20 3707O4 @|SO Properties, Inc., 2004 Page of POLICY NUMBER: 103GL0014207-00 86/03/2010T00803/2o17 103GIL0014267-00 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following ioadded toParagraph D.Transfer OfRights Of Recovery Against Others ToUoofSection PV—CondUUonm: We waive any rights of recovery we may have against any person or organization because of payments we makefurirjuryurdamag*naau|tingfromyouronguingop*radonaor'`yourmmrK'doneunderaoontnadvvith thatpmmonororganizationandindudedinthe^produdo'oomp|etedoperationnhezand^if: a. you agreed tosuch waiver; b. the waiver ieincluded aapart ofawritten contract orlease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U047-0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of EUNICE HETIEDIA (FIG Or KEYIEWE BY: POLICY NUMBER: 103 GL 0014267-00 06/03/2016 TO 06/03/2017 103 GL 0014267-00 73"RIMARY AND NON-CONTRIBUTING INSURANCE (Third -Party) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS,4. Other Insurance, and all subparts thereof, as contained in the policy is deleted in its entirety and replaced with the following condition as respects the Third Party shown below: 4. Other Insurance a. With respect to the Third Party shown below, the insurance provided by this policy shall be primary and non-contributing insurance. Any and all other valid and collectible insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for a loss covered by this policy, shall in no instance be considered as primary, co-insurance, or contributing insurance. Rather, any such other in- surance shall be considered excess over and above the insurance provided by this policy. Third Party to whom this endorsement applies is: All persons or organizations as required by written contract with the Named Insured Absence of a specifically named Third Party above means that the provisions of this endorsement apply "as required by written contractual agreement with any Third Party for whom you are perform- ing work". ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U407-0707 Contains material O ISO Properties, Inc., 2000 with its permission. Pagel oft REVIEwFD BYN— �� _ E NNa^E REREDIA (F of ) POLICY NUMBER: 103GL0014207-00 06/03/2016 TO 06/03/2017 103GL0014287-00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: All projects during the policy period. If no entry appears above, information required to complete this endorsement will be shown in the Declarz tions oeapplicable tothis endorsement.) A. For all sums which the insured becomes legally odklabad to pay as damages caused by "occurrences" Under SECTION |— COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION | — COVERAGE C MEDICAL F9\YK8ENTS, which can be attributed only to ongoing operations at single doeiQnehud con- struction project shown in the Schedule above: on'atruodonpnojeotohmwnintheSuhedu|oabovo: i. A separate Designated Construction Project General Aggregate Limit applies to each designated construction pnojoct, and that limit is equal to the amount of the General Aggregate Limit ohuvvn in the Declarations. 2. The Designated ConstmoUonProjectGenem|AggregateUmbiethemostwmwiUpayfortheoumof all damages under SECTION |— COVERAGES, COVERAGE ABODILY INJURY AND PROPERTY DAMAGE L|A8|L|Ty, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazand^, and for medical expenses under SECTION | — COVERAGE C MEDICAL PAYMENTS regardless of the number of: a. Insureds; h. Claims made m"smits"brought; m o. Persons ororganizations making claims orbringing ^ouits". 3. Any payments made under SECTION |— COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages orunder SECTION |- COVERAGE CMEDICAL PAYMENTS shall reduce the Designated Construction Project General Aggregate Limit for that des- ignated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each 0ocurnence, Damages to Premises Rented toYou and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. 5. The most we will pay for the sum of all Designated Construction Project General Aggregate Limits combined and towhich this insurance applies iu$5.UUO.ODO. UCG2603-1013 Includes copyrighted material ofInsurance Services Office, Ino,1SA8 Page 1of2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY VVC39O034 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET VVohave the righttor000varourpayments from anyone liable for aninjury oovormdbvthhsooioy.VVewiUnot enforceourhghtagainettheporoonororganizadonnamodintheSohedu|e.Olhieagnaementopp|ieson|ytothe extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION ALL CALIFORNIA OPERATIONS. FOR VVH{}M THIS WAIVER IS REQUIRED. Policy Number: VVVE5O3O35401 Insured: Crosstown Electrical & Data Inc Endorsement Effective: 0/3/2U1O Coverage Provided by: Insurance Company Ofthe West Issue Date: 5/27/2016 Countersigned by: VVCS9O834 CENTURY -NATIONAL INSURANCE COMPANY P.O. Box 3999 North Hollywood, [A 91609-0599 For Service Call Your Broker. For Claims Call: 8V0-733-1gBU CHA[X&ASSOC INS BROKERS INC 3200ELCAM|NOREAL STE2UO IRVINE CA920O2-13O2 (949) 722-4177 CROSSTOWN ELECTRICAL &DATA INC 5463DIAZST |RVV|NDALECAQ17O6 Name of Insured: CROSSTOWN ELECTRICAL & DATA Endorsement Effective Date and Time: 11/05/2016 at 12:01 AM Policy Number: Policy Term Covers from: Endorsement Number: BAP0171987 12:01 AM on 11/05/2016 to 11/05/2017 at 12:0 1 AM 000 Name of Agency: CHAIX &ASSOC INS BROKERS INC 122800 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [TCAREFULLY. Additional Insured Endorsement |T|SAGREED THAT INSURANCE AFFORDED DYTHE ABOVE POLICY SHALL APPLY TOTHE( S) NAMED BELOW, AS THEIR INTEREST MAY APPEAR BUT SHALL NOT OPERATE TO INCREASE THE LIMITS OF THE COMPANY'S LIABILITY. ANY ADDITIONAL INSURED LANGUAGE ON A CERTIFICATE OF INSURANCE |SVOID. The additionali na1nomedbolowis only an insured for liability which is the result of an act or omission of the "NAMED INSURED" of the policy and shall have no coverage under this endorsement or the policy for its own acts or omissions, those of its agents or employees, or those of any other person or entity for which it is vicariously liable, save for acts of omissions of the "NAMED INSURED" of the policy. Further, any insurance provided by this endorsement shall be excess to all other insurance available to any person or entity who becomes an insured by reason of this endorsement whether the other insurance is primary or excess and whether or not the other insurance is collectible. In the event the other insurer has a duty to defend any person or entity added to our policy by reason of this endorsement, we will have no duty to defend that person or entity however, we may elect to do so, and, if we do, we will be entitled to the rights of any person or entity we do defend against the other insurer. ADDITIONAL INSURED The insurance isPrimary and Non -Contributory with respect toany insurance carried bythe Additional Insured ALL OTHER TERMS AND CONDITIONS OFTHE POLICY REMAIN UNCHANGED, Date Printed: 1103/2U18 RENEFAJARDO CENTURY - INSURANCE COMPANY P.O. Box 399~North Hollywood, CA91O09-l5gg For Service Call Your Broker. For Claims Call.- 800-733-1980 Name of Insured: Endorsement Effective Date and Time: CROSSTOWN ELECTRICAL & DATA 11/05/2016 at 12:01 AM Policy Number: Policy Term Covers from: Endorsement Number: BAP0171987 12:01 AM on 11/05/2016 to 11 /05/2017 at 12:0 1 AM 000 |NnmcufAguocy: � CHAIX&ASSOC INS BROKERS INC 122800 � THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Waiver of Subrogation "THE RIGHT TO SUBROGATE AGAINST THE ADDITIONAL INSURED NAMED BELOW IS WAIVED FOR LOSSES PAID WHICH ARISE OUT OF THE OPERATIONS OF THE NAMED INSURED", FOR WHICH THE NAMED ADDITIONAL INSURED HAS NO INDEPENDENT NEGLIGENCE. CERTIFICATE HOLDER ALL OTHER TERMS AND CONDITIONS OFTHE POLICY REMAIN UNCHANGED Date Printed: 11/03/2O16 RENEF4JARDO �C®R►Q0 � CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) F05/26/2017 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(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 endorsement(s). PRODUCER LICENSE NO. 0637431 PATRICK MCRAE INSURANCE SERVICES 1265 N. MANASSERO ST. SUITE 303 ANAHEIM HILLS, CA 92807 NAME CT PATRICK MCRAE PHCNNo Ext): (714) 779 6999 FAX,No: (714) 779-6903 AoRIESS: p.mcrae@sbcglobal.net INSURERS AFFORDING COVERAGE NAIL# INSURERA: COLONY INSURANCE COMPANY 39993 INSURED CROSSTOWN ELECTRICAL & DATA, INC. 5454 DIAZ STREET IRWINDALE CA 91706 INSURER B: INSURANCE COMPANY OF THE WEST 27847 INSURER C: CENTURY -NATIONAL INSURANCE CO. 26905 INSURER D: TOPA INSURANCE COMPANY 18034 INSURER E: TOKIO MARINE SPECIALTY INSURANCE COI 23850 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. ILTR TYPE OF INSURANCE IN L S BR POLICY NUMBER MM%DDIYYYY POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR XCU X X 103 GL 0014267-01 DEDUCTIBLE $5,000 PER OCCURENCE 06/03/2017 06/03/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ 5,000 X OCP PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [ 7X PE 0 LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: C AUTOMOBILE LIABILITY X X BAP0171987 11/05/201611/05/2017 DO BIKaccidED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ _ X ANY AUTO X ALL OWNED�( SCHEDULED AUTOS AUTOS HIRED AUTOS X NOWOWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident E X- UMBRELLA LIAB EXCESS kIA6 - X OCCUR CLAIMS=MADE - PUB585602 UNDERLYING -LIMITS:- _ - GL; AL, EL POLICIES 06/03/2017 - - -- -- 06/03/2018 - EACH OCCURRENCE $ 10,000,000 AGGREGATE. $ 10,000,000 X DED RETENTION$ 0 $ - B WORKERS COMPENSATION x WVE 5030354-02 06/03/2017 06/03/2018X AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) iA STATUTE ETH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If es, describe under DESCRIPTION OF OPERATIONS below REVIEWED BY EUNICE HEREDIA PG OF PROPERTY & -5 . u.��� _ t. �.W) CONTRACTORS $1,000 DEDUCTIBLE 04/10/2017 04/10/2018 EQUIPMENT COV. INCL. THEFT E.L. DISEASE - POLICY LIMIT $ 1,000,000 1,4 780 B P Buildings $198:968Popertyoff Premises $300,000 Leased BPP $300,000 BI/EE D DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 707, Additional Remarks Schedule, may be attached if more space Is required) CITY OF SANTA ANA, MICHAEL BAKER, INTERNATIONAL, OCTA, CITY OF BREA, CITY OF ANAHEIM, CITY OF ORANGE, CALTRANS, CITY OF PLACETIA, ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED, RE: PROJECT NAME: GRAND AVE RTSSP PROJECT NO.: 14-6817 CROSSTOWN # 3435 PROJECT LOCATION: GRAND AVE CITY OF SANTA ANA 20 CIVIC CENTER PLAZA SANTA ANA CA 92701 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 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 103 GL 0014267-01 06/03/2017 TO 06/03/2018 103 GL 0014267-00 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations All persons or organizations as required by written contract As designated in written contract with the Named with the Named Insured Insured - - --.._.._....._.__..--_-._....._._.........._.._ - ...- --..._..__............._......._.. Information required to complete this Schedule, if not shown above, ------- ---------------- ---------.._._._..__......-..,_.. will shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" _-or __"personal_and_advertising_injury'_'__ caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. CG 20 10 07 04 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property -damage" occurring -after: - - — - 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. © ISO Properties, Inc., 2004 Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (PG JOF - ) POLICY NUMBER: 103 GL 0014267-01 06/03/2017 TO 06/03/2018 103 GL 0014267-00 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured -......._...---_-...__..._.....- - ---...------ ........_._... Information required to complete this Schedule, if not shown _.....__._..._.- - - - .....__...... ....... ...... ..__...-._.....----- ----------- - - above, will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown In the Schedule, but only with -respect-to-liability for "bodily- injury" -or -"property dam-_ _ - age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: 103 GL 0014267-01 06/03/2017 TO 06/03/2018 103 GL 0014267-00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any rights of recovery we may have against any person or organization because of payments we make for injury or damage resulting from your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" if: a. you agreed to such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U047-0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. REVIEWED BY: EuNICE NREDlA tpc car , ) POLICY NUMBER: 103 GL 0014267-01 06/03/2017 TO 06/03/2018 103 GL 0014267-00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTING INSURANCE (Third -Party) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS,4. Other Insurance, and all subparts thereof, as contained in the policy is deleted in its entirety and replaced with the following condition as respects the Third Party shown below: 4. Other Insurance a. With respect to the Third Party shown below, the insurance provided by this policy shall be primary and non-contributing insurance. Any and all other valid and collectible insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for a loss covered by this policy, shall in no instance be considered as primary, co-insurance, or contributing insurance. Rather, any such other in- surance shall be considered excess over and above the insurance provided by this policy. Third Party to whom this endorsement applies is: All persons or organizations as required by written contract with the Named Insured Absence of a specifically named Third Party above means that the provisions of this endorsement apply "as required by written contractual agreement with any Third Party for whom you are perform- ing work". ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U407-0707 Contains material © ISO Properties, Inc., 2000 with its permission. Pagel oft REUIEwED BY: EUNICE HEREDIA (PG60F POLICY NUMBER: 103 GL 0014267-01 06/03/2017 TO 06/03/2018 103 GL 0014267-00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT - RESTRICTED FORM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: All projects during the policy period. 'If no entry appears above, information required to complete this endorsement will be shown in the Decla tions as applicable to this endorsement.) a - A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" Under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION I — COVERAGE C MEDICAL PAYMENTS, which can be attributed only to ongoing operations at a single designated con- struction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard", and for medical expenses under SECTION I — COVERAGE C MEDICAL PAYMENTS regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages or under SECTION I - COVERAGE C MEDICAL PAYMENTS shall reduce the Designated Construction Project General Aggregate Limit for that des- ignated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damages to Premises Rented to You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. 5. The most we will pay for the sum of all Designated Construction Project General Aggregate Limits combined and to which this insurance applies is $5,000,000. UCG2503-1013 Includes copyrighted material of Insurance Services Office, Inc., 1996 Page 1 of 2 with its permission. R .VIEwEA BY: EUNICE HEREDiA (f G 9 J WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY VVCS9OG84 WAIVER QFOUR RIGHT TQRECOVER FROM OTHERS ENDORSEMENT -BLANKET VVohave the righttorecoverourpaymentnfnornanyone|iob|nforani juryoovormdbvUliaonicy.VVewiUnot 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). The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization Job Description ANY PERSON OR (}RG/\N|Z/\T|C)N ALL CALIFORNIA (]PER/\T|[>NG. FOR WHOM THIS WAIVER IS REQUIRED. Policy Number: VVVE 5030354 02 Insured: Crosstown Electrical & Data Inc Endorsement Effective: G/3/2O17 Coverage Provided by: Insurance Company ofthe West Issue Date: 5/26/2017 Countersigned by: WC80O834 (Ed. 8-00) REVIEWED BY'i EUMCEHEREDIA(P.. 0.4 NTLJ`"-"M"111/L IaN 0rnN P.O. Box 3999 . North Hollywood, CA 91609-0599 For Service Call Your Broker, For Claims Call: 800-733-1980 CHAIX & ASSOC INS BROKERS INC 3200 EL CAMINO REAL STE 290 IRVINE CA 92602-1382 (949) 722-4177 CROSSTOWN ELECTRICAL & DATA, INC. 5454 DIAZ ST IRWINDALE CA 91706 Name of Insured: CROSSTOWN ELECTRICAL &DATA Endorsement Effective Date and Time: 11/05/2016 at 12:01 AM Policy Number: Policy Term Covers from: Endorsement Number: BAP0171987 12:01 AM on 11/05/2016 to 11/05/2017 at 12:01AM 000 Name of Agency: CHAIX & ASSOC INS BROKERS INC 122800 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Additional Insured Endorsement IT IS AGREED THAT INSURANCE AFFORDED BY THE ABOVE POLICY SHALL APPLY TO THE PARTY(S) NAMED BELOW, AS THEIR INTEREST MAY APPEAR BUT SHALL NOT OPERATE TO INCREASE THE LIMITS OF THE COMPANY'S LIABILITY. ANY ADDITIONAL INSURED LANGUAGE ON A CERTIFICATE OF INSURANCE IS VOID. The additional insured named below is only an insured for liability which is the result of an act or omission of the "NAMED INSURED" of the policy and shall have no coverage under this endorsement or the policy for its own acts or omissions, those of its agents or employees, or those of any other person or entity for which it is vicariously liable, save for acts of omissions of the "NAMED INSURED" of the policy. Further, any insurance provided by this endorsement shall be excess to all other insurance available to any person or entity who becomes an insured by reason of this endorsement whether the other insurance is primary or excess and whether or not the other insurance is collectible. In the event the other insurer has a duty to defend any person or entity added to our policy by reason of this endorsement, we will have no duty to defend that person or entity however, we may -elect -to -do -so; and; if we -do; -we -will -be entitled to -the -rights -of any -person -or -entity we do- ---- defend -- defend against the other insurer. ADDITIONAL INSURED The insurance is Primary and Non -Contributory with respect to any insurance carried by the Additional Insured ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, Date Printed: 11/03/2016 RENE FAJARDO CN 613 (07/11) _z A Paye 1 REVIEWED BY: n EUNICE HEREDIA (PG , o CE TUFAY=- Ai"iONAL I SUISANQ :0�MPANY P.O. Box 3999 • North Hollywood, CA 91609-0599 For Service Cell Your Broker. For Claims Call., 800-733-1980 Name of Insured: Endorsement Effective Date and Time: CROSSTOWN ELECTRICAL & DATA 11/05/2016 at 12:01 AM Policy Number: Policy Term Covers from: Endorsement Number: BAP0171987 12:01 AM on 11/05/2016 to 11/05/2017 at 12:01AM 000 Name of Agency: CHAIX & ASSOC INS BROKERS INC 122800 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, Waiver of Subrogation "THE RIGHT TO SUBROGATE AGAINST THE ADDITIONAL INSURED NAMED BELOW IS WAIVED FOR LOSSES PAID WHICH ARISE OUT OF THE OPERATIONS OF THE NAMED INSURED", FOR WHICH THE NAMED ADDITIONAL INSURED HAS NO INDEPENDENT NEGLIGENCE. CERTIFICATE HOLDER ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Date Printed: 11/03/2016 RENE FAJARDO CN 613A (07/11) REVIEWED BY: EUNICEHEREDIA(PG gOFpf) -1)