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HomeMy WebLinkAboutDULUX PAINTING, INC.-2016IRNNCE ON FILE A-2016-298 O ?X WY PROCEED C. (I't.I'NSUFIANCEEXPSES cI.EaK or COUNCIL. AGREEMENT FOR PAINTING SERVICES p;i E I-)'/ "fit V AT CORBIN CENTER AND SOUTHWEST SENIOR CENTER THIS AGREEMENT is made and entered into this 18th day of October, 2016 by and between Dulux Painting Inc, ("Contractor"), 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 August 19, 2016, the City issued Request for Proposal No. 16098, by which it sought a contractor to provide interior and exterior painting services at the City's Corbin Center and Southwest Senior Center. B. Contractor submitted a responsive proposal that was selected by the City, Contractor represents that it is able and willing to provide the services described in the scope of work that was included in RTP No. 16-098 and attached herein as Exhibit A. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in cornpliance with such standards as may reasonably be expected from a professional contracting 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: L SCOPE OF SERVICES Contractor shall furnish the services that are described in Exhibit A to this Agreement. Contractor's proposal is also incorporated by reference as though fully set forth herein. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit B. The total sum to be expended under this Agreement shall not exceed $82,000. This aunornt includes (1) the sum of $72,000 and (2) a contingency amount of $10,000 for services to be performed by Contractor at the sole discretion of the City. b. Payment by City shall be made within forty-five (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 stated. above and continue through December 31, 2016, un loss terminated earlier in accordance with Section 14, below. 25C 4. INDL FNDENT CONTRACTOR Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor 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. INSURANCE Prior to undertaking performance of work tinder this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a, Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and. representatives as additionalrnsured(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 Contractor'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 resul,dng therefrom, and property damage, lar the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and, not coutrdbutory with respect to insurance or self-insurance programs maintained by the City, and (o) contain standard separation of insureds provisions. b. 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. Workers' Compensation Insurance, In accordance with the California Labor Code, Contractor, if Contractor has any employees, is required to be insured against liability for workers' compensation or to undertake self insurauoe. Prior to connnencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurancc with limits not less than 91,000,000 per accident. d. If Contractor is or employs a licensed professional such as an architect or engineer; Professional liability (errors and omissions) insurance, with a combined single limit of root less than $1,000,000 ,per claim with $2,000,000 in the aggregate. e, The following requirements apply to the insurance to be provided by Contractor pursuant to this section; (i) Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. C (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 (3 0) days prior written notice to the City. (iv) Contractor shall supply City with a fully executed additional insured endorsement. If Contractor 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 Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City, G. INDEMNIFICATION Contractor agrees to and shall indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives fiorn liability: (1.) for personal injury, damages, just compensation, restitution, judicial or equitable reliefarising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligence or willful misconduct of the Contractor or its, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section. I 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 tenns of or effects arising from this Agreement. This indemnity 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 Contractor further agrees to indemnify, bold hamiloss, and pay all costs for the defense of the City, inrluding.fees and costs for special courisel 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 persomil 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. Contractor's indemnification obligations in this section shall survive expiration of this Agreement. Notwithstanding the foregoing, to the extent Contractor'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, recklessnesa, or willful misconduct of the Contractor. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbutaements charged to the City for a minimum period of three (3) years, or for any longer period required bylaw, from the date of final payment to Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor 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. Contractor c shall allow inspection of all work, data, docrunents, proceedings, and activities related to this Agreement for a period of three (3) years front the date of final payment to Contractor under this Agroonrent, 8. CONFIDENTIALITY If Contractor receives from the City information which clue to the mature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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 loss than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written inforniation, but also information transferred orally, visually, electronically, or by other means, Confidential information disclosed to either patty by any subsidiary acid/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 Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presoutly has no interests and shall not have interests, direct or infivot, which would conflict in any manner with the performance of services specified under this Agreement. 10, 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 communication in the manner provided in this Section, to the following persons: To City: Cleric 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: Executive Director Finance and Management Services Agency City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 To Contractor Uulux Inc.. 26 Rookinghorse Road Rancho Palos Verdes, CA 90275 Attn: John Mantikas 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 boon 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) horn's 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. 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter therein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terns 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 Contractor 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. 12, ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior, written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be amsidered 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. 1.3. WAIVER No waiver of a breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreoment shall be effective unless it is in writing and signed by the party waiving the breach, failure, right, or remedy, No waiver of any breach, failure, right, or remedy shall be deemed a waiver of any other breach, failure, right, or remedy, whether or not similar, nor shall any waiver constitute a. continuing waiver unless the writing so specifies. 25th -11 14. TERMINATION 'This Agreement maybe terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a, As a condition of such payment, City may require Contractor 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 Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment awed not be made for work that falls to meet the standard of performance specified, in the Recitals of this Agreement. 15. NONDISCRIMINA'T'ION Contractor 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. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations, 1G. JURISDICTION •"VENUE This Agreement has been executed and delivered in the Stato 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. 17. PROF'ESSIONAIL LICENSES Contractor shall, throughout the term of this Agreement, maintain all necessary licensor, pen7nits, 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, Contractor 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, 18. 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 tine signatory or is withdrawn. 25012 1). 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 .I?. Iiuizar Clerk, of the Council APPROVED AS 710 FORM: SONIA R. CAR°VALH.O City Attorney By.John . 4—tj-- Assistant City Attorney FOR APPROVAL: CITY OFSANTA ANA 64nnl� David Cavazos City Manager , I I'll, - -elo .a_..... Francisco Gutierrez, Executive Ialrecto Finance and :Management Services Agency 260-13 EXHIBIT A CITY OF BANTA ANA REQUEST FOR PROPOSALS 16-098 PAINTING — CORBIN CENTER AND SOUTHWEST SENIOR CENTER SCOPE, OF SERVICES & SPECIFICATIONS The City of Santa Ana provides recreational activities, preventative health care, family support, referrals, and other social services at Clty-owned community centers such as Corbin Center and Southwest Senior Center. The two centers are located adjacent to each other. The goals of the project are to address deferred building maintenance Issues and provide a welcoming facility to center visitors and their families. Highly desirable contractor traits: • All Contractor workers for this project should have at least 5 years of work experience in painting special-purpose and high -impact exterior and Interior surfaces such as those found at recreation and community centers. • References for a minimum of three (3) previous completed paint jobs of similar size in commercial facilities. • Previous work In municipal environments Is highly desirable. MON,7:M.li� The work wili include, but is not limited to, surface preparation; baseboard and corner repairs, caulking around windows and other areas as needed; spackling nail and other holes; sanding; wallboard taping; wallpaper removal; equipment preparation; painting of wails, ceilings (various heights); wall texturing; or any other related services considered as standard for the industry. 1,0 General Requirements 1 .i Contractor shall furnish paint, labor, materials, equipment, supervision, and all other requirements necessary to complete the painting of the two community centers, 1.2 Contractor shall begin services within seventy-two (72) hours of notification. 1.3 All surfaces shall be thoroughly cleaned of all dirt, grease, mill scale, moisture, oil, rust, salts, stains, soluble residues, and any other foreign matter prior to painting, 1.4 Contractor shall perform all necessary site preparation such as moving and protecting shrubbery and furniture, and setting up warning signs around the project area. 1.5 Contractor shall perform all necessary surface preparation such as caulking, dry wall repair, spackling, scraping, and priming as needed to ensure the utmost quality of the end product according to manufacturer specifications; 1.5.1 Remove all surface contaminants that will Interfere with adhesion of subsequent coats of paint without damaging the substrate or adjacent areas. Painting—Corbin Center and Southwest Senior Carter 16-008 26C-14 1.5.2 After surface preparation as referenced in Section 2.7 below, surface must be carefully examined for blistering, cracking, flaking, or peeling of existing paint. Loose, unsound, or non -adhering paint must be removed. 1.6.3 The contractor shall not paint any surface which is not in proper condition for painting. The contractor shall notify the Project Manager of any surface irregularities before any painting or finishing of such surfaces commence. 1.6 Paint shall be applied by brush, roller, or spray in accordance with the manufacturer's printed directions. 1.7 All lines of demarcation between paint of different colors or shades and between painted and unpainted surfaces shall be carefully drawn and shall be free of wavy lines, blurred edges or overlaps, 1.8 Completed surfaces shall be uniform in color, finish, gloss, and sheen. 1.9 All finishes shall be applied evenly and free from crawls, runs, sags, skips, or other defects 1.9.1 The new and old coatings must be compatible. The determination of compatibility may be accomplished through examination of the owners' records, laboratory analysis, or by fleld-testing. 1.10 Contractor shall provide proper ventilation at all times and ensure that no potential or known fire hazards exist in the project area. 1.11 Contractor shall not paint over any electrical or telephone connections, or hardware, such as cords, hinges, lines, receptacles, switches, etc. unless specifically authorized by the Project Manager. 1.12 Contractor shall install drop cloths on floors and fixtures, and protective covering to doors, windows, and any areas that would be subjected to paint drippings or ovorspray. 1.15 Contractor shall Immediately remove all excess paint from all areas and ensure that such removal causes no damage to any surfaces. 1.14 Contractor shall take the necessary steps at all times to protect the public and all property from damage during his operations and shall be responsible for any and all kinds of damage to the work or property caused by the contractor's employees, 1.15 Contractor operations for the preparation of paints and storage of materials shall be limited to a designated area and such space shall be kept clean and orderly at all times. Contractor shall employ all safety measures during operations for the prevention of fires and any other possible health hazard. Painting — Corbin Center and Southwest Senior Center 16-098 26C-1 6 2.0 Product Specifications Product specifications and/or brand names stated in this RFP are for reference only and do not in any way obligate the proposer to use that brand name product, Sherwin Williams is preferred; however equivalent products may be considered by the Project Manager. For purposes of comparison, proposers are requested to state the brand name of any equivalent products being proposed, 2.1 Contractor shall provide and use Zero VOC paint products for this contract. 2.2 Contractor shall submit MSDS for products to be used. 2.3 Coverage area will be determined during the Mandatory Job Walk. 2.4 Specific color schemes for various locations in center interiors will be determined during the Pre -Con meeting. 2.5 Interior Finishes 2.5.1 Drywall previously painted, Wood Paneling, Ceilings, Ducts and Pipes Primer: B51WO0620 - PrepRiteO ProBlookO Interior/Exterior Latex Primer/Sealer White Pull prime, including previously painted Ducts and Pipes Finish: B20W12651 - ProMarO 200 Zero VOC Interior Latex Egg -Shell Extra White One Coal. to rover, Sheen and color rWill be determined by the City. 2.5.2 Drywall previously painted, Wood Paneling, Ceilings Finish: B31 W02651 - ProMarO 200 Zero VOC interior Latex Semi -Gloss Extra White One Coat to cover. Sheen and color to be determined by the City, 2.5.3 Acoustical Ceilings Primer; B51WO0620 - PrepRiteO ProBlockO Interlor/Exterior Latex Primer/Sealer White Spot prime stains and repaired areas. 2 Coats. B30WO2651 - ProMarO 200 Zero VOC Interior Latex Flat Extra White 2.5.4 Doors, Frames, Window Frames, Cabinets, Hand Rails Primer, B51WO0620 - PrepRiteO ProBlockO Interior/Exterior Latex Primer/Sealer White Fall Prince 2 Coats: B53W01151 - PI WB ALK UR SG EW 2.6 Exterior Finishes 2.6,1 Stucco, Masonry, Walls, Columns, Overhangs Primer: A24WO8300 - LoxonS Concrete & Masonry Primer, Interior/Exterior Latex White Spot prime over repaired areas then Pull Prime Finish: A06WO0151 - A-1000 Exterior Latex Flat Extra White One coat to Cover Painting: Corbin Center and Southwest Soniar Center 16-098 26C-16 2.6.2 Metal: Gutters, Downspouts, Trellises, Window Frames, Trim Primer; B66W00310 - Pro Industrial Pro-Cryl9 Universal Acrylic Primer Off White The city will determine if Signs, lightposts, etc, will be included. Full Prime 2 Coats: B53W01161 - PI WB ALK UR SG EW The city will determine if Signs, Lightposts etc, will be included, Full Prime, 2.6.9 Metal and Wood: Doors, Frames, Columns, Miscellaneous Trim Primer; B51 W00620 - PrepRiteO ProBlock9 Interior/Exterior Latex Primer/Sealer White Full Prime 2 Coats; 853W01151 - PI WB ALK 2,7 Surface Preparation 2.7.1 Hand Tool Cleaning Hand tools may be used to clean and remove loose mill scale, rust, and other foreign matter. However, handtools shall notbe usedto remove adherent mill scale, rust, and paint. Mill scale, rust, and paint are considered adherent if they cannot be removed by lifting with a dull putty knife. Instead, the contractor shall use the methods outlined in SSPC-SP1 to remove adherent mill scale, rust, and paint before using hand tools to clean and remove visible oil, grease, soluble residues, salts and other loose foreign matter. For complete Instructions, refer to Steel Structures Paint Council Surface Preparation Specification No. 2 (SSPC-SP2) 2.7.2 Water Blasting MACE Standard RP -01-72 Removal of all grease dirt, loose rust, loose mill scale, and loose paint by water at pressures of 2,000 to 2,500 psi at a flow of 4 to 14 gallons per minute. END OF PRODUCT SPECIFICATIONS Painting — Corbin Center and Southwest, Senior Coster 16.098 25C- 1 7 BXNT.BIT B img ®n uaMn rag nt1tREMEiVT oalculatio mpo Yssar�rtp include a prfntautlaapy ofttF zod qr5a�.1lS'tlans at the labor pitoing tar their RFP submittal�a f cfe_,I,r ons caws dared°son„�g� Z9 kC& �' lwfthout the prier written consent axaept In a e$g� atpa eons orpropey, or as specified otharwisa. Contractor to furnish goods and Installation sardines as described at this RFP. It shall be the Contractor's responsibility to legally dispaso of all debris and surplus materials off-site. prioing Description Corbin Center / Exterior 6 oc✓v, u`'-' Motorial required as specified $ r� oo Labor as specified (non taxabfa) Corbin Center I Interior $4- 2 Material required as specified $ Labor as specified (non-texabls) Southwest Senior Center I Exterior $ ( ^ Material required as spacltiod wC Labor as specified (horkaxabie) southwest senior Center I Interior $ I � ' CY-) Material required as specified Labor as specified (non-taxable) Total Materials for all locations Applicable Sales Tax (8,00%.) $ --- w Total Labor for all locations 27q�..; Grand Total Price for all locations $ _,IL-4-I,Or Company Name: 1)uVAX. 90_n� t`n CSLB License No: Diff Registration No:�C(••-•.— sns PROPOSALS THAT 00 NOT Pa0HTA1N'CHIB WpRPA WILL Ota CONSIDERED NOH4lt��pAH31V . 25C-18 AC "N" il*. --= CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) 10126/2016 _ THIS CERTIFICATE IS ISSUED ASA 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 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. Astatement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER CONTACT NAME: Golsa Dolatabadi(295033N) PHONE 1451 W 7th St Ste A PAX (A/C, NO, EXT): 310.371-3575 (A/C, NO): 855-320-8748 _ E-MAIL ADDRESS; gdolatabadi(Afarmersagent.com San Pedro CA 90732-3524 INSU RER(S) AFFORDING COVERAGE NAtC# INSURED J— INSURERA: Truck insurance Exchange 21709 INSURER B: Farmers Insurance Exchange 21652 PERSONAL &Any INJURY JOHN MANTIKAS INSURERC: Mid Century Insurance Company GENERALAGGREGATE Dulux Painting 26 ROCKINGHORSE RD RCH PALOS VRD CA 90275 INSURER D: _2_1687_ — — -- INSURERS: - INSURERF: AUTOMOBILE LIABILITY ANYAUTO OWNEDAUTOSSCHEDULED ONLY X AUTOS XHIREDAUTOS X NON -OWNED ONLY AUTOS ONLY COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMEN'f, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPEOFINSURANCE ADDTL INSD SURR WVD POLICYNUMBER POLICYEFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERALLIABILITY CLAIMS -MADE OCCUR u _ EACH OCCURR ENCE $ DAMAGE TO RENTED PREMISES (Ea Occurrence) $ MED EXP (Any one person) $ PERSONAL &Any INJURY $ GENT AGGREGATE LIMITAPPLIES PER: E PROJECT D LOC LOTHR: GENERALAGGREGATE $ PRODUCTS-COMP/OP AGO $ _$ B AUTOMOBILE LIABILITY ANYAUTO OWNEDAUTOSSCHEDULED ONLY X AUTOS XHIREDAUTOS X NON -OWNED ONLY AUTOS ONLY N 605889049 01/19/2016 01/19/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1�66Q,669 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLAUAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ _ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPR IETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEM BER EXCLUDED? (Mandatory In NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE OTHER$ E. L. EACH ACCI DENT _ $ E.L. DISEASE - EA EMPLOYEE E. L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may beattached If more space is required) 2008 FORD F250 SUPER; VIN: 1FTSW21R08EB70681 Policy 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. CERTIFICATE HOLDER CANCELLATION ITP-6F�SANT A DATE THEREOF OF NOTICE WILL DESCRIBED POLICIES BE CANCELLED BEFORETHEEXPOVIS0" DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. F_210CIRVIC CENTER PLA7�4 M -11 AU THORIZEDREPRESENTATIVE Goias Uolatabadi 10/25/2016 SANTA_ANA__._ rA a�7-0-1 ACORD 25 (2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD CERT5FOCATE OE I �LMY �O��Uff��NC DAosilziio ' s THISCERTIFICATE ISISSUED ASA MATTEROFINFORMATION ONLYAND CONFERS NO AMEND, EXTEND ORALTERTHECOVERAGEAFFORDED BYTHE POLICIES BELOW.THI$:.CER AUTHORIZED REPRESENTADVEORPRODUCER,ANDTHECERTIRCATEHOLDER. RIGH PON THECERTIFICATE HOLDER. THISCERTIRCATEDOES NOTAFRRMATIVELYOR NEGATIVELY CATEOFINSURANCE DOES NOTCONSTTfUTEACONTRACTRETWEEN THE ISSUINGINSURER(S), "^PORTANT.Iftherertitia hoiderison ADDRIONALINSURED,thepolicy(les)must iitionsofthepolicy,certainpoliciesrnayrequtmanendursement.Aslaterimenton ave PI&C I-UONALINSUREDpmvisiomorbeendomed.ifSUBROGATIONiSWA1VED,subjecttotheiamisand i a doesnotconferdghtswthecertiflmwholderin lieu ofsuchendomement(s). PRODUCER CONTACT NAME: GDlsa DDlatabadi(295033N) 1451 W7th St SteA PHONE (A/c, NO, EXT): 310-371-3575 FAX (A/C,NOX 855-320-87481 EMAIL San Pedro CA 90732-3524 ADDRESS: gdolatabadi@farmersagent.com j INSURER(S)AFFORDING COVERAGE NAIC# INSURED ; INSURERA: Truck Insurance Exchange 21709 INSURERB: Farmers Insurance Exchange ; 21652 JOHN MANTIKAS INSURERC: Mid Century Insurance Company 1 21687 Dulux Painting INSURER°' 26 ROCKINGHORSE RD INSURERE: RCH PALOS VRD CA 90275 INSURERF: COVERAGES CERTIFICATENUM8E8: REVISION NUMBER: THIS ISTO CERTIR'THATTHE POLICIESOF INSURANCE OSTED BELOW HAVE BEEN ISSUE5TO REQUIREMENT, TERM ORCONDITION OFANY CONTRACTOR OTHER DOCUMENTWITH POLICIES DESCRIBED HEREIN ISSUBJECTTO ALLTHETERMS, EXCLUSIONS AND COND ESP bNS I INSURED NAMEABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDINGA,NY - O WHICHTHIS CERTIFICATE MAYBE ISSUED OR MAYPERTAIN, THE INSURANCEAFFORDED BYTHE UCH POLICIES. LIMITS SHOWN MAYHAVEBEEN REDUCED BY PAID CLAIMS.. INSR LTR TYPE OFINSURANCE ADDTL IVSD SUBR WVD PO LYBER POLICY EFF (MM/DO/YYYY) POLICYEKP (MM/DD/YM) LIMNS :.., COMMERCIALGENERALLIABILITY f EACH OCCURRENCE i$ CLAIMS -MADE ❑OCCUR DAMAGETORENTEDPREMISES(Fa Occurrence) :$ MED EXP (Anyone person) $ i PERSOADV INJURY I$ GENT AGGREGATE LIMITAPPUES PER: GENERREGATE 1$ POLICY ❑ PROJECT LOC �. PRODUOMP/OPAGGI$ OTHER: 1 $ v AUTOMOBILE LIABILITY i COMBINGLE LIMIT (Ea acc .$ ANYAUTO ' BODILYY(Per person) '$ '100000OWNED Y(Peraccident)$HIREDAUTOS AUTOS v SCHEDULEDBODILY1300000ONLY /� AUTOS N 6058890 k ; 01/19/2016 01/19/2017 NON -OWNED AUTOS ONLY(Peracc 1PROPEMAGEONLY : 50,000$UMBRELLALIAB OCCUR EACH ORENCE $EXCESS AGGRE$ UAB CLAIMS -MADE ' OED RETENTION$ $ WORKERS COMPENSATION AND EMPIAYERS'LIA81LriY PERTA STUTE OTHER $ ANYPROPRIETOR/PARTNER/ Y/N EXECUTIVEOFFICER/MEMBER N/A I ELEACHACCIDENT $ E.L. DISEASE- EA EMPLOYEE EXCLUDED? (Mandatory in NH) �1 Ifyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POI ICYLIMIT $ II 1 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101, Addhional Rema , S ule,maybeattachedifmomspaceismquired) ' 2008 FORD F250 SUPER; VIN: I FTSW21R08EB70681 l Policy shall not be canceled or reduced in coverage or changed in any other r terial aspect without thirty (30) days prior written notice to the City, CERTIFICATEHOLDER r CANCELLATION �'A— ANK— PURCHASING DIVISION M-16 ! SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BECANCELLED BEFORETHEEKPIRAYION DATE THEREOF, NOTICEWiLLBEDIRIVEREDINACCORDANCEWRHTHEPOLfCf PROVISIONS. 20 CIVIC CENTER PLAZA RM 429 AUTHORIZEDREPRESENTATIVE GDlsa Dolatabadi 09/12/2016 i SADNrTFA.AN 11 �j I DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE �... 10/20/2016 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMATIVELY 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. I M PORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subJectto Cheterms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT POLICY EXP (MM/DD/YYYY) NAME: Golsa Dolatabadi(295033N) PHONE FAX 1451 W 7th St Ste A (A/C, NO, EXT): 310-371-3575_ (A/C, NO): 855-320-8748 E-MAIL ADDRESS: gmin$Uranceservices1@gmail.com San Pedro CA 90732-3524 INSU RER(S) AFFORDI NG COVERAGE NAIC# CLAIMS -MADE OCCUR INSURED INSURERA: HUSDON SPECIALTY INSURANCE COMPANY 25054 DULUX PAINTING INSURERS: DAMAGETORENTED PREMISES (Ea Occurrence) - -- INSURERC: MED EXP (Anyone person) $ 5,000 INSURER D: 26 ROCKINGHORSE RD INSURER E: RCH PALOS VRD CA 90275 --- INSURER F: – PERSONAL &ADV INJURY COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSRTYPEOPINSURANCE LTR 20 CIVIC CENTER PLAZA M-11 DDTANSOL SURR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE OCCUR DAMAGETORENTED PREMISES (Ea Occurrence) $ 100,000 MED EXP (Anyone person) $ 5,000 PERSONAL &ADV INJURY $ 2,000,000 HBD 10007003 GENT AGGREGATE LIM IT APPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBIN ED SING LE LIM IT (Ea accident) $ BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY (Per accident)$ B OWNEDAUTOS SCHEDULED ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOSONLV PROPERTY DAMAGE (Per accident) $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESSLIAB CLAIMS -MADE UED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER STATUTE OTFIER $ E. L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A E. L. DISEASE - EA EMPLOYEE E. L. DISEASE -POLICY LIMIT $ Ifyes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEli1CLES(ACORD 101, Additional Remarks Schedule, may be attached if morespace Is required) SEE ATTACHED CERTIFICATE HOLDER CANCELLATION ACORD 25(2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF SANTA ANA DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W ITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA M-11 AUTHORIZED REPRESENTATIVE GOLSA DOLATABADI 10/20/2016 SANIA.ANA— r1�927ll9— ACORD 25(2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD /ic_ A—IFft" DATE(MM/DD/YYYY) lw r CERTIFICATE OF LIABILITY INSURANCE 10/20/2016 THIS CERTIFICATE IS ISSUED ASA 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 ACONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lithe certificate holder is an ADDITIONAL INSURED, the pollcy(les) 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. Astatement on this certificate does not confer rights to the certificate holder in lieu ofsuch endorsement(s). PRODUCER CONTACT POLICY EFF (MM/DD/YYYY) NAME: Golsa Dolatabadi(295033N) PHONE FAX 1451 W 7th St Ste A (A/C, NO, EXT): 310.371-3575 (A/C, NO): 855-320-6748 E-MAIL ADDRESS: gminsuranceservicesl@gmail.com San Pedro CA 90732-3524 INSURER(S)AFFORDING COVERAGE NAIC# EACH OCCURRENCE INSURED INSURERA: HUSDON SPECIALTY INSURANCE COMPANY 25054 INSURER B: DULUX PAINTING — INSURER C: INSURERD: 26 ROCKINGHORSE RD INSURER E: RCH PALOS VRD CA 90275 ---- --- - INSURERF: $ 5,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE: POLICIES DESCRIBED HEREIN IS SUBJECi'TO ALLTHETERMS, EXCLUSIONS AND CONDITIONS Or SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDTL INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 V CLAIMS -MADE X OCCUR DAMAGETO RENTEDPREMISES(Ea Occurrence) $ 100,000 MED EXP (Anyone person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 HBD 10007003 GEN'L AGGREGATE UMITAPPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICY PROJECT ❑ LOC PRODUCTS-COMP/OPAGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Eaoccident) BODILY INJURY (Per person) $ ANYAUTO BODILY INJURY (Peraccident) $ B OWNEDMJTOS SCHEDULED ONLY AUTOS PROPERTY DAMAGE (Peraccident) $ HIREDAUTOS NON -OWNED ONLY AUTOSONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS HAS CIMS -MADE DED RUENTION$__ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER STATUTE OTHER $ E.L. EACHACCIDENT $ ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVEOFFICER/MEMBER EXCLUDED? (Mandatory in NH) C N/A E.L.DISEASE-EA EMPLOYEE 1 GL DISPASE- POLICV LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) SEE ATTACHED CERTIFICATE HOLDER CANCELLATION ACORD25(2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION, All Rights Reserved The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF SANTA ANA DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W ITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE GOLSA DOLATABADI 10/20/2016 20 CIVIC CENTER PLAZA M-11 cANLT[iANA—_—GA___92zfLt -----_—.__. ACORD25(2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION, All Rights Reserved The ACORD name and logo are registered marks of ACORD kJK " W....-- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1_0/20/2016 _ THISCERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMATIVELY 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 pollcy(les) 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. Astatement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT POLICY EXP (MM/DD/YYYY) NAME: GDisa Dolatabadi(295033N) PHONEFAX COMMERCIAL GENERAL LIABILITY 1451 W7th St SteA (A/C, NO, EXT): 310-371-3575 (A/c, NO): 855-320-8748 — _ E-MAIL ADDRESS: gminsuranceser0cesl@gmail.com San Pedro CA 90732-3524 – INSURER(S)AFFORDING COVERAGE NAIL# INSURED INSURER A: HUSDON SPECIALTY INSURANCE COMPANY 25054 INSURER B: DULUX PAINTING INSURERC: — INSURER D:— $ 5,000 26 ROCKINGHORSE RD INSURER E: RCH PALOS VRD CA 90275 INSURER F; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS ISTO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLIHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OFINSURANCE ADDTL INSD SUBR WVD POLICYNUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR DAMAGETORENTED PREMISES (Ea Occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV WJURY $ 2,000,000 HBD 10007003 01/13/2016 01/13/2017 'GEN'L AGGREGATE LIM IT APPLI ES PER: GENERALAGGREGATE $ 4,000,000 POLICY ❑ PROJECT a LOC PRODUCTS-COMP/OP AGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANVAUTO BODILY INJURY (Per accident) $ B OWNEDAUTOS SCHEDULED ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOSONLY PROPERTY DAMAGE (Per accident) $ UMBRELLALIAS OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER 5'fATU'fE OTHER $ E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER EXC LUDED7 (Mandatory In NH) Kyes, describe under DESCRIPTION OF OPERATIONS below N/A E.L. DISEASE - EA EMPLOYEE . E. L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONSAOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if morespace Is required) to the fullest ectent permitted by law, contractor shall indemnity, defend and hold harmless City, its officers, agents and employees( collectively, the indemnified parties)from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to properly),demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines,penalties, liabilities, costs and expenses( including, without limitation, attorney's fees,disbursements and court costs) of every kind and nature what so ever(individually, a claim; collectively, "claims")which may SLIER from or any manner related (see the attached ) CERTIFICATE HOLDER CANCELLATION SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF SANTA ANA DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA M-11 AUTHORIZED REPRESENTATIVE GOLSA DOLATABADI 10/20/2016 SANTA AMA C U ACORD25(2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD !Q %_ %_P1% " DATE. (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/20/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE. DOES NOTAFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGEAFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANP. If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 15 WAIVED, sublectto the terms and conditions of the policy, certain policies may require an endorsement. Astaternent on this certificate does not confer rights to the certificate holder In lieu starch endorsement(s). PRODUCER CONTACT NAME: Goias Dolatabadl(295033N) PHONE FAX 1451 W 7th St Ste A (A/C, NO, EXT): 310-371-3575 (A/C, NO): 855320-8748 E-MAIL --- — San Pedro CA 90732.3524 ADDRESS: gminsuranceservicesl@gmail.com INSURER(S)AFFORDING COVERAGE NAICS INSURED INSURERA: HUSDON SPECIALTY INSURANCE COMPANY 25054 INSURER B: DULUX PAINTING -- INSURERC: INSURER D: 26 ROCKINGHORSE RD INSURER E: RCH PALOS VRD CA 90275 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAME ABOVE FOR l"HE POLICY PERIOD INDICATED, NOTWITHSTANDING ANJBYTHE REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOPOLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDTL INSD SUBR WVO POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS 6OMMERCIAL GENERAL LIABILITY EACH OCCURRENCE X OCCl1R DAMAGE TO RENTEDCLAIMS-MADE PREMISES(Ea Occurrence) MED EXP(Anyone person) 5,000 PERSONAL &ADV INJURY $ 2,000,000 HBD 10007003 01/13/2016 01/13/2017 GENT AGGREGATE LIMIT APPLI ES PER: GENERAL AGGREGATE $ 4,000,000 POLICY lJ PROJECT n LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABI LITY COMBINED SINGLE LIM IT (Eaaccident) $ BODI LY INJURY (Per person) $ ANYAUTO B OWNEDAUTOS SCHEDULED ONLY AUTOS BODILY INJURY (Per accident) $ HI RED AUTOS NON OWNED ONLY AUTOSONLY PROPERTY DAMAGE (Peraccident) $ UMBRELLALIAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE :]::DTE_ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PEROTHER STATUTE $ ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER N/A E.L. EACH ACCIDENT $ — E.L. DISEASE- EA EMPLOYEE EXCLUDED? (Mandatory in NH) E.I-.DISEASE - POLICY LIMIT $ Ifyes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached timers space Is required) to the fullest ectent permitted by law, contractor shall indemnity, defend and hold harmless City, its officers, agents and employees( collectively, the indemnified parties)from and against any and all claims (Including, without limitation, claims for bodily injury, death or damage to property),demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines,penalties, liabilities, costs and expenses( including, without limitation, attorney's fees,disbursements and court costs) of every kind and nature what so ever(individually, a claim; collectively, "claims")which may arise from or any manner related (see the attached ) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF SANTA ANA DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA M-11 AUTHORIZED REPRESENTATIVE GOLSA DOLATABADI 10/20/2016 — SANTA ANA fA_92: _ ... ACORD 25(2016/03) 31-1769 11-15 ©1988-2015 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD POLICY NUMBER: HBDI0007003 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THOS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDffIONAL MURE® - OWNERS, LESSEES O CONTRACTORS 6 COMPLETED OPER TON This endorsement modifies insurance provided under the follo�Aiing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SC14E€ ULE Maria* Of Additional Insured Forson(s) Ate^ Or t0r aniza_i➢aaa CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M-11 SANTA ANA CA 92701 80cfiion Il — Who Is An Insured is amended to ncducie ae, an additional Insured the persons) or organizatlon(s) shoran in the Schedule, but only with respect to liability for "bodily injury" or "property domage" caused, in whole or in part, by "your work" at the location designated and described in the schedule or this endorsement performed for that additional insured and included in ti -ie "products - completed operations hazard". Location And CesCOPVOn Of CoMpleted Opera - will be Gia 20 37 07 04 rJ ISO Properties; Inc., 2004 'sage 1 oy 1 0 POLICY NUMBER: HBD10007003 COMMERCIAL GENERAL LIABILITY CG 20 27 07 04 THOS ENDORSEMENT CHANGES THE POLECY. PLEASE READ ff CAREFULLY. ADD�TI N L �N UE® - OWNERS, LESSEES OR CONTRACTORS, - COMPLETED OPERATOOK This endorsement modifies insurance provided under the following: COMMERCIAL. GENERAL LIABILITY COVEP,AGE PART Name Of Additional Insured Persons) CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M-11 SANTA ANA CA 92701 BCI M—ULE Locatlion And Description Of Completed Opera - I Information required to corriclete this Schedule. if not shown above. %miill be shown in the Declarations. I SeAaVon H – Who Is An insured is amended to ndude as an additional insured the person(s) or organization(s) shown in the. Sohedule, but only with respect to liability for "bodily injury" or "propety damage" caused, in whole or in part, by "your vioil'' at, the location designated and described in the schedule oP this endorsement performed for that additional insured and included in the "products - completed operations hazard'. CG 20 37 07 04 Q ISO Properties; Inc., 2004 Page 9 Of' 1 0- GCr33f6P[tP):3i7uig3LASZr7iF '4� ADDITIONAL REMARKS SCHEDULE Page Of Insurance agency CODE ADDITIONAL REMARKS FORM 15 A SCHEDULE TO ACORD FORM, FORM TITLE: Road, (directly or indirectly) to any work performed or services provide under this contract (including, without limitation, defects in workmanship and/or materials) or contractor's presence or activities conducted performing the work (including the negligent and/or willful acts, suppliers, contractors, Its principals, officers, agents, employees, vendors, suppliers, contractors, subcontractors anyone employed directly by any of them or for whose acts they may be liable for any or all of them). Notwithstanding the foregoing, nothing herein shall be construed to require contractor to indemnify the indemnified parties from any claim arising from the sole negligence or willful misconduct of the indemnified parties. VrA411104iX011AL411ri1K[11ffAi`fIrPF '4� ® ADDITIONAL REMARKS SCHEDULE Page Of insurance agency NUMBER 10007003 CODE ADDITIONAL REMARKS Bond, THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: acord 101 FORM TITLE: (directly or Indirectly) to any work performed or services provide under this contract (including, without limitation, defects in workmanship and/or materials) or contractor's presence or activities conducted performing the work (including the negligent and/or willful acts, suppliers, contractors, Its principals, officers, agents, employees, vendors, suppliers, contractors, subcontractors anyone employed directly by any of them or for whose acts they may be liable for any or all of them). Notwithstanding the foregoing, nothing herein shall be construed to require contractor to Indemnify the Indemnified parties from any claim arising from the sole negligence or willful misconduct of the indemnified parties. ACORD 101(2008/01) '2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 101 The ACORD name and logo are registered marks of ACORD 2008 ACORD CORPORATION. All riehts reserved. CERTHOLDER COPY SC P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-20-2016 CITY OF SANTA ANA 20 CIVIC CENTER PLZ RM M11 SANTA ANA CA 92701-4008 GROUP: POLICY NUMBER: 9123488-2016 CERTIFICATE ID: 27 CERTIFICATE EXPIRES: 01-28-2017 01-28-2016/01-28-2017 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE X 29 DATED 10-20-2016 SC JOB:CORBIN & SW SENIOR CENTER PAINTING This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration, This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein, Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the poliic/cyyy described herein is subject to all the terms, exclusions, and conditions, of such policy. ��t`yC�!/�y � d/I�IMN"!' .11 ��4'tA'L{i•t..e Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - JOHN MANTIKAS, PRES,SEC,TRES - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-28-2016 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER DULUX PAINTING 26 ROCKINGHORSE RD RANCHO PALOS VERDES CA 90275 Sc [ND7,CNI IREV.7-2014) PRINTED : 10-20-2016 POLICYHOLDER COPY SC P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-20-2010 CITY OF SANTA ANA 20 CIVIC CENTER PLZ RM M11 SANTA ANA CA 82701-4058 GROUP: POLICY NUMBER: - 9123458-2015 CERTIFICATE M4 27 CERTIFICATE EXPIRES: 01-28-2017 01-28-2016/01-28-2017 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE # 26 DATED 10-20-2016 SC JOB:CORBIN & SW SENIOR CENTER PAINTING This is to certify that we have issued a valid Workers' Compensation insurance policy In a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance Is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the ppolil�i��ccyyy described herein is subject to all the ter/ms.,, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - JOHN MANTIKAS, PRES,SEC,TRES - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-28-2016 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER DULUX PAINTING 20 ROCKINGHORSE RD RANCHO PALOS VERDES CA 90275 [ND7,CNI (REv.7-2014) PRINTED : 10-20-2016