PowerGen Inc 1 Version 05-23-23
SERVICE PROVIDER AGREEMENT
This SERVICE PROVIDER AGREEMENT (“ Agreement”) is entered into this ___ day of _________, 2024 (“Effective Date”), by and between the CITY OF ALAMEDA, a municipal corporation (“the City”), and POWERGEN INC., a California corporation, whose address is 300 WEST LARCH ROAD #4, TRACY, CALIFORNIA 95304 (“Provider”), in reference to the following facts and circumstances:
RECITALS
$ The City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of the City. % The City is in need of the following services: Generator Maintenance and Repair Services (Various Locations). City staff issued an RFP on March 8, 2024, and after a submittal period of 21 days received 5 of timely submitted proposals. Staff reviewe d the proposals, interviewed qualified firms and selected the service provider that best meets the City’s needs. & Provider possesses the skill, experience, ability, background, certification and knowledge to provide the services described in this Agreement on the terms and conditions described herein. ' Whereas, the City Council authorized the City Manager to execut e this agreement on -XQH .
( The City and Provider desire to enter into an agreement for Gen erator Maintenance and Repair Services (Various Locations), upon the terms and conditions herein.
AGREEMENT
NOW, THEREFORE, in consideration of the forgoing, which are inc orporated herein by reference, and for good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the City and Provider agree as follows:
1. TERM:
The term of this Agreement shall commence on the 1st day of July 2024 and shall terminate on the 30th day of June 2029, unless terminated earlier as set forth herein.
2. SERVICES TO BE PERFORMED:
Provider agrees to do all necessary work at its own cost and ex pense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all necessary work included in Exhibit A as requested. Provider acknowledges that the work plan included in Exhibit A is tentative and does not commit the City to request Provider to perform all tasks included therein.
3. COMPENSATION TO PROVIDER:
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a. By the 7th day of each month, Provider shall submit to the City an invoic e for the total amount of work done the previous month. Pricing and accou nting of charges are to be according to the fee schedule as set forth in Exhibit B and inc orporated herein by this reference.
Extra work must be approved in writing by the City Manager or their designee prior to performance and shall be paid on a Time and Material basis as set forth in Exhibit B. b. Compensation for work done under this Agreement, shall not exceed as follows:
FY 24-25 total compensation shall not exceed $16,566.00 FY 25-26 total compensation shall not exceed $17,063.00 FY 26-27 total compensation shall not exceed $77,691.00 FY 27-28 total compensation shall not exceed $18,103.00 FY 28-29 total compensation shall not exceed $18,646.00 Total five-year compensation shall not exceed $148,069
4. TIME IS OF THE ESSENCE:
Provider and the City agree that time is of the essence regardi ng the performance of this Agreement.
5. STANDARD OF CARE:
Provider agrees to perform all services hereunder in a manner c ommensurate with the prevailing standards of like professionals or service providers, as applicable, in the San Francisco Bay Area and agrees that all services shall be performed by qua lified and experienced personnel who are not employed by the City.
6. INDEPENDENT PARTIES:
Provider hereby declares that Provider is engaged as an independent business and Provider agrees to perform the services as an independent contractor. The manner and means of conducting the services and tasks are under the control of Provider except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Provider’s se rvices. None of the benefits provided by the City to its employees, including but not limite d to unemployment insurance, workers’ compensation plans, vacation and sick leave, are available from the City to Provider, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an em ployer-employee relationship from any compensation due to Provider. Payments of the above i tems, if required, are the responsibility of Provider.
7. IMMIGRATION REFORM AND CONTROL ACT (IRCA):
Provider assumes any and all responsibility for verifying the i dentity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Provider shall indemnify, defend, and hold the City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Provider.
8. NON-DISCRIMINATION:
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Consistent with the City’s policy and state and federal law tha t harassment and discrimination are unacceptable conduct, Provider and its employees, contractors, and agents shall not harass or discriminate against any job applicant, City emp loyee, or any other person on the basis of any kind of any statutorily (federal, state or local) protected class, including but not limited to: race, religious creed, color, national origin, ancestry, di sability (both mental and physical) including HIV and AIDS, medical condition (e.g. cancer), genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, pregnancy, political affiliation, military and veteran status or legitimate union activities. Provider agrees that any violation of this provision shall constitute a material breach of this Agreement.
9. HOLD HARMLESS:
a. To the fullest extent permitted by law, Provider shall indemni fy, defend (with counsel acceptable to the City) and hold harmless the City, its City Council, boards, commissions, officials, employees, agents and volunteers (“Indemnitees”) fro m and against any and all loss, damages, liability, obligations, claims, suits, judgments, costs and expenses whatsoever, including reasonable attorney’s fees and costs of litigation (“Claims”), arising from or in any manner connected to Provider’s performance of its obligations under th is Agreement or out of the operations conducted by Provider even if the City is found to h ave been negligent. If the Claims filed against Indemnitees allege negligence, recklessness or wi llful misconduct on the part of Provider, Provider shall have no right of reimbursement against Indemnitees for the costs of defense even if negligence, recklessness or willful misconduct is not found on the part of Provider.
Provider shall not have any obligations to indemnify Indemnitees if the loss or damage is found to have resulted solely from the negligence or the willful miscond uct of the City. The defense and indemnification obligations of this Agreement are undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this Agreement. b. As to Claims for professional liability only, Provider’s obliga tion to defend Indemnitees (as set forth above) is limited as provided in California Civil Code Section 2782.8. c. Provider’s obligation to indemnify, defend and hold harmless In demnities shall expressly survive the expiration or early termination of this Agreement.
10. INSURANCE:
a. On or before the commencement of the terms of this Agreement , Provider shall furnish the City’s Risk Manager with certificates showing the t ype, amount, class of operations covered, effective dates and dates of expiration of insurance coverage in compliance with Sections
10.b. (1) through (5). The Certificate Holder should be The Ci ty of Alameda, 2263 Santa Clara, Ave., Alameda, CA 94501. Such certificates, which do not limit Provider’s indemnification, shall also contain substantially the following statement:
“Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty (30) days’ adva nce written notice to the City of Alameda. Attention: Risk Manager.”
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Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required.
As to commercial general liability and automobile liability in surance, such insurance will provide that it constitutes primary insurance with respect to c laims insured by such policy, and, except with respect to limits, that insurance applies separately to each insured against whom claim is made or suit is brought. Such insurance is not additional to or contributing with any other insurance carried by or for the benefit of the City.
c. SUBROGATION WAIVER:
Provider hereby agrees to waive rights of subrogation that any insurer of Provider may acquire from Provider by virtue of the payment of any loss. Provider ag rees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of the City for all work performed by Provider, its employees, agents and subcontractors. d. FAILURE TO SECURE:
If Provider at any time during the term hereof should fail to s ecure or maintain the foregoing insurance, the City shall be permitted to obtain such insurance in Provider’s name or as an agent of Provider and shall be compensated by Provider for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid.
e. ADDITIONAL INSUREDS:
The City, its City Council, boards, commissions, officials, emp loyees, agents, and volunteers shall be named as additional insured(s) under all insurance coverages, except workers’ compensation and professional liability insurance. The naming of an additional insured shall not affect any recovery to which such additional insured would be e ntitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional i nsured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy.
Additional Insured coverage under Provider’s policy shall be pr imary and non-contributory and will not seek contribution from the City’s insurance or self-in surance. Any available insurance proceeds broader than or in excess of the specified minimum ins urance coverage requirements and/or limits shall be available to the additional insured(s). f. SUFFICIENCY OF INSURANCE:
The insurance limits required by the City are not represented as being sufficient to protect Provider. Provider is advised to consult Provider’s insurance broker to determine adequate coverage for Provider. The coverage and limits shall be (1) th e minimum coverage and limits specified in this Agreement; or (2) the broader coverage and ma ximum limits of the coverage carried by or available to Provider; whichever is greater. g. EXCESS OR UMBRELLA LIABILITY:
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If any Excess or Umbrella Liability policies are used to meet the limits of liability required by this Agreement, then said policies shall be true “following form” of the underlying policy coverage, terms, conditions, and provisions and shall meet all of the insurance requirements stated in this Agreement, including but not limited to, the additional insured, SIR, and primary insurance requirements stated therein. No insurance policies maintained by the indemnified parties or Additional Insureds, whether primary or excess, and which also apply to a loss covered hereunder, shall be called upon to contribute to a loss until all the primary and excess liability policies carried by or available to the Provider are exhausted.
11. CONFLICT OF INTEREST:
Provider warrants that it is not a conflict of interest for Pr ovider to perform the services required by this Agreement. Provider may be required to fill o ut a conflict of interest form if the services provided under this Agreement require Provider to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations.
12. PROHIBITION AGAINST TRANSFERS:
a. Provider shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law o r otherwise, without prior written consent of the City Manager. Provider shall submit a written request for consent to transfer to the City Manager at least thirty (30) days in advance of the desire d transfer. The City Manager or their designee may consent or reject such request in their sole and absolute discretion. Any attempt to do so without said consent shall be null and void, and any a ssignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money against the City under this Agreement may be assigned by Provider to a bank, trust company or other financial institution without prior written consent. b. The sale, assignment, transfer or other disposition of any of t he issued and outstanding capital stock, membership interest, partnership interest, or the equivalent, which shall result in changing the control of Provider, shall be construed as an assignment of this Agreement.
Control means fifty percent or more of the voting power of Provider.
13. APPROVAL OF SUB-PROVIDERS:
a. Only those persons and/or businesses whose names and resumés are attached to this Agreement shall be used in the performance of this Agreement. However, if after the start of this Agreement, Provider wishes to use sub-providers, at no additional costs to the City, then Provider shall submit a written request for consent to add sub-providers including the names of the sub- providers and the reasons for the request to the City Manager at least five (5) days in advance. The City Manager may consent or reject such requests in their sole and absolute discretion. b. Each sub-provider shall be required to furnish proof of worker s’ compensation insurance and shall also be required to carry general, automobi le and professional liability insurance (as applicable) in reasonable conformity to the insurance carried by Provider.
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c. In addition, any tasks or services performed by sub-providers s hall be subject to each provision of this Agreement. Provider shall include the following language in their agreement with any sub-provider: “Sub-providers hired by Provider agree to be bound to Provider and the City in the same manner and to the same extent as Provider is bound to the City.” d. The requirements in this Section 13 shall not apply to persons who are merely providing materials, supplies, data or information that Provider then analyzes and incorporates into its work product.
14. PERMITS AND LICENSES:
Provider, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City business license that may be required in connection with the performance of the services and tasks hereunder.
15. REPORTS:
a. Each and every report, draft, work product, map, record and oth er document produced, prepared or caused to be prepared by Provider pursuan t to or in connection with this Agreement shall be the exclusive property of the City.
b. No report, information or other data given to or prepared or assembled by Provider pursuant to this Agreement shall be made available to any indiv idual or organization by Provider without prior approval of the City Manager or their designee. c. Provider shall, at such time and in such form as City Manager or their designee may require, furnish reports concerning the status of services and tasks required under this Agreement.
16. RECORDS:
a. Provider shall maintain complete and accurate records with respect to the services, tasks, work, documents and data in sufficient detail to permit an evaluation of Provider’s performance under the Agreement, as well as maintain books and records related to sales, costs, expenses, receipts and other such information required by the C ity that relate to the performance of the services and tasks under this Agreement (collectively the “Records”). b. All Records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Provider shall provide free access to the Records to the representatives of the City or its designees during regular business hours upon reasonable prior notice. The City has the right to examine and audit the Records, and to make copies or transcripts therefrom as necessary, and to allow insp ection of all proceedings and activities related to this Agreement. Such Records, together w ith supporting documents, shall be kept separate from other documents and records and shall be mai ntained by Provider for a period of three (3) years after receipt of final payment.
c. If supplemental examination or audit of the Records is necessar y due to concerns raised by the City’s preliminary examination or audit of record s, and the City’s supplemental examination or audit of the records discloses a failure to adhe re to appropriate internal financial controls, or other breach of this Agreement or failure to act i n good faith, then Provider shall
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reimburse the City for all reasonable costs and expenses associ ated with the supplemental examination or audit.
17. NOTICES:
a. All notices shall be in writing and delivered: (i) by hand; or (ii) sent by registered, express, or certified mail, with return receipt requested or wi th delivery confirmation requested from the U.S. postal service; or (iii) sent by overnight or sam e day courier service at the party’s respective address listed in this Section.
b. Each notice shall be deemed to have been received on the earlie r to occur of: (x) actual delivery or the date on which delivery is refused; or (y ) three (3) days after notice is deposited in the U.S. mail or with a courier service in the man ner described above (Sundays and City holidays excepted).
c. Either party may, at any time, change its notice address (other than to a post office box address) by giving the other party three (3) days prior written notice of the new address. d. All notices, demands, requests, or approvals from Provider to t he City shall be addressed to the City at:
City of Alameda
Public Works
950 W. Mall Square, Room 110
Alameda, CA 94501
ATTENTION: Jay Reed, Project Manager
Ph: (510) 747-7981
e. All notices, demands, requests, or approvals from the City to P rovider shall be addressed to Provider at:
PowerGen Inc.
265 Quail Meadow Lane
Tracy, CA 95376
ATTENTION: Victor Poley, CEO
Ph: (209) 229-1990
f. All updated insurance certificates from Provider to the City sh all be addressed to the City at:
City of Alameda
Public Works
950 W. Mall Square, Room 110
Alameda, CA 94501
ATTENTION: Jeanette Navarro, Engineering Office Assistant Ph: (510) 747-7932 / [email protected]
18. SAFETY:
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a. Provider will be solely and completely responsible for conditio ns of all vehicles owned or operated by Provider, including the safety of all pers ons and property during performance of the services and tasks under this Agreement. Th is requirement will apply continuously and not be limited to normal working hours. In addition, Provider will comply with all safety provisions in conformance with U.S. Department of La bor Occupational Safety and Health Act, any equivalent state law, and all other applicable federal, state, county and local laws, ordinances, codes, and any regulations that may be detailed in other parts of the Agreement. Where any of these are in conflict, the more stringent requirements w ill be followed. Provider’s failure to thoroughly familiarize itself with the aforementioned safety provisions will not relieve it from compliance with the obligations and penalties set forth herein. b. Provider will immediately notify the City within 24 hours of any incident of death, serious personal injury or substantial property damage that occ urs in connection with the performance of this Agreement. Provider will promptly submit t o the City a written report of all incidents that occur in connection with this Agreement. This r eport must include the following information: (i) name and address of injured or deceased person (s); (ii) name and address of Provider’s employee(s) involved in the incident; (iii) name and address of Provider’s liability insurance carrier; (iv) a detailed description of the incident; and (v) a police report.
19. TERMINATION:
a. In the event Provider fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Provider shall be deemed in default in the performance of this Agreement. If such default is not cured within two (2) business days after receipt by Provider from the City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, the City may thereafter immediately terminate the Agreement forthwith by giving to Provider written notice thereof. b. The foregoing notwithstanding, the City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days’ prior written notice to Provider as provided herein.
c. Upon termination of this Agreement either for cause or for convenience, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. The obl igation of the parties under this Section 19.c. shall survive the expiration or early termination of this Agreement.
20. ATTORNEYS’ FEES:
In the event of any litigation, including administrative procee dings, relating to this Agreement, including but not limited to any action or suit by a ny party, assignee or beneficiary against any other party, beneficiary or assignee, to enforce, interpret or seek relief from any provision or obligation arising out of this Agreement, the parties and litigants shall bear their own attorney’s fees and costs. No party or litigant shall be entitled to recover any attorneys’ fees or costs from any other party or litigant, regardless of which party or litigant might prevail.
21. HEALTH AND SAFETY REQUIREMENTS.
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Provider acknowledges that the City shall have the right to imp ose, at the City’s sole discretion, requirements that it deems are necessary to protect the health and safety of the City employees, residents, and visitors. Provider agrees to comply with all such requirements, including, but not limited to, mandatory vaccinations, the use of personal protective equipment (e.g. masks), physical distancing, and health screenings. Provider also agrees to make available to the City, at the City’s request, records to demonstrate Provider’s compliance with this Section.
22. COMPLIANCE WITH ALL APPLICABLE LAWS:
During the term of this Agreement, Provider shall keep fully in formed of all existing and future state and federal laws and all municipal ordinances and regulations of the City of Alameda which affect the manner in which the services or tasks are to be performed by Provider, as well as all such orders and decrees of bodies or tribunals having any j urisdiction or authority over the same. Provider shall comply with all applicable laws, state an d federal and all ordinances, rules and regulations enacted or issued by the City.
23. CONFLICT OF LAW:
This Agreement shall be interpreted under, and enforced by the laws of the State of California without regard to any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the par ties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisd iction over this Agreement (or the successors of those authorities). Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Alameda, State of California.
24. WAIVER:
A waiver by the City of any breach of any term, covenant, or co ndition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character.
25. INTEGRATED CONTRACT:
Subject to the language of Section 30, the Recitals and exhibit s are a material part of this Agreement and are expressly incorporated herein. This Agreemen t represents the full and complete understanding of every kind or nature whatsoever betwe en the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or n ature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both the City and Provider.
29. CAPTIONS:
The captions in this Agreement are for convenience only, are no t a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement.
30. COUNTERPARTS:
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This Agreement may be executed in any number of counterparts (i ncluding by fax, PDF, DocuSign, or other electronic means), each of which shall be deemed an original, but all of which shall constitute one and the same instrument.
31. SIGNATORY:
By signing this Agreement, signatory warrants and represents th at they executed this Agreement in their authorized capacity and that by their signat ure on this Agreement, they or the entity upon behalf of which they acted, executed this Agreement.
32. CONTROLLING AGREEMENT:
In the event of a conflict between the terms and conditions of this Agreement (as amended, supplemented, restated or otherwise modified from time to time) and any other terms and conditions wherever contained, including, without limitation, terms and conditions included within exhibits, the terms and conditions of this Agreement shall control and be primary.
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ŝŝŝ͘ sŝƐƵĂůůLJĐŚĞĐŬďĂƚƚĞƌŝĞƐΘĐŽŶŶĞĐƚŝŽŶƐ
ŝǀ͘ ŚĞĐŬďĂƚƚĞƌLJĐŚĂƌŐŝŶŐƐLJƐƚĞŵĨŽƌĐŽƌƌĞĐƚŽƉĞƌĂƚŝŽŶĂŶĚĂĚũƵƐƚĂƐŶĞĞĚĞĚ
Ő͘ '
E
Z>
ŝ͘ sŝƐƵĂůůLJĐŚĞĐŬĞŶŐŝŶĞŵŽƵŶƚƐ
ŝŝ͘ sŝƐƵĂůůLJĐŚĞĐŬĐŽŵƉůĞƚĞƵŶŝƚ
Ś͘ '
E
ZdKZ^t/d,'
ZΘ
D
Z'
Ez^KhZ
&
Z^
ŝ͘ KƉĞƌĂƚĞŐĞŶĞƌĂƚŽƌĐŝƌĐƵŝƚďƌĞĂŬĞƌŵĂŶƵĂůůLJĂƚƚŝŵĞŽĨǀŝƐŝƚ;ŝĨƉŽƐƐŝďůĞͿ
ŝ͘ ZhEE/E'd
^d
ŝ͘
&KZ
^dZd/E'
E'/E
͗
ϭ͘ ŚĞĐŬĞŶŐŝŶĞŽŝůůĞǀĞůĂŶĚĐŽŽůĂŶƚůĞǀĞů
Ϯ͘ ŚĞĐŬ ďůŽĐŬ ŚĞĂƚĞƌͲǁŝůů ŵĂŝŶƚĂŝŶ ĐŽŽůĂŶƚ ƚĞŵƉĞƌĂƚƵƌĞ ŽĨ ĂďŽƵƚ ϵϬ ĚĞŐƌĞĞƐ&ŝŶƚŚĞďůŽĐŬ͘ŚĞĐŬĨƵĞůůĞǀĞůŝŶƐƚŽƌĂŐĞƚĂŶŬ ϯ͘ ŚĞĐŬďĂƚƚĞƌLJǁĂƚĞƌůĞǀĞůĂŶĚƚŽƉĂƐŶĞĐĞƐƐĂƌLJ
ϰ͘ ŚĞĐŬďĂƚƚĞƌLJƚĞƌŵŝŶĂůƐĨŽƌĐŽƌƌŽƐŝŽŶĂŶĚĐŽŶŶĞĐƚŝŽŶƐĨŽƌƚŝŐŚƚŶĞƐƐ ŝŝ͘ t/d,
E'/E
ZhEE/E'͗
ϭ͘ ŚĞĐŬŽŝůƉƌĞƐƐƵƌĞ
Ϯ͘ ŚĞĐŬĨƵĞůƉƌĞƐƐƵƌĞ
ϯ͘ ŚĞĐŬŽŝůůĞǀĞůĂŶĚĂĚĚŽŝůĂƐƌĞƋƵŝƌĞĚ͘ŚĞĐŬZWD;ĨƌĞƋƵĞŶĐLJͿ ϰ͘ ŚĞĐŬŐĞŶĞƌĂƚĞĚǀŽůƚĂŐĞ
ϱ͘ ŚĞĐŬĨŽƌůĞĂŬƐĂŶĚƵŶƵƐƵĂůŶŽŝƐĞƐ
ŝŝŝ͘ &d
Z^dKWW/E'
E'/E
͗
ϭ͘ ŚĞĐŬͬǀĞƌŝĨLJĂůůƐǁŝƚĐŚĞƐĂƌĞŝŶƉƌŽƉĞƌƉŽƐŝƚŝŽŶƐĨŽƌĂƵƚŽŵĂƚŝĐ ƐƚĂƌƚ͘ ŚĞĐŬĨƵĞůůĞǀĞůŝŶƚĂŶŬ
Ϯ͘ ZĞĐŽƌĚ ďĂƚƚĞƌLJ ĐŚĂƌŐĞƌ ǀŽůƚƐ͕ ĐŚĞĐŬ ĨŽƌ ƉƌŽƉĞƌ ŽƉĞƌĂƚŝŽŶ͘ ZĞŵŽǀĞ͕ ĐůĞĂŶ ĂŶĚ ƌĞŝŶƐƚĂůů Ăůů ďĂƚƚĞƌLJ ĐŽŶŶĞĐƚŝŽŶƐ ;ůĞĂĚ ĂĐŝĚͿ͘ /ŶƐƉĞĐ ƚ ŐĞŶĞƌĂƚŽƌĨŽƌĐůĞĂŶůŝŶĞƐƐ
ϯ͘ ƌĂŝŶĐƌĂŶŬĐĂƐĞŽŝůĂŶĚƌĞƉůĂĐĞǁŝƚŚŶĞǁŽŝů͘ZĞŵŽǀĞĂŶĚƌĞƉůĂĐ ĞŽŝů ĂŶĚĨƵĞůĨŝůƚĞƌƐ
ϰ͘ /ŶƐƉĞĐƚĂŝƌĨŝůƚĞƌ;ƐͿĂŶĚƌĞƉůĂĐĞĂƐƌĞƋƵŝƌĞĚ
ϱ͘ ^ƚĂƌƚ ĞŶŐŝŶĞ ĂŶĚ ůŽĂĚ ǁŝƚŚ ĐŽŶƚƌĂĐƚŽƌ ƐƵƉƉůŝĞĚ ƌĞƐŝƐƚŝǀĞ ůŽĂĚ ďĂŶŬ͘ ZƵŶƵŶĚĞƌůŽĂĚĨŽƌĂƚůĞĂƐƚŽŶĞŚŽƵƌ
ϲ͘ ŚĞĐŬŐĞŶĞƌĂƚŽƌŽƵƚƉƵƚ͘
ũ͘ Z
WKZd/E'
ŝ͘ WƌŽǀŝĚĞ ƚŚĞ ĨŽůůŽǁŝŶŐ ƌĞƉŽƌƚƐ ĨŽƌ ĞĂĐŚ ŐĞŶĞƌĂƚŽƌ ƚŽ ƚŚĞ ĐůŝĞŶƚŝŶ ĞůĞĐƚƌŽŶŝĐ ĨŽƌŵ;tŽƌĚ͕
džĐĞů͕ŽƌW&Ϳ
ϭ͘ ^ĞƌǀŝĐĞƌĞƉŽƌƚʹƌĞƉŽƌƚƚŽŝŶĐůƵĚĞƚŚĞĨŽůůŽǁŝŶŐ͗
Ă͘ tŽƌŬŽƌĚĞƌŶƵŵďĞƌ͕ĚĂƚĞ͕ĞŵƉůŽLJĞĞŶĂŵĞ
ď͘ 'ĞŶĞƌĂƚŽƌ ŝƚLJ / ŶƵŵďĞƌ͕ ŵĂŶƵĨĂĐƚƵƌĞƌ͕ ŵŽĚĞů͕ ƐĞƌŝĂů ŶƵŵďĞƌ͕ůŽĐĂƚŝŽŶ
Đ͘ ^ƚĂƚƵƐŽĨĂůůŝƚĞŵƐĂŶĚĚĞƚĂŝůŽŶůŝƐƚĂͲŝĂďŽǀĞ
Ě͘ ŶLJĂĐƚŝŽŶŝƚĞŵƐŶĞĞĚĞĚŝĨƐƚĂƚƵƐŝƐŶŽƚŶŽƌŵĂů
ŝŝ͘ ĚǀŝƐĞĐƵƐƚŽŵĞƌŽĨĂŶLJͬĂůůƵŶƵƐƵĂůƐŝƚƵĂƚŝŽŶŽƌƉŽƚĞŶƚŝĂůƉƌŽďůĞŵƐǁŚŝĐŚǁŝůů ƌĞƋƵŝƌĞĨƵƌƚŚĞƌĂƚƚĞŶƚŝŽŶ
ŝŝŝ͘ ĚǀŝƐĞǁŚĞŶŵĂŝŶĨƵĞůƚĂŶŬŝƐďĞůŽǁвĨƵůů
Ŭ͘ ZŽƵƚŝŶĞ ĂŶŶƵĂů ƐĞƌǀŝĐĞƐ ƐŚĂůů ďĞ ƉĞƌĨŽƌŵĞĚ ŽŶ ŶŽƌŵĂů ǁŽƌŬĚĂLJƐ ĚĞĨŝŶĞĚ ĂƐ ŶŽŶͲ ŚŽůŝĚĂLJDŽŶĚĂLJƐƚŚƌŽƵŐŚdŚƵƌƐĚĂLJƐ͘dŚĞƐĞƐĞƌǀŝĐĞƐƐŚĂůůďĞƐĐŚĞĚƵůĞĚŝŶƚŚĞŵŽŶƚŚƐ ŽĨKĐƚŽďĞƌƚŚƌŽƵŐŚĞĐĞŵďĞƌ͘/ŶǀŽŝĐĞƐĨŽƌĂŶŶƵĂůƐĞƌǀŝĐĞƐƐŚĂůů ŶŽƚďĞƐĞŶƚƚŽƚŚĞ ŝƚLJǁŝƚŚŽƵƚƚŚĞƐĞƌǀŝĐĞ͕ĂŶĚůŽĂĚƚĞƐƚƌĞƉŽƌƚƐ͕ĂŶĚŽŝůĂŶĂůLJƐŝƐƌĞƉŽƌƚƐĐŽŵƉůĞƚĞĚĂŶĚ ĂƚƚĂĐŚĞĚ͘
Ϯ͘ WƌĞǀĞŶƚŝǀĞDĂŝŶƚĞŶĂŶĐĞ^ĞƌǀŝĐĞƐͲWƌĞǀĞŶƚŝǀĞDĂŝŶƚĞŶĂŶĐĞ^ĞƌǀŝĐĞŝƐĂƚŚƌĞĞͲLJĞĂƌƌŽƚĂƚŝŽŶĂů ƉƌŽŐƌĂŵŝŶǁŚŝĐŚƚŚĞĐŽŶƚƌĂĐƚŽƌƐŚĂůůŝŶĐůƵĚĞƚŚĞĨŽůůŽǁŝŶŐƐĞƌ ǀŝĐĞƐŽŶŝƚLJŐĞŶĞƌĂƚŽƌƐ;ĨŝƌƐƚ ƐĞƌǀŝĐĞƚŽŽĐĐƵƌŝŶϮϬϮϳͿ
Ă͘ ZĞƉůĂĐĞŵĞŶƚŽĨĨĂŶĂŶĚĂůƚĞƌŶĂƚŽƌĚƌŝǀĞďĞůƚƐ
ď͘ ZĞƉůĂĐĞŵĞŶƚŽĨĞŶŐŝŶĞĐŽŽůŝŶŐƐLJƐƚĞŵŚŽƐĞƐ
Đ͘ ZĞƉůĂĐĞŵĞŶƚŽĨďůŽĐŬŚĞĂƚĞƌŚŽƐĞƐǁŝƚŚŚŝŐŚƚĞŵƉĞƌĂƚƵƌĞƐŝůŝĐŽŶĞŚŽƐĞƐ Ě͘ ZĞƉůĂĐĞŵĞŶƚŽĨƐƚĂŶĚĂƌĚĞƚŚLJůĞŶĞŐůLJĐŽůĐŽŽůĂŶƚ
Ğ͘ ZĞƉůĂĐĞŵĞŶƚŽĨƚŚĞďĂƚƚĞƌŝĞƐ
ϯ͘ dƌĂŶƐĨĞƌΘ>ŽĂĚ^ĞƌǀŝĐĞͲdƌĂŶƐĨĞƌΘ>ŽĂĚ^ĞƌǀŝĐĞŝƐĂƚŚƌĞĞͲLJĞĂƌƌŽƚĂƚŝŽŶĂůƉƌŽŐƌĂŵŝŶǁŚŝĐŚ ƚŚĞĐŽŶƚƌĂĐƚŽƌƐŚĂůůŝŶĐůƵĚĞƚŚĞĨŽůůŽǁŝŶŐƐĞƌǀŝĐĞƐŽŶŝƚLJŐĞŶĞƌĂƚŽƌƐ;ĨŝƌƐƚƐĞƌǀŝĐĞƚŽŽĐĐƵƌŝŶ ϮϬϮϳͿ͘
Ă͘ ŚĞĐŬŐĞŶĞƌĂƚŽƌΘŝŶƐƚƌƵŵĞŶƚƐƵŶĚĞƌďƵŝůĚŝŶŐůŽĂĚ
ď͘ ŚĞĐŬƚƌĂŶƐĨĞƌƐǁŝƚĐŚŽƉĞƌĂƚŝŽŶ
Đ͘ WƌŽǀŝĚĞǁƌŝƚƚĞŶƌĞƉŽƌƚ
ϰ͘ KŶͲĂůů
ŵĞƌŐĞŶĐLJ ĂŶĚ EŽŶͲ
ŵĞƌŐĞŶĐLJ ZĞƉĂŝƌ ^ĞƌǀŝĐĞƐͲ ŽŶƚƌĂĐƚŽƌ ƐŚĂůů ƉƌŽǀŝĚĞ ŽŶͲĐĂůů ĞŵĞƌŐĞŶĐLJĂŶĚŶŽŶͲĞŵĞƌŐĞŶĐLJƌĞƉĂŝƌƐŽŶĂƚŝŵĞĂŶĚŵĂƚĞƌŝĂůďĂƐŝƐ͘,ŽƵƌůLJƌĂƚĞƐƉĂŝĚƵŶĚĞƌ ƚŚĞĂŐƌĞĞŵĞŶƚƐŚĂůůďĞŽŶůLJĨŽƌĂĐƚƵĂůƉƌŽĚƵĐƚŝǀĞŚŽƵƌƐŽŶƚŚĞũŽďƐŝƚĞ͘dŚĞŝƚLJƐŚĂůůŶŽƚďĞ ĚŝƌĞĐƚůLJŝŶǀŽŝĐĞĚĨŽƌƚŚĞĨŽůůŽǁŝŶŐ͗
Ă͘ dƌĂǀĞůĂŶĚͬŽƌƚƌĂŶƐƉŽƌƚĂƚŝŽŶŽĨǁŽƌŬĞƌƐ
ď͘ WĂƌƚƐĂŶĚŵĂƚĞƌŝĂůƐĂĐƋƵŝƐŝƚŝŽŶŝŶĐůƵĚŝŶŐĨƌĞŝŐŚƚ͕ŚĂŶĚůŝŶŐ͕ĂŶĚĚĞůŝǀĞƌLJ͖ĂŶĚ Đ͘ DŽǀĞŵĞŶƚŽĨŽŶƚƌĂĐƚŽƌŽǁŶĞĚŽƌƌĞŶƚĞĚĞƋƵŝƉŵĞŶƚ͕
&Žƌ ƉƵƌƉŽƐĞƐ ŽĨ ƚŚĞ ĂŐƌĞĞŵĞŶƚ͕ ƚŚĞƐĞ ĂƌĞ ĐŽŶƐŝĚĞƌĞĚ ŽǀĞƌŚĞĂĚ͕ ĂŶĚ ƚŚĞ ĐŽƐƚƐ ƐŚĂůů ďĞ ŝŶĐůƵĚĞĚ ŝŶ ƚŚĞ ĨŝdžĞĚ ŚŽƵƌůLJ ƌĂƚĞƐ͘ ůů ŝŶǀŽŝĐĞƐ ƚŽ ƚŚĞ ŝƚLJ ĨŽƌ ŽŶͲĐĂůů ĞŵĞƌŐĞŶĐLJ ĂŶĚ ŶŽŶͲ ĞŵĞƌŐĞŶĐLJƌĞƉĂŝƌƐĞƌǀŝĐĞƐŵƵƐƚŝŶĐůƵĚĞĂďƌĞĂŬĚŽǁŶŽĨŶƵŵďĞƌŽĨ ŚŽƵƌƐĨŽƌĂůůĨŝdžĞĚƌĂƚĞƐ ĐŚĂƌŐĞĚĂŶĚƚŚĞŽƌŝŐŝŶĂůĐŽƐƚĂŶĚŵĂƌŬƵƉƉƌŝĐĞĨŽƌĂůůƉĂƌƚƐĂ ŶĚŵĂƚĞƌŝĂůƐĐŚĂƌŐĞĚ͘dŚĞŝƚLJ ƐŚĂůůƌĞƐĞƌǀĞƚŚĞƌŝŐŚƚƚŽƌĞƋƵĞƐƚďĂĐŬƵƉĚŽĐƵŵĞŶƚĂƚŝŽŶĨŽƌƚŚĞĐŽŶƚƌĂĐƚŽƌ͛ƐŽƌŝŐŝŶĂůĐŽƐƚŽŶ ƉĂƌƚƐĂŶĚŵĂƚĞƌŝĂůƐ͘
ϱ͘ EŽŶͲ
ŵĞƌŐĞŶĐLJZĞƉĂŝƌ^ĞƌǀŝĐĞƐ
ŽŶƚƌĂĐƚŽƌƐŚĂůůƉƌŽǀŝĚĞǁƌŝƚƚĞŶ͕͞ŶŽƚƚŽĞdžĐĞĞĚ͕͟ĞƐƚŝŵĂƚĞƐŽŶ ĂůůŶŽŶͲĞŵĞƌŐĞŶĐLJƌĞƉĂŝƌƐ͘ dŚĞƐĞĞƐƚŝŵĂƚĞƐƐŚĂůůŝŶĐůƵĚĞŶƵŵďĞƌŽĨŚŽƵƌƐ͕ŚŽƵƌůLJƌĂƚĞ͕ŶƵŵ ďĞƌĂŶĚƚLJƉĞŽĨĞŵƉůŽLJĞĞƐ ƌĞƋƵŝƌĞĚ͕ ĞƐƚŝŵĂƚĞĚ ŵĂƚĞƌŝĂů ĐŽƐƚƐ͕ ŵĂƌŬƵƉ ĐŽƐƚ͕ ĂŶĚ ĐŽŵƉůĞƚŝŽŶ ĚĂƚĞ͘ ůů ǁŽƌŬ ĨŽƌ ŶŽŶͲ
ĞŵĞƌŐĞŶĐLJ ƌĞƉĂŝƌƐ ƐŚĂůů ďĞ ƉĞƌĨŽƌŵĞĚ ĚƵƌŝŶŐ ƌĞŐƵůĂƌ ŽƉĞƌĂƚŝŶŐ ŚŽƵƌƐ ĂŶĚ ƉĞƌ ƚŚĞ ƌĞŐƵůĂƌ ƌĂƚĞƐ ŽŶ ƚƚĂĐŚŵĞŶƚ ͕ dĂƐŬ ϯ͘ ŽŶƚƌĂĐƚŽƌ ƐŚĂůů ƌĞƐƉŽŶĚ ƚŽ ĞŵĂŝů Žƌ ƉŚŽŶĞ ƌĞƋƵĞƐƚƐ ĨŽƌ ĞƐƚŝŵĂƚĞƐǁŝƚŚŝŶϮϰŚŽƵƌƐĂŶĚƉƌŽǀŝĚĞǁƌŝƚƚĞŶĞƐƚŝŵĂƚĞƐǁŝƚŚŝŶ ƚŚƌĞĞďƵƐŝŶĞƐƐĚĂLJƐŽĨƚŚĞ ŽƌŝŐŝŶĂůƌĞƋƵĞƐƚĚĂƚĞ͘/ƚƐŚĂůůďĞƚŚĞŽŶƚƌĂĐƚŽƌ͛ƐƌĞƐƉŽŶƐŝďŝůŝƚLJƚŽĞŶƐƵƌĞŝƚŚĂƐĂůůŝŶĨŽƌŵĂƚŝŽŶ ƚŽƉƌĞƉĂƌĞĂĐĐƵƌĂƚĞĞƐƚŝŵĂƚĞƐ͘EŽƌĞƉĂŝƌǁŝůůďĞĚŽŶĞǁŝƚŚŽƵƚƚ ŚĞǁƌŝƚƚĞŶĂƉƉƌŽǀĂůďLJƚŚĞ ŝƚLJ͛ƐƌĞƉƌĞƐĞŶƚĂƚŝǀĞ͘
ϲ͘
ŵĞƌŐĞŶĐLJZĞƉĂŝƌͬĨƚĞƌ,ŽƵƌƐ^ĞƌǀŝĐĞƐ
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
E-MAIL
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions o f the policy, certain policies may require an endorsement. A s tatement on this certificate does not confer rights to the certificate hold er in lieu of such endorsement(s).
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 CON TRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI OD 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 AFFORDE D 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. $
$
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
5/15/2024
Orr & Associates Insurance Services
28780 Single Oak Dr
Ste 255
Temecula CA 92590
Certificates
951-506-5859 800-474-3003
[email protected]
License#: 0E63493 Associated Industries Ins. Co. 23140
POWEINC-01 Kemper/Infinity Select Insuran 20260
Powergen Inc
793 S Tracy Blvd #307
Tracy CA 95376
Starstone National Ins. Co. 25496
Wesco Insurance Company 25011
Indian Harbor Insurance Co. 36940
Ohio Casualty Insurance Co. 24074
1386140488
A X 1,000,000
X 100,000
5,000
1,000,000
2,000,000
X
Y Y AES122246602 4/15/2024 4/15/2025
2,000,000
B 1,000,000
X
Y 50000146801 11/19/2023 11/19/2024
C X 5,000,000
X
70136S241ALI 4/15/2024 4/15/2025
5,000,000
D XY WWC3711041 5/3/2024 5/3/2025
1,000,000
1,000,000
1,000,000
E
F
Railroad protective
Equipment Floater
US00128332LI23A
BMO2464147534
4/6/2023
6/17/2023
4/6/2028
6/17/2024
Aggregate
Scheduled Equipment
5,000,000
122,050Certificate is subject to policy limits, conditions and exclusions.
The City of Alameda, its City Council, boards and commissions, officers & employees are named as Additional Insured as per attached endorsement form(s).
City of Alameda
2263 Santa Clara Avenue
Alameda, CA 94501
COMMERCIAL AUTO
BA 99 04 06 18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BA 99 04 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
ADDITIONAL INSURED WHEN REQUIRED BY CONTRACT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This provision does not apply in regard to any ownership, maintenance or use of the additional insured’s “autos.” Additional Insured When Required by Contract
(1) Paragraph A.1. – WHO IS AN INSURED –
of Section II – Liability Coverage is
amended to add:
d. When you have agreed, in a written
contract or written agreement, that a
person or organization be added as an
additional insured on your business auto
policy, such person or organization is an
“insured”, but only to the extent such
person or organization is liable for
“bodily injury” or “property damage”
caused by the conduct of an “insured”
under paragraphs a. or b. of Who Is An
Insured with regard to the ownership,
maintenance or use of a covered “auto.”
The insurance afforded to any such
additional insured applies only if the
“bodily injury” or “property damage”
occurs:
(1) During the policy period, and
(2) Subsequent to the execution of such
written contract, and
(3) Prior to the expiration of the period
of time that the written contract
requires such insurance be provided
to the additional insured.
(2) How Limits Apply
If you have agreed in a written contract
or written agreement that another
person or organization be added as an
additional insured on your policy, the
most we will pay on behalf of such
additional insured is the lesser of:
(a) The limits of insurance specified in
the written contract or written
agreement; or
(b) The Limits of Insurance shown in
the Declarations.
Such amount shall be a part of and not
in addition to Limits of Insurance shown
in the Declarations and described in this
Section.
(3) Additional Insureds Other Insurance
If we cover a claim or “suit” under this
Coverage Part that may also be covered
by other insurance available to an
additional insured, such additional
insured must submit such claim or “suit”
to the other insurer for defense and
indemnity.
However, this provision does not apply
to the extent that you have agreed in a
written contract or written agreement
that the insurance is primary and non-
contributory with the additional insured’s
own insurance.
(4) Duties in The Event Of Accident, Claim,
Suit or Loss
If another person or organization is
added as an additional insured on your
policy, the additional insured shall be
required to comply with the provisions in
A. Loss Conditions 2. – Duties In The
Event Of Accident, Claim, Suit Or
Loss – of SECTION IV – BUSINESS
AUTO CONDITIONS , in the same
manner as the Named Insured.
3ROLF\
&200(5&,$/ *(1(5$/ /,$%,/,7 <
&*
7+,6 (1'256(0(17 &+$1*(6 7+( 32/,&< 3/($6( 5($' ,7 &$5()8//< &* © ISO Properties, Inc., 2004 3DJHR I
$'',7,21$/ ,1685(' 2:1(56 /(66((6 25
&2175$&7256 $8720$7,& 67$786 :+(1
5(48,5(' ,1 &216758&7,21 $*5((0(17 :,7+ <28
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
$ 6HFWLRQ ,, :KR ,V $Q ,QVXUHG is amended to
include as an additional insured any person or or-
ganization for whom you are performing operations
when you and such person or organization have
agreed in writing in a contract or agreement that
such person or organization be added as an addi-
tional insured on your policy. Such person or or-
ganization is an additional insured only with re-
spect to liability for "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by:
Your acts or omissions; or
The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured.
A person's or organization's status as an additional
insured under this endorsement ends when your
operations for that additional insured are com-
pleted.
% With respect to the insurance afforded to these
additional insureds, the following additional exclu-
sions apply:
This insurance does not apply to:
"Bodily injury", "property damage" or "personal
and advertising injury" arising out of the render-
ing of, or the failure to render, any professional
architectural, engineering or surveying servic-
es, including:
D The preparing, approving, or failing to pre-
pare or approve, maps, shop drawings, opi-
nions, reports, surveys, field orders, change
orders or drawings and specifications; or
E Supervisory, inspection, architectural or
engineering activities.
"Bodily injury" or "property damage" occurring
after:
D All work, including materials, parts or
equipment furnished in connection with
such work, on the project (other than ser-
vice, maintenance or repairs) to be per-
formed by or on behalf of the additional in-
sured(s) at the location of the covered
operations has been completed; or
E That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontrac-
tor engaged in performing operations for a
principal as a part of the same project.
AES122246602
AES122246602
POLICY NUMBER: &200(5&,$/*(1(5$//,$%,/,7<
1;*/
7+,6(1'256(0(17&+$1*(67+(32/,&<3/($6(5($',7&$5()8//< 1;*/
3DJHRI
Includes copyrighted material of Insurance Services Office, Inc., with its permission $0(1'0(17 –$**5(*$7(/,0,762),1685$1&(
3(5352-(&7
This endorsement modifies insurance provided under the following:
&200(5&,$/*(1(5$//,$%,/,7<&29(5$*()250
6FKHGXOH
Subject to an Overall Policy Aggregate Limit: $
(Information required to complete this Schedule, if not shown a bove, will be shown in Declarations .) $ Paragraphs and of 6(&7,21,,,–/,0,762),1685$1&(are replaced by the following:
The Overall Policy Aggregate Limit is the most we will pay for the sum of D Medical expenses under Coverage &
E Damages under Coverage $ except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard"; and F Damages under Coverage %
The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage $ for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard" to each of your projects away from premises owned by or rented to you. % The following is added to 6(&7,21,,,–/,0,762),1685$1&(:
Subject to Paragraph and above, the General Aggregate Limit is the most we will pay under for the sum Coverage $Coverage % or Coverage&to each of your projects away from premises owned by or rented to you.
AES122246602
AES122246602
POLICY NUMBER: &200(5&,$/*(1(5$//,$%,/,7<
&*
&*
© Insurance Services Office, Inc., 2008 3DJH RI :$,9(52)75$16)(52)5,*+762)5(&29(5<
$*$,16727+(567286
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
6&+('8/(
1DPH2I3HUVRQ2U2UJDQL]DWLRQ
Blanket as required by written contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 7UDQVIHU2I
5LJKWV 2I 5HFRYHU\ $JDLQVW 2WKHUV 7R 8V o f
6HFWLRQ,9±&RQGLWLRQV
We waive any right of recovery we may have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
"your work" done under a contract with that person
or organization and included in the "products-
completed operations hazard". This waiver applies
only to the person or organization shown in the
Schedule above.
AES122246602
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84)
Schedule
Person or Organization Job Description
Any person or organization as required by written contract.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 5/3/2024 Policy No. WWC3711041 Endorsement No .0 Insured POWERGEN INC Premium $ 16,181
Insurance Company Wesco Insurance Company
Countersigned by
WC 04 03 06
(Ed. 04-84)