FIRST AMENDMENT TO SERVICE PROVIDER AGREEMENT
This FIRST AMENDMENT TO SERVICE PROVIDER AGREEMENT (“First Amendment”), is entered into this ___ day of _______, 20 24 (the “Effective Date ”), by and between the CITY OF ALAMEDA, a municipal corporation ( the "City"), and CSG CONSULTANTS, INC., a California corporation, whose address is 550 Pilgram Drive, Foster City, CA 94404 (the "Provider"), with reference to the following facts and circumstances:
RECITALS:
A. On July 13, 2022, an agreement was entered into by and between City and Provider ("Original Agreement") in an amount not to exceed $750,000.
B. City and Provider desire to modify the Agreement on the terms and conditions set forth herein.
NOW, THEREFORE, in consideration of the foregoing, which are incorporated herein by reference, and for good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, City and Provider agree as follows:
1. Section 2 (“Services to be Performed”) of the Agreement is modified to read as follows:
“Provider agrees to do all necessary work at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all necessary work included in Exhibit A as requested. The Provider acknowledges that the list of services included in Exhibit A is tentative and does not commit the City to request Provider to perform all tasks included therein.”
2. Paragraph 3 (“Compensation to Provider”) of the Agreement is modified to read as follows:
“a. By the 7th day of each month, Provider shall submit to the City an invoice for the total amount of work done the previous month. Pricing and accounting of charges are to be according to the fee schedule as set forth in Exhibit A and incorporated herein by this reference. Extra work must be approved in writing by the City Manager or his/her designee prior to performance and shall be paid on a Time and Material basis as set forth in Exhibit A.”
“b. The total five-year compensation for this Agreement shall not exceed $2,280,206.”
3. Except as expressly modified herein, all other terms and covenants set forth in the Agreement shall remain the same and shall be in full force and effect.
Signatures on Next Page
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA CSG Consultants, Inc. – First Amendment to Agreement 2
IN WITNESS WHEREOF, the parties have caused this modification of Agreement to be executed on the day and year first above written.
CSG CONSULTANTS, INC. CITY OF ALAMEDA
A California Corporation A Municipal Corporation
Cyrus Kainpour Jennifer Ott
President City Manager
RECOMMENDED FOR APPROVAL
Erin Smith
Public Works Director
APPROVED AS TO FORM:
City Attorney
Len Aslanisan
Assistant City Attorney
Secretary
Nourdin Khayata
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA
Local Assistance Procedures Manual EXHIBIT 10-H1
Cost Proposal
EXHIBIT 10-H1 COST PROPOSAL Page 1 of 3
COST-PLUS-FIXED FEE OR LUMP SUM OR FIRM FIXED PRICE CONTRACTS (DESIGN, ENGINEERING AND ENVIRONMENTAL STUDIES)
Note: Mark-ups are Not Allowed ☐ Prime Consultant ☐ Subconsultant ☐ 2nd Tier Subconsultant Consultant __________________________________________________________ Project No. _______________________ Contract No. ____________________ Date ____________________
DIRECT LABOR
Classification/Title Name Hours Actual Hourly Rate Total ____________________________
____________________________
____________________________
____________________________
________
________
________
________
LABOR COSTS
a) Subtotal Direct Labor Costs
b) Anticipated Salary Increases (see page 2 for calculation) __ _____________
_______________
c) TOTAL DIRECT LABOR COSTS [(a) + (b)] _______________
INDIRECT COSTS
d) Fringe B
enefits (Rate: _____ )
f) Overhead (Rate: _____ )
e) Total Fringe Benefits [(c) x (d)] _______________
g) Overh
ead [(c) x (f)] _______________
h) General and Administrative (Rate: ___ __ ) i) Gen & Admin [(c) x (h )] _______________ FIX
ED FEE
j) TOTAL INDIRECT COSTS [(e) + (g) + (i)] _______________ k) TOTA L FIXED FEE [(c) + (j)] x fixed fee ______ ] ______________ l) CONSULTANT’S OTHER DIRECT COSTS (ODC) – ITEMIZE (Add additional pages if necessary) Description of Item Quantity Unit Unit Cost Total
l) TOTAL OTHER DIRECT COSTS
m) SUBCONSULTANTS’ COSTS (Add additional pages if necessary) Subconsultant 1:
Subconsultant 2:
Subconsultant 3:
Subconsultant 4:
m) TOTAL SUBCONSULTANTS’ COSTS
n) TOTAL OTHER DIRECT COSTS INCLUDING SUBCONSULTANTS [(l)+(m)] ___________________ TOTAL COST [(c) + (j) + (k) + (n)] _____________________ NOTES:
1. Ke
y personnel must be marked with an asterisk (*) and employees that are subject to prevailing wage requirements must be marked with two asterisks (**). All costs must comply with the Federal cost principles. Subconsultants will provide their own cost proposals.
2. The cost proposal format shall not be amended. Indirect cost rates shall be updated on an annual basis in accordance with the consultant’s annual accounting period and established by a cognizant agency or accepted by Caltrans.
3. Anticipated salary increases calculation (page 2) must accompany.
January 2020
✔
CSG Consultants, Inc.
04/16/2024
RE/Sr Principal Eng ARE/OE Principal Eng Inspector Inspector Nourdin Khayata
1,520.00
$ 112.02
$ 170,270.40
ARE/OE Principal Eng
Nasser Fakih
1,520.00
$ 110.58
$ 168,081.60
Inspector
Bassam Badr
3,120.00
$ 77.17
$ 240,770.40
Inspector
Peiman Moghadman
576.00
$ 65.81
$ 37,906.56
$ 617,028.96
$ 7,384.77
$ 624,413.73
30.16%
$ 188,323.18
117.79%
$ 735,496.93
7.25%
$ 45,270.00
$ 969,090.11
$ 1,593,503.84
10.00%
$ 159,350.38
eBuilder license fees - 1st Construction Year
7 EA
$ 1,500.00
$ 10,500.00
eBuilder license fees - 2nd Construction Year
7 EA
$ 1,500.00
$ 10,500.00
Permit Fees
$ 0.00
Plan Sheets
$ 0.00
Test
$ 0.00
$ 21,000.00
ISI Inspection Servcies
$ 354,770.84
Stantec
$ 10,000.00
Callendar Associates
$ 23,000.00
MIG, Inc.
$ 10,000.00
$ 397,770.84
$ 418,770.84
$ 2,171,625.06
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA
Local Assistance Procedures Manual EXHIBIT 1 0-H1
Cost Proposal
EXHIBIT 10-H 1 COST PROPOSAL Page 2 of 3
COST-PLUS-FIXED FEE OR LUMP SUM OR FIRM FIXED PRICE CONTRACTS (CALCULATIONS FOR ANTICIPATED SALARY INCREASES)
1. Calculate Average Hourly Rate for 1st year of the contract (Direct Labor Subtotal divided by total hours) Direct
Labor Total Hours per Avg 5Year
Subtotal per Cost Cost Proposal Hourly Contract
Proposal Rate Duration
= $250,000.00 500 $50.00 Year 1 Avg
Hourly Rate
2. Calculate hourly rate for all years (Increase the Average Hourly Rate for a year by proposed escalation%) Avg Hourly Rate Proposed Escalation
Year 1 $50.00 + 2% = $51.00 Year 2 Avg Hourly Rate
Year 2 $51.00 + 2% = $52.02 Year 3 Avg Hourly Rate
Year 3 $52.02 + 2% = $53.06 Year 4 Avg Hourly Rate
Year 4 $53.06 + 2% = $54.12 Year 5 Avg Hourly Rate
3. Calculate estimated hours per year (Multiply estimate% each year by total hours) Estimated % Completed Total Hours per Cost Total Hours per Each Year Proposal Year
Year 1 20.0% 5000 = 1000 Estimated Hours Year 1
Year 2 400% 5000 = 2000 Estimated Hours Year 2
Year 3 15.0% 5000 = 750 Estimated Hours Year 3
Year 4 15.0% 5000 = 750 Estimated Hours Year 4
Years 100% 5000 = 500 Estimated Hours Year 5
Total 100% Total = 5000
4. Calculate Total Costs including Escalation (Multiply Average Hourly Rate by the number of hours) Avg Hourly Rate Estimated hours Cost per
(calculated above) (calculated above) Year
Year 1 $50.00 1000 $50,000.00 Estimated Hours Year 1 =
Year 2 $51.00 2000 $102,000.00 Estimated Hours Year 2 = Year 3 $52.02 750 $39,015.00 Estimated Hours Year 3 =
Year 4 $53.06 750 $39,795.30 Estimated Hours Year 4 =
Years $54.12 500 = $27,060.80 Estimated Hours Year 5
Total Direct Labor Cost with Escalation $257,871.10 =
Direct Labor Subtotal before Escalation = $250,000.00
Estimated total of Direct Labor Salary Transfer to Page 1 = Increase $7,871.10
NOTES:
1. This is not the only way to estimate salary increases. Other methods will be accepted if they clearly indicate the % increase, the# of years of the contract, and a breakdown of the labor to be performed each year.
2. An estimation that is based on direct labor multiplied by salary increase % multiplied by the# of years is not acceptable.
(i e. $250,000 x 2% x 5 yrs= $25,000 is not an acceptable methodology)
3. This assumes that one year will be worked at the rate on the cost proposal before salary increases are granted.
4. Calculations for anticipated salary escalation must be provided.
January 2020
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA
_
Local Assistance Procedures Manual EXHIBIT 10-H1
Cost Proposal
EXHIBIT 10-H 1 COST PROPOSAL Page 3 of 3
Certification of Direct Costs:
I, the undersigned, certify to the best of my knowledge and belief that all direct costs identified on the cost proposal{s) in this contract are actual, reasonable, allowable, and allocable to the contract in accordance with the contract terms and the following requirements:
1. Generally Accepted Accounting Principles {GAAP)
2. Terms and conditions of the contract
3. Title 23 United States Code Section 112 - Letting of Contracts
4. 48 Code of Federal Regulations Part 31 - Contract Cost Principles and Procedures
5. 23 Code of Federal Regulations Part 172 - Procurement, Management, and Administration of Engineering and Design Related Service
6. 48 Code of Federal Regulations Part 9904 - Cost Accounting Standards Board {when applicable)
All costs must be applied consistently and fairly to all contracts. All documentation of compliance must be retained in the project files and be in compliance with applicable federal and state requirements.
Costs that are noncom pliant with the federal and state requirements are not eligible for reimbursement.
Local governments are responsible for applying only cognizant agency approved or Caltrans accepted Indirect Cost Rate{s).
Prime Consultant or Subconsultant Certifying:
Name: ______________ _ Title*:
Signature: ____ _ _ ____ __ ____ _ Date of Certification {mm/dd/yyyy): _ Email: ______ ______ __ _ Phone Number:
Address: ________________________________ _
*An individual executive or financial officer of the consultant's or subconsultant's organization at a level no lower than a Vice President or a Chief Financial Officer, or equivalent, who has authority to represent the financial information utilized to establish the cost proposal for the contract.
List services the consultant is providinq under the proposed contract:
January 2020
CSG Consultants, Inc.
Senior Principal Engineer
04/17/2024
[email protected]
650-333-0831
550 Pilgrim Drive, Foster City, CA 94404
ISI Inspection Servcies - Inspection and special inspection servcies.
Stantec - Paleontological Services
Callendar Associates - Arborist
MIG, Inc. - Biological services
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA
Local Assistance Procedures Manual EXHIBIT 10-H2
Cost Proposal
EXHIBIT 10-H2 COST PROPOSAL Page 1 of3
SPECIFIC RATE OF COMPENSATION (USE FOR ON-CALL OR AS-NEEDED CONTRACTS) (CONSTRUCTION ENGINEERING AND INSPECTION CONTRACTS)
Note: Mark-ups are Not Allowed
Consultant _________________ _ D Prime Consultant D Subconsultant D 2nd Tier Subconsultant Project No. _________ _ Contract No. ------- - Participation Amount $ ________ _ Date --- - For Combined Rate
Fringe Benefit% + General &Administrative% = Combined ICR% OR
For Home Office Rate
Fringe Benefit % + General &Administrative% = Home Office ICR% For Field Office Rate
Frinqe Benefit % + General &Administrative% = Field Office ICR% = Fee %
BILLING INFORMATION CALCULATION INFORMATION
Name/Job Title/Classification 1 Hourly Billing Rates2
Str aight3 OT(1.5x) OT(2x)
Effective Date of Hourly Rate
From To
Actual or Avg.
Hourly Rate4
% or$
Increase
Hourly Range -
for Clas sifications Only
John Doe - Project Manager*
Civil Engineer II
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
01/01/2016
01/01/2017
01/01/2018
12/31/2016
12/31/2017
12/31/2018
$0.00
$0.00
$0.00
0.0%
0.0%
Not Applicable
Sue Jones- Const ruction
Engineeri1nspector
Engineer I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
01/01/2016
01/01/2017
01/01/2018
12/31/2016
12/31/2017
12/31/2018
$0.00
$0.00
$0.00
0.0%
0.0%
Not Applicable
Buddy Black - Claims Engineer
Engineer Ill
Land Surveyor
**
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
01/01/2016
01/01/2017
01/01/2018
01/01/2016
01/01/2017
01/01/2018
12/31/2016
12/31/2017
12/31/2018
12/31/2016
12/31/2017
12/31/2018
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.0%
0.0%
0.0%
0.0%
Not Applicable
$00-$00
$00-$00
$00-$00
Technician $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
01/01/2016
01/01/2017
01/01/2018
12/31/2016
12/31/2017
12/31/2018
$0.00
$0.00
$0.00
0.0%
0.0%
$00-$00
$00-$00
$00-$00
(Add pages as necessary)
January 2020
NOT APPLICABLE
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA
Local Assistance Procedures Manual EXHIBIT 10-H2
Cost Proposal
NOTES:
1. Key personnel must be marked with an asterisk (*) and employees that are subject to prevailing wage requirements must be marked with two asterisks (**).All costs must comply with the Federal cost principles. Subconsultants will provide their own cost proposals.
2. The cost proposal format shall not be amended.
3. Billing rate= actual hourly rate * (1 + ICR) * (1 + Fee). Indirect cost rates shall be updated on an annual basis in accordance with the consultants annual accounting period and established by a cognizant agency or accepted by Caltrans. All costs must comply with the Federal cost principles for reimbursement.
4. For named employees and key personnel enter the actual hourly rate. For classifications only, enter the Average Hourly Rate for that classification.
EXHIBIT 10-H2 COST PROPOSAL Page2ot3
SPECIFIC RATE OF COMPENSATION (USE FOR ON-CALL OR AS-NEEDED CONTRACTS) (CONSTRUCTION ENGINEERING AND INSPECTION CONTRACTS)
Consultant __________________ _ □ Prime Consultant □ Subconsultant Project No. __________ _ Contract No. -----------Date ________ _ SCHEDULE OF OTHER DIRECT COST ITEMS (Add additional pages as necessary) Description of Item Quantity Unit Unit Cost Total
Subconsultant 1:
Subconsultant 2:
Subconsultant 3:
Subconsultant 4:
Subconsultant 5:
Note: Add additional pages if necessary.
NOTES:
1. List other direct cost items with estimated costs. These costs should be competitive in their respective industries and supported with appropriate documentation.
2. Proposed ODC items should be consistently billed regardless of client and contract type.
3. Items when incurred for the same purpose, in like circumstance, should not be included in any indirect cost pool or in the overhead rate.
4. Items such as special tooling, will be reimbursed at actual cost with supporting documentation (invoice).
5. Items listed above that would be considered "tools of the trade" are not reimbursable as other direct cost
6. Travel related costs should be pre-approved by the contracting agency and shall not exceed current State Department of Personnel Administration rules.
January 2020
Mileage Costs
2 1
$ 10.00
$ 20.00
Equipment Rental and Supplies
2 EA
$ 20.00
$ 40.00
Permit Fees
3 $ 30.00
$ 90.00
Plan Sheets
$ 0.00
Test
$ 0.00
Vehicle
$ 0.00
ISI Inspection Servcies
$ 100.00
Stantec
$ 200.00
Callendar Associates
$ 300.00
MIG, Inc.
$ 500.00
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Local Assistance Procedures Manual EXHIBIT 10-H2
Cost Proposal
7. If mileage is claimed, the rate should be properly supported by the consultant's calculation of their actual costs for company vehicles. In addition, the miles claimed should be supported by mileage logs.
8. If a consultant proposes rental costs for a vehicle, the company must demonstrate that this is its standard procedure for all of their contracts and that they do not own any vehicles that could be used for the same purpose.
9. The cost proposal format shall not be amended. All costs must comply with the Federal cost principles.
10. Add additional pages if necessary.
11. Subconsultants must provide their own cost proposals.
January 2020
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Local Assistance Procedures Manual EXHIBIT 10-H2
Cost Proposal
EXHIBIT 10-H2 COST PROPOSAL Page 3 of 3
Certification of Direct Costs:
I, the undersigned, certify to the best of my knowledge and belief that all direct costs identified on the cost proposal(s) in this contract are actual, reasonable, allowable, and allocable to the contract in accordance with the contract terms and the following requirements:
7. Generally Accepted Accounting Principles (GAAP)
8. Terms and conditions of the contract
9. Title 23 United States Code Section 112 - Letting of Contracts
10. 48 Code of Federal Regulations Part 31 - Contract Cost Principles and Procedures
11. 23 Code of Federal Regulations Part 172 - Procurement, Management, and Administration of Engineering and Design Related Service
12. 48 Code of Federal Regulations Part 9904 - Cost Accounting Standards Board (when applicable)
All costs must be applied consistently and fair1y to all contracts. All documentation of compliance must be retained in the project files and be in compliance with applicable federal and state requirements.
Costs that are noncompliant with the federal and state requirements are not eligible for reimbursement.
Prime Consultant or Subconsultant Certifying:
Name: ______________ _ Title*: ______________ _
Signature�: _____________ _ Date of Certification (mm/dd/y yyy):
Email: ______________ _ Phone Number: ___________ _
Address: ________________________________ _
* An individual executive or financial officer of the consultant's or subconsultant's organization at a level no lower than a Vice President or a Chief Financial Officer, or equivalent, who has authority to represent the financial information utilized to establish the cost proposal for the contract.
List services the consultant is providing under the proposed contract:
January 2020
CSG Consultants, Inc.
Senior Principal Engineer
04/17/2024
[email protected]
650-333-0831
550 Pilgrim Drive, Foster City, CA 94404
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA
Local Assistance Procedures Manual EXHBIT 10-H3
Cost Proposal
EXHIBIT 10-HJ COST PROPOSAL Page 1 of 2
COST PER UNIT OF WORK CONTRACTS
(GEOTECHNICAL AND MATERIAL TESTING)
Note: Mark-ups are Not Allowed □ Prime Consultant □ Subconsultant □ 2nd Tier Subconsultant Consultant __________________ _
Project No. _________ _ Contract No. --------- Date ------ - Unit/Item of Work:
(Example: Log of Test Boring for Soils Report, or ADL Testing for Hazardous Waste Material Study} Include as many Items as necessary.
DIRECT LABOR Hours Billing Hourly Rate {$) Total{$)
Professional {Classification)*
Sub-professional/Technical**
EQUIPMENT 1 {with Operator)
EQUIPMENT 2 {with Operator)
Consultant's Other Direct Costs (ODC)- Itemize:
Description of Item Quantity Unit Unit Cost Total
Subconsultant 1:
Subconsultant 2:
Subconsultant 3:
Subconsultant 4:
Subconsultant 5:
Nole: Attach addtllonal pages if necessary.
TOTAL COST PER UNIT OF WORK
NOTES:
1 . Key personnel must be marked with an asterisk (*) and employees that are subject to prevailing wage requirements must be marked with two asterisks (**). All costs must comply with the Federal cost principles. Subconsultants will provide their own cost proposals. The cost proposal format shall not be amended.
2. Hourly billing rates should include prevailing wage rates and be consistent with publicly advertised rates charged to all clients (Commercial, Private or Public).
3. Mobilization/De-mobilization is based on site location and number and frequency of tests/items.
4. ODC items shall be based on actual costs and supported by historical data and other documentation.
5. ODC items that would be considered "tools of the trade' are not reimbursable.
6. Billing Hourly Rates must be actual, allowable, and reasonable.
January 2020
NOT APPLICABLE
✔
✔
✔
CSG Consultants, Inc.
04/16/2024
Mileage Costs
2 1
$ 10.00
$ 20.00
Equipment Rental and Supplies
2 EA
$ 20.00
$ 40.00
Permit Fees
3 $ 30.00
$ 90.00
Plan Sheets
$ 0.00
Test
$ 0.00
ISI Inspection Servcies
$ 100.00
Stantec
$ 200.00
Callendar Associates
$ 300.00
MIG, Inc.
$ 500.00
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA
_ _
Local Assistance Procedures Manual EXHBIT 10-H3
Cost Proposal
EXHIBIT 10-H3 COST PROPOSAL Page 2 of 2
Certification of Direct Costs:
I, the undersigned, certify to the best of my knowledge and belief that all direct costs identified on the cost proposal{s) in this contract are actual, reasonable, allowable, and allocable to the contract in accordance with the contract terms and the following requirements:
13. Generally Accepted Accounting Principles {GAAP)
14. Terms and conditions of the contract
15. Title 23 United States Code Section 112 - Letting of Contracts
16. 48 Code of Federal Regulations Part 31 - Contract Cost Principles and Procedures
17. 23 Code of Federal Regulations Part 172 - Procurement, Management, and Administration of Engineering and Design Related Service
18. 48 Code of Federal Regulation Part 9904 - Cost Accounting Standards Board {when applicable)
All costs must be applied consistently and fair1y to all contracts. All documentation of compliance must be retained in the project files and be in compliance with applicable federal and state requirements.
Costs that are noncompliant with the federal and state requirements are not eligible for reimbursement.
Prime Consultant or Subconsultant Certifying:
Name: ______________ _ Title*: ______________ _
Signature�: _____________ _ Date of Certification {mm/dd/yyyy...._____ : _ Email: ______________ Phone Number,_,_: __________ _
Address: ________________________________ _
* An individual executive or financial officer of the consultant's or subconsultant's organization at a level no lower than a Vice President or a Chief Financial Officer, or equivalent, who has authority to represent the financial information utilized to establish the cost proposal for the contract.
List services the consultant is providinq under the proposed contract:
January 2020
CSG Consultants, Inc.
Senior Principal Engineer
04/17/2024
[email protected]
650-333-0831
550 Pilgrim Drive, Foster City, CA 94404
ISI Inspection Servcies - Inspection and special inspection servcies.
Stantec - Paleontological Services
Callendar Associates - Arborist
MIG, Inc. - Biological services
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA csGcoNs-01
CERTIFICATE OF LIABILITY !NSURANCE
THIS CERNFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY A IENO, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER{S), AUTHORIZEO REPRESENTATIVE OR PROOUCER, ANO THE CERTIFICATE HOLDER. 1112912023
tMpORTANTI tf ths certificate holder is an ADDITIONAL INSURED, the policy(ies) must haYe ADDITIONAL INSUREO provisions or be endorsed ATIO n rsdo ment atemest ntestct asterm nda nditi ofns thethe pol requmayAIVE ect tosuN pol cysu ROB Gtf bjD, lieun sOI uch dn eo13emto certithe holficate deth certifi dcate noloes confer lI3.*,L. .,,r, (+t s) s+o-zsoo [il, *r,
ADORESS:
INSURER(S} AFFORDING COVERAGE
rNsuRER
^
: General Casualty Co of W (QBE)
IrlsuRER B : North Pointe lnsurance comPany
NsuRER c :QBE lnsurance CorPoration
Nsuaea o ,Praetorlan lnsurance Company
rNsuRER E : Pacific lnsurance Company, Limited
INSURED
pRoDUcER Llcense # 0C36851
Alllant lnsurenco Sedices, lnc
560 Uisslon St 6th Fl
San Franclsco, CA 94105
24414
27740
39217
372s7
10045
CSG Consultanls, lnc
550 Pilgrim Drive
Foster City, CA 9/tit04
CER EVISION NUMBE
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOO
INDICATED NOTWTHSTANOING ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES OESCRIAED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS' I
3 3
t
I
191000608
10,000
NON-OWNEO
5 $
c
!
$
$
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s
s
I
X X CGA'1,114883
X X 1610010E8
1214t2023 12t412024
oeo X RETENTION$
't,000,000
GEN'L AGGREGATE LIMITAPPLIES PER:
POLICY EFF POLICY EXP
IMM/DOTYYYY] IMI'/DO/YYYY)
A X cortERcat GENERAL LlaBrLrrY
CLATMS.MADE X occuR
B lutoroaru rugrm
X pry ruro
OIYNEO
AUTOS ONLY
HIREO
AIJTOS ONLY
COMBINEO SINGTE LIMTT
(Ea 6ccdoit)
12142023 1211t2021 BootLy TNJURY (Perp*on)
BODTLY INJURY (P6r .ccil€.i)SCHEOULEO
5,000,000
5,000,000
EACII OCCURRENCE
AGGREGATE
Aggrogate
1,000,000
1,000,000
10,000
1,000,000
2,000,000
2,000,000ro.,"" Iffi [4].o.
OT}iER:
X uugneuLua X occun
EXCE!}S LIAB CLAIMS'MAOE
EACII OCCURRENCE
OAMAGE TO RENIEO
PREMISES (Ea oeur€n@)
M€o ExP (Any o.o por$n)
PERSONAL & AOV INJURY
GENERAT AGGREGATE
PROOUCTS - COMP/OP AGG
1520007s3
83 0H 0489503-23
EL DISEAS',POLICY LIMIT I
D woR(ERs co PEisarroN
ANO EMPLOYERS' LTABILITY
PER OTH.
12J1.12O23121412021 OediSSoK
12t1t2024
s,000,000
1,000,000
1,000,000
1,000,000
OESCRIPIION OF OPEI{A
E Prolessional Liab
oEscRtpnoN oF opER^Ttot{s / Locafioxs / vEHtcfEs lacoRD lot, addirion.l R.n.rt sch.dul.. !.y b..ti.ch.<l if mon rp.6 i. nqul.il) ^,. - ntisii--i"-i'ii.iia"i Al;;;;;i.iiil cl;; At"-;;oa i'ait i n-mp iaii eAiaRAMPi Pe;r and constructibility R';view. city or alameda, its city council, boards and commissions, olficiats, emptoyees .nd volunteers are included as additional insureds on on GL & Auto wilh waiver ot subrcgation and 30 Day Notice of Cance ation per e'tlached- t0 D;y fuotice ot Cancellalion on Protessional per attached. '10 Day Notice of Cancellation on WC is noi available. Named Additional u
lnsured endorsoments on
\2trifii\-;-
FICATE HOLOER
PUBLIC WORKS
CITY OF ALAMED,',
City ofAlam.da
Attn: Jean.tt6l Clty of Alam.da
950 West tt'lall Square, Room '110
Alameda, CA 94501
SHOTJLD ANY OF THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE THE EXPIRATIOI{ DATE THEREOF, I{OTICE wlLL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIOIIS,
AUTHORIZED REPRES€NTATIVE
uqw
O lgEE-20t5 ACORD CORPORATION. All rights re3erved.
Th€ ACORD name and logo are registered marks of ACORD
ACORD 2s (20r6/03)
A,CORD
certain
12142023 1A4,/i2021
12t4t2023ANY PROPRIETOR/PARTNER,EXECUT]VE
OFFIC€R/VEMAER EXCLUOED?
E.L ErACH ACCIDENT t
EL orsE^sE E EMELqIEEI
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA 9/3/2024
AMENDMENT _ NOTICE TO OTHERS OF CANCELLATION
SCHEDULE"
Policy Number: CGA1414883
16100'1088
152000753
INTERLINE FORM
tL70 24 06 12
C. lf notice per paragraph A. is mailed, Proof of mail- ing will be sufficient proof of notice.
D. Written notices mailed or delivered by us pursuant
to the terms of this endorsement are inlended only
to be an advance notification to the person(s) or
organization(s) named in the Schedule of this en-
dorsement in the event of a pending cancellation
and shall not operate or be deemed to benefit, di-
rectly or indirectly, any person or organization not
named in the Schedule above.
ptreeu\zLB[0-]
DEC 07 2023
PUBLIC WORI(S
CITY OF ALAMEDA
Name and Address of Psrson or Organization
Number
of Days
Notlce
(- of Alameda, 950 West Mall S uare, Room I 10, Attn: Jeanette, Alameda, CA 94501 30 .lnformation required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations.
tL 70 2106 12 Page I of I
All other terms and conditions of the policy remain
unchanged.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
The following is added to the policy:
A- lf we cancel the policy by notice to the first Named lnsured, for any feason other than nonpayment of
premium, we will mail or deliver a copy of such
written notice of cancellation to the person(s) or or-
ganization(s) shown in the Schsdule above.
B. Any copy of notice per paragraph A. above will be
mailed or delivered:
1. To the address conesponding to each person
or organization indicated in the Schedule
above; and
2. At least the number of days set forth in the
Schedule prior to the cancellation date appli-
cable to the policy, as advised in our notice to
the first Named lnsured.
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Policy Number: CGA1414883
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
A REASONABLE FORCE
Paragraph 2.a. Expected or lntended lnjury
under COVERAGE A BODILY INJURY AND
PROPERTY DAMAGE LIABILITY of SECTION I
- COVERAGES within the COMMERCIAL
GENERAL LIABILITY COVERAGE FORM is
replaced by:
a. Expected or lntended lnjury
"Bodily injury" or "property darnage" expected
or intended fom the standpoint of the in-
sured. This exclusiqt does not apply to "bodi-
ly injury" or "property damage" resulting fom
the use of reasonable fcrce to protect any
person or property.
B. CONTRACTUAL LIABILITY
Paragraph 2.b. Contractual Liability under
COVERAGE A. BODILY INJURY AND PROP-
ERTY DAMAGE LIABILITY oI SECTION I -COVERAGES within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FORM is replaed
by:
b. Contractua I Liability
"Bodily injury" or "property dannge" for which
the insured is obligated to pay damages by
reason of the assumption of liability in a con-
tract or agreement. This exclusion does not
apply to liability fo. damages:
(1) That the insured would ha\E had in the
absence of the contract or agreemenl; or
(2) Assumed in a contract or agreement that
is an "insured conlracl", pro\,ided the
"bodily injury" or "property damage" oc-
curs subsequent to the execution of the
contract or agreement.
C. NON OWNED WATERCRAFT
Paragraph 2.9.(21 in the Aircraft, Auto Or Wa-
lercraft exclusion under COVERAGE A. BODILY
INJURY AND PROPERTY DAMAGE LIABILITY
of SEGTION I
- COVERAGES within the COM-
MERCIAL GENERAL LIABILITY COVERAGE
FORM is replaced by:
COMMERCIAL GENERAL LIABILITY
cG 82 240512
g. Aircraft, Auto Or Watercraft
(2) A watercraft you do not own that is:
(a) less than 75 fuet long; and
(b) Not being used to cany persons or
property fur a charge.
ELECTRONIC DATA LIABILITY
1. Paragraph 2.p. Elec{ronic Data under COV-
ERAGE A. BODILY INJURY AND PREERTY
DAMAGE LIABUTY of SEGTION I - COV-
ERAGES within he COiIMERCIAL GENERAL
LIABILITY COVERAGE FORM is rephced by:
p. Electronic Data
Damages arising out ofthe loss ol loss d
use ol damage to, corruption ol inability
to access, or inability to manipulate "elec-
tronic data" that does not result from
physical injury to tangible property.
Howerer, this exclusion does not apply to
liability for damages because of "bodily
inlury".
2. The tollowing defnition is added to SEC-
TION V _ DEFINITIONS:
"Electronic data" means information, facts or
programs stored as or on, created or used d\
or transmitted to or from compuler software,
hard or floppy disks, CD-ROMS, lapes,
dri\,es, cells, data processing deriices or any
olher media which are used with electronically
controlled equipment.
3. For purposes of the co\,erage pror,ided for
"Electronic Data", Paragraph 17. in SEC-
TION V - DEFINITIONS is replaced by:
17- "Property damage" means:
a. Physical injury to tangible property,
including all resulting loss of use of
that property. All such loss of use
shall be deemed to occur at the time
injury that caused it s
PREMIER GENERAL LABIL]TY COVERAGE
EXTENSION
D
DEC oZ 2023
lncludes copyri ghted material of lns ur341,6ftti961ffi e, lnc with its perm igl-tfr:on ar,eUroacG 82 24 0512 Page 1of 6 RtrGEUVEEI"
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Policy Number: CGA1414883
b. Loss of use of tangible property that
is not physicalty iniued. All such loss
of use shall be deemed to occur at
the time of the "occunence" that
caused it; or
c. Loss of, loss of use of damage to,
conuption of inability to access, or
inability to properly manipulate "elec-
tronic data", resulting tom physical
injury to tangible property. All such
loss of "electronic data" shall be
deemed to occur at the time of the
"occunence" that caused it.
For purposes ofthis insurance, 'dectron-
ic data" is not tangible property.
E. DAMAGE TO PREMISES RENTED TO YOU
1. The last paragraph afterthe listed exclusions
under COVERAGE A. BODILY INJURY AND
PROPERTY DAMAGE LIABILITY of SEC-
TION I - COVERAGES within the COM-
MERCIAL GENERAL LIABILITY COVER.
AGE FORM is replaced by:
Exclusions c. through n. do not apply to
"property damage" by fire; smoke from a
"hostile fre"; explosion; lightning; smoke re-
sulting tom such explosion or lightning; colli-
sion by "mobile equipment" or leakage from
fire protection systems to premises while
rented to you or temporarily occupied by you
with permission of the owner. A separate limit
of insurance applies to this co\erage as de-
scribed in SECTION lll - LIMITS OF lN-
SURANCE.
2. Paragraph 6. of SECTION lll - LIMITS OF
INSURANCE within the COMMERCIAL
GENERAL LIABLITY COVERAGE FORM is
replaced by:
6. Subject to Paragraph 5. abo\e, the Dam-
age To Premises Rented To You Limit is
the most we will pay in any one e\ent un-
der COVERAGE A. BODILY INJURY
AND PROPERTY DAMAGE tor damages
because of "property damage" fom fre;
smoke from a "hostile fre"; explosion;
lightning; smoke resulting fom such ex-
plosion or lightning; collision by "mobile
equipment" or leakage from fre protectir
systems to premises while rented to you
or temporarily occupied by you with per-
mission of the owner.
F. MEDICAL PAYI'ENTS
1. Paragraph '1.a. under COVERAGE
C. MEDICAL PAYMENTS of SEGTION I -COVERAGES within the COMMERCIAL
GENERAL LIABILITY COV
replaced by:
1. ln$ring Agreement
a. We will pay medical expenses as de-
scribed below br 'bodily injury"
caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you
own or rent: or
(3) Because of your operations:
Prouded that:
(a) The accident takes place in
the 'co\€rage tenitory" and
during the policy period;
(b) The exp€nses are incurred
and reported to us within
three years of the date of the
accident; and
(c) The injured person submits to
examination, at our expense,
by physicians of our choice
as often as we reasonable
require.
G. SUPPLEMENTARY PAYIVIENTS
SUPPLEMENTARY PAYMENTS _ COVERAG.
ES A AND B of SECTION I COVERAGES within
the COMMERCIAL GENERAL LIABILITY Cov-
ERAGE FoRM is replaced by:
1. We Wll pay, with respect to any claim we
in\estigate or settle, or any "suit" against an
insured we defend:
a. All expenses we incur.
b. Up to $5,000 ficr cost of bail bonds re-
quired because of accidents or traffic law
liolations arising out of the use of any
\,ehicle to which the Bodily lnjury Liability
Cowrage applies. We do not ha\,e to fur-
nish these bonds.
c. The cost of bonds to release attach-
ments, but only br bond amounts within
the applicable limit of insurance. We do
ha\,e to fumish these bonds.
d. All reasonable expenses incuned by the
insured at our request to assist us in the
in\estigation or defense of the claim or
"suit", including aclual loss of eamings up
to $500 a day because of time off fom
work.
e. All costs taxed against the "insured" in
any "suit".
f. Prejudgment interest awarded against ttE
insured on that part of the .iudgment we
pay. tf we make an offer to pay the appli-
*Hre Eu v )Em[,ji[,ii1ili,lro"':*H* :"i &?
tnctudes copyrishteo r"tJ5GtGsr?n0" r"r"". ofice, lnc., witFlJBffenfitufrks
CITY OF ALAMEDP,
cG 82 24 0512
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Policy Number: CGA1414883
All interest on the full amount of any
judgment that accrues after entry ofthe
judgment and beficre we ha\e paid, of-
fered to pay, or deposited in court the pdt
of the judgment that is within the applica-
ble limit of insurance.
These payments will not reduce the limits of
insurance.
2. lf we deEnd an insurcd against a "suit' and an
indemnitee of the insured is also named as a
parly to the "suit", we will defend that indem-
nitee if all of the following conditions are met:
a. The 'suit" against the indemnitee seeks
damages for which the insured has as-
sumed the liability of the indemnitee in a
contftlct or agleement that is an "insured
contltlct":
b. This insurance applies to such liability as-
sumed by the insured;
c. The obligation to defund, or the cost of
the defense of, that indemnitee, has also
been assumed by the insured in tlE sane
"insured contract";
d. The allegations in the "suit' and the in-
formation we know about the "occur-
rence" are such that no conflict appears
to exist between the interests of the in-
sured and the interests ofthe indemnitee;
e. The indemnitee ard he insured ask us to
conduct and cmtolthe defeNe of that in-
demnitee against such 'suit" and agree tH
we can assign he sarne comselto defund
the insured and the indemnitee; and
f. The indemnitee:
(1) Agrees in wfiting to:
(a) Cooperate with us in the in\€sti-
gation, settlement or debnse of
the "suit";
(b) lmmediately send us copies of
any demands, notices, sum-
monses or legal papers recei\,ed
in connection with the "suit";
(c) Notifo any other insurer whose
co\erage is alailable to the in-
demnitee; and
(d) Cooperate with us with resPect
to coordinating other apPlicable
insurance a\ailable to the in-
demnitee; and
(2) Provides us with witten authoriza-
tion to:
(a) Obtain records and other infor-
(b) Conduct and control the defense
of the indemnitee in such "suit".
Our obligation to defiend an insured's in-
demnitee and to pay br attomeys' fees
and necessary litigation expenses as
Supplementary Payments ends when we
ha\,e used up the applicable limit of in-
surance in the payment ofjudgments or
settlements or the conditions set forth
abo\€, or the terms of the agreement de-
scribed in Paragraph f. abo\,e, are no
longer met.
H. FELLOW EMPLOYEE COVERAGE
SUPERVISOR OR HIGHER
Paragraph 2.a.(1) of SECTION ll - WHO lS AN
INSURED within the COMMERCIAL GENERAL
LIABILITY COVERAGE FORM does not apply to
the icllowing:
Your supervisory or management "employees" fcr
"bodily injury" only.
Damages owed to an injured co-"employee" or
"\olunteer workef' will be reduced by any amount
paid or a\ailable to the injured coJemployee" or
"rolunteer worke/' under any other wlid and
collectible insurance.
I. NEWLY ACQUIRED ORGANIZATIONS
Paragraph 3.a. of SECTION ll - WHO lS AN
INSURED within the COMMERCIAL GENERAL
LIABILITY COVERAGE FORM is replaced by:
a. Cor,erage underthis pror,ision is afforded only
until the end of the cunent policy period.
J. BROAD FORM NAMED INSURED
The following is added to SECTION ll - WHO lS
AN INSURED within the COMMERCIAL GEN-
ERAL LIABILITY COVERAGE FORM:
Throughout this policy the words 'you" and "youf'
refi-or to any corporalion or other business organi-
zation, other than a.ioint \Enture, in which the fi rst Named lnsured has or acquires during the policy
period an ownership interest of more than 50%
and is subject to the management control of the
first Named lnsured or its subsidiaries, and which
is domiciled within the United States of America
or its lenitories or possessions.
K. AMENDMENT OF AGGREGATE LIMIT OF
INSURANCE
The General Aggregate Limit Of lnsurance refer-
enced in Paragraph 2. of SECTION lll - LIMITS
OF INSURANCE within the CoMMERCIAL
GENERAL LIABILITY COVERAGE FORM
applies separately to:
1. Each of your "locations" owned by or rented
to you; and
g
mation related
FEuervtEEl
cG 82 24 05 12 Page 3 of 6
tncludes copyrightJ5&*rld0i3urance Senices ofice, lnc., __p_uHilldW6Hll'Si",CITY OF ALAMEDA
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Policy Number: CGA1414883
2. Each of your projects away from premises
owned by or rented to you.
"Location" means premises inlolving the same or
connecting lots, or premises whose connection is
intenupted only by a street, roadway, waterway s
right-of-way of a railroad.
L. KNOWLEDGE OF OCCURRENCE
The following is added to Paragraph 2. Duties ln
The Event Ot Occurence, Offunse, Claim Or
Suit of SECTIOtI lV- COIITMEROA- GENERAL
LIABILIIY CONIInONS within ttp COMMERCAL
GENERAL LIABILITY COVERAGE FORM:
Knowledge of an "occufence", offense, claim or
'suit" by your agent, se^ant or "employee' shall
not be considered knowledge by you unless you,
your insurance manager or any other person you
designate has recei\ed notice of the "occur-
rence", ofiense, claim or "suit" tom your agent,
senant, or "employee."
M. OTHER INSURANCE
Paragraph a.b.(1)(a) in the Other lnsurance
condition of SECTION lV - COMMERCIAL
GENERAL LIABILITY CONOITIONS within the
COMMERCIAL GENERAL LIABILITY COVER-
AGE FORM is replaced by:
4. Other lnsrrance
b. E)(c€ss lnsurance
(1) This insurance is excess or,er
(a) any of the other insurance,
whether primary, excess, contin-
gent or on any other basis:
(i) That is Fire, Extended Cor
erage, Builders Risk; lnstalla-
tion Risk or similar co\,erage
br 'your wo*";
(ii) that is insurance co\ering
Fire; smoke fom a "hostile
fre"; explosion; lightning;
smoke resulting from such
explosion or lightning; colli-
sion by "mobile equipmenl"
or leakage from fire protec-
tion systems for premises
while rented to You or tempo-
rarily. occupied. bY You with
permission of the ownec or
RtrGEuvtrB
lncludes copyrighted rl$gri$ fftBlance Senices offce, lnc., with its oermission.
PUBLIC.WORK5
CITY OF ALAMEDA
(iii)Ihat is insurarrce to co\er yq.r
liability as a tenant for "proper-
ty damage" to premises while
rented to you or temporarily
occupied by you with permis-
sion of the owne[ or
(iv) tf the loss arises out of the
maintenance or use of aircrd,
"autos", or watercrafl to the
extent not subject to Para-
graph 2.9. Arcraft, Auto Or
Watercrafi under COVER-
AGE A. BODILY INJURY
AND PROPERTY DAMAGE
LIABILITY of SECTION I -
COVERAGES within the
COMMERCIAL GENERAL
LIABILITY COVERAGE
FORM.
N. UNINTENTIONAL FAILURE TO OISCLOSE
HAZARDS
The following is added to Paragraph
6. Representations of SECTION lV - COM-
MERCIAL GENERAL LIABILITY CONDITIONS
within the COMMERCIAL GENERAL LIABILITY
COVERAGE FORM:
Any unintentional fuilure to disdose all exposures
or hazards existing as of the effecti\€ date of the
Commercial General Liability Cowrage Form or
at any time during the policy period will not in\ali-
date or ad\,ersely affect the cor,erage for such
exposure or hazard- Howerer, you must report
the undisclosed exposure or hazard to us as ssl
as reasonably possible after the exposure or
hazard is discolered.
O. WAIVER OF SUBROGATION
The following is added to Paragraph L Transfer of
Rights Of Recovery Against others To Us of
SECTION IV _ COMMERCIAL GENERAL
LtABlLlw GONDITIoNS within the GOMMER-
CIAL GENERAL LIABILITY COVERAGE FORM:
This condition does not apply to any person or
organization to which you wai\,ed this conditidl by
written contract or agreement, but only to the
extent that subrogation is waircd prior to the
"bodily iniury" or "property damage" under a
contract with that person or organization.
P. LIMITED WORLTIiYIOE LIABILITY COVERAGE
The followino is added to SECTION lV - CON-
DITIONS WiihiN thE COMMERCIAL GENERAL
LIABI LITY COVERAGE FORIIi :
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Policy Number: CGAl 414883
AGE FORM
Expanded Coverage Territory
1. lf a "suit" is brought in a part of the "co\erage
tenitory" that is outside the United States of
America (including its tenitories and posses-
sions), Puerto Rico or Canada, and we are
pre\€nted by law, or otherwise, fiom defend-
ing the insured, the insured will initiate a de-
fense of the "suit". We will reimburse the in-
sured, under Supplementary Payments, fcr
any reasonable and necessary expenses in-
cuned for the defunse of a "suit" seeking
damages to which this insurance applies, that
we would ha\€ paid had we been able to ex-
ercise our right and duty to defend.
tf the insured becomes legally obligated to
pay sums because ot damages to which this
insurance applies in a part of the "co\erage
tenitory" that is outside the United States of
America (including its tenitories and posses-
sions), Puerto Rico or Canada, and we are
pre\ented by law, or otherwise, fom paying
iuch sums on the insured's behall we will re-
imburse the insured for such sums.
2. All payments or reimbursemenb we make fcr
damages because of .iudgments or settle-
ments will be made in U.S. cunency at the
prerailing exchange rate at the time the in-
sured became legally obligated to pay such
sums. All payments or reimbursements we
make for expenses under Supplementary
Payments will be made in U.S. cunency at
the pre\ailing exchange rate at the time the
expenses were incuned.
3. Any disputes between you and us as to
whether there is cor,erage under this policy
must be filed in the courts of the United
Stales of America (induding ib tenitories and
possessions), Puerto Rico or Canada.
4. The insured must fully maintain any co\,erage
required by la$/, regLlatbn or other go\,emrnen-
tal authority during the pd'rcy period, except for
reduction of the aggregate limits due to pay-
ments of claims, judgments or settlements.
Failure to maintain such cowrage required by
law, regulation or other go\emmental aulhori-
ty will not in\alidate this insurance. Hower,er,
this insurance will apply as if the required
co\€rage by law, regulation or other go\,ern-
mental authority was in full effect.
For purposes of this co\,erage only, the following
is added to Paragraph 4.b.(1xa) under Other
lnsrrance of SECTION lV - COMMERCIAL
GENERAL LIABILITY CONDITIONS within the
COMMERCIAL GENERAL LIABILITY COVER-
tf the insured's liability to pay damages is deter-
mined in a "suit" brought outside the United
States of America (including its tenitories and
possessions), Puerto Rico or Canada; or
That is co\,erage required by law, regulation or
other go\emmental authority in a part of the
"co\erage tenitory" that is outside the United
States of America (including its tefiitories and
possessions), Puerto Rico or Canada.
For purposes ofthis co\erage only, Paragraph 4.
of SECTION V - DEFlNlTlOl,lS within the
GOMMERCIAL GENERAL LIABILITY COVER.
AGE FORM is replaced by:
4. "Cor,erage tenitory" means anywhere in the
world with the exception ofany country orju-
risdiction which is subject to trade or other
economic sanclion or embargo by the United
States of America.
Q. BODILY INJURY REDEFINITION
Paragraph 3. of SECTION V. - DEFINITIONS
within the COMMERCIAL GENERAL LIABILITY
COVERAGE FORM is replaced bY:
3. "Bodily injury" means bodily injury, sickness
or disease sustained by a person, including
mental anguish, iniury or illness or emotional
distress ahd/or death resulting fom any of
these at any time.
R. INSURED CONTRA T _ LEASE OF PREMISES
Paragraph 9.a. of SECTION v - DEFINITIONS
within ttie COMMERCIAL GENERAL LIABILITY
COVERAGE FORM is replaced bY:
9. "lnsured contract" means:
a. a contract fcr lease of premises. Howe\ts
er, that portion of the contract for a lease
of premises that indemnifies any person
or organization for "property damage" by
fire; smoke fom a "hostile ire", explo-
sion; lightning, srnoke resulting from sucfi
explosion or lightning; collision by "mobb
equipment" or leakage fom fire prolectin
systems to premises while rented to you
oi temporarily occupied by you with per-
mission of the owner is not an "insured
contract".
S. LIBERALIZATION
tf we rer,ise this endorsement to pro\,ide more
co\,erage without additional premium charge, yor
policy will automatically provde the co\,erage as
of the day the re\,ision is efiecti\e in your state.
cErvtr[f,r
tnctudes copyright"a ."RtS f,}Il"1031""
s"ru""" offce, lnc.,
cG 82 24 0512 witbih,rernioaioo.
cirY on ALAMEI'',
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Policy Number: CGA1414883
T. GOOD SAMARITAN SERVICES
1. Under SECTION ll - wHO lS AN INSURE),
pa€graph 2.d., the following is added:
This exclusion does not apply to your em-
ployees or rolunteer workers, other than an
employed or \olunteer physician, rendering
"Good Samaritan senices'.
2. The frlllowing definition is added to SECTION
V _ DEFINITIONS:
"Good Samaritan senices" means any emer-
gency medical senices for which no compen-
sation is demanded or recei\ed.
rncrudescopyrishtirffiffi$f se^/icesofice, lnc.,
cca224os1z
[REGeuvlEEl'' DEC oz 2023
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ 1T CAREFULLY.
CONTRACTORS BLANKET ADDITIONAL INSURED
ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Policy Number: CGA1414883
A. WtlO lS AN INSURED (Section ll) is amended to
include as an insured any person or organization
(called additional insured) whom you are required
to add as an additional insured on this policy
under a written contract or written agreement; but
the w'itten contract or written agreement must be:
1. Currently in effect or becoming effective
during the term of this policy; and
2. Executed prior lo the'bodily injury", 'property
damage" or'personal and advertising injury'.
B. The insurance provided to the additional insured
is limited as follows:
1. That person or organization is an additional
insured only with respect to liability for "bodily
injury", "property damage" or 'personal and
advertising injury' caused in whole or in part,
by:
a. Your acts or omissions; or
b. The acts or omissions of lhose acting on
your behalf.
in the performance of your oPerations for the
additional insured.
2. The Limits of lnsurance applicable to the
additional insured are those specified in the
written contract or written agreement or in the
Oeclarations of this policy, whichever is less.
These Limits of lnsurance are inclusive of,
and not in addition to, the Limits of lnsurance
shown in the Declarations.
3. The coverage provided to the additional C'
insured by this endorsement and paragraph f.
of the definition of "insured contract' under
DEFINITIONS (SECTION V) do not apply to
"bodily injury" or "property damage" arising
out of the "products-completed oPerations
hazard" unless required by the written
contract or written agreement
COMMERCIAL GENERAL LIABILITY
cG El 02 08 05
The insurance provided to the additional
insured does not apply to:
'Bodily injury", "property damage', or
"personal and advertising injury" arising out of
the rendering of, or failure to render, any
professional architectural, engineering or
surveying services, including:
a. The preparing, approving, or failure to
prepare or approve maps, shop drawings,
opinions, repo(s, surveys, field orders,
change orders or drawings and
speciflcations: and
b. Supervisory, inspection, architeclural or
engineering activities.
We have no duty to defend or indemnify an
additional insured under this endorsement:
a. For any liability due lo negligence
attributable to any person or entity other
than you or those acting on your behalf in
the performance of your operations for
the additional insured.
b. For any loss which occurs prior to our
named insured commencing operations
at the location of the loss.
c. Until we receive written notice of a claim
or 'suit" from the additional insured as
required in the Duties ln The Event of
Occurrence, Offense Claim or Suit
Condition.
4. 5.
GEuvtrEI
DEC 0? 2023
PUBLIC WORKS
tnctudes copyrishte0iEE8BflkSlSPB'i"*i""" om"" lnc., with its permission As respects the coverage provided under this
endorsement, the COMMERCIAL GENERAL
LIABILITY CONDITIONS (SECTION lV) are
amended as follows:
1. The following is added to the Duties ln The
Event of Occurrence, Offense, claim or
Suit Condition:
An additional insured under this endorsement
will as soon as practicable:
cG 81 02 08 05 Copyright, lnsurance Services Office, lnc. 2002 Page 1 of 2 Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA Policy Number: CGA1414883
(1) Give written notice of an occurrence
or an offense to us which may result
in a claim or "suit" under this
insurance;
(2) Agree to trigger or activate any other
insurance which the additional
insured has, which is primary, for a
loss we cover under this Coverage
Part by tendering the defense to the
insurers of all such other insurance.
GEB\7
DEC 0? 2023
PUBLIC WORKS
CITY OF ALAMEDA
lncludes copyrighted material of lnsurance Services Office lnc., with its permission Copyright, lnsurance Services Office, lnc. 2002
2. As respects the coverage provided under this
endorsement, Paragraph 4.b. of the Other
lnsurance Condition is deleted and replaced
by the following:
4. Other lnsurance
b. Excess lnsurance
This insurance is excess over any
other insurance naming the additional
insured as an insured whether
primary, excess, contingent or on any
other basis unless the wr,tten contract
or agreement described in A. above
specilically requires that this
insurance be provided on either a
primary basis or a primary and
noncontributory basis.
EEt
Docusign Envelope ID: 17A41A6C-9BAC-45FA-8D66-C8796C736EDA WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wc 00 03 13 (Ed.4-84)
We have the right to recover our payments from anyone liable for an iniury covered by this policy. We will not en- force 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
Schedule
Blanket Waiver of Subrogation 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 .equired only when lhis endoBement is issued subsequent to preparation ol the policy.) EndorsementEffectjve 12412023
lnsured CSG Consultants, lnc.
Policy No. 152000753 Endo.sement No.
Premium S
Countersigned by
eEC 0? 2023
PUBLIC WO&jllfoh 1983 Natbnal council o.1 compensalion lnsuranc€.
CITY OF ALAMEDA
wc 00 03 13
(Ed.4-84)
lnsurance
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