DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 September 19, 2023
20th Sept
September
20th
23
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DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 9/20/2023
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ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
PHONE FAX (A/C, No, Ext): (A/C, No):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO- POLICY LOC JECT PRODUCTS - COMP/OP AGG
OTHER: $
COMBINED SINGLE LIMIT
(Ea accident) $
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
$
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTHSTATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
8/17/2023
License # 0C36861
44520
Terraphase Engineering, Inc.
1300 Clay Street, Suite 1000
Oakland, CA 94612
22357
25674
A 5,000,000
XX EPK-141223 10/4/2022 10/4/2023 50,000
10,000
5,000,000
5,000,000
5,000,000
B 1,000,000
XX 72UECCF8294 10/4/2022 10/4/2023
A 5,000,000
XX EFX-121276 10/4/2022 10/4/2023 5,000,000
0 C
X UB-7J183014 10/4/2022 10/4/2023 1,000,000 N 1,000,000 1,000,000
A Prof Liab/Pollution EPK-141223 10/4/2022 Each Claim/Each Occ 5,000,000 A Prof Liab/Pollution EPK-141223 10/4/2022 10/4/2023 Aggregate 5,000,000 The City, its City Council, boards, commissions, officials, employees, agents, and volunteers are additional insured(s) under all insurance coverages, except workers’ compensation and professional liability insurance.
City of Alameda
2263 Santa Clara Ave
Alameda, CA 94501
TERRENG-02 AGEORGE
Seattle-Alliant Insurance Services, Inc.
1420 Fifth Ave 15th Floor
Seattle, WA 98101
Melanie Kelly
[email protected]
Crum & Forster Specialty Insurance Company
Hartford Accident and Indemnity Company
Travelers Property Casualty Company of America
X
10/4/2023
X
X
X X
X
X
X
X
DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06
COMMERCIAL AUTOMOBILE
HA 99 16 03 12
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. © 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 1 of 5
COMMERCIAL AUTOMOBILE BROAD FORM
ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply.
1. BROAD FORM INSURED
A. Subsidiaries and Newly Acquired or
Formed Organizations
The Named Insured shown in the
Declarations is amended to include:
(1) Any legal business entity other than a
partnership or joint venture, formed as a
subsidiary in which you have an
ownership interest of more than 50% on
the effective date of the Coverage Form.
However, the Named Insured does not
include any subsidiary that is an
"insured" under any other automobile
policy or would be an "insured" under
such a policy but for its termination or
the exhaustion of its Limit of Insurance.
(2) Any organization that is acquired or
formed by you and over which you
maintain majority ownership. However,
the Named Insured does not include any
newly formed or acquired organization:
(a) That is a partnership or joint
venture,
(b) That is an "insured" under any other
policy,
(c) That has exhausted its Limit of
Insurance under any other policy, or
(d) 180 days or more after its
acquisition or formation by you,
unless you have given us notice of
the acquisition or formation.
Coverage does not apply to "bodily
injury" or "property damage" that results
from an "accident" that occurred before
you formed or acquired the organization.
B. Employees as Insureds
Paragraph A.1. - WHO IS AN INSURED - of
SECTION II - LIABILITY COVERAGE is
amended to add:
d. Any "employee" of yours while using a
covered "auto" you don't own, hire or
borrow in your business or your
personal affairs.
C. Lessors as Insureds
Paragraph A.1. - WHO IS AN INSURED - of
Section II - Liability Coverage is amended to
add:
e. The lessor of a covered "auto" while the
"auto" is leased to you under a written
agreement if:
(1) The agreement requires you to
provide direct primary insurance for
the lessor and
(2) The "auto" is leased without a driver.
Such a leased "auto" will be considered a
covered "auto" you own and not a covered
"auto" you hire.
D. Additional Insured if Required by Contract
(1) Paragraph A.1. - WHO IS AN INSURED
- of Section II - Liability Coverage is
amended to add:
f. 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."
Policy Number: 2 EC CF24
DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 © 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 2 of 5 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 this insurance is primary and noncontributory with the additional insured's own insurance.
(4) Duties in The Event Of Accident, Claim,
Suit or Loss
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
additional insured shall be required to
comply with the provisions in 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.
E. Primary and Non-Contributory if
Required by Contract
Only with respect to insurance provided to
an additional insured in 1.D. - Additional
Insured If Required by Contract, the
following provisions apply:
(3) Primary Insurance When Required By
Contract
This insurance is primary if you have
agreed in a written contract or written
agreement that this insurance be
primary. If other insurance is also
primary, we will share with all that other
insurance by the method described in
Other Insurance 5.d.
(4) Primary And Non-Contributory To Other
Insurance When Required By Contract
If you have agreed in a written contract
or written agreement that this insurance
is primary and non-contributory with the
additional insured's own insurance, this
insurance is primary and we will not
seek contribution from that other
insurance.
Paragraphs (3) and (4) do not apply to other
insurance to which the additional insured
has been added as an additional insured.
When this insurance is excess, we will have no
duty to defend the insured against any "suit" if
any other insurer has a duty to defend the
insured against that "suit". If no other insurer
defends, we will undertake to do so, but we will
be entitled to the insured's rights against all
those other insurers.
When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the sum
of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(2) The total of all deductible and self-insured
amounts under all that other insurance.
We will share the remaining loss, if any, by the
method described in Other Insurance 5.d.
2. AUTOS RENTED BY EMPLOYEES
Any "auto" hired or rented by your "employee"
on your behalf and at your direction will be
considered an "auto" you hire.
The OTHER INSURANCE Condition is amended
by adding the following:
DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 © 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 3 of 5 If an "employee’s" personal insurance also
applies on an excess basis to a covered "auto"
hired or rented by your "employee" on your
behalf and at your direction, this insurance will
be primary to the "employee’s" personal
insurance.
3. AMENDED FELLOW EMPLOYEE EXCLUSION
EXCLUSION 5. - FELLOW EMPLOYEE - of
SECTION II - LIABILITY COVERAGE does not
apply if you have workers' compensation
insurance in-force covering all of your
"employees".
Coverage is excess over any other collectible
insurance.
4. HIRED AUTO PHYSICAL DAMAGE COVERAGE
If hired "autos" are covered "autos" for Liability
Coverage and if Comprehensive, Specified
Causes of Loss, or Collision coverages are
provided under this Coverage Form for any
"auto" you own, then the Physical Damage
Coverages provided are extended to "autos" you
hire or borrow, subject to the following limit.
The most we will pay for "loss" to any hired
"auto" is:
(1) $100,000;
(2) The actual cash value of the damaged or
stolen property at the time of the "loss"; or
(3) The cost of repairing or replacing the
damaged or stolen property,
whichever is smallest, minus a deductible. The
deductible will be equal to the largest deductible
applicable to any owned "auto" for that
coverage. No deductible applies to "loss" caused
by fire or lightning. Hired Auto Physical Damage
coverage is excess over any other collectible
insurance. Subject to the above limit, deductible
and excess provisions, we will provide coverage
equal to the broadest coverage applicable to any
covered "auto" you own.
We will also cover loss of use of the hired "auto"
if it results from an "accident", you are legally
liable and the lessor incurs an actual financial
loss, subject to a maximum of $1000 per
"accident".
This extension of coverage does not apply to
any "auto" you hire or borrow from any of your
"employees", partners (if you are a partnership),
members (if you are a limited liability company),
or members of their households.
5. PHYSICAL DAMAGE - ADDITIONAL
TEMPORARY TRANSPORTATION EXPENSE
COVERAGE
Paragraph A.4.a. of SECTION III - PHYSICAL
DAMAGE COVERAGE is amended to provide a
limit of $50 per day and a maximum limit of
$1,000.
6. LOAN/LEASE GAP COVERAGE
Under SECTION III - PHYSICAL DAMAGE
COVERAGE, in the event of a total "loss" to a
covered "auto", we will pay your additional legal
obligation for any difference between the actual
cash value of the "auto" at the time of the "loss"
and the "outstanding balance" of the loan/lease.
"Outstanding balance" means the amount you
owe on the loan/lease at the time of "loss" less
any amounts representing taxes; overdue
payments; penalties, interest or charges
resulting from overdue payments; additional
mileage charges; excess wear and tear charges;
lease termination fees; security deposits not
returned by the lessor; costs for extended
warranties, credit life Insurance, health, accident
or disability insurance purchased with the loan or
lease; and carry-over balances from previous
loans or leases.
7. AIRBAG COVERAGE
Under Paragraph B. EXCLUSIONS - of
SECTION III - PHYSICAL DAMAGE
COVERAGE, the following is added:
The exclusion relating to mechanical breakdown
does not apply to the accidental discharge of an
airbag.
8. ELECTRONIC EQUIPMENT - BROADENED
COVERAGE
a. The exceptions to Paragraphs B.4 -
EXCLUSIONS - of SECTION III - PHYSICAL
DAMAGE COVERAGE are replaced by the
following:
Exclusions 4.c. and 4.d. do not apply to
equipment designed to be operated solely
by use of the power from the "auto's"
electrical system that, at the time of "loss",
is:
(1) Permanently installed in or upon
the covered "auto";
(2) Removable from a housing unit
which is permanently installed in
or upon the covered "auto";
(3) An integral part of the same unit
housing any electronic
equipment described in
Paragraphs (1) and (2) above; or
DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 © 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 4 of 5 (4) Necessary for the normal
operation of the covered "auto" or
the monitoring of the covered
"auto's" operating system.
b.Section III – Version CA 00 01 03 10 of the
Business Auto Coverage Form, Physical
Damage Coverage, Limit of Insurance,
Paragraph C.2 and Version CA 00 01 10 01 of
the Business Auto Coverage Form, Physical
Damage Coverage, Limit of Insurance,
Paragraph C are each amended to add the
following:
$1,500 is the most we will pay for "loss" in
any one "accident" to all electronic
equipment (other than equipment designed
solely for the reproduction of sound, and
accessories used with such equipment)
that reproduces, receives or transmits
audio, visual or data signals which, at the
time of "loss", is:
(1) Permanently installed in or upon
the covered "auto" in a housing,
opening or other location that is not
normally used by the "auto"
manufacturer for the installation of
such equipment;
(2) Removable from a permanently
installed housing unit as described
in Paragraph 2.a. above or is an
integral part of that equipment; or
(3) An integral part of such equipment.
c.For each covered "auto", should loss be limited
to electronic equipment only, our obligation to
pay for, repair, return or replace damaged or
stolen electronic equipment will be reduced by
the applicable deductible shown in the
Declarations, or $250, whichever deductible is
less.
9. EXTRA EXPENSE - BROADENED
COVERAGE
Under Paragraph A. - COVERAGE - of SECTION
III - PHYSICAL DAMAGE COVERAGE, we will
pay for the expense of returning a stolen covered
"auto" to you.
10. GLASS REPAIR - WAIVER OF DEDUCTIBLE
Under Paragraph D. - DEDUCTIBLE - of SECTION
III - PHYSICAL DAMAGE COVERAGE, the
following is added:
No deductible applies to glass damage if the
glass is repaired rather than replaced.
11. TWO OR MORE DEDUCTIBLES
Under Paragraph D. - DEDUCTIBLE - of SECTION
III - PHYSICAL DAMAGE COVERAGE, the
following is added:
If another Hartford Financial Services Group,
Inc. company policy or coverage form that is not
an automobile policy or coverage form applies to
the same "accident", the following applies:
(1) If the deductible under this Business Auto
Coverage Form is the smaller (or smallest)
deductible, it will be waived;
(2) If the deductible under this Business Auto
Coverage Form is not the smaller (or
smallest) deductible, it will be reduced by
the amount of the smaller (or smallest)
deductible.
12. AMENDED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
The requirement in LOSS CONDITIONS 2.a. -
DUTIES IN THE EVENT OF ACCIDENT,CLAIM,
SUIT OR LOSS - of SECTION IV - BUSINESS
AUTO CONDITIONS that you must notify us of
an "accident" applies only when the "accident" is
known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive officer or insurance manager, if
you are a corporation.
13. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
If you unintentionally fail to disclose any hazards
existing at the inception date of your policy, we
will not deny coverage under this Coverage
Form because of such failure.
14. HIRED AUTO - COVERAGE TERRITORY
Paragraph e. of GENERAL CONDITIONS 7. -
POLICY PERIOD, COVERAGE TERRITORY -
of SECTION IV - BUSINESS AUTO
CONDITIONS is replaced by the following:
e. For short-term hired "autos", the coverage
territory with respect to Liability Coverage is
anywhere in the world provided that if the
"insured's" responsibility to pay damages for
"bodily injury" or "property damage" is
determined in a "suit," the "suit" is brought in
the United States of America, the territories
and possessions of the United States of
America, Puerto Rico or Canada or in a
settlement we agree to.
15. WAIVER OF SUBROGATION
TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US - of SECTION IV -
BUSINESS AUTO CONDITIONS is amended by
adding the following:
DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 © 2011, The Hartford (Includes copyrighted material
Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) Page 5 of 5 We waive any right of recovery we may have
against any person or organization with whom
you have a written contract that requires such
waiver because of payments we make for
damages under this Coverage Form.
16. RESULTANT MENTAL ANGUISH COVERAGE
The definition of "bodily injury" in SECTION VDEFINITIONS is replaced by the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by any person, including
mental anguish or death resulting from any of
these.
17. EXTENDED CANCELLATION CONDITION
Paragraph 2. of the COMMON POLICY
CONDITIONS - CANCELLATION - applies
except as follows:
If we cancel for any reason other than
nonpayment of premium, we will mail or deliver
to the first Named Insured written notice of
cancellation at least 60 days before the effective
date of cancellation.
18. HYBRID, ELECTRIC, OR NATURAL GAS
VEHICLE PAYMENT COVERAGE
In the event of a total loss to a "non-hybrid" auto
for which Comprehensive, Specified Causes of
Loss, or Collision coverages are provided under
this Coverage Form, then such Physical
Damage Coverages are amended as follows:
a.If the auto is replaced with a "hybrid" auto or
an auto powered solely by electricity or natural
gas, we will pay an additional 10%, to a
maximum of $2,500, of the "non-hybrid" auto’s
actual cash value or replacement cost,
whichever is less,
b.The auto must be replaced and a copy of a bill
of sale or new lease agreement received by us
within 60 calendar days of the date of "loss,"
c.Regardless of the number of autos deemed a
total loss, the most we will pay under this
Hybrid, Electric, or Natural Gas Vehicle
Payment Coverage provision for any one
"loss" is $10,000.
For the purposes of the coverage provision,
a.A "non-hybrid" auto is defined as an auto that
uses only an internal combustion engine to
move the auto but does not include autos
powered solely by electricity or natural gas.
b.A "hybrid" auto is defined as an auto with an
internal combustion engine and one or more
electric motors; and that uses the internal
combustion engine and one or more electric
motors to move the auto, or the internal
combustion engine to charge one or more
electric motors, which move the auto.
19. VEHICLE WRAP COVERAGE
In the event of a total loss to an "auto" for which
Comprehensive, Specified Causes of Loss, or
Collision coverages are provided under this
Coverage Form, then such Physical Damage
Coverages are amended to add the following:
In addition to the actual cash value of the "auto",
we will pay up to $1,000 for vinyl vehicle wraps
which are displayed on the covered "auto" at the
time of total loss. Regardless of the number of
autos deemed a total loss, the most we will pay
under this Vehicle Wrap Coverage provision for
any one "loss" is $5,000. For purposes of this
coverage provision, signs or other graphics
painted or magnetically affixed to the vehicle are
not considered vehicle wraps.
DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Form IH 03 13 06 11 Page 1 of 1
© 2011, The Hartford
NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
This policy is subject to the following additional
Conditions:
A. If this policy is cancelled by the Company, other
than for nonpayment of premium, notice of such
cancellation will be provided at least thirty (30)
days in advance of the cancellation effective date
to the certificate holder(s) with mailing addresses
on file with the agent of record or the Company.
B. If this policy is cancelled by the Company for
nonpayment of premium, or by the insured, notice
of such cancellation will be provided within (10)
days of the cancellation effective date to the
certificate holder(s) with mailing addresses on file
with the agent of record or the Company.
If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient
proof of notice.
Any notification rights provided by this endorsement
apply only to active certificate holder(s) who were
issued a certificate of insurance applicable to this
policy's term.
Failure to provide such notice to the certificate
holder(s) will not amend or extend the date the
cancellation becomes effective, nor will it negate
cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives.
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DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 ENDORSEMENT WC 00 03 13 (00) -
POLICY NUMBER:
EMPLOYERS LIABILITY POLICY
AND
WORKERS COMPENSATION
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
001
ONE TOWER SQUARE
HARTFORD CT 06183
UB-7J183014
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.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
SCHEDULE
DESIGNATED ORGANIZATION:
DESIGNATED PERSON:
ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER.
DATE OF ISSUE: ST ASSIGN: OF PAGE 11
DocuSign Envelope ID: EE1009D2-883F-47CA-AF8D-6AE1D544FC06 07/18/23 Amendment Terraphase Engineering Inc. – Clement/Tilden – First Amendment
FIRST AMENDMENT TO AGREEMENT
This First Amendment of the Agreement, entered into this _____ day of __________ 2025, by and between the CITY OF ALAMEDA, a municipal corporation (hereinafter "the City") and TERRAPHASE ENGINEERING INC., a California S corporation, whose address is 1400 Franklin Street, Suite 600, Oakland, CA 94612, (hereinafter "Provider"), is made with reference to the following:
RECITALS:
A. On September 20, 2023, an agreement was entered into by and between the City and Provider (hereinafter "Agreement") in an amount not to exceed $200,000, for environmental support services pertaining to the Clement Avenue/Tilden Way project.
B. Whereas, the City Council authorized the City Manager to execute this Amendment on ___________________.
C. The City and Provider desire to modify the Agreement on the terms and conditions set forth herein.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows:
1. Paragraph 2, SCOPE OF WORK, 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-1 as requested. The Provider acknowledges that the work plan included in Exhibit A-1 is tentative and does not commit the City to request Provider to perform all tasks included therein.
2. Paragraph 3, COMPENSATION TO PROVIDER, 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-1 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-1. b. Provider shall be compensated for the services performed in accordance with the original contract consistent with the terms of the Agreement. Additionally, Provider shall be compensated for the First Amendment, covering services performed during the period between June 3, 2025 and June 30, 2027, at the hourly rates set forth in Exhibit A-1 of the First Amendment.
Compensation for services performed pursuant to the First Amendment shall not exceed $305,000 including contingencies. Total Compensation for this Agreement shall not exceed $505,000 including contingencies.
May 20, 2025
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB 21st May
07/18/23 Amendment Terraphase Engineering Inc. – Clement/Tilden – First Amendment
4. 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 following page
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB 5/21/2025
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
PHONE FAX (A/C, No, Ext): (A/C, No):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO- POLICY LOC JECT PRODUCTS - COMP/OP AGG
OTHER: $
COMBINED SINGLE LIMIT
(Ea accident) $
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
$
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTHSTATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
10/8/2024
License # 0C36861
44520
Terraphase Engineering, Inc.
1300 Clay Street, Suite 1000
Oakland, CA 94612
35289
10717
20478
A 10,000,000
XX EPK-149149 10/4/2024 10/4/2025 50,000
10,000
10,000,000
10,000,000
10,000,000
B 1,000,000
XX 7063362068 10/4/2024 10/4/2025
C 6,000,000
XX EX00UFY24 10/4/2024 10/4/2025 6,000,000
0 D
X 7040301201 10/4/2024 10/4/2025 1,000,000 N 1,000,000
1,000,000
A Prof Liab/Pollution EPK-149149 10/4/2024 Each Claim/Each Occ 5,000,000 A Prof Liab/Pollution EPK-149149 10/4/2024 10/4/2025 Prof Liab/Pollution 5,000,000 All Other States Workers Compensation Policy #7040301196 | 10.4.24 - 10.4.25 | National Fire Insurance of Hartford | Employers Liability Limits: $1m/$1m/$1m | Statutory Coverage Applies
City of Alameda
2263 Santa Clara Ave
Alameda, CA 94501
TERRENG-02 MLACYMCCLINTOCK
Seattle-Alliant Insurance Services, Inc.
401 Union Street, 31st Floor
Seattle, WA 98101
Melanie Kelly
[email protected]
Crum & Forster Specialty Insurance Company
Continental Insurance Company
Aspen Specialty Insurance Company
National Fire Insurance Company of Hartford
X
10/4/2025
X
X
X
X
X
X
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Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Workers Compensation And Employers Liability Insurance
Policy Endorsement
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual.
Schedule
Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement.
The premium charge for the endorsement is reflected in the Schedule of Operations.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.
7 40301196
Endorsement No: 4; Page: 1 of 1 Policy Page: 100 of 165 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606
Form No: WC 00 03 13 (04-1984)
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 Copyright 1983 National Council on Compensation Insurance.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Workers Compensation And Employers Liability Insurance
Policy Endorsement
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
This endorsement changes the policy to which it is attached.
It is agreed that Part One - Workers’ Compensation Insurance G. Recovery From Others and Part Two - Employers’ Liability Insurance H. Recovery From Others are amended by adding the following:
We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE - Refer to the Schedule of Operations
The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 3%.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.
7 40301201
Endorsement No: 2; Page: 1 of 1 Policy Page: 35 of 51
Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606
Form No: G-19160-B (11-1997)
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright CNA All Rights Reserved.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Business Auto Policy
Policy Endorsement
PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
A. The following is added to the Other Insurance Condition in the BUSINESS AUTO COVERAGE FORM and the Other Insurance - Primary And Excess Insurance Provisions in the MOTOR CARRIER COVERAGE FORM and supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:
1. Such “insured” is a Named Insured under such other insurance; and
2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such “insured”.
B. The following is added to the Other Insurance Condition in the AUTO DEALERS COVERAGE FORM and supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an “insured” under your policy provided that:
1. Such “insured” is a Named Insured under such other insurance; and
2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such “insured”.
BUA 7063362068
Endorsement No: 8; Page: 1 of 1 Policy Page: 59 of 142
Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CA 04 49 11 16
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright Insurance Services Office, Inc., 2016
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Business Auto Policy
Policy Endorsement
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: TERRAPHASE ENGINEERING, INC
Endorsement Effective Date: 10/04/2023
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR TO LOSS.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization.
BUA 7063362068
Endorsement No: 7; Page: 1 of 1 Policy Page: 58 of 142
Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CA 04 44 10 13
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright Insurance Services Office, Inc., 2011
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Business Auto Policy
Policy Endorsement
EXTENDED COVERAGE ENDORSEMENT - BA PLUS
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. LIABILTY COVERAGE
A. Who Is An Insured
The following is added to SECTION II, Paragraph A.1., Who Is An Insured:
1. a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the date of inception of this Coverage Form; provided that, b. The insurance afforded by this provision A.1. does not apply to any such entity that is an insured under any other liability policy providing auto coverage.
2. Any organization you newly acquire or form, other than a limited liability company, partnership or joint venture, and over which you maintain majority ownership interest.
The insurance afforded by this provision A.2.:
a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. b. Does not apply to:
(1) Bodily injury or property damage caused by an accident that occurred before you acquired or formed the organization; or
(2) Any such organization that is an insured under any other liability policy providing auto coverage.
3. Any person or organization that you are obligated to provide Insurance where required by a written contract or agreement is an insured, but only with respect to legal responsibility for acts or omissions of a person for whom Liability Coverage is afforded under this policy.
4. An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in that employee's name, with your permission, while performing duties related to the conduct of your business.
Policy, as used in this provision A. Who Is An Insured, includes those policies that were in force on the inception date of this Coverage Form but:
1. Which are no longer in force; or
2. Whose limits have been exhausted.
B. Bail Bonds and Loss of Earnings
SECTION II, Paragraphs A.2.a.(2) and A.2.a.(4) are revised as follows:
1. In a.(2), the limit for the cost of bail bonds is increased from $2,000 to $5,000, and
2. In a.(4), the limit for the loss of earnings is increased from $250 to $500 a day.
C. Fellow Employee
SECTION II, Paragraph B.5 does not apply.
BUA 7063362068
Endorsement No: 26; Page: 1 of 5 Policy Page: 116 of 142 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: SCA 23 500 D (10-2011)
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Business Auto Policy
Policy Endorsement
Such coverage as is afforded by this provision C. is excess over any other collectible insurance.
II. PHYSICAL DAMAGE COVERAGE
A. Towing
SECTION III. Paragraph A.2., is revised to include Light Trucks up to 10,000 pounds G.V.W.
B. Glass Breakage – Hitting A Bird Or Animal – Falling Objects Or Missiles The following is added to SECTION III, Paragraph A.3.:
With respect to any covered auto, any deductible shown in the Declarations will not apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced.
C. Transportation Expenses
SECTION III, Paragraph A.4.a. is revised, with respect to transportation expense incurred by you, to provide:
a. $60 per day, in lieu of $20; subject to
b. $1,800 maximum, in lieu of $600.
D. Loss of Use Expenses
SECTION III, Paragraph A.4.b. is revised, with respect to loss of use expenses incurred by you, to provide:
a. $1,000 maximum, in lieu of $600.
E. Personal Property
The following is added to SECTION III, Paragraph A.4.
c. We will pay up to $500 for loss to Personal Property which is:
(1) Owned by an insured; and
(2) In or on the covered auto.
This coverage applies only in the event of a total theft of your covered auto.
This insurance is excess over any other collectible insurance and no deductible applies.
F. Rental Reimbursement
The following is added to SECTION III, Paragraph A.4.:
d. We will pay for rental reimbursement expenses incurred by you for the rental of an auto because of loss to a covered auto. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered auto. No deductibles apply to this coverage.
1. We will pay only for those expenses incurred during the policy period beginning 24 hours after the loss and ending, regardless of the policy's expiration, with the lesser of the following number of days:
(a) The number of days reasonably required to repair or replace the covered auto; or, (b) 15 days.
2. Our payment is limited to the lesser of the following amounts:
(a) Necessary and actual expenses incurred; or,
(b) $25 per day subject to a maximum of $375.
BUA 7063362068
Endorsement No: 26; Page: 2 of 5 Policy Page: 117 of 142 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: SCA 23 500 D (10-2011)
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Business Auto Policy
Policy Endorsement
a.
b.
c.
d.
e.
3. This coverage does not apply while there are spare or reserve autos available to you for your operations.
4. If loss results from the total theft of a covered auto of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage Coverage Extension.
G. Hired “Autos”
The following is added to SECTION III. Paragraph A.:
5. Hired Autos
If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired Autos, then Physical Damage coverage is extended to:
Any covered auto you lease, hire, rent or borrow without a driver; and Any covered auto hired or rented by your employee without a driver, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business.
The most we will pay for any one accident or loss is the actual cash value, cost of repair, cost of replacement or $75,000 whichever is less minus a $500 deductible for each covered auto. No deductible applies to loss caused by fire or lightning.
The physical damage coverage as is provided by this provision will be limited to the types of physical damage coverage(s) provided on your owned autos.
Such physical damage coverage for hired autos will:
(1) Include loss of use, provided it is the consequence of an accident for which the Named Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing or rental concern.
(2) Such coverage as is provided by this provision G.e.(1) will be subject to a limit of $750 per accident.
H. Airbag Coverage
The following is added to SECTION III, Paragraph B.3.
The accidental discharge of an airbag shall not be considered mechanical breakdown.
I. Electronic Equipment
SECTION III, Paragraphs B.4.c and B.4.d. are deleted and replaced by the following:
c. Physical Damage Coverage on a covered auto also applies to loss to any permanently installed electronic equipment including its antennas and other accessories d. A $100 per occurrence deductible applies to the coverage provided by this provision.
J. Diminution In Value
The following is added to SECTION III, Paragraph B.6.
Subject to the following, the diminution in value exclusion does not apply to:
a. Any covered auto of the private passenger type you lease, hire, rent or borrow, without a driver for a period of 30 days or less, while performing duties related to the conduct of your business; and BUA 7063362068
Endorsement No: 26; Page: 3 of 5 Policy Page: 118 of 142 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: SCA 23 500 D (10-2011)
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Business Auto Policy
Policy Endorsement
b.
b. Any covered auto of the private passenger type hired or rented by your employee without a driver for a period of 30 days or less, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business. c. Such coverage as is provided by this provision is limited to a diminution in value loss arising directly out of accidental damage and not as a result of the failure to make repairs; faulty or incomplete maintenance or repairs; or the installation of substandard parts. d. The most we will pay for loss to a covered auto in any one accident is the lesser of:
(1) $5,000; or
(2) 20% of the auto's actual cash value (ACV)
III. Drive Other Car Coverage – Executive Officers
The following is added to SECTIONS II and III:
1. Any auto you don't own, hire or borrow is a covered auto for Liability Coverage while being used by, and for Physical Damage Coverage while in the care, custody or control of, any of your executive officers, except:
a. An auto owned by that executive officer or a member of that person's household; or An auto used by that executive officer while working in a business of selling, servicing, repairing or parking autos.
Such Liability and/or Physical Damage Coverage as is afforded by this provision will be:
(1) Equal to the greatest of those coverages afforded any covered auto; and (2) Excess over any other collectible insurance.
2. For purposes of this provision, executive officer means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document, and, while a resident of the same household, includes that person's spouse.
Such executive officers are insureds while using a covered auto described in this provision.
IV. BUSINESS AUTO CONDITIONS
A. Duties In The Event Of Accident, Claim, Suit Or Loss The following is added to SECTION IV, Paragraph A.2.a.
(4) Your employees may know of an accident or loss. This will not mean that you have such knowledge, unless such accident or loss is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager.
The following is added to SECTION IV, Paragraph A.2.b.
(6) Your employees may know of documents received concerning a claim or suit. This will not mean that you have such knowledge, unless receipt of such documents is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager.
B. Concealment, Misrepresentation or Fraud
The following is added to SECTION IV, Paragraph B.2.
Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not prejudice you with respect to the coverage afforded provided such failure or omission is not intentional.
C. Policy Period, Coverage Territory
SECTION IV, Paragraphs 7.(5).(a). is revised to provide:
BUA 7063362068
Endorsement No: 26; Page: 4 of 5 Policy Page: 119 of 142 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: SCA 23 500 D (10-2011)
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB Business Auto Policy
Policy Endorsement
a. 45 days of coverage in lieu of 30 days
V. DEFINITIONS
SECTION V. Paragraph C. is deleted and replaced by the following:
Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury or death resulting from any of these
BUA 7063362068
Endorsement No: 26; Page: 5 of 5 Policy Page: 120 of 142 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: SCA 23 500 D (10-2011)
Endorsement Effective Date:
Policy No:
Endorsement Expiration Date: Policy Effective Date: 10/04/2023 © Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB (1 3DJHRI
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Policy Number: EPK-145420
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB 1300 Clay Street, Suite 1000 | Oakland, California 94612 | www.terraphase.com April 16, 2025
Gail Payne
Property Manager
City of Alameda
2263 Santa Clara Avenue
Alameda, California 94501
sent via email to [email protected]
Subject: Proposal – 2025 Remedial Action Implementation Support Activities Dear Ms. Payne:
Terraphase Engineering Inc. (Terraphase) is pleased to submit this Proposal for 2025 Remedial Action Implementation Support Activities to the City of Alameda (City) for the property located on the northeastern corner of Broadway Avenue and Tilden Way in Alameda, California (Site), commonly referred to as the Tilden Way/Clement Avenue property in reference to a future intersection.
Terraphase has prepared this proposal to assist with the implementation of the Department of Toxic Substances Control (DTSC) Voluntary Cleanup Agreement (VCA). Terraphase understands that the proposed development for the Site includes a public walking/biking trail, dog park and roadway segment. A draft Remedial Action Work Plan (RAW) has been prepared and is pending approval by DTSC.
The RAW includes the proposed remedial action objectives (RAOs) and recommended remedial approach, which is excavation and disposal of soil with lead and arsenic concentrations above the RAOs.
The scope of work provided below incorporates an assumed level of effort based on the history of the project and preliminary discussions with the DTSC from 2019 to present. This scope of work may need to be revised as the documents and associated assessments are fully defined in coordination with the DTSC.
Scope of Work
The scope of work for each of the proposed tasks is described below.
Task 1: Finalize Remedial Action Work Plan
Terraphase prepared and submitted a draft of the Remedial Action Work Plan (RAW) to the Department of Toxic Substances Control (DTSC). DTSC provided comments on the draft RAW in a letter dated January 29, 2025. This task includes attending a meeting with DTSC to discuss their comments on the RAW, preparing an updated draft of the RAW, and preparing a response-to-comment table.
Terraphase anticipates that this draft will be approved by the DTSC and will be finalized with only minor revisions thereafter.
Exhibit A-1
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB April 16, 2025
Gail Payne
Proposal – 2025 Remedial Action Implementation Support Activities
Task 2: Community Air Monitoring Plan, Health and Safety Plan, and Specifications Terraphase will prepare a Community Air Monitoring Plan (CAMP) for remedial excavation activities in accordance with DTSC guidelines. The CAMP will describe perimeter air monitoring parameters, equipment and action levels to be implemented during the remedial excavation. A draft of the CAMP will be submitted to DTSC and Terraphase will incorporate one round of comments prior to finalization.
Terraphase will prepare a health and safety plan (HASP) for the remedial excavation activities for submittal to DTSC. The HASP will cover anticipated hazards and mitigation measures and provide appropriate controls to minimize worker exposure to site contaminants of concern.
Terraphase will prepare specifications for the remedial excavation activities. The specifications will include requirements for implementation of the remedial excavation such as submittals, materials, and measurement and payment.
Task 3: Site Management Plan
Terraphase will prepare a site management plan (SMP) to describe requirements for site activities that may encounter remaining soil with elevated concentrations of COCs. The SMP will describe activities covered by the SMP, required procedures for notification, material handling and disposal, and monitoring. The draft SMP will be submitted to DTSC. Terraphase will incorporate one round of DTSC comments into the final draft.
Task 4: Pre-Excavation Waste Characterization Sampling
Terraphase will collect waste characterization samples prior to remedial excavation at locations where additional data is needed for waste profiling. At least one sample will be collected from each excavation area where concentrations detected during previous sampling exceeded ten times the Soluble Threshold Limit Concentration or twenty times the Toxicity Characteristic Leaching Procedure criteria. The samples will be analyzed for total lead and arsenic by United States Environmental Protection Agency (EPA) Method 6010 and for leachable lead and/or arsenic, as appropriate.
This scope of work assumes that up to ten samples will be collected.
Task 5: Oversight and Air Monitoring
Terraphase will provide oversight and air monitoring during remedial excavation. This includes two days of baseline monitoring and up to twelve days of oversight and monitoring during remedial excavation and offhaul. Monitoring and oversight includes a full-time onsite staff for each day of excavation and/or offhaul activities. Terraphase will procure the required equipment and sampling materials and will set up air monitors each day. Equipment will be configured with telemetry and alarms to monitor concentrations and data will be logged on the equipment. Terraphase will download and review data each day. Monitoring reports will be prepared monthly for submittal to DTSC in accordance with the CAMP. This scope of work assumes that two reports will be required.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB April 16, 2025
Gail Payne
Proposal – 2025 Remedial Action Implementation Support Activities Terraphase Engineering Inc. Page 3 of 5
At the request of the City, Terraphase can also provide air monitoring during soil-disturbing project activities following remedial excavation and offhaul. These activities would include grading and soil import or export. The monitoring scope would be the same as during remedial excavation. We have assumed this task would include an additional ten days of air monitoring and two reports.
Task 6: Implementation Support
Implementation support during remedial excavation includes submittal review and responding to contractor requests for information. Terraphase will review and provide feedback on the required submittals identified in the specifications. We will coordinate with the contractor on their schedule and planned activities and be responsive to questions or requests for information related to the requirements for the remedial excavation extents, material handling, and waste profiling and disposal.
Task 7: Post Re-Grading Sampling
As discussed in the RAW, Terraphase will collect samples from the upper two feet of soil after project grading is complete to represent post-grading conditions. This data will be used to update the human health risk assessment and confirm that the remedial action objectives have been met. Terraphase assumes that up to 40 samples will be collected for analysis of metals by EPA Method 6010. This work is anticipated to take two person-days in the field for sample collection and also includes time for planning, scheduling, analytical laboratory coordination, and data review. Terraphase will prepare a brief data transmittal memorandum to DTSC summarizing the sample results.
Task 8: Closeout Reporting
Terraphase will prepare a remedial action completion report (RACR) to document the completed remedial activities and post-project conditions. The draft RACR will include a description of remedial activities and associated monitoring. The draft RACR will also include the updated human health risk assessment as an appendix. The draft RACR will be submitted to DTSC and Terraphase will incorporate one round of DTSC comments into the final draft.
Task 9: Agency Interaction, Project Management, and Coordination Throughout the duration of planning, implementation, and reporting for remedial excavation, Terraphase will continue to communicate with the City of Alameda project manager, DTSC, and the implementation contractor. The scope for this task includes internal and external progress meetings, status updates on deliverables and budgets, and general coordination and management activities.
Schedule
Terraphase understands that the City of Alameda aims to have remedial excavation completed prior to the end of 2025. We will continue to work on ongoing tasks with authorization from the City and will work closely with the City project manager and DTSC to facilitate timely submittal, review, and approval of required deliverables to meet the project deadlines.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB April 16, 2025
Gail Payne
Proposal – 2025 Remedial Action Implementation Support Activities
Cost Estimate
Terraphase proposes to complete this work on a time and materials basis. Terraphase will not exceed this authorization without prior written approval of the client. The estimated cost for each task and the project total are summarized in the table below.
Table 1 Cost Summary by Task
Task Estimated Cost
1 – Finalize Remedial Action Work Plan $11,800
2 – CAMP, HASP, and Specifications $12,700
3 – Site Management Plan $29,200
4 – Pre-Excavation Waste Characterization Sampling $14,300 5 – Oversight and Air Monitoring $112,400
6 – Implementation Support $7,200
7 – Post Re-Grading Sampling $22,100
8 – Closeout Reporting $30,900
9 – Agency Interaction, Project Management and Coordination $36,700 Total $277,300
Closing
Terraphase is grateful for the opportunity to offer our services on this important project. If you have any questions or comments regarding this submittal, please contact Andrew Romolo at (510) 645-1856 or Emily Mosen at (510) 645-1850, ext. 42.
Sincerely,
for Terraphase Engineering Inc.
Andrew Romolo, PG Emily Mosen, PG
Vice President/Senior Principal Geologist Senior Associate Geologist Attachment: 2025 Standard Schedule of Charges with 10% Discount and 10% ODC Acceptance of Proposal
The cost, specifications, and conditions outlined herein are satisfactory and are hereby accepted.
Terraphase is authorized to proceed with the work, as specified.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB April 16, 2025
Gail Payne
Proposal – 2025 Remedial Action Implementation Support Activities Terraphase Engineering Inc. Page 5 of 5
This proposal is hereby accepted by a duly authorized representative of the Client to whom it is addressed:
Signature: Date:
Printed Name:
Title:
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB 2025 Standard Schedule of Charges with10% Discount/10% ODC Labor Classification
Standard
Hourly Rate
Hourly Rate with
10% Discount
Senior Principal $320 $288.00
Principal Engineer/Scientist $301 $270.90
Senior Associate Engineer/Scientist $282 $253.80
Associate Engineer/Scientist $264 $237.60
Senior Project Engineer/Scientist $247 $222.30
Project Engineer/Scientist $230 $207.00
Senior Staff 2 Engineer/Scientist $213 $191.70
Senior Staff 1 Engineer/Scientist $193 $173.70
Staff 2 Engineer/Scientist $171 $153.90
Staff 1 Engineer/Scientist $149 $134.10
Senior Technician
Technician 3
Technician 2
$156
$136
$114
$140.40
$122.40
$102.60
Technician 1 $96 $86.40
Senior Editor/Senior Project Coordinator
Editor 2/Project Coordinator 2/Accountant 2
Editor 1/Project Coordinator 1/Accountant 1
$166
$147
$122
$149.40
$132.30
$109.80
Administrator/Project Assistant/Billing Specialist $103 $92.70 Labor Charges
Client acknowledges that labor is provided for design professional services only. All time will be recorded and charged to nearest 0.1 hour. Expert testimony at trials, hearings and depositions will be billed at 150% of the standard hourly rate. For each day when testimony is provided, a minimum of 8 hours will be billed. Preparatory time will be billed at standard rates.
Expenses
Subcontractor fees and other direct costs, such as air travel, project supplies and rental equipment, etc. will be itemized and billed at our cost plus a ten percent handling charge. Vehicle mileage when itemized is billed at the standard government rate in effect at the time of travel (www.gsa.gov/mileage).
Payment
Payment is to be made to Terraphase Engineering Inc. as follows:
Check Payments: Wire/ACH Payments:
Terraphase Engineering Inc.
P.O. Box 102399
Pasadena, CA 91189-2399
Terraphase Engineering Inc.
JPMorgan Chase Bank
Account Number 217693099
Routing Number 322271627
Payment is due within 30 days of receipt of invoice. A service charge of 1.5% per month or the allowable legal rate may be charged on amounts that are past due for more than 30 days.
Annual Escalation
Rates are subject to revision by annual calendar year escalation in January. Rates on invoices will reflect rates in effect at time of invoicing.
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB
Exhibit 1: Agreement
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB
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POLICY NUMBER:
EMPLOYERS LIABILITY POLICY
AND
WORKERS COMPENSATION
:$,9(52)2855,*+7725(&29(5)52027+(56(1'256(0(17
001
ONE TOWER SQUARE
HARTFORD CT 06183
UB-7J183014
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.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
SCHEDULE
DESIGNATED ORGANIZATION:
DESIGNATED PERSON:
ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER.
DATE OF ISSUE: ST ASSIGN: OF PAGE 11
Docusign Envelope ID: 2642B297-FD11-4F81-BD90-5D536D7C19DB