AGREEMENT NO. 2023- 303( 1)
AMENDMENT NO. [ 1 ] TO
AGREEMENT NO. 2023- 303
THIS AMENDMENT NO. 1 TO AGREEMENT NO. 2023- 303 is made and entered into on Nov 7 0 2t1?4 by and between the CITY OF BAKERSFIELD, a municipal corporation ( referred to herein as " CITY"), and SILVAS OIL COMPANY, INC., a Corporation authorized to do business in California ( referred to herein as CONTRACTOR").
RECITALS
WHEREAS, on December 13, 2023, the CITY and CONTRACTOR entered into Agreement No. 2023- 303 in the amount of $ 1,550,000 for fuel supply and delivery; and
WHEREAS, the parties desire to enter into Amendment No. 1 to Agreement No. 2023-303 to extend the term of the agreement by one year and increase compensation by $ 1,500,000 to continue the service for fuel supply and delivery.
NOW;-=THfREFORE, incorporating the -foregoing recitals ---herein, CITY and` - -- CONTRACTOR mutually agree as follows:
1. Section 2 of Agreement No. 2023- 303 entitled " COMPENSATION" is hereby amended to read as follows:
2. COMPENSATION. Compensation for all work, services or products called for under this Agreement shall consist of a total payment NOT TO EXCEED THREE MILLION FIFTY THOUSAND DOLLARS ($ 3,050, 000) in accordance with the bid documents.
The compensation set forth in this section. shall be the total compensation under this. Agreement including, but not limited to, all out- of- pocket costs and taxes.
CITY shall pay only the compensation listed unless otherwise agreed to in writing by the parties.
2. Section 12 of Agreement No. 2023- 303 entitled " TERM" is hereby amended to read as follows:
12. TERM. Unless terminated sooner, as set forth herein, CONTRACTORshall provide services for an additional one ( 1) year term beginning December 13, 2024. The agreement shall be renewable for three ( 3) consecutive one- year periods at -the City' s option and upon mutually agreeable terms.
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OoRIGI°VO
6 3. Except as amended herein, all provisions of Agreement No. 2023-303 shall remain in full force and effect. -
IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. one ( 1) to Agreement No. 2023-303 to be executed the day and year first above written.
CITY
CITY OF BAKERSFIELD
By:
KAREN GOH
Mayor
APPROVED AS TO FORM:
VIRGINIA GENNARO
City Attorney
ylSHVeSputy
UA H. RUDNICK K
City Attorney
APPROVED AS TO CONTENT:
PUBLIC WORKS DEPARTMENT
By:
AC MEYER
Acting Public Works Director
CONTRACTOR"
SILVAS OIL COMPANY, INC.
By:
Print Name: 4 /" s
Title: % c 5 :. c.'
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vORIG4NF.l.
COUNTERSIGNED:
By:
RXNEWMcfPEGAN
Finance' Director
Insurance Approved by
Risk Management:
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ORIGIW
A` cow - DATE,IMMIDD/ YYYY).
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CERTIFICATE OF LIABILITY - INSURANCE F10/
3112024.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION - ONLY AND CONFERS NO RIGHTS UPOMTHE CERTIFICATE HOLDER. THIS CERTIFICATE DOESNOTAFFIRMATIVELYOR NEGATIVELYAMEND, EXTENDORALTERTHE COVERAGEAFFORDEDBY THE.POLICIESBELOW. THIS CERTIFICATEOF INSURANCE
DOES NOT CONSTITUTEA CONTRACTBETWEEN THE ISSUING, INSURER(S), AUTHORIZEDREPRESENTATIVEOR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
If thecertificateholder is, an ADDITIONALINSURED, the policy(ies) must have ADDITIONALINSURED provisions or be endorsed. if SUBROGATION IS WAIVED, 'subject to thetermsand conditionsof thepolicy, certain policiesmay, requirean endorsement, A statementon thiscertificate does not conferrights to thecertificateholder in lieuof suchendorsement(s). PRODUCER
FEDERATED
MUTUAL INSURANCE. COMPANY HOME
OFFICE: P. O. BOX328 OWATONNA,
MN' S5060NAME:
CLIENT CONTACTCENTER A/
C, No, Exti: 868-333-49491 IMP.No): 507-446.4664AIL
ADDRESS: CLIENTCONTACTCENTER®FEDINS. COM INSURERS'
AFFORDINGCOVERAGE _ NAIC/ 1 INSURER
A: FEDERATEDMUTUAL INSURANCECOMPANY 13935 INSURED
SILVAS
OIL COMPANYINC, PENCEPETROLEUMrCOINC PO
BOX1046 FRESNO,
CA 93714-1048 INSURER
B: INSURER
C: INSURER
D: INSURER
E: INSURER
F: VVVGRn_.
NGm I iriMms;"umocK: i4 11CVIAIUr1 IVUMUCK: N THIS•
IS TO -CERTIFY -THAT THE POLICIESOF INSURANCELISTED BELOW HAVE•. BEEN ISSUEDTO THEINSUREDNAMED ABOVE FOR THE POLICYPERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIONOF ANYCONTRACTOR OTHERDOCUMENTWITH RESPECTTO WHICHTHIS CERTIFICATEMAY BE'. ISSUED OR MAYPERTAIN. THE INSURANCEAFFORDED BY THEPOLICIES. DESCRIBEDHEREIN IS SUBJECTTO ALLTHE TERMS, EXCLUSIONSAND CONDITIONSOF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCEDBY PAIDCLAIMS. ILTR
TYPE OF INSURANCEIANDSR SOUIBDRPOLICY NUMBER MMIDDNVV MMIO IYEXPYYYLIMITS A X
COMMERCIALGENERAL LIABILITY - CLAIMS -
MADE X OCCURY
Y 9370720 08101/ 2024 08/ 01/ 2025EACH
OCCURRENCE1, 000,000 EAMAGE
TO ENTEDPREMISESoccurrenceFM100, 000 MEP
EXP (any on. person) EXCLUDED' PERSONALS
ADV INJURY1, 000000GENL
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1, 000, 0 BODILYINJURY (
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UMBRELLA
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N N 9370T2108/ 01/ 202408/ 01/ 2025EACHOCCURRENCE..
10, 000, 000AGGREGATE10,
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RETENTIONWORKERSCOMPENSATION- -
AND EMPLOYERS'
LIABILITYYIN ANY PROPRIETOR/
PARTNERtEXECUTIVEOFFICERIMEMBEREXCLUDED?
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NH) _ If yea,
describeunderDESCRIPTIONOF
OPERATIONS below. NIA PER
STATUTE:
OTHERE: LEACH
ACCIDENT ' E. I.
DISEASEEAEMPLOYEE - E. L
DISEASE •POLICYLIMIT DESCRIPTIONOF
OPERATIONSI LOCATIONS I VEHICLE$ ( ACORD101, AdditionalRemarksSchedule, may be attachedIt more spaceIs requlred) - - - SEEATTACHED
PAGE CERTIFICATE HOLDER
CANCELLATION' CITY OFBAKERS
FIELD1501 TRUXTUN
AVE 1498 SHOULD ANY OF THE ABOVEDESCRIBEDPOLICIESBE CANCELLEDBAKERSFIELD, CA 93301- 5201BEFORETHE EXPIRATIONDATETHEREOF, NOTICEWILL - BE DELIVEREDIN ACCORDANCEWITH THE POLICYPROVISIONS. 1988. 2015
ACORDCORPORATION. All rights reserved. ACORD 25 (
2016103) TheACORD name and logo are registeredmarksof ACORD Y 0ORIGRNF L
FEDERATED
lNSURANCEv
Dear Policyholder,
Thank you for choosingFederatedInsuranceto handleyour insuranceand risk management needs. The attached certificate document( s) have been issued or updated.
Pleasefeel free to contactus with any additionalchanges, additionsor deletionsthat may be needed by contacting the Federated Client Contact Center at:
E- mail: clientcontactcenter( 2fedins. com
Phone: 1- 888- 333- 4949
Fax: 507- 446- 4664
Thank you for your business!
Client Contact Center
Enclosed:
Certificate Document( s)
MISC- 0829 ( 03- 22)
AGENCY CUSTOMER ID:
AC RO LOC #:
1. ADDITIONAL REMARKS SCHEDULE Page 1
AGENCY NAMEDINSURED -
FEDERATED MUTUAL INSURANCE COMPANY SILVAS OIL COMPANY INC, PENCE PETROLEUM CO INC PO BOX 1048
FRESNO, CA 93714-1048POLICY NUMBER
SEE CERTIFICATE # 149. 8
CARRIER NAIC CODE EFFECTIVEDATE: SEE CERTIFICATE # 149. 8 SEE CERTIFICATE N 149.8
ADDITIONAL REMARKS
THIS ADDITIONAL. REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
ADDITIONAL NAMED INSUREDS INCLUDE
WHOLESALE FUELS
GENERALLIABILITY CONTAINSA WAIVEROF TRANSFEROF RIGHTSOF'RECOVERYAGAINSTOTHERSTO US ( WAIVEROF SUBROGATION)
AUTOMATIC ENDORSEMENT
THE CITY IS NAMEDAS ADDITIONAL INSUREDFORALL LIABILITY ARISING OUT OF THE OPERATIONSBY OR ON BEHALFTHE NAMED
INSURED,, ANDTHISPOLICYPROTECTSTHE ADDITIONALINSURED, ITS OFFICERS, APPOINTEDAND ELECTEDOFFICIALS, AGENTS, EMPLOYEES
AND VOLUNTEERSAGAINST LIABILITY FOR BODILYINJURIES, DEATHS OR PROPERTYDAMAGE OR DESTRUCTIONARISING IN ANY RESPECTDIRECTLYOR INDIRECTLYIN THEPERFORMANCEOF THECONTRACT. THE INCLUSIONOF MORETHANONE INSUREDSHALL NOT OPERATETO IMPAIRTHE RIGHTSOF ONEINSUREDAGAINST ANOTHER INSURED AND THE COVERAGESAFFORDED SHALL APPLY AS. THOUGH SEPARATEPOLICIES"HAVE BEENISSUEDTO EACHINSURED. THE INSURANCEPROVIDED HEREIN IS PRI14ARYAND NO INSURANCE HELD OR OWNEDBY THECITY SHALLBE CALLEDUPON TO CONTRIBUTETO A LOSS. THIS POLICYDOES NOT EXCLUDEEXPLOSION,
COLLAPSE, UNDERGROUNDEXCAVATION HAZARD OR REMOVALOF LATERALSUPPORT, THE
CERTIFICATEHOLDER IS AN' ADDITIONALINSURED ON GENERALLIABILITY SUBJECT TO THECONDITIONSOF THEADDITIONALINSURED - OWNERS, LESSEES, OR CONTRACTORS - COMPLETED OPERATIONS ENDORSEMENT. GENERAL LIABILITYCONTAINS CG 25 03, DESIGNATEDCONSTRUCTIONPROJECT( S) GENERALAGGREGATELIMIT ENDORSEMENT. FOR REASONSOTHER THAN NON- PAYMENTOF PREMIUM, 30 DAYSNOTICEWILL BE PROVIDEDTO THECERTIFICATEHOLDER IN THEEVENT THAT THE ISSUINGCOMPANYCANCELSTHE POLICYBEFORETHE EXPIRATIONDATE OF THEPOLICY. INSURANCE PROVIDED BY THEGENERALLIABILITY COVERAGE IS PRIMARYAND NONCONTRIBUTORYOVER OTHERINSURANCE.. ACORD 101 ( 2008101) ® 2008 ACORDCORPORATION. All rightsreserved. The ACORDname and logo are registeredmarks of ACORD
COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insuranceprovidedunder the following: COMMERCIAL
GENERAL LIABILITY COVERAGE PART LIQUOR
LIABILITY COVERAGE PART PRODUCTS/
COMPLETED OPERATIONS LIABILITY COVERAGE PART The
followingis addedto the OtherInsuranceCondition
and supersedesany provisionto the contrary:
Primary
And NoncontributoryInsurance This
insuranceis primaryto and will not seek contribution
from any otherinsuranceavailable to an
additionalinsured under your policy providedthat:
1)
The additionalinsured is a NamedInsured under
such other insurance; and 2)
Youhave agreedin writingin a contractor
agreementthat this insurancewould be primary
and wouldnot seek contributionfrom
any otherinsuranceavailable to theadditional
insured. Insurance
Services Office, Inc., 2018 Page 1of1 CG
20 01 12 19 Policy Number: 9370720 Transaction Effective Date: 08/ 01/ 2024 POLICY NUMBER: 9370720 COMMERCIAL GENERAL LIABILITY
CG 20 10 12 19
THIS ENDORSEMENTCHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsementmodifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person( s)
Or Organization( s): Location( s) Of Covered Operations City of Bakersfield Any Coverage Provided by This Endorsement Office of Risk Management Applies Only to the Delivery of Fuel to the 1600 Truxtun Ave Certholder
Bakersfield, CA 93301- 5141
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended to
include as an. additional insured the person( s) or
organization( s) shown in the Schedule, but only
with respect to liability for " bodily injury",
property damage" or " personal and advertising
injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured( s) at the location( s)
designated above.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured
is required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to " bodily injury" or
property damage" occurring after:
1. All work, including materials, parts or
equipment furnished in connection with such
work, on the project ( other than service,
maintenance or repairs) to be performed by or
on behalf of the additional insured( s) at the
location of the covered operations has been
completed; or
2. That portion of " your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.
Insurance Services Office, Inc., 2018
u
y
m
ORI& N°
o
CG 20 10 12 19 Policy Number: 9370720 Transaction Effective Date: 08/ 01/ 2024 C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section Ill - Limits Of insurance:
If coverage provided to the additional insured is
required by a. contract or agreement, the most we
will pay on behalfof the additionalinsuredis the
amount of insurance:
1. Required by the contract or agreement; or
Insured:
Silvas Oil Company Inc
PO Box 1048
Fresno, CA' 93714- 1048
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
CG 20 10 12 19 Policy Number: 9370720 Transaction Effective Date: 08/ 01/ 2024 POLICY NUMBER: 9370720 COMMERCIAL GENERAL LIABILITY
CG 20 37 12 19
THIS ,ENDORSEMENTCHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED OWNERS, LESSEES OR
CONTRACTORS -- COMPLETED OPERATIONS
This endorsement modifies insurance provided underthe following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person( s)
Or Organization( s) Location And Description Of Completed Operations amityof Bakersfield
3ffice of Risk. Management
1600 Truxtun Ave
3akersfield, CA 93301- 5141
y Coverage Provided by This
dorsement Applies Only to the Delivery
Fuel to the Certholder
lInformation required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended to
include as an additional insured the person( s) or
organization( s) shown in the Schedule, but only
with respect to liability for ". bodily injury" or
property damage" caused, in whole or in part, by
your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and included
in the " products - completed operations hazard".
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III - Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the applicable
limits of insurance.
Insured:
Silvas Oil Company Inc
PO Box 1048
Fresno, CA 93714- 1048
N`
vq
OFIGINAl
Insurance Services Office, Inc., 2018 Page 1 of 1
CG 20 37 12 19 Policy Number: 9370720 Transaction Effective Date: 08/ 01/ 2024
COMMERCIAL GENERAL LIABILITY
CG24531219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US ( WAIVER OF SUBROGATION) -
AUTOMATIC
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of Section
IV Conditions:
We waive any right of recovery against any person or
organization, because of any payment we make under
this Coverage Part, to whom the insured has waived
its right of recovery in a written contract or
agreement. Such waiver by us applies only to the
extent that the insured has waived its right of recovery against such person or organization prior to loss.
Insurance Services Office, Inc., 2018 Page 1 of 1
CG 24 53 12 19 Policy Number: 9370720 Transaction Effective Date: 08/ 01/ 2024 POLICY NUMBER: 9370720 COMMERCIAL GENERAL LIABILITY
CG 25. 03 05 09
THIS ENDORSEMENTCHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED : CONSTRUCTION PROJECT( S)
GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:.
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Project( s):
Any Coverage Providedby This EndorsementApplies Only to the Delivery of Fuel for the Certificate Holder. the City of Bakersfield, its Mayor, Council,, Officers, Agents, Employees & Designated Volunteers Are Also Listed As Additional Insureds.
Information required to complete this Schedule if not shown above, will be shown in the Declarations.
A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical occurrences" under Section t - Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under. Section I - Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated. construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: s-_ I dhe"; - e- u_ e ariv - i=- r sere g--Zhed
1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated- construction project designated construction project, and that Limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To
2. The Designated Construction Project General You and Medical Expense continue to apply.
Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, except General Aggregate Limit shown in the damages because of " bodilyinjury" or Declarations, such limits will be subjectto theproperty damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medicalGeneral AggregateLimit. expenses under CoverageC regardlessof the number
of: a.
Insureds; b.
Claimsmade or " suits" brought; or c.
Personsor organizationsmaking claims or
bringing "suits". r
90RIGINP.
L CG
25 03 05 09 O InsuranceServices Office, Inc., 2008 Page 1 of2 B. For all sums which the insured becomes legally
obligated to pay as damages caused by
occurrences" under Section I - Coverage A, and
for all medical expenses caused by accidents
under Section 1 - Coverage C, which cannot be
attributed only to ongoing operations at a single
designated construction project shown in the
Schedule above: `
1. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the amount. available
under the General Aggregate Limit or the
Products - completed Operations Aggregate
Limit, whichever is applicable; and
2. Such payments shall not reduce any
Designated Construction Project General
Aggregate Limit.
C. When coverage for liability arising out of the
products - completed operations hazard" is
provided, any payments for damages because of
bodily injury" or "' property damage" included in
the " products - completed operations hazard" will
reduce the Products - completed Operations
Aggregate Limit, and not reduce the General
Aggregate Limit nor the Designated Construction
Project General Aggregate Limit.
D. If the applicable designated construction project
has been abandoned, delayed, or abandoned and
then restarted, or if the authorized contracting
parties deviate from plans, blueprints, designs,
specifications or timetables, the project will. still
be deemed to be the same construction project.
E. The provisions of Section III - Limits Of Insurance
not otherwise modified by this endorsement shall
continue to apply as stipulated.
Federated Mutual Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE, READ IT CAREFULLY.
LIMITED AMENDMENT OF CANCELLATION PROVISIONS
All Coverage Parts included in this policy are subject to the following conditions:
If we cancel this .policy, we will mail advance .notice to the person( s) or organization( s) as shown in the Schedule.
SCHEDULE
Name and Address of Person( s) Or Organization( s):
City of Bakersfield
Attn Ins Dept
1501 Truxtun Ave
Bakersfield, CA 93301
Number of days advance notice for any reason, other than non-payment of premium: 3 0 Numberof days advancednotice for non-paymentof premium: See Common Policy Conditions Insured: Silvas Oil CompanyIncPO
Box 1048 Fresno,
CA 93714-1048 m
Includes
copyrightedmaterial of InsuranceServices Office, Inc., with its permission. OPIGINAL IL- F- 50 (04- 13) Policy Number: 9370720 Transaction Effective Date: 08/ 01/ 2024 ACoR ` CERTIFICATE OF LIABILITY INSURANCE DAT9/11IZO2N4 Y)
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: Ifthe 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).
PRODUCER - -
Andreini & Company
220 West 20th Avenue
San Mateo CA 94403
CONTACT _ - ---
NAME: Vicki Davison
PHONE
FAXA,c No): 650-378-4361c o E • 650- 573- 1111 (, C.
E- RESS: [email protected] `
INSURERS) AFFORDING COVERAGE .. NAIC# '
INSURERA: Insurance Company of the. West _ - 27847License#: OK78680 INSURED SILVA-3 INSURERB : . -
Silvas Oil Company Inc.
P. O. Box 1048
INSURER C :
INSURER D : Fresno CA 93714- 1048
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 540581768 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER 'DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I R TYPE OF INSURANCE
ADDL SU
D POLICY NUMBER MMIDD/ YYYY MM/ DDIIYYYY LIMITS'
COMMERCIALGENERAL LIABILITY EACH OCCURRENCE
CLAIMS - MADE OCCUR
DAMAGE
S(
RENTED
PREMISES Ea occurrence)
MED EXP ( Any one person)
PERSONAL & ADV INJURY
GEN' L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
POLICY - PROJECTElLOC PRODUCTS - COMP/ OP AGG
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident
BODILY INJURY ( Per person) ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY ( Per accident)
HIRED. _ NON - OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
UMBRELLALAB OCCUR EACH OCCURRENCE.
HCLAIMS-MADE AGGREGATEEXCESS LIAB
DEDI I RETENTION $ .
A WORKERSCOMPENSATION
AND EMPLOYERS' LIABILITY Y / N
Y WPL502750210 10/ 1/ 2024 10/ 1/2025 X PER OTH--
STATUTE ER
E. L. EACH ACCIDENT 1, 000, 000ANYPROPRIETOR/ PARTNER/ EXECUTIVE OFFICER/ MEMBER EXCLUDED? NIA
E. L. DISEASE - EA EMPLOYEE 1, 000, 000Mandatory in NH) If yes, describe under
DESCRIPTION OF OPERATIONS below E. L. DI -;EASE- POLICY LIMIT 1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) BID No. 23- 24- 42 A/ C Fuel
Waiver Endt Form - # WC990634 applies as per attached.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bakersfield
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
Purchasing Division
1600 Truxtun Ave
Second Floor
Bakersfield CA 93301
AUT ORIZED REPRESENTATIVE
Ir
li
1988- 2015 ACORD CORPORATION. All rigfwrsryryerved.
4O1ACORD 25 ( 2016103) The ACORD name and logo are registered marks of ACORD ® ^ a
RICIM4,Ir
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 Ed. 8- 00)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET Wehavethe right to recoverour paymentsfrom anyone liablefor an injury covered by this policy. Wewill not enforce our right against the person or organization named in the Schedule. ( This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us).
The additional premium for this endorsement shall be
otherwise due.
Person or Organization
ANY PERSON OR
ORGANIZATION FOR
WHOM THE NAMED
INSURED IS REQUIRED
UNDER WRITTEN
CONTRACT TO FURNISH
THIS WAIVER,
CALIFORNIA
OPERATIONS ONLY.
2 % of the total California Workers' Compensation premium Schedule
Job Description
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 10/ 01/ 2024 Policy No. WPL 5027502 10 Endorsement No.
Insured SILVAS OIL CO INC
Insurance Company INSURANCE COMPANY OF THE WEST
Countersigned By
WC 99 06 34
Ed. 8- 00)
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