AMENDMENT NO. 2
TO AGREEMENT FOR CONTRACTOR SERVICES
Blue Triton Brands, Inc. (DBA ReadyRefresh)
Water Delivery Service
This Amendment No. 2 to Agreement for Contractor Services is made and entered into as of 1/31/2024, by and between the City of Lake Elsinore, a municipal corporation (“City), and Blue Triton Brands, Inc, (DBA ReadyRefresh), a Corporation (“Contractor”).
RECITALS
A. The City and Contractor have entered into that certain Agreement for Contractor Services dated as of 6/14/2021, (the “Original Agreement”). Except as otherwise defined herein, all capitalized terms used herein shall have the meanings set forth for such terms in the Original Agreement.
B. The Original Agreement provided for compensation to Contractor in an amount of Six Thousand dollars ($6,000.00).
C. The term of the Original Agreement is twelve (12) months and allows the City to extend the term on a 12-month basis, not to exceed two (2) additional 12-month renewals.
D. Amendment No. 1 dated 6/6/2023, increased compensation by an additional $500.00 for a not to exceed compensation amount of $6,500.00 per fiscal year.
E. The parties now desire to amend an increase in the payment for such services as set forth in this Amendment No. 2 for an annual amount not to exceed $9,500.00.
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, City and Contractor agree as follows:
1. Section 3, Compensation, of the Original Agreement is hereby amended to read in its entirety as follows:
Notwithstanding the foregoing, for purposes of Amendment No. 2 and the term thereof, compensation to be paid to Contractor shall be in accordance with the Schedule of Charges set forth in Contractor ’s Proposal (referenced collectively as Exhibit A-1 Amendment No. 2). In no event shall Contractor ’s compensation related to Exhibit A-1 to Amendment No. 2 exceed Nine Thousand Five Hundred dollars ($9,500.00) without additional written authorization from the City Council.
2. Except for the changes specifically set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect.
IN WITNESS WHEREOF, the parties have caused this Amendment No. 2 to be executed on the respective dates set forth below.
“CITY”
CITY OF LAKE ELSINORE, a municipal
corporation
“CONTRACTOR”
Blue Triton Brands, Inc. (DBA ReadyRefresh) a
Corporation
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479
City Manager
Date:
Tim Anderson, Key Account
Manager
Date: __
ATTEST:
City Clerk
APPROVED AS TO FORM:
City Attorney
Assistant City Manager
Attachments: Exhibit A-1 – Contractor ’s Proposal
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 2/2/2024 | 2:25 PM PST
2/2/2024 | 3:15 PM PST
Readv. Refresh
Thank you for your interest in ReadyRefresh .
Attached is a summary of benefits , as well as a proposal with the specific needs in mind. I hope you find this information helpful in your decision making process .
In addition , we also offer a wide variety of other products and services .
Thanks again for your interest in ReadyRefresh . Please feel free to call me with questions at 714-412-3053 . I look forward to establishing a mutually rewarding business relationship .
Sincerely ,
Area Growth Manager
714-412-3053
Timothy .Anderson@waters .nestle.com
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 ReadY. Refresh.
Benefits of ReadyRefresh's Service
Bottled Water
✓ Superior purified Drinking Water in 3 and 5 Gallon bottles ✓ Spring Water in cases of convenient .5 Liter bottles
✓ Competitive pricing
✓ An established delivery system perfected over many years of service ✓ Saturday service available , in many areas, for bottled water delivery or equipment exchange ✓ We perform over 15 quality checks every hour, far exceeding government requirements Coffee
✓ Complete line of brand name coffees , as well as our own private blend ✓ Free loan of coffee pots
✓ Free brewer service and cleaning
✓ Free regularly scheduled deliveries
✓ Free monthly pot exchange
✓ Free coffee filters
✓ Individually sealed packets to assure freshness
✓ Plumbed-in units available for convenience
Service
✓ Customer satisfaction is our number one goal
✓ No need to monitor your water , cup or coffee inventory - your delivery person will manage all re-orders based upon your individual needs
✓ One person to handle all of your sales, service and billing needs ✓ Monthly invoicing rather than 28 day cycle billing
✓ No annual service charge
✓ One invoice for all services to allow for ease of payment ✓ Customized billing for multiple locations
✓ Free replacement of rental equipment , in the event of equipment performance problems ✓ We do not charge any set fees
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 ReadY. Refresh®
smart (f filtration
Benefits of ReadyRefresh's Filtration Service
Advanced point of use technology
✓ Activated Carbon Filtration is highly effective at reducing bacterial cysts, asbestos and other biological impurities
✓ Reverse Osmosis Filtration provides the additional benefit of reducing dissolved minerals in tap water ✓ Exclusively use filtration technologies developed by 3M Purification Inc. ✓ Tested and Certified by NSF International
Expert service
✓ Free* and efficient installation by Nestle Waters AccuPure factory-certified techn icians, a $150 value, with rental service
✓ Regularly scheduled maintenance visits included with rental service Unmatched savings
✓ Pay one low monthly fee
✓ Competitive pricing
Hassle-free
✓ Never run out of great-tast ing water
✓ Get clean , filtered water directly from one of our freestanding dispensers or from a dedicated faucet on the sink
✓ No bottles to store or lift
✓ Choose from a variety of dispenser styles to match your office decor Environmentally friendly
✓ A lighter carbon footprint than water delivery services, because there are no plastic bottles to manufacture or transport
✓ Energy-efficient dispensers provide instant hot and cold water on demand • Free standard installation includes up to one hour of labor and up to 25 feet of related materials; customer is responsible for the cost of labor and materials in excess of such amounts
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 Product
5 Gallon Nestle Pure Life
Delivery Fee
Ready Refresh
Service Proposal
Energy Star Room Temp & Cold Dispenser
Energy Star Hot & Cold Dispenser
L
List Price
$8.49
$10.99
$15.99
Pricing based upon an estimated monthly volume and effective upon agreement.
Thank you for the opportunity to serve you.
Tim Anderson
Area Growth Manager
714-412-3053
Your Price
$5.49
$9.99
$3.99
$4.99
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 ACORD® CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DD/YYYY)
~ 06/02/2023
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 prov isions or be endorsed .
If SUBROGATION IS WAIVED, subject to the terms and cond itions of the policy , certain pol icies may requ ire an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
"MARSH USA, LLC. NAME:
PHONE
I
FAX
501 Merritt 7 IA/C No Extl : IA/C Nol:
Norwalk, CT 06856-0770 E-MAIL
ADDRESS :
INSURER(S ) AFFORDING COVERAGE NAIC#
CN 133249025-T rini-GAWU-23-24 INSURER A : Starr Indemnity & Liability Company 38318 INSURED INSURER B : Starr Specialty Insurance Company 16109 TRITON WATER HOLDINGS, INC.
BLUETRITON BRANDS, INC. INSURER C :
900 LONG RIDGE RD INSURERD :
STAMFORD, CT 06902
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: NYC-011112049-09 REVISION NUMBER : 8
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.
INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE •••~n ••n,n POLICY NUMBER IMM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY 1000100162231 03/31 /2023 03/31 /2024 EACH OCCURR ENCE $ 2,000,000 f--
~ CLAIMS-MADE 0 OCCUR
DAMAGE TO RENTED
PREMISES /Ea occurrence\ $ 1,000,000
MED EXP (Any one person) $ 10,000
f--
PERSONAL & ADV INJURY $ 2,000,000
f--
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 ~
□ P RO- □ L OG PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY JECT OTHER: $
A AUTOMOBILE LIABILITY 1000639318231 (AOS) 03/31 /2023 03/31 /2024 COMBINED SINGLE LIMIT $ 5,000,000 /Ea accident\ A
f--
X ANY AUTO 1000639319231 (MA) 03/31 /2023 03/31 /2024 BODILY INJURY (Per person) $ f-- ~
OWNED SCHEDULED BODILY INJURY (Per accident) $
f-- AUTOS ONLY f------ AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
(Per accident) $
f------ AUTOS ONLY f------ AUTOS ONLY
$
A X UMBRELLA LIAB
M
OCCUR 1000589671231 ($10M) 03/31 /2023 03/31 /2024 EACH OCCURRENCE $ 10,000,000 f------
10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED I I RETENTION $ $
B WORKERS COMPENSATION 100 0004563 (AOS) UJ/Jl /LULJ 03/31 /2024 X I ~f f Tu TE I I OTH-
ER
B
AND EMPLOYERS' LIABILITY Y / N 100 0004564 (AZ CT IA NJ NY NC TX) 03/31 /2023 03/31 /2024 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE 0 EL EACH ACCIDENT $
A OFFICER/MEMBER EXCLUDED? N / A
100 0004565 (FL) 03/31 /2023 03/31 /2024 1,000,000 (Mandatory in NH) EL DISEASE - EA EMPLOYEE $ B If yes, describe under
DESCRIPTION OF OPERATIONS below 100 0004566 (WI, MA) 03/31 /2023 03/31 /2024 EL DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) City of Lake Elsinore its officers, elected and appointed officials, officers, agents, and employees are included as additional insured where required by written contract with respect to General Liability.
CERTIFICATE HOLDER CANCELLATION
City of Lake Elsinore - City Yard SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 521 N Langstaff THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN Lake Elsinore, CA 92530 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
I
~ -:ee,s...4 .....e...,ee
© 1988-2016 ACORD CORPORATION . All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479
COMMERCIAL AUTO
SICA-1015 (0919)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CANCELLATION AND NONRENEWAL NOTICE TO DESIGNATED
PERSON OR ORGANIZATION AMENDATORY ENDORSEMENT
Policy Number: 1000639318231 Effective Date: 3/31/2023
Named Insured: Triton Water Holdings, Inc.
This endorsement modifies the insurance provided under the following:
COMMERCIAL AUTO COVERAGE PART
It is hereby agreed that, in the event we cancel or nonrenew this Coverage Part for any reason other than nonpayment of premium, we will endeavor to mail prior written notice of cancellation or nonrenewal to:
Name:
Address:
Number of days
advance notice: 3o
SCHEDULE
All other terms and conditions of this Policy remain unchanged .
SICA-1015 (0919) Copyright © Starr Indemnity & Liability Company . All rights reserved .
Includes copyrighted material of Insurance Services Office , Inc., with its permission .
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 POLICY NUMBER: 1000100162231 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Omanizationlsl Location Isl Of Covered Operations
All owners, lessees or contractors as required by written All owners, lessees or contractors as required by agreement signed prior to occurrence. written agreemert signed prior to occurrence.
Information renuired to comolete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended to
indude 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 in jury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
beha~;
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 add~ional
insured only applies to the extent permitted by
law; and
2. ~ 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. W~h respect to the insurance afforded to these
additional insureds, the following add~ional
exdusions apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
1. All work, induding 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 danage 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.
CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 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 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.
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479 Starr Indemnity & Liability Company
Dallas, TX 1-866-519-2522
AMENDMENT- 30 DAY NOTICE OF CANCELLATION
Policy Number: 1000100162231 Effective Date: 3/31/2023
Named Insured: Triton Water Holdings, Inc.
This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies) carefully.
Commercial General Liability Coverage Form
Products Completed Operations Coverage Form
Contractors Pollution Coverage Form
Site Pollution Coverage Form
Prciessiona l Liability Coverage Form
It is agreed thirty (30) days notice of cancellation, except as respects non-payment of premium for which ten (10) days will apply, will be given as respects the following certificate holder(s):
SCHEDULE
Certificate holders indude only those entities where thirty (30) days notice of cancellation is required by an "insured contract" but only with respects to an entity for which "you" are directly or incirectly performing "your work". It is further understood and agreed that "you" will provide a complete list of certificate hdders including name(s) and physical addresses to "us" that require the notice of cancellation , and that "you" will provide "us" this list at the time of the notice of cancellation .
All other terms and conditions of this Policy remain unchanged.
OG • 040 (08/11) Page 1 of 1
Copyright ~ C. V. Starr & Compa ny and Starr Indemn ity Insurance Company . All rights reserved .
Includes copyrighted materia l of ISO Properties, Inc. , used with its permission .
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
WC 00 0313
(Ed. 4-84)
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 .
Schedule
Any person or organization against whom you become obligated to waive your rights of recavery against, under any contract or agreement you enter into prior to the occurrence of loss.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The infonnation below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 3-31-2023
Insured Triton Water Hddings, Inc.
Insurance Company
Starr Specialty Insurance Co.
WC 00 0313
(Ed. 4-84)
© 1983 Nationa l Council on Compensation Insurance .
Policy No .1000004564 Endorsement No.
Premium
Countersigned by _________________ _
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479
EXHIBIT A-1
CONTRACTOR ’S PROPOSAL
[ATTACHED]
DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479
CITY OF LAKE ELSINORE
TO BE POSTED IN A CONSPICUOUS PLACE
Business Name:
Business Location:
Owner Name(s):
BUSINESS LICENSE NO.
Issue Date:
Description:
Expiration Date:
BUSINESS LICENSE
THIS IS YOUR LICENSE • NOT TRANSFERABLE
2200 CABOT DR STE 300 Business Type:
LISLE, IL 60532
READYREFRESH
BLUETRITON BRANDS, INC
251 LITTLE FALLS DR
WILMINGTON, DE 19808-1674
This business license is issued for revenuepurposes only and does not grant authorization to operate a business. This business license is issued without verification that the holder is subject to or exempted from licensing by t he state, county, feder al government, or any other governmental agency.
Administrative Services - Licensing
130 South Main Street, Lake Elsinore, CA 92530
PH (951 ) 674-3124
READYREFRESH
MOBILE SERVICE AND/OR DELIVERY
VEHICLES
DELIVERY OF BOTTLED WATER
001236
2/1/2024 1/31/2025
Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender-based discrimination of business establishments. A full notice is available in English or other languages by going to: https://www.dca.ca.gov/publications/ DocuSign Envelope ID: D54FA7CF-730B-4C3A-B519-DA9128B7F479