Agenda packet — Lake Elsinore City Council, July 8, 2025 (part 5 of 8)

REPORT TO CITY COUNCIL
To: Honorable Mayor and Members of the City Council
From: Jason Simpson, City Manager
Prepared by: Damaris Abraham, Community Development Director Date: July 8, 2025
Subject: Notice of Decision - Planning Commission Approval of Planning Application No. 2021- 34 (Evergreen/ Dutch Bros) for a Commercial Design Review and Amendment to Conditional Use Permit No. 2021- 12 for a New 980 Sq. Ft.

Drive- through Dutch Bros Coffee Shop on an approximately 1.13-Acre Site Located South of Central Avenue ( SR-74) and east of Cambern Avenue within the Evergreen Commercial Development
Applicant: Brianna Uy, Barghausen Consulting Engineers, LLC Recommendation
Receive and file the Notice of Decision for Planning Application No. 2021- 34 approved by the Planning Commission on June 17, 2025.

Background
On April 25, 2023, the City Council approved Planning Application No. 2021-34 to establish an approximately 57,000 sq. ft. new commercial center known as Evergreen Commercial Development. The project’ s approval included:

CDR No. 2021-17 to construct five (5) new commercial buildings CUP No. 2021-09 to allow a 4,116 sq. ft. car wash and 25 self-service vacuum stations CUP No. 2021-10 to allow a 3,000 sq. ft. quick-service restaurant with a drive-through lane CUP No. 2021- 11 to establish a 4,088 sq. ft. convenience store, fuel canopy with eight (8) pumps with concurrent sale of beer and wine for off-site consumption CUP No. 2021-12 to allow a 3,000 sq. ft. quick-service restaurant with a drive-through lane The applicant is requesting approval for a Commercial Design Review ( CDR No. 2024- 05) to construct a new 980 sq. ft. drive-through Dutch Bros Coffee Shop as well as an amendment to CUP No. 2021- 12 (CUP No. 2024- 07) to modify the previously approved drive-through site layout and circulation.

PA 2021- 34 (Evergreen – Dutch Bros)

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The project proposes the construction of a one- story 980 sq. ft. drive-through Dutch Bros Coffee Shop with a walk-up ordering window and related improvements, including:

Drive- through queuing capacity for 19 vehicles
340 sq. ft. outdoor dining area
Related site improvements, including directional signage, 13 new parking spaces, and new landscape/ hardscape
The CUP amendment would reduce the approved drive-through building size from 3,000 sq. ft. to 980 sq. ft. and modify the site layout by expanding the approved one-lane drive-through with an eight ( 8) vehicle queuing capacity to a two-lane drive-through with a 19-vehicle queuing capacity.

The modification also includes the addition of a 340- square- foot outdoor dining area.

The project site is located south of Central Avenue/ State Route 74 (SR-74) and east of Cambern Avenue, within the retail center known as Evergreen Commercial Development, which is currently under construction. Other planned retail businesses within the center include Stater Bros., 7- Eleven, and Pollo Campero. The entire Evergreen Commercial Development is an approximately

8.86-acre site located within the C-2 – General Commercial District. The proposed Dutch Bros Coffee Shop will be located on approximately a 1.13-acre lot ( Lot 5 of TPM 38281), which is a portion of Assessor Parcel Number 377-020-014.

On June 17, 2025 the Planning Commission by a 4-0 vote took the following actions:

1. Found that pursuant to the California Environmental Quality Act (CEQA) Guidelines Section 15162, the proposed project would not have a significant effect on the environment and no new environmental documentation is necessary because all potentially significant effects have been adequately analyzed in a previously adopted Mitigated Negative Declaration MND) ( SCH No. 2022090133);

2. Adopted A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF LAKE

ELSINORE, CALIFORNIA, APPROVING AMENDMENT TO CONDITIONAL USE PERMIT NO. 2021- 12 ( CUP 2024- 07) TO MODIFY THE PREVIOUSLY APPROVED

DRIVETHROUGH OPERATION FOR DUTCH BROS COFFEE SHOP LOCATED ON LOT 5 OF TENTATIVE PARCEL MAP NO. 38281 WITHIN THE EVERGREEN COMMERCIAL DEVELOPMENT ( A PORTION OF APN 377-020-014); and

3. Adopted A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF LAKE ELSINORE, CALIFORNIA, APPROVING COMMERCIAL DESIGN REVIEW NO. 2024- 05 FOR THE CONSTRUCTION OF A NEW 980 SQ. FT. DRIVE- THROUGH DUTCH BROS COFFEE SHOP LOCATED ON LOT 5 OF TENTATIVE PARCEL MAP NO. 38281 WITHIN THE EVERGREEN COMMERCIAL DEVELOPMENT ( A PORTION OF APN 377-020-014).

Discussion
The Planning Commission voted 4-0 (with one commissioner abstaining) to approve the project at its regular meeting on June 17, 2025. No written or oral public comments were received. Only the applicant attended the hearing.

PA 2021- 34 (Evergreen – Dutch Bros)

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The Planning Commission’ s decision is final, and no action by the City Council is required unless the City Council, by majority vote, elects to review and reconsider the Commission’ s decision by ordering the matter set for a future noticed public hearing according to Section 17.410.110.F of the Lake Elsinore Municipal Code ( LEMC), or the applicant or an interested person files a complete appeal application within 15 days of this notice appearing on the City Council’ s Agenda.

Fiscal Impact
The time and cost related to processing this application have been covered by fees paid for by the applicant. No General Fund budgets have been allocated or used in the processing of this application. Project approval does not fiscally impact the City’s General Fund. Mitigation to protect the City fiscally have already been included in the Conditions of Approval.

Attachments
Attachment 1 – Planning Commission Staff Report
Community Development

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REPORT TO PLANNING COMMISSION
To: Honorable Chair and Members of the Planning Commission From: Damaris Abraham, Community Development Director
Prepared by: Carlos Serna, Associate Planner
Date: June 17, 2025
Subject: Planning Application No. 2021-34 ( Evergreen/Dutch Bros) – Commercial Design Review and Amendment to Conditional Use Permit No. 2021-12 for a New 980 Sq. Ft. Drive-through Dutch Bros Coffee Shop on an approximately

1.13-Acre Site Located South of Central Avenue ( SR-74) and east of Cambern Avenue within the Evergreen Commercial Development Applicant: Brianna Uy, Barghausen Consulting Engineers, LLC Recommendation

1. Find that pursuant to the California Environmental Quality Act (CEQA) Guidelines Section 15162, the proposed project would not have a significant effect on the environment and no new environmental documentation is necessary because all potentially significant effects have been adequately analyzed in a previously adopted Mitigated Negative Declaration ( MND) SCH No. 2022090133);

2. Adopt A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF LAKE

ELSINORE, CALIFORNIA, APPROVING AMENDMENT TO CONDITIONAL USE PERMIT NO. 2021-12 ( CUP 2024-07) TO MODIFY THE PREVIOUSLY APPROVED DRIVETHROUGH OPERATION FOR DUTCH BROS COFFEE SHOP LOCATED ON LOT 5 OF TENTATIVE PARCEL MAP NO. 38281 WITHIN THE EVERGREEN COMMERCIAL DEVELOPMENT ( A PORTION OF APN 377-020-014); and

3. Adopt A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF LAKE ELSINORE, CALIFORNIA, APPROVING COMMERCIAL DESIGN REVIEW NO. 2024-05 FOR THE CONSTRUCTION OF A NEW 980 SQ. FT. DRIVE-THROUGH DUTCH BROS COFFEE SHOP LOCATED ON LOT 5 OF TENTATIVE PARCEL MAP NO. 38281 WITHIN THE EVERGREEN COMMERCIAL DEVELOPMENT (A PORTION APN 377-020-014).

PA 2021-34 (Evergreen – Dutch Bros)

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Project Location
The project site is located south of Central Avenue/State Route 74 (SR-74) and east of Cambern Avenue, which is within the retail center known as Evergreen Commercial Development that is currently under construction. Other planned retail businesses within the center include Stater Bros., 7 Eleven, and Pollo Campero. The entire Evergreen Commercial Development is approximately 8.86-acres. The proposed Dutch Bros Coffee Shop will be located on approximately 1.13-acre lot (Lot 5 of TPM 38281) which is a portion of Assessor Parcel Number 377-020-014.

Environmental Setting

EXISTING

LAND USE

GENERAL PLAN ZONING
Project
Site
Vacant General Commercial ( GC) General Commercial ( C-2) North Vacant General Commercial ( GC) General Commercial ( C-2) South Residential Medium Density Residential ( MDR)
High Density Residential ( HDR)
Medium Density Residential ( R-2)
High Density Residential ( R-3)
East Residential Low Density Residential ( LDR) Residential Estate ( R-E) West Commercial General Commercial ( GC) General Commercial ( C-2) Table 1: Environmental Setting
Background
On April 25, 2023, the City Council approved Planning Application No. 2021-34 to establish an approximately 57,000 sq. ft. new commercial center known as Evergreen Commercial Development. The project’s approval included:

CDR No. 2021-17 to construct five (5) new commercial buildings CUP No. 2021-09 to allow a 4,116 sq. ft. car wash and 25 self-service vacuum stations CUP No. 2021-10 to allow a 3,000 sq. ft. quick-service restaurant with a drive-through lane Conditional Use Permit No. 2021-11 to establish a 4,088 sq. ft. convenience store, fuel canopy with eight (8) pumps with concurrent sale of beer and wine for off-site consumption CUP No. 2021-12 to allow a 3,000 sq. ft. quick-service restaurant with a drive-through lane Project Description
Planning Application No. 2021-34 is a request for a Commercial Design Review (CDR No. 2024- 05) to construct a new 980sq. ft. drive-through Dutch Bros Coffee Shop as well as an amendment to CUP No. 2021-12 (CUP No. 2024-07) to modify the previously approved drive-through site layout and circulation. The project proposes the following construction and improvements:

One-story 980 sq. ft. drive-through Dutch Bros Coffee Shop with a walk-up ordering window including:
o Drive-through queuing capacity for 19 vehicles
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o 340 sq. ft. outdoor dining area
o Related site improvements including directional signage, 13 new parking spaces, and new landscape/hardscape
The CUP amendment would reduce the approved drive-through building size from 3,000 sq. ft. to 980 sq. ft. and modify the site layout by expanding the approved one-lane drive through with an eight (8) vehicle queuing capacity to a two-lane drive through with a 19-vehicle queueing capacity.

The modification also includes the addition of a 340 sq. ft. outdoor dining area.

Analysis
The analysis below provides a discussion of the proposed project’s consistency with the General Plan and the Lake Elsinore Municipal Code ( LEMC) including the nonresidential development standards and requirements. In addition, the Design Review Committee, including Staff from Planning, Building and Safety, Fire, and Engineering Departments and the Elsinore Valley Municipal Water District, has reviewed the project and have included recommended conditions of approval to ensure compliance with adopted plans, policies, and regulations.

General Plan Consistency
The subject site has a General Plan Land Use designation of General Commercial ( GC) and is located in the Business District. The GC Land Use designation provides for retail, services, restaurants, professional and administrative offices, hotels, and motels, mixed-use projects, public and quasi-public uses, and similar and compatible uses with a maximum 0.40 floor area ratio (FAR). The project is proposing to develop a drive-through coffee shop with a 0.02 FAR. The CUP amendment is proposed to modify the site layout and circulation of the previously approved drive-through restaurant. The CUP amendment would reduce the approved building size from 3,000 sq. ft. to 980 sq. ft. and does not increase the square footage or site size.

Therefore, the project is consistent with the General Plan.

Municipal Code Consistency
The current zoning designation of the subject site is General Commercial ( C-2). Pursuant to LEMC Section 17.124.030 of the C-2 zone, uses subject to a CUP in the C-1 zone also require a CUP in the C-2 zone. Drive-through establishments and restaurants with outdoor dining areas in the C-1 zone are subject to a CUP as indicated in LEMC Section 170.120.030 of the C-1 zone.

The proposed drive-through was previously analyzed for consistency and compliance with the C2 development standards. Staff reviewed the proposed amendment to the previously approved drive-through plans and have determined that the proposed project would continue to conform to the C-2 requirements as well as the drive-through establishment standards contained in LEMC Section 17.148.060 as shown in Table 2 below.

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Development Standard Required Proposed
Front Yard Setback 20 ft. 54.83 ft.

Building Height 45 ft. (Maximum) 40 ft.

Landscape improvements
Adjacent to Street 15 ft. min./ Avg. 20 ft. 20 ft.

Buffer Landscaping 15 ft. 15 ft.

Landscape Coverage 15% 15.53%
Parking
Drive Through Restaurant One (1) space per 45 sq. ft. of customer area
One (1) space per 200 sq. ft.
of non-customer area
Total Required: 11
Customer Area: 340 sq.
ft. – 7.5 parking spaces
Non-Customer Area:
640 sq. ft. – 3.2 spaces
Total Provided: 39
Drive-through Standards
Drive Through Lane Storage 8 vehicles / 20 ft. per vehicle 160 ft.)
19 Vehicles / 20.7 ft. per
vehicle (394 ft.)
Table 1: Development Standards
Architecture and Site Design
The architectural design of the proposed building complies with the Nonresidential Development Standards (Chapter 17.112) of the LEMC. The proposed commercial building elevations employ a contemporary architectural style. The structure also employs staggered roof heights to add additional architectural articulation, and stone veneer will be employed throughout the structure toavoid long expanses of untreated open walls. The exterior consists of stucco incool toned color palettes consistent with the Evergreen Commercial Development’ s master development color scheme. The exterior architecture, including colors and materials, have been designed to be harmonious and compatible with the surrounding development. Furthermore, the proposed landscaping improvements complement the proposed building design, provide shade, and breakup expanses of pavement.

Traffic and Drive-through Queue Management
A Trip Generation Memorandum dated February 11, 2025 was prepared by Kittelson & Associates for the proposed Dutch Bros coffee shop (Attachment 6). The memorandum compared the overall approved trip generation for the Evergreen Development to determine whether further traffic analysis are required. The memorandum concluded that the proposed coffee shop would remain within the approved trip generation during the AM and PM peak hours. The daily trip generation is expected to increase by 29 vehicles per day. However, the daily traffic has less effect on operations of the adjacent roadway network compared to peak hours, and 29 trips (averaging approximately 2 vehicles per operating hour) is considered to have negligible impacts on traffic operations.

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A Queuing Technical Memorandum dated November 7, 2024 was also prepared by Kittelson & Associates to assess the project's on-site circulation, site access, and queuing scenarios for the proposed Dutch Bros (Attachment 7). The memorandum determined that there is a low probability that the number of vehicles waiting in the drive-through queue would exceed 18 vehicles at peak hours of operations. The drive-through lanes are proposed to accommodate up to 19 vehicles and as such, would be sufficient to accommodate the operations during peak times (which are typically in the mornings and afternoon during lunchtime).

Furthermore, Dutch Bros will implement a proactive traffic management plan during their grand opening as well as expected peak hours (Attachment 8). There would be an employee dedicated to managing the drive-through queue by taking orders in advance and helping to keep the line moving smoothly. This is typical of how other Dutch Bros location (including the existing one on Mission Trails) are operated to ensure the drive-through queue line flows efficiently to prevent spillover” traffic onto the public street as well as ensure that access to adjacent businesses and residential areas are not obstructed. Additionally, Dutch Bros implements speed and service time expectations to further minimize any potential congestion. The project has also been conditioned to provide a drive-through queue management plan prior to occupying the building and would be required to comply with said management plan at all times (COA No. 13). Should the use result in concerns related to parking and traffic, a condition of approval has been included to refer the CUP back to Planning Commission for a subsequent review at a public hearing.

Environmental Determination
Pursuant to CEQA Guidelines Section 15162, staff has determined that the proposed project would not have a significant effect on the environment and no new environmental documentation is necessary because all potentially significant effects have been adequately analyzed in an earlier Mitigated Negative Declaration ( MND). All potentially significant impacts have been avoided or mitigated pursuant to the earlier mitigated negative declaration and none of the conditions described in Section 15162 exist. MND (SCH No. 2022090133) was adopted by the City Council on April 25, 2023. No substantial changes which require major revisions to the mitigated negative declaration exist and no new information of substantial importance which requires revisions to the earlier mitigated negative declaration exist. Therefore, no further environmental documentation is necessary.

MSHCP Consistency
The Project is consistent with the Western Riverside County Multiple Species Habitat Conservation Plan (MSHCP). The proposed project site is not located in a Criteria Cell and was not required to be processed through the Lake Elsinore Acquisition Process (LEAP) and Joint Project Review ( JPR) processes. The project complies with all other applicable requirements of the MSHCP.

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Public Notice
Notice of the public hearing for this application has been published in the Press-Enterprise newspaper and mailed to property owners within 500 feet of the subject property. As of the writing of this report, no written comments concerning this application have been received by staff.

Attachments
Attachment 1 – CUP Resolution
Attachment 2 – CDR Resolution
Attachment 3 – Conditions of Approval
Attachment 4 – GIS Package
Attachment 5 – Design Review Package
Attachment 6 – Trip Generation Memorandum
Attachment 7 – Queuing Technical Memorandum
Attachment 8 – Traffic Management Plan
Attachment 9 – Public Notice Package
RESOLUTION NO. 2025-

A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF LAKE

ELSINORE, CALIFORNIA, APPROVING AMENDMENT TO CONDITIONAL USE PERMIT NO. 2021-12 (CUP 2024-07) TO MODIFY THE PREVIOUSLY APPROVED

DRIVE-THROUGH OPERATION FOR DUTCH BROS COFFEE SHOP LOCATED ON LOT 5 OF TENTATIVE PARCEL MAP NO. 38281 WITHIN THE EVERGREEN COMMERCIAL DEVELOPMENT ( A PORTION OF APN 377-020-014)
Whereas, Brianna Uy, Barghausen Consulting Engineers, Inc., has filed an application with the City of Lake Elsinore (City) requesting approval of Planning Application No. 2021-34 which includes Commercial Design Review ( CDR No. 2024-05) to develop and operate a 980 square-foot drive-through Dutch Bros Coffee Shop with a 340 sq. ft. outdoor dining area and amendment to Conditional Use Permit No. 2021-12 (CUP No. 2024-07) to modify the previously approved drive-through operation;
Whereas, the project site is located south of Central Avenue/State Route 74 (SR-74) and east of Cambern Avenue, which is within the retail center known as Evergreen Commercial Development that is currently under construction. The entire Evergreen Commercial Development is approximately 8.86-acres. The proposed Dutch Bros Coffee Shop will be located on an approximately 1.13-acre lot (Lot 5 of TPM 38281) which is a portion of Assessor Parcel Number 377-020-014;
Whereas, on April 25, 2023, the City Council approved Planning Application No. 2021-34 to establish an approximately 57,000 sq. ft. new commercial center known as Evergreen Commercial Development. The project’s approval included CDR No. 2021-17 to construct five (5) new commercial buildings, CUP No. 2021-09 to allow a 4,116 sq. ft. car wash and 25 self-service vacuum stations, CUP No. 2021-10 to allow a 3,000 sq. ft. quick-service restaurant with a drivethrough lane, Conditional Use Permit No. 2021-11 to establish a 4,088 sq. ft. convenience store, fuel canopy with eight (8) pumps with concurrent sale of beer and wine for off-site consumption, and CUP No. 2021-12 to allow a 3,000 sq. ft. quick-service restaurant with a drive-through lane; Whereas, Conditional Use Permit (CUP) No. 2024-07 proposes to modify the previously approved CUP No. 2021-12 to reduce the drive-through size from 3,000 sq. ft. to 980 sq. ft., allow a340sq. ft. outdoor dining area, and expand thedrive-through queue capacity from eight vehicles to 19 vehicles;
Whereas, Section 6.0 of the Western Riverside County Multiple Species Habitat Conservation Plan (MSHCP) requires that all discretionary projects within a MSHCP Criteria Cell undergo the Lake Elsinore Acquisition Process (LEAP) and Joint Project Review (JPR) process to analyze the scope of the proposed development and establish a building envelope that is consistent with the MSHCP criteria;
Whereas, Section 6.0 of the MSHCP further requires that the City adopt consistency findings demonstrating that the proposed discretionary entitlement complies with the MSHCP Criteria Cell, and the MSHCP goals and objectives;
Whereas, Section 17.415.070 of the LEMC provides that certain uses are desirable but may have operational characteristics that disproportionately impact adjoining properties, businesses, or residents. Accordingly, such uses require a more comprehensive review and PC Reso. No. 2025-____

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approval procedure, including the ability to condition the project in order to mitigate significant impacts;
Whereas, pursuant to Section 17.415.070.B of the LEMC, the Planning Commission Commission) has been delegated with the responsibility of reviewing and approving, conditionally approving, or denying Conditional Use Permits; and
Whereas, on June 17, 2025, at a duly noticed Public Hearing, the Commission has considered evidence presented by the Community Development Department and other interested parties with respect to this item.

NOW, THEREFORE, THE PLANNING COMMISSION OF THE CITY OF LAKE

ELSINORE, CALIFORNIA, DOES HEREBY RESOLVE, DETERMINE AND ORDER AS FOLLOWS:

Section 1: The Commission has considered the project and has found it acceptable.

Section 2: That in accordance with the MSHCP, the Commission makes the following findings for MSHCP consistency:

1. The project is not subject to the City’s LEAP and the Western Riverside County Regional Conservation Authority’s (RCA) JPR processes as it is not located within a Criteria Cell.

2. Section 6.1.2 of the MSHCP requires the assessment of a proposed project’s potential impacts to riparian/riverine or vernal pool resources, and those species that depend on such resources. Drainage 1, which traverses the eastern portion of the project site, meets the criteria for riparian/riverine, as defined in the MSHCP. Phase 2 of the proposed project would result in the permanent removal of Drainage 1, and approximately 0.52 acre (469 linear feet) of riparian/riverine area, including 0.09 acres of native riparian/riverine vegetation (scale broom scrub). The portion of Drainage 1 that traverses the project site comprises earthen bed and banks that exhibit natural hydrology and support native vegetation that provide marginal foraging and breeding habitat for wildlife; however, this resource is isolated and is no longer capable of functioning as contiguous habitat.

Vegetation both upstream and downstream of the project site consists almost exclusively of ornamental vegetation ( e.g., river red gum). While this vegetation may support nesting birds, it provides little value as habitat for most indigenous wildlife, including those considered special status or otherwise sensitive species. Incorporation of Mitigation Measure BIO-1 ( either from the Riverpark Mitigation Bank or Barry Jones Wetland Mitigation Bank; applicable only during Phase 2 of the proposed Project), the payment of development fees, and the implementation of appropriate Best Management Practices outlined in MSHCP Appendix C (Dudek 2003) would ensure that the Project is consistent with the provisions of the MSHCPAs such, the Riparian/Riverine Areas and Vernal Pool Guidelines as set forth in Section 6.1.2 of the MSHCP are not applicable.

3. The project is consistent with the Protection of Narrow Endemic Plant Species Guidelines as set forth in MSHCP Section 6.1.3 and the Additional Survey Needs and Procedures as set forth in MSHCP Section 6.3.2 because the project is not located within any Narrow Endemic Plant Species Survey Areas or Critical Species Survey Areas.

4. The project is consistent with the Fuels Management Guidelines because the project site is not within or adjacent to any MSHCP Criteria Cell or conservation areas.

PC Reso. No. 2025-____

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5. The project has been conditioned to pay any applicable MSHCP Local Development Mitigation fees.

Section 3: The Commission has reviewed and analyzed the proposed project pursuant to the California Planning and Zoning Laws (Cal. Gov. Code §§ 59000 et seq.), the Lake Elsinore General Plan ( GP), and the LEMC and finds and determines that the proposed project is consistent with the requirements of California Planning and Zoning Law and with the goals and policies of the GP and the LEMC.

Section 4: The Commission finds that no new environmental documentation is necessary because all potentially significant effects have been adequately analyzed in an earlier adopted Mitigated Negative Declaration (MND) (SCH # 2022090133). All potentially significant impacts have been avoided or mitigated pursuant to the earlier MD and none of the conditions described in Sectio 15162 exist. MND (SCH # 2022090133) was adopted in 2023 for the master Evergreen Commercial Development. No substantial changes that require major revisions to the MD exist and no new information of substantial importance that require revisions to the earlier MND exist.

Section 5: That in accordance with LEMC Section 17.415.070.C. Findings, the Commission makes the following findings regarding CUP No. 2024-07:

1. That the proposed use, on its own merits and within the context of its setting, is in accord with the objectives of the General Plan and the purpose of the planning district in which the site is located.

The project has a General Plan Land Use designation of General Commercial (GC) and is located within the Business District. The GC Land Use designation provides for retail, services, restaurants, professional and administrative offices, hotels and motels, mixeduse projects, public and quasi-public uses, and similar and compatible uses with a maximum 0.40 Floor Area Ratio (FAR). The project is proposing a one-story 980 sq. ft.

Dutch Bros drive-through coffee shop with a 0.02 FAR. The new business will support the Business District in that it would progress Goal No. 1 of the Business District, “ to encourage its position as the industrial and commercial hub of the city” by providing an additional commercial amenity in the district. Therefore, the Project is consistent with the General Plan.

2. The proposed use will not be detrimental to the general health, safety, comfort or general welfare of persons residing or working within the neighborhood of the proposed use or the City, or injurious to property or improvements in the neighborhood or the City.

The proposed drive-through restaurant would not cause detrimental impacts to the existing surrounding community because the design of the parking lot layout and circulation was designed toallow multiple points of egress and ingress for both emergency and pedestrian vehicles. The proposed business will be compatible with the surrounding uses which also includes other retail commercial uses such as the Walmart Shopping Center and the Costco Shopping Center. Furthermore, the project has also been conditioned as such to avoid any potential impacts associated with the proposed use.

3. The site for the intended use is adequate in size and shape to accommodate the use, and for all the yards, setbacks, walls or fences, landscaping, buffers and other features required by this title.

PC Reso. No. 2025-____

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The proposed use and design have been analyzed and staff has determined that the site is compatible and adequate in size and shape to accommodate the proposed use and project design. The design meets all applicable sections of the LEMC including the nonresidential development standards. As designed the project would not encroach on any setback as prescribed by the LEMC and sufficient landscaping has been provided throughout the site. Furthermore, the proposed use and design will complement the existing commercial uses within the vicinity.

4. The site for the proposed use relates to streets and highways with proper design both as to width and type of pavement to carry the type and quantity of traffic generated by the subject use.

The proposed use is located within an existing built environment, inclusive of streets. The existing streets are of adequate size to facilitate safe and convenient transportation to and from the site. Further, the Engineering Division has reviewed the proposed project including its potential traffic impacts and have included conditions of approval to ensure safe on and offsite circulation is provided.

5. In approving the subject use at the specific location, there will be no adverse effect on abutting properties or the permitted and normal use thereof.

The proposed project has been thoroughly reviewed and conditioned by all applicable City departments thereby eliminating the potential for any adverse effects. Furthermore, the project site abuts existing developed commercial properties that are compatible with the proposed project including Costco, Walmart, Taco Bell, and other retail and restaurant uses.

6. Adequate conditions and safeguards pursuant to LEMC 17.415.070.B, including guarantees and evidence of compliance with conditions, have been incorporated into the approval of the subject project to ensure development of the property in accordance with the objectives of this chapter and the planning district in which the site is located.

Pursuant to Section 17.415.070.B of the LEMC, the project was considered by the Planning Commission at a duly noticed Public Hearing on June 17, 2025 and appropriate and applicable conditions of approval have been included to protect the public health, safety and general welfare. Further, compliance with the conditions of approval will be reviewed during the plan check and inspection review process prior to commencing operations.

Section 6: Based upon the evidence presented, the above findings, and the Conditions of Approval imposed upon the project, the Commission hereby approves Conditional Use Permit No. 2024-07.

Section 7: This Resolution shall take effect immediately upon its adoption.

Passed and Adopted on this 17th day June, 2025.

John Gray, Chair
PC Reso. No. 2025-____

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Attest:

Damaris Abraham,
Community Development Director

STATE OF CALIFORNIA )
COUNTY OF RIVERSIDE ) ss.

CITY OF LAKE ELSINORE )
I, Damaris Abraham, Community Development Director of the City of Lake Elsinore, California, hereby certify that Resolution No. 2025-__ was adopted by the Planning Commission of the City of Lake Elsinore, California, at a regular meeting held June 17, 2025 and that the same was adopted by the following vote:

AYES
NOES:

ABSTAIN:

ABSENT:

Damaris Abraham,
Community Development Director
RESOLUTION NO. 2025-

A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF LAKE ELSINORE, CALIFORNIA, APPROVING COMMERCIAL DESIGN REVIEW NO. 2024-05 FOR THE CONSTRUCTION OF A NEW 980 SQ. FT. DRIVE-THROUGH DUTCH BROS COFFEE SHOP LOCATED ON LOT 5 OF TENTATIVE PARCEL MAP NO. 38281 WITHIN THE EVERGREEN COMMERCIAL DEVELOPMENT ( A PORTION APN 377-020-014)
Whereas, Brianna Uy, Barghausen Consulting Engineers, Inc., has filed an application with the City of Lake Elsinore ( City) requesting approval of Planning Application No. 2021-34 which includes Commercial Design Review ( CDR No. 2024-05) to develop and operate a 980 square-foot drive-through Dutch Bros Coffee Shop with a 340 sq. ft. outdoor dining area and amendment to Conditional Use Permit No. 2021-12 (CUP No. 2024-07) to modify the previously approved drive-through operation;
Whereas, the project site is located south of Central Avenue/State Route 74 (SR-74) and east of Cambern Avenue, which is within the retail center known as Evergreen Commercial Development thatis currently under construction. Theentire Evergreen Commercial Development is approximately 8.86-acres. The proposed Dutch Bros Coffee Shop will be located on an approximately 1.13-acre lot (Lot 5 of TPM 38281) which is a portion of Assessor Parcel Number 377-020-014;
Whereas, on April 25, 2023, the City Council approved Planning Application No. 2021-34 to establish an approximately 57,000 sq. ft. new commercial center known as Evergreen Commercial Development. The project’s approval included CDR No. 2021-17 to construct five (5) new commercial buildings, CUP No. 2021-09 to allow a 4,116 sq. ft. car wash and 25 self-service vacuum stations, CUP No. 2021-10 to allow a 3,000 sq. ft. quick-service restaurant with a drivethrough lane, Conditional Use Permit No. 2021-11 to establish a 4,088 sq. ft. convenience store, fuel canopy with eight (8) pumps with concurrent sale of beer and wine for off-site consumption, and CUP No. 2021-12 to allow a 3,000 sq. ft. quick-service restaurant with a drive-through lane; Whereas, Section 6.0 of the Western Riverside County Multiple Species Habitat Conservation Plan (MSHCP) requires that all discretionary projects within a MSHCP Criteria Cell undergo the Lake Elsinore Acquisition Process (LEAP) and Joint Project Review (JPR) process to analyze the scope of the proposed development and establish a building envelope that is consistent with the MSHCP criteria;
Whereas, Section 6.0 of the MSHCP further requires that the City adopt consistency findings demonstrating that the proposed discretionary entitlement complies with the MSHCP Criteria Cell, and the MSHCP goals and objectives;
Whereas, pursuant to Section 17.415.060 (Minor Design Review), Section 17.410.070 Approving Authority), and Section 17.410.030 (Multiple Applications) of the LEMC, the Planning Commission ( Commission) has been delegated the responsibility of reviewing and approving, conditionally approving, or denying this minor design review application; and Whereas, on June 17, 2025, at a duly noticed Public Hearing, the Commission has considered evidence presented by the Community Development Department and other interested parties with respect to this item.

PC Reso. No. 2025-____

Page 2 of 4 ends

NOW, THEREFORE, THE PLANNING COMMISSION OF THE CITY OF LAKE ELSINORE DOES HEREBY RESOLVE, DETERMINE AND ORDER AS FOLLOWS:

Section 1: The Commission has considered the project and its consistency with the MSHCP prior to adopting Findings of Consistency with the MSHCP.

Section 2: That in accordance with the MSHCP, the Commission makes the following findings for MSHCP consistency:

1. The project is not subject to the City’s LEAP and the Western Riverside County Regional Conservation Authority’s (RCA) JPR processes as it is not located within a Criteria Cell.

4. The project is consistent with the Fuels Management Guidelines because the project site is not within or adjacent to any MSHCP Criteria Cell or conservation areas.

5. The project has been conditioned to pay any applicable MSHCP Local Development Mitigation fees.

PC Reso. No. 2025-____

Page 3 of 4 ends

Section 4: The Commission finds that no new environmental documentation is necessary because all potentially significant effects have been adequately analyzed in an earlier adopted Mitigated Negative Declaration ( MND) ( SCH # 2022090133). All potentially significant impacts have been avoided or mitigated pursuant to the earlier MD and none of the conditions described in Section 15162 exist. MND (SCH # 2022090133) was adopted in 2023 for the master Evergreen Commercial Development. No substantial changes that require major revisions to the MD exist and no new information of substantial importance that require revisions to the earlier MND exist.

Section 5: That in accordance with Section 17.415.050.G of the LEMC, the Commission makes the following findings regarding Commercial Design Review No. 2024-05:

1. The project, as approved, will comply with the goals and objectives of the General Plan and the zoning district in which the project is located.

The current zoning designation of the subject site is General Commercial (C-2), the intent of the C-2 district is to provide appropriate locations consist with the General Plan to accommodate a full range of retail stores, offices, personal and business service establishments offering commodities and services scaled to meet the needs of the residents of the entire city. The proposed project is a new drive-through establishment situated in one of the city’s major commercial hubs and therefore, the project is consistent with the C-2 zoning district.

2. The Project complies with the design directives contained in the LEMC and all applicable provisions of the LEMC.

The project is appropriate to the site and surrounding developments. The architectural design of the proposed buildings conforms to the Nonresidential Development Standards Chapter 17.112) of the LEMC. Sufficient setbacks and enhanced onsite landscaping have been provided thereby creating interest and varying vistas as a person moves along abutting streets. The architecture has been designed to achieve harmony and compatibility with the surrounding area. The colors and materials proposed will assist in blending the architecture into the existing landscape and are compatible with other colors and materials used on other properties near the project site. In addition, safe and efficient circulation has been achieved onsite.

3. Conditions and safeguards pursuant to Section 17.415.050.G.3 of the LEMC, including guarantees and evidence of compliance with conditions, have been incorporated into the approval of the Project to ensure development of the property in accordance with the objectives of Section 17.415.050.

PC Reso. No. 2025-____

Page 4 of 4 ends

Pursuant to Section 17.415.050.E of the LEMC, the project was considered by the Planning Commission at aduly noticed Public Hearing held onJune 17, 2025. The project, as reviewed and conditioned by all applicable City divisions, departments and agencies, will not have a significant effect on the environment. Further, compliance with the conditions of approval will be reviewed during the plan check and inspection review process prior to commencing operations.

Section 6: Based upon the evidence presented, the above findings, and the Conditions of Approval imposed upon the project, the Commission hereby approves Commercial Design Review No. 2024-05.

Section 7: This Resolution shall take effect immediately upon its adoption.

Passed and Adopted on this 17th day of June, 2025.

John Gray, Chair
Attest:

Damaris Abraham,
Community Development Director

STATE OF CALIFORNIA )
COUNTY OF RIVERSIDE ) ss.

AYES:

NOES:

ABSTAIN:

ABSENT:

Damaris Abraham,
Community Development Director
Applicant’ s Initials: _____ Page 1 of 4

CONDITIONS OF APPROVAL
PROJECT: PA 2021-34 (CDR 2024-05 & CUP 2024-07)
PROJECT NAME: Evergreen Commercial Development – Dutch Bros PROJECT LOCATION: A Portion of APN: 377-020-014
APPROVAL DATE:

EFFECTIVE DATE:

EXPIRATION DATE:

GENERAL CONDITIONS

1. The project proposes to develop and operate a 980 square-foot drive-through Dutch Bros Coffee Shop with a 340 sq. ft. outdoor dining area (CDR No. 2024-05) and an amendment to Conditional Use Permit No. 2021-12 (CUP No. 2024-07) to modify the previously approved drive-through operation. The project site is located south of Central Avenue/State Route 74 SR-74) and east of Cambern Avenue, which is within the retail center known as Evergreen Commercial Development that is currently under construction. The entire Evergreen Commercial Development is approximately 8.86-acres. The proposed Dutch Bros Coffee Shop will be located on an approximately 1.13-acre lot (Lot 5 of TPM 38281) which is a portion of Assessor Parcel Number 377-020-014.

2. The applicant shall defend (with counsel acceptable tothe City), indemnify, and hold harmless the City, its Officials, Officers, Employees, Agents, and its Consultants (Indemnitees) from any claim, action, or proceeding against the Indemnitees to attack, set aside, void, or annul an approval of the City, its advisory agencies, appeal boards, or legislative body concerning approval, implementation and construction of CDR 2024-05 and CUP 2024-07, which action is bought within the time period provided for in California Government Code Sections 65009 and/or 66499.37, and Public Resources Code Section 21167, including the approval, extension or modification of CDR 2024-05 and CUP 2024-07 or any of the proceedings, acts or determinations taken, done, or made prior to the decision, or to determine the reasonableness, legality or validity of any condition attached thereto. The Applicant's indemnification is intended to include, but not be limited to, damages, fees and/or costs awarded against or incurred by Indemnitees and costs of suit, claim or litigation, including without limitation attorneys' fees, penalties and other costs, liabilities and expenses incurred by Indemnitees in connection with such proceeding. The City will promptly notify the applicant of any such claim, action, or proceeding against the City. If the project is challenged in court, the City and the applicant shall enter into formal defense and indemnity agreement, consistent with this condition.

3. Within 30 days of project approval, the applicant shall sign and complete an Acknowledgement of Conditions,” and shall return the executed original to the Community Development Department for inclusion in the case records.

PLANNING DIVISION

4. Conditional Use Permit No. 2024-07 shall lapse and become void two years following the date on which the conditional use permit became effective, unless one of the following: ( 1) prior to the expiration of two years, a building permit related to the conditional use permit is issued and construction commenced and diligently pursued toward completion; or (2) prior to the expiration of two years, the applicant has applied for and has been granted an extension PA 2021-34/CDR 2024-05 & CUP 2024-07
Conditions of Approval PC Hearing: June 17, 2025
Applicant’ s Initials: _____ Page 2 of 4
oftheconditional usepermit approval pursuant tosubsections (a), (b), and (c) of Lake Elsinore Municipal Code (LEMC) Section 17.415.070.D.2. Subject to the provisions of LEMC Section

17.415.070.I, a conditional use permit granted pursuant to the provisions of this section shall run with the land and shall continue to be valid upon a change of ownership of the site or structure, which was the subject of the Conditional Use Permit application.

5. Commercial Design Review No. 2024-05 shall lapse and become void two years following the date on which the design review became effective, unless one of the following: (1) prior to the expiration of two years, a building permit related to the design review is issued and construction commenced and diligently pursued toward completion; or ( 2) prior to the expiration of two years, the applicant has applied for and has been granted an extension of the design review approval pursuant to subsections ( 1) and ( 2) of LEMC, Section

17.415.050.I.1. Notwithstanding conditions to the contrary, a design review granted pursuant to LEMC Section 17.415.050.I.2 shall run with the land for this two-year period, subject to any approved extensions, and shall continue to be valid upon a change of ownership of the site, which was the subject of the design review application.

6. An application for modification, expansion or other change in a Conditional Use Permit shall be reviewed according to the provisions of the Section 17.415.070 of the LEMC, in a similar manner as a new application

7. If operation of this use raises concerns related to parking, noise, traffic, or other impacts, at the discretion of the Community Development Director, this Conditional Use Permit may be referred back to the Planning Commission for subsequent review at a Public Hearing. If necessary, the Commission may modify or add conditions of approval to mitigatesuch impacts or may revoke said Conditional Use Permit.

8. The project shall comply with all the underlying conditions of approval for PA 2021-34 (TPM 38195, TPM 38281, CUP 2021-09, CUP 2021-10, CUP 2021-11, CUP 2021-12, CDR 2021- 17, PCN 2021-01, PCN 2021-02, and SIGN 2021-35) approved by the City Council on April 25, 2023.

9. All site improvements shall be constructed as indicated on the submitted plans. The applicant shall meet all required development standards as indicated by the Commercial Design Guidelines and the LEMC. Any other revisions tothe approved siteplan or building elevations shall be subject to the review of the Community Development Director or his designee. All plans submitted for Building Division Plan Check shall conform to the submitted plans.

10. All materials and colors depicted on the plans shall be used. If the applicant wishes to modify any of the approved materials or colors depicted on the plans, the applicant shall submit a proposal setting forth the modifications for review by the Community Development Director or his designee.

11. No individual signs are approved as part of this approval. The applicant or designee shall submit an application for a sign permit, pay appropriate fees and receive approval from the Community Development Department for any sign(s) installed at the project site consistent with the sign program for the project.

12. The Applicant shall comply with all applicable City codes and ordinances.

13. The applicant will be required to provide a Queueing Management Plan prior to occupancy of PA 2021-34/CDR 2024-05 & CUP 2024-07
Conditions of Approval PC Hearing: June 17, 2025
Applicant’ s Initials: _____ Page 3 of 4
thedrive-through restaurant building. The project shall be required tocomply with the Queuing Management Plan at all times to ensure that the operation of the drive-through does not interfere with free and orderly circulation of the parking lots and to avoid spillover of vehicles in the public right-of-way.

14. If any of the conditions of approval set forth herein fail to occur, or if they are, by their terms, to be implemented and maintained over time, if any of such conditions fail to be so implemented and maintained according to their terms, the City shall have the right to revoke or modify all approvals herein granted, deny or further condition issuance of all future building permits, deny revoke, or further condition all certificates of occupancy issued under the authority of approvals herein granted; record a notice of violation on the property title; institute and prosecute litigation to compel their compliance with said conditions or seek damages for their violation.

15. The applicant shall comply with all mitigation measures identified in the Mitigation Monitoring Reporting Program for the Mitigated Negative Declaration (Environmental Review No. 2021- 05; SCH # 2022090133) prepared for the project.

BUILDING DIVISION

16. The applicant shall meet all applicable Building Codes in effect at the time, including requirements for the occupancy.

ENGINEERING DEPARTMENT

17. The project shall comply with all underlying conditions of approval for PA 2021-34 ( TPM 38195, TPM 38281, CUP 2021-09, CUP 2021-10, CUP 2021-11, CUP 2021-12, CDR 2021- 17, PCN 2021-01, PCN 2021-02, and SIGN 2021-35) approved by the City Council on April 25, 2023.

18. Project is required to follow all City and State codes, Engineering standards, and regulations applicable at the time of final engineering.

19. The project shall obtain formal approval of the Final Water Quality Management Plan FWQMP) prior to issuance of any grading permit.

20. Project is required to implement mitigation measures identified in the approved Traffic Management Plan and Traffic Study referenced in the project’s approval documents.

CITY OF LAKE ELSINORE FIRE MARSHAL

21. The applicant/operator shall comply with all requirements of the Riverside County Fire Department Lake Elsinore Office of the Fire Marshal. Questions should be directed to the Riverside County Fire Department, Lake Elsinore Office of the Fire Marshal at 130 S. Main St., Lake Elsinore, CA 92530. Phone: (951) 395-1759.

PA 2021-34/CDR 2024-05 & CUP 2024-07
Conditions of Approval PC Hearing: June 17, 2025
Applicant’ s Initials: _____ Page 4 of 4
I hereby state that I acknowledge receipt of the approved Conditions of Approval for the above named Project and do hereby agree to accept and abide by all Conditions of Approval as approved by the Planning Commission on ______________. I also acknowledge that all Conditions shall be met as indicated.

Date:

Applicant’s Signature:

Print Name:

Address:

Phone Number:
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SHEET NAME:SHEET NUMBER: DESCRIPTION: No: DATE:REV:Project CA5803 Dutch Bros Coffee - New Freestanding Store 2550 - A1 PROTOTYPE SEC CENTRAL AVE. & CAMBERN AVE. LAKE ELSINORE, CA 92532c ARMET DAVIS NEWLOVE & ASSOCIATES, AIA ARCHITECTS1330 OLYMPIC BLVD. SANTA MONICA, CALIFORNIA 90404PH SCALE: 1/4" =
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STONE VENEER AT WAINSCOT & COLUMNS

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COLOR: BANFF SPRINGS

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SHERWIN WILLIAMS - 8656-11295
COLOR: DUTCH BROS DARK GRAY

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COLOR: DUTCH BROS BLUE
Dutch Bros Coffee CA5803
SEC Central Ave. & Cambern Ave.

Lake Elsinore, CA. 92532

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Kittelson & Associates, Inc.

TECHNICAL MEMORANDUM
February 11, 2025 Project# 31138
To: City of Lake Elsinore
130 S Main Street
Lake Elsinore, CA 92530
From: Kittelson & Associates, Inc
RE: Dutch Bros at Central Avenue and Cambern Avenue – Trip Generation Memorandum This technical memorandum summarizes the trip generation estimates for the proposed Dutch Bros coffee shop to be located at the southeast corner of Central Avenue and Cambern Avenue in Lake Elsinore, California (“project”). These estimates are then compared against the overall development’s approved trip generation to help the City determine whether supplemental traffic analyses are required.

PROJECT CONTEXT
The project site would consist of a 950-sf retail structure, 11 proposed vehicle parking stalls including one ADA stall and four EV capable parking stalls, and a vehicle drive-through served by a single service window. The drive-through has two lanes that converge at the service window and has been designed to accommodate a queue of 16 vehicles at one time.

The proposed coffee shop is part of a larger commercial plaza development which will be constructed in two phases. The project site will be developed as part of phase 2 which is anticipated to start construction in 2025.

A more detailed site plan of the Dutch Bros development is provided in Appendix A.

PROJECT TRIP GENERATION
Trip generation for the Dutch Bros project uses a combination of the Institute of Transportation Engineers ITE) Trip Generation Manual 11th Edition and historical drive- through transaction data of four (4) existing similar Dutch Bros. The similar Dutch Bros selected based on market service, layout, and traffic conditions are at the following locations:
32690 Yucaipa Blvd, Yucaipa, CA 92399
81-776 Highway 111, Indio, CA 92201
44175 Jefferson St, La Quinta, CA 92253
2560 E Palmdale Blvd, Palmdale, CA 93550
These four locations were chosen because of their similar size and layout to the project (i.e. approximately 950 square feet, two drive-through lanes, and no indoor seating), market competition (i.e. multiple nearby coffee shops and/or Dutch Bros), as well as the suburban-urban traffic context. 750 The City Drive, Suite 410
Orange, CA 92868
P 714. 468.1997
February 11, 2025 Queuing Technical Memorandum Project trip generation Kittelson & Associates, Inc. Page 2
The ITE Trip Generation Manual was used to develop the proportional traffic inflow and outflow rates experienced during weekday morning (AM) and afternoon (PM) peak hours and pass -by rate assumptions.

The hourly average historical Dutch Bros transaction data between April 1, 2023 and March 31, 2024 were used to approximate the total inbound and outbound trips throughout an average weekday and determine the weekday AM and PM peak hours.

The hourly historical transaction data for each location is provided in Appendix B.

Figure 1 visualizes the average historical transaction data across the similar Dutch Bros stores mentioned prior. As shown in the figure, the average peak number of transactions between the stores during the AM network peak period between 7:00 – 9:00 AM is 58, and the average during the PM network peak period between 4:00 – 6:00 PM is 43 transactions. It was assumed that each transaction represents one vehicle, although multiple transactions could occur within one vehicle.

Figure 1: Dutch Bros Daily Drive-Through Transactions Averaged Across All Locations SOURCE: DUTCH BROS (2024)
Internal capture and pass- by trips are important to capture for the proposed coffee shop. Internal capture trips are significant since their incorporation recognizes trips between different land uses within the same development ( such as residential, commercial, and recreational areas) which may not contribute to external road traffic. Internal capture rates that were conservative and consistent with trip generation estimates from the overall development were applied. A pass- by trip reduction of 75% for the AM Peak Hour, PM Peak Hour, and daily traffic was applied, which is the average of the pass -by trip rates from ITE Trip Generation Manual for Land Use 934: Fast-Food Restaurant with Drive-Through Window and Land Use 938: Coffee/Donut Shop with Drive-Through Window and No Indoor Seating. This pass-by trip rate is consistent with previous traffic studies conducted for Dutch Bros in Lake Elsinore.

The site anticipates having seven to nine employees on site throughout the day. At peak times, four of the employees will be outside with one controlling traffic. These employees are on a shift schedule assumed Drive Thro gh TransactionsHo
r o Da ee daDtch
February 11, 2025 Queuing Technical Memorandum alignment with Overall Development plans Kittelson & Associates, Inc. Page 3
to commute to the site outside of typical AM and PM peak hours so they are not represented in the peak hour but are represented in the daily calculations.

Table 1 presents the inbound/outbound patterns used in the analysis and Table 2 presents the resulting trip generation estimates.

Table 1: Weekday Inbound and Outbound Rates for Trip Generation Land Use Unit
AM Peak Hour PM Peak Hour Daily
In Out In Out In Out
Coffee/Donut Shop with Drive-Through
Window and No Indoor Seating
1000
SF
50% 50% 50% 50% 50% 50%
SOURCE: INSTITUTE OF TRAFFIC ENGINEERS TRIP GENERATION MANUAL, 11TH EDITION.

Table 2: Weekday Project Trip Generation Estimates
Trip Type
AM Peak Hour PM Peak Hour Daily
In Out Total In Out Total In Out Total
Primary Trips 7 12 19 8 6 14 114 114 228
Internal Capture1 28 8 36 12 18 30 246 245 491
Pass- By Trips2 23 38 61 23 19 42 342 343 685
Total Trips3 58 58 116 43 43 86 702 702 1,404
Note:
1 Internal capture rates consistent with the overall development trip generation estimates were utilized. 2 A pass- by trip rate of 75% for AM Peak Hour, PM Peak Hour and Daily Traffic. 3 Total inbound/ outbound trip generation estimates are the average hourly historical transaction data across similar Dutch Bros sites.

SOURCE: DUTCH BROS ( 2024), COMPILED BY KITTELSON & ASSOCIATES, INC ( 2025)

ALIGNMENT WITH OVERALL DEVELOPMENT PLANS
This section eval ates the proposed co ee shop’s alignment with the overall development’s trip generation for the lot as provided in the approved corresponding traffic study. The overall development anticipated and planned for two quick service restaurants that combine up to 3,871- sf. Table 3 summarizes the AM Peak Hour, PM Peak Hour, and Daily trip generation estimates for Dutch Bros and the approved land use.

The approved traffic study trip generation summary table has been provided in Appendix C.

As demonstrated from the table, the proposed coffee shop will remain within the approved trip generation during the AM and PM peak hours. The daily trip generation is expected to increase by 29 vehicles per day. The daily traffic has less effect on operations of the adjacent roadway network compared to peak hours, and 29 trips (averaging approximately 2 vehicles per operating hour) is considered to have February 11, 2025 Queuing Technical Memorandum alignment with Overall Development plans Kittelson & Associates, Inc. Page 4
negligible impacts on traffic operations but the overall development could look for ways to offset this difference.

Table 3: Overall Development Trip Generation
Land Use Unit
AM Peak Hour PM Peak Hour Daily
In Out Total In Out Total Total
Approved Trip Generation
Fast-Food Restaurant with
Drive-Through Window
3,871
SF
79 76 155 66 61 127 1,824
Internal Capture1 ( 38) ( 11) ( 49) ( 19) ( 25) ( 44) ( 632) Pass-By (49% AM; 50% PM/Daily) ( 20) ( 20) ( 40) ( 18) ( 18) ( 36) ( 596) Subtotal 21 45 66 29 18 47 596
Proposed Trip Generation
Phase 1: Pollo Campero
Confirmed by Client)
2,580
SF
53 51 104 44 40 84 1,215
Internal Capture1 ( 25) ( 7) ( 32) ( 13) ( 16) ( 29) ( 421) Pass-By (49% AM; 50% PM/Daily) ( 14) ( 22) ( 36) ( 16) ( 12) ( 28) ( 397) Subtotal 14 22 36 15 12 27 397
Phase 2: Dutch Bros Coffee
Shop
950
SF
58 58 116 43 43 86 1,404
Internal Capture1 ( 28) ( 8) ( 36) ( 12) ( 18) ( 30) ( 246) Pass-By (75% AM/PM/Daily)2 ( 23) ( 38) ( 61) ( 23) ( 19) ( 42) ( 685) Subtotal 7 12 19 8 6 14 228
Net Difference
Approved – Proposed)
341
SF
0 11 11 6 0 6 ( 29)
Note:
1 Internal capture rates are consistent with the overall development trip generation estimates. 2 Pass- by trip rates are consistent with previous traffic studies for Dutch Bros in Lake Elsinore.

SOURCE: URBAN CROSSROADS (2022); KITTELSON & ASSOCIATES, INC (2025) APPENDIX APreliminary Site Plan
DUTCH
BROS
COFFEE980
SQ.

FT.
28282815GROCERY -
43,
050
SF15'
ROW15' SETBACKDUTCHBROSCOFFEE950
BDutch APPENDIX
Bros Historical Transaction Data

COverall APPENDIX
Development Trip Generation
Central & Cambern Retail Traffic Analysis
13782- 06 TA Report REV2
44 TABLE 4-1: PROJECT TRIP GENERATION SUMMARY
As shown in Table 4-1, the proposed Project is anticipated to generate a total of 4,818 trip-ends per day with 316 AM peak hour trips and 449 PM peak hour trips.

ITE Weekday
Land Use1 Code Units2 In Out Total In Out Total Daily
Supermarket 850 TSF 2.29 1.53 3.82 4.71 4.53 9.24 106.78 Fast-Food Restaurant with Drive-Through Window 934 TSF 20.50 19.69 40.19 16.99 15.68 32.67 470.95 Automated Car Wash3 948 TUN N/A N/A N/A 38.75 38.75 77.50 775.00 Super Convenience Market/ Gas Station 960 VFP 14.04 14.04 28.08 11.48 11.48 22.96 230.52 Land Use1 Quantity Units2 In Out Total In Out Total Daily Phase 1
Super Convenience Market/Gas Station 16 VFP 225 225 450 184 184 368 3,688 Internal Capture: - 8 - 29 - 37 - 19 - 15 - 34 - 342
Pass- By (76% AM/ PM/ Daily):- 149 - 149 - 298 - 125 - 125 - 250 - 2,804 Retail Subtotal: 68 47 115 40 44 84 542
Fast-Food Restaurant with Drive-Through Window 3.000 TSF 61 59 120 51 47 98 1,414 Internal Capture: 0 0 0 0 0 0 0
Pass-By (49% AM; 50% PM/Daily): - 30 - 30 - 60 - 24 - 24 - 48 - 708 Restaurant Subtotal: 31 29 60 27 23 50 706
Automated Car Wash Tunnel 1 TUN 0 0 0 39 39 78 776
Phase 1 Total: 99 76 175 106 106 212 2,024
Project Buildout
Supermarket 43.050 TSF 99 66 165 203 195 398 4,598
Internal Capture: - 6 - 21 - 27 - 14 - 11 - 24 - 284
Pass- By (36% PM/Daily): 0 0 0 - 68 - 68 - 136 - 1,554
Super Convenience Market/Gas Station 16 VFP 225 225 450 184 184 368 3,688 Internal Capture: - 5 - 17 - 22 - 11 - 8 - 20 - 198
Pass-By (76% AM/PM/Daily):- 158 - 158 - 316 - 131 - 131 - 262 - 2,804 Fast-Food Restaurant with Drive-Through Window 3.871 TSF 79 76 155 66 61 127 1,824 Internal Capture: - 38 - 11 - 49 - 19 - 25 - 44 - 632
Pass-By (49% AM; 50% PM/Daily): - 20 - 20 - 40 - 18 - 18 - 36 - 596 Automated Car Wash Tunnel 1 TUN 0 0 0 39 39 78 776
Project Buildout Subtotal: 176 140 316 231 218 449 4,818 1 Trip Generation Source: Institute of Transportation Engineers ( ITE), Trip Generation Manual, Tenth Edition ( 2017). 2 DU = Dwelling Units; TSF = thousand square feet; TUN = Tunnels VFP = Vehicle Fueling Position 3 Daily rate is not readily available in the ITE Trip Generation Manual, Tenth Edition ( 2017). As such, the daily rate is assumed to be 10 times the PM peak hour rate.

AM Peak Hour PM Peak Hour
AM Peak Hour PM Peak Hour
Kittelson & Associates, Inc.

TECHNICAL MEMORANDUM
November 7, 2024 Project# 31138
To: City of Lake Elsinore
130 S Main Street
Lake Elsinore, CA 92530
From: Kittelson & Associates, Inc
RE: Dutch Bros at Central Avenue and Cambern Avenue – Queuing Memorandum This technical memorandum evaluates on-site circulation, site access, and queuing scenarios for the proposed Dutch Bros coffee shop to be located at the southeast corner of Central Avenue and Cambern Avenue in Lake Elsinore, California (“project”).

PROJECT CONTEXT
The project site would consist of a 950-sf retail structure, 11 proposed vehicle parking stalls including one ADA stall and four EV capable parking stalls, and a vehicle drive-through served by a single service window. The drive-through has two lanes that converge at the service window and is designed to accommodate a queue of 16 vehicles at one time.

A more detailed site plan of the Dutch Bros development is provided in Appendix A.

SITE PERFORMANCE ANALYSES
The existing roadway conditions and proposed site plan were assessed to determine if on- site safety or operational improvements were necessary due to an increase in traffic from the project.

Site Access and On-Site Circulation
When reviewing the proposed site access and on-site circulation, the following details were noted:

Parking. Generally, parking would not be regularly needed by customers since it is primarily a drive - through operation. While the site has some designated spaces for the lot, shared parking is also provided in the commercial plaza where the project is to be located. The amount of parking within the commercial plaza is assumed to suffice for any walk-up customers and employees.

Sight Distance. Sight distance from the drive-through entrance and exit were assessed, and no anticipated issues were found. The site plan confirms that there would not be any landscaping or other installations obstructing sightlines. Visibility from where vehicles exit near the service window 750 The City Drive, Suite 410
Orange, CA 92868
P 714. 468.1997
November 7, 2024 Queuing Technical Memorandum Site Performance Analyses Kittelson & Associates, Inc. Page 2
area allows for adequate monitoring of approaching cyclists, pedestrians, or vehicles in the parking aisles. The site plan provides adequate throat depth to allow vehicles to enter the parking area and determine the appropriate drive through lane.

Driveway Impacts. The site plan depicts driveways east and west of the project site. Project-related traffic that enters through the east driveway can only queue up to two vehicles before affecting the ingress/egress operations of this driveway. However, based on existing land uses and its connection to the Interstate 15 freeway, majority of project traffic is expected to come from Central Avenue and thus utilize the driveway west of the project site. Therefore, minimal impacts to the driveway are anticipated. However, it is still recommended for Dutch Bros staff to monitor the situation and guide vehicles to the appropriate driveway on an as-needed basis.

Adequacy of Pedestrian Facilities. Pedestrian access to the site would include sidewalks as proposed for the overall commercial plaza development, crosswalks and walkways along the project frontage that would facilitate pedestrian access from Cambern Avenue to the project site.

Bicycle Accessibility. There are no existing bicycle facilities on Cambern Avenue or Central Avenue.

Therefore, bicyclists would need to use vehicle travel lanes or sidewalks along Cambern Avenue to access the project site.

Accessibility from Adjacent Transit Stops. The nearest bus stop to the project is approximately 600 feet from the project along Central Avenue and serves Route 9 of the Riverside Transit Agency. Riders who get off at this stop would not need to cross any intersection and can access the project site using sidewalks. The next closest bus stop is approximately 700 feet from the project site along Central Avenue and serves Route 9 as well. Riders would need to cross a signalized intersection Central Avenue / Cambern Avenue intersection) to access the project site. Sidewalks will be provided from the bus stops to the project site.

Site Queuing, Safety, and Operations
Queuing at coffee shop drive- throughs often are where potential impacts to the roadway network occur.

To estimate the potential queueing conditions and how often it may affect public right -of-way, an M/ M/ 1 queuing model was used. This model assumes that customer arrivals and service times are random and requires the average arrival and service rates as inputs. Using historical transaction data from similar Dutch Bros stores, 68 and 80 vehicles per hour were used as conservative average arrival and service rates, respectively, for the proposed store.

From the model, it was determined that there is approximately a 5% probability that the number of vehicles waiting to be served will be longer than 18 vehicles, as shown in Figure 1. The drive- through can accommodate up to 16 vehicles and the additional two vehicles would spill into the adjacent parking aisle.

The Dutch Bros parcel is at the corner of of the commercial center’ s parking lot and the parking aisle that would be blocked by queues is not expected to be parking that is high demand from other uses within the center. Therefore, it is expected that queues would not have much affect on the flow or access to parking, even during the highest 5% of demand times. However, it is recommended for Dutch Bros to implement the following strategies upon reaching 75% of drive-through capacity (approximately 12 vehicles) to manage queues as efficiently and effectively as possible:

Dutch Bros staff takes orders and payments from and makes deliveries to the queued drive -through lanes to minimize the wait time at the service window. The site plan includes a queue exit lane November 7, 2024 Queuing Technical Memorandum Site Performance Analyses Kittelson & Associates, Inc. Page 3
adjacent to the pick-up window. This is an important queue length management feature because it allows vehicles that receive their fulfilled orders prior to reaching the pick-up window to exit out of the queue early, thereby reducing the overall length of the queue.

Dutch Bros staff can place signage to guide non-Dutch Bros customer vehicles away from the drivethrough entrance and act as temporary traffic control personnel who can effectively manage queues and prevent blockage situations.

Parking on site can be used as waiting areas for vehicles that make large orders. This is an important operations factor that provides the ability to remove vehicles with long order fulfillment times from the queue and provide a significant positive effect on the overall queue length.

It should be noted that accurately estimating total latent demand is difficult due to various factors. These factors include the location, type, convenience, and pricing of competing opportunities in the area, as well as the traffic volume on adjacent streets and the socioeconomic characteristics of the nearby population and employment areas.

Queuing data at Apple Valley, Indio, and La Quinta Dutch Bros locations from a separate traffic study is provided in Appendix B to corroborate the queuing model results.

November 7, 2024 Queuing Technical Memorandum Site Performance Analyses Kittelson & Associates, Inc. Page 4
Figure 1: 95th Percentile Queuing Scenario
SOURCE: KITTELSON AND ASSOCIATES ( 2024); SITE PLAN IS DRAWN BY BARGHAUSEN CONSULTING ENGINEERS ( 2024) APPENDIX ASitePlan
DUTCH
BROS
COFFEE980
SQ.

FT.
28282815GROCERY -
43,
050
SF15'
ROW15' SETBACKDUTCHBROSCOFFEE950
APPENDIX BQueuing Data
LOCATION: Dutch Bros, 21690 Bear Valley Rd DAY: Tuesday CITY: Apple Valley DATE: 2/ 1/ 2022
TIME
PickUp Window
To Order Board
Order Board
to DT Entrance
DT Entrance
into Street
TOTAL
5: 00 1 0 0 1
5:05 2 0 0 2
5: 10 0 0 0 0
5:15 0 0 0 0
5: 20 0 0 0 0
5:25 1 0 0 1
5: 30 3 1 0 4
5:35 4 1 0 5
5: 40 3 0 0 3
5:45 2 0 0 2
5: 50 3 0 0 3
5:55 2 0 0 2
6: 00 1 0 0 1
6:05 1 0 0 1
6: 10 4 0 0 4
6:15 1 0 0 1
6: 20 1 1 0 2
6:25 3 1 0 4
6: 30 4 1 0 5
6:35 3 2 0 5
6: 40 4 3 0 7
6:45 4 3 0 7
6: 50 6 3 0 9
6:55 5 4 0 9
7: 00 5 2 0 7
7:05 6 5 0 11
7: 10 6 9 0 15
7:15 5 7 0 12
7: 20 5 9 0 14
7:25 4 7 0 11
7: 30 5 4 0 9
7:35 6 6 0 12
7: 40 6 8 0 14
7:45 6 4 0 10
7: 50 3 2 0 5
7:55 2 4 0 6
8: 00 6 9 0 15
8:05 5 9 0 14
8: 10 5 9 1 15
8:15 6 9 0 15
8: 20 6 6 0 12
8:25 6 5 0 11
8: 30 5 6 0 11
8:35 5 6 0 11
8: 40 5 3 0 8
8:45 5 7 0 12
8: 50 5 7 0 12
8:55 5 3 0 8
9: 00 5 1 0 6
9:05 3 1 0 4
9: 10 2 4 0 6
9:15 4 4 0 8
9: 20 5 6 0 11
9:25 4 5 0 9
9: 30 4 3 0 7
9:35 5 2 0 7
9: 40 4 5 0 9
9:45 5 5 0 10
9: 50 6 5 0 11
9:55 5 1 0 6
10: 00 3 1 0 4
10:05 3 2 0 5
10: 10 4 3 0 7
10:15 4 2 0 6
10: 20 3 2 0 5
10:25 4 4 0 8
10: 30 5 5 0 10
10:35 4 3 0 7
10: 40 1 2 0 3
10:45 3 2 0 5
10: 50 3 2 0 5
10:55 4 0 0 4
11: 00 2 1 0 3
11:05 2 2 0 4
11: 10 2 2 0 4
11:15 4 2 0 6
11: 20 3 1 0 4
11:25 3 0 0 3

DRIVE THRU SURVEY
Counts Unlimited, Inc.

PO Box 1178
Corona, CA 92878
951 268 6268
LOCATION: Dutch Bros, 21690 Bear Valley Rd DAY: Tuesday CITY: Apple Valley DATE: 2/ 1/ 2022
TIME
PickUp Window
To Order Board
Order Board
to DT Entrance
DT Entrance
into Street
TOTAL

DRIVE THRU SURVEY
11: 30 1 1 0 2
11:35 0 1 0 1
11: 40 0 5 0 5
11:45 4 3 0 7
11: 50 1 3 0 4
11:55 3 4 0 7
12: 00 3 1 0 4
12:05 3 0 0 3
12: 10 3 2 0 5
12:15 4 2 0 6
12: 20 3 2 0 5
12:25 4 0 0 4
12: 30 3 1 0 4
12:35 0 3 0 3
12: 40 2 2 0 4
12:45 3 0 0 3
12: 50 0 0 0 0
12:55 2 2 0 4
13: 00 3 1 0 4
13:05 3 1 0 4
13: 10 2 2 0 4
13:15 3 3 0 6
13: 20 4 0 0 4
13:25 5 4 0 9
13: 30 2 0 0 2
13:35 1 3 0 4
13: 40 4 4 0 8
13:45 5 5 0 10
13: 50 4 3 0 7
13:55 2 3 0 5
14: 00 4 3 0 7
14:05 3 2 0 5
14: 10 2 0 0 2
14:15 3 0 0 3
14: 20 4 2 0 6
14:25 5 3 0 8
14: 30 5 4 0 9
14:35 4 2 0 6
14: 40 0 7 0 7
14:45 4 4 0 8
14: 50 4 0 0 4
14:55 4 3 0 7
15: 00 4 7 0 11
15:05 5 5 0 10
15: 10 3 4 0 7
15:15 4 4 0 8
15: 20 2 3 0 5
15:25 4 3 0 7
15: 30 2 2 0 4
15:35 4 3 0 7
15: 40 1 1 0 2
15:45 1 0 0 1
15: 50 1 0 0 1
15:55 2 2 0 4
16: 00 3 7 0 10
16:05 2 3 0 5
16: 10 4 1 0 5
16:15 3 1 0 4
16: 20 0 2 0 2
16:25 2 3 0 5
16: 30 2 3 0 5
16:35 2 1 0 3
16: 40 2 0 0 2
16:45 1 2 0 3
16: 50 4 4 0 8
16:55 3 5 0 8
17: 00 3 4 0 7
17:05 5 0 0 5
17: 10 3 2 0 5
17:15 2 0 0 2
17: 20 0 0 0 0
17:25 3 0 0 3
17: 30 1 1 0 2
17:35 2 0 0 2
17: 40 0 0 0 0
17:45 2 0 0 2
17: 50 1 2 0 3
17:55 2 3 0 5
Counts Unlimited, Inc.

DRIVE THRU SURVEY
18: 00 3 4 0 7
18:05 3 3 0 6
18: 10 3 3 0 6
18:15 1 1 0 2
18: 20 1 0 0 1
18:25 1 1 0 2
18: 30 2 2 0 4
18:35 3 0 0 3
18: 40 2 0 0 2
18:45 1 1 0 2
18: 50 1 0 0 1
18:55 1 0 0 1
19: 00 1 0 0 1
19:05 3 1 0 4
19: 10 3 2 0 5
19:15 3 4 0 7
19: 20 1 4 0 5
19:25 2 2 0 4
19: 30 2 1 0 3
19:35 3 0 0 3
19: 40 2 1 0 3
19:45 2 0 0 2
19: 50 2 0 0 2
19:55 2 0 0 2
20: 00 2 1 0 3
20:05 1 0 0 1
20: 10 1 0 0 1
20:15 0 4 0 4
20: 20 3 0 0 3
20:25 2 0 0 2
20: 30 2 1 0 3
20:35 3 1 0 4
20: 40 4 1 0 5
20:45 4 0 0 4
20: 50 2 0 0 2
20:55 1 0 0 1
21: 00 0 0 0 0
21:05 1 1 0 2
21: 10 3 0 0 3
21:15 1 0 0 1
21: 20 0 0 0 0
21:25 1 0 0 1
21: 30 0 1 0 1
21:35 2 0 0 2
21: 40 1 0 0 1
21:45 1 1 0 2
21: 50 2 0 0 2
21:55 1 0 0 1
22: 00 0 0 0 0
22:05 0 0 0 0
22: 10 0 0 0 0
22:15 0 0 0 0
22: 20 0 0 0 0
22:25 0 0 0 0
22: 30 0 0 0 0
22:35 0 0 0 0
22: 40 0 0 0 0
22:45 0 0 0 0
22: 50 0 0 0 0
22:55 0 0 0 0
23: 00 0 0 0 0
Counts Unlimited, Inc.

PO Box 1178
Corona, CA 92878
951 268 6268
LOCATION: Dutch Bros, 21690 Bear Valley Rd DAY: Saturday CITY: Apple Valley DATE: 1/ 29/ 2022
TIME
PickUp Window
To Order Board
Order Board
to DT Entrance
DT Entrance
into Street
TOTAL
5: 00 1 0 0 1
5:05 1 0 0 1
5: 10 0 0 0 0
5:15 1 0 0 1
5: 20 0 0 0 0
5:25 1 0 0 1
5: 30 0 0 0 0
5:35 1 0 0 1
5: 40 3 0 0 3
5:45 2 0 0 2
5: 50 1 0 0 1
5:55 1 0 0 1
6: 00 1 0 0 1
6:05 0 0 0 0
6: 10 0 0 0 0
6:15 1 0 0 1
6: 20 2 1 0 3
6:25 2 0 0 2
6: 30 3 1 0 4
6:35 2 1 0 3
6: 40 2 1 0 3
6:45 3 1 0 4
6: 50 2 0 0 2
6:55 2 0 0 2
7: 00 2 1 0 3
7:05 2 1 0 3
7: 10 2 1 0 3
7:15 2 1 0 3
7: 20 2 1 0 3
7:25 2 0 0 2
7: 30 3 1 0 4
7:35 3 2 0 5
7: 40 4 6 0 10
7:45 4 6 0 10
7: 50 5 3 0 8
7:55 4 3 0 7
8: 00 5 6 0 11
8:05 4 4 0 8
8: 10 4 4 0 8
8:15 3 3 0 6
8: 20 2 3 0 5
8:25 3 1 0 4
8: 30 2 2 0 4
8:35 4 2 0 6
8: 40 4 4 0 8
8:45 5 3 0 8
8: 50 5 5 0 10
8:55 4 8 0 12
9: 00 6 7 0 13
9:05 5 5 0 10
9: 10 5 2 0 7
9:15 4 3 0 7
9: 20 4 4 0 8
9:25 4 4 0 8
9: 30 4 2 0 6
9:35 3 3 0 6
9: 40 3 3 0 6
9:45 3 3 0 6
9: 50 6 5 0 11
9:55 5 5 0 10
10: 00 5 8 0 13
10:05 5 6 0 11
10: 10 4 7 0 11
10:15 4 10 0 14
10: 20 4 7 0 11
10:25 6 8 0 14
10: 30 5 8 0 13
10:35 4 10 0 14
10: 40 6 6 0 12
10:45 5 10 2 17
10: 50 6 7 1 14
10:55 6 7 0 13
11: 00 6 6 0 12
11:05 5 7 0 12
11: 10 5 10 1 16
11:15 6 8 2 16
11: 20 6 9 4 19
11:25 6 8 5 19

DRIVE THRU SURVEY
Counts Unlimited, Inc.

DRIVE THRU SURVEY
11: 30 6 8 7 21
11:35 5 11 6 22
11: 40 6 8 3 17
11:45 5 7 0 12
11: 50 5 9 0 14
11:55 6 8 0 14
12: 00 6 9 1 16
12:05 5 9 0 14
12: 10 4 6 0 10
12:15 5 8 0 13
12: 20 5 10 1 16
12:25 6 8 3 17
12: 30 6 7 0 13
12:35 5 5 0 10
12: 40 6 7 0 13
12:45 6 8 4 18
12: 50 6 9 6 21
12:55 6 8 6 20
13: 00 6 9 3 18
13:05 6 10 5 21
13: 10 6 11 5 22
13:15 7 10 4 21
13: 20 5 9 4 18
13:25 6 8 1 15
13: 30 6 8 0 14
13:35 5 6 0 11
13: 40 5 2 0 7
13:45 6 2 0 8
13: 50 6 2 0 8
13:55 6 5 0 11
14: 00 4 3 0 7
14:05 4 3 0 7
14: 10 4 2 0 6
14:15 5 0 0 5
14: 20 5 1 0 6
14:25 6 0 0 6
14: 30 5 2 0 7
14:35 6 5 0 11
14: 40 6 3 0 9
14:45 6 4 0 10
14: 50 5 1 0 6
14:55 3 0 0 3
15: 00 5 1 0 6
15:05 6 3 0 9
15: 10 5 6 0 11
15:15 4 6 0 10
15: 20 5 6 0 11
15:25 6 8 0 14
15: 30 5 10 5 20
15:35 5 8 0 13
15: 40 6 8 3 17
15:45 6 6 0 12
15: 50 6 0 0 6
15:55 4 2 0 6
16: 00 3 0 0 3
16:05 2 0 0 2
16: 10 3 2 0 5
16:15 4 3 0 7
16: 20 3 2 0 5
16:25 0 2 0 2
16: 30 4 2 0 6
16:35 4 0 0 4
16: 40 4 0 0 4
16:45 1 3 0 4
16: 50 6 3 0 9
16:55 5 2 0 7
17: 00 5 5 0 10
17:05 5 5 0 10
17: 10 6 5 0 11
17:15 5 4 0 9
17: 20 4 3 0 7
17:25 5 1 0 6
17: 30 3 1 0 4
17:35 1 0 0 1
17: 40 1 0 0 1
17:45 0 0 0 0
17: 50 3 1 0 4
17:55 2 1 0 3
Counts Unlimited, Inc.

DRIVE THRU SURVEY
18: 00 2 5 0 7
18:05 4 2 0 6
18: 10 4 3 0 7
18:15 5 2 0 7
18: 20 4 2 0 6
18:25 2 2 0 4
18: 30 3 0 0 3
18:35 4 1 0 5
18: 40 4 1 0 5
18:45 4 0 0 4
18: 50 0 0 0 0
18:55 0 0 0 0
19: 00 0 4 0 4
19:05 2 1 0 3
19: 10 1 0 0 1
19:15 1 0 0 1
19: 20 0 4 0 4
19:25 3 1 0 4
19: 30 1 0 0 1
19:35 1 1 0 2
19: 40 0 0 0 0
19:45 2 1 0 3
19: 50 3 0 0 3
19:55 1 2 0 3
20: 00 2 2 0 4
20:05 3 1 0 4
20: 10 4 0 0 4
20:15 4 2 0 6
20: 20 4 1 0 5
20:25 4 0 0 4
20: 30 3 0 0 3
20:35 2 0 0 2
20: 40 0 0 0 0
20:45 0 1 0 1
20: 50 0 0 0 0
20:55 1 0 0 1
21: 00 1 1 0 2
21:05 3 2 0 5
21: 10 3 1 0 4
21:15 1 0 0 1
21: 20 3 0 0 3
21:25 2 0 0 2
21: 30 1 1 0 2
21:35 3 0 0 3
21: 40 2 0 0 2
21:45 0 0 0 0
21: 50 0 0 0 0
21:55 0 0 0 0
22: 00 1 0 0 1
22:05 1 0 0 1
22: 10 3 0 0 3
22:15 2 0 0 2
22: 20 2 0 0 2
22:25 1 0 0 1
22: 30 1 0 0 1
22:35 1 1 0 2
22: 40 2 1 0 3
22:45 2 0 0 2
22: 50 1 0 0 1
22:55 0 0 0 0
23: 00 0 0 0 0
Counts Unlimited, Inc.

PO Box 1178
Corona, CA 92878
951 268 6268
LOCATION: Dutch Bros, 44 175 Jefferson St DAY: Tuesday
CITY: La Quinta DATE: 2/ 1/ 2022
TIME
PickUp Window
To Order Board
Order Board
to DT Entrance
DT Entrance
into Street
TOTAL
5: 00 0 0 0 0
5:05 0 0 0 0
5: 10 0 0 0 0
5:15 0 0 0 0
5: 20 1 0 0 1
5:25 1 0 0 1
5: 30 2 0 0 2
5:35 2 0 0 2
5: 40 2 0 0 2
5:45 0 0 0 0
5: 50 2 0 0 2
5:55 3 0 0 3
6: 00 4 0 0 4
6:05 4 0 0 4
6: 10 1 1 0 2
6:15 0 2 0 2
6: 20 1 1 0 2
6:25 2 0 0 2
6: 30 2 0 0 2
6:35 1 1 0 2
6: 40 5 4 0 9
6:45 0 6 0 6
6: 50 3 3 0 6
6:55 0 4 0 4
7: 00 1 3 0 4
7:05 1 4 0 5
7: 10 0 5 0 5
7:15 2 5 0 7
7: 20 1 8 0 9
7:25 2 8 1 11
7: 30 1 8 0 9
7:35 1 9 0 10
7: 40 3 9 0 12
7:45 4 7 0 11
7: 50 2 4 0 6
7:55 4 7 2 13
8: 00 4 8 1 13
8:05 4 6 0 10
8: 10 0 9 0 9
8:15 1 8 0 9
8: 20 0 9 0 9
8:25 1 7 0 8
8: 30 4 5 0 9
8:35 3 2 0 5
8: 40 3 3 0 6
8:45 4 4 0 8
8: 50 1 3 0 4
8:55 2 3 0 5
9: 00 2 3 0 5
9:05 0 5 0 5
9: 10 3 5 0 8
9:15 3 7 0 10
9: 20 0 7 0 7
9:25 2 3 0 5
9: 30 2 1 0 3
9:35 3 4 0 7
9: 40 1 1 0 2
9:45 2 4 0 6
9: 50 3 5 0 8
9:55 3 5 0 8
10: 00 3 4 0 7
10:05 3 6 0 9
10: 10 2 4 0 6
10:15 1 0 0 1
10: 20 0 2 0 2
10:25 0 1 0 1
10: 30 1 0 0 1
10:35 1 6 0 7
10: 40 4 4 0 8
10:45 2 3 0 5
10: 50 1 1 0 2
10:55 2 4 0 6
11: 00 2 6 0 8
11:05 3 6 0 9
11: 10 3 10 1 14
11:15 2 3 0 5
11: 20 2 1 0 3
11:25 1 3 0 4

DRIVE THRU SURVEY
Counts Unlimited, Inc.

DRIVE THRU SURVEY
11: 30 0 3 0 3
11:35 0 1 0 1
11: 40 1 2 0 3
11:45 2 2 0 4
11: 50 0 3 0 3
11:55 2 2 0 4
12: 00 2 1 0 3
12:05 1 2 0 3
12: 10 1 2 0 3
12:15 0 6 0 6
12: 20 2 4 0 6
12:25 3 3 0 6
12: 30 1 0 0 1
12:35 1 3 0 4
12: 40 1 2 0 3
12:45 0 2 0 2
12: 50 2 3 0 5
12:55 0 1 0 1
13: 00 2 3 0 5
13:05 0 3 0 3
13: 10 1 3 0 4
13:15 2 3 0 5
13: 20 2 3 0 5
13:25 0 4 0 4
13: 30 3 6 0 9
13:35 2 4 0 6
13: 40 1 2 0 3
13:45 1 1 0 2
13: 50 2 1 0 3
13:55 1 0 0 1
14: 00 1 2 0 3
14:05 2 5 0 7
14: 10 3 5 0 8
14:15 4 6 0 10
14: 20 4 4 0 8
14:25 4 3 0 7
14: 30 1 4 0 5
14:35 2 3 0 5
14: 40 2 4 0 6
14:45 4 3 0 7
14: 50 2 5 0 7
14:55 1 1 0 2
15: 00 0 1 0 1
15:05 2 2 0 4
15: 10 0 5 0 5
15:15 0 3 0 3
15: 20 1 1 0 2
15:25 0 3 0 3
15: 30 2 2 0 4
15:35 3 3 0 6
15: 40 3 6 0 9
15:45 2 3 0 5
15: 50 1 4 0 5
15:55 1 2 0 3
16: 00 2 1 0 3
16:05 1 1 0 2
16: 10 2 1 0 3
16:15 1 4 0 5
16: 20 1 2 0 3
16:25 3 3 0 6
16: 30 0 4 0 4
16:35 4 3 0 7
16: 40 2 2 0 4
16:45 2 4 0 6
16: 50 1 3 0 4
16:55 2 2 0 4
17: 00 2 2 0 4
17:05 0 5 0 5
17: 10 1 1 0 2
17:15 1 0 0 1
17: 20 1 1 0 2
17:25 1 2 0 3
17: 30 1 3 0 4
17:35 2 1 0 3
17: 40 2 3 0 5
17:45 2 3 0 5
17: 50 3 2 0 5
17:55 3 2 0 5
Counts Unlimited, Inc.

DRIVE THRU SURVEY
18: 00 3 3 0 6
18:05 2 3 0 5
18: 10 1 3 0 4
18:15 2 2 0 4
18: 20 3 2 0 5
18:25 3 3 0 6
18: 30 1 2 0 3
18:35 2 3 0 5
18: 40 3 4 0 7
18:45 4 4 0 8
18: 50 3 3 0 6
18:55 2 1 0 3
19: 00 0 1 0 1
19:05 2 2 0 4
19: 10 2 0 0 2
19:15 1 1 0 2
19: 20 1 1 0 2
19:25 1 0 0 1
19: 30 2 2 0 4
19:35 2 0 0 2
19: 40 2 0 0 2
19:45 3 1 0 4
19: 50 3 2 0 5
19:55 4 2 0 6
20: 00 1 1 0 2
20:05 2 0 0 2
20: 10 1 1 0 2
20:15 1 3 0 4
20: 20 2 2 0 4
20:25 2 1 0 3
20: 30 1 0 0 1
20:35 0 0 0 0
20: 40 0 1 0 1
20:45 0 1 0 1
20: 50 1 0 0 1
20:55 1 0 0 1
21: 00 1 0 0 1
21:05 2 1 0 3
21: 10 2 1 0 3
21:15 2 2 0 4
21: 20 3 2 0 5
21:25 1 1 0 2
21: 30 0 1 0 1
21:35 0 0 0 0
21: 40 0 1 0 1
21:45 1 2 0 3
21: 50 2 0 0 2
21:55 2 0 0 2
22: 00 0 0 0 0
22:05 0 0 0 0
22: 10 0 0 0 0
22:15 0 0 0 0
22: 20 0 0 0 0
22:25 0 0 0 0
22: 30 0 0 0 0
22:35 0 0 0 0
22: 40 0 0 0 0
22:45 0 0 0 0
22: 50 0 0 0 0
22:55 0 0 0 0
23: 00 0 0 0 0
Counts Unlimited, Inc.

PO Box 1178
Corona, CA 92878
951 268 6268
LOCATION: Dutch Bros, 44 175 Jefferson St DAY: Saturday CITY: La Quinta DATE: 1/ 29/ 2022
TIME
PickUp Window
To Order Board
Order Board
to DT Entrance
DT Entrance
into Street
TOTAL
5: 00 0 0 0 0
5:05 1 0 0 1
5: 10 1 0 0 1
5:15 0 0 0 0
5: 20 0 0 0 0
5:25 1 0 0 1
5: 30 1 0 0 1
5:35 2 1 0 3
5: 40 1 0 0 1
5:45 1 0 0 1
5: 50 2 0 0 2
5:55 1 0 0 1
6: 00 0 0 0 0
6:05 1 0 0 1
6: 10 0 0 0 0
6:15 0 0 0 0
6: 20 2 1 0 3
6:25 1 2 0 3
6: 30 2 0 0 2
6:35 1 1 0 2
6: 40 1 0 0 1
6:45 1 1 0 2
6: 50 1 0 0 1
6:55 1 3 0 4
7: 00 2 1 0 3
7:05 1 1 0 2
7: 10 0 1 0 1
7:15 2 3 0 5
7: 20 2 2 0 4
7:25 1 0 0 1
7: 30 2 3 0 5
7:35 4 6 0 10
7: 40 3 9 0 12
7:45 1 10 0 11
7: 50 2 7 0 9
7:55 3 7 0 10
8: 00 0 5 0 5
8:05 2 2 0 4
8: 10 2 3 0 5
8:15 3 3 0 6
8: 20 3 5 0 8
8:25 3 3 0 6
8: 30 4 5 0 9
8:35 3 4 0 7
8: 40 4 7 0 11
8:45 4 8 0 12
8: 50 4 9 2 15
8:55 5 7 0 12
9: 00 4 8 0 12
9:05 3 8 0 11
9: 10 3 4 0 7
9:15 4 7 1 12
9: 20 3 9 2 14
9:25 4 7 0 11
9: 30 4 4 0 8
9:35 3 4 0 7
9: 40 2 1 0 3
9:45 3 4 0 7
9: 50 3 8 2 13
9:55 3 7 6 16
10: 00 4 8 7 19
10:05 4 8 8 20
10: 10 3 9 5 17
10:15 4 8 3 15
10: 20 3 10 7 20
10:25 3 7 3 13
10: 30 4 8 0 12
10:35 3 8 0 11
10: 40 5 8 0 13
10:45 3 8 0 11
10: 50 2 9 2 13
10:55 3 7 3 13
11: 00 3 8 0 11
11:05 3 8 2 13
11: 10 3 8 7 18
11:15 3 8 6 17
11: 20 3 9 6 18
11:25 3 10 6 19

DRIVE THRU SURVEY
Counts Unlimited, Inc.

DRIVE THRU SURVEY
11: 30 3 8 5 16
11:35 4 10 0 14
11: 40 3 7 0 10
11:45 2 4 0 6
11: 50 3 4 0 7
11:55 1 1 0 2
12: 00 3 3 0 6
12:05 2 6 0 8
12: 10 3 5 0 8
12:15 4 4 0 8
12: 20 3 6 0 9
12:25 2 4 0 6
12: 30 3 5 0 8
12:35 3 5 0 8
12: 40 0 8 0 8
12:45 3 5 0 8
12: 50 3 4 0 7
12:55 0 0 0 0
13: 00 1 4 0 5
13:05 4 6 0 10
13: 10 3 6 0 9
13:15 3 5 0 8
13: 20 2 2 0 4
13:25 2 4 0 6
13: 30 3 4 0 7
13:35 3 8 0 11
13: 40 3 5 0 8
13:45 2 2 0 4
13: 50 2 1 0 3
13:55 2 4 0 6
14: 00 3 5 0 8
14:05 3 4 0 7
14: 10 3 5 0 8
14:15 3 7 1 11
14: 20 3 6 0 9
14:25 3 9 1 13
14: 30 3 9 3 15
14:35 3 8 4 15
14: 40 3 10 0 13
14:45 3 9 0 12
14: 50 3 10 6 19
14:55 3 9 8 20
15: 00 3 7 1 11
15:05 3 9 1 13
15: 10 3 8 2 13
15:15 4 8 5 17
15: 20 3 9 2 14
15:25 3 9 2 14
15: 30 3 9 0 12
15:35 4 5 0 9
15: 40 3 8 0 11
15:45 3 6 0 9
15: 50 3 6 0 9
15:55 4 7 0 11
16: 00 2 7 0 9
16:05 1 2 0 3
16: 10 1 2 0 3
16:15 2 2 0 4
16: 20 3 3 0 6
16:25 1 5 0 6
16: 30 3 2 3 8
16:35 3 7 0 10
16: 40 3 7 0 10
16:45 3 6 0 9
16: 50 4 9 0 13
16:55 3 3 0 6
17: 00 2 0 0 2
17:05 1 3 0 4
17: 10 2 2 0 4
17:15 3 5 0 8
17: 20 3 2 0 5
17:25 1 1 0 2
17: 30 1 1 0 2
17:35 1 2 0 3
17: 40 2 4 0 6
17:45 1 5 0 6
17: 50 2 2 0 4
17:55 1 1 0 2
Counts Unlimited, Inc.

DRIVE THRU SURVEY
18: 00 0 2 0 2
18:05 1 1 0 2
18: 10 1 1 0 2
18:15 2 3 0 5
18: 20 3 3 0 6
18:25 1 2 0 3
18: 30 1 0 0 1
18:35 1 0 0 1
18: 40 1 2 0 3
18:45 1 2 0 3
18: 50 1 2 0 3
18:55 1 1 0 2
19: 00 1 3 0 4
19:05 1 4 0 5
19: 10 1 3 0 4
19:15 2 3 0 5
19: 20 2 2 0 4
19:25 3 3 0 6
19: 30 3 4 0 7
19:35 1 2 0 3
19: 40 2 0 0 2
19:45 2 0 0 2
19: 50 2 0 0 2
19:55 0 0 0 0
20: 00 1 2 0 3
20:05 1 1 0 2
20: 10 1 0 0 1
20:15 1 0 0 1
20: 20 2 5 0 7
20:25 1 3 0 4
20: 30 0 1 0 1
20:35 1 0 0 1
20: 40 1 0 0 1
20:45 1 2 0 3
20: 50 2 1 0 3
20:55 1 2 0 3
21: 00 1 3 0 4
21:05 1 2 0 3
21: 10 1 0 0 1
21:15 2 0 0 2
21: 20 2 3 0 5
21:25 2 0 0 2
21: 30 2 0 0 2
21:35 2 2 0 4
21: 40 1 3 0 4
21:45 2 4 0 6
21: 50 1 3 0 4
21:55 0 2 0 2
22: 00 1 0 0 1
22:05 1 0 0 1
22: 10 1 1 0 2
22:15 2 2 0 4
22: 20 2 4 0 6
22:25 3 6 0 9
22: 30 2 5 0 7
22:35 2 1 0 3
22: 40 0 0 0 0
22:45 0 0 0 0
22: 50 0 0 0 0
22:55 0 0 0 0
23: 00 0 0 0 0
Counts Unlimited, Inc.

PO Box 1178
Corona, CA 92878
951 268 6268
LOCATION: Dutch Bros, 81 776 CA 111 DAY: Tuesday
CITY: Indio DATE: 2/ 1/ 2022
TIME
PickUp Window
To Order Board
Order Board
to DT Entrance
DT Entrance
into Street
TOTAL
5: 00 0 0 0 0
5:05 0 0 0 0
5: 10 0 0 0 0
5:15 1 0 0 1
5: 20 0 0 0 0
5:25 0 0 0 0
5: 30 3 1 0 4
5:35 1 1 0 2
5: 40 1 0 0 1
5:45 1 0 0 1
5: 50 2 0 0 2
5:55 2 0 0 2
6: 00 1 0 0 1
6:05 2 0 0 2
6: 10 3 0 0 3
6:15 2 1 0 3
6: 20 3 1 0 4
6:25 3 0 0 3
6: 30 3 2 0 5
6:35 2 2 0 4
6: 40 1 6 0 7
6:45 3 5 0 8
6: 50 1 3 0 4
6:55 1 4 0 5
7: 00 2 2 0 4
7:05 2 1 0 3
7: 10 1 2 0 3
7:15 2 5 0 7
7: 20 1 5 0 6
7:25 1 7 0 8
7: 30 2 6 0 8
7:35 3 7 1 11
7: 40 3 10 2 15
7:45 3 8 4 15
7: 50 3 11 1 15
7:55 2 9 0 11
8: 00 3 8 0 11
8:05 2 6 0 8
8: 10 3 2 0 5
8:15 3 8 3 14
8: 20 3 8 0 11
8:25 3 10 1 14
8: 30 3 8 0 11
8:35 3 9 0 12
8: 40 3 7 0 10
8:45 3 4 0 7
8: 50 2 3 0 5
8:55 2 2 0 4
9: 00 3 1 0 4
9:05 2 7 0 9
9: 10 3 7 0 10
9:15 3 7 0 10
9: 20 1 1 0 2
9:25 2 1 0 3
9: 30 2 0 0 2
9:35 3 2 0 5
9: 40 3 2 0 5
9:45 1 1 0 2
9: 50 1 2 0 3
9:55 2 0 0 2
10: 00 1 2 0 3
10:05 1 1 0 2
10: 10 1 0 0 1
10:15 2 1 0 3
10: 20 3 2 0 5
10:25 3 3 0 6
10: 30 2 2 0 4
10:35 1 1 0 2
10: 40 2 0 0 2
10:45 3 1 0 4
10: 50 2 1 0 3
10:55 3 4 0 7
11: 00 3 3 0 6
11:05 3 4 0 7
11: 10 3 7 0 10
11:15 2 4 0 6
11: 20 3 1 0 4
11:25 3 1 0 4

DRIVE THRU SURVEY
Counts Unlimited, Inc.

DRIVE THRU SURVEY
11: 30 2 2 0 4
11:35 3 3 0 6
11: 40 3 2 0 5
11:45 1 3 0 4
11: 50 3 3 0 6
11:55 0 1 0 1
12: 00 1 0 0 1
12:05 2 1 0 3
12: 10 3 2 0 5
12:15 2 2 0 4
12: 20 0 0 0 0
12:25 0 0 0 0
12: 30 3 2 0 5
12:35 1 1 0 2
12: 40 1 1 0 2
12:45 1 2 0 3
12: 50 2 2 0 4
12:55 2 4 0 6
13: 00 1 2 0 3
13:05 1 1 0 2
13: 10 2 2 0 4
13:15 2 1 0 3
13: 20 0 1 0 1
13:25 3 2 0 5
13: 30 1 2 0 3
13:35 1 2 0 3
13: 40 2 1 0 3
13:45 1 2 0 3
13: 50 2 2 0 4
13:55 0 0 0 0
14: 00 1 1 0 2
14:05 1 0 0 1
14: 10 1 0 0 1
14:15 0 0 0 0
14: 20 1 0 0 1
14:25 1 0 0 1
14: 30 2 0 0 2
14:35 0 0 0 0
14: 40 0 0 0 0
14:45 2 1 0 3
14: 50 1 0 0 1
14:55 1 0 0 1
15: 00 2 0 0 2
15:05 1 2 0 3
15: 10 1 0 0 1
15:15 0 0 0 0
15: 20 0 0 0 0
15:25 2 0 0 2
15: 30 1 0 0 1
15:35 0 1 0 1
15: 40 0 3 0 3
15:45 1 2 0 3
15: 50 1 0 0 1
15:55 0 0 0 0
16: 00 1 3 0 4
16:05 3 3 0 6
16: 10 2 0 0 2
16:15 0 0 0 0
16: 20 3 0 0 3
16:25 1 1 0 2
16: 30 2 1 0 3
16:35 0 0 0 0
16: 40 2 0 0 2
16:45 3 0 0 3
16: 50 1 1 0 2
16:55 1 0 0 1
17: 00 2 3 0 5
17:05 2 2 0 4
17: 10 1 4 0 5
17:15 2 0 0 2
17: 20 1 1 0 2
17:25 3 2 0 5
17: 30 2 1 0 3
17:35 0 2 0 2
17: 40 2 0 0 2
17:45 3 0 0 3
17: 50 3 2 0 5
17:55 3 2 0 5
Counts Unlimited, Inc.

DRIVE THRU SURVEY
18: 00 2 1 0 3
18:05 2 1 0 3
18: 10 1 0 0 1
18:15 2 0 0 2
18: 20 0 0 0 0
18:25 2 0 0 2
18: 30 3 1 0 4
18:35 3 2 0 5
18: 40 2 0 0 2
18:45 1 0 0 1
18: 50 2 0 0 2
18:55 1 0 0 1
19: 00 1 0 0 1
19:05 3 0 0 3
19: 10 2 0 0 2
19:15 2 0 0 2
19: 20 1 0 0 1
19:25 2 1 0 3
19: 30 2 2 0 4
19:35 2 2 0 4
19: 40 1 0 0 1
19:45 1 0 0 1
19: 50 1 0 0 1
19:55 1 4 0 5
20: 00 2 2 0 4
20:05 2 2 0 4
20: 10 3 1 0 4
20:15 2 0 0 2
20: 20 2 0 0 2
20:25 2 1 0 3
20: 30 3 2 0 5
20:35 2 3 0 5
20: 40 1 1 0 2
20:45 2 0 0 2
20: 50 3 0 0 3
20:55 1 0 0 1
21: 00 0 0 0 0
21:05 1 0 0 1
21: 10 1 0 0 1
21:15 1 0 0 1
21: 20 1 0 0 1
21:25 3 1 0 4
21: 30 2 2 0 4
21:35 0 1 0 1
21: 40 2 0 0 2
21:45 2 0 0 2
21: 50 2 3 0 5
21:55 2 2 0 4
22: 00 2 2 0 4
22:05 1 1 0 2
22: 10 0 0 0 0
22:15 0 0 0 0
22: 20 2 0 0 2
22:25 2 1 0 3
22: 30 2 2 0 4
22:35 2 0 0 2
22: 40 2 0 0 2
22:45 1 1 0 2
22: 50 3 0 0 3
22:55 1 0 0 1
23: 00 0 0 0 0
Counts Unlimited, Inc.

PO Box 1178
Corona, CA 92878
951 268 6268
LOCATION: Dutch Bros, 81 776 CA 111 DAY: Saturday
CITY: Indio DATE: 1/ 29/ 2022
TIME
PickUp Window
To Order Board
Order Board
to DT Entrance
DT Entrance
into Street
TOTAL
5: 00 0 0 0 0
5:05 0 0 0 0
5: 10 1 0 0 1
5:15 2 0 0 2
5: 20 1 0 0 1
5:25 2 0 0 2
5: 30 1 0 0 1
5:35 1 0 0 1
5: 40 0 0 0 0
5:45 0 0 0 0
5: 50 0 0 0 0
5:55 1 0 0 1
6: 00 1 0 0 1
6:05 1 0 0 1
6: 10 0 0 0 0
6:15 1 0 0 1
6: 20 2 1 0 3
6:25 2 2 0 4
6: 30 2 2 0 4
6:35 2 0 0 2
6: 40 2 2 0 4
6:45 2 2 0 4
6: 50 3 1 0 4
6:55 2 2 0 4
7: 00 2 1 0 3
7:05 2 0 0 2
7: 10 2 1 0 3
7:15 2 0 0 2
7: 20 0 0 0 0
7:25 1 0 0 1
7: 30 3 1 4
7:35 3 3 0 6
7: 40 3 6 0 9
7:45 3 7 0 10
7: 50 2 9 0 11
7:55 3 8 0 11
8: 00 2 8 0 10
8:05 2 7 0 9
8: 10 2 4 0 6
8:15 2 3 0 5
8: 20 2 0 0 2
8:25 2 0 0 2
8: 30 1 0 0 1
8:35 2 0 0 2
8: 40 2 0 0 2
8:45 2 3 0 5
8: 50 2 2 0 4
8:55 2 6 0 8
9: 00 1 8 0 9
9:05 3 8 0 11
9: 10 2 6 0 8
9:15 3 8 0 11
9: 20 3 7 0 10
9:25 3 7 0 10
9: 30 3 7 0 10
9:35 2 5 0 7
9: 40 2 4 0 6
9:45 2 1 0 3
9: 50 1 2 0 3
9:55 3 3 0 6
10: 00 2 4 0 6
10:05 3 4 0 7
10: 10 3 4 0 7
10:15 2 5 0 7
10: 20 2 4 0 6
10:25 0 4 0 4
10: 30 2 7 0 9
10:35 3 2 0 5
10: 40 2 3 0 5
10:45 2 4 0 6
10: 50 3 4 0 7
10:55 3 2 0 5
11: 00 2 2 0 4
11:05 2 3 0 5
11: 10 3 4 0 7
11:15 3 2 0 5
11: 20 3 1 0 4
11:25 2 0 0 2

DRIVE THRU SURVEY
Counts Unlimited, Inc.

DRIVE THRU SURVEY
11: 30 3 4 0 7
11:35 3 11 0 14
11: 40 2 12 0 14
11:45 1 10 0 11
11: 50 1 6 0 7
11:55 2 2 0 4
12: 00 1 2 0 3
12:05 2 4 0 6
12: 10 2 4 0 6
12:15 3 2 0 5
12: 20 2 3 0 5
12:25 3 7 0 10
12: 30 2 8 0 10
12:35 2 6 0 8
12: 40 3 5 0 8
12:45 1 2 0 3
12: 50 2 6 0 8
12:55 3 6 0 9
13: 00 1 2 0 3
13:05 2 2 0 4
13: 10 1 2 0 3
13:15 2 0 0 2
13: 20 1 0 0 1
13:25 3 0 0 3
13: 30 2 3 0 5
13:35 3 1 0 4
13: 40 3 1 0 4
13:45 3 0 0 3
13: 50 1 0 0 1
13:55 2 4 0 6
14: 00 1 2 0 3
14:05 3 5 0 8
14: 10 3 5 0 8
14:15 3 4 0 7
14: 20 3 3 0 6
14:25 3 3 0 6
14: 30 3 2 0 5
14:35 3 3 0 6
14: 40 3 0 0 3
14:45 2 2 0 4
14: 50 3 4 0 7
14:55 3 6 0 9
15: 00 3 5 0 8
15:05 3 5 0 8
15: 10 3 1 0 4
15:15 1 1 0 2
15: 20 2 0 0 2
15:25 1 2 0 3
15: 30 0 0 0 0
15:35 2 0 0 2
15: 40 2 1 0 3
15:45 0 0 0 0
15: 50 0 0 0 0
15:55 2 3 0 5
16: 00 3 2 0 5
16:05 1 3 0 4
16: 10 1 2 0 3
16:15 3 0 0 3
16: 20 2 2 0 4
16:25 2 1 0 3
16: 30 1 1 0 2
16:35 0 0 0 0
16: 40 1 1 0 2
16:45 2 1 0 3
16: 50 0 0 0 0
16:55 2 1 0 3
17: 00 1 0 0 1
17:05 0 0 0 0
17: 10 1 2 0 3
17:15 2 2 0 4
17: 20 1 2 0 3
17:25 0 1 0 1
17: 30 1 0 0 1
17:35 0 0 0 0
17: 40 2 4 0 6
17:45 3 4 0 7
17: 50 2 2 0 4
17:55 1 1 0 2
Counts Unlimited, Inc.

DRIVE THRU SURVEY
18: 00 0 0 0 0
18:05 2 1 0 3
18: 10 1 4 0 5
18:15 2 6 0 8
18: 20 2 2 0 4
18:25 1 0 0 1
18: 30 3 0 0 3
18:35 3 0 0 3
18: 40 2 2 0 4
18:45 3 0 0 3
18: 50 1 0 0 1
18:55 2 1 0 3
19: 00 3 2 0 5
19:05 3 2 0 5
19: 10 3 3 0 6
19:15 2 0 0 2
19: 20 2 2 0 4
19:25 2 1 0 3
19: 30 0 0 0 0
19:35 2 1 0 3
19: 40 2 1 0 3
19:45 2 1 0 3
19: 50 1 0 0 1
19:55 1 3 0 4
20: 00 2 2 0 4
20:05 2 1 0 3
20: 10 1 0 0 1
20:15 0 0 0 0
20: 20 2 1 0 3
20:25 3 2 0 5
20: 30 2 3 0 5
20:35 3 4 0 7
20: 40 2 6 0 8
20:45 3 5 0 8
20: 50 2 7 0 9
20:55 3 5 0 8
21: 00 3 3 0 6
21:05 3 2 0 5
21: 10 2 2 0 4
21:15 1 1 0 2
21: 20 2 1 0 3
21:25 1 1 0 2
21: 30 0 1 0 1
21:35 2 0 0 2
21: 40 0 0 0 0
21:45 2 1 0 3
21: 50 1 2 0 3
21:55 1 0 0 1
22: 00 3 1 0 4
22:05 2 2 0 4
22: 10 3 2 0 5
22:15 2 2 0 4
22: 20 2 1 0 3
22:25 2 2 0 4
22: 30 2 2 0 4
22:35 2 0 0 2
22: 40 3 4 0 7
22:45 2 2 0 4
22: 50 2 1 0 3
22:55 2 0 0 2
23: 00 0 0 0 0
Counts Unlimited, Inc.

PO Box 1178
Corona, CA 92878
951 268 6268
Traffic Management Plan and Site
Summary
Property Management Team
CA5803 - Lake Elsinore
SEC Central Ave & Cambern Ave
WEST
Operator: TBD
Coach: TBD
Construction Manager: John Caglia
CRED Coordinator: Christina Bennett
Regional Activation Coach: TBD
Timing Standards
45 seconds per car (at window). Speed timings conducted weekly in addition to a quarterly company wide evaluation.

Speed, Quality, Service
Escape Lane
An escape lane permits customers to leave the line as soon as their drinks are delivered by a drink runner.

Peak Hours
DB will staff an additional traffic controller
during peak hours as needed.

Off-Site Operations
DB always evaluates the need of off-duty police officer support during our grand opening period.

Off duty police officers provide off-site support during business hours as determined necessary by DB leadership. Their job is to safely direct customer vehicles to and from a location. Prevent vehicles from blocking critical drives or otherwise restricting traffic flow (off-site).

Staffing Model
Schedules are written a minimum of 1-2 weeks in advance in accordance with state and local guidelines) based on gross sales, trends, local events, and weather.

Speed, Quality, Service
Speed, Quality, Service
Line Buster (LB)
Job Duty: Increase speed of the customers experience
by taking orders while ensuring 2’ gap between cars. Ensuring when the line pulls forward the customers moves forward.

Drink Runner (DR)
Job Duty: Deliver completed drinks to the customer in
line before reaching the window. Ensuring escape lane is used to minimize service time.

Outside Traffic Management
Dutch Bros Traffic Controller ( DBTC)
Job Duty: Direct traffic in and out of location. Ensuring vehicles from blocking critical drives or otherwise restricting traffic flow (on-site).

Training and FAQ’s
Full Shop Meetings:

Monthly meetings in which all shop personnel are required to attend. Discuss traffic plans and new commitments in detail.

Pre-Shift Huddles:

Before each shift (morning, noon, night) the crew goes over updates, important communication, issues, and ensures
strategy is set for the shift
Promotional Days / Major Holidays / Sticker Days:

Dutch will determine if needed and hire a Third-Party Traffic Control Company to come in when the Stacking could possibly be an issue.

Evolving Traffic Plan:

The Grand Opening plan will be utilized whenever necessary to mitigate traffic congestion that may occur from our new shop opening. We reserve the right to adjust the plan as conditions dictate, and expect that after the initial community response, our traffic patterns will settle to a predictable level within the first 90 days of operation.

Directional Signage Examples
Grand Opening Staffing Plan
Standard Operations Staffing Plan
Grand Opening Signage Plan
Standard Operations Signage Plan

NOTICE OF PUBLIC HEARING
NOTICE IS HEREBY GIVEN that the Planning Commission of the City of Lake Elsinore, California, will hold a Public Hearing on June 17, 2025, at the Lake Elsinore Cultural Center, 183 North Main Street, Lake Elsinore, California, 92530, at 6:00 p.m., or as soon thereafter as the matter may be heard, to consider the following:

Planning Application No. 2021-34 (Evergreen – Dutch Bros): The proposed projectis arequest by Brianna Uy, Barghausen Consulting Engineers, LLC, requesting approval of Commercial Design Review (CDR No. 2024-05) and Conditional Use Permit No. (CUP No. 2024-07) to develop and operate a 987 sq. ft. drive-through Dutch Bros coffee shop and a modification to Conditional Use Permit No. 2021-12 to allow the expanded drive-through operation. The project site is located south of Central Avenue/State Route 74 (SR-74) and east of Interstate 15 (I-15; APNs: 377-020- 014, 016, - 017, 018, and 019).

Pursuant to CEQA Guidelines Section 15162, no new environmental documentation is necessary because all potentially significant effects have been adequately analyzed in an earlier Addendum Mitigated Negative Declaration (MND) (SCH# 2022090133) and none of the conditions described in Section 15162 exist. MND (SCH# 2022090133) was adopted on April 25, 2023. No substantial changes that require major revisions to the MND exist and no new information of substantial importance that require revisions to the earlier MND exist.

ALL INTERESTED PERSONS are invited to submit written information, express opinions or otherwise submit written evidence by email to jmatie@Lake- Elsinore.org.

If you wish to legally challenge any action taken by the City on the above matter, you may be limited to raising only those issues you or someone else at the Public Hearing described in this notice, or in written correspondence delivered to the City prior to or at the Public Hearing. If you require accommodation to participate in a Public Hearing, please contact the Administrative Secretary at (951) 674-3124 ext. 297. All Agenda materials are available for review on the City’s website at www.lake-elsinore.org the Friday before the Public Hearing.

FURTHER INFORMATION on this item may be obtained by contacting Carlos Serna, Associate Planner in the Planning Division at cserna@lake- elsinore.org or (951) 824-7415.

Damaris Abraham,
Community Development Director
PC NOPH PA 2021- 34 (Evergreen - Dutch Bros) - Page 1 of 1 The Press-Enterprise
3512 14 Street
Riverside, California 92501
951) 368-9229
City of Lake Elsinore
130 South Main Street
Lake Elsinore, California 92530
Publication: The Press-Enterprise

PROOF OF PUBLICATION OF
Ad Desc: 0011739034
FILE NO. 0011739034

PROOF OF PUBLICATION
I am a citizen of the United States. I
am over the age of eighteen years and
not party to or interested in the aboveentitled matter. I am an authorized representative of THE PRESSENTERPRISE, a newspaper of general circulation, printed and published daily
in the County of Riverside, and which
newspaper has been adjudicated a
newspaper of general circulation by the
Superior Court of the County of
Riverside, State of California, under
date of April 25, 1952, Case Number
54446, under date of March 29, 1957,
Case Number 65673, under date of
August 25, 1995, Case Number
267864, and under date of September
16, 2013, Case Number RIC 1309013;
that the notice, of which the annexed is
a printed copy, has been published in
said newspaper in accordance with the
instructions of the person( s) requesting
publication, and not in any supplement
thereof on the following dates, to wit:
06/06/2025
I certify ( or declare) under the penalty
of perjury that the foregoing is true and
correct.

Date: June 6, 2025.

At: Riverside, California
Signature

10) Change Order No.1 with Elsinore Valley Municipal Water District to Provide Construction Inspection Services for the Camino Del Norte Sewer Extension Project.

EVMWD W.O. 2025-00164-INS
Approve and authorize the City Manager to execute Change Order No. 1 with Elsinore Valley Municipal Water District for $76,240.00 to provide Inspection Construction Services for the Camino Del Norte Sewer Extension Project.

Page 1 of 2 ends

REPORT TO CITY COUNCIL
To: Honorable Mayor and Members of the City Council
From: Jason Simpson, City Manager
Prepared by: Remon Habib, City Engineer
Date: July 8, 2025
Subject: Change Order No.1 with Elsinore Valley Municipal Water District to Provide Construction Inspection Services for the Camino Del Norte Sewer Extension Project. EVMWD W.O. 2025-00164-INS
Recommendation
Approve and authorize the City Manager to execute Change Order No. 1 with Elsinore Valley Municipal Water District for $76,240.00 to provide Inspection Construction Services for the Camino Del Norte Sewer Extension Project.

Background
On January 28, 2025, the City Council approved a professional services agreement with Aneen Construction Inc. to provide Public Works Construction Services for the Camino Del Norte Sewer Extension Improvements Project. The City paid an initial Inspection deposit to EVMWD in the amount of $29,900.00 on March 18, 2025, at project commencement.

During the field verification and construction survey staking, contractor Aneen Construction Inc. discovered that the Contract plans contained a major design error. The design plans were prepared by Ardurra Inc., an engineering design firm with experience working on Elsinore Valley Municipal Water District (EVMWD) facilities. The design plans were reviewed and approved by EVMWD in January of 2025 prior to the City advertising the project for construction. Additional inspection by EVMWD is now necessary due to the actual existing manhole depth changing from

12.2 feet on the plans to an actual depth of 25.2 feet observed in the field. Additional field conditions encountered include breaking up of boulders and chipping away rock that is much shallower than anticipated. These issues have contributed to a lower production rate and more inspection effort by EVMWD than originally anticipated.

EVMWD is requesting that the City provide additional funding for construction inspection fees for the project to remain on track. The expected completion date is now July 2025.

Inspection Funding Request EVMWD

Page 2 of 2 ends

Discussion
The requested additional funds by the district will cover the following:

Facility Installation Inspections
Facility Testing Inspections
Punchlist Walk
As-Built Drawings
Record Notice of Completion
1-Year Warranty Inspection
Close out
Fiscal Impact
Inspection Change Order Funding Request No. 1 to EVMWD will result in a revised total inspection cost of $106,140.00. The original inspection amount was $64,000.00.

Attachments
Attachment 1- Change Order No. 1
Exhibit A - Additional Funds Request Letter
Attachment 2 – Inspection Check Initial Funds Calculation Engineering

CONSTRUCTION CONTRACT

CHANGE ORDER
Date 07/08/2025 C.C.O No. 1
951-674-3124
130 S. MAIN STREET
LAKE ELSINORE, CA 92530
WWW.LAKE-ELSINORE. ORG
CONTRACTOR:

Elsinore Valley Municipal Water
District ( EVMWD)
In conformance with and as part of the existing project the City of Lake Elsinore authorizes and directs changes to the Deposit as described below.
1) EXTRA WORK ORDER (EWO) (Unknown or Unforeseen Work not covered by Contract) a) Extra Work Item: Due to field depth errors that differed from the approved plans, the necessary field revisions for construction will create added inspections.

Facility Testing and Installation Inspections
Punchlist Walk
As-Built Drawings
1 Year Warranty Inspection
TOTAL Lump Sum = $76,240
2) CHANGED WORK ORDER (CWO) (Significant increases in quantity of Unit-Price items; greater than 25%):
a) Changed Work Item A
i) Time impact is (+) additional Working Days.
3) CLOSING SUMMARY ORDER (CSO) (Final adjustment of original estimated contract quantities based on final measured quantities):
a) Closing Summary Order:
i) Payment for this work is paid as follows:

Total = $76,240
AGREEMENT AMOUNT: Compensation as set
forth in the Agreement and as amended by
this and prior Contract Change Order(s) is:
106,140.00
Original Contract Amount: $29,900.00
Amount All Previous CCOs (+-): $0.00
Amount This CCO (+-): $76,240.00
Total Contract Amount: $ 106, 140.00
CITY’S ACCEPTANCE: The above described
work is hereby approved and directed to be
completed in accordance with the Contract
Documents.

City of Lake Elsinore
Rec.: _______________________________
City Engineer Date
App.: _______________________________
City Manager Date
CONTRACTOR’ S ACCEPTANCE: Contractor agrees to perform
the above work as directed, inaccordance withthe
Contract Documents, and accept payment described above
as full compensation for work described subject to
additions and reductions ofthe quantities of various items.

Contractor: Elsinore Valley Municipal Water District
EVMWD)
By __________________________________________
Title: ________________________________________
Date: ________________________________________
951-674-3146 | 31315 Chaney Street, Lake Elsinore, CA 92530 | www.evmwd. com BOARD OF DIRECTORS Darcy M. Burke, Treasurer
Chance Edmondson, President Matthew Dobler, Director
Harvey R. Ryan, Vice President

GENERAL MANAGER

LEGAL COUNSEL

DISTRICT SECRETARY
Andy Morris, Director
Greg Thomas
Best, Best & Krieger
Christy Gonzalez
June 11, 2025
City Of Lake Elsinore
Attn: Carlos Norvani
130 S. Main Street
Lake Elsinore, CA 92530
Subject: ADDITIONAL FUNDS REQUEST 1ST NOTICE

CLE CAMINO DEL NORTE SEWER MAIN DIR
APPLICATION # 2025- 00164- INS
Dear Mr. Norvani,
Elsinore Valley Municipal Water District has reviewed the above referenced project account balance. The deposit submitted for Inspection is 183.59% depleted. The District kindly requests that a payment is made in the amount of $ 76,240.00 to bring the deposit account current and have sufficient funds to perform the remaining services on the project. It is our goal to help the project succeed and provide excellent services. We look forward in receiving the payment as soon as possible. Any remaining funds in the deposit account will be returned to the Developer Responsible Party) upon project close- out.

The additional funds requested above are an estimate of the funds required to cover services that have been performed or will be performed in the future to complete the project. Enclosed is the Payment Remittance Form that summaries the deposit( s) amount and estimated costs being billed towards the deposit account. There are three costs billed to the account noted as billed, unbilled and future costs. Billed Costs are services performed that have been billed to the account and are reflected in the enclosed Statement of Project Costs. Unbilled Costs are services performed that have not been reflected in the Statement of Project Costs due to processing durations. Future Costs are the estimated future charges for the remaining services that will be performed for the project. A brief list of services that may be remaining are as follows:

Facility Installation Inspection
Facility Testing Inspection
Punchlist Walk
As-Built/ Record Drawings Review
Record Notice of Completion
1 year Warranty Inspection
Close- out Processing
Misc. Administrative Activities
City Of Lake Elsinore
June 11, 2025

Page 2 ends

Please make the payment online via credit card or ACH through the online permit portal at https:// permits. evmwd. com/.

Please reference the subject Application No. with any correspondence to the District. If you have any questions regarding the above information, please feel free to contact Engineering Services at 951) 674-3146 extension 6705.

Sincerely,
Mayra Cardenas
Principal Engineer
Development Services
Attachment: None
cc: Finance, File
WO# 2025-00164-INS
Funds For: Inspections
Total Deposit $ 28,411.76 Billed Costs1 $ 52,159.75 Unbilled Costs2 $ 0.00 Remaining Deposit ($ 23,747.99) Future Costs3 $ 52,484.85 Total Due4 $ 76,240.00
Notes:

4. Total Due is rounded to the nearest ten.

1. Billed Costsare the charges for the services that have been performed and have been billed to the project account. Please refer to your Rhythm Portal account for billing charges. 2. Unbilled Costsare the charges for the services that have been performed and have not been billed to the project account due to processing durations.Please refer to your Rhythm Portal account for billing charges. 3. Future Costs are the estimated future charges for the services that will be performed until project completion.

Payment Remittance Form( Please remit this form with your payment) Payment Remittance Slip
Payable to: Elsinore Valley Municipal Water DistrictEngineering Dept. 31315 Chaney StreetLake Elsinore, CA 92531 Inspection Sewer (S)
Project Name:

WO#:

Description Rate Hrs. Cost
52,159.75$
52,159.75$
Meters Remaining ( each) 41.50$ -$
Backflow Inspection ( each) 41.50$ -$
Sewer Laterals Remaining ( each) 41.50$ -$
Punchlist 290.00$ 8 2,320.00$
As-builts/ Redlines 290.00$ 8 2,320.00$
CofO ( Final) ( each) 41.50$ -$
NOC and Grant Deed 86.00$ 1 86.00$
NOC Recording Fee ( each) 101.00$ 1 101.00$
Warranty Inspection 290.00$ 8 2,320.00$
Engineering Manager 399.00$ -$
Senior Engineer Inspector 290.00$ 126 36,540.00$
Senior Civil Engineer 357.00$ -$
Development Service Representative 86.00$ -$
Field Maintenance Worker 244.00$ 8 1,952.00$
Close- Out 86.00$ -$
Contingency 45,639. 00$ 15% 6,845.85$
52,484.85$
Total Deposit 28,411.76$
Billed Costs1 52,159.75$
Unbilled Costs2 -$
Remaining Deposit ( 23,747.99)$
Future Costs3 52,484.85$
Total Due (Rounded Up) 76,240.00$
Legend:

Only fill-in the yellow cells
Notes:

1. Billed Costs - This is the charges billed on the Billing Summary. Itis the Total Costs on the billing summary

2. Unbilled Costs - This is the consultant charges that have not been billed in the Billing Summary

3. Future Costs - This is the costs for the remaining services that will be performed in the project

4. Total Due is rounded to the nearest ten.

Water
Inspection Additional Funds Request for Water and Sewer Projects Billed Costs
Statement of Project Costs ( Billing Summary) - Total Costs Billed Costs Sub-Total
Unbilled Costs
Unbilled Costs Sub-Total
CLE Camino Del Norte Sewer Main DIR
2025-00164-INS
Future Costs
Sewer
General
Future Costs Sub-Total
Summary of Costs

Page 1 of 1 ends

Application No:

Project Name:

QUANTITY UNIT ITEM UNIT COST COST
EA Reports/Studies $ 5,000 -$
Planning Subtotal -$

QUANTITY UNIT ITEM UNIT COST COST
LF 8" PVC Water Main 50.00$ -$
LF 12" DIP Water Main 65.00$ -$
EA 4" RW Gate Valve 1,800.00$ -$
EA 6" RW Gate Valve 2,000.00$ -$
EA 8" RW Gate Valve 2,200.00$ -$
EA 12" RW Gate Valve 3,000.00$ -$
EA Fire Hydrant (6") Super 6,500.00$ -$
EA Fire Hydrant (6") Standard/Blow-Off 5,500.00$ -$
EA 1" Water Service 1,100.00$ -$
EA 2" Water Service 3,000.00$ -$
EA 1" Air/Vac Assembly 2,500.00$ -$
EA 2" Air/Vac Assembly 4,000.00$ -$
EA Fire Double Check Detector Assmbly 10,000.00$ -$
Water Pipeline Subtotal -$

QUANTITY UNIT ITEM UNIT COST COST
1248 LF 8" Sewer Main 35.00$ 43,680.00$
LF 10" Sewer Main 45.00$ -$
LF 12" Sewer Main 50.00$ -$
LF 6" PVC Sewer Force Main 80.00$ -$
LF 8" PVC Sewer Force Main 120.00$ -$
LF 12" PVC Sewer Force Main 140.00$ -$
6 EA 5' Manhole Depth 6,500.00$ 39,000.00$
Sewer Pipeline Subtotal 82,680.00$

QUANTITY UNIT ITEM UNIT COST COST
1 LS Complex Facility Description: -$
Complex Facility Subtotal -$
82,680.00$
16,536.00$
99,216.00$
14,882.40$
14,882.40$
1,488.24$
Additional Inspection Deposit Required, Calculated from Contractor' s Schedule 13,529.36$ 29,900.00$
Attach an engineer cost estimate prepared by the Registered Civil Engineer for the complex facility. Provide the lump sum amount below.

Inspection Check Initial Funds Calculation
2024-00402-INS
City of Lake Elsinore Camino del Norte Sewer Extension Project Planning ( Water Analysis, Sewer Analysis, Preliminary Design Report, and Other Studies) A minimum $ 7,000 deposit is required
Water Pipeline
Sewer Pipeline
Complex Facilities ( Booster Station, Lift Station, Reservoir, Tranmission Main (>12"), Trunk Sewer Main (>12"), and Other)
Initial Deposit Submitted
Additional Initial Deposit Required
Sub-Total Engineers Cost Estimate
Contingency ( 20%)
Total Engineers Cost Estimate
15% of Engineers Cost Estimate
Total Inspection Check Deposit Required
Mapping Fee Required
Printed: 3/4/2025
11) Change Order No. 1 to the Agreement with Aneen Construction Inc. to Provide Public Works Construction Services for the Camino Del Norte Sewer Extension Project Project No. Z30016)
Approve and authorize the City Manager to execute Change Order No. 1 to the Agreement with Aneen Construction Inc. in the amount of for $432,246.00 for Public Works Construction Services for the Camino Del Norte Sewer Extension Improvements Project in such final form as approved by the City Attorney and authorize the City Manager to execute change orders not to exceed a 10% contingency amount of $43,224.60 for uncertainties and adjustments.

Page 1 of 2 ends

REPORT TO CITY COUNCIL
To: Honorable Mayor and Members of the City Council
From: Jason Simpson, City Manager
Prepared by: Remon Habib, City Engineer
Date: July 8, 2025
Subject: Change Order No. 1 to the Agreement with Aneen Construction Inc. to Provide Public Works Construction Services for the Camino Del Norte Sewer Extension Project (Project No. Z30016)
Recommendation
Approve and authorize the City Manager to execute Change Order No. 1 to the Agreement with Aneen Construction Inc. in the amount of for $432,246.00 for Public Works Construction Services for the Camino Del Norte Sewer Extension Improvements Project in such final form as approved by the City Attorney and authorize the City Manager to execute change orders not to exceed a 10% contingency amount of $43,224.60 for uncertainties and adjustments.

Background
On January 28, 2025, the City Council approved an Agreement for Public Works Construction in the amount of $851,780.00 with Aneen Construction Inc., to provide Public Works construction services for the Camino Del Norte Sewer Extension Improvements Project. During field verification and construction survey staking of the project, the contractor discovered the elevation depth to the existing sewer was incorrect. The design plans reviewed and approved by Elsinore Valley Municipal Water District (EVMWD) showed a connecting manhole depth of 12.2 feet. The actual depth was 25.2 feet.

The significant change in depth resulted in a fundamentally different scope of work. The contractor required more robust shoring to facilitate the installation of the sewer line.

Construction for the project began in May 2025, and the original expected completion date was July 2025 (60 Working Days). Due to the manhole elevation discrepancy on the approved plans and construction-related delays caused by encountering boulders and shallow rock throughout most of the alignment, the project duration has increased by 30 working days and is now expected to be completed in September 2025 (90 Working Days).

Contract Change Order No. 1- Aneen Construction

Page 2 of 2 ends

Prior to construction, it was decided that the work would be performed at night to avoid trafficrelated delays, as there had been recent road closures to the Grape Street ramp and Railroad Canyon. Nighttime work contributed to increased unit prices due to slower production rates, the need for additional equipment for lighting, and variations in labor rates.

Change Order No. 1 would provide Aneen Construction Inc. with an adequate budget to continue the necessary construction services through the updated completion date for the project. The negotiated change order also eliminates about 500 ft and two manholes of the shallower section, which can be constructed by future development.

Discussion
Change order reflects the components below:

Change the pipe material to accommodate the new depth of installation.

Manhole depths for two manholes doubled from 12 feet to over 24 feet.

Additional trench excavation and trench shoring to accommodate the depth increase.

Due to the complexity of the excavation and additional depth, there has been production loss as well as equipment and labor cost increases.

Work performed at night
Fiscal Impact
Change Order No. 1 to the Agreement for Public Works Construction with Aneen Construction Inc., will result in a revised total contract amount cost of $1,284,026.00 plus an additional 10% contingency. The original contract award was $851,780.00. The work has been programmed in the City’s CIP budget.

Attachments
Attachment 1- Change Order No. 1
Exhibit A - Proposal
Attachment 2 – Redline Plan
Attachment 3 - Original Agreement
Engineering

CONSTRUCTION CONTRACT

CHANGE ORDER
Date 06/24/2025 C.C.O No. 1
951-674-3124
130 S. MAIN STREET
LAKE ELSINORE, CA 92530
WWW.LAKE-ELSINORE. ORG
CONTRACTOR:

Aneen Construction Inc.

In conformance with and as part of the existing Agreement for this project the City of Lake Elsinore authorizes and directs changes to the Agreement as described below. 1) EXTRA WORK ORDER (EWO) (Unknown or Unforeseen Work not covered by Contract) a) Extra Work Item: Correct EVMWD design error to the new revised plans to accommodate the increased depth of two manholes to 25 feet.

Pipe Grade and Alignment – Upgrade to DR18
Manhole Depth – must be constructed deeper to adjust to the increased depth.

Coating Requirement change due to depth.

Additional Excavation Volume and use of larger shoring equipment TOTAL Lump Sum = $432,246.00
2) CHANGED WORK ORDER (CWO) (Significant increases in quantity of Unit-Price items; greater than 25%):
a) Changed Work Item A
i) Time impact is (+) 40 additional Working Days.
3) CLOSING SUMMARY ORDER ( CSO) ( Final adjustment of original estimated contract quantities based on final measured quantities):
a) Closing Summary Order:
i) Payment for this work is paid as follows:

Total = $432,246.00
AGREEMENT AMOUNT: Compensation as set
forth in the Agreement and as amended by
this and prior Contract Change Order( s) is:
1,284,026.00
Original Contract Amount: $851,780.00
Amount All Previous CCOs (+-): $0.00
Amount This CCO (+-): $432,246.00
Total Contract Amount: $1,284,026.00
CITY’ S ACCEPTANCE: The above described
work is hereby approved and directed to be
completed in accordance with the Contract
Documents.

City of Lake Elsinore
Rec.: _______________________________
City Engineer Date
App.: _______________________________
City Manager Date
CONTRACTOR’ S ACCEPTANCE: Contractor agrees toperform
the above work as directed, in accordance with the
Contract Documents, and accept payment described above
as full compensation for work described subject to
additions and reductions of the quantities of various items.

Contractor: Aneen Construction, Inc.

By __________________________________________
Title: ________________________________________
Date: ________________________________________
9938 Magnolia Ave
Riverside Ca, 92503
909)-913-3024
To: City of Lake Elsinore
130 S. Main St,
Lake Elsinore, Ca, 92503
Attention: Carlos Norvani
We are submitting the enclosed: COST PROPOSAL FOR PROJECT DUE TO

CARDINAL CHANGE TO PROJECT DESIGN
Plans & Procedure Sample RFI
Shop Drawings Permits Submittal
Certifications Construction
Work Plan
Resubmittal
Product Data X Change Order Other:

Disposition:

X For Approval Approved No Action Taken
For Your
Information
Approved As
Noted
Submit___ copies
As Requested, Revise & Resubmit Resubmittal___
Copies For
Approval
Review &
Comment
Rejected Other:

Date:

June 6, 2025
ACI Project No.:
25-C2103
Project Name:

Camino Del Norte Sewer
City Project No.:

Z30016
Change Order No:
001
RFI No.:
9938 Magnolia Ave
Riverside Ca, 92503
909)-913-3024
As requested, here is the narrative explaining the implications of changing the design depth from 12 to 25 feet for the existing invert elevation:

The change to a 25-foot design depth has substantially impacted the overall project in several ways:

1. Pipe Grade and Alignment: The increase in depth has necessitated adjustments to the pipe grade and to accommodate the deeper placement load, the pipe had to be upgraded to DR18 to accommodate load from the increased depth

2. Manhole Depth: The increased depth also means that manholes must be constructed deeper, impacting the equipment, labor and the materials needed for construction.

3. Coating Requirements: Deeper installations require additional coating materials.

4. Excavation Volume: The amount of excavation required has increased significantly, which impacts both the time and cost of construction.

5. Shoring Equipment: The depth change has necessitated the use of larger, more robust shoring equipment to ensure safety and stability during the excavation process and an engineered plan stamped by a civil engineer.

6. Production Loss: The additional depth and complexity of excavation have resulted in reduced production rates, affecting project timelines and labor, equipment, traffic control and shoring cost. We request the original contract working days of 60 to be increased by 30, for a total of 90 working days to accommodate the increase in work

7. Switching to Nights: has generated an overall increase due to the special shift labor prevailing wage costs and plant night opening fees for the asphalt and rock material and other material. These additional nighttime operational requirements have impacted the cost structure and scheduling of the project significantly. The necessity for nighttime labor comes with increased wage costs due to prevailing wage laws for special shifts.

Additionally, the need to open plants at night to supply asphalt and rock materials has incurred extra fees.

These comprehensive changes have collectively triggered a series of design, material, and operational adjustments throughout the project, necessitating further analysis and potential adjustments in budget and scheduling. Cost for reduction all purchased material will be carried by the city per our agreement.

Due to budget constraints, per your request we deleted line -item No. 9 (Construct 541LF 8” DR18) and reduced Line Item No. 11 (Manhole Installation) from 3 to 1 9938 Magnolia Ave
Riverside Ca, 92503
909)-913-3024

ITEM DESCRIPTION UNIT QTY UNIT
COST
TOTAL
1 MOBILIZATION, BONDS, PERMITS LS 1 $ 59,606.00 $ 59,606.00 2 TEMPORARY EROSION CONT LS 1 $ 10,000.00 $ 10,000.00
3 TRAFFIC CONTROL AND PUBLIC LS 1 $ 62,867.00 $ 62,867.00 4 PRE/POST-CONSTRUCTION VIDEO LS 1 $ 6,000.00 $ 6,000.00 5 EXCAVATION SAFETY MEASURES LS 1 $ 62,920.00 $ 62,920.00 6 POTHOLE UTILITIES LS 1 $ 12,000.00 $ 12,000.00
7 CONSTRUCTION SURVEYING LS 1 $ 18,729.00 $ 18,729.00
8 PROVIDE AS-BUILT DRAWINGS LS 1 $ 5,000.00 $ 5,000.00
10 CONSTRUCT 8" (DR18) LF 707 $ 790.00 $ 558,530.00
11A CONSTRUCT 60" PRECAST
MANHOLE NO. 4-6
EA 1 $ 28,750.00 $ 28,750.00
11B CONSTRUCT 60" PRECAST
MANHOLE NO. 1-3
EA 3 $ 66,558.00 $ 199,674.00
12 NON-RIPPABLE GRANITIC ROCK CY 500 $ 100.00 $ 50,000.00 13 REMOVE AND DISPOSE OF

EXISTING
EA 1 $ 20,000.00 $ 20,000.00
14 INSTALL 8" END CAP EA 2 $ 1,000.00 $ 2,000.00
15 GEOTECHNICAL BORING REPAIR EA 3 $ 2,650.00 $ 7,950.00 16 CONSTRUCT TRENCH PAVEMENT SF 18,000 $ 10.00 $ 180,000.00 New Contract Amount Total $ 1,284,026.00
Original Contract Amount Total -$ 851,780.00
CCO01Total Change Order Total $ 432,246.00
1365. 00
INV
S=0. 0233
1365. 10
INV
1341. 47
INV1341. 27
INV
3 1334. 29
INV13301334. 09
INV
3 CN 5/08/ 25 REVISED

INVERT ELEVATIONS
MC 4/24/ 25
1 Agreement No. __________

AGREEMENT FOR PUBLIC WORKS CONSTRUCTION
Aneen Construction Inc.

For the
Camino Del Norte Sewer Extension Project
CIP PROJECT NO. Z30016
This Agreement for Public Works Construction (“Agreement”) is made and entered into as of January 28, 2025 by and between the City of Lake Elsinore, a municipal corporation (“City”) and Aneen Construction Inc., a Corporation (“ Contractor”).

The City and Contractor, in consideration of the mutual promises and covenants set forth herein, agree as follows:

1. The Project and Project Documents. Contractor agrees to construct the following public improvements (“work”) identified as:

Camino Del Norte Sewer Extension (the “Project”)
The City-approved plans for the construction of the Project, which are incorporated herein by reference and prepared by Ardurra Engineering, are identified as:

Camino Del Norte Sewer Extension
The Project Documents include this Agreement and all of the following: ( 1) the Notice Inviting Bids, Instructions to Bidders, Bid Documents including Bidder’s Proposal as submitted by the Contractor, Contract Documents, General Specifications, Special Provisions, and all attachments and appendices; ( 2) everything referenced in such documents, such as specifications, details, standard plans or drawings and appendices, including all applicable State and Federal requirements; ( 3) all required bonds, insurance certificates, permits, notices, and affidavits; and ( 4) any and all addenda or supplemental agreements clarifying, amending or extending the work contemplated as may be required to insure completion in an acceptable manner. All of the provisions of the above-listed documents are made a part of this Agreement as though fully set forth herein.

2. Compensation.
a. For and in consideration of the payments and agreements to be made and performed by City, Contractor agrees to construct the Project, including furnishing all materials and performing all work required for the Project, and to fulfill all other obligations as set forth in the Bidder’s Proposal, such contract price being Eight-Hundred Fifty-One Thousand Seven-Hundred Eighty and 00/100 dollars ($851,780.00).

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 2 b. City hereby promises and agrees to employ, and does hereby employ, Contractor to provide the materials, do the work, and fulfill the obligations according to the terms and conditions herein contained and referred to, for the prices set forth, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the Project Documents.
c. Contractor agrees to receive and accept the prices set forth in the Bidder’s Proposal as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Such compensation shall cover all expenses, losses, damages, and consequences arising out of the nature of work during its progress or prior to its acceptance including those for well and faithfully completing the work and the whole thereof in the manner and time specified in the Project Documents; and also including those arising from actions of the elements, unforeseen difficulties or obstructions encountered in the prosecution of the work, suspension or discontinuance of the work, and all other unknowns or risks of any description connected with the work.

3. Completion of Work.
a. Contractor shall perform and complete all work within Sixty (60) working days from the date of commencement specified in the Notice to Proceed, and shall provide, furnish and pay for all the labor, materials, necessary tools, expendable equipment, and all taxes, utility andtransportation services requiredfor construction ofthe Project. b. All work shall be performed and completed in a good workmanlike manner in strict accordance with the drawings, specifications and all provisions of this Agreement as hereinabove defined and in accordance with applicable laws, codes, regulations, ordinances and any other legal requirements governing the Project.
c. Contractor shall not be excused with respect to the failure to so comply by any act or omission of the City, the City Engineer, a City inspector, or a representative of any of them, unless such act or omission actually prevents the Contractor from fully complying with the requirements of the Project Documents, and unless the Contractor protests at the time of such alleged prevention that the act or omission is preventing the Contractor from fully complying with the Project Documents. Such protest shall not be effective unless reduced to writing and filed with the City within three ( 3) working days of the date of occurrence of the act or omission preventing the Contractor from fully complying with the Project Documents. d. City and Contractor recognize that time is of the essence in the performance of this Agreement and further agree that if the work called for under the Agreement is not completed within the time hereinabove specified, damages will be sustained by the City and that, it is and will be impracticable or extremely difficult to ascertain and determine the actual amount of damages the City will sustain in the event of, and by reason of, such delay. It is, therefore, agreed that such damages shall be presumed to be in the amount of One Thousand dollars ($1,000.00) per calendar day, and that the Contractor will pay to the City, or City may retain from amounts otherwise payable to Contractor, such amount for each calendar day by which the Contractor fails to complete the work, including corrective items of work, under this Agreement within the time hereinabove specified and as adjusted by any changes to the work.

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 3 4. Changes to Work. City and Contractor agree that the City may make changes to the work, or suspend the work, and no matter how many changes, such changes or suspensions are within the contemplation of the Contractor and City and will not be a basis for a compensable delay claim against the City nor be the basis for a liquidated damage claim against the Contractor.

Any change to the work shall be by way of a written instrument (“change order”) signed by the City and the Contractor, stating their agreement to the following:
a. The scope of the change in the work;
b. The amount of the adjustment to the contract price; and c. The extent of the adjustment to the Schedule of Performance.

The City Engineer is authorized to sign any change order provided that sufficient contingency funds are available in the City’s approved budget for the Project. All change in the work authorized by the change order shall be performed under the applicable conditions of the Project Documents. City and Contractor shall negotiate in good faith and as expeditiously as possible the appropriate adjustments for such changes.

5. Bonds. Contractor shall provide, before commencing work, a Faithful Performance Bond and a Labor and Material Bond, each for one-hundred percent (100%) of the contract price in the form that complies with the Project Documents and is satisfactory to the City Attorney.

6. Non-Assignability. Neither this Agreement nor any rights, title, interest, duties or obligations under this Agreement may be assigned, transferred, conveyed or otherwise disposed of by Contractor without the prior written consent of City.

7. Licenses. Contractor represents and warrants to City that it holds the contractor’s license or licenses set forth in the Project Documents, is registered with the Department of Industrial Relations pursuant to Labor Code Section 1725.5, and holds such other licenses, permits, qualifications, insurance and approvals of whatsoever nature which are legally required of Contractor. Contractor represents and warrants to City that Contractor shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this Agreement, any licenses, permits, insurance and approvals which are legally required of Contractor to practice its profession. Contractor shall maintain a City of Lake Elsinore business license.

8. Indemnity. Contractor shall indemnify, defend, and hold harmless the City and its officials, officers, employees, agents, the County and Board Supervisors, and volunteers from and against any and all losses, liability, claims, suits, actions, damages, and causes of action arising out of any personal injury, bodily injury, loss of life, or damage to property, or any violation of any federal, state, or municipal law or ordinance, to the extent caused, in whole or in part, by the willful misconduct or negligent acts or omissions of Contractor or its employees, subcontractors, or agents, by acts for which they could be held strictly liable, or by the quality or character of their work. The foregoing obligation of Contractor shall not apply when ( 1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful misconduct of the City or its officers, employees, agents, or volunteers and (2) the actions of Contractor or its employees, subcontractor, or agents have contributed in no part to the injury, loss of life, damage to
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 4 property, or violation of law. It is understood that the duty of Contractor to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 of the California Civil Code.

Acceptance by City of insurance certificates and endorsements required under this Agreement does not relieve Contractor from liability under this indemnification and hold harmless clause.

This indemnification and hold harmless clause shall apply to any damages or claims for damages whether or not such insurance policies shall have been determined to apply. By execution of this Agreement, Contractor acknowledges and agrees to the provisions of this Section and that it is a material element of consideration.

9. Insurance Requirements.
a. Insurance. Contractor, at Contractor’s own cost and expense, shall procure and maintain, for the duration of the Agreement, unless modified by the City’s Risk Manager, the following insurance policies.
i. Workers’ Compensation. Coverage. Contractor shall maintain Workers’ Compensation Insurance and Employer’s Liability Insurance for his/her employees in accordance with the laws of the State of California. In addition, Contractor shall require each subcontractor to similarly maintain Workers’ Compensation Insurance and Employer’s Liability Insurance in accordance with the laws of the State of California for all of the subcontractor’ s employees. Any notice of cancellation or non-renewal of all Workers’ Compensation policies must be received by the City at least thirty ( 30) days prior to such change. The insurer shall agree to waive all rights of subrogation against City, its officers, agents, employees and volunteers for losses arising from work performed by Contractor for City. In the event that Contractor is exempt from Worker’s Compensation Insurance and Employer’s Liability Insurance for his/her employees in accordance with the laws of the State of California, Contractor shall submit to the City a Certificate of Exemption from Workers Compensation Insurance in a form approved by the City Attorney.
ii. Commercial General Liability Coverage. Contractor shall maintain commercial general liability insurance in an amount not less than one million dollars 1,000,000) per occurrence for bodily injury, personal injury and property damage. If a commercial general liability insurance form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this Agreement or the general aggregate limit shall be at least twice the required occurrence limit. Required commercial general liability coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 (ed. 11/88) or Insurance Services Office form number GL 0002 (ed. 1/73) covering comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. No endorsement may be attached limiting the coverage.
iii. Automobile Liability Coverage. Contractor shall maintain automobile liability insurance covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with the work to be performed under this Agreement, including coverage for owned, hired and non-owned vehicles, in an amount of not less than one million dollars ($ 1,000,000) combined single limit for each occurrence. Automobile liability coverage must be at least as broad as Insurance Services Office Automobile Liability form CA 0001 ( ed. 12/90) Code 1 (“ any auto”). No endorsement may be attached limiting the coverage.

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 5 iv. Builder’s Risk Coverage. Prior to the commencement of any construction of the Project, Design-Builder shall obtain ( or cause to be obtained) and keep in force during the term of any construction, builder’s risk insurance insuring for all risks of physical loss of or damage (excluding the perils of earthquake and flood). b. Endorsements. Each general commercial liability and automobile liability insurance policy shall be with insurers possessing a Best’s rating of no less than A:VII and shall be endorsed with the following specific language:
i. The City, its elected or appointed officers, officials, employees, agents and volunteers are to be covered as additional insured with respect to liability arising out of work performed by or on behalf of the Contractor, including materials, parts or equipment furnished in connection with such work or operations. ii. This policy shall be considered primary insurance as respects the City, its elected or appointed officers, officials, employees, agents and volunteers. Any insurance maintained by the City, including any self-insured retention the City may have, shall be considered excess insurance only and shall not contribute with it. iii. This insurance shall act for each insured and additional insured as though a separate policy had been written for each, except with respect to the limits of liability of the insuring company.
iv. The insurer waives all rights of subrogation against the City, its elected or appointed officers, officials, employees or agents. v. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its elected or appointed officers, officials, employees, agents or volunteers.
vi. The insurance provided by this Policy shall not be suspended, voided, canceled, or reduced in coverage or in limits except after thirty ( 30) days written notice has been received by the City.
c. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions must be declared to and approved by the City. At the City’s option, Contractor shall demonstrate financial capability for payment of such deductibles or self-insured retentions. d. Certificates of Insurance. Contractor shall provide certificates of insurance with original endorsements to City as evidence of the insurance coverage required herein.

Certificates of such insurance shall be filed with the City on or before commencement of Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 6 performance of this Agreement. Current certification of insurance shall be kept on file with the City at all times during the term of this Agreement.

10. Notices. Any notice required to be given under this Agreement shall be in writing and either served personally or sent prepaid, first class mail. Any such notice shall be addressed to the other party at the address set forth below. Notice shall be deemed communicated within 48 hours from the time of mailing if mailed as provided in this section.

If to City: City of Lake Elsinore
Attn: City Manager
130 South Main Street
Lake Elsinore, CA 92530
With a copy to: City of Lake Elsinore
Attn: City Clerk
130 South Main Street
Lake Elsinore, CA 92530
If to Contractor: Aneen Construction Inc.

Attn: Tamer Khalil
9860 Indiana Ave. # 18
Riverside, CA 92503

11. Entire Agreement. This Agreement constitutes the complete and exclusive statement of agreement between the City and Contractor. All prior written and oral communications, including correspondence, drafts, memoranda, and representations, are superseded in total by this Agreement.

12. Amendments. This Agreement may be modified or amended only by a written document executed by both Contractor and City and approved as to form by the City Attorney.

13. Assignment and Subcontracting. Contractor shall be fully responsible to City for all acts or omissions of any subcontractors. Assignments of any or all rights, duties for obligations of the Contractor under this Agreement will be permitted only with the express consent of the City. Nothing in this Agreement shall create any contractual relationship between City and any subcontractor nor shall it create any obligation on the part of the City to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise is required by law.

14. Waiver. Waiver of a breach or default under this Agreement shall not constitute a continuing waiver of a subsequent breach of the same or any other provision under this Agreement.

15. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect.

16. Controlling Law Venue. This Agreement and all matters relating to it shall be governed by the laws of the State of California and any action brought relating to this Agreement shall be held exclusively in a state court in the County of Riverside.

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 7 17. Litigation Expenses and Attorneys’ Fees. If either party to this Agreement commences any legal action against the other party arising out of this Agreement, the prevailing party shall be entitled to recover its reasonable litigation expenses, including court costs, expert witness fees, discovery expenses, and attorneys’ fees.

18. Mediation. The parties agree to make a good faith attempt to resolve any disputes arising out of this Agreement through mediation prior to commencing litigation. The parties shall mutually agree upon the mediator and share the costs of mediation equally. If the parties are unable to agree upon a mediator, the dispute shall be submitted to JAMS or its successor in interest. JAMS shall provide the parties with the names of five qualified mediators. Each party shall have the option to strike two of the five mediators selected by JAMS and thereafter the mediator remaining shall hear the dispute. If the dispute remains unresolved after mediation, either party may commence litigation.

19. Authority to Enter Agreement and Administration. Contractor has all requisite power and authority to conduct its business and to execute, deliver, and perform the Agreement. Each party warrants that the individuals who have signed this Agreement have the legal power, right, and authority to make this Agreement and to bind each respective party. The City Manager is authorized to enter into an amendment or otherwise take action on behalf of the City to make the following modifications to the Agreement: ( a) a name change; ( b) grant extensions of time; ( c) non-monetary changes in the scope of services; and/or (d) suspend or terminate the Agreement. The City Engineer shall act as the Project administrator on behalf of the City.

20. Prohibited Interests. Contractor maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Contractor, to solicit or secure this Agreement. Further, Contractor warrants that it has not paid nor has it agreed to pay any company or person, other than a bona fide employee working solely for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. For breach or violation of this warranty, City shall have the right to rescind this Agreement without liability. For the term of this Agreement, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom.

21. Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination.

22. Prevailing Wages.
a. Contractor and all subcontractors shall adhere to the general prevailing rate of per diem wages as determined and as published by the State Director of the Department of Industrial Relations pursuant to Labor Code Sections 1770, 1773, and 1773.2. Copies of these rates and the latest revisions thereto are on file in the office of the City Clerk of the City of Lake Elsinore and are available for review upon request.

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 8 b. Contractor's attention is directed to the provisions of Labor Code Sections 1774, 1775, 1776, 1777.5 and 1777.6. Contractor shall comply with the provisions of these Sections. The statutory provisions for penalties for failure to comply with the State's wage and the hours laws will be enforced.
c. Labor Code Sections 1774 and 1775 require the Contractor and all subcontractors to pay not less than the prevailing wage rates to all workmen employed in the execution of the contract and specify forfeitures and penalties for failure to do so. The minimum wages to be paid are those determined by the State Director of the Department of Industrial Relations. Labor Code Section 1776 requires the Contractor and all subcontractors to keep accurate payroll records, specifies the contents thereof, their inspection and duplication procedures and certain notices required of the Contractor pertaining to their location. The statutory penalties for failure to pay prevailing wages will be enforced. If the Project has been awarded to Contractor on or after April 1, 2015, Contractor and its subcontractors must furnish electronic certified payroll records to the Labor Commissioner. Beginning January 1, 2016, Contractor and its subcontractors must furnish electronic certified payroll records to the Labor Commissioner without regard to when the Project was awarded to Contractor. d. Labor Code Section 1777.5 requires Contractor or subcontractor employing tradesmen in any apprenticeable occupation to apply to the Joint Apprenticeship Committee nearest the site of the public works project, which administers the apprenticeship program in that trade for a certificate of approval. The certificate will also fix the ratio of apprentices to journeymen to be used in the performance of the Agreement. The Contractor is required to make contributions to funds established for the administration of apprenticeship programs if the Contractor employs registered apprentices or journeymen in any apprenticeable trade and if other contractors on the public works site are making such contributions.

Information relative to apprenticeship standards, contributions, wage schedules and other requirements may be obtained from the State Director of Industrial Relations or from the Division of Apprenticeship Standards. Labor Code Section 1777.6 provides that it shall be unlawful to refuse to accept otherwise qualified employees as registered apprentices solely on the grounds of race, religious creed, color, national origin, ancestry, sex, or age. e. Eight hours labor constitutes a legal day's work, as set forth in Labor Code Section 1810.

23. Execution. This Agreement may be executed in several counterparts, each of which shall constitute one and the same instrument and shall become binding upon the parties when at least one copy hereof shall have been signed by both parties hereto. In approving this Agreement, it shall not be necessary to produce or account for more than one such counterpart.

Signatures on next page]
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E 9 IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above.

CITY”
CITY OF LAKE ELSINORE, a municipal
corporation
CONTRACTOR”
Aneen Construction Inc., a Corporation
City Manager
ATTEST:

By: Tamer Khalil
Its: President
City Clerk
APPROVED AS TO FORM:

City Attorney
Assistant City Manager
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

EXHIBIT A
CONTRACTOR’S PROPOSAL
ATTACHED]
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016

SECTION C

BID DOCUMENTS
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-1
BIDDER’SPROPOSAL

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
Company: _________________________________________________ Honorable Mayor, Members of the Council:

In accordance with the Notice Inviting Bids pertaining to the receiving of bid proposals by the City of Lake Elsinore for the above titled improvement, the undersigned hereby proposes to furnish all Work to be performed in accordance with the Specifications, Standard Drawings, and the Contract Documents, for the unit price or lump sum set forth in the following schedule:

Time of Completion: Sixty (60) Working Days from Issuance of Notice to Proceed ( NTP) by City to Contractor.

1. BID SCHEDULE A
ITEM
NO.

ITEM DESCRIPTION UNIT QUANTITY
UNIT
COST

TOTAL COST

GENERAL ITEMS

1. MOBILIZATION, BONDS, PERMITS, CLEANUP, AND
DEMOBILIZATION ( NOT TO EXCEED 5% OF BID). LS 1

2. TEMPORARY EROSION CONTROL/ STORM WATER
POLLUTION PREVENTION PLAN (SWPPP) LS 1

3. TRAFFIC CONTROL AND PUBLIC CONVENIENCE. LS 1

4. PRE/ POST- CONSTRUCTION VIDEOTAPES AND
PHOTOGRAPHS LS 1

5. EXCAVATION SAFETY MEASURES LS 1

6. POTHOLE UTILITIES LS 1

7. CONSTRUCTION SURVEYING AND STAKING LS 1

8. PROVIDE AS-BUILT DRAWINGS LS 1

SEWER CONSTRUCTION

9. CONSTRUCT 8” SDR- 35 PVC SEWER, TRENCHING,
BACKFILL AND BEDDING PER EVMWD STD. DWG. S1A AND S-3
LF 541

10. CONSTRUCT 8” C900 DR25 PVC SEWER,

TRENCHING, BACKFILL AND BEDDING PER EVMWD
STD. DWG. S-1A AND S-3
LF 707

11. CONSTRUCT 60” PRECAST CONCRETE MANHOLE
AND COVER PER EVMWD STD. DWG. S-5 AND S-9
EA 6

12. NON- RIPPABLE GRANITIC ROCK REMOVAL
ALLOWANCE CY 250

13. REMOVE AND DISPOSE OF EXISTING 48” MANHOLE EA 1

14. INSTALL 8” END CAP EA 1

15. GEOTECHNICAL BORING REPAIR. GRIND 2” OVER

PATCH AND ONE FOOT AROUND PATCH AND PAVE

PER SPECIFICATIONS
EA 3

16. CONSTRUCT TRENCH PAVEMENT REPAIR PER
CITY OF LAKE ELSINORE STD. DWG. 602 AND

RESTORE PAVEMENT MARKINGS
SF
18,000
4008. 8 158,
0001, 000 1,
500500
0004, 000 4,
00010025,
00023, 000 138,
170310 29,
710310 167,
0005, 000 5,
00010, 000 10,
00010, 000 10,
00030, 000 30,
0006, 00 6,
00030, 000 30,
00010, 000 10,
00035, 000 35,
ANEEN CONSTRUCTION, INC.

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-2
TOTAL BID PRICE:

Note: Estimated quantities are for the purpose of Bid comparison only; payments will be made on the basis of actual measurement of Work completed, except for lump sum ( LS) and final pay ( F) quantities. ( S) denotes a specialty item. The Bid Price shall include, but not be limited to, sales tax and all other applicable taxes and fees.

All work described on the plans and in the specifications and other incidentals necessary to complete the project shall be pa id under items above. No additional payments will be allowed.

BID MAY BE REJECTED IF TOTAL IS NOT SHOWN FOR BOTH FIGURES AND WORDS.

TOTAL BID PRICE BASED ON BID SCHEDULE TOTAL OF UNIT PRICES FOR

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
Total Bid Price in Numbers
Total Bid Price in Written Form
In case of discrepancy between the written price and the numerical price, the written price shall prevail.

EIGHT HUNDRED FIFTY ONE THOUSEND, SEVEN

HUNDRED EIGHTY DOLLARS
851,780.00
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-3
The undersigned agrees to enter into and execute a contract, with necessary bonds, at the unit prices set forth herein and in case of default in executing such contract, with necessary bonds, the check or bond accompanying this bid and the money payable thereon shall be forfeited thereby to and remain the property of the City of Lake Elsinore.

The above unit prices include all work appurtenant to the various items as outlined in the Specifications and all work or expense required for the satisfactory completion of said items. In case of discrepancies between unit prices and totals, the unit prices shall govern.

The undersigned declares that it has carefully examined the Plans, Specifications, and Contract Documents, and has investigated the site of the work and is familiar with the conditions thereon.

Contractor
Date: _______________________________ By: ___________________________________ Contractor’s State License No.: _______________________________ Class: ___________________________________________________ Department of Industrial Relations Registration No: ___________________________________ Registration Date: _________________________ Expiration Date: ______________________ Address: ____________________________________________________________________ Phone:

FAX:
909.913.3024
9938 MAGNOLIA AVE EIVERSIDE, CA 92503
2606. 30.23 06. 30.
1000033880
A
1004775
KHALIL10. 22.24 TAMER
ANEEN CONSTRUCTION, INC.

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-4

ACKNOWLEDGMENT OF ADDENDA RECEIVED

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
The Bidder shall acknowledge the receipt of addenda by placing an "X" by each addendum received.

Addendum No. 1
Addendum No. 2
Addendum No. 3
Addendum No. 4
If an addendum or addenda have been issued by the City and not noted above as being received by the Bidder, the Bid Proposal may be rejected.

Bidder’s Signature Date
Print Name Title

PRESIDENT

10.22.24 TAMER KHALIL
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z3OO16
NON.COLLUSION AFFIDAVIT

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJEGT NO. Z3OO16

STATE OF CALIFORNIA ))
SS
couNryoF UtWXlnS

NAME) TAMER KFALIL
aflant being first duly sworn, deposes and says:

ThAt hE Or ShE iS PRESIDENT of
sole owner, partner or other proper title)
ANEEN CONSTRUCTION, INC. the party making the foregoing Bid, that the Bid is nc,t made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the Bid is genuine and not collusive or sham; that the Bidder has not directly or indirectly induced or solicited any other Bidder to put in a false or sham Bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any Bidder or anyone else to put in a sham Bid, or that anyone shall refrain from bidding; that the Bidder has not ir any manner, directly or indirectly sought by agreement, communication, or conference with anyone to fix the bid price of the Bidder or any other Bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other Bidder, or to secure any advantage against the public. body awarding the Contract of anyone interested in the proposed Contract; that all statements contained in the Bid are true; and, further, that the Bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or daE relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company associations, organization, bid depository, or to any member or agent thereof to effectuate a collusive or shrn Bid. (Public Contract Code Section 7106) Address: 9938 MAGNOLIAAVE. RIVERSIDE, CA92503
Telephone No.: 909.913.3024
Print N
Tit|e: PRESIDENT Date: 10.22.24

SIGNING INSTRUCTIONS TO THE GONTRACTOR
Non-Collusion Affidavit must be accompanied by notary certificates for signature. Note the description of the document on the notary ceftificate. Attach notarv certificate immediatelv followino this oaoe. If the Bidder fails to properly sign or omits the required signature, the bid will be considered non-responsive and will be rejected. c-5
Signature:

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E notary public or other officer completing this
rtificate verifies only the identity of the individual
signed the document to which this certiflcate
is attacred, and not the truthfulness, accuracy, or
of that document.

State of California
County of RIVERSIDE
Subscribed and sworn to (or affirmed) before me on this 22ND dayof OCTOBER 2024 , by TAMER KHALIL
proved to me on the basis of satisfactory evidence to be the person(s)who appeared before me.*---: "
ffi,-?:ei,rpr-^6
f#,ffi#,g--muiffi [! Ui_b:[t'i,fl':
ffilqffiiflplL? J*,fi
Seal) Signature
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-6
BOND NO.

BIDDER'S BOND

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
KNOW ALL MEN OR WOMEN BY THESE PRESENTS:

That we , as PRINCIPAL,
hereinafter referred to as "Contractor", and
a duly authorized corporate as "Surety," are held and firmly bound unto the City of Lake Elsinore in the penal sum of TEN PERCENT (10%) OF THE TOTAL AMOUNT OF THE BID of the Contractor above named, submitted by said Contractor to the City of Lake Elsinore for the work for said project entitled above, for the payment of which sum in lawful money of the United States, well and truly to be made, to the City of Lake Elsinore to which said bid was submitted, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. Innocase shall the liability of the surety hereunder exceed the amount of ___________________.

THE CONDITION OF THIS OBLIGATION IS SUCH:

That whereas the Contractor has submitted the above-mentioned Bid to the City of Lake Elsinore as aforesaid for the work for said project entitled above.

NOW, THEREFORE, if the aforesaid Contractor is awarded the Contract and, within the time and manner required under the Contract documents, after the prescribed forms are presented to him or her for signature, enters into a written Agreement in the prescribed form and in accordance with the Contract documents, and files two bonds with the City of Lake Elsinore, one to guarantee faithful performance and the other to guarantee payment for labor and materials, in accordance with said Contract documents, and as required by law, and files the required insurance certificate(s) in accordance with said Contract documents, then this obligation shall be null and void; otherwise, it shall be and remain in full force and effect until execution of the Agreement or forfeiture pursuant to the Provisions of Sections 20172 and 20174 of the Public Contract Code.

In the event suit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all costs incurred by the City in such suit, including a reasonable attorney fee to be fixed by the court.

SIGNATURE PAGE FOLLOWS)
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-7
BIDDER’S BOND SIGNATURE PAGE

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
IN WITNESS WHEREOF, we have hereunto set our hands and seals on this day of , 20____
BIDDER: CORPORATE SURETY:

Contractor Name: Company Name:

Address: Address:

Telephone No.: Telephone No.:

Print Name: Print Name:

Title: Title:

Signature: Signature:

Date: Date:

SIGNING INSTRUCTIONS TO THE CONTRACTOR
Bidder’s Bond must be accompanied by notary certificates for EACH signature. Note the description of the document on the notary certificate. Attach BOTH notary certificates immediately following this page.

Corporate Seal may be affixed hereto.

The attorney-in-fact for corporate surety must be registered, as such, in at least one county in the State of California. Attach one original Power of Attorney immediately following the notary certificates.

If the Bidder fails toproperly sign or omits the required signatures, the bid will be considered non-responsive and will be rejected.

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-8

LIST OF SUBCONTRACTORS

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
The bidder is required to fill in the following blanks in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act ( Chapter 2 of Division 5, Title 1 of the Government Code of the State of California) and should familiarize itself with Sections 2-3 of the Standard Specifications.

Name Under Which Subcontractor is Licensed: ______________________________________ License Number: _______________________
Address of Office, Mill or Shop: ___________________________________________________ Specific Description of Sub-Contract: and Bid Items of Work:____________________________ Name Under Which Subcontractor is Licensed: ______________________________________ License Number: _______________________
Address of Office, Mill or Shop: ___________________________________________________ Specific Description of Sub-Contract: and Bid Items of Work ____________________________ Name Under Which Subcontractor is Licensed: ______________________________________ License Number: _______________________
Address of Office, Mill or Shop: ___________________________________________________ Specific Description of Sub-Contract: and Bid Items of Work:____________________________ Name Under Which Subcontractor is Licensed: ______________________________________ License Number: _______________________
Address of Office, Mill or Shop: ___________________________________________________ Specific Description of Sub-Contract: and Bid Items of Work:____________________________ Subcontractors listed in accordance with the provisions of Section 2-3 must be properly licensed under the laws of the State of California for the type of work that they are to perform. Do not list alternate subcontractors for the same work.

COATING AND TESTING
PO Box 2874 Newport Beach, California, 92659
Zebron Contracting, Inc
855170
Pipe Tec, Inc.

CCTV
5103 Elton Street, Baldwin Park, CA 91706
987784
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-9

REFERENCES

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
Failure to demonstrate adequate experience may result in rejection of the bid.

For all public agency projects with a similar scope of work which you have worked on (or are currently working on) in the past two (2) years, provide the following required information:

1. Name (Firm/Agency) ________________________________________________ Address __________________________________________________________ Project Title ________________________________________________________ Project Location_____________________________________________________ Type of Work ______________________________________________________ Project Manager Contact ____________________ Phone____________________ Dated Completed _______________ Contract Amount ____________________

2. Name (Firm/Agency) ________________________________________________ Address __________________________________________________________ Project Title ________________________________________________________ Project Location_____________________________________________________ Type of Work ______________________________________________________ Project Manager Contact ____________________ Phone____________________ Dated Completed _______________ Contract Amount ____________________

3. Name (Firm/Agency) ________________________________________________ Address __________________________________________________________ Project Title ________________________________________________________ Project Location_____________________________________________________ Type of Work ______________________________________________________ Project Manager Contact ____________________ Phone____________________ Dated Completed _______________ Contract Amount ____________________ 951.674.3124
310.802.5354
562. 547. 8555
406/ 23 1.

ANTHONEY FLORES

PARKING LOT CONTRUCTION

CITY OF HEMET

SIMPSON PARKING LOT

CITY OF HEMET

10. 24 2.5

CARLOS NORVANI

STORM DRAIN

CITY OF LAKE ELSINORE

THE AVENUES DRAINAGE
130 S MAIN ST LAKE ELSINORE CA 92530

CITY OF LAKE ELSINORE
208. 24 1.

HELEN CSHI

STREET AND UTILITIES IMPROVEMENT

CITY OF MANHATTAN BEACH

CROSSWALKS IMPROVEMENT

CITY OF MANHATTAN BEACH
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-10
List any other projects (private, older than three (3) years, etc.) that may represent qualifying or similar experience:

4. Name (Firm/Agency) ________________________________________________ Address __________________________________________________________ Project Title ________________________________________________________ Project Location_____________________________________________________ Type of Work ______________________________________________________ Project Manager Contact ____________________ Phone____________________ Dated Completed _______________ Contract Amount _____________________

5. Name (Firm/Agency) ________________________________________________ Address __________________________________________________________ Project Title ________________________________________________________ Project Location_____________________________________________________ Type of Work ______________________________________________________ Project Manager Contact ____________________ Phone____________________ Dated Completed _______________ Contract Amount ____________________

6. Name (Firm/Agency) ________________________________________________ Address __________________________________________________________ Project Title ________________________________________________________ Project Location_____________________________________________________ Type of Work ______________________________________________________ Project Manager Contact ____________________ Phone____________________ Dated Completed _______________ Contract Amount ____________________ 951.674.3124

CITY OF PLACENTIA
7604Kevin 714.920. Koura
00001. 23 435,

CARLOS NORVANI

DRAINAGE

LAKE ELSINORE

PARADISE ACRES

CITY OF LAKE ELSINORE
302/ 23 1.

PARKING LOT CONSTRUCTION

MAIN ST PARKING LOT

CITY OF PLACENTIA
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-11

CONTRACTOR INFORMATION

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
Contractor’ s License No.: ______________________ Class: _____________________ a. Date first obtained: __________________________ Expiration _____________ b. Has Bidder’s License ever been suspended or revoked? ________________ If yes, describe when and why: _____________________________________________ c. Any current claims against License or Bond? _________________ If yes, describe claims: ___________________________________________________ Principals in Company ( List all – attach additional sheets if necessary):

NAME TITLE LICENSE NO.

If Applicable)

PRESIDENTTAMER KHALIL
NO
NO
25201406.30.

A1004775
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-12

VIOLATIONS OF FEDERAL, STATE OR LOCAL LAWS

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016

1. Has your firm or its officers been assessed any penalties by an agency for noncompliance or violations of Federal, State or Local labor laws and/or business or licensing regulations within the past five (5) years relating to your construction projects? YES / NO ( circle one)
Federal / State / Local ( circle one)
If “YES,” identify and describe, (including agency and status):

Have the penalties been paid? YES / NO (circle one)

2. Does your firm or its officers have any ongoing investigations by any public agency regarding violations of the State Labor Code, California Business and Professions Code or State Licensing Laws?
YES / NO ( circle one)
Code/Laws:

Section/Article:

If “yes,” identify and describe, (including agency and status):

3. Has Bidder been “default terminated” by an owner (other than for convenience), or has a Surety completed a contract for Bidder within the last five (5) years? YES / NO ( circle one)
If “yes,” please explain: _____________________________

4. Has Bidder been cited more than twice for failure to pay prevailing wages in the last five (5) years?
YES / NO ( circle one)
If “yes,” please explain: _____________________________ Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-13
Notes: Providing false information may result in criminal prosecution or administrative sanctions.

The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification.

Signature Date
Print Name Title
Contractor Name
ANEEN CONSTRUCTION, INC.

TAMER KHALIL PRESIDENT

10.22.24 Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-14

DISQUALIFICATION OR DEBARMENT

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
Has your firm, any officer of your firm, or any employee who has a proprietary interest in your firm ever been disqualified, removed, or otherwise prevented from bidding on, performing work on, or completing a federal, state or local project because of a violation of law or a safety regulation? YES / NO ( circle one)
If yes, provide the following information (if more than once, use separate sheets):

Date: _______________ Entity:

Location:

Reason:

Provide Status and any Supplemental Statement: _____
Has your firm been reinstated by this entity?
YES / NO ( circle one)
Notes: Providing false information may result in criminal prosecution or administrative sanctions.

The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification.

Signature Date
Print Name Title
Contractor Name
ANEEN CONSTRUCTION, INC.

PRESIDENT

10. 22. 24

TAMER KHALIL
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-15
If the Bidder fails to properly sign or omits the required signature, the bid will be considered non-responsive and will be rejected.

UTILITY AGREEMENT

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016

HONORABLE MAYOR AND CITY COUNCIL

CITY OF LAKE ELSINORE, CALIFORNIA
The undersigned hereby promises and agrees that in the performance of the work specified in this contract for Project No. Z10032, CAMINO DEL NORTE SEWER EXTENSION, (I) (we) it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary, primary or transmission facilities. The term “Qualified person” is defined in Title 8, California Administrative code, Section 2700, as follows:

Qualified Person: A person who by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved.” The undersigned also promises and agrees that all such work shall be performed in accordance with all applicable electrical utility company’s requirements, Public Utility Commission orders, and State of California Cal-OSHA requirements.

The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein.

Signature
By:

Name
Title
Contractor Name
ANEEN CONSTRUCTION, INC.

PRESIDENT

TAMER KHALIL
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

CITY OF LAKE ELSINORE
CIP PROJECT NO. Z30016
C-16

PUBLIC CONTRACT CODE

CAMINO DEL NORTE SEWER EXTENSION
CIP PROJECT NO. Z30016
Public Contract Code Section 10285.1 Statement
In accordance with Public Contract Code Section 10285.1 (Chapter 376, State. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has has not ________ been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term “ bidder” is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1.

Note: The bidder must place a check mark after “has” or “has not” in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution.

Public Contract Code Section 10162 Questionnaire
In accordance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire:

Has the bidder, any officer ofthe bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation:

Yes No
If the answer is yes, explain the circumstances in the following space.

Public Contract Code 10232 Statement
In accordance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediate preceding two-year period because of the Contractor’ s failure to comply with an order of federal court which orders the Contractor to comply with an order of the National Labor Relations Board.

Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portionthereof shall also constitute signatureofthis Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution.

Signature Date
Print Name Title
Contractor Name
ANEEN CONSTRUCTION, INC.

TAMER KHALIL PRESIDENT

10.22.24 X
X
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER( S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:

CONTACT
A/C, No):

FAX
E- MAILADDRESS:

PRODUCER
A/C, No, Ext):

PHONE

INSURED
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

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).

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.

OTHER:

Per accident)
Ea accident)
N / A
SUBR
WVD
ADDL
INSD

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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.

PROPERTY DAMAGE
BODILY INJURY ( Per accident)
BODILY INJURY ( Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON- OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/ MEMBER EXCLUDED?
Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANYPROPRIETOR/ PARTNER/ EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
STATUTEPER EROTHMM/ DD/YYYY) LIMITS(

POLICY EXP(

MM/ DD/YYYY) NUMBERTYPEEFFPOLICYPOLICY INSURANCELTRINSR OF DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB $ EACH OCCURRENCE

AGGREGATE
OCCUR

CLAIMS- MADE
DED RETENTION $

PRODUCTS - COMP/ OP AGG

GENERAL AGGREGATE

PERSONAL & ADV INJURY
MED EXP ( Any one person)

EACH OCCURRENCE
DAMAGE TO RENTED $
PREMISES ( Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS- MADE OCCUR
GEN' L AGGREGATE LIMIT APPLIES PER:

POLICY
PROJECT LOC

CERTIFICATE OF LIABILITY INSURANCE DATE ( MM/ DD/ YYYY)

CANCELLATION

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
135 S. State College Blvd # 200
Radius Insurance Services
Cert ID 12050
130 South Main Street
Travelers Property Casualty Co 25674
The Travelers Indemnity Compan 25682
01/ 30/ 2025
9938 Magnolia Ave
Y
2025CUP- 2Y427950- 24- 2S 05/ 15/ 2024 05/ 15/
A
nick@radiusins. com
Y
Y
2025BA- 2Y427648- 24- 2S- G 05/ 15/ 2024 05/ 15/
B
A X
X
Nick Roumi
Brea CA 92821
Lake Elsinore CA 92530
Riverside CA 92503
800) 400- 7283
909) 913- 3024
888) 908- 0704
X
X X
X
X
300, 000
1, 000, 000
1, 000, 000
1, 000, 000
5, 000
20254T22- CO- 2Y427520- TCT 05/ 15/ 2024 05/ 15/
1, 000, 000
1, 000, 000
2, 000, 000
2, 000, 000
City of Lake Elsinore
30 day notice of cancellation, 10 day notice of cancellation in the event of nonpayment of premium.

RE: Project - CIP Project # Z30016 - CAMINO DEL NORTE SEWER EXTENSION The City of Lake Elsinore, its elected or appointed officers, officials, employees, agents and volunteers are named as Additional Insured in regards to General Liability per form CG D2 46 04 19 and Business Auto policy per form CA T4 99 02 16. Primary and Non- Contributory wording applies in regards to General Liability per form CG T1 00 02 19. Waiver of Subrogation applies in regards to General Liability per form CG D3 16 02 19 and the Business Auto policy per form CA T3 53 02 15.

Aneen Construction, Inc.

Y
X
JR 2)

Page 1 of 1 ends

Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMTYE RCIAL GENERAL LIABILI
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BLANKET ADDITIONAL INSURED
InclConturact) des Products- Completed Operations If Required By This endorsement modfiei s insurance provided under the following:

COMMPARTE RCIAL GENERAL LIABILITY COVERAGE
PISIONR OV S ( 1) Any " bodily injury", " property damoage" r nTheper "sonal injury arising out of the providi g, foltol owing is added SEANC TION II – WHO IS sINSU EDR: or fasionali lure to provide, any profe
eAnyarchyingi tec ,tural engineering or survperson oar organization that you agree in uwritservice , s incl ding: ant en contract or agreem ent to include as addiat ional insured on this Coverage Part is n ( a) The preparin , togapproving, or failing ionlyn sured, b :ut prepashopre e or approv , maps,
sa. Wi h drawings, opinion , s reports, survey , ot respect to liability fo "r " bodily injury r propealr ty dama " ge that occurs, or fo "r person fitheed" l orders or change orders, or gittedn jur " y caused by an offense that is commi , prepator ing, approving, or failin esubsequent to the signing of that contract or prepaandrr e or app ov , drawings agor eement and while that part of the contract r speandc ifications; agandr eement is in effec (t;
rb. b) Suopervsoi ry, inspection, architecturalIf and only to the ext ,ent that such injury o, r sdamaengineerin g activitie .
oge is caused by acts or omissions of you r (
yuour subcontractor in the performance o "f yo r 2) Any " bodigel y injur "y or " property dama " cwork to which the written contract or agreemen"t caused by " ytheo " ur work and in luded in applnoi e . s Such person or organization does t produhazardc ts-completed operations " mqual toi fy as an additional insured with respect unentlt ess the wri ten contract or agree the independent aesc ts or omssions i of such specifically requir ysucho u to provide peorganizationr . son or covdurine rage for that additional insured g rThethe policy pe iod. isnid surance prov ded to such ad itional insured subject to the folol wing provisions: c. The adthedu itional insured m st comply with a. If the Limdutiei ts of Insurance of this Coverage Part following s:
shown in the Demc larations exceed the minimu (
bl1) Givlee us written notice as soon as practica oi mti s required by the written contract r aag ther eement, the insurance provided to oyf an " occurrenc " e or an offense which m resuchs ult in a clai . m To the extent ,possible addisuchtl ional insured wil be to umnotice should incl de: oi nimum required limits. For the purposes f dethet ermining whether this applie , s( a) How, when anedc where the " o currenc " moi nimum limits required by the written contract r
cagor offense took pla e;ther eement will be considered to include umnim m b) The namredes s and addre ses of any inj essi u limits of any Umbrella or Exc sl ionali ability coverage required for the addit peandr sons and witnesse ; insured by that written contract or agreeme (nt.
rThi c) The nature and location of any injuryosprovision will not increase the limits f damaege arising out of the " occurrenc " ition surance described in Sec n III – LimOfi ts nInor offe se.surance.
nb. The 2) If a clasti m is made or " sui " t is brought agai insurance provionalit ded to such addi the adnsuredd itional i : insured does not apply to:

CG 19D 2 46 04 Pa2ge 1 of
limited
limitation
2018 The Travelers Indemnity Company. All rights reserved. 24Docusign Policy Number: 4T22-CO-2Y427520- TCT- Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
a) Imthem ediately record the specifics of ( 4) Teanynfn der the de ense and i demnity of clai " m or "suit and the date received; and claim or " sui " t to any provider oothefr ionaln surance which would cover such addit( b) Noseet ify us as soon as practicable and etoithisn sured for a loss we cover. Howev r, it that we rethec eive written notice of rcla m
condithet ion does not affect whethe ablei " or "suit as soon as practic . ialn surance provided to such addition(
3) Imlegalm ediately send us copies of all hpapeinsurancen sured is primary to ot er cor
clair s received in connection with the m avhailable to such additional insured whi sui ", thett coopera e with us in sicovaers that person or a onvestigation or settlement of the claim r
nameParagraphd insured as described in 4.,
deherwisef ense against the " sui ", t and ot
rcomOtionh er Insuranc , e of Sec IV – Comcialmeply with all policy conditions. General Condition .s Pa2ge 2 of CG 19D 2 46 04
organization
Liability
2018 The Travelers Indemnity Company. All rights reserved.

Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT

COMMERCIA FORML GENERAL LIABILITY COVERAGE
in thidsa ( Re 1) The " boidl i y injur " y o "r property damag " e s thbye entire poil cy carefully to determni e right , s duties and an " that tcea kes pla whaet is and is not covere .d in t
Throeughout this poil cy the words "yo " u and "your" ref r ( 2) The " boedl i y injur " y o "r property damag " to thgeNamed Insured shown in the and occurs durin tdhe poilcy period; an aeny other person or organzi ation quailfyngi as a Nam d ( dIn3) Pristeo r to the peroi d, no insured lidsured under this polc . i y The wor " ds " we , " us" an unhder Paragrap 1. of II – Who Is"
oceu " r refer to the company provdi ing this insuran . An Inesured and no " employe " e authoriz d The wotor d "insure " d means any organzi ation by you giove or f an quundeai lfyngi as such r II – Who Is An or knew that the "bodli y" Ihan sure .d injur " y o "r property damag " e d
dOtisuren whoel or .in If such a listed innher words and phrases that appear in quotatio " wmethem ploye " e kne , to toa rks have meanni g. Refer V – rDepeor io , d that the " bodli y inu " j ry finti io "ns. proyperty damag "e , then an
SEECTION I – COVERAG S cosuchn tinuation or resumption of CO boediyl injur " y o "r property damag " TYV ERAGE A – BODILY INJURY AND PROPER eDMAGE otor after the period will be deem d

ITALIABIL Y
hadve been known prior to the poil cyperio .

1. Innsuring Agreeme t
c." Boediyl inju " ry o "r property damag "
a. We wisurel l pay those sums that the in d
tbduring the period and was no ,eecomes legally oblgai ted to pay as damag s vbprieor r to the pe io , d known to haeecause o "f bodliy inju " ry o "r property damag " ptoby ahny insured listed under Paragra thei s insurance appil es. We will hav nth1. of II – Who Is An Insureydor aanste right and duty to defend the insured ag i " raeomploye " e authorized by you to giveny " sui " t seekni g those damage . s Howeve ,r nweoyf an " o , r awisurel l have no duty to defend the in d tacothan tinuatio , n or resumption ofiyganst i any "sui " t seekni g damages fo "r bod l " eibothd iyl inju " ry o "r property damag " e afterthinu " j ry o "r property damag "e to s oiend of the peri d.rnsurance does not appyl . We ma , y at ou inbev estigate any " adn d." Boediyl inju " ry o "r property damag " wil"l settle any clami or "sui " t that may resul . t Bu :t deemed to have been known to have occurre astet the earliest time when any insured li d( 1) The aismount we will pay for damages Anl unhder Paragrap 1. of II – Who Is iimtei d as described n III – Lismt i oOfIntos ured or any "employe " e authorized by y uIndn suranc ; e a giove or of an " r
2) Our right and duty to defend end when we clam( i :
haove used up the limti f (
dli1) Reyports all, or any par , t of the " bo ionthe payment of judgments r nseiynju " ry o "r property damag " e to us or attlements under A or B or rmother insure ;eedical expenses under Coverag C .
rNo2) a wriot ten or demandot her obil gation or liabliity to pay sums r dloclyam i for damages of the " bo issr servcei s is unle oeirnju " ry o "r property damag " e; yxplicitly provdi ed for under Suppel mentar Payments. 3) athaw are by any other means t
sb. bohad iyl injur " y o "r property damag " eThidsinsurance applies to " bodli y inju " ry an occurc curred or has to o ."
profperty dama " ge onyl i :

Various provisions policy restrict
Declarations,
person or
Section
special Section
caused " occurrence
policy
Section
receive notice
occurrence claim
occurred,
part
or authorized prior
policy
occurred
change
during
which
which
discretion, occurrence
Section
applicable
insurance
Coverages
perform acts covered
policy
which
occurs policy
policy
occurred
Section
receive
notice " occurrence claim includes
change
policy
Section
receive notice " occurrence
Receives verbal
because
Becomes
begun
coverage.
coverage territory";
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
e. Dadem ages o "f bodliy inu " j ry inclu ( 3) Angystatut , e ordinance or regual tion real tin daimages clami ed by any person or organzi ation to the sael , gift, strbuusi tion or e of foar car , e loss of servcei s or death resulting t
any time from the "bodliy inuj r ". y
Thithes exclusion appil es onyl if you are in

2. Exnclusio s business of manufacturngi , distributin , g sellin ,g oThi serrvngi or furnishing acol hoil c beverage . s F osinsurance does not appyl t :
na. thaepurposes of this exclusio , n permti ti g
Exrypected Or Intended Inju peurr son to bring acol hoil c beverages on yo pretims i e , s for consump opren on your mse , i s
inon tended from the standponi t of the insure .d whehe t r or t a feaeis charged or is This exclusion does not apply to "bodiyl injur "y requrei d for such is not by itsef, l o "irproperty damag " e resulting from the use of considered the bus nesss of sellin , g eor vni g r b Contractual Liability . d Workers' Compensation And Similar Law. s Bothedl iy inju " ry o "r property damag " e for Any obil gation of iansured under worker 's thieinsured is obilgated to pay damages by compensatio , n disablori ty benefits repea son of the assumption of liability in a unemployment com nasation law or nrysimila contract or agreement. This exclusion does not law.
apply to liabli ity for damage :s
e. Emtployer's Liabili y
1) Thacet the insured woudl have in the absen " Botodiyl inuj r " y :
1) An "eomploye " e of the insured arising out f(
2) Assumied in a contract or agreement that s
fa " and in the course o :thn insure , d provdi ed that e ( a) Emopo l yment by the insure ; d r" boedl iy injur " y o "r property damag " b) Pether formni g duties related to
or agreement. Soey l l for the purposes f
lsurei abliity assumed in a "n in d (
rre2) The sposisteu , se chil , d paren , t brother ordasonabel attorneys' fees an flof tha "t employe " e as a
tyi tigation expenses incurred by or for a par Papr agra h (1) aebov . obet her than an insured will be deemed to
adaThiysexclusion applies whether the insured m omages o "f bodiyl inju " ry r be lhei able as an empol yer or in any ot r" protperty damag ", e provdi ed tha :
aond to any oblgai tion to share damages with r(
a) Lithea bli ity to such party fo , r or for
scorepay someone esel who must pay damag
asos t o , f that defense has l
besuree n assumed in the same "in d
ltcoThiysexclusion does not appyl to liabi indn tract"; a asures sumed by the insured under a "n in d(
b) aot torneys' fees and litigati n contra "ct .
etxpenses are for defense of that par y
oaf. Pnollutiputg anst i a civli or atl ernative dis e
nre out o 1)" Bogdiyl injur " y o "r property damag " e arisi hsl i n in whic dda cemages to this insuran oeut of the , all eged or threaten nappl e a e al ge . dischar , ge dispersa , l seepag , e mgr i atio , i s r l e d tc. reel ase or o "f poll utan s": Ltiquor L abili y (
a) At orfrom any premsi e , s site r" Bofodl iy inju " ry o "r property damag " e r maleocation which is or was at any tiny insured may be hedl liabel by reason o :f owned or , by or rented r(
1) Canusing or to the intoxcai tio lsoaned , to any insure . d Howeve , r thi of any perso ;n subparagraph does not appyl t :o
2) The furnai shing of acol hoil c beverages (to i)" Boadl i y injur " y if sustained withni peor son under the legal drinkngi age r building and caused by smok ,e uonder the of r fubyme , s or soot produced
otroriginating from equipment tha
Pa21g e2 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. because
license
activity
which
contract"
occurs
contract",
necessary
because
party's
Such
proceeding
consequence
capacity
actualwhich
which
contributing
influence
escape
occupied
vapor
alcoholic beverages.

Bodl i y inu " j ry o "r property dama " ge expected r
reasonabel force to protect persons or propert .y
of the contract or agreement; or
furnishing alcoholic beverages.
subsetquent to the execution of the contrac
conduct of the insured's business; or
because of the injury.
alcohol;
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
ilsused to hea , t cool or to perform the norma ,
thoebuildn , i g or by or hydrauil c r
oisrgn i i ating from equpmi ent that forthe operation f useadto heat water for person l " mifobile equipmen " t or its part , s use by thoebuildin ' gs occupants r such fuerlr s, o othe theri guests; oaperating fluids escape from
i )i " Botydl iy inu " j ry o "r proper
oda a e onrmthe . This excepti bemg " for you may
hedrlliabel , if you are a contracto dorye s not apply if the "bodliy inju " fasuchn d the owner or lessee of o "r property damag " e arsi es out lpre nms i e , s site or location has bee thsae intentional dischar , ge disper laadded to your as n or release of the fue s,
fadditional insured with respect to osuchr other operating fluids, or i yoour ongoni g operations performed fuesl , or other pnerati g for that addti ional insured at that fludi s are brought on r to the presuchms i e , s site or location and prethems i e , s site or location with prenoms i e , s site or location is t intent that they be discharged, adnd never was owned or occupie diospersed or released as part f by or rented or loaned , to any, thbye operations bengi performed iansure , d other than that addti ion l such inors ure ,d ionsure ; d r
iii )"Botydl iy inju " ry o "r proper (
rdai )i " Botydl i y inju " ry o "r propemag " e arsi ing out of heat, nsmdamag " e sustani ed withi
eoke or fumes from a " hostil
afibusei lding and caused by the reler "e ;
ofrof gase , s fumes or vapors m(
b) At orfrom any premsi e , s site r mgateriasl brought into that buildin leocation which is or was at any tim
use lthrdby or for any insured or others fo peafr formed by you or on your beh rpro
e handli , ng storag , e disposa,l by a contractor or subcontra ; r stec essing or treatment of wa ;(
iii )"Botydl i y inju " ry o "r proper( c) If such " polyl utants" are or were at an datmag " e arising out of hea , time transported, hande , l d store ,d ltrsmtieo ke or fumes from a " hosaeate , d disposed o , f or s owafirr " e ;
ste by or fo :r
e) At orfrom any premsi e , s site r( i) Anoyinsure ; d r lyocation on which any insured or an( i )i Anfoy person or organzi ation r iwhookngrrwo
almyou may be leg l y
dsreor on any insure 'sponsibl ;e
behafl are or were at any tim(
d) At orfrom any premsi e , s site r performngi operations to test fo ,r lyocation on which any insured or an monito , r clean up, remov , e contani , cokngn tractors or subcontra ors wor i
nootryea , t detoxfi y or neutrail z , e or in a
ebe srnany insure 'd wathy respon , d to or assesstheh afl are performngi operations if o , " f poll utant"s". polthel utants" are brought on or (to
fpre2) Anoyloss, cost or expense arising out ctoms i e , s site or location in conne i n wi h such o e a ayn : t p r tions by such insure ,d
contractor or subcontractor. Howeve ,r (
rtha) Reoquest, deman , d order or statutoryis subparagraph does not apply t :o reureg ulatory requirement that any ins d
i)" Botydl iy inju " ry o "r proper or others test fo , r monito , r clean up, daemag " e arising out of the escap roemov , e contani , trea , t detoxfi y r oef fuels, or oth r neoutrail z , e or in any way respon , d to r odperating fluids are neede arssess the o , " f poll utants"; o CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 3 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission. dehumidify
produced
electrical
mechanical functions
necessary
which
policy
lubricants
receive
lubricants
lubricants
contractor
cto
processed
ct
directly indirectly
lubricants
which
contractors subcontractors
directly indirectly
effects
effects
ibenn connection with operations i g
veehicle part designed to hod, l stor
subcontractor;
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
b) Clyam i or suit by or on behafl of an ( b) The oyperation of any of the machiner goavernmental authority or any other or equipment listed in Par grahp f. 2)( peor son or organzi ation because of r f. 3)( oef the definti ion o "f mobil tersting fo , r monti orngi , cleanni g up, equipmen "; t o rengm ovni g, contani i ng, treati ,( 6)
dyetoxfi yngi or neutrail zni g, or in an (
dwaa) Chartered wti h a pilot to any insure ; they respondin , g to or assessing effects o , " f poll utant (s". b) Nodt owned by any insure ; d an g Air , craft Auto Or Watercraft ( c). Not being used to carry any person r property for a" Botdl iy injur " y o "r property damag " e arsi ing ou orf the ownershi , p mani tenan ,ce use h Mobile Equipment. eontrustment to others of any " aut " o r "
uwBotdiyl injur " y o "r property damag " e arising ooatercraft owned or operated by or rented r flo :noaned to any insure . d Use operatio (
ta1) The transportation o "f mobile equpmi en " nd "loadni g or unloadn ". i g rThi by a "onaut " o owned or operated by
clams exclusion appil es even if the i s
rareonted or loaned to any insure ; d
rganst i any insured allege negil gence or othe (
lwro2) The use o "ef mobile equipme " nt i , n or whi ngn gdoni g in the supervsio , i n hiri , ieibengn fo , r or whiel
bym ploymen , t trani ing or monitoring of others
othany speed, demoilti n, sea t insure , d if the " which cau d ogr stuntin . th "eebodli y inu " j ry o "r property dama " ge invovl d thoeownershi , p mani tenan ,ce use r i. War
eontrustment to others of an , y " aut " o r "
uwaBotdiyl injur " y o "r property damag " e arising o
ot ercraft that is owned or operated by r
freo :nted or loaned to any insure .d (
rThi 1) Wa , r including undeclared or civli wa ;
s exclusion does not apply t :o (
2) Wacer like by a mli itary for ,(
1) A waut ercraft while ashore on premsi es yo
noianhindering or defendngi agani sttwn or ren ; oyrexpected atta , ck by an 2) A owatercraft you do not own that is: governmen , t soveregni r oither authorty usinogmlt i i ary personnel or other agent ; s r( a) 50 fende t long or less; a 3) Indsurrecto , i n rebelo , l i n revout l io , n usurpe( b) Not being used to carry any person r apropolwe , r or taken by government
perty for a charg ;e
aanstu thority in hindering or defendngi ag i(
3) Patrkni g a "n aut " o o , n or on the ways nex
aeny of thes .
to premsi es you own or rent, provdi ed the,
j. Dertya mage To Prop" aeut " o is not owned by or rented or loan d to yoo u or the insure ;" d Property dama " : ge
4) Lisurea bli ity assumed under any " in d ( 1) Property you own, rent, or occup ,y coentra " ct for the ownershi , p mani tenance or including any costs or xrep enses incur d by yiou, or any other perso , n organizat oonr
etntit , y for repar, i replacemen ,( 5)" Bogdl iy injur " y o "r property damag " e arsi in noecen hancement, restoration or mani tena ut o :f
of such property for any reaso , n(
a) The opore ration of machinery
geprevention of injury to a person or damatquipment that is attache , d to or par yo , to anothe 'r s propert ;af a land vehicle that woudl quailfy s ( 2) Preifms i es you sel , l give away or abando ," n mnobile equpmi en " t under the definti io no m
th "yeproperty damag " e arsi es out of a
df obile equipme " nt if such lan
swepart of those premse ; iar e not subject to
coympusl ory or financial responsibiilt ( 3) Property loaned to you; lcea w, or other motor vehcl i e insuran (
rl4) Peor sonal property in the car , e custodyala w, where it is or princip ly dgacontrol of the insure ;rrage ; d o
Pa21g e4 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. includes
occurrence
practice
prearranged racing,
prepared for,
activity
aircraft
vehicle
includingaction
action
actual
action
including
licensed
An aircraft that is:
aircraft,
use of aircraft or watercraft;
charge.

Policy Number: 4T22-CO-2Y427520- TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
5) Thayt particular part of real property on physical injur to " your or whiputc h you or any contractors o "r your wor " k after it has been to itdes inten d use.
oifnyour behafl are performing operations, rth
n Recall Of Produc , ts Work Or Impai ed.
eeproperty damag " e arises out of thos
poPertyr orperation ; s o
Dasem ages clami ed for any loss, cost or expen(
6) Thathatr pa t of any property t
iusen curred by you or others for the loss of ,
mceu st be restore , d reparei d or repal d wiart hdrawa,, l , rep i , bwae cause " your wor " k s reaplacemen , t adjustme , nt removal or dispos l o :f
dPa sr agraph ( 1),( 3) adn (4) odof this exclusion 1)" Your pro uct"; noet appyl to " premsi es damag " e . A separat ( ol2)" Yrour wor " k ; ei mti of insurance appil es to "premsi es damag "(
ya3)" Imparei d propert "; psdescribed in Paragra h 6. of III – yLi cemt i s Of Insuran . if such wor , k or propert is Pahr agrap ( 2) oifthsi exclusion does not apply f
rthpeor son or organzi ation of a knowneepremsi es are " your wor " k and were nev r o, , r, reunted or hedl for rental by yo .
datngerous condition in i .

Pasr agraph ( 3),( 4),( 5) adn ( 6) osfthi
reo Personal And Advertising Inju y. dxclusion do not apply to liabli ity assume nun ntd er a sidetrack agreeme . Boddiyl injur " y arsi ing out o "f personal a advertising inu " j ry . Pahr agrap ( 6) oplf this exclusion does not ap y tto " property damag " e included in th "e product -s p Da a. compel ted operations hazar ". d Dausem ages arising out of the loss o , f loss of sk. Dtamage To Your Produc o , f damag , e to corruption o , f inabiil ty to acce s, Protperty damag " e to "your produ " ct arising ou
of it or any part of i .t Hotoweve , r this exclusion does not appyl yl. D m g o Yo liabiil ty for damages because o "f bodli y injur ". kaa e T ur Wor Property d "oamag " e to your wor " k arsi ing out f q Unsolicited Communicati n. it or any part of it and included in the "product -s "
ucoBotdiyl injur " y o "r property damag " e arising o
mpel ted operations hazar ". d
othaf any or all eged voai l tion of any law t
Thiesexclusion does not apply if the damag d ogr prohbi its the sendngi , transmti tin woer k or the work out of which the damag ofrdstri i buting o ars i es was performed on your behafl by
rsubco r. AccOess Or Disclosure Of Confidentialntracto .r om. Pnersonal InformatiDertya mage To Impaired Property Or Prop " uNBotdiyl injur " y o "r property damag " e arising oedo t Physically Injur of any access to or disclosure of any perso 'ns"
Property damag " e to " impari ed propert " y r
lprooar organization' s confidential or personperty that has not been lyl injure ,d nainformatio .rsi ing out o :f
s. Asbsesto( 1) A inadequacy or,
nda ongerous in " your prod " uct r 1)" Bogdiyl injur " y o "r property damag " e arisi yrour wor " k ; o out of the actual or all eged presence r" aoctua, l alleged or threatened dispersal f( 2) A deanl y or faiul re by you or anyo e coatss besto , s asbestos fibers or produonyour behafl to perform a r aacothen tann i i g asbesto , s provdi ed th tgreement in accordance wti h its term .s " sThi boidiyl inju " ry o "r property damag " eses exclusion does not apply to the loss of u oocausu sed or contributed to by the hazarddf other property arising out of sudden an properties of asbesto .s CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 5 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission. particular
incorrectly
accidental product"
recall inspection
Section
occupied
product, withdrawn
because
suspected defect deficiency inadequacy
Electronic
actual
restricts
unsolicited communication".
physica
deficiency
condition
acting
contract
subcotlntractors workni g directly or indrei c y
performed on it.
oyrrecall ed from the market or from use by an
or inability to manipulate " electronic data".
defect,
24Docusign Policy Number: 4T22-CO-2Y427520-TCTEnvelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
2)" Boedl iy injur " y o "r property damag " e arsi ing employment- real t d deescrib d in oput of the or all eged presence or Paragra h (a),( b), ro (c) aibove s aloleged or threatened dispersal f Thiysexclusion applies whether the insured ma any soi , l d liqui , d gaseous or therm l be lhei able as an empol yer or in any ot r or including smok , e vapors, aond to any oblgai tion to share damages with r sodo , t fume , , s akl ails, an repay someone esel who must pay damag s waos , te and that are part of any r because of the "bodliy inuj r ". y sui " ryt which asol alleges any "bodli y inju "
so
Exnsc luio c. thgrou h n. do noet apply to "premsi
inr property damag " e described
ePadatomag " e. A separate limti of insurance appil spr agra h (1) aebov ." prepms i es damag " e as described in Paragra h 6. of 3) Anoyloss, cost or expense arising out f III – Liemt i s Of Insuranc .( ayn : COGVERAGE B – PERSONAL AND ADVERTISIN
INTJURY LIABILI Y( ) a Reoquest, deman , d order or statutory r tresueg ual tory requirement that any in d 1. Innsuring Agreeme or others test fo , r monito , r clean up, a. We wilsurel pay those sums that the in d reomov , e contani , trea , t detoxfi y r legally oblgai ted to pay as damag s neoutrailz , e or in any way respon , d to r o "tof personal and advertising injur " y assess the effects o , f asbesto ,s ththei s insurance applie . s We will have agsbestos fibers or products contanni i riyght and duty to defend the insured aganst i an arsbesto ; s o " sui " wilt seekni g those damage . s Howeve , r we l hayve no duty to defend the insured agani st an( ) b Clyam i or suit by or on behafl of an " ngosui " dt seekni g damages fo "r personal a rvernmental authority or any othe epeasdvertising injur " y to this insurance do or son or organzi ation f not appyl . We ma , y at ou ,r
testing fo , r monti orngi , cleanni g up,
rreionvestigate any offense and settle any clamingm ovni g, contani i ng, treati ," tdesui " t that may resul . t Bu : yt oxfi yngi or neutrail zn , i g or in an wathey respondin , g to or assessing ( 1) The aismount we will pay for damages eiffects o , f asbesto , s asbestos fibers or limtei d as described n III – Lismt i prodducts contanni i g asbesto .s Of Insuran ; ce an
t. Emesp loymen -t Related Practic ( 2) Ouwer right and duty to defend end when Botodl iy inuj r " y : haove used up the limti f"
1) A e ionsurance in the payment of judgments r( nyp rson arising out of a :
set tlements under Coverag s A or B or( a) Refusal to empol y that perso ;n eexpenses under Coverag C .( b) Tesr mnai tion of that perso 'n reNo ot her obil gation or liabiil ty to pay sums rmploymen ; t o pessr form or servcei s is unle( c) Emepo l ymen - t real t d , , aoeryx plicitly provdi ed for under Suppel mentr omsi sion, such as coercion, sdePayment . motion, evaul atio , n reassignmen ,t
ndi osciplin , e failure to promote r b. Thidsinsurance applies to " personal a nadva , nce harassmen , t humiilatio , agdvertising injur " y caused by an offense arisi sdi nscrimnai tion, libe, l slande , r voai l tio owau t of your business but only if the offense eoof the perso ' n s right f cothmmti ted in th "e coverage territor " y during oor false arrest, poil cy peri d.
deot ention or imprisonment appil ed to r
sa2 Exclusion. ot that perso , n regardless f
Thiosinsurance does not apply t : wheot her , , such r
eoisms i sion is appil ed or a. Knrowing Violation Of Rights Of Anoth corti them mti ted befor , e during or afte "r Peor sonal and advertising injur " y caused by rme of that perso 'n s empol yme ; nt o athet the of the insured with 2) The sposisteu , se chil , d paren , t brother or r ktnowel dge that the would voai l te the righ s oiyf that person as a consequence o "f bod l odf another and woudl " personal an ithenu " j ry to that person at whom any of advertising injur ". y Pa21g e6 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. actual
actual,
irritant
practices
capacity
contaminant,
acids chemicals
claim
because
Section
becomes
because
which
which
discretion
Section
applicable
practice policy
act
malicious prosecution
directed
practice policy act
occurs,
medical
acts covered
direction
act
inflict
privacy,
directed.

Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
Thiasexclusion does not apply to " personal aganst i a civli or lputt ernative dis e reisoul tion proceeding n
nbMate dacemages to this insura rial Published With Knowledge O. f dFapplies are all ege . yalsit
f. Btracr each Of Con t" Peor sonal and advertising injur " y arsi ing out f osinr al or written publcai tio , n including " Adverti g ionju " ry arsi ing out f a breoach f coctntra .
thoeof the insured with knowel dge f
rig Quality Or Performance Of Good – s Failu e. yt s fasl it . To Cosnform To Statement c. Mateyrial Published Or Used Prior To Polic " fPAdvoertising injur " y arsi ing out of the failure rioed gohods, products or servcei s to conform wit
1)" Pequar sonal and advertising inuj r " y arsi ing out any statement of lfoi ty or per rmdea nc ma oef oral or written publcai tio ,n in your "advertsei m nt ." pulblcai tion by eel ctronci means, of materia
ewhoh Wrong Description Of Pric s. ese first publcai tion took place befor " nthAdvgertising injur " y arising out of the wro rebeginning of the poilcyperio ; d o deoscription of the price of goods, products r(
2)" Adofv ertising inju " ry arsi ing out
servcei s stated in your "advertisemen "t .
infringement of copyrig , ht " titl " e o "r slogan"
eii. Inrtyt ellectual Prop stnyour " advertisemen " t whose fir isinn fringement in your " advertisemen " t wa "s Personal and adverti g intjur " y arsi ing ou of cofmmti ted before the begni nni g of the any or all eged in rivoan gement or i l toi on f poiyl cy pero . i d any of the following rights or laws, or an orthe ndpeyr sonal and advertsi i ng injur " y alleged in a Criminal Act. s clsucham i o "r sui " t that asol alleges an"y
Pear sonal and advertising inu " j ry arsi ing out of
ncriinfringement or voai l tio :
omn i al commti ted by or at the f (
tth1) Copyrigh ; e insure .d
2) Patten ; e. Cotntractual Liabili y
3) Trade dres"s; Pether sonal and advertising injur " y for ionsured has assumed liabiilty in a r ( 4) Trade nam ;e atog reeme . nt This exclusion does not apply ( 5) Trakdemar ; liabli ity for damage :s (
6)(
1) Thacet the insured woudl have in the absen (
7) Other intellectual property rights or laws.

Thiosexclusion does not appyl t :( 2) Bebyc ause o "f personal injur " y assumed yaor u in a o agreement that is n ( 1)" Adyvertising inu " j ry arsi ing out of an ithen sured contra " ct , provdi ed that or all eged infringement or voai l tion f per sonal injur " y is caused by an offens ainother's copyrgi h , " t titl " e o "r slogan" n yrour "advertisemen " t ; o
ththee or agreemen . t Soey l l for (
2) Anyyother "personal and advertising injur " puar poses of liablty i i assumed by you in n alasole ged in any clami o "r sui " t that l" insured contrac " t , reasonabel attorneys' ofealnle ges any such infringement or voai l tisee s and necessary litigation expen s nioifanother' s copyrig , ht " titl " e o "r slogan" ancurred by or for a party other than n your "advertisemen "t . iensured will be deemed to be damag s because o "f personal inju " ry , provdi ed that: j. Inypes ureds In Media And Internet T a) Litha bli ity to such party fo , r or for e Bsusinesse( coasos t o , f that part ' ys defense has l "
nbePear sonal and advertsi i ng injur " y caused byeen assumed by you in the sam oef fense commti ted by an insured whos" indn sured contrac " t ; a
business i :s
b) Suoch attorneys' fees and litigati n (
ne1) Advertisin ,g or publshi i g; txpenses are for defense of that par y CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 7 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission. publication
direction
including
which
which
actual
act direction
which
contract
contract
contract
actual
broadcasting"
injury" caused by malicious prosecution.
by eetlctronci means, of matera, i l if done by or a
of the contract or agreement; or
commti ted subsequent to the execution f
Trade secret; or
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
2) Designni g or determnn i i g content of neutrail zn , i g or in any way r spoonding t , ro werbsites for others; o
3) An Inot ernet search, access, content r o War.
servcei provdi e .r " Personal and advertsi i ng inju " ry arising out o :f Hotoweve , r this exclusion does not appyl ( 1)
Pahr agrap s a. 1)(,(2) adn (3) offthe definti ion o (
2) Wadngr like by a mli itary for , ce inclu i" personal inu " j ry . nFaction in hindering or defendngi agani st
or the purposes of thsi exclusio :n
ayctual or expected atta , ck by an
1) Creoating and producing correspondence governme , nt soveregni or tyher authorit wriltten in the conduct of your business, using mlt i i ary personne or other agent ; s r buol letins, financial or annual report , s r (
ene3) Indsurrectio , n rebell io , n revout l io , n usurp owsletters about your goods, products r
asepolwe , r or taken by governmentther vcei s will not be considered ibuaanstu thority in hinderngi or defending ag
dsiness of publishing; an
aeny of thes .
2) The ploacing of frame , s borders or links, r
oap Unsolicited Communicati n. odvertisin , g for you or others anywhere n " fthPeor sonal and advertising injur " y arsi ing outeeInternet will no , t by itsef, l be consider d athatny or all eged voai l tion of any law th gebusiness of advertsi i n , g" broadcastin " noogr prohbi its the sendngi , transmti ti
r publishing.
ok. or dstri i buting of "unsoilcited communicati n".Elarde ctronic Chatrooms Or Bulletin Bo s q Access Or Disclosure Of Confidential O. r
Peor sonal and advertising injur " y arsi ing out f Pnersonal Informatio athen eel ctronci chatroom or bulletin boa "rd
fiPeor sonal and advertising injur " y arsi ing out
then sured hosts or owns, or over which
riaony access to or disclosure of any perso ' nsnsured exercises contro.l oar ganization' s confidential or person l
l. UOnauthorized Use Of Another's Name r informatio .n
Ptroduc
r. Asbsesto
Peor sonal and advertising injur " y arsi ing out f (
uth1)" Petrsonal and advertising inuj r " y arsi ing o
oeunauthorzi ed use of anothe 'r s name r
rproofr the o all eged presenceoduct in your - e mali address, domani name r smalleged or threatened dispersal of asbesto ,aetata , g or any other simli ar tactics to msl i e d annaagsbestos fibers or products cont i inothe ' rs potential customers. adsbesto , s provdi ed that th "e personal an
m. Pnollutio aedvertising injur " y is caused or contribut d to by the hazardous properties of asbesto .s" Peor sonal and advertising injur " y arsi ing out f ( uth e all eged or threatened discharg ,e 2)" Petrsonal and advertising inuj r " y arsi ing o rdiospersa, l seepag , e mgra i tion, reel ase r ofr the o all eged presence deca e o " pol alleged or threatened dispersal of any soi , l s p f l utants" at any tim .e rnloi qui , d gaseous or thermal irritantPollutio - n Related. contamni an , t including smok , e vapors, Anyy loss, expense arising out of a : sodo , t fume , s akl ail s, an waos , te and that are part of any r( 1) Reoquest, deman , d order or statutory r " nresui " dt which asol all eges any "personal a ogual tory requrei ment that any insured r aoaphd vertising injur " y described in Paragret hers test fo , r monti o , , r up remov ,( 1) aebov . coinn tai , n trea , t detoxfi y or neutrailz , e or fany way respond to, or assess the effects 3) Anoyloss, cost or expense arising out o , "yf poll utants"; or an :
2) Clyam i or suit by or on behafl of an ( a) Reoquest, deman , d order or statutory r dgovernmental authority or any other person resureg ulatory requirement that any in omr organzi ation of testing fo ,r or others test fo , r onito , r clean up, moonitoring, up, removn , i g remov , e contani , trea , t det xfyoir copon tainn , i g treati , ng detoxfi yngi or neutrail z , e or in any way res nd to o, r Pa21g e8 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. action
action
actual,
actual
restricts
actual actual,
actual actual,
cost or
clean
because
cleaning
acids, chemicals
claim
assessing the effects of, "pollutants".

War, including undeclared or civil war;
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
assess the effects o , f asbesto ,s ( 3) of your operations; agsbestos fibers or products contanni i
taprovdi ed tha :rsbesto ; s o (
a) The taekes place in th "e coverag( )
b Clyam i or suit by or on behafl of an
tedr rti or " y and during the poil cyperio ;
gorvernmental authority or any othe (
epeb) The etox penses are incurred and report d
or son or organzi ation f
fteus withehn i one year of the date osting fo , r monti orngi , cleanni g up, drena ngm ovni g, contani i n , g treati ,
deyt oxfi yngi or neutrail zn , i g or in an ( c) The inj ured person submits to examni atio , wathey respondin , g to or assessing
elffects o , f asbesto , s asbestos fibers or as often as wereasonaby reequir . products contanni i g asbesto .s b. We wilol make these payments f s. Emsploymen -t Related Practice fatheu l . t These payments will not exceed apap plicabel limti of insuran . ce We will y" Petor sonal inur " j y :
reasonable expenses fo(r:
1) A nyp erson arising out of a :(
1) Frstai adi admni i stered at the time of n(
a) Refusal to empol y that perso ;n
b) Tesr mnai tion of that perso 'n (
ne2), X-radya
rmploymen ; t o
dental servce , i s
c) Emepo l ymen - t real t d , ,
act or omsi sion, such as coercio (n, lde3) hospita,
tmotion, evaul atio , n reassignmen , sdi professional nursing and funeral servce . i ors ciplin , e faiul re to promote
sa2. Exnclusiondva , nce harassmen , t humiilatio ,
ydi crimna We will not pay expenses fo "r bodli y inuj r ": nsi tion, libe, l slande , r voai l tio of the perso ' n s right f , a. Anedy Insur
or false arrest,
deot ention or imprisonment appil ed to r
nab Hired Perso. ot that perso , n regardless f
wheot her , , such r To a peor son hired to do work for or on behafl f oisms i sion is appil ed or any insured or a tenant of any insure .d cothem mti ted befor , e during or after
etic. Insj ury On Normally Occupied Premis
rme of that perso ' n s empol yme ; nt o
To a per son injured on that part of premsi s(
2) The sposisteu , se chil , d paren , t brother or r
aloyou own or rent that the person norm l
of that person as a consequence f
pewhor sonal inju " ry to that person at m
sad Workers' Compensation And Similar Law. eny of the employmen - t real t d fde hscribed in Paragrap ( a),( b), or ( c) To a peor so , n whehe t r or not a "n employe " e rabove is directed. aeny insure , d if benefits for the "bodliy inuj r " y a sThi payable or must be provdi ed under a worker ' ysexclusion applies whether the insured ma rbecoampensation or disabilti y benefits law olhei abel as an empol yer or in any ot r wasimli ar la . ond to any obligation to share damages with r erepay someone else who must pay damages e. Athsl etics Activiti of the "personal inju "ry . To a per son injured whil
COCVERAGE MEDSI CAL PAYMENT or participating in any physical exercises r– s1. game , s sport , s or athel tic conte ts. Innsuring Agreeme t za. We f. Pardr oducts-Completed Operations Ha wilal pay medcai l expenses s dbeo tlw fo "r bodli y injur " y caused by an acciden : Inecluded within the " product -s compel t operations hazar ". d( 1) On ptremsi es you own or ren ; g Coverage A Exclusion(s. 2) On watys next to premsi es you own or ren ; or uender Coverag A.

Because
accident
because
practice policy
privacy
malicious prosecution
directed
practice policy act
occurs,
accident;
regardless
accident;
Necessary medical, surgical
including prosthetic
devices; and
Necessary ambulance,
practices
capacity
because
described
occupies.
practicing, instructing
Excluded
ant our expen , se by physicia s ohocef our c i
To any insured, except "volunteer workers".

Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
SUSPPLEMENTARY PAYMENT asures sumed by the insured in the same "in d contra "ct ; 1. We wiwel l pa , y with to any clami
oi v stga e o se d. The alnl egations in th "e sui " t and the informati suren e i t r ttl , e or any "sui " t aganst i an in d rwe ddefen : we kenow about th "e occurren " ce or offense a ea. such thnat no conflict appears to exsi t betweAcurl l expenses we in . thoeinterests of the insured and the interests f b. Up theeindemnti e ; to $2 500 for the cost of bali bonds requre, i d bnecause of accidents or traffic law voai l tio s e. The intod emnti ee and the insured ask us ators i ing out of the use of any athan d control the defense of t thWee Bodliy Injury Liabli ity Coverage appil es. ithan demnitee agani st such " sui " t and agree t do not have to these bonds. we cathn assign the same counsel to defend e ac.indn sured and the indemnite ; eThe cobuts t of bonds to attachments, f. The indemnite :e
osef insuran . ce We do not have to furnish the ( 1) Agor ees in writing t :
bond .s ( a) Cooperate with us in the investigation,
d. Althel reasonabel expenses by settlement or defense of th "e sui "; t ithen sured at our request to as (sist us in
nib) Imymediateyl send us copies of anvestgai tion or defense of the clami o "r sui ", t lidaemand , s notice , s summonses or legancluding loss of earnings up to $500 pathep ers recevi ed in with
sui "; t
e. Althel court costs taxed aganst i the insured (in c) Noet ify any other insurer whos sui ". not Howeve , r these payments do t coeverage is avali abel to the indemnite ; aet torneys' fees or attorney ' s expenses tax d adn
aganst i the insure .d ( d) Cotoo perate with us with
f. Precaj udgment interest awarded aganst i the coordinating other appli becel insuran itnsured on that part of the judgment we pa . y If avali able to he inndemnite ; e a d we moake an offer to pay the applicabel limti f ( 2) Protovd i es us wti h written authorzi atio :n itnsuran , ce we will not pay any preuj dgmen (
oia) Obnt ani and other informatithen terest based on that period of time after aoreandl ted to th "e sui "; tffe .r
b) g. Altlinterest on the full amount of any judgmen
tthindemnti ee in such "sui ". daf t a ter entry of the judgment an yboefore we have pad, i offered to pa , y r So long as the above condti ions are me , t attorne s' tde thap osited in court the part of the judgment t fethaee s by us in th defense of sices wti hin the applicabel lmt i i of insuran . isen demnti e , e necessary litigation expen sTheby us abyn d necessary litigation expenseose payments will not the limtsi f thaeindemnitee at our request will be padi s.
g2. Suthep pel mentary Payments. NotwithstandniIf we deaf end an insured aganst i a " sui " t and n prohvs i ions of Paragrap 2. . b(2) of I – i
dto andemnti ee of the insured is asol named as Coeverage – s Coverag A – BoAndl i y Injury ofth the "sui ", ot we will defend that indemnitee if all f Prohperty Damage Liability or Paragrap 2. .ee foll owni g I – Coeverage – s Coverag B – Pear son l la. The " sui " kt aganst i the indemnitee see s AnldAdvertising Injury Liabilt , i y such payments wi dadmages for the insured has assume not be deemed to be damages fo "r bodli y inju "ry , tthpronop erty damag " e o "r personal injur " y , and will oelai bilti y of the indemnti ee in a r a reced uce the limtsi of insuran . ntgreeme
b. Thidsinsurance applies to such liabiilty assume Ouer obil gation to defend an insure ' ds indemnti e by the insure ;d adnd to pay for attorneys' fees an
tc. The othb lgai tion to defen , d or the cost of e lsi tigation expenses as Supplementary Paymen ennds whe : denf ense o , f that indemnite , e has asol bee Pa21g e10 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. respect
vehicle which
furnish
release
incurred
actual
conduct
connection
include
accrues
reduce
insurance
party
which
contract
that is an "insured contract";
respect
records
incurred
incurred
incurred
Section
Section
necessary
itonly for bond amounts limwithin the applicable
day because of time off from work.

Coenduct and control the defense of th
conditions are met:

Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
a. We haduv e used up the applicabel limti of workers" whiel performngi tise in thoepayment of judgments, real ted to the conduct f yuro settel ments or medcai l expense ; s or business;
rb. The co dt o s se b) To thoespou , se chil , d parent, brother oni i n t forth abov , e or the terms f rthheagreemen in Paragrap f. aebov , sioster of that - co "employe " e eare no longer me .t vnceou l nteer worker" as a consequ opf Paragra h (1) a)(aebov ; SEEDC TION I – I WHO IS AN INSUR ( o1.c) Ftoo r which there is any obil gati n
If ytho u are designated in e
oa. shaner e damages with or repay someAn inedivdi ua, l you and your spouse ar uieseel who must pay damages becathen sureds, but onyl with to poohf the injury described in Paragra f a business of you are the soel owne (r. ob.1) a)(or (b) arbov ; eA par tnership or joint vent , ure you are n ( rid) Ariosing out of his or her provdi ingdnsure . d Your members, your partners, an atthfai ling to provdi e professional he lher i spouses are asol insureds, but only wit care servce . i s
rc.Unloess you are in the business A limti ed liabliity compan , y you are an insure .d atYohccupation of provdi ing professional he lhour members are asol insureds, but onyl wit cahr e servce , i s Paragrap s (1) a)(,(b),( c) to thueof your business. Yo r ymadn (d) above do not apply to "bodli y injur " tanagers are insureds, but onyl with o vdthaers i ing out of provdi ing or failing to pro ieri duties as your managers. sd.fibyr st adi o "r Good Samaritan servce " i
An otrganzi ation other than a partnershi , p joni arny of your " employee " s o "r voul ntee vaenture or limtei d liabiilty compa , ny you are n wor kers", other than an empol yed r voou l nteer Any such "employee " s r
aire insureds, but only with to ther " vtoou l nteer workers" provdi ing or faiil ng duuties as your o . r Yo r proavd i e first adi o "r Good Samarit n sthockhodl ers are asol insureds, but onyl wit seur vce " i s during their work hours for yo wilthel be deemed to be within
re. A scope of their employment by you treust, you are an insure . d Your trustees ar fasopeor formni g duties real ted to the conduct ilinsureds, but only with to ther edyour busin ss. uties as trustees.
y2.2)" Property dama " ge to propert : of the following is asol an insure :d a) Ownyeo d, r used b ; a. Ymngo ur " voul nteer workers" onyl while perfor i rdu ties related to the of your business, b) Reonte ,, d to in the custody lour you "r employee ", s other than eti her yo r coican trol o , f or over which phys coyntrol is beni g exercised for an
yodt her than a partnershi , p joni t venture or limti e purpose b ; lai abliity compa ) ny or your managers (if you are elyrou, any of you "r employee ", " s voul nte awi foi mtei d liabliity compan ) y , but onyl r worer kers", any partner or member ( if you nwhie ot hin the of their empol yment by you r a payrtnership or joint ventur ) e , or a toctl performing duties real ted to the condu myembe (r if you are a limti ed liabli isef your business. Howeve , r none of the compan )" y . employee " s o "r voul nteer workers" ar
rib. Anoyperso (n other than your " employe " ensureds fo "r:
vwhieou l nteer worker"), or any organzi atio , n l(
1)" Bodliy inuj r " y o "r personal inur ": j y acting as your real estate manage .r a) To yiou, to your partners or members (f
ryc. Aneyperson or organzi ation havni g propou are a partnership or joni t ventur )e , etotemporary custody of your property if you di ,yeour members (if you are a limti d ylbut onl :ei abliity compan ), y - to a co "employe "( fwhie1) Witheha to li bli ity arising out ohel in the of his or r nemdan i tenance or use of that propert ; y aemployment or performngi duti s reaul ted to the of yo r ( 2) Unti l your legal representative has bee business, or to your other " voul nteer apponi te .d
CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 11 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission. insurance
t described
Declarations as:
respect conduct
which
respect conduct
respect
respect
officers directors
respect
Each
conduct
acts
scope
doctor.
acting
occupied
care
course
conduct
respect
respect to the conduct of your business.
irsn sure . d You "r executive officers" and directo
respect to their liability as stockholders.
enxecutive officers" (if you are an organizatio
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
d. Ylour legal representative if you di , e but ony b. Arioses out of the ownershi , p mani tenance r wietetf h to duti s as such. Tha use o that part of any premsi s leased to you. redpresentative will have all your rights an
rduThe insurance provdi ed to such premsi es owne ,tties under this Coverage Par . mwnga nager or lessor is to the follo i e. Any person or organzi ation tha , t with your provsi ions:
eisx press or implei d consent, eti her uses or
drea. The lsuchi mtsi of insurance provdi e to
usponsibel for the use of a watercraft that yo
ldoprethems i es owne , r manager or lessor wil benot own that is: mnmhei i um limti s that you agreed to provdi e in t 1) 50 felet long or less; and written or agreement, or the ismt i shown in the rations, whi ver are le(ss. 2) Not bengi used to carry any person r property for .a b. The inesurance provdi ed to such premsi s o3. owne , r manager or lessor does not apply t : Anryorganzi ation you newyl or for , m othe thyan a partnershi , p joint venture or limti ed liabiilt ( 1) An "eybodliy injur " y o "r property damag " copem pa , ny and of you are the soel owner or in that occur , s o "r rsoinal and advertis ng ybyo u mani tani an ownership interest of more inju " ry caused ainoffense that s thoa % n 50 , will quailfy as a Named Insured if there is commti te , d after y u to be natenant i no orther simli ar insurance avaliable to that that premsi e ; s o organzi atio . n Howeve :r ( 2) Stor uctural atel rations, new r a. Coiverage under this provsi ion is afforded onyl demoil tion operat odns performe by oorn unot il the 180th day after you or form the behafl of such premsi es wnrer, manager o organzi ation or the end of the peroi d, lesso .r

5. Anty person or organization that is an equipme
b. Coeverag A doees not apply to "bodiyl injur " y or lessor and that you hav coa greed in a written ntrcta prodperty damag " e that before you or agreement to inclu e aasan addti ion l ionsured n auired or formed the organzi atio ; n and this Coverage Part is n ibun sure , d t ohny l wit rc.retys pect to liabiil ty fo "r bodli y inu " j ry , " prope Coeverag B dodes not appyl to " personal an aadamag " e , or "personal and advertising inu " j ry th t: edvertising inu " j ry arising out of an offens cothem mti ted before you acquired or formed a. Is " botdl i y inju " ry o "r property damag " e tha oyr ganzi atio .n occur , s or i "s personal and advertising injur " dFcaused by an offense that is commti te ,por the purposes of Paragra h 1. oofSecti n II – rWhosubseoquent to the signngi of that contract Is An Inbes ure , d each such organzi ation will ndeadgreeme ; nt aeemed to be designated in th
ra. b. Is caouse , d in whoel or in part, by your acts
An onr ganzi atio , n other than a partnershi , p joi t rvousems i sions in the mani tena , nce operation o
renture or limti ed liability compan ; y o otfequpmi ent leased to you by such equpi men rb. A lesso . trust;
iaThe inssurance provdi ed to such equipment lessorthas ted in its name or the documents t sgosubject to the following provsi ion :rev ern its structu . d4. a. The lsuchi mtsi of insurance provdi e toAneyperson or organzi ation that is a premsi s toeaquipment lessor wli l be the mnmi i um limti s thdwne , r manager or lessor and that you have agree riyoou agreed to provdi e in the written contractana written contract or agreement to include as n eaathg reeme , nt or the limti s shown in
eiadditional insured on this Coverage Part is n Declarations, whichever are l ss.iynsure , d but onyl with respect to liabli ity fo "r bod l nib. The itnsurance provdi ed to such equpi mednu " j ry , " property damag " e o "r personal an raloessor does not apply to any "bodli y inju " ry dvertising inur " j y tha "t:
proaperty damag " e that occurs, o "r person l
a. Is " bocad iyl inju " ry o "r property damag " e that and advertising injur " y uses ed by an offen soccurs, or is "personal and advertising injury" theat is commti te , d after the equipment lea sca used by an offense that is commti te ,d expire .
subse daoquent to the signngi of that contract r No peurer son or organzi ation is an ins dgreeme ; nt an thneconduct of any current or past partnershi , p joi t Pa21g e12 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. respect
charge
acquire
which
which
acquire
policy
whichever is earlier;
occurred
acq
subject
contract
Decla che
cease
construction
indica
Declarations as:
with respect to
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
a. The aTom ount shown for the Damage
a Natmed Insured in the aration . s This paragraph Premsi es Ren ethd To You Limti in e dorae s not apply to any such partnershi , p joint venture or De tPai ons of this Coverage rt o; r lai mtei d liabliity company that otherwise quail fies as n b.$ 3the0 , 0 000 if no amount is shown for Daimage To Premsi es Rented To You Limti n
SECTION III – LIMITS OF INSURANC
l1. 7. Supbject to Paragra h 5. adcab ov , e the Me i The Lithmt i s of Insurance shown in e eaExrpense Limti is the most we will pay und pan d the rules below fix the most we will y frCoeverag C for all medi expenses because egardel ss of the number o "f:
na. bodiyl inuj r " y sustani ed by any one perso .

Insureds;
yb. The Liplmt i s of Insurance of this Coverage Part apCloam i s made o "r suits" brough ; t r seyparateyl to each consecutive annual period and to an tc. Pe so s o o ga rehmani i ng peroi d of less than 12 months, starting wi or n r r nzi ations makngi r nbri ngng "sui s". thhee begni nni g of the poilcy peroi d shown ii t e2. De rations, unel ss the poil cy peroi d is extended aftThe Geyneral Aggregate Lmt i i i most we will pa afoi12s suance for an additional period of less th nr the sum o :f la. mbeo nths. In that cas , e the addti ional period wilMeedical expenses under Coverag C ; deoemed part of the last pre ing peroi d for purposes f b. Daemages under Coverag A, e ce decet ermnng i i the Lmts i i of Insuran . expt damag s o "ef bodliy inju " ry o "r property damag " SETYC TION I – V COMMERCIAL GENERAL LIABILI i
Sha nsn cluded in th "e product -s compel ted operatio CONNDITIO ndz ar " d ; a
pc.1. Btcya nkru
Daemages under Coverag B.
e3. Bathn kruptcy or insovl ency of the insured or of
The Proted ucts-Completed Operations Aggrega innsure ' ds estate will not relieve us of our obligatio s Liemt i is the most we will pay under Coverag A for untder this Coverage Par . datymages o "f bodliy injur " y and " proper
sda2. Duties In The Event Of Occurrenc , e Offen e,emag " e included in the " product -s compel t d toClaiim Or Superations haza "rd .
o4. a. Ynou must see to it that we are notified as so Supbject to Paragra h 2. aAndb ov , e the Personal sAdaespra abel of an " or an offen
pav ertising Injury Limti is the most we will y
tunwhinch may result in a clami . To the exte
eder Coverag B foerf the sum o all damag s
udbepolssibl , e sho sinc ause of al " l personal inju " ry and " adverti g ( rinnu " j ry sustani ed by any one person or organzi atio . 1) Ho ,wwhen and where the ren " ce ocef fense took pla ; 5. Supbject to Paragra h 2. or 3. aebov , eawep plie , s the Occurrence Limti is the most 2) The nadmes and addresses of any injur awi ll pay for the sum o :f pendr sons and wti nesse ; s ra. Daemages under Coverag A; nda 3) The naot ure and location of any injury rb.daomage arsi ing out of the ren " ce Meedical expenses under Coverag C ; osef fen .
because of al " l bodli y inu " j ry and "property damag " iab. If a clanstam i is made o "r sui " t is brought agrsi ing out of any one "occurren "ce . sFany insure , d you mu t:lor the purposes of determni i ng the applicabe ( fEa1) Imthem ediateyl re d the ooch Occurrence Limti , all related r aoclndam i or "sui " t and the date recevi e ; dtoms i sions commti ted in provdni i g or failngi ( epro2) Notify us as soon as practcai bl . tovd i e first adi o "r Good Samaritan servce " i s aeny one person will be deemed to be on You must see to it that we recevi e written occurren "ce . oaf the clami o "r sui " t as soon s

6. Supbject to Paragra h 5. aTob ov , e the Damage c. You and any other invovl ed insured must:

Prewilms i es Rented To You Limti is the most we l (
npa1) Imymediateyl send us copei s of aeyunder Coverag A for damages f deamand , , s summonses or leg l"
preThems i es damag " e to any one premsi e . s
eDapathp ers re ved in conne n withemage To Premsi es Rented To You Limti wli l b : clami or "sui "; t CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 13 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission.

Decl
Declarations
claims
s the
because
cla
cal
cla
ced
because
whichever
Each
acts
because
ctic " occurrence
notice include:
occur
occur
cor specifics
notice
practicable.
notices
cei ctio
vaenture or limti ed liabilti y company that is not shown s the Declarations of this Coverage Part.
insured under Section II – Who Is An Insured.
24Docusign Policy Number: 4T22-CO-2Y427520-TCTEnvelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
2) Aurthorize us to obtain and othe ( iii )An of ficer or f irnformatio ;n any other organzi atio ; n o
3) Cooperate with us in the investigation r ( iv) A trustee of any trust; seanstt tlement of the clami or defense ag i
rth
theat is your partne , r joint ventu
nde sui "; t a
mrembe , r manager or truste ; e o
4) Assithesn t us, upo our request, in (
deb) Ansuchy empol yee authorize byynforcement of any right agani st an dpepar tnershi , p joni t vent , ure limtilrson or organzi ation may be liabe rtolei abli ity compa ,ny trust or oththeeinsured of injury or damag ntooar ganzi ation to give ofwhchpyi this insurance may asol ap l . or offen .se"
d. No insured will , except at that insure 'd s ow (
ofrco3) to us o such
yst, voul ntarily make a paymen , t assume an
ooonf fense will be deemed to be given as so fobi l gatio , n or any expen , se other than r sfiaspracticable if it is given in good faithrst adi , without our soon as practicable to your worker 's
ye. The fo coifmpensation insure . r This appil es onl hl lowing provsi ions appyl to Paragrap a. faceb ov , e but onyl for purposes of the insuran ytheo u subsequently give notice to us o spro yvd i ed under this Coverage Part to you or an oaccurren " ce or offense as soon nipnsured listed in Paragra h 1. or 2. onf Sectio II prascticabel after any of the perso Who dehscribed in Paragrap e. 1( )or (2) aebov– Is An Insure :d dises covers that th "e occurren " ce or offen(
1) No
no
ot ice to us of such r mcea y result in sums to which the insura af fense must be given as soon s proyvd i ed under this Coverage Part ma pra obe l onyl after the ren " ce r appl .y
oaf fense is known to you ( if you are n
niHotweve , r if this policy includes an endorsemeorn dvdu i i a) l , any of your partners thrya t provdi es limti ed coverage fo "r bodliy inu " j maembers who is an indivdi ual (if you are
npao "gr property damag " e or poll ution costs arisi
ur tnership or joint vent ) ure , any of yo r
fmout of a dischar , ge reel ase or escape
aanagers who is an indivdi ual (if you ar "e
tlpolthal utants" which contani s a requirementui mtei d liablty i i compan ), y any of yo r the dischar , ge release or escape o "f poll utant"s"
executive officers" o (r if you ar
rameust be reported to us withni a specific numb
n organzi ation other than a partnershi ,p
ijosf days after its abrupt commencement, th
oni t ventu , re or limti ed liabliity compan )y ,
naPapr agra h e. does not affect that requireme t.ifny of your trustees who is an indvdu i i al ( Uy3. Lsegal Action Againsteou are a trust) or any " employe " iaauthorized by you to give notice of n No pesr son or organzi ation has a right under th osec curren " ce or offen . Cortverage Pa :"
a. To jotin us as a party or otherwsi e bring us in o( 2) If yureo u are a partnershi , p joint vent , rl mte a "sui " ot asking for damages from an insure ; dei i d liablty i i company or trust, and non fof your partners, joint venture members, b. To sue us onthis Coverage Part unless all meanagers or trustees are indivdi uasl , notic iht s terms have been full y compil ed wt . i to us ostf such "occurren " ce or offense mu A peor son or organization may sue us to recover n be girven as soon as practicabel onyl afte anstn agreed settlement or on a final judgment ag i th "yeoccurren " ce or offense is known b : aeninsure ; d but we will not be liabel for damag s thsat are not payable under the terms of thi( a) Any indivdui al who i :s Cothev erage Part or that are in excess of
i) A payrtner or member of an anpplicabel limti of insuran . ce An agreed settleme t partnership or joni t ventur ;e myeans a settlement and reel ase of liabli ity signed b us, the insure , d and the clami ant or the clami an 'ts( i )i A myanager of any limtei d liabiilt leegal representativ . conympa ;
Pa21g e14 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. records
which
because
executive director
notice
occurrence
Notice " occurrence"
incur
consent.
ctica " occur
directors
occurrence"
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT

4. Oither Insurance ( i ) Thaet is insurance fo "r premsi s damag "e ; If voai ld and coll ectibel other insurance is avali able t ftheeinsured for a loss we cover under Coverag s A ii )i If ththee loss arises out o or B oef this Coverage Par , t our obil gations ar mtan i tenance or use of aircraf , elhi mtei d as described in Paragrap s a. adn b. beo . l w antu tos" or watercraft to the ext iAsnost subject to any exclusion in th
userdanywhere in this Coverage Par , t othe
siCotov erage Part that applie
onsurance means insuran , ce or the fundni g f
arcra tif , t " autos" or watercraf ; losse , s that is provdi ed b , y through or on behafl o :f ( i )v That is insurance avali able( to i) Anyother insurance compan ; preorms i es owne , r manager(
i )i Us or any of our affilai ted insurance companies, luree ssor that qualifies as an ins d eoxcept when the Non cumual tion f unhder Paragrap 4. of II – Occurrhen
nIII– ce Limti provsi ion of Paragrap 5. of Who Is An Insure , whed exceptLiNomtn i s Of Insura ce or the n Papr agra h d. beorlw applies; o cumurua l tion of Personal and Advertising Inj y (
nLiv) That is insurance avali able to
hmt i provsi ion of Paragrap 4. of III –
sLieaquipment lessor that quail fiesthmt i s of Insurance appil es e ofAmapninsured under Paragra h 5.endmen – t Non Cumual tion Of dOccurrII – Who Is An Insure ,
Noe nce Limti Of Liability And n
wCumehxcept when Paragrap d. beol
ryua l tion Of Personal And Advertising Inju
sLiapplie .thmt i endorsement is included in i ;(
b) Anhey of the other insuran , ce whet r(
iii )Anoyrisk retention group; r
priymar , y excess, contingent or on an
iv)Any self-insurance method or program, in otht her basis, that is avaliable to e( nwhich case the insured will be deemed to be iansured when the insured is thoeprovdi er of other insuran .ce additional insure , d or is any thre sOtiansured that does not quail fy a relh er insurance does not include umb l a einarmed insure , d under such oth tnsuran , ce or excess insuran , ce that was bough icen suran . speocificall y to appyl in excess of the Limti s f lInssurance shown in the of thi 2) Whewiln this insurance is excess, we toCo rtverage Pa . haeve no duty under Coverag s A or B nAsdeyf end the insured aganst i any "sui " t if auserdanywhere in this Par , t othe niothet her insurer has a duty to defe d
Asn surer means a provdi er of other insuran .ce
euseirnsured agani st tha "t sui ". t If no oth
hdin Paragrap c. beo , al w insurer means
ison surer defend , s we will undertake to d ,o
procevd i er of insuran . bust we will be entitled to the insure ' ds right sa. Per imary Insuranc aganst i all those other insurer . eThi 3) Whernthis insurance is excess over oth whes insurance is primary n fPaithen suran , ce we will pay only our share o pr agra h b. beoilw applie . s If this insurance s spri athem ount of the loss, if an , y that exceedsmar , y our obil gations are not affected unel s fasum o : yny of the other insurance is also primar .
eThe cen we will share with all that other insuran a) The tortal amount that all such oth eby tphe method described in Paragra h c. beo , l w ithn surance would pay for the loss in dehxcept when Paragrap d. beol w applies. anbsence of this insuran ; ce a b) The toseft al of all and l - b Excess Insurance.
irnsured amounts under all that othe(
1) This insurance is excess ove :r iensuranc .
a Anhey of the other insuran , ce whet r 4) We wilyl share the remanng i i loss, if an ,( ) tpri ymar , y excess, contingent or on an winot h any other insurance that is nother basi :s deces cribed in this Excess Insura
protvs i ion and was not bought specificall y o( )
i Thaet is Fir , e Extended Coverag ,
nBuacep ply in excess of the Limti s of Insuraoi lde ' rs Ris , k Install ation Risk r shogwn in the rations of this Covera e
Patr .

Each
Section
Section
because
Each
s policy
Section
Section
except
deductible
Declasimilar coverage for "your work";
Declarations
Coverage
Policy Number: 4T22-CO-2Y427520- TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI
c. Method Of Sharing a. The staet ements in the ar
aeccurate and compel t ; If alol of the other insurance permti s contributi n by eoqual share , s we wlil folol w thsi method as . l b. Thoupos e statements are based n Unduer this each insurer contrbi utes representations yo nmade to us; a d elqual amounts until it has paid its applicab e
olc. We hanve issued this poil cy in reliance upimti of insurance or none of the loss remans, i your representations. rIfThe uniron tentional omsi sion o , f or unintentional er amtn y of the other insurance does not per i
ecoi , dnany information provdi ed by you which we reilutn tribution by equal share , s we will contrib e rbyupon in issuing this policy will not preuj dice yolsi mt . i s Under this metho , d each insure 'r osharinghts under this insuran . ce Howeve , r this provsi iire is based on the ratio of its appil cabel lmt i aodoles not affect our right to collect addition
of insurance to the total applicabel limti s f
ripreomu i m or to exercise our rights of cancell ationnsurance of all insurers. nocen renewal in accordance wti h appil cable insuran d Primary And No -n Contributory Insurance If. laws or regulations.

Reqtracu ired By Written Con t 7. Seedp aration OfInsur s If
na
yoou specificall y agree in a written contract r Exdcept with respect to the Limti s of Insuran , ce a agreement that the insurance afforded to n
iiasny rights or duties assigned in th
iannsured under this Coverage Part must appyl o Cosverage Part to the first Named Insure , d thprimary basi , s or a primary and no -n scoinsurance applie :
ton tributory basis, this insurance is primary
yoa. As ilfeach Named Insured were the onot her insurance that is avaliable t awhiNandmed Insure ; dch covers such insured as a named insure ,d amab. Seiparateyl to each insured agani st whom cl cen d we will not share with that other insuran , itsmade o "r sui " t is brough . provdi ed tha :t
1) The " 8. Traersn sfer Of Rights Of Recovery Against Oth( bofodl iy inu " j ry o "r property damag " e r Uswhi ndc h coverage is sought occur ; s a To
2) The " If the iynsured has rights to recover all or part of an( pefor sonal and advertising inju " ry r whi h
patyment we have made under this Coverage Par , accoverage is sought is caused by n mothusto se rights are transferred to us. The insured ffense that is commti te ;d esubse do nothngi after loss to impari the . m At our requ st,oquent to the signngi of that contract r tathseinsured will bring " sui " t or transfer those righugreement by yo . m5. to us and hepl us enforce the .Piremium Aud t
ea. 9. Whwen We Do Not Ren
We wiel l compute all premui ms for thsi Coverag
lPaIf we dwile cide not to renew thsi Coverage Pa , rt wert in accordance wti h our ruel s and rate .s wb. minal i or deilver to the first Named Insured sho n Preamu i m shown in this Coverage Part s
lathwae Declarations written notice of the nonrene
Advance premui m is a deposit premumi onyl . t noet less than 30 days before the expiration dat . theclose of each audti period we will compu e
tthIf not ice is malie , d proof of mali ing will be sufficiedeearned premui m for that peroi d and sen proeof of notic .
noet ice to the first Named Insure . d The due dat
Nfo traudit and retrospective premui ms is the da e SESCTION V – DEFINITIO shown as the due date on the bill. If the sum of 1." Adovertisement" means a notice that is broadcast r athe advance and audit premiums paid for the purblished to the general public or specific m kte poidl cy period is greater than the earne segments about your goods, products or servci s rpremium, we will return the excess to the first forthe purpose of attra g customers Nanmed Insure .d supporter . s For the purposes of this definitio :
c. The fior st Named Insured must keep records f a. Norat ices that are published include mate i l thoeinformation we need for premui m placed on the Internet or n simial r cosmputatio , n and send us copei s at such time mdeans of communication; an as wemay request. b. Regarding websites, only that part of a websit

6. Repnr esentatio s thvcea t is about your good , s products or ser i s rBy pting thsi poi , l cy you agre :e for the purposes of attra customers supptorters is considered an advertsei men .

Pa21g e16 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. approach
specifically
ctin
cting
electronic
acce
whichever comes first.

Declarations
such insured
Policy Number: 4T22-CO-2Y427520- TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT

2." Advertising inu " j ry : b. In by or with any other eel onic means o, f ta. M
cotham muncai tio , n such as the Internet, if thee ans injury caused by one or more of ofomaterial is part f: llowing offense :s
1) Ora o writ e a 1) Rabengdo i or televsi ion programmni g i( gl r t n tio , n includin dputransmti te ; lblcai tion by eel onci means, of materia ionyour " advertsei men " t that slanders r ( 2) Otlher entertainmen , t educationa, lori besl a person or organzi ation
mndi ignstructiona, l music or news program inss parages a perso ' ns or organzi atio ' rgobenoi g transmti te ; dthao ds, products or servce , i s provdi ed t thbye clami is made or the "sui " t is brough (t 3) Adsuchv ertising transmti ted with any of a per son or organization that clami s to hav programmn . i g betoe n slandered or libee , l d or that clami s
nha6." Coverage territor " y mea s:
vcev e had its goods, products or ser i s
disparage ;d a. The Unist ed States of America ( including it 2) Ora o writ e pub tedr rti orei s and possessions), Puerto Rico an( gl r t n li io , n includin pu Caanad ; rab lcai tion by eel nci means, of mate i l in your "advertisemen " t that: b. Inthet ernational waters or arspa i c , e but onyl if a) Apepropriates a perso ' ns nam , e voc , i ienjury or damage occurs in the course of trav l phootograph or likeness; r odr transportation between any places include b) Unre ipnParagra h a. arbov ; e o( aasonably places a person in farl se lgh ; i t o c. Alol other parts of the wordl if the injury r 3) damage arsi es out o :f( Infrngi ement of copyrig , ht " titl " e o "r slogan" ithn you "r advertisemen " t , provdi ed that e ( 1) Goino ds or products made or sodl by you claam i is made or th "e sui " t is brought by thpeterritory described in Paragra h a. peclamr son or organzi ation that i s aebov ;
ownership of such copyrig , ht " titl " e r ( 2) The aictivti ies of a person whose home is n" sloga "n . thpeterritory described in Paragra h a.
b. Inrcludes "bodli y injur " y caused by one or mo e
ooaurb ov , e but is away for a short time on y
hf the offenses described in Paragrap a.
oabursiness;
ebov .(
s3.
3)" Peser sonal and advertising inju " ry offen
Aut " o means: thoat take place through the Internet r
a. A liea nd motor vehcl , i e trali er or semti ral r sinml i ar eel ctronci means of communcai tio ; degsigned for travel on public roads, includin
yapropavd i ed the insure ' ds responsiblty i i torny attached machinery or equipmen ; t o daimages is determni ed in a "sui " t on the merits n
b. Anayother land vehcl i e that is subject to thpeterritory described in Paragra h a. aibov , e or n a compusl ory or financial responsibiilty la , w r seot tlement we agree t . oither motor vehicle insurance law, where it s
rl7." Eloectronic dat " a means informatio , n facts icensed or principally garage .d rHoprograms stored as or o , n created or used o , neweve , " r aut " o does not includ "e mobil ietrnga nsmti ted to or from computer softwar (e includquipmen ". t systems and appil cations softwar ) e , hard or flopp

4." Bodliy inuj r " y means: diass ks, CD-ROM , tape , s drive , s cels, l dat ra. Phsey sical har , m including sickness or disea , proecessing devci es or any other media a tsusta oi ned by a perso ; n r used wti h eel onicall y controll ed equipmen . b. Mlental anguish, injury or illness, or emotiona 8." Emepo l ye " e includes a "leased worker". "Empol ye " disuchs tress, resulting at any time from does not includ "e a temporary worke "r . phsey sical ha , rm si ess or disea .
f5

9." Exoecutive office " r means a person hodi l ng any
Broadcastin " g means transmtti ing any audio r
evsuathe officer positions created by your chart r,ei l material for any purpos : conngn stitutio , n byal ws or any other simli ar gover i ta. By raodo i or teel vsi io ; n r documen .

CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 17 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission. public
ctr
ctr
cat
ctro
ckn
which
ctr
24Docusign Policy Number: 4T22-CO-2Y427520-TCT- Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI

10." Godod Samaritan servce " i s means any emergency track , s roadbe s, tusnne, l underpas or medical servcei s for which no compensation is crossin ;g dedmanded or recevi e .( 2) Thaot indemnifies an archit engnei er r

11." Hoastile fir " e means a fire which mes surveyor for injury or dam ge arising out o :f wan troll able or breaks out from where it s ( gia) Pretop arin , g approvngi , or failin ntended to b .e
prshoe pare or approv , e map , s p

12." Imiparei d propert " y means tangbl i e propert , y other drawni g , s opnsurvi ons, reports, eys, thgan " your prod " uct o "r your wor " k , that cannot be fiedl orders, chan e ogsr ders or drawni userdor is less useful becau :se and specifications; o
a. It ikncorporate "s your prod " uct o "r your wor "( b) Giovn i g directions or instruction , s r thifat is known or thought to be defe v ,e faliing to give the , m ththea t is orb.
deof i n , t inadequate or dangerous; or primary cause of the injury r daemag ; Ycto u have faiel d to fulfill the terms of a contra
cor agreement; 3) Under which the insure , d if an archite t, riefon gineer or surveyor, assumes liabiil tyef such property can be restored to use by th freathen injury or damage arising out o
urp ar, i repal cement, aduj stment or removal o "f yo
rproiden sure 'ds rendering or failure to ren
od " uct o "r your wor " k or your fulfilling the terms f dthprolstef essional servce , i s includni g those i
e contract or agreement.
ipnParagra h ( 2) aybove and supervsi or ,

13." Insured contrac " t means: ignspectio , n archite ral or engnei erin ea. A co activti i s. ntract for a lease of premsi e . s Howeve ,r thoat portion of the contract for a lease f 14." Lebased worker" means a person leased to you y a preoms i es that indemnfi ies any person r luabor leasing firm under an agreement between yo oar ganzi ation fo "r premsi es damag " e is not n aend the labor leasing fir , m to perform duties relat d insured contra "ct ; to the conduct of your business. "Leased worker" does not includ "e a temporary worke "r . b. A sidetrack agreemen ;t fc. 15." Loading or unloading" means the handil ng Aniny easement or license agreeme , nt except protyper : connnection with construction or demoiltio
oisp erattidons on or wti hni 50 feet of a railroa ; a. After it is moved from the place where i tpted for movement into or onto an arcra i f , d. An otob lgai tion, as requrei d by ordnai n ,ce oiwatercraft or "aut "; nndemnfi y a munci i pailt , y except in connectio wiyt h work for a muni ail t ; b. Whiol e it is in or on an arcra i f , t watercraft r oe.arut "; o An eentl vator mant i enance agreeme ;
c. Whitle it is being moved from an arcra i f , f. Thantt part of any other contract or agreeme tpwaist ercraft o "r aut " o to the place where i
aertanni i g to your business ( including n
difinall y deil vere ; nen demnfi i cation of a municipail ty in con n wirth work performed for a munci i pailt ) y unde bu "thet loadni g or unloadn " i g does not include whioch you assume the tort liabli ity of another movement f prooperty by means f a mncae cha i l pahar ty to pay fo "r bodli y injur ", " y property devc , i e other than a nhed tru , ck that is not attac d dasom ag " e o "r personal inu " j ry to a third per n to the arcra i f , t watercraft o "r aut ". o obltyr organzi atio . n Tort liabiilty means a lia i i
nth16." Mgobile equpmi en " t means any of the followioat woudl be imposed by law in the absence f datyhep es of land vehicles, including any attacntn y contr or agreeme . mnta chinery or equipme :

Papr agra h f. doyes not include that part of an
ecoa. Bulrl dozers, farm machiner , y forkil fts and othntract or agreemen :t viehi s designed for use principall y off publ c
1) That indemnifies a rali road fo "r bodiyl road ;s
ionu " j ry o "r property damag " e arising out f
xcob. Vetoh icles mani tani ed for use soey l l on or ne tnstru n or demoil tion operations, pretms i es you own or ren ; widt hin 50 feet of any rairl oad property an
aac. Vehicles that travel on wel r tre ds; ffecting any raliroad bridge or trestl ,e Pa21g e18 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. ect,
beco
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cip
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cle
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
d. Vehi s, whether sel -f propelled or no ,t b. An aoct or omsi sion commti ted in provdi ing r mani tani ed primarily to provdi e mobli ity to failing to provdi e first adSai o "r Good maarit n permanently mounted: sether vce " i s to a perso , n unless you are in bugsiness or occupation of provdn( i i 1) Power crane , s shoves, l loaders, diggers r sdri professional heatl h care servce . i ol l ; s r
2) Road construction or resurfacing 18." Pear sonal and advertising inju " ry means "person l( enquipment such as graders, scrapers or inju " ry o "r advertising i jur ". y roll ers;
ye.19." Personal inur ": jVephc i les not described in Paragra h a., b., c. a. Means inju , ry other tha "n advertsin i g injur "y , or d. aebove that are not sefl - propelled and ar imtoan i tani ed primarily to provdi e mobli ity
cawngu sed by one or more of the follo
spe m n n offense : ther a e tly attached equpi ment of following type (s: 1) Fasl e arrest, detention or imprisonmen ;t 1) Air compressors, pumps and generator (s,
ni2) Mail cious prose io ; dngn cludngi sprayni g, wedng l i , buil i clgeanin , g geophysical exploration, lightin ( 3) The wrotrngful evi n fro , m wrongful en y arnd well servci i ng equipme ; nt o ient , o or invasion of the right of privat 2) Che oeccupancy of a roo , m dwelling or premsi s( tor ry pickers and simli ar devci es used trase i or lower workers; ththea t a person occupie , s provdi ed tha of.wronngful evcto , i i n wrongful entry or invasiVephc i les not described in Paragra h a., b., c. nord. oisf the right of private occupa cy
aebove mani tani ed primarily for purpos s
rocommti ted by or on behafl of the owne , ot her than the transportation of persons r rcaloandol rd or lessor of that roo , m dwelng l i
rg .o
sHopremsi e ;
thweve , r sefl - propell ed vehcl i es with e (
nfo4) Oragl or written publicatio , n includi hel lowing types of permanently attac d lewilq uipment a e no " m bi e e u pm n " bu purab lication by eel ctronic means, of mate i r t o l q i e t t l rbe considere "d autos": thoat slanders or libesl a person or disparages a perso ' n s r( 1) Equipment designed primarily for:
a) Snlow remova; provdi ed that the clami is made or the "sui "t b) Ronoa d mani tenan ,ce but t ithas brought by a person or organzi ation t( coenstru n or resurfacing; or clami s to have been slandered or lib loed, r thsa t clami s to have had its goods, produc( c) Street ning; or servcei s disparage ; d r( 2) Cher ry pickers and simliar devci s gmsiso unted on automobi e o truck cha 5) Oranl or written publication, includi l r s aadnd used to rasei or lower workers; an pulblication by eel ctronci means, of materi tha(t: 3) Air compressors, pumps and generators,
igncluding sprayn , i g wedi l n , g buildin ( a) Apepropriates a perso ' ns nam , e voc , i clgeanin , g geophysical exploration, lightin phootograph or likeness; r antn d well servci i ng equipme .(
nHob) Unreaasonably places a perso inyweve , " r mobile equpi men " t does not include an tlfalse ligh .oand vehcl i e that is subject to a compulsory r efinancial responsibility law, or other motor vehicle b. Inrcludes "bodliy injur " y caused by one or mo iensurance law, where it is licensed or principall y of the offens s dehscribed in Paragrap a. garer age . d Such land vehcl i es are conside d aebov . autos".
r17.

20." Poll utants" mean any soi , l d liqudi , gaseous
Occurrenc " e means: thermal irritant or contamni a , nt including smok ,e na. Adnaccident, including continuous or repeate
vdapo , r soot, fume , s ds, akl ail s, chemci asl a
eepo ure was . te Waste includes materiasl to be recycl d, axs to substantiall y the same gener l dha m ul co di reconditioned or reclami e . rrf n tion ; s o CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 19 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission. cle
cut
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organization
organization's goods, products or services,
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI

21." Prenms i es damag " e means: contract calls for work at more tha oene job sit . a. Witheh res to the first paragraph of
esiox ceptions in Exclu n j. of I –( c) Wheanthat part of the work done at Coeverag A – Botdl i y Injury And Proper y jdob site has been put to its intende Daymage Liablty " i i , property damag " e to an use bryany person or organzi ation othe preoms i es whiel rented to you for a peroi d f
thora n another contractor
sethev en or fewer consecutive days, includngi subcoentractor workni g on the sam corntents of such premsi e ; s o proetjc .
b. Witnsh respect to the exception to Exclusio c. Wocer k that may need servcei , mani tenan , thgrou h n. ipnthe last paragraph of Paragra h 2.
cocohr recto , i n repari or repal cement, but whinf Sectio I – Coeverag A – BoAnddl iy Injury sProiasotherwise complet , e will be treatedtop erty Damage Lai biilt , y " property dama "ge dcompel te . ony premsi es whiel rented to you for a peroi d f
rmb. Dotye s not includ "e bodli y injur " y o "r prope eore than seven consecutive days, or whil ftedamag " e arsi ing out o : omporarily occupied by you with permssio i n f thyeowner, caused b :( 1) The trthea nsportation of propert , y unless innjury or damage arises out of a condti ion i( 1) Frei ; obyr on a vehcl i e not owned or operated( 2) Expol sion; ytheo u, and that condition was created by 3) Lightning; loadni g or unloading" onyf that vehci le by a( insure ;d( 4) Smooke resulting from fir , e explosion r lri ghtnn ; i g o ( 2) The edxs i tence of toosl , uninstall e eunuseq uipment or abandoned or d( 5)
oBu " mrateriasl ;
pt premsi es damag " e under this Paragra h (
eb. 3) Prothd ucts or operations for which doyes not includ "e property damag " e to an rprecloassification, listed in the De rations msi es caused b :y in a poil cy Schedul , e states that product -s(
1) Rupsuret ur , e burstin , g or operation of pres
erei cothem pel ted operations are subj ct to
l ef devci e ;s General Aggregate Limti .
2) Rupot ure or bursting due to expansion r
nswel 23." Property dama " ge mea s:
oli ng of the contents of any buildni g r
lstrua. Phaly sical injury to tangibel propert , y in dngi cture caused by or resulting from water;
lorl resuchs ulting loss of use of that propert . y Al
foss of use will be deemed to at the time o(
3) Expol sion of steam boiel r , s steam pipe ,s threphysical inuj ry that caused i ; t o steam engines or steam turbine .s
b. Lonos s of use of tangible property that is t
l22.

Products- completed operations hazard": phbey sically injure . d All such loss of use wil decee med to occur at the time of the n "
a. Intyc ludes al " l bodli y injur " y and " proper
thtat c used i .
daumag " e occurring away from premsi es yo
o n o Faor the purposes of this insuran , ce " eel nci dat " owr rent and arising out o "f your prod " uct r is not tangbl i e propert .y" your wor " k except:

24." Sloga "( n : 1) Proicad ucts that are still in your phys l opossession; or a. Msee ans a phrase that others use for the purp of attracting attention in theri advertisin .g( 2) Wor k that has not yet been compel ted r abeb andoned. Howeve , " r your wor " k will b. Dothee s not include a phrase used a , s or ,in fde m d co pl name o : thee e m eted at the earlei st of following time :s ( 1) Any person or organzi atio , n other than you; or( a) Wheunall of the work calel d for in yo r
contract has been compel te .d ( 2) Any business, or any of the premsi e ,s goyods, product , s servcei s or wor , k of an( b) Whethen all of the work to be done at ujperson or organizatio , n other than yo . uob site has been completed if yo r Pa21g e20 of 2017 The Travelers Indemnity Company. All rights reserved. CG 1T1 00 02 9© Includes copyrighted material of Insurance Services Office, Inc. with its permission. pect
Section
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Water.

Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT

25." Suei " t means a civli proceedni g in which damag s ( a) Yuo ; beocause o "f bodliy injur " y , " property damag " e r ( b) Otrhers trading under your nam ; e o" pethir sonal and advertising inu " j ry to which s (
sic) A per son or organization who nsurance applies are allege . " d Sui " t include :s da. business or assets you have acquire ;An asuchr bti ration proceeding in which adn daurem ages are clami ed and to which the ins d (
asm2) Contani ers (other than vehicles), materi l , tust submti or does submti with our consen ; oorwi panr ts or equpmi ent furnished in connectith such goods or product .s b. Anoyother alternative dispute resout l i n
eprb. Includ s:eoceeding in which such damages are clami d ( na1) Wayrranties or representations made at a
rnd to which the insured submtsi with ou
tiyme with respect to the fitness, quail t , consent.
o26.
durr abilt , i y performance or use o "f y
Teimporary worke " r means a person who s
afuprondd " uct ;
trnished to you to substitute for a permanen (
2) The proevd i ing of or failure to provd" i
etmploye " e on leave or to meet seasonal or shor -
ntewarnings or instructoi s. rm workol ad condition .s
e27.
c. Dores not include vendngi machnei s or oth
Tikt l " e means a name of a literary or artistic wor . f28.
property rented to or located for the use
Unsoiyl d communcai tio " n means an osodt hers but not l . communcai tio , n in any for , m that the re ient f

31." Your wor "k : such cotommuncai tion did not spe ficall y request nre cev . i e a. Mea s:
n29.

Voul nteer worke " r means a person who is not yo r 1) Wor k or operations performed by you or edmploye " e , and who donates his or her work an ydour behaf; l an" aocts at the direction of and within the scope f ( ddu2) Mina teriasl , parts or equpmi ent furnishe ties determni ed by yo , u and is not padi a fe ,e
ssaaconnection with such work or operation .esel ry or other compensation by you or anyone l efob. Includ s:
r theri work performed for yo .u
n30." 1) Wayrranties or representations made at a
Your prod "uct :
tiyme with respect to the fitness, quail t ,
a. Means: durr abilt , i y performance or use o "f yo
1) Andygoods or product , s other than real wor " k ; an proper , ty manufacture , d sodl , hande , l d ( vddi 2) The proevd i ing of or failure to pro i ystributed or dspo i sed of b : or instructoi ns.

CG 1T1 00 02 9 2017 The Travelers Indemnity Company. All rights reserved. Pa21g e 21 of© Includes copyrighted material of Insurance Services Office, Inc. with its permission. cite
cip
ci
warnings
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modfiei s insurance provided under the following:

COMMTERCIAL GENERAL LIABILITY COVERAG E PAR
GENERAL DESCRIPTION OF COVERAGE – Thianys endorsement broadens coverage. Howeve , r coverage for iprovn jury, damage or medical expenses described in any of the ibsions of this endorseme nt may e exorc luded lci mted i by another endorsement to this Coverage Part, and these ovtoeit rage broadening prov sions do no apply the exnt ent that coverage is excluded or limited by such an dorsemgen . t The folowing listing is a eneral covendorse rage descripti . on only Read all the provsions i of this emulles nt and the re t of your policy caref y to determine rights, duties, and what is and is not covered.

A. Wharieo Is An Insured – Unnamed Subsidi s C. Inecidental Medcal i Malpractic B. Blataln ket Additional Insured – Governmen D. Blaogationn ket Waiver Of Subr EnTot itie – s Permti s Or Authorizations Relating
sOpeE. Coroadn tractual Liability – Railsration
F. DaYoum age To Premises Rented To
PROVISIONS a. An ontr ganization other than a partnership, joi iA. WH vore nture or limited liabil ty company; UNNAMEDOR IS AN INSU ED – tSUBS DIARIESI b. A rust;
The foltold owing is ad ed SEISCTION II – WHO athas indicated in its name or the documents t AN INSUEDR : govern its structure.

AnyLjo of your subsidiarie , s other than a partnershi ,p B BLANKET ADDITIONA INSURED –.

Rno iint venture or limited liabil ity company, that s GOVERNMENTAL ENTITIES – PERMITS thete shownNi as a Nam d Insured in AUSTHORIZATIONS RELATING TO OPERATIO s a Named Insured if:

ISCa. The foltold owing is ad ed SE TION II – WHOYoanul are the so e owner o , f or maintain AN INSUEDR :
ownership interesuchs t of more than 50% in,
isubsidia ry on the first day of the policy perio ;d Any govternmental entity that has issued a perm randor authorizaationst ion with respect to ope
fb.peyour formed by you or on your behal and that Suundecss h subsidiary i not an in ured r coderdsi are required by any o dinance, law, buil ingmilar other insurance. or written contanrn act or agreeme t to include as
No such subsidiary iysan insured fo "r bodily injur " addiat ional insured on this Coverage Part is n or " property damapge" that occurred, o "r personal insured, but only with res ebodilyc t to liabi lity fo "r nand ased vertising injury" caused by an offen iandn jury", " property damage" or " perso al ncom mti ted: advertising injury" arising out of such operatio s. ta. Betfore you maintained an ownership interes The inals urance provided to such governmen tomo e entity does not apply o: orf r than 50% in such subsidiary; rb. Afperiot er the date, if , any during the policy d a. Any " bodil y injur "y , " property damag " e fthat peore sonal and adv rtising injury" arising out yoownershiui no longer ma ntain an p tioperatioaln s performed for the governmen nterest of more than 50% in such subsidiary. enort ; ity
Foagraphr purposes of Par 1. otionf Sec II – Who
b. Any " bodily injgeu " ry or " property dama " Is An Insured, eabecl h such subsidiary wil tdeemiedn cluded in the " products- compleed to be designated in the Declarat ions a :s operations hazard".

Declarations
Policy Number: 4T22-CO-2Y427520-TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMYERCIAL GENERAL LIABILIT
C. INECIDENTAL MEDICAL MALPRACTIC pharmathec euticals committ , ed by or with kuredn owledge or consent o , f the ins . 1. The foagraphl lowing replaces Par b. othef dethef inition o "f occurrenc "e in 5. The folthel owing is added to DTIONE FINI S DTIONE FINI S Section: Sectio :n
b. An adinc t or omission commti ted in provi g "
norIncidental medcal i service " s mea s:faicai ling to provide " incidental med l a. Medcal rayi , surgic , , al dental laborator -y, x
sertanr vice ", s first aid o "r Good Sama i
rseor nurosing servcei or treatmen , t advceiirvice " s to a person, unless you are n ftheion , struction or the related furnishing businedins s or occupation of provi g eprofooro d or bev rages; fessional health care servce . i s r2. b. The furnioshing or dispensing of drugs The fol lowing replaces the last paragraph f rPa aphr agr 2. .( a 1) of SECTISON II – WHO moedcal i , , dental or surgical supplie s sANappliance . INSUEDR :

Unlecupatios s you are in the business or oc n 6. The folaphl owing is added to Paragr 4.b., Cof providing professional health care service ,s Exurancec ess Ins , of SE TION IV – Paaphsr agr ( 1) a)(,(b),( c) and (d) abovdoe COITMRL MERCIAL GENE AL LIABI Y Snot apply to :" bodily injury" arising out of CONDONI TI providing or failing to provide: Thians insurance is excess over any valid d a)" Inocidental medical service " s by any f collectible other ins ,urance whether primary, ynurseo ur " employee " s who is a nurse, exthatc ess, contingent or on any other basis, aiase sistant, em rgency medical technic n ifos available to any of your " employees" r ororp aramed "ic; bod " ily injury that arises out of providing r b) Fbyi rst aid or "Good Samaritan service " s failing to provide "incidental medical servce " i s( anotn y of you "r employee " s o "r tocv lunteero to any person to the extent subje t Anworkers", other than an employed or Paaphr agr 2.a. 1)( oonf Secti II – Who Is volunteer doctor. Any such " employee "s Insured.
or "vngo lunteer workers" providing or faili
GtoD BLANKET WAIVER OF SUBRO ATION.
provani de first aid or " Good Samarit
rse your vice " s during their work hours for The foParagraphl lowing is added to 8., Trasfen wilthel be deemed to be acting within OUsf Rights Of Recovery Against Ot ,hers To GENERALCMsco ope of their employment by you r of SE TION IV – CO MERCIAL petrforming duties related to the conduc LONI ABILITY CONDITI S :
of your business. If the insured has aogreed in a contract r

3. The fol lowing replaces the last sentence f agor eement to waive that insured' s right f Paaphr agr 5. of SEOCF TION III – LIMITS rewec overy against any person or organization, INSUERANC : waivoeour right of recovery against such person r kFo thers the purpo es of determining organiezr ation, but only fo payments we ma fappl relatedi cable Each Occurrence Limit, all because o :
aocts or omssions i commti ted in providing r
afaa." Bothatd ily injury" o "r property dam ge" icai ling to provide " incidental med l rseooccurs; rtanr vice ", s first aid o "r Good Sama i
useb." Pebyr sonal and advertising injury" ca sed tor vice " s to any one person will be deemed be one "o an oedf fense that is committ ; ccurrence".

4. The fothel lowing exclusion is added to subsequent to the execution of contor act r Paaphr agr 2., Exclusonis , of SECTION I – agreement.

COYVVL ERAGES – CO ERAGE A – BODI
SINJUE. CONOADTL RACTUAL IABILIT – Y RAILR DAMAGERR Y AND P OPERTY LYI ABILIT : 1. The folagraphl owing replaces Par c. othef nSa icalsl e O Ph rmaceu dethef inition o "f insured contract" i f a t DTIONE FINI S Sec"tion: Boingd ily injur "y or " property damage" aris out of the violation of a penal statute r c. Any easement or license agreement; ordiont ance rela ing to the sale f
Pa3ge 2 of © 2017 The Trightsry avelers Indemnit Company. All reserved. CG 9D3 16 02 1 Includes copyrighted material of iceIf , nsurance Services Of Inc., with its permission.

Policy Number: 4T22-CO-2Y427520- TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMLITYE RCIAL GENERAL LIABI

2. Paaphr agr f. 1)( osuredf the definition o "f in a. Any premoi ses while rented to you r contther ac " t in DTIONE FINI S Sessioncp tion is tem orarily occupied by you with permi deorlf eted. o the owne ; r
F DAMAGE TO PREMISES RENT .ED TO YOU b. The cosuchn tents of any premises while oThepremsuchi ses is rented to yo , u if y u rent folselc owing repla es the definition o "f premi s rdamapremfewei ses for a period of seven or heg " e in t DEFONSI NITI Setionc :
consecutive day .s"
Premises damag " e means "property dama ge" to:

Policy Number: 4T22-CO-2Y427520- TCT-24
Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMERC ITYIAL GENERAL LIABIL
POLICY :NUMBER ISSUE D :ATE
THIS ENDORSEMENT CHAEFULLYNGES THE POLICY. PLEASE READ IT CAR

DESIGNATED PROJECT(S)

GENERAL AGGREGATE LIMIT
This endorsement folmodfvhe i ies insurance pro ided under t lowing:

COMMERCAIALIABILCOGE GENERAL L ITY VERA P RT

SCHEDULE
Designated jectPro
Designated Project(s): General Aggregate(s):

A. For all sums which the insured becomes legally 3. Any payments made unde COVERAGE A. obligated to pay as damages caused by " occur- for daformages or under COVERAGE C. rences" under , siCOVERAGE A. (SECTIION ) and medical expenses shall reduce the De gfor alorl medical expenses caused by accidents un- nated Project General Aggregate Limit der , paymentsCOVERAGEC ( SECTION I) which can be that designated " project". Such attrLimibuted only to operations at a single desig- shall not reduce the General Aggregate it nated "project shown in the Schedule abo ve:" shown in the Declarations nor shall they reduce any other Designated ProGeneralject 1. A separate Designated Project General AgAggregate Lidesignatedmr it fo any other gregate Limit applies to each "designated " provject" project" shown in the Schedule abo e. and that limit is equal to the amount of, the General Aggregate Liformiiits t shown in the 4. The l m shown in the Declarations Each Declarat separateions, unless Designated Occurrence, Damage TReonted Premises Project General AgExpegregate( s)nseare schetod- To You and Medical continue uled abo .ve apply. Howetover, instead of being subject themi2. the General Aggregate Li t shown in The Designated Project General Aggregate mLiitDeclarat theions, such li its will be subject to almf is the most we will pay for the sum o l applicab le Designated Project General Ag- damages under , exceptCOVERAGE A. gregate Liitm. damages because of " bodily in "jury or "property damage included in the " products- lyB. For all sums which the insured becomes legal" completed "operations hazard , and for medi- obligated to pay as damages caused by " occurcal expenses under , andCOVERAGE C regarId- rences" under , COVERAGE A. (SECTION ) less of the onumberf: for all medical expenses caused by accidents unTIa. der , cannotCOVERAGEC. ( SEC ON I) which Insureds; be attribudesited only to operations at a single gb. Claiorms made or "suits" brought; nated " project shown in the Schedule abo ve:" c. Persons or organizations mmsaki ing cla
or bringing " suits".

CG D2 11 01 04 Copyright,oThe Travelers Indemnity Company, 2004 Page 1 f 2 Docusign Envelope ID: 05C20542- 43C0-4826-BB9D- 4F5B94B5C65E

COMMERC ITYIAL GENERAL LIABIL

1. Any payments made under COVERAGE A. vofiymages ded, any pa ments for da because for dainmages " or under COVERAGE C. for " bodily injury or " property damage" medwillical expenses shall reduce the amount the " products-completed operations hazard" available under the General Aggregate Limit - reduce the Products Completed Operations Agor the Products Completed Operations Ag- gregate Limit, and not reduce the General Aggre-- gregate Libm , it whichever is applica le; and gate LiGeneralmject it nor the Designated Pro Aggregate Li itm . 2. Such payments shall not reduce any Designated Projec t General Aggregate L im .it E. For the purposes of this endorsement the DefinitioSectionsn is amended by the addittheion of C. OFPart 2. of SECTION III – LIMITS INSURANCE foitl lowing defin ion: is deleted and rep folaced by the llowing:
m2. Projec " isestm means an area away fro pre The General Aggregate Liwemt i is the most owned by or rented to you at which you are per- will pay for the sum o :f fororming operations pursuant to a contract
a. BDamages under ; Coverage and agreement. For the purposes of deterthemin ing b. Damages feachrole m " occurrences" under applicab aggregate limit of insurance, COVERAGE A (SECTION I) and for al "thelises project" that includes prem involving medical expenses caused by accidents same or connecting lots, or premises whose conunder COVERAGE C ( SECTION I) which nection is interrupted only by a street, roadway, cannot be attrbeiions - buted only to operat at waterway or right of way of a railroad shall tasingle designated " project" shown in the considered a single " projec ".

SCHEDULE above. F. OFThe proofvisi ons SECTION I – II LIMITS D. INSURANCEW hen coverage for liability arising out of the not otherwise modified by this enproducts-completed "operations hazard is pro- dorsement shall applycontinue to as stipulated."

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Lake Elsinore City CouncilJuly 8, 2025

Lake Elsinore City Council
July 8, 2025