2022-05-16_item_4.18_approve_industrial_solid_waste_license_renewal_for_fy_22-23

ITEM 4. 18

CITY MANAGER' S REPORT
MAY 16, 2022 CITY COUNCIL SPECIAL MEETING
ITEM: APPROVAL OF INDUSTRIAL SOLID WASTE LICENSE
RENEWAL FOR FISCAL YEAR 2022- 23
RECOMMENDATION: Adopt Resolution Approving Annual Industrial Solid Waste License Renewal for Stockton Scavengers
Association, Delta Container Corporation and
Ground Force Enterprises for Fiscal Year 2022- 23
SUMMARY:

The Legislature of the State of California, by enactment of the California lntegrated Waste Management Act of 1989 ( AB939), has acknowledged that it is within the public interest to authorize and require local agencies to make adequate provisions for solid waste management. The process requires cities and other local agencies to implement plans for source reduction, reuse, and recycling as part of their integrated waste management practices.

In an effort to comply with said legislation, the City of Lathrop adopted Municipal Code Chapter 8. 16 ( Garbage Collection and Disposal). Lathrop Municipal Code Section 8. 16. 140 requires any company that collects industrial solid waste in the City of Lathrop to annually apply for an Industrial Solid Waste Removal License.

The City' s current industrial solid waste haulers are Stockton Scavengers Association ( subsidiary of Waste Management, Inc.) and Delta Container Corporation ( subsidiary of Allied Waste of San Joaquin County dba Republic Services, Inc.). Ground Force Enterprises is a new company that wishes to become a hauler. Staff requests approval of the annual industrial solid waste license renewals for Stockton Scavengers Association, Delta Container Corporation, and Ground Force Enterprises.

BACKGROUND:

Lathrop Municipal Code 8. 16. 140, Section ( A) requires any company who collects and removes industrial solid waste within the City of Lathrop to apply annually for an industrial solid waste removal license. Lathrop Municipal Code 8. 16. 140 also states that the contractor who provides both residential and commercial waste removal service shall not be required to pay the annual license fee.

Delta Container is a subsidiary of Allied Waste dba Republic Services, Inc., which provides both residential and commercial waste collection service and therefore is not required to pay the annual license fee in the sum of two thousand five hundred dollars ($ 2, 500). However, Delta Container and Ground Force Enterprises are required to pay the standard eleven percent ( 11%) of their annual gross receipts and $ 92 administration fee, which is set forth by Lathrop Municipal Code 8. 16. 140.

CITY MANAGER' S REPORT PAGE 2
MAY 16, 2022 CITY COUNCIL SPECIAL MEETING

APPROVAL OF INDUSTRIAL SOLID WASTE LICENSE RENEWAL FOR FISCAL YEAR 2022- 23
Stockton Scavengers Association and Ground Force Enterprises do not provide residential waste removal service within the City of Lathrop. Therefore, they are required to pay an annual license fee in the sum of two thousand five hundred dollars ($ 2, 500) and the standard eleven percent ( 11%) of their annual gross receipts and $ 92 administration fee, which is set forth by Lathrop Municipal Code

8. 16. 140.

The haulers, Stockton Scavengers Association, Delta Container Corporation, and Ground Force Enterprises have submitted their annual license renewal application, fee, bonds, insurance, locations serviced, and their financial status report.

REASON FOR RECOMMENDATION:

To continue our efforts to meet the terms of the AB939 legislation, and continue implementing plans for source reduction, reuse, and recycling as part of our integrated waste management practices, staff recommends that City Council approve the Industrial Solid Waste Removal License renewals for Stockton Scavenger Association, Delta Container Corporation, and Ground Force Enterprises.

FISCAL IMPACT:

Annual gross receipt monies received from these companies will be deposited into the Franchise Tax- Solid Waste Industrial revenue account number 1010- 15- 10- 319- 05- 05.

The license administration fee( s) in the sum of ninety- two dollars ($ 92) received from each company will be deposited into Parks, Recreation, and Maintenance Services Administration account number 1010- 30- 01- 341- 01- 01.

The annual license fee in the sum of two thousand five hundred dollars ($ 2, 500) received from Stockton Scavenger Association and Ground Force Enterprises will be deposited into the Franchise Tax- Solid Waste Industrial revenue account number 1010- 15- 10- 319- 05- 05.

ATTACH M E NTS:

A. Resolution Approving Annual Industrial Solid Waste License Renewal for Stockton Scavengers Association and Delta Container Corporation for Fiscal Year2022- 23
B. Industrial Refuse Collection Application Republic Services dba Delta Container C. Industrial Refuse Collection Application Stockton Scavengers D. Industrial Refuse Collection Application Ground Force Enterprises CITY MANAGER' S REPORT PAGE 3
May 16, 2022 CITY COUNCIL SPECIAL MEETING

APPROVAL OF INDUSTRIAL SOLID WASTE LICENSE RENEWAL FOR FISCAL YEAR 2022- 23
APPROVALS:
r
Melissa Stathakopoul s Date
Recreation Manager
2 Tod Seb an Date
Director of Parks, Recreation and
Maintenance Services
r'
J/ f7o---
Cari Jam s Date
Finance i ector
S3- ZZ
Salvador Navarrete Date
City Attorney
ZZ
Ste J. Salvatore Date
City Manager
RESOLUTION NO. 22-

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF LATHROP APPROVING

ANNUAL INDUSTRIAL SOLID WASTE LICENSE RENEWAL FOR STOCKTON

SCAVENGERS ASSOCIATION, DELTA CONTAINER CORPORATION, AND GROUND FORCE ENTERPRISES FOR FISCAL YEAR 2022- 23
WHEREAS, Lathrop Municipal Code 8. 16. 140, Section ( A) requires any company which collects and removes industrial solid waste within the City of Lathrop to annually apply for an industrial solid waste removal license; and WHEREAS, the City' s current haulers are Stockton Scavengers Association and Delta Container Corporation; and
WHEREAS, Ground Force Enterprises would like to become a hauler; and WHEREAS, Delta Container is a subsidiary of Allied Waste dba Republic Services, Inc., which provides both residential and commercial waste removal service for the City of Lathrop and therefore is not required to pay the annual license fee; and WHEREAS, Delta Container and Ground Force Enterprises are required to pay the standard eleven percent ( 11%) of their annual gross receipts and $ 92 administration fee, which is by Lathrop Municipal Code 8. 16. 140; and WHEREAS, Stockton Scavengers Association and Ground Force Enterprises do not provide residential waste removal service within the City of Lathrop and therefore are required to pay an annual license fee in the sum of two thousand five hundred dollars ($ 2, 500); and
WHEREAS, Stockton Scavengers Association and Ground Force Enterprises are required to pay the standard eleven percent ( 11%) of their annual gross receipts and 92 administration fee, which is by Lathrop Municipal Code 8. 16. 140; and WHEREAS, to continue our efforts to meet the terms of the AB939 legislation and continue implementing plans for source reduction, reuse, and recycling as part of their integrated solid waste management practices, staff recommends that City Council approve the Industrial Solid Waste Removal License renewals for Stockton Scavenger Association, Delta Container Corporation and Ground Force Enterprises; and WHEREAS, the following monies received from these companies will be deposited as follows:

Annual gross receipt monies received from these companies will be deposited into the Franchise Tax- Solid Waste Industrial revenue account number 1010- 15- 10- 319- 05- 05;
License administration fee in the sum of ninety- two dollars ($ 92) received from these companies will be deposited into Parks, Recreation, and Maintenance Services Administration account number 1010- 30- 01- 341- 01- 01; Annual license fee in the sum of two thousand five hundred dollars ($ 2, 500) received from Stockton Scavenger Association and Ground Force Enterprises will be deposited into the Franchise Tax- Solid Waste Industrial revenue account number 1010- 15- 10- 319- 05- 05.

NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Lathrop does hereby approve the Industrial Solid Waste Licenses renewals for FY 22- 23 with Stockton Scavengers Association, Delta Containers Corporation and Ground Force Enterprises.

The foregoing resolution was passed and adopted this 16th day of May 2022, by the following vote of the City Council, to wit:

AYES:

NOES:

ABSENT:

ABSTAIN:

Sonny Dhaliwal, Mayor
ATTEST: APPROVED AS TO FORM:
yJ`'
Teresa Vargas, City Clerk Salvador Navarrete, City Attorney

ATTACHMENT
c ty of
Park, Recreation & Mainfenance Services 390 Towne Centre Drive, Lathrop, CA 95330 Phone ( 209) 941- 7370
www. ci.lathrop. ca. us

INDUSTRIAL REFUSE COLLECTION

LICENSE APPLICATION
COMPANY NAME: Republic Services
ADDRESS: 1145 W. Charter Way, Stockton CA 95206
PHONE/ FAX 209) 466. 3604/( 209) 465. 0631
EMAIL: MGomez2@RepublicServices. com
The following license requirements are setforth by the City ofLathrop Municipal Code, Title 8 Health & Safety, Chapter 8.16 Garbage Collection& Disposal, Section 8.I6.140 Industrial Solid Waste Removal— License Required.

CHECK IF

ENCLOSED
PROPOSED CUSTOMERS LIST( Names and Addresses): X

SIGNED STATEMENTS FROM NEW INDUSTRIAL CUSTOMERS ADDRESSED N/ A TO CITY( See Municipal Code section 8. 16. 140. 2):

NUMBER, KiND, AND CAPACITY OF VEHICLES AND OTHER EQUIPMENT X Must be in compliance with all applicable air pollution control laws):

ORIGINAL PERFORMANCE BOND OR OTHER SECURITY ATTACHED ($ 25, 000)- X

OR-MOST RECENT FINANCIAL STATEMENT AND/OR AUDIT
The applicant shall provide proof of financial ability to provide service contemplated by the application)

INSURANCE CERTIFICATE NAMING THE CITY, ITS OFFICES AND EMPLOYEES

AS AN ADDITIONAL INSURED X
See Municipal Code section 8. 16. 140. I for Insurance Requirements):

LICENSE FEE ENCLOSED ($ 2, 500) N/ A
ADMINISTRATION FEE($ 92) X

Page 1 ends

City of
Park, Recreafion 8 Maintenance Services 390 Towne Centre Drive, Lathrop, CA 95330 Phone ( 209) 941- 7370
www.ci.lathrop.ca.us
TYPE OF WASTE REMOVAL SERVICE:

MSW generated at industrial accounts located in the City of Lathrop.

Thefollowing definitions are setforth by the City ofLathrop Municipal Code, Title 8 Health & Safety, Chapter 8.16 Garbage Collection & Disposal, Section 8. 16. 010 ` 7ndustrial solid waste" means solid waste originating from mechanized manufacturing facilities, factories, refineries and publicly operated treatment works.

APPLICANT SIGNATURES:
0 Il" 4/ 20/ 22

SIGN RE DATE
Molly Gomez

PRINT NAME
Municipal Manager
TITLE
PROCESSED BY:
a

SIGNATURE DATE

MELISSA STATHAKOPOULOS

MANAGER

PARKS, RECREATION& MAINTENANCE SERVICES
APPROVED BY:

TODD SEBASTIAN DATE

DIRECTOR

PARKS, RECREATION& MAINTENANCE SERVICES

Page 2 ends

Name Address

RIVER ISLAND( TOOL SHED) LAKESIDE& MARINA
WILLIAM ASSAD 15810 HARLAN RD 5
DRAGON ESP PRODUCTS 15700 MCKINLEY AVE
OLD DOMINION ODMOOOSTC 40YD 601 DARCY PKWY
SHERWIN WILLIAMS 8523 3YD 15390 S HARLAN RD
MOBILE MINI 1134 6YD 16351 MCKINLEY AVE
ONE LATHROP ( LATHROP PROPERTY) 16424 S HARLAN RD
KELLY BUSINESS PARK, LLC 91- 201 D' ARCY PKWY
SEGURA& SONS TRUCKING 12796 S HARLAN RD
PREMIER INDUSTRIAL FINISHING 17700 SHIDELER PKWY
CITY OF LATHROP COMM CENTER FL 15557 5TH ST
LATHROP SANDS MOBILE HOME# 2 11550 5 HARLAN RD
BELLAS BAKERY 155 LATHROP RD
LATHROP SELF STORAGE 1644 E LOUISE AVE
BUDS CONCRETE 11145 HARLAN RD
CITY OF LATHROP W/ TREATMENT 18800 CHRISTOPHER WAY
CITY OF LATHRP/ STONEBRIDGE PRK 13400 SLATE ST
SAVE MART# 94 15240 S HARLAN RD
PFLUG PACKAGING 17600 SHIDELER 17600 SHIDELER PKWY
PFLUG PACKAGING 20YRD TRASH 17420 SHIDELER PKWY
CON FAB 1910 LATHROP RD
DAYS INN 14750 S HARLAN RD
DELTA AC SUPPLY 3515 YOSEMITE AVE
BOISE CASCADE BLDG MATERIALS 12030 5 HARLAN RD
TOP GUN DRY WALL SUPPLY 15500 MCKINLEY AVE
SUPER STORE/ COMP 2400 E LOUISE AVE
TESLA TRUCK YARD 500 E LOUISE AVE
RSNA TESLA MOTORS INC 701 DARCY PKWY
CHICAGO' S PIZZA 159 LATHROP RD
SUNSET BY: PULTE HOMES 40YRD W 3200 GARDEN FARMS AVE
TRU HOTEL 161 E LOUISE AVE
SUPER STORE INDUSTRIES 16888 MCKINLEY AVE
WESTERN PACIFIC CRANE& EQUIP 1500 MADRUGA RD
TESLA 401 30YD OT 401 NESTLE WAY
LATHROP COMMUNITY APOLISTIC CHURCH 15074 5TH ST
TRU HOTEL 161 E LOUISE AVE
LATHROP WASH & DRY 16460 CAMBRIDGE DR
BORAL ROOFING ROTH RD 342 ROTH RD
LATHROP COMMUNITY CHURCH 937 J ST
GOLDEN VALLEY STORAGE 16000 GOLDEN VALLEY PKWY
NMW/ MOTOR CARGO/ UPS FREIGHT 1444 LATHROP RD
KNIGHT TRANSPORTATION SWIFT 901 DARCY PKWY
GUTHRIE GENERAL INC 901 DARCY PKWY
CBK LATHROP 16948 S HARLAN RD
DE SILVA GATE CONSTRUCTION 550 NESTLE WAY
SIGNATURE HOMES- CARDIFF RIVER 17184 VERMEER CT
AMAZON SITE VUJH 11950 S HARLAN RD 11950 S HARLAN RD
CLOROX OVERFLOW FACILITY 619 TESLA DR
TESLA( TEMP WOOD) 700 DARCY PKWY
TOWNE CENTRE- SOUTH SITE 240 TOWNE CENTRE DR
SIGNATURE HOMES 17180 REMBRANDT DR
TESLA- MCKINLEY 15660 MCKINLEY AVE
LEARNING TREE PRESCHOOL 15551 7TH ST
LATHROP FIRE DISTRICT 800 J ST
PENTECOSTAI CHURCH OF GOD 14172 AVON AVE
LATHROP HIGH SCHOOL- YARD WASTE 647 SPARTAN WAY
PETS& PALS 12488 S HARLAN RD
MANTECA LATHROP FIRE DIST# 34 460 RIVER ISLAND PKWY
MANTECA LATHROP FIRE DIST# 31 800 J ST
GIGLICO INC 12333 S MANTHEY RD
KORNHAUSER 1683 E LOUISE AVE
PERFORMANT RECOVERY, INC. 17080 S HARLAN RD
HERITAGE PAPER ( PIONEER) 17740 SHIDELER PKWY
FIRESIDE INN 854 LATHROP RD
D' ARCY BUSI PK COM/ CONDO ASSOC 17320 D' ARCY PKWY
D' ARCY BUS PK COM/ CONDO ASSOCI 17918 MURPHY PKWY
GRACE COMMUNITY CHURCH 850 J ST
LATHROP BUSINESS PARK 16916 S HARLAN RD
LATHROP BUSINESS PARK 16980 S HARLAN RD
HAMPTON INN 103 E LOUISE AVE
MOSSDALE ELEMENTARY SCHOOL 455 BROOKHURST BLVD
THE DOG HOUSE 3221 YOSEMITE AVE
FAST LANE CENTRAL VALLEY 116 ROTH RD
DOT TRUCK SALES 11299 S HARLAN RD
BROWN SAND INC 800 MOSSDALE RD
ROGER AQUINO 11471 S MANTHEY RD
CITY OF LATHROP PUBLIC 1 15445 7TH ST
LUCIA MACHADO 904 O STREET
BARBOSA CABINETS INC. 11900 S HARLAN RD
ROBINSON TRANSPORTATION 4180 NEWTON RD
CHEVRON ( F/ L) 17395 S MANTHEY RD
HOLIDAY INN AND SUITES 15688 S HARLAN RD
CALIFORNIA NATURAL EAST GATE 3 15188 S MCKINLEY AVE
TEAM HEALTH 16974 S HARLAN RD
PETER HOLTZ CPA 210 TOWNE CENTRE DR
TRIAD ADOPTION SERVICES 17259 GOLDEN VALLEY PKWY
PILKINGTON LATHROP 40YD 500 E LOUISE AVE
BERRY PLASTIC 601 TESLA DR
IN N OUT BURGER( DIST. CNTR) 18240 S HARLAN RD
LATHROP HEAD START 721 THOMSEN RD
TARGET 2347 TGT002347 35YD C 16858 GOLDEN VALLEY PKWY
CREATIVE OUTDOOR ENVIRONMENT 15929 S MANTHEY RD
RIVER ISLAND @ LATHROP 73 STEWART RD
RIVER ISL@CONST. OFC/ LAY DWN YD 401 STEWART RD
DELLOSSO FARMS 26 STEWART RD
CAFE PLATANO 14725 S HARLAN RD
VATTADI LATHROP CROSSING, LLC 15362 5 HARLAN RD
CBC STEEL 1919 E LOUISE AVE
LOUISIANA KITCHEN 16837 S HARLAN RD
RIVER ISLAND BOAT HOUSE REST. 980 LAKESIDE DR
FLYING J# 101700 345 ROTH RD
SIMWON AMERICA CORP. 400 DARCY PKWY
UNION LOGISTICS 1631 E LOUISE AVE
LA COSTA DE ACAPULCO 16444 CAMBRIDGE DR
RESIDENTIAL DESIGN SERVICES 19105 CHRISTOPHER WAY
LA REINA SUPERMARKET 1357 E LOUISE AVE
RAYMOND HANDLING 19107 CHRISTOPHER WAY
HD LATHROP LLC 16609 S HARLAN RD
SEFNCO COMMUNICATIONS( TRASH) 12687 5 MANTHEY RD
TRI- WEST LTD LIMITED 17690 SHIDELER PKWY
AMERICAN RIVER CONSTRUCTION 800 ROTH RD
TACO BELL 16905 S HARLAN RD
FERELLGAS LP DBA BLUE RHINO 12693 S MANTHEY RD
ABSOLUTE VENTURES 15901 6TH ST
THE SHOPS AT LATHROP CROSSING 15382 5 HARLAN RD
CHEEMA FREIGHT LINE LLC 16200 MCKINLEY AVE
HALE CONST INC LAY/ DWN YARD 401 W STEWART RD
DARTANO FARMS INC 17270 GOLDEN VALLEY PKWY
QUALITY INN & SUITES 16855 S HARLAN RD
TESLA LATHROP 20YD RO 501 NESTLE WAY
RIVER ISLANDS BASEBALL CLUB LL 1051 RIVER ISLANDS PKWY
CROSSLINK PRO TAX SOLUTIONS 16916 S HARLAN RD
TESLA- COMPACTOR 17100 MURPHY PARKWAY
SUNRISE TRUCKING INC./ A& A INTE 1850 E LOUISE AVE
ALTO SYSTEMS, INC. 11980 S HARLAN RD
RAVINDER DHILLON 11378 5 HARLAN RD
AMAZON DCK1 OFFSITE PKNG LOT 16350 MCKINLEY AVE
ASHLEY FURNITURE DC 0049 40YD 18290 5 HARLAN RD
WAYFAIR INC. 5120 GLACIER ST
RIVER ISLANDS- WELCOME CENTER 1401 RIVER ISLANDS
PFLUG PACKAGING 17500 SHIDELER PKWY
SIMWON AMERICA CORP. ( BUILDIN 18231 MURPHY PKWY
ECLIPSE METAL FABRICATION 17700 SHIDELER PKWY
WEST COAST RV& BOAT STORAGE 4052 YOSEMITE AVE
SUNRISE TRUCKING SITE 3 1625 E LOUISE AVE
THE BLESSED KITCHEN 151 LATHROP RD
NMW/ UPS- LATHROP 10634 S HARLAN RD
COMFORT INN 14730 5 HARLAN RD
RAFAEL& FRANCES SANDOVAL 15485 7TH ST
STORAGE PRO OR LATHROP# 26 15550 S HARLAN RD
AMG RESOURCES PACIFIC CORP. 15332 MCKINLEY AVE
SEVENTH STREET APARTMENTS 16015 7TH ST
O STREET APARTMENTS 934 O ST
CAMINO REAL MOBILE HOM PARK 15820 S HARLAN RD

CITY OF LATHROP PARK STONE BRIDGE PARK
MC DONALDS RESTAURANT LATHROP 300 E LOUISE AVE
FOOD 4 LESS LTHP TRASH/ RECYCLE 17935 MURPHY PKWY
HOME DEPOT HMD005363 COMP 40YD 18300 S HARLAN RD
FLEETPRIDE 729 1629 E LOUISE AVE
SWIFT TRANSP 901 DARCY PKWY
UTILITY TRAILER SALES 12608 S HARLAN RD
LATHROP ELEMENTARY 15851 5TH ST
LATHROP POST OFFICE 15529 7TH ST
CALIFORNIA NAT. PROD. ** ADC1** 15789 MCKINLEY( WAREHOUSE) AVE S CALIFORNIA NATURAL PRODUCTS 11518 MCKINLEY AVE
CALIFORNIA NATURAL PRODUCTS 1250 LATHROP RD
CITY OF LATHROP 2112 E LOUISE AVE
CITY OF LATHROP GENERATION CTR 450 SPARTAN WAY
NICKS 76 16500 S HARLAN RD
TESLA 05518YD 18260 S HARLAN RD
RUBIK BUILT 18007 MANTHEY RD 4 18007 S MANTHEY RD
TESLA 701 DARCY PKWY 701 DARCY PKWY
CITY OF LATHROP/ WELL 7 40YD GR OFF MC KINLEY COUNTY DIRT RD NMW/ UPS- LATHROP R/ 0 501 DARCY PKWY
TESLA 0551 18260 S HARLAN RD
KAISER PERMANENTE- LATHROP 17000 S HARLAN RD
KIPER HOMES BALBOA AT RIVER IS 16243 DUGGAR DR
PFLUG REC COMPACTOR DR# 18 17420 SHIDELER PKWY
TWO GUYS FOOD FUEL 147 LATHROP RD
MANTECA LATHROP FIRE DIST# 35 19001 SOMERSTON PKWY
VEOLIA WATER 18800 CHRISTOPHER WAY
WALGREENS# 10631 14780 S HARLAN RD
GHIRARDELLI 11980 S HARLAN RD
D' ARCY BUS PK COM/ CONDO ASSOCI 401 DARCY PKWY
JOES PLACE 15600 S HARLAN RD
LA CRESCENTA PROP/ LOUISE PLAZA 201 LOUISE AVE
JOSEPH WIDMER MIDDLE SCHOOL 751 STONEBRIDGE AVE
CBC STEEL 1700 E LOUISE AVE
LATHROP HIGH SCHOOL 647 SPARTAN WAY
JACK IN THE BOX# 588 100 E LOUISE AVE
JOHN DEERE LATHROP 17400 SHIDELER PKWY
CITY CONTRACT/ CITY OF LATHROP 390 TOWNE CENTRE DR
BALWANT SINGH SANDHU 2690 W YOSEMITE AVE
OUR LADY OF GUADALUPE 16200 CAMBRIDGE DR
TOTTEN TUBES 15540 MCKINLEY AVE
JH MOTOR SPORTS 14150 S HARLAN RD
CITY FOOD & LIQUOR 16470 CAMBRIDGE DR
HEARTLAND EXPRESS 12550 S HARLAN RD
TEC EQUIPMENT( R/ O) 2050 E LOUISE AVE
NATIONWIDE FLEET 17605 S MANTHEY RD
LATHROP GAS& FOOD INC 140 IATHROP RD
RIVER ISLAND TECH ACADEMY 1175 MARINA DR
EAGLE' S NEST HARLEY DAVIDSON 13900 S HARLAN RD
HIGH FIVE PLAZA, LLC 16925 S HARLAN RD
ORIELLY ORE004719 4YD 15079 S HARLAN RD
DENISE' S FARMER MARKET 950 S MANTHEY RD
SWISS AMERICAN 251 DARCY PKWY
DENNYS RESTAURANT 16851 S HARLAN RD
NEXT GENERATION 18001 COMMERCIAL ST
COLONIAL ENERGY, LLC 192 LATHROP RD
KIWI CRATE INC 11980 S HARLAN RD
TESLA INC MOTORS REC 18250 MURPHY PKWY
ATLAS COPCO 1601 MADRUGA RD
PRATT INDUSTRIES 2131 E LOUISE AVE
SAVE MART CENTER SITE 15010- 18 S HARLAN RD
DONA TERE PERUVIAN RESTAURANT 16438 CAMBRIDGE DR
STARBUCKS 58278 16538 GOLDEN VALLEY PKWY
LATHROP SMOG 15151 S HARLAN RD
LATHROP VETERINARY CENTER 17600 GOLDEN VALLEY PKWY
PANDA EXPRESS 3104 15099 S HARLAN RD
BURGER KING 22460 15119 5 HARLAN RD
NMW/ UPS- LATHROP( COMPACTOR) 11800 S HARLAN RD
CHIPOTLE# 3535 16542 GOLDEN VALLEY PKWY
CARL' S JR# 7415 200 E LOUISE AVE
HEALTH SERVICES BENEFIT ADMIN 16960 S HARLAN RD
KFC# 219 ( LEHA 219 INC) 150 E LOUISE AVE
CITY OF LATHROP SENIOR CENTER 15567 5TH ST
KABARITI AM- PM MINI MARKET 85 E LOUISE AVE
CLOROX 11950 5 HARLAN RD
KAREN MEYER 947 H ST
y g2rie an c;
Trk # Serial # ' er 1 #' ' Year Descr. Lieense # Numbex c S DB ' US DQT# 0125 MLA07570- 0002 73186061 2011 FREIGHTLINER 34439A2 1FVACWDTI6DBD4842 REPUBLIC 3171547 2000 31ROX21124932 46663959 2007 AUTOCAR 90796G2 5VCHC6MF47H2O4293 SUNRISE 3171547 2001 5121PX281659175 X01741 2021 PETERBILT 44833G3 36PDXKOX4MF111096 SUNRISE 3171547 2430 103PDX284220887 46509949 2005 AUTOCAR 8B18582 5VCHC6MFX6H2O2451 REPUBLIC 3171547 2452 65VOX284733872 73080044 2010 AUTOCAR 37566A1 5VCACD8F3AH211081 REPUBUC 3244872 2453 72ROX314225929 46619149 2007 AUTOCAR 8M37046 SVCHC6MF47HT04407 SUNRISE 3171547 2455 63VOX284733767 73080059 2010 AUTOCAR 3T562A1 5VCACDBFSAH211089 REPUBLIC 3171547 2456 42TOX314230851 46981902 2009 AUTOCAR 8V67950 5VCHC6JF69H2O9423 SUNRISE 3244872 2458 54VOX2& 4733608 73078457 2070 AUTOCAR 45045A7 SVCACD8F4AH211073 ALLIED 3244851 2459 62VOX314233726 73078458 2070 AUTOCAR 47567B1 SVCACD8FSAH211132 REPUBLIC 3244872 2460 63VOX314233771 73078459 2010 AUTOCAR 47569B1 SVCACDSF7AH211133 SUNRISE 3244872 2461 63VOX314233785 73078462 2010 AUTOCAR 4756687 SVCACD8F9AH211134 REPUBLIC 3244872 2464 RR8105244 73657439 2014 AUTOCAR 86527S1 SVCACDVF3EH217456 INDEPENDENT 3171547 2465 RR8105247 73660949 2014 AUTOCAR 86518S1 SVCACDVF9EH217459 INDEPENDENT 3171547 2466 RR8705248 73660952 2074 AUTOCAR 86519S1 5VCACDVF5EH277460 INDEPENDENT 3177547 2467 RR8105256 73660959 2014 AUTOCAR 86520S1 SVCACDVF7EH277461 INDEPENDENT 3171547 2468 RR8105254 73660950 2014 AUTOCAR 86521S1 SVCACDVF9EH277462 INDEPENDENT 3171547 2469 RR8105257 73665455 2014 AUTOCAR 8613051 SVCACDVFOEH217463 INDEPENDENT 3171547 T470 RR8105250 73665454 2074 AUTOCAR 86522S7 SVCACDVF2EH217464 INDEPENDENT 3171547 2471 RR105258 73665460 2014 AUTOCAR 86523S1 SVCACDVF4EH217465 INDEPENDENT 3171547 2472 RR8105245 73657413 2074 AUTOCAR 8673151 SVCACDVFSEH217457 INDEPENDENT 3177547 2473 RR8105246 73660955 2014 AUTOCAR 86129S1 5VCACDVF7EH217458 INDEPENDENT 3177547 2474 32160X284845853 73938865 2076 AUTOCAR 17515A2 SVCACDVF7GH222762 N LSG 3171547 2475 32160X284845859 73938984 2016 AUTOCAR 17516A2 5VCACDVF9GH222163 N LSG 3771547 2476 RR8105444 73950664 2076 AUTOCAR 43913B2 5VCACDVF3HH222578 N LSG 3771547 2477 RR8705528 X003795 2018 PETERBILT 57503H2 38PDLKOX8JF184222 INDEPENDENT 3171547 2478 RR8105529 X003203 2018 PETERBILT 51504N2 36PDLKOXXJF184223 INDEPENDENT 3171547 2479 3478PX314850976 X004962 2018 PETERBILT 60357M2 36PDLKOX7JF162079 INDEPENDENT 3171547 2480 6318PX314851640 X005739 2019 PETERBILT 62734M2 3BPDLKOX3KF102933 INDEPENDENT 3244851 2481 6418PX314857653 X005825 2019 PETERBILT 61633M2 38PDLKOX5KF102934 INDEPENDENT 3171547 2482 2320PX274856198 X012817 2020 PETERBILT 40406Z2 36PDLKOX3LF108961 SUNSET 3171547 2483 3220PX274856366 X010534 2020 PETERBILT 27018Y2 36PDLKOX5LF108962 SUNRISE 3177547 2484 3120PX274S56353 X012733 2020 PETERBILT 01285A3 38POLKOXSLF108959 SUNRISE 2485 3220PX274856370 X012810 2020 PETERBILT 88754Z2 3BPDLKOX1LF108960 SUNRISE 3171547 2486 3220PX274856387 X012818 2020 PETERBIIT 40805Z2 3BPDLKOX7LF708963 SUNRISE 3171547 2457 3220PX274856372 X0128' 15 2020 PETERBILT 88753Z2 36PDLKOX9LF108964 SUNRISE 3' 1 547 2488 3421PX274858809 X017191 2021 PETERBILT 97905F3 36PDXKOX2MF170724 SUNRISE 3171547 2489 3421PX274858835 X017109 2021 PETERBILT 19278F3 3BPDXKOX4MF110725 SUNRISE 3171547 2490 2222PX274861146 X022243 2022 PETERBILT 38PDXKOX2NF113429 INDEPENDENT 3171547 2491 2722PX274861714 X022246 2022 PETERBIIT 36PDXKOX9NF113430 INDEPENDENT 3171547 2492 7422PX274861103 X022238 2022 PETERBILT 36PDXKOXONF113431 INDEPENDENT 3171547 2546 53YOX314241517 73657433 2014 AUTOCAR 8612851 5VCACDVF8EH217767 INDEPENDENT 3244872 Bady ngine ` Yin G
Trk # Seria # erial # Year Descr.; License # N amber OW R,SHP DBA US Df T# 1324 82UOAd38534140 73079092 2010 AUTOCAR 9488IG1 SVCACLSFfiAH211182 AlLIEO 324d855 1333 73UOA438533990 73078884 2010 AUTOCAR 2467561 SVCACL8 OAFi211176 ALLIED 3244855 1335 65VOA438533888 73076850 2010 AUTOCAR 4735061 SVCACL8FOAH211047 REPUBLIC 32A4855 1336 83JOA438534153 73076852 2010 AUTOCAR 2415381 SVCACL8F2JW211048 SUNRISE 3244855 1339 54118PA407851470 X005655 2018 PETERBILT 62509M2 36PDXKOX1KF161693 INDEPENDENT 3244855 1340 82181PA407852015 X006723 2019 PETERBILT 59917N2 38PDXKOX7KF161696 DELTA 32d4855 1341 10120PA438755140 X010251 2020 PETERB LT 75845W2 38PDXKOX2LF107465 DELTA 3244855 1342 2220PA438756167 X013383 2020 PETERBILT 27019Y2 36PDXKOXXLF109643 DE TA 3244855 1343 2420PA438756251 X013365 2020 PETERBI T 88751Z2 36PDXKOX7LF109644 DEITA 3244855 1344 2420PA438756259 X013384 2020 PETERBILT T7020Y2 38PDXKOX3lF109645 DELTA 3244855 1345 2320PA438756224 X013461 2020 PETERBILT 8875222 38PDXKOX8lF109642 DELTA 3244855 1346 1521PA438758399 X016698 2021 PETERBILT 52310E3' 36PDXKOX4MF110837 DELTA 3244855 3009 2006 PETERBILT 7U86726 7NPZLOOX46D716535 DELTA 3244855 3353 13H27575 46539533 2006 AUTOCAR 77202C1 SVCDC6MF36H2O2838 DE TA 3244855 3354 13H26950 46534012 2006 AUTOCAR 33536W1 SVCDC6MF26H2O2832 INDEPENDENT 3244855 3355 13H28234 191867 46676412 2007 AUTOCAR 76509T2 SVCDC6MF27H2O4419 DELTA 3244855 3356 13H28523 197870 46676564 2007 AUTOCAR 35494G3 5VCDC6MF97H2O4420 DELTA 3244855 3357 13H28524191873 46676508 2007 AUTOCAR 8H43125 SVCDC6MF07H2O4421 DELTA 3244855 3358 13H2S526 191875 46676517 2007 AUTOCAR SH95615 SVCDC6MF27H2O4422 DELTA 3244855 3360 13H30001 46815909 2008 AUTOCAR SP93118 5VCDC6JF38H2O6508 DELTA 3244855 3361 13H30002 46815928 2008 AUTOCAR 66432K2 5VCDC6JFSSH2O6509 DELTA 3244855 3362 13H30200 35221185 2008 AUTOCAR 53450L3 5VCDC6KFX8H2O7444 ALLIED 3244855 3363 13H40933 X003120 2018 PETERBILT 87575G2 38PZLKOX1JF184228 INDEPENDENT 3244855 3364 73H40934 X003719 2018 PETERBILT 87452G2 36PZLKOX3JF184229 INDEPENDENT 3244855 3365 13H42158 X005082 2018 PETERBILT 90125G2 36PDLKOXOJF162036 INDEPENDENT 3244855 3366 13H42159 X005354 2018 PETERBILT 90124G2 36PDlKOX4JF762038 INDEPENDENT 3244855 3368 35100902 2005 AUTOCAR 35578G3 5VCDC6BE45H2O1089 DELTA 3244855 3369 13H46789 X012827 2020 PETERBILT 75664Y2 36PDLKOX1LF109090 DELTA 3244855 3371 13H48351 X016679 2021 PETERBILT 07378D3 3BPDLKOXOMF110877 DELTA 3244855 3370 13H46790 X012829 2020 PETERBILT 27017Y2 36PDLKOX3LF109091 DELTA 3244655 3424 18058996 X002839 2U16 PETERBILT 62729M2 38PZLKOX8HF175147 DELTA 3244855 3433 TH0151 2003 AUTOCAR 7607860 5VCDC9UE63N194349 DELTA 3244855 3434 N/ A 35033943 2002 VOLVO 6R84715 4V2DC6UE32N328095 REPUBLIC 3244855 3440 13057 YQ22584 2013 PETERBILT 67348E1 1NPSXPEXXDD205495 3244855 0467 EF114ZA122 73665676 2015 FORD 61006Pt 3FRWF7FC2FV545042 REPUBLIC 3244855 0468 E1716 1503187367819 2018 FORD 61269P2 1FDWF7DC2JDF04786 3244855 B-BQ- TRL 0000 SPCNS/ TRL 4DF7567 CA930785 DELTA 3244855 BDT Dave& Mike buiit 2015 BIN DELIVERY TRL 4NJ8752 CA1150407 DELTA 3244855 79 SERIAL# AT3531559 MODEI 2P50000 FORKLIFT- CAT GiLP AU2293 TIRE SIZE 7. 00X72/ 6. 00X9 H39084 HOLT OF 0015 F15 2004 FORD F150 7M17721 2FTRF17W24CA60026 INDEP. TRUCKING 0025 F250 2010 FORD F250 8S79607 1FTNF2A59AEA19161 INDEP. TRUCKING 0055 F550 2014 FORD F550 99349L1 1FDUFSGTIEEA62597 INDEP. TRUCKING July 7,? p 1
FedEx Priority Overnight
Diti;eti Prasad
ltepublic Setti ces
ii4 1Vest Charter Wa}
Stockton, CA 9 206
9i6-585- i889
RE: Upcoming Renewals
Dear Aaron:

Please find enctosed} our renewal dacuments for tlze following bond{ s). You wilt need#o send these originaI cIocuinents io the respectiae Obtigee at your earIiest conuenience:

Bond Subsidiarp Principal Name Obiigee Bond Dc: scription Bond Expir.tion Number Amount Date
9( 1gG3-32 4[} 7 Larhrop Sunrisc City Of l.athrop S lid Wastc Handling and S25, OQU. Up b/30/ 2Q21 5anitation Haulin u
Co or.tion
Should y
ou r
qt irc fiirther assistance or if yau 1 e any questions, plcase do not hesitate to contact me at 2o6- i-iaoo or at arnUer.engel a' usi.com.

Sinccrel•,
c lll(' I'
Ambcr E gel
Surety Account Man igcr
Sat•ety Sert ices
r€, R; Casu it • m oys . rs tits Persor+ i Risk • tirement Consulti U S1 GN A van rage'
CONTINUATi I t CERTIFlGATE
The Westem Suretv Companv{ hereinafter calied the Surety) hereby continues in force its Bond No. 929 86342 in the sum of Twentv Five Thousand Dollars and 00/ 100 ($ 25, 0OO. OQ) Dallars, on behalf o# Lathrop Sunrise Sanitation Corporation
in favor of Citv Of a#hrop
subject to all the conditions and terms thereof through June 30. 2022 a# loca#ion ofi risk.

This Continuation is executed upon the express condition ihat the Surety' s liability shall not be cumulative and shall be limited at aq times by the amount of the penalty stated in the bond.

IN WITNESS WHEREOF, the Surety has caused this instrument to be signed by its duly authorized Attorney-in- Fact and its carporate seal to be hereto affixed this 22 day of July, 2021.

Western Surety Comt anv
Surety
B y: A_ i`[ f-f 2 f r%"; Y, 1. f --'
Debbie Lindstram Attorney-in- Fact
Vestern ure} r an y
PO ER F ATTORNEY APPf31tiTItiG IP iD1VIDUAL ATTORhE1'- il+t- FACT I( nux, Ui 11rn By Thrs E' resea s, That W T K3i 5 TttiiY CtJIiNAVY, a Sadh I}rkota capotatios, is a duly orbanizrd and c.cistingcarporaaion l;a issg ft3 pnncipat ol3icr in t: r City uf Saouz Falls, and S#a;e ot' Seath!) aknta. aiui Uut it ikxs by viriue ut 11se signasure ami ual harin afCued hrrcby makc, canstiiutc anS appnint
kathleen A1 MitcheU, Holly E Uliee-s, Roxana Pulaci s, Pegg,y A Firth, Debbie A Lindstrom, Scott Alderman, Lori Stark, Kylenc Everett, Timothy S Bu ite, Brandi Heinbaugh, Jamic Armfield, Kath Nyc, Tara Koioski, t mber Engel, Individually a( Scatdc, IVA, iU tntc aad lau ful Anomcy(s} in-Fact a ith full to ccr aiad authoriry hereby coafcrtccl to segn, scal and cxccutc for and on its behal!' bands, unJcrt: d: ing. and thcr ahli atory instrumcnts uf similar ncttnrc 1n Unlimited Amounts-auJ to bind it thcmby as fully nnd to the wtttc cstcnt as it such u, tt mcnt wcro si u! by a duly authoriza! o ccr of d c corporation rud all thc actc ol' aid Attumcy, pursuant to the autherity hcreby givcn, arc hcreU} ralificd ard cun6mirJ.

This Pow r af Attomcy is inadc and csccutcd pursuant to and by aa hority of thc Sy- Law printixl on 1hc mti crsc hrrcnf, duly adoptcJ, as indicafcd, by hc sharrho3drrs oCthc cc rporadun.
ln Vitness 14' herenf, 1' ES7TRN SUKE7Y Cqh1P: 1N1' has cauaccl lhcse prcscnts to be signcd by ii Vice Arc sident and itx ca o le scal to be hcrcto atlircd on his I Sth day oflunc,?) 21.

Err WESTERN SURETY COMPANY
0 e°°;
3=
f.sen, a
rron
Paul T, IIruflat Vice Presidcnt
Statc af South bal nta
ss
Counry of tinnch ha J
On this ISth day of 1unc,? U21, bcPorc mc pcncmally cainc Pau] T.[ irutlat, to mc knoun, w ha, tx;ing by mc duly sHom, did dcpusc and say: that hc resid. s in dic Clty ofSiaux Falls, Swtc f Snuth Daknta; thn ho is tiic Vicc Presidrni of WESTERN SUREfY COMPAIYI' Jcscribai in and which cxccutcd hc stw c inatrument; that hc knuw thc sral of said eorporation; chat thc scal affixecl to the said inswmcnt is such cor wratc scal; that it was ui ai'6xcd pursu: mt tn auiho ity giti•en by sUe paaal of Dir ctors af saiJ cnrpor sie n and tha[ he signed his name thrnto pursuant! o like authoriry, and acknowledges samc to b d c acl u ct dced of: id corporation.

Aty couimi, si, n cxpires
M. BEN7 '
if_.:'' FqGar WBIK u*
Ai:udi° 42ti SrF SOt 7 a ma,
M...

M. Bcnt, Notary Pub[ ic
CEIt"ClFICATE:

L. Nciwn, r ssisiattt S4cretary of VC•_S7TRN SURETY Ct IPANY J; hen4ry ceniCy lhat thc Pou•rr at Attomey hercinabove sei forth is s il( in turcc:. and Cunlier tcrtiCy hat th,: t3}'- Law of Ihr coRaoration prirtrt! n: hU revcrsc h nf is stilt in fwce. lestimony whercvf t have hcreuato subxrib l nty namc anci atlixat the s: al ciI tl c+ aid curForatiop this%z- cL y cf . n. Y . 202t
RETrc y,
r

O STERN SURETY C MFANY
14op s?
s S; A 7
M~
s!^'
Fucm E#'_ 0-''-'< i:

T t dson, hssistant Sccmtary
Go 4u wway. cnasuretv. tam> Owner/ Qbtigee Services> Validate Bond Ccrve age, if you want ta verify bond a sthentiaty, riuihurizit B}- Law
ADOPTED BY THE SHAREH+ OLDERS UF ESTERN SUREZ' Y C+E3MPANY 17iis I'a i°cr ofAZtorncy is m:sd and cxccutul punuan icr r,d hy authc ily of Ihe following t3y- lax duly adoptes] by thc shamhoIdcrs otthe Co iipany.

Scctioza 7. All bun ls, palicic. s, undcrtaking,. Po rs of Attomcy, or othcr obiigations of thc caspor, tion shail bc exccvtcd in thc rurpor.itc namc of thc Cumpany by tlre Presidcnt, Sccm ry, ancl Assistant Sccntary, Trcasarcr, vt any Vicc Pccsidcnt, or by such othcr ofiiccrs ss thc t3oard af llirrctars cn.ny authoriu. " ii c Prc iden. any Vicc Pn.sident, Sccrctary, any Assistant SccreWry, ur thc Trcasurcr may appoini Attorncys in Fact or agcnts who shall 1 a' c. authority to issuc b nds, pc( icics, or undcn ings in thc nan c of the Company.

Thc carporatc scal is not a. ccssary for tlic validity of an bands, policics, undertakings, Powcrs of Attomcy or othcr obligations of thc corporatican. Tlic sigT ariirc of any such o{ iiccr and thc cnrpi rrte sca! may bc prinicd by facsimitc.

DATE( MM/ DD/ YYYY) CERTIFICATE OF LIABILITY INSURANCE p' ° f4 06/ 29/ 2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer ri hts to the certificate holder in lieu of such endorsement s .

PRODUCER CONTACT NAME:

CANNON COCHRAN MANAGEMENT SERVICES, INC.
17015 N. SCOTTSDALE RD PHONE( A/ C No. Ext): FAX( A/C No.Ext):

SCOTTSDALE, AZ 85255 E- MAIL ADDRESS: certificateteam ccrosi. com INSURER S AFFORDING COVERAGE NAIC#
INsurtert a: ACE American Insurance Co. 22667
INSURED iNsuRER B: Indemnit Insurance Co of North America 43575 REPUBLIC SERVICES, INC. iNSUReRc: ACE Fire Underwriters Insurance Co. 20702 18500 N. ALLIED WAY iNsuReR n: Illinois Union Insurance Com an 27960 PHOENIX, AZ 85054 INSURER E:

INSURER F:

COVERAGES CERTIFICATE NUMBER: 1977651 REVISION NUMBER:

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR
TypE OF INSURANCE ADDL SUBR pOLICY NUMBER

POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/ DD MM/ DD/ YYYY) A
X COMMERCIAL GENERAL LIABILITY HDO G72482074 06/ 30/ 2021 06/ 30/ 2022 EACH OCCURRENCE 5, 000, 000

CLAIMS- MADE OCCUR DAMAGE TO RENTED
PREMISES( Ea occurrence)
5, 000, 000
MED EXP( Any one person)
PERSONAL& ADV INJURY 5, 000,000
GEN'L AGGREGATE LIMIT APPLIES PER:

GENERALAGGREGATE 5, 000, 000

POLICY PROJECT LOC
PRODUCTS- COMP/ OP AGG 5, 000,000
OTHER:

A
UTOMOBILE LIABILITY ISA H25549752 06/ 30/ 2021 06/ 30/ 2022 COMBINED SINGLE LIMIT x ANY AUTO Ea accident)
5, 000, 000
X OWNED AUTOS SCHEDULED BODILY INJURY( Per person)

ONLY AUTOS

X HIRED AUTOS NON- OWNED
BODILY INJURY( Per accident)

ONLY AUTOS ONLY PROPERTY DAMAGE
Per accident)

UMBRELLA LIAB OCCUR EACH OCCURRENCE

EXCESS LIAB CLAIMS- MADE GGREGATE
DED RETENTION$
B

ORKERS COMPENSATION
Y N N q WLR C67824064 AOS 06/ 30/ 2021 06130/ 2022 X PER ND EMPLOYERS' LIABILITY STATurE OTHER
4 WLR C67824027 CA1MA/ OR 06/ 30/ 2021 06/ 30/ 2022
NY PROPRIETOR/ PARTNER/ EXECUTIVE SCF C67824106- WI O6/ 30/ 2021 06/ 30/ 2022 E. L. EACH ACCIDENT 3, 000, 000 C FFICER/ MEMBER EXCLUDED? WCU C67824143- OH XS 06/ 30/ 2021 06/ 30/ 2022 E. L. DISEASE- EA EMPLOYEE $ 3, 000, 000 Mandatory in NH)
TNS C68990592- TX NSXS 06I30/2021 06/ 30/ 2022 E. L. DISEASE- POLICY LIMIT 3, 000, 000 p If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Division Number: 4207- Named Insured Includes: Lathrop Sunrise Sanitation Corporation- Dba: Allied Waste Lathrop Sanitation Services

CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED

BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Lathrop ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE
390 Towne Centre Drive
LATHROP, CA 95204
United States
OO 1988- 2016 ACORD CORPORATION. All rights reserved.

ACORD 25( 2016/ 03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:

LOC#:

A ADDITIONAL REMARKS SCHEDULE P P 4

AGENCY NAMEDINSURED
REPUBLIC SERVICES, INC.

POLICY NUMBER 18500 N. ALLIED WAY
See First Page PHOENIX, AZ 85054

CARRIER NAIC CODE
See First Page EFFECTIVE DATE:

ADDITIONAL REMARKS CERTIFICATE NUMBER: 1977651
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM.

FORM NUMBER: 25 FORnn TIT e: CERTIFICATE OF LIABILITY INSURANCE The following provisions apply when required by written contract. As used below, the term certificate holder also includes any person or organization that the insured has become obligated to include as a resuit of an executed contract or agreement.

GENERAL LIABILITY:

Certificate holder is Additional Insured including on- going and completed operations when required by written contract.

Coverage is primary and non- contributory when required by written contract.

Waiver of Subrogation in favor of the certificate holder is included when required by written contract.

AUTO LIABILITY:

Certificate holder is Additional Insured when required by written contract.

Coverage is primary and non- contributory when required by written contract.

Waiver of Subrogation in favor of the certificate holder is included when required by written contract.

WORKERS COMPENSATION AND EMPLOYERS LIABI ITY:

Waiver of Subrogation in favor of the certificate holder is included when required by written contract where allowed by state law.

Stop gap coverage for ND, WA and WY is covered under policy no. WLR C67824064 and stop gap coverage for OH is covered under policy no. WCU C67824143, as noted on page 1 of this certificate.

TEXAS EXCESS INDEMNITY AND EMPLOYERS LIABILITY:

Insured is a registered non- subscriber to the Texas Workers Compensation Act. Insured has fifed an approved Indemnity Plan with the Texas Department of Insurance which offers an alternative in benefits to employees rather than the traditional Workers Compensation Insurance in Texas. The excess policy(# TNS C68990592) shown on this certificate provides excess Indemnity and Employers Liability coverage for the approved Indemnity Plan.

Contractual Liability is inciuded in the General Liability and Automobile Liability coverage forms. The General Liability and Automobile Liability policies do not contain endorsements excluding Contractual Liability.

Separation of Insured( Cross Liability) coverage is provided to the Additional Insured, when required by written contract, per the Conditions of the Commercial General Liability Coverage form and the Automobile Liability Coverage form.

Additional Insured includes: City of Lathrop, iYs Officers, Officials, Employee and Volunteers, when required by written contract.

The ACORD name and logo are registered marks of ACORD
Pa e3o#4
2 P C LIC''' lalU 9B R: HDO G 2482U74 En rsEmen# Numbsr: 1d9 aGCMiIiiER CIA GENE IABILITY
CG 20 10 07 Q4
THIS ENDORS ME IT CHAN ES THE OLI C'. PLEAS F El 1D I' CI, REFU I.Y.

ADDITIC3NAL INSUR E - VMER, LES E OR
C t TRACTQRS - S IE ULED PE C3N OR

ORGANIZA' IQN
This endfl sement modifies insurance provided under the ft l Iflwing:

GOtv1MERCIAL GEtVERAL LIASILITY GOVERAGE PART

S CMEDULE
Na e Uf Addltlonal Insured P'erson( s} Location s) Of Covered Operations Or arganization( s):

Any Owner, Lessee or Contractor whom you have All lacations where you are performing operations for agreed to include as an additianal insured under a such additional insured pursuant to any such written written contract requiring CG2t310( Q704), provided contract. such caniract was execut d prior to the date of
lass.

Infonrration re uired to cam lete this Schedule if nat shau rn above, will be shown in the Declara#ions_ A. Section II — Wha Is An Insured is amended to 8. Wi#h respect ta the insurance afforded to these include as an addi6anal insured the persan( s} or additional insureds, the following additional exclu-organization( sy shown in the 8chedule, bu# only sians apply:
with respect to liability fs r " badily injury", " pro- his insurance does nat apply ta " bodily injury" or petty damage" ar " personal and adWertising property damage" accurring after: injury" caused, in whale or in part, bY: qll wark, in iuding materiais, parts oc equip.

1. Yflur acts ar omiss ans; ar ment furnished in connecEiort with such work,

2. ? he acts or omissians of those acting an
on th project( other than setvice, maintenance
yaur behalf; or repairs) tq be performed by c r on behalf of the ad ibanal insured( s) at th Icfcatian af the
in the pertormance of your angaing c eratians cauered aperatians has beer ccympleted; or fo the additianal insu ed( s at tl e loea o( s}
designated aboWe. t part on of" yQur wsrk" ou af wh e€ the i
j r c r dar ac e arises has t een put tra its r-ter ded use by any persan ae arganization other tf r anather cc r trac 6r esr sufaco tractar
engag ee n perfo rr ing apera ns for a p i c-pal as a art af the sarne prQ cf.

GG 20 itt t? Q4 ISE7 Properties, I c., 2Qt} 4 Pags 1 e f 1 Pa e of 4
13 PL LI' NIJMBER: HO+ G72 8207 3 ndorsem nt l um,t eer. 1' 1 1MEFR UAL GENE 1. LI 4BILITY
CG 3 3' 071} 4
THIS EN} flR3 AAEN? MANGES 1 lE PilLICY. PL 4SE tE3AD I? CAR FUL. Y.

ADDITI i 4. INaURE - + J1N lEFiSj LES EES C3R
C TRJ4CT RS - CC IUIP. ETE] + O ERAT1 3l 1S
t' h s endflrsement modi es nsurance pravided under me following:

CflN1 NERCIAL GENERAL. LIABILITY CQVERAGE PART

SCHEDU E
Name Of Addltianal Insured Person( s)
Or Or an zatio s : Location And Descri tion+Df Com leted O eratians Any dwner, Lessee or Ctsntractor whom yQu ha e All locations where you are performing operations for agreed to include as an additibnal insured under a such additit nal insured pursuant to any such writter written cnntract requiring CG2037( 0704}, provided contract. such contract was executsd p ior to the date of lass.

Inforrnation re uired to cam lete this Schedule, if not shown above, wiil be shown in the Declara4ions.

Section II - Who Is An Insured is amended ta
include as an additional insured the persan( s) ar
arganization( s) shown in the Schedule, but only wi#h
respect ta Ilaaility far" badily injury" ar" prapeRy dam-age" caused, in whole or in part, by " yaur v rork" at he location designated and described in the sched-ule of this endorsement pertarmed for that additional insured and included in the " praducts- completed
aperatians hazard".

GG E13 Q?' E14 I C f'rcz ter es, Inc,. ac) 4 Page' af 1 DocuSign Envelope ID: 8CE04408- 1647- 460B- 94F7- CFD7303310EC ATTACHMENT _.
c ty of
Park, Recreafion & Maintenance Services 390 Towne Centre Drive, Lathrop, CA 95330 Phone ( 209) 941- 7370
www.ci.lathrop.ca.us

INDUSTRIAL REFUSE COLLECTION

LICENSE APPLICATION
COMPANY NAME: USA Waste of California, dba Stockton Scavengers ADDRESS: 1240 Navy Dr
Stockton, CA 95206

PHONE/ FAX
EMAIL:

The following license requirements are setforth by the City ofLathrop Municipal Code, Title 8 Health & Safety, Chapter 8. 16 Garbage Collection & Disposal, Section 8. I6.I40 Industrial Solid Waste Removal— License Required

CHECK IF

ENCLOSED
PROPOSED CUSTOMERS LIST( Names and Addresses): X

SIGNED STATEMENTS FROM NEW INDUSTRIAL CUSTOMERS ADDRESSED TO CITY( See Municipal Code section 8. 16. 140. 2):

NUMBER, KIND, AND CAPACITY OF VEHICLES AND OTHER EQUIPMENT X Must be in compliance with all applicable air pollution control laws):

ORIGINAL PERFORMANCE BOND OR OTHER SECURITY ATTACHED ($ 25, 000)- X

OR-MOST RECENT FINANCIAL STATEMENT AND/ OR AUDIT
The applicant shall provide proof offinancial ability to provide service contemplated by the application)

INSURANCE CERTIFICATE NAMING THE CITY, ITS OFFICES AND EMPLOYEES AS AN ADDITIONAL 1NSURED X
See Municipal Code section 8. 16. 140.I for Insurance Requirements):

LICENSE FEE ENCLOSED ($ 2, 500) X
ADMINISTRATION FEE ($ 92) X

Page 1 ends

DocuSign Envelope ID: 8CE0440B- 1647-4606-94F7-CFD7303310EC ilty Of
Park, Recreafion & Maintenance Services 390 Towne Cenrre Drive, Larhrop, CA 95330 Phone ( 209) 941- 7370
www.ci.lathrop. ca.us
TYPE OF WASTE REMOVAL SERVICE:

Thefollowing definitions are setforth by the Ciry ofLathrop Municipal Code, Title 8 Health& Safety, Chapter 8. 16 Garbage Collection & Disposal, Section 816.010 " Industrial solid waste" means solid waste originatingfrom mechanized manufacturingfacilities,factories, refineries andpublicly operated treatment works.

APPLICANT SIGNATURES:

CDocuSigned
by:
j ( 04/ 29/ 2022
nr,anne rEAFd S

SIGNATURE DATE
Barry Skolnick
PR1NT NAME
President
TITLE
PROCESSED BY:
l'' ; a'

SIGNATURE DATE

MELISSA STATHAKOPOULOS

MANAGER

PARKS, RECREATION& MAINTENANCE SERVICES
APPROVED BY:

TODD SEBASTIAN DATE

DIRECTOR

PARKS, RECREATION& MAINTENANCE SERVICES

Page 2 ends

C R A INC 16777 HOWLAND RD LATHROP 95330- 9777
CALAVERAS MATERIALS INC 1945 LATHROP RD LATHROP 95330- 9708 CUNHA DRAYING INC 1500 MADRUGA RD LATHROP 95330- 9779
DIAMOND PET FOOD PROCESSORS 250 ROTH RD LATHROP 95330- 9724 DIAMOND PET LATHROP 20YDS FWST 250 ROTH RD LATHROP 95330- 9724 DIAMOND PET LATHROP- FEL 11900 S HARLAN RD LATHROP 95330- 8767 ENTERPRISE TRUCK RENTAL 12715 S MANTHEY RD LATHROP 95330- 8401 FOOD EXPRESS 1250 MADRUGA RD LATHROP 95330- 9779
HAVEN ACRES RIVERCLUB 1691 FREWERT RD LATHROP 95330- 9784 J R SIMPLOT CO 16777 HOWLAND RD LATHROP 95330- 9777
J R SIMPLOT CO- TRASH 16777 HOWLAND RD LATHROP 95330- 9777 MORONES, SHAWN 891 MANILA RD LATHROP 95330- 8711
OLIVERA FOODS 944 BOWMAN LATHROP 95330
PRESTON PIPELINES INC 12687 S MANTHEY RD LATHROP 95330- 8400 QUEST MANUFACTURING 3964 YOSEMITE AVE LATHROP 95330- 8714 RAMIREZ, JESUS 483 MANILA RD LATHROP 95330- 9380
SILVER CHASE SELF STORAGE 12565 S MANTHEY RD LATHROP 95330- 9732 TUFF BOY SALES INC 3870 YOSEMITE AVE LATHROP 95330- 9748 WIRE MESH WEST COAST LLC 15380 5 MCKINLEY AVE LATHROP 95330- 8782

CAPITAL USED
1 RO TRUCK
10, 20, 40 YARD CONTAINERS AND COMPACTORS

NATIONAL GUARANTY INSURANCE COMPANY OF VERMONT
76 ST. PAUL STREET, SUITE 500 BURLINGTON, VT 05401
Memorandum
DT: May 6, 2021
7'0: Cathy Ng
Waste Management
Attn: Cathy Ng
172- 98th Ave.

Oakland, CA. 94603- 1004
FR: Brandi Guthrie
Insurance Officer
Bond No. LB03- 0549- TX— Stockton Scavenger
Enclosed please find the renewal document for the above referenced bond. This document has been executed at your request for the June 30, 2021 to June 30, 2022 term.

Please forward the original to the Obligee and retain a copy for your files.

If you have any questions or need further assistance, please contact Diana Seng, Director of Treasury and Financial Assurance at( 713) 265- 1322 or Dseng@wm. com.

Enclosures

NATIONAL GUARANTY IAISURANCE COMPANY OF VERMONT
76 ST. PAUL STREEf, SUITE 500 BURLiNGTON, VT 05401

EXTENSION CERTIFICATE
To be filed with the Obligee)
License/ Permit Bond
Bond Number: LB03- 0549- TX
To be attached to Bond described below, executed by National Guaranty Insurance Company of Vermont as Surety:

PRINCIPAL: Waste Management of California, Inc.

OBLIGEE: City of Lathrop
DESCRIPTION: Industrial Refuse Collection
Said Principal and said Surety hereby agree that the term of said bond is extended from the 30th day of June, 2021 to the 30' day af June, 2022 subject to a11 other provisions, conditions and limitations of said bond, upon the express condition that Surety' s liability during the original term of said bond and during any extended term shall not be cumulative and shall in no event exceed the amount of Twenty Five Thousand and 00/ 100 - - --- -- - - - - - --- ($ 25, 000. 00).

Signed, sealed and dated this 6' day of May 2021.

WastP l Ianagement of California, Inc.

By: G
Peter Snell, Attorney- In-Fact
National Guazanty Insurance Company ofVermont
By:
randi Guthrie, Attorney- In-Fact

ACKNOWLEDGEMENT BY SURETY

STATE OF VERMONT

COUNTY OF CHITTENDEN
On this 6' day of May, 2021, before me Sandra Groenin a notary public in and for the State of VERMONT with principal office in the County of CHITTENDEN residing therein, duly commissioned and sworn, personally appeared Peter Snell. known to me to be the attorney- in-fact of the corporation that executed the within instrument, and acknowledged to me that such corporation executed the same.

In witness whereof, I have hereunto set my hand and xed my oi icial seal, at my office in the aforesaid County, the day and year in this certificate first above written. te G. oe'''
5 .

Notary Public in and for th tate of Vermont
Commission :
2 ; No. 0012895 : My commission expires 31 2
od F
tA .'
3;
0 F
o .....• J
Gb Sta$° ACKNOWLEDGEMENT BY PRINCIPAL

STATE OF VERMONT

COUNTY OF CHITTENDEN
On this 6' day of Ma,y, 2021, before me Sandra Groenin a notary public in and for the Staxe of VERMONT with principal office in the County of CHITTENDEN residing therein, duly commissioned and sworn, personally appeared Brandi Guthrie, known to me to be the attorney- in- fact of the corporation that executed the within instrument, and acknowledged to me that such corporation executed the same.

In witness whereof, I have hereunto set my hand and affixed my official seal, at my office in the aforesaid County, the day and year in this certificate ftrst above written. s,aaG' @: f
Notary Public in and for the ate ofVermont
Commission :

Z ; No. 0012895 ; -- My commission expires o,, • c
p. 3 .•'•
o
A •••.....•• . 0
Sfai6°

POWER OF ATTORNEY
KNOWN ALL MEN BY TRESE PRESENTS that Waste Management. Inc. and eacn of its direct and indirect majority owned snbsidiaries( the" WM Entities"), have constituted anu appointed and do hereby appoint Peter Snell, Brandi Guthrie, Bradley Klein, and Nancy Madden ofAon Instuance Managers( USA} Inc., each its true and lawful Attorney-in-fact to execute under such designation in its name, to affix the corporate seal approved by the WM Entities for such purpose, and to deliver£ or and on its behalf as surety thereon or otherwise, bonds of any of the following classes, to wir

1. Surety bonds to the United States of America or any agency thereof, and lease and miscellaneous surety bonds required or permitted under the laws, ordinances or regulations of any State, City, Town, Village, Board or any other body or organization, public or private.

2. Bonds on behalf of WM Entities in connection with bids, proposals or contracts.

The foregoing powers granted by the WM Bntities shall be subject to and conditional upon the wvritten d.irection of a duly appointed officer ofthe applicable VJM Entity( or any designee ofany such officer) to cxecute and deliver any such bonds.

The signatutes and attestations of such Attomeys-in-fact and the seal ofthe WM Entity may be affixed to any such bond, policy or to any cerll'ificate relating thereto by facsimile and any such. bond, policy or certificate bearing such facsiYnile signatures or facsimile seal shall be valid and binding upon the applicable WM Entiiy when so affixed.

IN WITNESS WHEREOF, the WM Entities have caused these presents to be signed by the Vice President and Treasurer and its corporate seal to be hereto affixed. Tius power of attomey is in effect as of Mav 202 1 .
11Vitness: On behalf of Waste Management, Inc. and
each ofthe other WM Entities
c-v. 6'' c-.

David Ree
Vice President and Treasurer

POWER OF ATTORNEY
KNOWN ALL MEN BY THFSE PRESENTS that the National Guaranty Inswance Campan} of Vermoirt, 76 St Paul Street, Suite 500, Burlington, Vermont Ccxporation ( the" Cocporation")_ has constituted and appointed and does hereby constitube and appo t Peber Snell, Brandi Guthrie, Bradley Kleus, and Nancy Madden ofBurlington, Vermont, each ixs true and Iawful Attorney- in- fact to execute undar such desi nation in its name and to affix its corporate seal to deliver for and on its behalf as surety Wereon or otherwisa, bonds of any ofthe following classes, to wit:
l. Surety bonds to the United States ofArnerica or any agency therea including lease and miscellaneous surety bonds required or peimitted under the laws, ordinances or rogulations ofany State, City,' I'ow t, Village, Board or any other body or orga.nization, public or private.

Bonds on behalf of conttactors in connection with bids. proposals or conaacts.

3. Insurance policies and Certificates ofInsurance related to financia7 assurance for closure, post- closure andlor corrective action obligations.

The foxegoing powers granted by the Corporarion shall be subject to and cunditional upon the written dire.ction of any o cer( or any designee of any such officer) to execute and deliver anv such bonds.

The signatures and attestations of such Attomeys- in-fact and the seal of the Corporation mey be affixed to any such bond, policy or to any certificate relating thereto by fncsimile and any such bond, policy or rt icate bearmg such facsimile signat ues or facsimile seal shall be valid and binding upon the Cor wration when so affixed.

IN WITNESS WHEREOF, the Corporadon has caused these preserrts to be si med bv the President and its corporate seal to be hereto affixed. This power of attorney is in effect as of Mav 6 202-
Witness: NATIONAL GUARANTY INSIIRANCE

COMPANY OF VERMONT
il -
Diana Seng David Reed
Secretary President
Revised 06/ 02f20

DATE( MM/ DDIYYYV)
ACORL7 CERTIFICATE OF LIABILITY INSURANCE iiii2o23 12/ 9/ 2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

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 ri hts to the certificate holder in lieu of such endorsement( s).

PRODUCER LOCKTON COMPANIES NAMEACT
3657 BRIARPARK DRIVE, SUITE 700 PHONE i a Na:

HOUSTON TX 77042 e- Mni
866- 260- 3538
ADDRESS:
iNSURER S AFFORDING COVERAGE NAIC#
NsuReR n: ACE American Insurance Com an 22667

INSURED
WASTE MANAGEMENT HOLDINGS, INC.& ALL AFFILIATE INSURER B: I11d0I11111 Insurance Co of North America 43575 1300299
LATED& SUBSIDIARY COMPANIES INCLUDING: NsuReR c: ACE Fire Underwriters Insurance Com an 20702 STOCKTON SCAVENGERS INSURER D: ACE PTOpO & Casualty Insurance Co 20699 1240 NAVY DRIVE
INSURER E:

STOCKTON CA 95206
INSURER F:

COVERAGE CERTIFICATE NUMBER: 11291846 REVISION NUMBER: XXXXXXX

INSR
7ypE OF INSURANCE

ADDL SUBR
pOLICY NUMBER MMIDDIYYW MM/ DDIYYYY LIMITS LTR

COMMERCIAL GENERAL LIABILITY
A X Y Y HDO G72492365 I/ t/ 2022 1/ 1/ 2023 EACH OCCURRENCE S OOO OOO CLAIMS- MADE OCCUR PREM SES Ea oNcur ence $ S OOO OOO
X XCjJ jNCLjJDED MED EXP( Any one person) $ XXXXXXX
X ISO FORM CG00010413 PERSONAL& ADV INJURY $ S OOO OOO
GEN' L AGGREGATE LIM T APPLIES PER: GENERAL AGGREGATE $ C) OOO OOO POLICY jE LOC PRODUCTS- COMP/ OP AGG $ O OOO OOO
OTHER:

A AUTOMOB LE LIABILITY Y Y MMT H25550328 1/ 1/ 2022 1/ 1/ 2023 COMBINED SINGLE LIMIT $
Ea accident 1 0
X
ANY AUTO BODILY INJURY( Per person) 8 XXXXXXX
X AUTOS ONLY AUTOSULED BODILY INJURY( Per accidenl) S XXXXXXX X

HIRED XNON- OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident XXXXXXX
X MCS- 90 XXXXXXX
D X
UMBRELLALIAB X OCCUR Y Y XEUG27929242007 1/ 1/ 2022 1/ 1/ 2023 EACHOCCURRENCE ISOOOOOO EXCESS LIAB CLAIMS- MADE AGGREGATE 1 S OOO OOO
DED RETENTION$ XXXXXXX
B

WORKERS COMPENSATION Y X
PER OTH-AND EMPLOYERS' LIABILITY WLR C68918595 AOS 1/ 1/ 2022 1/ 1/ 2023 STATUTE ER t1 Y N WLR C68918558 AZ, A Bc MA UI/ 2022 I/ I/ ZO23 E. L EACH ACCIDENT 3 OOO OOO C ANY OFFICER/ PROPRIETOR/ MEMBEREXCLUDED? PARTNER/ EXECUTIVE NIA SCFC6H91H63( I UU2O22 I/ UZOZ3 Mandatory in NH) E. L. DISEASE- EA EMPLOYEE $ 3 Q Q 000 DESCRIPTION OF OPERATIONS below E. L. DISEASE- POLICY LIMIT $ 3 OOO OOO q EXCESS AUTO Y Y XSA H25550286 1/ 1/ 2022 1/ 1/ 2023 COMBINED SINGLE LIMIT LIABILITY 9, 000,000

EACH ACCIDENT)
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

BLANKET WAIVER OF SUBROGATION IS GRANTED IN FAVOR OF CERTIFICATE HOLDER ON ALL POLICIES WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT WHERE PERMISSIBLE BY LAW. CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED ON ALL POLICIES( EXCEPT FOR WORKERS' COMP/ EL) WHERE AND TO THE EXTENT REQUIRED BY WRITTEN CONTRACT. ADDITIONAL INSURED IN FAVOR OF CITY OF LATHROP( ON ALL POLICIES EXCEPT WORKERS' COMPENSATION/ EL) WHERE REQUIRED BY WRITTEN CONTRACT.

CERTIFICATE HOLDER CANCELLATION See Attachment
11291846

CITY OF LATHROP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 390 TOWNE CENTRE DRIVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN LATHROP CA 95330 ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIV
O 1988-2015 ACORD CORPORATIO . Ail rights reserved.

ACORD 25( 2016/ 03) The ACORD name and logo are registered marks of ACORD Attachment Code: D462684 Certificate ID: 11291846
POLICY NUMBER: HDO G72492365 Endorsement Number: 39

COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - ( Form B)
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART.

SCHEDULE
Name of Person or Organization: CITY OF OAKLAND AND ITS COUNCIL MEMBERS, DIRECTORS, OFFICERS, AGENTS AND EMPLOYEES.

If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)
WHO IS AN INSURED( Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of" your work" for that insured by or for you.

CG 20 10 1185 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 ATTACHMENT .....

City of
W _._,____ =—
Mw.- ._.:._ ____.________ .. W:. ....._. . .-,-....:_..

M ......

Park, Recreat on& Mc intencxnce Services 390 T wne Cenrre Drive, La hrop, CA 95330 Pizone ( 209) 941- 73? 0
www.ci.lathrop,ca.us
INDUSTRIAL REFUSE COLLECTI4N
LICENSE APPLICATIt N
COMPANY NAME: Ground Force+ Enterprises
ADDRESS: 6 2' 1 Grassland Drive
Castro Vailey, CA 94552
PHONE/ FAX S O. g 2.g055
EMAIL: office@groundforceenlerprises. cam
ThefoClowing license require nents are setf rth h the City afLathrop Municipal Code, 7'itle 8 Health& Safety, '/ iapter 116 Garbage Collection& Disposal, Section$. 16.140 Industrial Svli l Waste R moval- License Requrrerx

CHECK IF
ENCLO5ED
PROPOSED CUSTOMERS LIST( Nam s and Addresses): X
SIGNED STATEMENTS FROM NEW INDUSTRIAL CUS' COMERS ADDR: ES5ED X TO CITY( See Munici al Code section 8. C. 140. 2):

NUMBER, KIND, AND CAPACITY OF VEH[ CLES AND OTHBR EQUIPMENT X fMust be in compliance tivith all applicable airpolltttion control laws):

ORIGINAL FERFQRMANCE BOND OR OTI-IER SECUI ITY ATTACHF, D($ 25, 000)- X

OR-IVIOST RF,C NT FINANCIAL STATBMENT AND/OR AUDIT
The applicant shall provide proof af financial ability to provide service c ntemplated by the application)
INSURANC:E CERTIFiCATE NAMING THE CITY, 1TS OP' ICBS ANQ EIVIPLOYEES AS AN ADDiTIONAL INSURED X
See Municipal Code section 8. 16. I40.I for Insurance Reqt irements):

LICENSE FEE ENCLOSED($ 2, 500) X
ADMINISTRATION FEE($ 92} X

Page 1 ends

City of
ti,- _:._.._. ,_...
v,...__.__.._.._ _.___._... __ .. e .- ...--- -..

Ppf ReCi'@qflCil & Mp1fi @l1p tC@ S@NiCeS 39 Towne Centre Drive, Taatl rop, C: A. 95330 Phone( Z(79) J41- 737(}
www.cilar.hr p.ca. us
TYPE(? F WASTE REMQV IL SERVICE:

Drop-off and pick-up of ratl-off debris qoxes
Tlae followar g definitions c re setforth by tlae C'ity ofLathrop Munici al C'ode, Title 8 Health& Safety, Chapter 8.16 Gtrrbabre Collection 8 Dixpasal, Seclion 8.16. O1U " Industrial solid w ste" means snlid waste originatin frv n mechanizet! manufacturing facililies,factories, refineries andpuhlic[y operate! treatment wr tks.

APPLICANT SIGNATURES•
GL--''"
i`
t'' J 5-2-2022

SIG ATURE DATE
Siivia Teixeira

PRINT NAME
tlffice Manager
TITLE
PRU ESSED BY:

SIGNATUItE DATE

MELISSA STATHAKOPOULOS

MANAGER

PARKS, RECREATION& MAINTENANC SCRVIC S
APPRQVED BYt

TODD SEBASTIAN DATE

DIRECTQR
AARKS, RECREATION & MAINTENANCE SERV[ CES

Page 2 ends

Proposed Customer List
Tesla Motors
18260 S. Harlan Rd., Lathrop CA 95330

TRUCK LIST
Year Make Model License VIN # Capacity
1 2010 _ KW T880 8W44532W 1NKDLUOX5AJ272163 24, QOOIbs
2 2018 KW_ _ T880
T
25236M2 1NKZLPDX5JJ218692 24, 000 Ibs
3 2019 KW T880 40414S2 1NKZLPDX5KJ343709 24, OOOfbs
4 2024 KW T880 16409Y2 1NKZLPpX2LJ423969 24, OOOIbs
5 2021 KW T880 78372C3 1 NKZLPDX2MJ467911 24, 000 Ibs
6 2021 KW K270a 43942C3 ^ 3BKJHM6X4MF582545 10, 000 Ibs Y
i
Natiancvid Mutual Tas• aiiae Cc mpany
Bond Deparhnent
Nationwiride• l 10f C.. ocust Deparfrt e t 20Q6
I s M ines, IA 50391- 2 QG
Pi one: 86 i-387- 0457
xa ail: bandcora zn? natiotjw ide. c om
f
L,icense and Pern it Bonc#
Band No. 79t?1( 0075
KNOW, 1LI. MEN 13Y Tt-{ESE PRESFNTS:

TIInt tve, rounrf F'oree Enterprises
vf C' astra V liey State of A a PritS p, nd
t i tio ide 1Vtit[ l F aslir tace onlpa y, car araCion G dttly tie nsed to do busi rtess he St e af s St r t, aK( ze d nd rnily 6ot nd c nto c;: v r1. a tu p, c t car, x 51<tt: c f' A i tfte p 17d Suc'f1 C f ' r°enty]^ ive Thausa td nd tioliU4 ciollars{ 525, 0{}Q. QOJ I uE l 1iaz y c f' tlYe Uatitec StAtes, to! e paid ta the nid{) b( i ee, for which ayrnent wvell d trti ly to be t de, ri e bii1 1 o rselv s i d c ur l gal rept esentatives, jaintl y ancl severaily t y fi se pr•ese ts. i
I- l OI*I tJITTt7N f T- I Af QV O 3LiGATION IS StJGH, thr t wheceas, tl e said Peii ci l# as l e n isstred licens or peranii dcscribec as foilo vs: G a Gc industriat Sntid asie tlie aid C?blige.
t
i
T' C W THEi ET` R, if Itie said I' ein ipt l sh l1 f ith' ully perfaz•tn the dt ties and in alI tlaiiigs can ply vitil he lativs nd oedinances, i clucii; alt A nendi et fs theretcas appei- ainitt; to tl e [ ic a e c r perit it descril ed th n tlais bli lio ta be void, othei- vise t• etllain i i futl foF ce r d effcct fi rrm Ap il?9, 2Q22 utifil April 28> 2023 unless extet cied k y cantinuation CerCi cate.

This bc ttci znay be te nliz ated at: uny tit e t y
tlte S ie; ty ipon sendin 7 ti: e i1 v ritizxg, to tl e oUli, ee vittz 4vEtU n this bond is E"ilc:c) r cl t tite I' rit ci aC, at the t st kn wn address, and at the expit atic 1 c f thirty( 3) days fi n n tl c
iling af' slid n ti, e, tt is bai td sha( f ipso facEo t• x1 i i t i c th; Surety shall ela re on t e re ieuec fz•om iny I 6i[ ity fc r an r acts t• n is io i o" kl e Pcincipal s ibsec u nt tr s id date.

I
Gated this ' day of Y 202
i
5h il sav nd kee} I t ri aless tf e_ CiEy c f I. tl i•o, C li[ c tn a fi•or 11 3
lc ss c r da a vhicll it m y
sttstiri t ot fc r tivl ich it n
iy cc tt e Ii lalr c n z cc i nt c f' tl e issuar cc f s id Iicei s. at p rtiiit.

Ura n d f`c rc,° t6 rprises
y
t
l t' lI1Ct i1
r,,, N tianwide„ A tua( I surance Ct a» p r y
1 SEAL y: ..
r;: /
R Pest na Attc i•n y- in- Fact
k
i
Pawer of AtYorney
KNOW ALL MEN BY THESE pRESE1VTS THAT:

Nationwide Mutuai Insurance Company, an Ohio cnrporaiion hereinaRer referred to saveratly as Iha" Company" and collactively as" the Camparties" does hereby make, constilute and appoint R Pestana
each in lheir individuat capaaty, its Irue and lawFul eitorneyin-fect, with fuil powar and authority fo sign, seal, and exocute on Its behalf any and a11 bonds and undertakings, and pther obligatory instrumenls oi sfmilar nature, in penalties not exceeding the sum of Twenty Five Thousand and no/ 100 dolEars($ 25, 000. 00) and to bind the Company ihereby, as fully and to the same extent as if such inslruments were signed by the duly authorized ofRcers of Ihe Company; and all acts of sald Altorney pursuant to ihe auEhority given are hereby ralifled and confirmad. his power of attomey Is made and execuied pursuant ta and by aulhorlty of khe following resolution duly adoptod by the board o£directors ot the Company:

RESOLVEb, thal the presideni, or any vice presldent be, and each hereby is, authorized and empowered to appoint attorneys- in- facl ot the Company, and lo authorize thom to execuie and deliver on behalf of ihe Company any and alf bands, forms, appllcallons, memorandums, undertekir gs, recognizances, transfers, contracts of Indemnity, policles, contracts quaranieeing tfle fldetity of persons holdirtg posilions of publlc or private trust, and other wrilings abligatory in nature that the dusiness of Ihe Company may require; and to modify or ravoke, wilh ar wlthout cause, any such appoiniment or aulhorily; provided, howave, that the aulhority granled here6y sha11 in no way Ilmil tfte authorify ot other duly aulhorized agents to sign and counterslgn any oi said documents on behalf of the Company." RESOLVEp FUR7HER, thai such atlorneys- In-( aci shall have full power and authority to execute and deliver any and a11 such dacuments and to bind the Company suhJect to tlie terms and iimltatlons of the power of attotney issued to fhem, and to affix the seal of the Company therelo; proVided, however, that sald seal shafl not ba necessary for the validity of any such documents." Thls power of attorney is signed and sealed under and by tha tollowing bylaws duiy adopted by the board of directors of tha Company.

Execution of instruments. Any vlce presldent, any assislant secretary or any assistant treasurer shall have tha power and authority to slgn or attest ail approve ocuments, nstruments, contracls, or other papers in conneotion with the operatfon of ihe business of the company! n addEtion to the chatrman of the 6oaM, the chief executive oificer, presldent, treasurer or secretary; provided, however, the signeture of any of them moy be prinled, engraved, or stamped on any approved document, contract, insirument, ar olher papers of lhe Company.

IN WITNESS WHEREOF, the Company has caused this instrumenl lo be sealed and duly ettested by Ihe slgnature ot its ofCCer the 20th day of August, 202t, t
Anlonio C. Albanese, Vice Presldent of Nationwide Mutual Ensurance Company

ACKNOWLEDGMENT
y' 4{y' STqTE OF NEW YORK COUNTY OF NEW YORK: ss
On thls 20th day of August, 2021, before me cam the above- named o(ffcer for the Company t ti, T H,. f atoreseid, lo me persOn811y known to be the officer described in and who executed the preceding t z`"'' y instrumenl, and he acknowledged the execulion of tha same, and being by me duly sworn, deposes and says, that he Is the oificer of Lhe Campany aforesaid, Ihat the seal affixed niL'yaiis`' herelo Is the corporala seal of sald Cvrnpany, and the said corporete seal end hls slgnatu e Were r duly aHixed and subscribed to said Snstrument by the aulhority and direclion of said Company.

StepheNe Ru6Mo h1CNUwr O
r
A , J _ ] y_/ X li
NolaryPublic, SlateoiNewYork p5 Lti( GtiyE Y+ I( l'Zi^
No. 02MC62701t7
Qupllpe0 In NCW YOrk County
Commisston Notary pubEc Cx lroa OCtober 19 2024
Alycommisyon Ex e:

CERTIFICATE
b 19, 2011
f, Laura B. Guy, Assistant 5ecretary of ihe Company, da hereby terlify that Ihe( oregoing is a full, true and correct copy of the original power o( attorney issued by the Company; Ihat 1he resolutlon included therein is a true and correct transcript( rom the minules of Ihe meelings of the boards of directars and the same has nol been revoked or amended in any rnanner, that said Antonio C. Albanese was on the date of Ihe executlon of ihe lorec oing power of altorney Ihe duly elected oflicer of the Company, end ihe corporate seal and his signature as officer were dufy aHixed and su6scribed to ths sald instrument by the authority of said board of directors; and the forec oing power oi attorney Is stilf in full( orce and effect.

INMaYWfTNESS WHEREOF, 2Q221 have hereunlo suBscrfbed my name s Assistant Secretary, and affixed the corporate seal of said Company th( s 3Cd dey oF BOJ 1( 08- 21) 00 Assistant Secretary
i
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CERTI' ICATE OF ACKNOWLEDGMCNT OF NOTARY PUI3LIC
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W TN, S my I atid a id c lficial seal.

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NUtMY PUBI• CALIFCSiiNM
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CERTiFICA"I'E OF AC i iU"W LCDGIVIENT 3F N4TAIxY PUBLIC t A notary} ublic or c ther c fficer cc mpletin; this cerCi cate veri ies+only the ide ti: r of t6e individual who sigf ed the docun ent fio Izieh thia certificate is aktaal cd, and int th truthfulness, accuracy, or vatidi y ofth i:t aeurnent. i
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OATE MMfDDlYYYY
A o CERTIFICATE OF LIABILITY INSURANCE 05103/ 2Q22
7HiS CERTIFfCATE IS 15SUED AS A MA' i"i' ER OF IHFORMA710N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFiCATE HOLUER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR N GATIVEI.Y AMEND, EXTEND OR ALTER THE COVERAGE AFFOR ED BY THE POLICIES BELOW. THIS CERTIFICATE F INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESEIVTATIVE OR PRODUCER, AND THE CERTiFICATE HOLDER.

IMPORTANT; If the certificate holder is an ADDiTIONAL INSURED, the policy( ies) must have ADDI710NAL lNSURED provisions or be endorsed. if SUBROGA' fION IS WAIVED, subjeci 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 tieu of such endorsement( s).

PRODUCER C NTA T
ssica Martin
McDermott- Costa Co., Inc.
aME`
1045 MacArthur Blvd. o. Exi• ( 510) 351- 7460 ac No: (
510) 357- 3230
San Leandro, CA 84577 a Ress: jessicamQmcdermottcosta. com INSUR6R S AFFORDIN6 COVERAGE NAIC Vi
iNsuReRa: Capitol Specialty Insurance CAPSP1
INSURED Garden of Eden Landscapes fnc., Ground Force Enierprises INSl1RHR B: ff2d FIf1811C18I C8SU8Ity GO 1177Q 6021 Grassland Drive
iNsuaeR c: Ohio Security Insurance Company 24082
Castro Valley, CA 94546
INSURER D:

INSURER E:

INSURER F:

COVERAGES CERTIFiCATE NUMBEit: REVISION NUMBER:

THIS iS TO CERTIFY THAT THE POLICtES OF INSURANCE LISTED BELOW HAVE BEEN fSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDiCATED. NOTUVITHSTANDfNG ANY REQUIREMENT, TERM OR CONDI710N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WH1CH THIS CERTIFICATE MAY BE ISSUEb OR NIAY PERTAIN, TNE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJEGT TO ALL TME TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLfGiES. LIMITS SHOWN MAY MAVE BEEN REDUCED BY PAID CLAIMS. 7R TYPEOFINSURANCE
AdD S
pOLICYNUMBER MMl DVYW M pY LIMI7S
A /,
M
COMMERCIALGENERqLI, IABILITY Y Y E728625 Q6l01/ 2021 06/ O1/ 2022 EACHOCCURRENCE $ 4, OflO, OOO CI.kIMS• MADE ;./! occuR PREMIS ence a 100, 000
I MED EXP An one y person) 5 5, OQfl
i AERSONAL& AOVINJURY S 4, ODO, OOO
GEN' LAGGREGATEIJMITAPPLIESPER: GENERALAGGREOATE $ rJ', UOO, OOO POLICY f j
ARO• __ !
JHCT LOC I PRODUCTS- COMPfOPAGG S 5, O, Ofl
IorHeR: Pollution Liability s 3, OOO, U00
B
AUTOMOBILELIpBILITY Y Y 02i83661- 1 6// 2 2 Qs/ Q J2Q22 Eaecadenl5lNOLELiMIT § j QQ Q jANYAU70 BODILYINJURY( Perperson) S
10WfJED SCMEDULED
AUTOS ONLY t:„ S AUTOS BODILY INJURY( Per accident) S
HIRED NON- OWNED PROPER7YDAMAGH AUTOS ONLY .._ AUTOS ONLY Per aaident I 5
A ;/ UMBRELLALIAB i/ p CUR Y 560002657Q00 s/z8/ 202 08/ 28/ 2022 EACHOCCURRENCE S 3, DOO, fl j E8CBS9 LfAB ; __ CLAIMS- MADE AGGREGATE y 3, fl00, 000 i 1........... D# Ep I RETENTION$ y
C

ANDEMPLOYERS' LABTLIIY
YlN
XWS58033192 0' 1// 2 22 01/ 01/ 2023 JSTA_` w. rv H-ANYPROPRIHTOR/ PqRTNER/ EXHCU7IVH E. I.EACHACCIDENT 5 I, OOOAOO OFFICER/ MEMBEREXCLUDED? Y N! A Mandatory In NN) E. L DISEASE• EA EMPLOYEE 3 9, 0 0, 000 If yes, describe under
DESCRIPTION OF OPERATIONS below E. L. DISEASE- POLICY LIA81T $ 1, 000, 000 DESCttIPTION OF OPERATIONS! LDCATIONS 1 VEHICLES( ACORD 101, Atlditlanal Remarke Schedufe, may 6e attaehed I( mare spaee Is requlred) City of Lathrop, its OKces and Employees are included as an additional insured and primary, non- contributory on the General and Auto Liability. Waiver of Su6rogation applies to General Liabiliiy and Workers Compensation.

CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE AHOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPiRA710N DA7 THEREOF, NOTICE WILL BE DELIVERED IN City of L8U1fOp ACCORDANCE WITH THE POLICY PROVISiONS.
390 Tawne Centre Drive,
Lalhrop, CA 95330 AUTHORIZEDREPRE5ENTATIYE
i"lar
1988- 2075 ACQRD CQRPORATI N. Alf rights reseroed.

ACORD 26{ 2016/ 03) The ACORD nama and logo are registered marks of ACORD

MCDERMOTT- COSTA CO
PROGREll/ I/E"
1045 MACARTHUR BLVD
COMMERC/.9L
SAN LEANDRO, CA 94577
1- 510• 351- 74G0
Policy number: OZ183661- t
Underwritten by:

United Financial Ces Co
June Z9, zozi

Page 1 of 2 ends

Certificate of Insurance
Certiiicate tlofder
Additional Insured
Cf ty of Latl rop
390' Powne Centre Drive
I,allirop C', A 9533Q
Insured AgentlSurplus Lines Broker
GROUND FORCE ENTERPRISES MCDERMOTT- CdSTA CO
6021 GRASSLAND DRIVE 1645 MACARTHUR BLVD
CASTRQ VALLEY, CA 94546 SAN LEANDRO, CA 94577
This document certifies that insurance poJicies identified below have been issued by the designated insurer to the insured named above{ or the period( s} indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, or extend t e coverages atforded by the poiicies listed below.

The coverages afforded by the policies listed belaw are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies.

Policy Effective Date; Jun 1, 2021 Poliry Expiration Date: Jun 1, 2022 Insurance wverage( s) M ti
Bodily 9.................,...........,.................................,... Injury/ Properry Damage 1, 000, 000 Combined Sin le Limit UninsuredlUnderinsured Motorist 1, 004, 000 Combined Single Limii Description of Location/ Vehicles/ Special Items
5cheduled autos only
20Z1 KENWOR7HT8801Nt LPDX2M1467911
Comprehensive 1, 000 Ded
Coliision 1, 000 Ded w/ Waiver
This policy is primary and non- contributory as to City of Lathrop regardless of whether Holder is a named insured of any other policy
Continu
Policy number: 02183661- i

Page 2 of 2 ends

Certificate number
18021A156G1
Please be advised that additional insureds and loss payees will be notified in the event of a mld-term cancellation.
r--' (
Form 5291( 10/ 02)
p o,. rrrr
WAfVER OF SUBROGATION ENDORSEMENT
This endorsement modifies insurance provided under the following:

Commerciai Auto Policy
Motor Truck Cargo Legal Liability Caverage Endorsement
Commercial General Liability Coverage Endorsement
We agree to waive any and all subrogation claims against the person or organization designated below except for losses that are due in whole or part to the negligence or errors and amissions of the designated person or organization.

City of Lathrop
390 Towne Centre Drive
Lathrop CA 95330
This endarsement applies to Policy Number: 0218366- 1
r a s'- 4
T.

Expiration: 06/ 01/ 2022
AII other terms, limits and provisions of this policy remain unchanged.

Form 8610( OS/ 09}
MCDERMOTf{ OSTA CO 0`+',
1045 MACARTHUR BLVD COM LIERC/ L
SAN LEANDRO, CA 94577
Policy number: 02183661- 1
Underwritten by:

GARDEN OF EDEN United Financiai Cas Co
LANDSCAPES INC Insured:

GROUND FORCE ENTERPRISES GARDEN Of EDEN
6021 GRASSLAND DRIVE April 17, 2021
CAS7R0 VALLEY, CA 94546 Policy Period: lun i, 2021 • 1un 1, 2022 Mailing Address
United Financial Cas Co
r r
PO Box 94739
Additional insured endorsement Cleveland, OH44101
1- 804- 444- 4487
Name of Person or Organization For customer service, 24 hours a day, City of Lathrop
T days a week
390 Towne Centre Drive
Lathrop, CA 95330
The person or organizatian named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability, We also agree with you that insurance provided by this endor5ement will be primary for any power unit specifically described on the Declarations Page.

I. imi# of Liability
Bodily Injury Not applicable
Praperty Damage Not applicable
Combined Liability 1, 000, 000 ea accident
All other terms, limits and provisions of this policy remain unchanged.

This endorsement applies ta Policy Num6er: 02183661- 1
Issued to( Name of Insured}; GARDEN OF EDEN

LANDSCAPES INC

GROUND FORCE ENTERPRISES
Effective date of endorsement: 06/ 01/ 2021 Policy expiration date; 06/ 01/ 2022 Form 1148( D1/ 04)
PQLICY NUMSER: E72$ 625 COMMERCIAL GENERAL LIABILITY
GLE 24 04 05 09
UVAIVER OF TRANSFER 4F RIGHTS OF RECOVERY

AGAINST OTHERS TO US
This endorsement mociffies insurance provided underthe following:

COMMERCIAL GENERAL LIASI ITY COVERAGE FORM WITH BROADENING ENDORSEMENT AND

POLLUTION LEABILITY COVERAGE

SCHEDULE
Name Of Person Or Organization:

9. An owner of real or personal property on which you are performing operations, but only atthe specific written request by#hat person or organization to you, and only if:
a. 7hat request is made prior to#he date your operations for that person or organization commenced; and b. A Certificate of Insurance evidencing that request has been issued by yourauthorized insurance agent or hroker; or

2. Acontractor on whnse behalfyou are performing operations, but only atthe specificwritten request bythat person or organization to you, and only if:
a. That request is made priorto the date youroperations forthat person ororganization commenced; and b. A Certificate of I nsu rance evidencing that request has been issued by your authorized insurance a ent or broker.

Inforrnation required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to Paragraph 8. Transfer Of
Rights f Recovery Against Others To lJs of
Section 1V— Conditions:

We waive any right of recovery we may have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
your work" done under a contract with that person
or organization and included in the " products-completed operations hazard". This waiver appfies on[ y to the person or organization shown in the
Schedule above.

GLE 24 04 05 09 O Insurance Services Office, Inc., 2008 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POlICY. PLEASE READ IT CAREFULLY.

PRIMARY/ NON- CONTRIBUTORY CQVERAGE

NAMED PERS N OR ORGANIZATI N
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM WITH
BROADENING END RSEMENT AND POLLUTIfJN lIABILITY

CQVERAGE
PRIMARY/NON- CONTRIBUTORY— If required by written contract oragreement, efFective priorto the date your operations forthat person or organization commenced and named below, such insurance as is afforded by this policy to any additional insureds underthis policy shall be primary insurance, and any insurance orself-insurance maintained by such additional insured( s) shall not contribute to the insurance afforded to the named insured.

All other terms and conditions remain unchanged.

SCHEDULE
Name of Person or Organization:

1. An owner of real or personal property on which you are pertorming operations, bul only at the speCific wrlften request by that person or orgenizaEion to you, and onEy if:
a. Thatrequestismedepriortothedateyouroperationsforthatpersonororganizationcommenced; end b. ACertificateoflnsuranceevidencingthatrequesthasbeenissuedbyyoureuthorizedinsuranceagentor broker; or

2. Acontractoronwhosebehelfyouereperformingoperations, butonlyatthespecificwrittenrequestbythat person or organizalion to you, and only if:
a. ThatrequesEismadepriortothedateyouroperaftonsforthatpersonororganizationcommenced; and b. ACerEificateoflnsuranceevidencingthatrequesthasbeenissuedbyyourauthorizedinsuranceagentor broker.

GLE 50 06 72 19 Includes copyrighted material of Insurance Services Off1ce, Inc. Page 1 of 9 with its permission
POLICY NUMBER: E728625 COMMERCIAL GENERAL LIABII,ITY
GLE 20 37 0413
TH[ S END RSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITI4NAL INSURED - 0lNNERS, LESSEES OR

CONTRACT RS - COMPLETED OPERATI( JNS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABfLITY COVERAGE FORM WiTH BROADENING ENDORSEMENT AND

P LLUTION LIABILITY COVERAGE
SCHEDiJLE
Name Of Additional Insured Person( s)
O Or anizaEion s Location And Description Of Compieted Operations ny person or organization for whom you are performing In respect to any location where the named insured is peratinns when you and such person or organization rtorming" your work". have agreed in writing in a contract or agreement,
ffected prior to the date your operations for thaf person r organization commenced, that such person or
rganization be added as an additional insured on your
olic .

Information re uired to com lete this Schedule if not shown above, will be shown in the Declarations.

A. Section II - Who Is An Insureti is amended to B. With respect to the insurance afforded to these include as an additional insured the person( s) or additional insureds, the Pollowing is added to organization( s) shown in the Schedule, but oniy Section III- Limits Of Insurance:
with respect to liability for " bodily injury" or
If coverage provided to the additional insured is
prope ty damage" caused, in whole or in part, by requirecf by a contract or agreement, the most we your worEc" at the locatian designated and
described will pay on behalf of the additional insured is the in the Schedule of this endorsement amount of insurance:
perFormed for that additional insured and
included in the " products- completed operations 7• Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of
Mowever: Insurance shown in the Declarations;

1. The insurance afforded to such additianal Whichever is fess. insured only applies to the extent permitted This endarsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations.

2. ! f coverage provided to the additional insured
is required by a contract or agreetnent, the
insurance afforded to such additional insurec!
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.

GLE 20 37 0413 4 Insurance Services ffTce, Ine., 2012 page 1 of 1

Lathrop City CouncilMay 16, 2022

Lathrop City Council
May 16, 2022