ITEM 4. 5
CITY MANAGER' S REPORT
FEBRUARY 12, 2024 CITY COUNCIL REGULAR MEETING
ITEM: RATIFY THE PURCHASE OF TWO DIGITAL
MARQUEES AND APPROVE A SERVICE CONTRACT
WITH ABV SCOREBOARD SERVICES, INC., FOR THE
INSTALLATION OF TWO MARQUEES AT CITY HALL
RECOMMENDATION: Adopt Resolution to Ratify the Purchase of Two Digital Marquees and a Service Contract with ABV
Scoreboard Services, Inc., for the Installation of Two
Marquees at City Hall
SUMMARY:
In August of 2023, staff solicited three quotes for digital marquees for City Hall.
Based on the review and evaluation of the three quotes, the lowest response for the project was determined to be ABV Scoreboard Services, Inc., with a quote of $ 68, 175 for two digital marquees. ABV Scoreboard Services, Inc., advised the lead time for the digital marquees would be twelve weeks and they required a purchase order to start the assembly of the marquees. In September of 2023, Purchase Order 2024- 00000237 was processed with ABV Scoreboard Services, Inc. Staff is requesting Council to ratify Purchase Order 2024- 00000237 with ABV Scoreboard Services, Inc., for the two digital marquees.
In January of 2024, the City received both digital marquees and worked with ABV Scoreboard Services, Inc., and the installation. The installation is complete, and staff is requesting Council to approve the service contract with ABV Scoreboard Services, Inc., in the amount of $ 12, 500.
In addition to the purchase and installation of the two digital marquees for City Hall, minor electrical work was performed to supply power and data to the marquees. The total cost of powering the marquees was $ 1, 697. Staff is requesting Council to approve the electrical work in the amount of $ 1, 697.
Sufficient funds were already approved in the FY 23- 24 budget for this project.
BACKGROUND:
To share information about City services, events, and programs that can significantly impact the quality of life for community members, two digital marquees were installed at City Hall. The digital marquees visibility, reach, and overall outreach are effective tools for building community awareness and transparency.
CITY MANAGER' SREPORT PAGE 2
FEBRUARY 12, 2024 CITY COUNCIL REGULAR MEETING
RATIFY THE PURCHASE OF TWO DIGITAL MARQUEES AND APPROVE A SERVICE AGREEMENT WITH ABV SCOREBOARD SERVICES, INC., FOR THE
INSTALLATION OF TWO MARQUEES AT CITY HALL
Staff solicited three quotes for digital marquees from vendors whose product was determined to meet the needs of the city. Three quotes were received; ABV Scoreboard Services, Inc., was determined to be the lowest and most responsible quote.
Table 1: Summary of Results for Digital Marquees
Contractor Quote Ranking Quote Amount
ABV Scoreboard Services, Inc. 1 68, 175. 00
Golden Rule Signs 2 92, 436. 52
Stewart Signs 3 92, 839. 00
Staff is requesting Council to ratify Purchase Order 2024- 00000237 with ABV Scoreboard Services, Inc., for two digital marquees, approve the service contract with ABV Scoreboard Services, Inc., in the amount of $12, 500, and approve electrical work in the amount of $ 1, 697 for a grand total of $82, 372.
FISCAL IMPACT:
The purchase of two digital marquees with ABV Scoreboard Services, Inc., is $ 68, 175.
The installation service agreement with ABV Scoreboard Services, Inc., is $ 12, 500 and the electrical work to power the marquees is $ 1, 697, for a project total of 82, 372. Sufficient funds were authorized in the approved FY 23- 24 budget for this project.
ATTACHMENTS:
A. Resolution of the City Council of the City of Lathrop to Ratify Purchase Order 2024- 00000237 with ABV Scoreboard Services, Inc., for Two Digital Marquees, Approve the Service Contract with ABV Scoreboard Services, Inc., in the Amount of $ 12, 500, and Approve the Electrical Work in the Amount of $ 1, 697, for a Grand Total of $82, 372
B. Purchase Order 2024- 00000237 with ABV Scoreboard Services, Inc., for Two Digital Marquees and Installation
C. Service Contract with ABV Scoreboard Services, Inc
CITY MANAGER' S REPORT PAGE 3
FEBRUARY 12, 2024 CITY COUNCIL REGULAR MEETING
RATIFY THE PURCHASE OF TWO DIGITAL MARQUEES AND APPROVE A SERVICE AGREEMENT WITH ABV SCOREBOARD SERVICES, INC., FOR THE
INSTALLATION OF TWO MARQUEES AT CITY HALL
APPROVALS:
Todd Sebastian
Director of Parks and Recreation
Date
0 —to -2Q 4
Ken Reed Date
Senior Construction Manager
ernandes Date
A- 9
Inforypation Systems Director
Cari Jame
Director oflhinance
Date
Thomas Hedegard - Date
21Li11O1, 4
Deputy City Manager
4/lZo2/
Michael King Date
Assistant City Manger
2-- zoZy
Salvador Navarrete Date
City Attorney
Stephen J. Salvatore Date
City Manager
710/ ze
RESOLUTION NO. 24-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY LATHROP TO RATIFY THE
PURCHASE ORDER FOR TWO DIGITAL MARQUEES AND A SERVICE CONTRACT WITH ABV SCORBOARD SERVICES, INC., FOR THE INSTALLATION OF TWO AT
CITY HALL
WHEREAS, Staff solicited three quotes from vendors for digital marquees for City Hall; and
WHEREAS, ABV Scoreboard Services, Inc., provided the lowest response quote of $68, 175; and
WHEREAS, a purchase order was processed with ABV Scoreboard Services, Inc., to purchase two marquees; and
WHEREAS, the City received the marquees and worked with ABV Scoreboard Services, Inc., to schedule the installation; and
WHEREAS, the installation is complete, and staff is requesting Council to approve the service contract with ABV Scoreboard Services, Inc., in the amount of 12, 500; and
WHEREAS, minor electrical work was performed to supply power and data to the marquees in the amount of $ 1, 697; and
WHEREAS, staff is requesting Council to approve the electrical work in the amount of $ 1, 697; and
WHEREAS, the purchase and installation of the two marquees is completed for a grand total of $82, 372; and
WHEREAS, sufficient funds were allocated in the FY 23/4budget.
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Lathrop approves and ratifies the purchase order for two digital marquees, a service contract with ABV Scoreboard Services, Inc., for the installation of two marquees, and an agreement for electrical work in the amount of $82, 372.
The foregoing resolution was passed and adopted this 12th day of February 2024, by the following vote of:
AYES:
NOES:
ABSTAIN:
ABSENT:
Sonny Dhaliwal, Mayor
ATTEST: APPROVED AS TO FORM:
Teresa Vargas, City Clerk Salvador Navarrete, City Attorney DocuSign Envelope ID: 1BBA7A93- 028B- 41B8- 98BE- 6F78242EF1A ATTACHMENT" 6 " The parties to this agreement
are:
Vendor No. 3729
ABV SCOREBOARD SERVICES,
S
INC
C. 1270 AVENIDA ACASO SUITE F
g CAMARILLO, CA 93012
co 390 Towne Centre Dr
c Lathrop, CA 95330
0 Cl) 390 Towne Centre Dr
2 Lathrop, CA 95330
0 Purchase Order
No. 2024- 00000237
Date 9/ 6/ 2023
Resolution
PURCHASE ORDER NUMBER MUST
APPEAR ON ALL INVOICES, SHIPPERS, BILL.
OF LADING AND CORRESPONDENCE
DELIVER BY
SHIP VIA
FREIGHT TERMS
PAGE 1 of 3
ORIGINATOR Bonnie Evans
QUANTITY UNIT DESCRIPTION I
UNIT COST TOTAL COST
2. 00
1. 00
1. 00
EACH Custom Marquees
EACH Shipping
EACH Sales Tax
31, 000.000
750. 000
5, 425. 0000
The contractor agrees to furnish all labor, equipment and materials necessary to perform the services describe herein and agrees to comply with the terms and conditions identified below which are made a part hereof by this reference ( Outline exact detail what is to be done, where is to be done and include work specifications, if applicable.)
l•}• Z3
CITY OF LATHROP
RECOMMENDED FOR APPROVAL DATE
DATE
0+ —
CITY OF LATHROP
APPROVED BY
Special Instructions
DocuSigned by:
r atfivd,
seeersreie„ ens.
VENDOR ( Signature)
APPROVED BY
John L. Alfino
62, 000.
750. 00
5, 425. 00
68, 175. 00
9/7/ 2023
DATE
9/ 7/ 2023
VENDOR ( Print Name)
APPROVED BY DATE
Two Custom Marquees for City Hall
DocuSign Envelope ID: 16BA7A93- 0288- 41B8- 98BE- 6F7E8242EF1A
3. Pate 2 of 3
STANDARD PURCHASE ORDER
TERMS AND CONDITIONS
l . ACCEPTANCE. Acceptance of this Purchase Order" whether by written acknowledgement or by performance by Seller. shall be upon the terms and conditions hereof; no other terms or conditions shall be binding on Buyer unless mitten approval thereof specifically referring. to such other terms and conditions shall have been given to Seller.
INVOICES Separate mvoice shall be supplied for each Purchase Order shipment Each invoice shall be itemized and shall show Contract Number, terms, discounts. date of shipment or service dates. and Purchase Order Number. Faihue to show said items may result in delay of payment with all rights reserved, including cash discounts. The Vendor name on this Purchase Order resulted from a quotation signed in the same name. Payment will not be made to a firm name other than that shown on the face hereof without written assignment PAYMENT TERMS Seller shall receive payment either by One - Time payment ( Lump Sum). Monthly or Quarterly ITEMIZED DIVOICE. All payments are in arrears.
ORDER CHANGES. The Buyer shall have the right from time to time by written notices to make changes in quantities andor delivery dates of any article, material, or services covered by this Purchase Order prior to the time the item or items are actually placed into final production by the Seller. If such changes are made after the article, material, or services are placed into final production by the Seller and such changes cause a substantial increase or decrease in Seller' s performance will be made and this order will be modified in writing accordingly, provided that any claim for adjustment must be asserted by the Seller within a reasonable time (in no case to exceed twenty days) after the change is ordered
5. SHIPPING. Seller will indicate plainly the Purchase Order Number on all bills of lading. all goods shipped pursuant to said order. and on all invoices, freight bills. and packages Each package must contain a memorandum showing Seller' s name. content of package. and Purchase Order Number
Shipments of goods specified on this Purchase Order number should result in lowest possible & eight rate unless otherwise specified by Buyer Penalties or increased charges due to failure to observe this provision will be charged to Seller Shipping costs for goods on back order shall be paid only at the rate which would have been applicable had the complete order been shipped at one time. All excess costs shall be borne by Seller. Partial shipments must be identified as such on shipping memoranda and invoices
When shipping. Seller will make no declaration of value to canied. except where shipment is subject to released value ratings Any materials supplied to City which are covered by the OSHA Hazard Comnnmrcation Standard must be accompanied by the applicable Material Safety Data Sheet (MSDS) at the time of delivery 6 DELIVERY. Unless otherwise expressly provided_ Seller shall deliver all articles to Buyer' s premises. free of all freight handling. transportation drayage, boxing and similar charges. All times in this contract are of the essence ` TERMINATION. Buyer may terminate all or part of this contract. with or without cause If buyer terminates without cause. then Buyer shall pay all reasonable termination charges incurred by Seller S DECLINE LN PRICES. Buyer shall be protected m the event of declining prices on the undelivered portion of this Purchase Order. If prices decline got items ordered. Seller may elect to meet priced reductions or other vendors. or is own lower prices to other purchasers. but if Seller should refuse to do so. Buyer shall have the right to cancel any or all of the balance due on this Purchase Order without cost to Buyer
9 FORCE 41AJELURE Neither Seller nor Buyer shall be liable for nonperformance due to causes beyond reasonable control Where only a part of Seller' s
capacity to perform is excused under this paragraph, Seller must allocated production and deliveries among the various customers then under contract for similar goods during the period. The allocation must be made in a fair and equitable manner. Where either Seller or Buyer claims an excuse far nonperformance under this paragraph. it must give notice m writing to the other party. Seller shall not be obligated to sell. nor Buyer obligated to purchase. at a later date. that portion of the goods that Seller is unable to deliver or Buyer is unable to receive or use due to any excused cause No goods are to be tendered by Seller after the expiration of the terms specified in this Purchase Order without consent of Buyer. 10 WARRANTY. Seller warrants that all articles and services covered by this Purchase Order will conform to drawings. specifications" or samples and will be merchantable and of good material design and workmanship, free from all defects. and suitable for the use intended Ail articles will be subject to Buyers inspection and rejection at the place of deliver}. Defective articles may be returned to the Seller for full credit or replacement at the Seller' s risk and expense. including transportation charges both ways. but no defective articles shall be replaced without formal replacement order signed by the Bnyer 11 ASSIGNMENT. Neither party shall assign or transfer this Purchase Order without the written consent of the other 1? ENDEMICITY. SELLER WARRANTS THAT GOODS FURNISHED UNDER THIS PURCHASE ORDER DO NOT LNFRIirGE
ANY PATENT, TRADEMARK, OR TRADE NAME, OR COPYRIGHT AND AGREES TO LN- DEMLNIFY AND SAVE HARMLESS BUYER OR ITS VENDEES FROM ANY AND ALL CLALIIS, SUITS, LIABILITIES, DANLAGES, LOSSES, OR EXPENSES INCURRED BY BITER OR ITS V- ENDEES BY REASON OF ANY ALLEGED ECFRINGEMENT OF ANY SUCH RIGHTS.
DocuSign Envelope ID: 1BBA7A93- 028B- 41 B8- 98BE- 6F7E8242EF1A PAGE 3 OF 3
SELLER SHALL LNDEMN1TY AND HOLD HARMLESS BUYER AND ITS AGENTS AND EMPLOYEES FROM AN AGALNST ALL CLAMS, DAMAGES, LOSSES AND EXPENSES, ll\ CLUDL\ GATTORN' EY' SFEES, ARISING OUT OF OR
RESULTING FROM THE PERFORMANCE OF THE WORK CAUSED BY ANY NEGLIGENT ACT OR OMISSION OF SELLER, ANY SUBCONTRACTOR, OR ANYONE FOR WHOSE ACTS ANY OF THEM MAY BE LIABLE. IN CASE OF C' ONCITRRLNG FAULT, EACH PARTY SHALL BEAR ITS SHARE OF THE LOSS. 13 BUYER' SPROPERTY. Any property of Buyer in Seller' s active or constrictive possession or custody hereunder will be at Seller' srisk. and Seller agrees to reimburse Buyer for any loss or damage to such property however caused 14 COMPLIANCE WITH APPLICABLE LAWS AND REGULATIONS By acceptance hereof. Seller Warrants. a) that all goods, merchandise, and materials delivered and services rendered hereunder will have been produced and provided in compliance with all requirements of the Fair Labor Standards Act of 1933, as amended. and b) that all goods, materials_ and equipment delivered hereunder shall comply with the applicable federal standards prescribed by the Occupational Safety and Health Act of 1970. cr as amended c) that Seller will comply with all applicable laws. pules and regulations of federal state and local governments and agencies. thereof_ including but not limited to Executive Orders 11246, 11701, and section 503 of Public Law 93- 112. The Rehabilitation Act of 1973, the provisions of The Americans and Disabilities Act, Transient Employer Law ( 285.30 R. S Mo et seq.) and Excessive U: nemplo} went Law ( Section 290. 550 et seq R. S. Mo.) which are hereby incorporated by reference. unless this Purchase Order is exempt pursuant to said Executive Orders. or Acts and the regulations issued thereunder
15. WORKER' SCOMPENSATION. EMPLOYER' SLIABILITY, AND GENERAL LIABILITY When work as performed on Buyer' s premises. Seller agrees to carry at Sellers own expense. a) Worker' sCompensation and Employer' s Liability Insurance. b) General liability ( including Contractual Liability and Products Liability/ Completed Operations) Insurance and Auto Liability insurance each in amounts no less than $ 1. 000,00 per occurrence. Insurance certificates of such coverage shall be submitted to City Utilities' Risl: Management upon request ofBuyer
16 LNSOLVENC' Y. If Seller shall become insolvent. file a petition in bankruptcy, or shall make an assi_ grmnent for the benefit of creditors. or if a receiver or trustee shall be appointed of or for any of Seller' s property or business. the Purchase Order may be cancelled at Buyers option without liability_
17 TAXES. Seller agrees to cooperate with Buyer m opposing the unpositiou of any tax on any article covered by this Purchase Order. the legality of which is questioned by Buyer, and in securing any abatement or any refund thereof sought by Burger
18 FOREIGN SHIPMENTS Foreign shipments must be preceded by execution of formal Consular Invoice At time of shipment Ocean Bills of Lading. Consular Invoice. and Commercial Invoices. in triplicate, shall be forwarded directly to the Purchasuag Agent issumg this Purchase Order.
19 VENUE. This Purchase Order shall be governed by the law of the State of California 20 BRANDING Seller warrants that all materials covered by this Purchase Order are no altered or misbranded within the meaning of the Federal Food. Drug and Cosmetic Act: not an article with may nor , under provisions of Section 404 or 505 of said act. be introduced into interstate commerce. and not adulterated or misbranded within the meaning of the pure food and drug laws or the ordinances of any state or city which are applicable to such shipment or delivery, and Seiler hereby agrees to indemnify and save the Buyer harmless from and against all claims, charges. action and proceedings brought against Buyer by any lawful government authority or by any person on account of any alleged adulteration or misbranding by Seller of any such material referred to above Seller does no guarantee against any such material becoming adulterated or misbranded after delivery to Buyer by reason of causes beyond Seller' scontrol 21 CONFLICTING TERMS. In case of a conflict between these terms and conditions and those of a separate written contract signed by both Buyer and Seller, the written contract shall prevail
22 REVIEW OF RECORDS During the teen of the purchase order' agreement and for three years thereafter. City of Lathrop ( City) shall have the right to review Seller' srecords, only for the purposes of verifying claims for payment and compliance with the terms and conditions of the purchase order, agreement for at least three years after final payment. 23 OFFSETTING BILLS City reserves the right to apply offsetting payments for goods and or services that are due against delinquent utility bills which are due City
24 NON- EXC' LUSIGE AGREE 1ENT The purchase order is a non- exchisive contract and City reserves the right to purchase same or like materials and or services from other sources as City deems necessary and appropriate.
Office of the City Manager
ATTACHMENT" "
390 Towne Centre Dr. - Lathrop, CA 95330
Phone ( 209) 941- 7220 - fax (209) 941- 7248
www. ci. lathrop. ca. us
NOTICE TO PROCEED
ABV Scoreboard Services, Inc.
John L. Alfino, President
1270 Avenida Acaso, Unit F
Camarillo, CA 93012
Dear Mr. Alfino:
Enclosed please find your original executed Service Contract to provide the installation of custom marquees located at City Hall from ABV Scoreboards Services, Inc. This is your Notice to Proceed to the attached Contract.
Should you have any questions regarding this project, please contact Todd Sebastian at 209) 941- 7384, the staff member directly involved with this project.
Sincerely,
Folk
Stephen J. Salvatore
City Manager
Copy: Teresa Vargas, City Clerk
Project File
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT BETWEEN THE CITY OF LATHROP AND ABV
SCOREBOARD SERVICES, INC.
INSTALLATION OF TWO CUSTOM MARQUEES
LOCATED AT CITY HALL
THIS SERVICE CONTRACT ( hereinafter " Contract") is made on the 8 of February, 2024, by and between the City of Lathrop, a municipal corporation of the State of California ( hereinafter " City") and ABV Scoreboard Services, Inc. hereinafter " Contractor"), whose Taxpayer Identification Number is 45- 2695081.
For and in consideration of the following covenants, terms and conditions, City and Contractor (the parties) agree:
SCOPE OF WORK
Contractor agreed to install two custom marquees located at City Hall in accordance with the scope of work and fee proposal provided by the Contractor, attached hereto as Exhibit " A" and incorporated herein by reference. Contractor agreed to diligently perform these services in accordance with the upmost standards of its profession and to the City' ssatisfaction.
CONTRACT PRICE
The City agrees to pay and the Contractor agrees to accept, in full payment for the work above agreed to be done based on time and materials basis not to exceed $ 12, 500 set forth in Exhibit " A", for the installation of two custom marquees located at City Hall.
TIME FOR PERFORMANCE
The installation shall be completed no later than February 29, 2024.
PERMITS; COMPLIANCE WITH LAW
The Contractor shall, at its expense, obtain all necessary permits, licenses, easements, etc., for the construction of the project, give necessary notices, pay all fees required by law, and comply with all laws, ordinances, rules and regulations relating to the work and to the preservation of the public health and safety.
INSPECTION BY CITY
The Contractor shall at all times maintain proper facilities and provide safe access for inspection by the City to all parts of the work, and to the shops wherein the work is in preparation. Where the Specifications require work to be specially tested or approved, it shall not be tested or covered up without timely, written approval by the City.
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
Should any such work be covered up without such notice, approval, or consent, it must, if required by City, be uncovered for examination at the Contractor' s expense.
NOTICE
Any notice from one party to the other under the Contract shall be in writing and shall be dated and signed by the party giving such notice or by a duly authorized representative of such party. Any such notice shall not be effective for any purpose whatsoever unless served in the following manner.
a) If the notice is given to the City, by personal delivery thereof to the City' s Director of Parks, Recreation, and Maintenance Services, or by depositing the same in the United States mail, enclosed in a sealed envelope, addressed to the City' s
Director of Parks, Recreation, and Maintenance
Services, postage prepaid and certified;
b) If the notice is given to the Contractor, by personal delivery thereof to said Contractor or to its duly authorized representative at the site of the project, or by depositing the same in the United States mail, enclosed in a sealed envelope, addressed to the Contractor at the address set forth in the Contractor' sBid postage prepaid and certified; or
c) If the notice is given to the surety or any other person, by personal delivery to such surety or other person, or by depositing the same in the United States mail, enclosed in a sealed envelope, addressed to such surety or other person, as the case may be, at the address of such surety or person last communicated by it to the party giving the notice, postage prepaid and certified.
ACCIDENT PREVENTION
Precautions shall be exercised at all times for the protection of persons ( including employees) and property. The safety provisions of applicable laws, building and construction codes shall be observed. Machinery, equipment, and other hazards shall be guarded or eliminated in accordance with the safety provisions of the Construction Safety Orders issued by the Occupational Safety and Health Standards Board of the State of California.
CONTRACTOR' SWARRANTY
The City shall not, in any way or manner, be answerable or suffer loss, damage, expense or liability for any loss or damage that may happen to said building, work, or equipment or any part thereof, or in, on, or about the same during its construction and before acceptance. Contractor unqualifiedly warrants all work and materials to be free of defects whether performed or installed by it or by any subcontractor or supplier in the project which is the subject of this Contract.
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
APPRENTICES
a) The Contractor' sattention is directed to the provisions of Sections 1777. 5, 1777. 6, and 1777. 7 of the California Labor Code concerning employment of apprentices by the Contractor or any subcontractor under him. In addition, Contractor shall obtain a certificate of apprenticeship before employing any apprentice pursuant to Sections 1777. 5, 1777. 6and 1777. 7 of the California Labor Code.
b) Information relative to apprenticeship standards, wage schedules, and other requirements may be obtained from the Director of Industrial Relations, ex officio the Administrator of Apprenticeship, San Francisco, California, or from the Division of Apprenticeship Standards and its branch offices.
c) Knowing violations of Section 1777. 5 will result in forfeiture not to exceed one hundred dollars ($ 100) for each calendar day of non- compliance pursuant to Section 1777. 7.
HOURS OF WORK
Eight (8) hours of work in any calendar day shall constitute a legal day' s work. The
Contractor and each subcontractor shall forfeit, as penalty to the City, twenty- fivedollars 25) for each worker employed in the execution of work on the Project by the Contractor or any subcontractor under him for each calendar day during which such worker is required or permitted to work more than eight ( 8) hours in any one calendar day and forty 40) hours in any calendar week in violation of the provisions of the Labor Code, and in particular, Section 1810 to Section 1815, thereof, inclusive, except that work performed by employees of the Contractor and his subcontractors in excess of eight hours per day at not less than one and one half times the basic rate of pay, as provided in Labor Code section 1815.
PAYROLL RECORDS
Pursuant to Labor Code section 1776, as amended from time to time, the Contractor and each subcontractor shall keep records showing the name, address, social security number, work classification, straight time and overtime hours paid each day and week, and the actual per diem wages paid to each journeyman, apprentice, worker or other employee employed by him or her in connection with the work.
The certified payroll records shall be on forms provided by the Division of Labor Standards Enforcement or shall contain the same information as the forms provided by the Division. The payroll records shall be certified and shall be available for inspection at all reasonable hours at the principal office of the Contractor on the following basis:
DocuSign Envelope ID: 922E3033- A6B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
a) A certified copy of the employee' s payroll records shall be made available for inspection or furnished to such employee or his or her authorized representative on request.
b) A certified copy of all payroll records shall be made available for inspection or furnished upon request, or as required by Labor Code section 1771. 7to the City, the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards of the Department of Industrial Relations. c) A certified copy of all payroll records shall be made available upon request to the public for inspection or copies thereof made; provided, however, that if request by the public shall be made through either the City, the Division of Apprenticeship Standards, or the Division of Labor Standards Enforcement, if as requested, payroll records have been provided pursuant to paragraph ( b), the requesting party shall, prior to being provided the records, reimburse the cost of preparation by the Contractor, subcontractors and the entity through which the request was made. The public shall not be given access to such records at the principal office of the Contractor.
The Contractor shall file a certified copy of the payroll records with the entity that requested such records within ten ( 10) calendar days after receipt of a written request.
Any copy of records made available for inspection as copies and furnished upon request to the public or the City, the Division of Apprenticeship Standards, or the Division of Labor Standards Enforcement, shall be marked or obliterated in such a manner as to prevent disclosure of an individual' sname, address, and social security number. The name and address of the Contractor or any subcontractor performing work on the Project shall not be marked or obliterated.
The Contractor shall inform the City of the location of the payroll records, including the street address, city and county, and shall, within five ( 5) calendar days, provide a notice of a change of location and address.
In the event of noncompliance with the requirements of this section, the Contractor shall have ten ( 10) calendar days in which to comply subsequent to receipt of written notice specifying in what respects the Contractor must comply with this section. Should noncompliance still be evident after such ten ( 10) calendar day period, the Contractor shall, as a penalty to the City, forfeit twenty- five dollars ($ 25) for each calendar day, or portion thereof, for each worker until strict compliance is effectuated.
Upon the request of the Division of Labor Standards Enforcement, such penalties shall be withheld from payments due Contractor.
PREVAILING WAGES
a) The Contractor is aware of the requirements of California Labor Code Sections 1720 et seq. and 1770 et seq., as well as California Code of Regulations, Title 8, section 16000 et seq. ("Prevailing Wage Laws") which
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
require the payment of prevailing wage rates and the performance of other requirements on certain " public works" and " maintenance" projects. Since this Contract involves an applicable " public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $ 1, 000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. The Contractor shall obtain a copy of the prevailing rates of per diem wages applicable to the work to be performed by subcontractors from the website of the Division of Labor Statistics and Research of the Department of Industrial Relations located at
http:// www. dir. ca. gov/ dlsr/ PWD/ index. htm. In the alternative, the City shall provide Contractor with a copy of the prevailing rates of per diem wages applicable to the work to be performed by subcontractors. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to perform work on the Project available to interested parties upon request, and shall post copies at the Contractor' s
principal place of business and at the Project site.
Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claims, liabilities, costs, penalties or interest arising out of any failure or allege failure to comply with the Prevailing Wage Laws.
b) The Contractor and each subcontractor shall forfeit as a penalty to the City not more than fifty dollars ($ 50) for each calendar day, or portion thereof, for each worker paid less than the stipulated prevailing rate for any work done by him, or by any subcontract under him, in violation of the provisions of the California Labor Code. The difference between such stipulated prevailing wage rate and the amount paid to each worker for each calendar day or portion thereof for which each worker was paid less than the stipulated prevailing wage rate shall be paid to each worker by the Contractor.
INSURANCE
On or before beginning any of the services or work called for by any term of this Agreement, CONTRACTOR, at its own cost and expense, shall carry, maintain for the duration of the Agreement, and provide proof thereof that is acceptable to the CITY the insurance specified in subsections ( a) through ( c) below with insurers and under forms of insurance satisfactory in all respects to the CITY.
CONTRACTOR shall not allow any subcontractor to commence work on any subcontract until all insurance required of the CONTRACTOR has also been obtained for the subcontractor. Verification of this insurance shall be submitted and made part of this Agreement prior to execution.
a) Workers' Compensation. CONTRACTOR shall, at
CONTRACTOR' Ssole cost and expense, maintain Statutory
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
Workers' Compensation Insurance and Employer' s Liability Insurance for any and all persons employed directly or indirectly by CONTRACTOR. Said Statutory Workers' Compensation Insurance and Employer' sLiability Insurance shall be provided with limits of not less than one million dollars ($ 1, 000,0). In the alternative, CONTRACTOR may rely on a self- insurance program to meet these requirements provided that the program of self- insurance complies fully with the provisions of the California Labor Code. The insurer, if insurance is provided, or the CONTRACTOR, if a program of selfinsurance is provided, shall waive all rights of subrogation against the CITY for loss arising from work performed under this Agreement. b) Commercial General and Automobile Liability Insurance.
CONTRACTOR, at CONTRACTOR' Sown cost and expense, shall maintain commercial general and automobile liability insurance for the period covered by this Agreement in an amount not less than two million dollars per occurrence ($ 2, 000,00), combined single limit coverage for risks associated with the work contemplated by this Agreement. If Commercial General Liability Insurance or an Automobile Liability 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.
Such coverage shall include but shall not be limited to, protection against claims arising from bodily and personal injury, including death resulting therefrom, and damage to property resulting from activities contemplated under this Agreement, including the use of owned and non -owned automobiles.
Coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 ( ed. 11/ 88) and Insurance Services Office Automobile Liability form CA 0001 ed. 12/ 90) Code 1 ( any auto).
Each of the following shall be included in the insurance coverage or added as an endorsement to the policy:
i) CITY, its officers, employees, and volunteers are to be covered as insured with respect to each of the following:
liability arising out of activities performed by or on behalf of CONTRACTOR, products and completed operations of
CONTRACTOR; premises owned, occupied or used by
CONTRACTOR. The coverage shall contain no special
limitations on the scope of protection afforded to CITY, its officers, employees, agents, or volunteers.
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
ii) The insurance shall cover on an occurrence or an accident basis, and not on a claim made basis.
iii) An endorsement must state that coverage is primary insurance and that no other insurance affected by the CITY will be called upon to contribute to a loss under the coverage. iv) Any failure of CONTRACTOR to comply with reporting
provisions of the policy shall not affect coverage provided to CITY and its officers, employees, agents, and volunteers. v) Insurance is to be placed with California - admitted insurers with a Best' s rating of no less than A: VII.
vi) Notice of cancellation or non -renewal must be received by CITY at least thirty days prior to such change.
c) Deductibles and Self -Insured Retentions. CONTRACTOR shall disclose the self -insured retentions and deductibles before beginning any of the services or work called for by any term of this Agreement.
During the period covered by this Agreement, upon express written authorization of CITY Manager, CONTRACTOR may increase such deductibles or self -insured retentions with respect to CITY, its officers, employees, agents, and volunteers. The CITY Manager may condition approval of an increase in deductible or self -insured retention levels upon a requirement that CONTRACTOR procure a bond guaranteeing payment of losses and related investigations, claim administration, and defense expenses that is satisfactory in all respects to each of them.
d) Notice of Reduction in Coverage. In the event that any coverage required under subsections ( a), (b), or ( c) of this section of the Agreement is reduced, limited, or materially affected in any other manner, CONTRACTOR shall provide written notice to CITY at CONTRACTOR' Searliest possible opportunity and in no case later than five days after CONTRACTOR is notified of the change in coverage.
e) In addition to any other remedies CITY may have if CONTRACTOR fails to provide or maintain any insurance policies or policy endorsements to the extent and within the time herein required, CITY may, at its sole option:
i) Obtain such insurance and deduct and retain the amount of the premiums for such insurance from any sums due under the Agreement;
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
ii) Order CONTRACTOR to stop work under this Agreement or withhold any payment which becomes due to CONTRACTOR
hereunder, or both stop work and withhold any payment, until CONTRACTOR demonstrates compliance with the
requirements hereof;
iii) Terminate this Agreement.
Exercise of any of the above remedies, however, is an alternative to other remedies CITY may have and is not the exclusive remedy for CONTRACTOR' Sbreach.
INDEMNIFICATION
Contractor agrees to protect, defend, indemnify and hold City, its City Council members, officers, employees, engineer, and consultants harmless from and against any and all claims, demands, liabilities, losses, damages, costs, expenses, liens, penalties, suits, or judgments, arising in whole or in part, directly or indirectly, at any time from any injury to or death of persons or damage to property as a result of the willful or negligent act or omission of Contractor, or which results from Contractor' snoncompliance with any Law respecting the condition, use, occupation or safety of the Project site, or any part thereof, or which arises from Contractor' sfailure to do anything required under this Contract or for doing anything which Contractor is required not to do under this Contract, or which arises from conduct for which any Law imposes strict liability on Contractor in the performance of or failure to perform the terms and conditions of this Contract, except as may arise from the sole willful or negligent act or omission of City or any of its City Council members, officers, employees.
This indemnification shall extend to any and all claims, demands, or liens made or filed by reason of any construction, renovation, or remodeling work performed by Contractor under this Contract at any time during the term of this Contract, or arising thereafter.
SEVERABILITY
Nothing contained in the Contract shall be construed so as to require the commission of any act contrary to law. Should a conflict arise between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no legal right to contract or act, the latter shall prevail and the provision of this Contract which is affected shall be curtailed and limited but only to the extent necessary to bring it within the requirements of the law. If such curtailment or limitation is not possible, the affected provision shall be of no force and effect. Except as aforesaid, such illegality shall not affect the validity of this Contract.
COMPLETE AGREEMENT
This Contract supersedes any and all agreements, either oral or in writing, between the Parties with respect to the subject matter herein. Each party to this Contract
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
acknowledges that no representation by any party which is not embodied herein or any other agreement, statement, or promise not contained in this Contract shall be valid and binding.
INTERPRETATION
a) The parties hereto acknowledge and agree that each has been given the opportunity to independently review this Contract with legal counsel, and/ or has the requisite experience and sophistication to understand, interpret and agree to the particular language of the provisions of the Contract. b) In the event of a controversy or dispute between the parties concerning the provisions herein, this document shall be interpreted according to the provisions herein and no presumption shall arise concerning the draftsmanship of such provision.
APPLICABLE LAW
a) The parties hereto understand and agree that the terms of this Contract, and its Exhibits, have been negotiated and executed within the State of California and shall be governed by and construed under the laws of the State of California.
b) In the event of a dispute concerning the terms of this Contract, the parties hereto expressly agree that the venue for any legal action shall be with the appropriate court in the County of San Joaquin, State of California.
SIGNATURES
The individuals executing this Agreement represent and warrant that they have the right, power, legal capacity, and authority to enter into and to execute this Agreement on behalf of the respective legal entities of the CONSULTANT and the CITY. This agreement shall inure to the benefit of and be binding upon the parties hereto and their respective successors and assigns.
DocuSign Envelope ID: 922E3033- A36B- 4E4E- 9DDE- B694658180D5
SERVICE CONTRACT
INSTALLATION OF CUSTOM MARQUEES LOCATED AT CITY HALL
Approved as to Form: City of Lathrop
City Attorney
Salvador Navarrete
Z--?- 2DzY
Recommended for Approval: City of Lathrop
Parks, Recreation, and Fleet Director
Tod Sebastian
Date
Z. p2J- 1
Approved by: City of Lathrop
390 Towne Centre Drive
Lathrop, CA 95330
Contractor:
FoR
Stephen J. Salvatore
City Manager
ABV Scoreboard Services, Inc.
1270 Avenida Acaso, Unit F
Camarillo, CA 93012
800) 204- 0402
Federal ID # 45- 2695081
Business License #42513
DocuSigned by:
DDC6cDc5+ CD0^
Signature
John Alfino - President
Date
8 / toy,/
ate
2/ 7/024
Date
President
Print Name and Title
EXHIBIT A
ABV SCOREBOARD
SERVICES, INC.
1270 Avenida Acaso, Unit F
Camarillo, CA 93012
Phone: (800) 204- 0402
Fax: (805) 484- 5020
CONTRACT FOR MATERIALS/ INSTALLATION SERVICES
Client/ Owner:
Name: City of Lathrop
Contact Person: Todd Sebastian
Business address:
Telephone: 209- 941- 7370
Job name: City of Lathrop City Hall
Job Street: 390 Towne Centre Drive
Job City, State, ZIP: Lathrop, CA 95330
ABV Scoreboard Service, Inc., agrees to furnish all labor and materials necessary to install two Vantage 6' x10' full color message boards for the sum of Twelve Thousand Five Hundred Dollars($ 12, 500).
1. Scope of Work. Includes preparing the displays for installation, securing necessary support structure and connecting data and electrical.
Client will provide electrical and data path within 10' of each location.
2. Price. The price for the work described above will be payable as follows:
A) Balance due upon completion of work.
3. Time for Commencement of Work. Work under this contract shall commence after: (1) Company and Client have both executed this contract
4. Additional Work or Changes. Client/ Owner may order additional work or changes in writing at any time, at a price agreed on or at Company' sregular rates for time and material used in additional work or change -orders. Company shall not be required to perform any extra or change -order work without: (1) a written request from Client/ Owner; and ( 2) a written acceptance by Company. All accepted written ABV Scoreboard Services, Inc. Page 1 of 3 Initials: /
Contract for Installation Services Owner ABV
requests for changes or extra work shall be incorporated into, and become part of, this contract.
5. Contract Payments. Company shall not be required to proceed with work if the payments due to Company have not been made as specified in this contract.
6. Unavoidable Interruptions. Company shall not be held responsible or liable for any loss, damage, or delay caused by fire, strikes, civil or military authority, or any other cause beyond Company' scontrol.
7. Charges to the Company. Company shall not be liable for any charges for temporary wiring, electrical energy, heat, job cleanup, hoisting, job telephone, job office or storage space, etc., unless specifically stated in this contract,
8. Damages. Company shall not be liable for any damages resulting from delay in completion of the work caused by factors beyond Company' scontrol.
9. Acceleration of Obligation on Transfer of Title. If Client/ Owner disposes of the property on which work is pending under this contract by sale or otherwise, prior to completion of all payments, the full amount remaining unpaid on this contract shall be due at once and payable within 48 hours after date of disposal.
10. Arbitration. Any controversy or claim relating to this contract shall be submitted to arbitration in accordance with the rules of the American Arbitration Association. The result of that arbitration shall be binding on the parties to this contract. Judgment on any arbitration award may be entered in any court having appropriate jurisdiction.
11. Default. If Client/ Owner does any of the following, Client/ Owner shall be deemed in default under this Agreement: fails to pay any installment or installments on the contract price when due; declares bankruptcy; makes an assignment for the benefit of creditors; or permits an attachment or execution to be levied against Client/ Owner. If Client/ Owner is in default according to the terms of this Paragraph 11, then as long as Client/ Owner remains on the premises, Company, at Company' soption, may remove from the premises any materials or fixtures that have been installed or delivered by Company and may sell those materials or fixtures at private sale without notice, that notice being expressly waived. Company shall apply any amount received in that private sale on account for any indebtedness due to Company on the contract. The option provided for in this Paragraph shall be in addition to any and all other remedies the Company may have to enforce this contract. If Company initiates legal proceedings against Client/ Owner to retake possession of or collect any money due under this contract, Client/ Owner agrees to pay all costs, interests, and reasonable attorneys' fees.
ABV Scoreboard Services, Inc. Page 2 of 3 Initials: /
Contract for Installation Services Owner ABV
12. Release for Payment. On satisfactory payment made for any portion of the work performed, Company shall, at the request of Client/ Owner, furnish to Client/ Owner a full and unconditional release from any claim or mechanics' lien for that portion of the work for which payment has been made.
COMPANY! Client/ Owner:
ABV Scoreboard Services, Inc.
By: Ste arner Step SPM Signature
Name and Title:
ABV Scoreboard Services, Inc. Page 3 of 3
Contract for Installation Services
A LJ® CERTIFICATE OF LIABILITY INSURANCE
DATE )
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Orr & Associates Insurance Services
28780 Single Oak Dr
Ste 255
Temecula CA 92590
License#. 0E63493
CONTACT
Certificates
PHONE FAX
WC. No, Ext): 951- 506-859 ( A/ c, No): 800- 474- 3003
ADDRESS: certs@orrandassociates. com
INSURER( S) AFFORDINGCOVERAGE NAIC#
INSURER A: California Auto Insurance Co. 38342
INSURED ABVGREE- 01
ABV Scoreboard Services Inc
1270 Avenida Acaso Ste F
Camarillo CA 93012
INSURER B : Mt. Hawley Insurance Company 37974
INSURER c: Insurance Com pany of the West 27847
INSURER D: Great American Insurance Co. 16691
INSURER E : Concert Specialty Insurance Co 17151
INSURER F :
COVERAGES CERTIFICATE NUMBER: 2075811792 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
LTR TYPE OF INSURANCE
ADDL
INSD
SUBR
MD POLICY NUMBER
POLICY EFF
SMM/ OD/ YYYY)_,. tMM/ DD/ YYYY)
POLICY EXP
LIMITS
E X COMMERCIAL GENERAL LIABILITY Y Y CSTMGL0001143- 00 5/ 2/023 5/ 2/024 EACH OCCURRENCE 1, 000,00 CLAIMS - MADE [ X1 OCCUR
DAMAGE TO RENTED
PREMISES ( Ea occurrence) 50, 000
MED EXP ( Any one person) 5, 000
PERSONAL & ADV INJURY 1, 000,00
GE
X
L AGGREGATE LIMIT APPLIES
PRO- 1JECT
PER:
LOC
GENERAL AGGREGATE 2, 000,00
PRODUCTS - COMP/ OPAGG 2, 000,00
A AUTOMOBILE
X
1 LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
HIRED
SCHEDULED
Y Y BA040000040946 1/ 28/023 1/ 28/024 SO aBI EDtSINGLE LIMIT 1, 000,00 BODILY INJURY ( Per person)
BODILY INJURY Per accident) ident )
DAMAGE PROPERTYeaccident)
B
X
UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS - MADE
GXS0006721 3/ 6/ 2023 3/ 6/ 2024 EACH OCCURRENCE 1, 000,00 AGGREGATE 1, 000,00
DED RETENTION $
C WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBEREXCLUDED? (
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/ A
Y WSD506667100 7/ 24/022 7/ 24/023 X
PER
STATUTE
O H
ER
E. L. EACH ACCIDENT 1, 000,00
E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
D
D
D
Equipment Floater
Equipment Floater
Equipment Floater
IMPE976454
IMPE976454
IMPE976454
4/ 19/ 2023
4/ 19/ 2023
4/ 19/ 2023
4/ 19/ 2024
4/ 19/ 2024
4/ 19/ 2024
BPP
Installation Floater
Scheduled Equipment
165, 000
200, 00
10, 500
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate is subject to policy limits, conditions and exclusions.
City of Lathrop its officers, employees and volunteers are named as Additional Insured as per attached endorsement form( s).
CERTIFICATE HOLDER CANCELLAT
City of Lathrop
390 Towne Centre Dr
Lathrop, CA 95330
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
at
ACORD 25 (2016/ 03)
1988- 2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Policy Number: BA040000040946
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Business Auto Broadening Endorsement
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. NEWLY ACQUIRED OR FORMED ENTITY ( BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS
III. AUTOMATIC ADDITIONAL INSURED
IV. EMPLOYEE HIRED AUTO LIABILITY
V. SUPPLEMENTARY PAYMENTS
VI. FELLOW EMPLOYEE COVERAGE
VII. ADDITIONAL TRANSPORTATION EXPENSE
VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE
IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE
X. LOAN/EASE GAP COVERAGE
XI. GLASS REPAIR — DEDUCTIBLE WAIVER
XII. TWO OR MORE DEDUCTIBLES
XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV. WAIVER OF SUBROGATION
XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE
XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO — COVERAGE TERRITORY
XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH MCA85101213- CA
Copyright 2013 Mercury Insurance Services, LLC. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 1 of 6 Policy Number: BA040000040946
BUSINESS AUTO COVERAGE FORM
NEWLY ACQUIRED OR FORMED ENTITY ( Broad Form Named Insured) SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added:
d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity.
Coverage under this provision is afforded only until the end of the policy period.
Coverage does not apply to an " accident" which occurred before you acquired or formed the organization.
II. EMPLOYEES AS INSUREDS
SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added:
e. Any " employee" of yours is an " insured" while using a covered " auto" you don' t own, hire or borrow in your business or your personal affairs.
III. AUTOMATIC ADDITIONAL INSURED
SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added:
f. Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the " bodily injury" or "property damage" occurs and that is in effect during the policy period is an " insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an " insured" under the Who Is An Insured provision contained in Section II.
IV. EMPLOYEE HIRED AUTO LIABILITY
SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added:
g. An " employee" of yours is an " insured" while operating an " auto" hired or rented under a contract or agreement in that "employee' s" name, with your permission, while performing duties related to the conduct of your business.
V. SUPPLEMENTARY PAYMENTS
SECTION II — LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary Payments, Subparagraphs ( 2) and (4) are replaced by the following:
2) Up to $ 3, 000 for cost of bail bonds ( including bonds for related traffic law violations) required because of an " accident" we cover. We are not obligated to furnish these bonds.
4) All reasonable expenses incurred by the " insured" at our request, including actual loss of earnings up to $500 a day because of time off from work.
MCA85101213- CA
Copyright 2013 Mercury Insurance Services, LLC. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 2 of 6 Policy Number: BA040000040946
VI. FELLOW EMPLOYEE COVERAGE:
SECTION II — LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee This exclusion does not apply if you have workers' compensation insurance in -force covering all of your " employees". Coverage is excess over any other collectible insurance.
VII. ADDITIONAL TRANSPORTATION EXPENSE
SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses, is replaced with the following:
We will pay up to $50 per day to a maximum of $1000 for temporary transportation expense incurred by you because of the total theft of a covered " auto" of the private passenger type. We will pay only for those covered " autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy' s expiration, when the covered " auto" is returned to use or we pay for its " loss". If your business shown in the Declarations is other than an auto dealership, we will also pay up to $1, 000 for reasonable and necessary costs incurred by you to return a stolen covered auto from the place where it is recovered to its usual garaging location.
VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE
SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, the following is added:
c. If hired " autos" are covered " autos" for Liability Coverage in this policy and Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this coverage form for any " auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire, subject to the following limit:
1) The most we will pay for " loss" to any hired " auto" is $ 50, 000 or Actual Cash Value or Cost of Repair, whichever is less
2) $ 500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to " loss" caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered " auto" you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance.
IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions, 3. a., is amended to add the following:
This exclusion does not apply to the accidental discharge of an airbag.
MCA85101213- CA
Copyright 2013 Mercury Insurance Services, LLC. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 3 of 6 Policy Number: BA040000040946
X. LOAN/EASE GAP COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE C. Limit of Insurance, the following is added:
4. In the event of a " total loss" to a covered " auto" shown in the schedule or declarations for which Collision and Comprehensive Coverage apply, we will pay any unpaid amount due on the lease or loan for that covered " auto," less:
a. The amount paid under the Physical Damage Coverage Section of the policy; and
b. Any:
1) Overdue lease/oan payments at the time of the " loss"; 2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage.
3) Security deposits not returned by the lessor;
4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and 5) Carry- over balances from previous loans or leases.
XI. GLASS REPAIR — DEDUCTIBLE WAIVER
SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added:
No deductible applies to glass damage if the glass is repaired rather than replaced.
XII. TWO OR MORE DEDUCTIBLES
SECTION I II - PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added:
If two or more " company" policies or coverage forms apply to the same accident:
1. If the applicable Business Auto deductible is the smallest, it will be waived; or
2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible; or
3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived.
For the purpose of this endorsement " company" means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies.
XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit, Or Loss, a., In the event of "accident", you must notify us of an accident" applies only when the " accident" is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership;
3) A member, if you are a limited liability company; or 4) An executive officer or insurance manager, if you are a corporation.
MCA85101213- CA
Copyright 2013 Mercury Insurance Services, LLC. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 4 of 6 Policy Number: BA040000040946
XIV. WAIVER OF SUBROGATION
SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following:
5. Transfer Of Rights Of Recovery Against Others To Us
We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any " accident" or loss", provided that the " accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract.
XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation, or Fraud, the following is added:
Any unintentional omission of or error in information given by you, or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery.
This provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal.
XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE
SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, b. For Hired Auto Physical Damage Coverage, is replaced by the following:
b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered autos" you own:
1. Any covered " auto" you lease, hire, rent or borrow; and
2. Any covered " auto" hired or rented by your " employee" under a contract in that individual " employee' s" name, with your permission, while performing duties related to the conduct of your business.
However, any " auto" that is leased, hired, rented or borrowed with a driver is not a covered auto".
XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, the following is added and supersedes any provision to the contrary:
e. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that:
1) The additional insured is a Named Insured under such other insurance; and 2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
MCA85101213- CA
Copyright 2013 Mercury Insurance Services, LLC. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 5 of 6 Policy Number: BA040000040946
XVIII. HIRED AUTO - COVERAGE TERRITORY
SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period, Coverage Territory, e. Anywhere in the world if:, is replaced by the following:
e. Anywhere in the world if:
1) A covered " auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and
2) The " insured' s" responsibility to pay damages is determined in a " suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to.
XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V — DEFINITIONS, C. "Bodily Injury" is amended by adding the following:
Bodily injury" also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease.
MCA85101213- CA
Copyright 2013 Mercury Insurance Services, LLC. All rights reserved.
Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 6 of 6 TMGL 172 10/1
Policy Number: CS TMGL0001143- 00
Effective Date: 5/ 2/023 11: 59: 00 AM
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION
AGREEMENT WITH YOU ( PRIMARY & NONCONTRIBUTORY)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II - Who is An Insured is amended to include as an insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured.
A person' s or organization' sstatus as an insured under this endorsement ends when your operations for that additional insured are completed.
B. With respect to the insurance afforded these additional insureds, the following additional exclusion apply:
This insurance does not apply to:
1. "Bodily injury", "property damage", "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including:
a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities.
2. "Bodily injury", "property damage" occurring after:
a. All work, including materials, parts or equipment furnished in connection with such work, on the project( otherthan service, maintenance or repairs) to be performed by or on behalf of the additional insured( s) at the location of the covered operations has been completed; or b. That portion of " your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project; or c. "Property Damage" which manifests after expiration of the Policy.
If required by written contract or agreement, such insurance a is afforded by this policy shall be primary insurance, and any insurance or self insurance maintained by the above additional insured( s) shall be excess of the insurance afforded to the Named Insured and shall not contribute to it.
ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED.
TMGL 175 01 20
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
COMPLETED OPERATIONS ( PRIMARY)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART:
Name of Additional Insured Person( s) Or Organization. Location and Description of Completed Operations:
We shall name person( s) or organization( s) as
additional insured( s) to this insurance as
required under a legally enforceable, fully
executed written contract with the Named
Insured, entered into before the claim or loss
for which this policy applies.
Any operations performed under a written
contract or agreement as described in the
schedule of Name of Additional Insured
Person( s) or Organization( s)
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Section II - Who Is An Insured is amended to include as an additional insured the person( s) or shown in the Schedule, but only with respect to liability for "bodily injury" or " organization( s)
property damage" caused, in
whole or in part, by " your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and including in the " products - completed operations hazard." No coverage, indemnity and/ or defense obligations shall be provided under this endorsement to any person( s) or organization( s) claiming to be additional insured( s) for claims or losses which do not arise from the Named Insured' swork or operations under a written contract and completed during the policy period.
The Named Insured' smere presence at a work site shall not be deemed sufficient cause to require coverage, indemnity and/ or defense to any person( s) or organization( s) claiming to be an additional insured under this endorsement.
There shall be no coverage, indemnity, and/ or duty to defend any person( s) or organization( s) claiming to be an additional insured under this endorsement if the claim or loss does not arise, in whole or in part, from the negligence and/ or fault of the Named Insured.
We have a
right of reimbursement for attorney' sfees and litigation expenses that can be allocated solely to claims not potentially covered.
If required by written contract or agreement, such insurance as is afforded by this policy shall be primary insurance, and any insurance or self insurance maintained by the above additional insured( s) shall be excess of the insurance afforded to the Named Insured and shall not contribute to it.
ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED.
COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
an additional insured under your policy provided
that:
1) The additional insured is a Named Insured
under such other insurance; and
2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution
from any other insurance available to the
additional insured.
CG 20 01 12 19 Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US ( WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person( s) Or Organization( s):
Persons or organizations as required under a
legally enforceable, fully executed written contract with the named insured, entered into before the claim or loss for which this policy applies.
Information 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 Of Recovery Against Others To Us of
Section IV — Conditions:
We waive any right of recovery against the person( s)
or organization( s) shown in the Schedule above
because of payments we make under this Coverage
Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against
such person( s) or organization( s) prior to loss. This endorsement applies only to the person( s) or
organization( s) shown in the Schedule above.
CG 24 04 12 19 Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: CS TMGL0001143- 00 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED
GENERAL
CONSTRUCTION
AGGREGATE
PROJECT( S)
LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Project( s): All Projects of the Insured where required by written contract.
The General Aggregate Limited is $ 2, 000,00 per project with an absolute General Aggregate Limit of 5, 000,00 all projects for this policy.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. For all sums which the insured becomes legally
obligated to pay as damages caused by
occurrences" under Section I — Coverage A, and
for all medical expenses caused by accidents
under Section I — Coverage C, which can be
attributed only to ongoing operations at a single
designated construction project shown in the
Schedule above:
1. A separate Designated Construction Project
General Aggregate Limit applies to each
designated construction project, and that limit
is equal to the amount of the General
Aggregate Limit shown in the Declarations.
2. The Designated Construction Project General
Aggregate Limit is the most we will pay for the
sum of all damages under Coverage A,
except damages because of " bodily injury" or
property damage" included in the
products -completed operations hazard", and
for medical expenses under Coverage C
regardless of the number of:
a. Insureds;
b. Claims made or " suits" brought; or
c. Persons or organizations making claims or
bringing " suits".
3. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the Designated
Construction Project General Aggregate Limit
for that designated construction project. Such
payments shall not reduce the General
Aggregate Limit shown in the Declarations
nor shall they reduce any other Designated
Construction Project General Aggregate Limit
for any other designated construction project
shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented To
You and Medical Expense continue to apply.
However, instead of being subject to the
General Aggregate Limit shown in the
Declarations, such limits will be subject to the
applicable Designated Construction Project
General Aggregate Limit.
CG 25 03 05 09 Insurance Services Office, Inc., 2008 Page 1 of 2 0 B. For all sums which the insured becomes legally
obligated to pay as damages caused by
occurrences" under Section 1— Coverage A, and
for all medical expenses caused by accidents
under Section 1 — Coverage C, which cannot be
attributed only to ongoing operations at a single
designated construction project shown in the
Schedule above:
1. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the amount available
under the General Aggregate Limit or the
Products -completed Operations Aggregate
Limit, whichever is applicable; and
2. Such payments shall not reduce any
Designated Construction Project General
Aggregate Limit.
C. When coverage for liability arising out of the
products -completed operations hazard" is
provided, any payments for damages because of
bodily injury" or " property damage" included in
the " products - completed operations hazard" will
reduce the Products - completed Operations
Aggregate Limit, and not reduce the General
Aggregate Limit nor the Designated Construction
Project General Aggregate Limit.
D. If the applicable designated construction project
has been abandoned, delayed, or abandoned
and then restarted, or if the authorized
contracting parties deviate from plans, blueprints,
designs, specifications or timetables, the project
will still be deemed to be the same construction
project.
E. The provisions of Section 111 — Limits Of
Insurance not otherwise modified by this
endorsement shall continue to apply as
stipulated.
i
7 ACCORD CERTIFICATE OF LIABILITY INSURANCE
DATE ( MM/ DD/ YYYY)
07/ 21/023
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 po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Brown & Brown Insurance Services of Califomia, Inc
License # 0D04053
1001 Mark Avenue, Suite 201
Carpinteria CA 93013
CONTACT
NAME: Vicky Salgado
PHONE
Est):
965- 0071 FAX, No): ( 805) 690- 3200
EMAIL
ADDRESS: Vicky. Salgado@bbrown. com
INSURER( S) AFFORDING COVERAGE NAIC #
INSURER A: State Compensation Insurance Fund of CA 35076
INSURED
ABV Scoreboard Services, Inc.
1270 Avenida Acaso, Ste. F
Camarillo CA 93012
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 23/4 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER
POLICY EFF
MM/ DD/ YYYYj
POLICY EXP
MM/ DO/ YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
DAMAGE ORENTED
CLAIMS - MADE OCCUR PREMISES ( Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GEN' L AGGREGATE LIMIT APPLIES
PROJECT
PER:
LOC
GENERAL AGGREGATE
PRODUCTS - COMP/ OAGG
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
HIRED
SCHEDULED
AUTOS
NON - OWNED
AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident)
BODILY INJURY (Per person)
BODILY INJURY ( Per accident)
PROPERTY DAMAGE
Per accident)
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS - MADE
EACH OCCURRENCE
AGGREGATE
DED RETENTION $
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBER EXCLUDED?
Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y/ N
N / A Y 93429802023 07/ 24/023 07/ 24/024
X
PER
STATUTE
OTH
ER
ELEACH ACCIDENT 1, 000.00
E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) Waiver of Subrogation applies to the Workers Compensation per the attached form SCIF FORM 10217 (REV. 4- 2018), as required by written contract.
CERTIFICATE HOLDER CANCELLATION
City of Lathrop
390 Towne Centre Dr.
Lathrop,
1 CA 95330
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
kwtdo —
ACORD 25 ( 2016/ 03)
1988- 2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
STATE
c r,M+r .J-_. r,Ttot;
1 A; U E A NCE
F Li D
HOME OFFICE
SAN FRANCISCO
ALL EFFECTIVE DATES
AT 12: 01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
ENDORSEMENT AGREEMENT
WAIVER OF SUBROGATION
BLANKET BASIS
EFFECTIVE July 24, 2023 AT 12: 01 AM.
AND EXPIRING July 24, 2024 AT 12: 01 AM
ABV SCOREBOARD SERVICES, INC.
1270 AVENIDA ACASO, STE F
CAMARILLO, CA 93012
9342980- 23
NEW
Los Angeles
8672132
WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE.
THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2. 00% OF THE TOTAL POLICY PREMIUM.
SCHEDULE
PERSON OR ORGANIZATION JOB DESCRIPTION
ANY PERSON OR ORGANIZATION
FOR WHOM THE NAMED INSURED
HAS AGREED BY WRITTEN
CONTRACT TO FURNISH THIS
WAIVER
BLANKET WAIVER OF SUBROGATION
NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL
BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: July 21, 2023
AUTHORIZED REPRESENTATIVE PRESIDENT AND CEO
2572
SCIF FORM 10217 ( REV. 4 - 2018) OLD DP 217
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 Ed. 8- 00)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. ( This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us).
The additional premium for this endorsement shall be 2% % of the total California Workers' Compensation premium otherwise due.
Schedule
Person or Organization Job Description
ANY PERSON OR ' CALIFORNIA
ORGANIZATION FOR OPERATIONS ONLY.
WHOM THE NAMED
INSURED IS REQUIRED
UNDER WRITTEN
CONTRACT TO FURNISH
THIS WAIVER.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 07/ 24/022 Policy No. WSD 5066671 00 Insured ABV SCOREBOARD SERVICES INC
Insurance Company INSURANCE COMPANY OF THE WEST
Countersigned By
WC 99 06 34
Ed. 8- 00)
Endorsement No.
Premium $ INCL.
INSURED