RECITALS
Scope of Services
Compliance with Law
Time is of the Essence
Professional Competence
Independent Contractor
MASTER AGREEMENT FOR CONSULTANT SERVICES
ATTACHMENT 12
Confidentiality
Ownership of Material
Documentation
Testimony
Compensation
Invoices
Status Reports
Withholding
Effective Date
Termination
Final Payment
Other Remedies
CITY Contact
CONSULTANT Contact
Indemnification
Health and Safety
Insurance
Entire Agreement
No Assignment
Severability
Counterparts
Choice of Law
Waiver
Mediation
Attorney’s Fees
Interpretation
Authority
Third Parties.
Signatures on Next Page
CITY OF PACIFICA
CONSULTANT:
NCE
1-11-2022
EXHIBIT A
TASK ORDER
EXAMPLE OF
TASK ORDER NO. 1
CITY OF PACIFICA
AND
CONSULTANT
SECTION 1 – PURPOSE
SECTION 2 – SCOPE OF WORK
SECTION 3 – COMPENSATION AND PAYMENT
SECTION 4 – TIME OF PERFORMANCE
SECTION 5 – ITEMS AND CONDITIONS
CITY OF PACIFICA
CONSULTANT
NCE
ATTACHMENT “A”
SCOPE OF SERVICES
ATTACHMENT “B”
COMPENSATION
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT NAME: PHONE FAX
(A/C, No, Ext): (A/C, No): E-MAIL ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE LIMITS (MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB
EXCESS LIAB WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $
DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO- POLICY LOC JECT PRODUCTS - COMP/OP AGG
OTHER: $
COMBINED SINGLE LIMIT
(Ea accident) $
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
$
OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH- STATUTE ER
E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
5/14/2021
License # 0E67768
(858) 754-0063 50233 (619) 574-6288
13056
Nichols Consulting Engineers, CHTD
1885 S. Arlington Ave., #111
Reno, NV 89509
22829
A 1,000,000
X X PSB0003222 5/17/2021 5/17/2022 1,000,000
Cont Liab/Sev of Int 10,000
1,000,000
2,000,000
2,000,000
Deductible 0
A 1,000,000
PSA0001184 5/17/2021 5/17/2022
Comp.: $500 Coll.: $500
A 5,000,000
PSE0003030 5/17/2021 5/17/2022 5,000,000
0 A
X PSW0001955 5/17/2021 5/17/2022 1,000,000
1,000,000
1,000,000
B Professional Liab. USF00807821 5/17/2021 Per Claim 5,000,000 B Ded.: $50k Per Claim USF00807821 5/17/2021 5/17/2022 Aggregate 5,000,000 Re: All Operations
City of Pacifica, its City Council, boards, commissions, committees, officers, employees and agents are Additional Insureds with respect to General Liability per the attached endorsement as required by written contract. Insurance is Primary and Non-Contributory. Waiver of Subrogation applies to General Liability and Workers' Compensation.
30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of Premium in accordance with the policy provisions.
City of Pacifica
Engineering & Field Services
151 Milagra Drive
Pacifica, CA 94044
NICHCON-02 MCGRAWM
IOA Insurance Services
4370 La Jolla Village Drive Suite 600
San Diego, CA 92122
Erica Wilson
[email protected]
RLI Insurance Company
Interstate Fire & Casualty Company
X
5/17/2022
X
X
X
X
X
X X
X
X
X