Agenda packet — Placentia City Council, July 16, 2024 (part 2 of 5)

2024-25 Operating Budget. Funding for year two of the agreement shall be allocated during the regular budget process for Fiscal Year 2025-26. Accordingly, sufficient funds exist for the recommended actions.

Prepared by:

Veronica 00tiz _-
Deputy Director of Community Services
2 Reviewed and approved: Reviewed and approved:
%Lampman
or of Finance
DamierrR Arrula
City Administrator
Attachments:

1. Amendment No. 2 to the Maintenance Services Agreement with Team One Management Inc.

2. Maintenance Services Agreement with Team One Management Inc.

AMENDMENT NO. 2 TO

PROFESSIONAL SERVICES AGREEMENT
PROVISION OF MAINTENANCE SERVICES WITH TEAM ONE MANAGEMENT INC.

This Amendment No. 2 ("Amendment") to Professional Services Agreement is made and entered into effective the 1ST day of August 2024, by and between the CITY OF PLACENTIA, a Charter City and Municipal Corporation ("CITY"), and TEAM ONE MANAGEMENT INC., a California corporation (hereinafter "CONTRACTOR"). CITY and CONTRACTOR are sometimes hereinafter individually referred to as "Party" and or collectively referred to as the "Parties." A. Recitals.
(i) CITY and CONTRACTOR entered into a Professional Services Agreement ("Agreement") effective July 1st, 2021, through which CONTRACTOR has been providing professional services as more fully explained in the Scope of Services attached to the Agreement as Exhibit "A".
(ii) The Parties now seek to amend the Agreement to extend the term for a period of two years through July 31, 2026, and increase compensation for a total of $174,594. (iii) All legal prerequisites to the making of this Amendment have occurred.

NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, the Parties agree as follows:

B. Amendment to Agreement.

1. Section 2, Paragraph 1 of the Agreement is hereby amended to read as follows:

2.1. Contract Sum Contractor shall be paid in accordance with the fee schedule set forth in Exhibit "A". Consultant's total compensation shall not exceed One Hundred Seventy -Four Thousand, Five Hundred Ninety Four Dollars ($174,594).

2. Section 4.1, Paragraph 1 of the Agreement is hereby amended to read as follows:

4. 1. Term. This Agreement shall commence on the Effective Date and continue for a period of 24 months, ending on July 31, 2026, unless previously terminated as provided herein or as otherwise agreed to in writing by the parties.

3. Except as specifically modified herein, all of the terms, conditions and provisions of the Agreement shall remain in full force and effect.

4. The Agreement, all amendments together with this Amendment No. 2 and all Exhibits attached thereto, constitutes the entire Agreement between the Parties and supersedes all prior negotiations, arrangements, representations, and understandings, if any, made by or between the Parties with respect to the subject matter hereof. No amendment or other modification of the Agreement, as modified by this Amendment No. 2 shall be binding unless executed in writing by both Parties hereto, or their respective successors, assigns, or grantees.

Page 1 of 2 ends

5. Each of the undersigned represents and warrants that he or she is duly authorized to execute and deliver this Amendment No. 2 and that such execution is binding upon the entity for which he or she is executing this document.

IN WITNESS WHEREOF, the Parties have caused Amendment No. 2 to the Consulting Services Agreement are to be executed as of the day and year first above written.

CONSULTANT CITY OF PLACENTIA
By: By:

Mike Akhavan Damien R. Arrula
President City Administrator
ATTEST:

Robert S. McKinnel
City Clerk
APPROVED AS TO FORM:

By:

Christian L. Bettenhausen
City Attorney

Page 2 of 2 ends

TEAM]
l

MANAGMENT
June 19, 2024
City of Placentia
Matthew Brand, Community Services Coordinator
401 East Chapman Avenue
Placentia, CA 92870
RE: Contract Renewal for Janitorial Services
We would like to extend the current contract and we do agree to an increase of 843.50 per month for the next 24 months.

If you have any questions or need additional information, please call us at 949-348-1446.

Sincerely,
Mike Akhavan
27324 Camino Capistrano #209 Laguna Niguel CA 92677 (949) 348-1446 Fax (949) 348-1722

TEAT

MANAGMENT
March 5, 2023
City of Placentia
Matthew Brand, Community Services Coordinator
401 East Chapman Avenue
Placentia, CA 92870
RE: Janitorial Services for Valadez Middle School Restrooms As requested, the cost to provide Janitorial services for the above two restrooms 7 days per week would be $1,300.00 per month. Please note this will include all labor, equipment, solutions and also consumable supplies such as toilet tissue, soap, bags, etc.. Per our discussion, the city staff will be in charge of opening and locking up the restrooms on a daily basis.

In addition, the soap that will be utilized in the restrooms will be the same as all the park restrooms.

If you have any questions or need additional information, please call us at 949-348-1446.

Sincerely,
Mike Akhavan
27324 Camino Capistrano #209 Laguna Niguel CA 92677 (949) 348-1446 Fax (949) 348-1722

City of Placentia
California

BR) FOR
Park Restroom Janitorial Services
PARK
Kraemer Park
201 N. Bradford
Avenue
McFadden
Park
974 S. Melrose Avenue
Tuffree Park
2101 N. Tuffree Boulevard
Koch Park 2210 N.

Valencia
Avenue
Vaqueros Park 1200 N.

Carlsbad Street
Arroyo Verde Park 1001 E. Palm
Drive
Atwood Park
1701 Atwood Avenue
Placentia
Champions
Sports Park (2) restroom north and south
505 Jefferson
EST. QTY
365
365
365
365
365
365
365
365

UNIT PRICE
a
2a .So
'1O-ov

ITEM COST
Sa
*8a\a.�d
Ig�i.2s v
$03U-oo
789-7 -So
4,7
\4-, 60000
Grand Total Bid Amount:
$11117. 0(
Page C-2

l /` CERTIFICATE OF LIABILITY INSURANCE
`�/ CO IJ
A44.....-----

DATE (M M/DDIYYYY)
09/27/2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

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

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED 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
Insurance Solutions
License #0K07568
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT Angela Dancy
NAME:
(A/C,PHONE Ext): (949) 348-7400 FAX A/C, No): (949) 201-4515 E-MAIL [email protected]
ADDRESS: g

INSURER(S) AFFORDING COVERAGE
NAIC s
INSURER A: West American Ins. Co.
44393

INSURED
Team One Management Inc
DBA: Team One Management Services
PO Box 203
Lake Forest CA 92609
INSURER 8 : California Automobile Insurance Co.
38342
INSURER C : CNA Surety
524126
INSURER D :

INSURER E :

INSURER F :

COVERAGES
CERTIFICATE NUMBER:
23-24 all
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
WVD

POLICY NUMBER

POLICY EFF
(MM/DDIYYYY)

POLICY EXP
(MM/DD/YYYY)
LIMITS
A
X

COMMERCIAL GENERAL LIABILITY
BKW55748813
07/24/2023
07/24/2024

EACH OCCURRENCE
$ 1 ,000,000

CLAIMS -MADE
X
OCCUR

DAMAGE RENTED
PREMISESO(Ea occurrence)
S 500,000
MED EXP (Any one person)
S 10,000

PERSONAL&ADVINJURY
$ 1,000,000

GEN'LAGGREGATE
_
POLICY
OTHER:

LIMIT APPLIES

JECT PRO
X
PER:

LOC

GENERAL AGGREGATE
S 2,000,000

PRODUCTS - COMP/OP AGG
$ 2,000,000
$
B

AUTOMOBILE
X
_

LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY
_

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
BA040000009648
10/03/2023
10/03/2024

COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
S

PROPERTY DAMAGE
(Per accident)
$
S

UMBRELLA LIAB

EXCESS LIAB
_
OCCUR

CLAIMS -MADE

EACH OCCURRENCE
$

AGGREGATE
S
DED
RETENTION $
S

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
PER

STATUTE
OTH-
ER
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
S
C
Janitorial Bond including Employee
Dishonesty
69410585
07/24/2023
07/24/2024
Limit:
$100,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are additional insureds with respects to liability arising out of activities performed by or on behalf of the Named Insured pursuant to its contract with the City; products and completed operations of the Named Insured; premises owned, occupied or used by the Named Insured; Automobiles owned, leased, hired, or borrow by the Named Insured. This insurance coverage shall be primary insurance as respects the City of Placentia, its officers, officials, agents, employees, and volunteers. Any other insurance maintained by the City of Placentia shall be excess and not contributory.

CERTIFICATE HOLDER

CANCELLATION
City of Placentia Attn: City Administrator
401 E. Chapman
Placentia
CA 92870

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
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

ACORO® CERTIFICATE OF LIABILITY INSURANCE

40.....-----

DATE(MM/DD/YYYY)
07/18/2023
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 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
Capital Providers Insurance
License #0H52316
20750 Ventura Blvd., Ste 305
Woodland Hills CA 91364
CONTACT Meyer Chadorchi
NAME:

PHONE (818) 676-0016 FAX (818) 676-0015
(A/C, No, Ext): (A/C, No):

E-MAIL [email protected]
ADDRESS:

INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: National Casualty Insurance Company

INSURED
Team One Management
27324 Camino Capistrano
209
Laguna Niguel CA 92677

INSURER B
INSURER C :

INSURER D:

INSURER E :

INSURER F :

COVERAGES
CERTIFICATE NUMBER: 23 24 WC
REVISION NUMBER:

TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD

POLICY NUMBER

POLICY EFF
(MM/DDIYYYY)

POLICY EXP
(MMIDD/YYYY)
LIMITS

COMMERCIAL GENERAL LIABILITY

EACH OCCURRENCE
$

CLAIMS -MADE
OCCUR

DAMAGE TO RENTED
PREMISES (Ea occurrence)
S
MED EXP (Any one person)
S

PERSONAL & ADV INJURY
$

GEN'LAGGREGATE
LIMIT APPLIES PER:

GENERAL AGGREGATE
$
POLICY

PRO JECT
LOC

PRODUCTS - COMP/OP AGG
S
OTHER:
$

AUTOMOBILE LIABILITY

COMBINED SINGLE LIMIT
(Ea accident)
S
—

ANY AUTO
BODILY INJURY (Per person)
S
_
OWNED

AUTOS ONLY

SCHEDULED
AUTOS
BODILY INJURY (Per accident)
S
_
HIRED

AUTOS ONLY

NON -OWNED

AUTOS ONLY

PROPERTY DAMAGE
(Per accident)
$
$

UMBRELLA LIAB
OCCUR

EACH OCCURRENCE
$

EXCESS LIAB

CLAIMS -MADE

AGGREGATE
S
DED
RETENTION $
S

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
PER

STATUTE
OTH-
ER
A
YIN

ANY PROPRIETOR/PARTNER/EXECUTIVE Y
N/A
WCNCC31242404
07/24/2023
07/24/2024
E.L. EACH ACCIDENT
$ 1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Placentia, its elected and appointed boards, officials, agents, employees, and voluteers are named as addtional insured

CERTIFICATE HOLDER

CANCELLATION
City of Placentia
401 E. Chapman
Placentia
CA 92870

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
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

ACORO® CERTIFICATE OF LIABILITY INSURANCE
ikto.....-----

DATE (MM/DD/YYYY)
09/27/2023
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.

PRODUCER
Insurance Solutions
License #0K07568
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT Angela Dancy
NAME:
(HICNNo, Ext): (949) 348-7400 FAX
No): (949) 201-4515
E-MAIL [email protected]
ADDRESS: g

INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: West American Ins. Co.
44393

INSURED
Team One Management Inc
DBA: Team One Management Services
PO Box 203
Lake Forest CA 92609
INSURER B: California Automobile Insurance Co.
38342
INSURER C : CNA Surety
524126
INSURER D :

INSURER E
INSURER F :

COVERAGES
CERTIFICATE NUMBER: 23-24 all
REVISION NUMBER:

INSR
LTR

TYPE OF INSURANCE

ADDLSUBR
INSD
WVD

POLICY NUMBER

POLICY EFF
(MMIDD/YYYY)

POLICY EXP
(MM/DD/YYYY)
LIMITS
A
X

COMMERCIAL GENERAL LIABILITY
BKW55748813
07/24/2023
07/24/2024

EACH OCCURRENCE
000
$ 1,000,DAMAGE

CLAIMS -MADE
X
OCCUR
TO TED
PREMISES (Ea occurrence) r
$ 500,000
MED EXP (Any one person)
$ 10,000

PERSONAL & ADV INJURY
$ 1,000,000
GEN'L

AGGREGATE

LIMIT APPLIES

JECT PRO
X
P
PER:

LOC

GENERAL AGGREGATE
5 2,000,000

PRODUCTS - COMP/OPAGG
$ 2,000,000
S
B

AUTOMOBILE
X
_

LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY
.----
_

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
BA040000009648
10/03/2023
10/03/2024

COMBINED SINGLE LIMIT
(_Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
S

PROPERTY DAMAGE
(Per accident)
5 S

UMBRELLA LIAB

EXCESS LIAB
OCCUR

CLAIMS -MADE

EACH OCCURRENCE
s

AGGREGATE
S
DED
RETENTION $
S

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
PER

STATUTE
OTH-
ER
E.L. EACH ACCIDENT
s
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
5 C
Janitorial Bond including Employee
Dishonesty
69410585
07/24/2023
07/24/2024
Limit:
$100,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are additional insureds with respects to liability arising out of activities performed by or on behalf of the Named Insured pursuant to its contract with the City; products and completed operations of the Named Insured; premises owned, occupied or used by the Named Insured; Automobiles owned, leased, hired, or borrow by the Named Insured. This insurance coverage shall be primary insurance as respects the City of Placentia, its officers, officials, agents, employees, and volunteers. Any other insurance maintained by the City of Placentia shall be excess and not contributory.

CERTIFICATE HOLDER

CANCELLATION
City of Placentia Attn: City Administrator
401 E. Chapman
Placentia
CA 92870

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
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

ACORO®
�� CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)
07/18/2023
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.

PRODUCER
Capital Providers Insurance
License #0H52316
20750 Ventura Blvd., Ste 305
Woodland Hills CA 91364
CONTACT Meyer Chadorchi
NAME:

PHCONE
Eat): (818) 676-0016 FAXA/c, No): (818) 676-0015
E-MAIL [email protected]
ADDRESS:

INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: National Casualty Insurance Company

INSURED
Team One Management
27324 Camino Capistrano
209
Laguna Niguel CA 92677
INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

COVERAGES
CERTIFICATE NUMBER: 23 24 WC
REVISION NUMBER:

INSR
LTR

TYPE OF INSURANCE
ADDL
INSD
SUER
WVD

POLICY NUMBER

POLICY EFF
(MM/DDIYYYY)

POLICY EXP
(MM/DD/YYYY)
LIMITS

COMMERCIAL GENERAL LIABILITY

EACH OCCURRENCE
$

CLAIMS -MADE
OCCUR

DAMAGE TO RENTED
PREMISES (Ea occurrence)
S
MED EXP (Any one person)
$

PERSONAL & ADV INJURY
$

GEN'LAGGREGATE
P
POLICY
OTHER:

LIMIT APPLIES

PRO JECT
PER:

LOC

GENERAL AGGREGATE
$

PRODUCTS - COMP/OP AGG
$
S

AUTOMOBILE
_

LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY

COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$

PROPERTY DAMAGE
(Per accident)
$

UMBRELLA LIAB

EXCESS LIAB
-
OCCUR

CLAIMS -MADE

EACH OCCURRENCE
$

AGGREGATE
S
DED
RETENTION $
S
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
Y
NIA
WCNCC31242404
07/24/2023
07/24/2024
PER

STATUTE
OTH-
ER
E. L. EACH ACCIDENT
1 000 000
$ ,,
EL. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1 000 000
S , ,
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Placentia, its elected and appointed boards, officials, agents, employees, and voluteers are named as addtional insured

CERTIFICATE HOLDER

CANCELLATION
City of Placentia
401 E. Chapman
Placentia
CA 92870

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
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

ADDITIONAL COVERAGES
Ref #
Description
Blkt Waiver Subrogation
Coverage Code
BWWSB
Form No.

Edition Date
Limit 1
Limit 2
Limit 3
Deductible Amount
Deductible Type
Premium
Ref #
Description
Coverage Code
Form No.

Edition Date
Limit 1
Limit 2
Limit 3
Deductible Amount
Deductible Type
Premium
OFADTLCV Copyright 2001, AMS Services, Inc.

COMMERCIAL GENERAL LIABILITY
CG 88 60 12 08
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EACH LOCATION GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I - Coverage C Medical Payments, which can be attributed only to operations at a single "location" owned by or rented to you:

1. A separate Each Location General Aggregate Limit applies to each "location", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.

2. The Each Location 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 regard- less 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 Each Location General Aggregate Limit for that "location". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Each Location General Aggregate Limit for any other "location".

4. The limits shown in the Declarations for Each Occurrence, Fire Damage 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 Each Location General Aggregate Limit.

B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I - Coverage C Medical Payments, which cannot be attrib- uted only to operations at a single "location" owned by or rented to you:

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 Each Location 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 Each Location General Aggregate Limit.

D. For the purposes of this endorsement, the following definition is added to Sectio n V - Definitions:
"Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad.

E. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated.

CG 88 60 12 08
Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 1

Policy Number: BKW55748813

COMMERCIAL GENERAL LIABILITY
CG 88 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMERCIAL GENERAL LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
INDEX

SUBJECT

NON -OWNED AIRCRAFT

NON -OWNED WATERCRAFT

PROPERTY DAMAGE LIABILITY - ELEVATORS
EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)

MEDICAL PAYMENTS EXTENSION

EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B

ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT

PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE"

WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN

INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES

NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES

FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES

KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT

LIBERALIZATION CLAUSE

BODILY INJURY REDEFINED

EXTENDED PROPERTY DAMAGE

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -

WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU
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With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement.

A. NON -OWNED AIRCRAFT
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided:

1. It is not owned by any insured;

2. It is hired, chartered or loaned with a trained paid crew;

3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and

4. It is not being used to carry persons or property for a charge.

However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision.

B. NON -OWNED WATERCRAFT
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following:

This exclusion does not apply to:
(2) A watercraft you do not own that is:
(a) Less than 52 feet long; and
(b) Not being used to carry persons or property for a charge.

C. PROPERTY DAMAGE LIABILITY - ELEVATORS

1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations.

2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance:

The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis.

D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part:

1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability:
a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing:

Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to:
(i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days.

Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days.

A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance.

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b. The last paragraph of subsection 2. Exclusions is replaced by the following:

Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance.

2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following:

6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to:
a. Any one premise:
(1) While rented to you; or
(2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or
b. Contents that you rent or lease as part of a premises rental or lease agreement.

3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following:

9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract".

E. MEDICAL PAYMENTS EXTENSION
If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows:

1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following:
b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds.

2. Paragraph 1.d. is replaced by the following:
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work.

G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT

1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by:
a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or
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b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or
d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions:
(1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard".
(3)
Insurance applies to premises you own, rent, or control but only with respect to the following hazards:
(a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or
(b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when:
(1)
All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or 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.

With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends.

With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor.

The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage".

We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions.

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2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2.

Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability:

This insurance does not apply to:
a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including:
(1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities.

This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services.
d. "Bodily injury" or "property damage" occurring after:
(1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy.

3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the contract or agreement; or
b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns.

H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy.

Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows:
a. The following is added to Paragraph a. Primary Insurance:

If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover.

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b. The following is added to Paragraph b. Excess Insurance:

When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured.

Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies.

I. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy.

1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit:

An additional insured under this endorsement will as soon as practicable:
a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us;
b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and
c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part.
d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured.

2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy.

J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/ MALPRACTICE

WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following:
(1) "Bodily injury" or "personal and advertising injury":
(a)
To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above;
(c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply.

Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and CG 88 10 04 13
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advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances.

The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee".

K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES
Paragraph 3. of Section II - Who Is An Insured is replaced by the following:

3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However:
a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you;
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and
c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured.

No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision.

L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES
Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations:

Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional.

M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit:

Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph

1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee".

N. LIBERALIZATION CLAUSE
If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state.

O. BODILY INJURY REDEFINED
Under Section V - Definitions, Definition 3. is replaced by the following:

3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease.

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P. EXTENDED PROPERTY DAMAGE
Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following:
a. Expected Or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the insured.

This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property.

Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A

CONTRACT OR AGREEMENT WITH YOU
Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us:

We waive any right of recovery we may have against a person or organization 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" provided:

1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and

2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment.

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Policy Number: BA040000009648
Insured: Team One Management, Inc.

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
II I. 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/LEASE 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 MCA85100817-CA
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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 H - 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 I I.

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.

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 I I I - 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 I I I - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, the following is added:
c. If Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis 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.

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X. LOAN/LEASE GAP COVERAGE
SECTION I II - 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/loan 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.

The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 25% of the actual cash value of that insured auto at the time of the loss.

XI. GLASS REPAIR — DEDUCTIBLE WAIVER
SECTION I II - 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.

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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.

MCA85100817-CA
Copyright 2017 Mercury Insurance Services, LLC. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 5 of 6

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 3O 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.

MCA85100817-CA
Copyright 2017 Mercury Insurance Services, LLC. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 6 of 6

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT —CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.

Blanket 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: 07/24/2023
Insured:

Team One Management
Insurance Company:

National Casualty Company
Policy No.: WCNCC 312424 Endorsement No.:

Premium $ INCL
Countersigned by
©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.

AMENDMENT NO. 1 TO

PROFESSIONAL SERVICES AGREEMENT
WITH TEAM ONE MANAGEMENT, INC.

This Amendment No. 1 ("Amendment") to Professional Services Agreement is made and entered into effective the 1St day of July, 2021, by and between the CITY OF PLACENTIA, a Charter City and Municipal Corporation ("CITY"), and TEAM ONE MANAGEMENT, INC., a California corporation (hereinafter "CONSULTANT"). CITY and CONSULTANT are sometimes hereinafter individually referred to as "Party" and or collectively referred to as the "Parties." A. Recitals.
(i). CITY and CONSULTANT entered into a Professional Services Agreement ("Agreement") effective July 1st, 2021 through which CONSULTANT has been providing professional services as more fully explained in the Scope of Services attached to the Agreement as Exhibit "A."
(ii). The Parties now seek to amend the Agreement to extend the terms of the to add the cleaning of one additional restroom for 16 months, for a cost of $1,300 totaling $20,800 from April 1, 2023 to July 31, 2024.
(iii). All legal prerequisites to the making of this Amendment have occurred.

NOW, THEREFORE, in consideration of the mutual covenenants and conditions set forth herein, the Parties agree as follows:

B. Amendment to Agreement.

1. Section 4.1, Paragraph one of the Agreement is hereby amended to read as follows:

4. 1. Term. This Agreement shall commence on the Effective Date and continue for a period of 16 months, ending on July 31, 2024, unless previously terminated as provided herein or as otherwise agreed to in writing by the parties.

2. Except as specifically modified herein, all of the terms, conditions and provisions of the Agreement shall remain in full force and effect.

3. The Agreement, all amendments together with this Amendment No. 1 and all Exhibits attached thereto, constitutes the entire Agreement between the Parties and supersedes all prior negotiations, arrangements, representations, and understandings, if any, made by or between the Parties with respect to the subject matter hereof. No amendment or other modification of the Agreement, as modified by this Amendment No. 1 shall be binding unless executed in writing by both Parties hereto, or their respective successors, assigns, or grantees.

Page 1 of 2 ends

5. Each of the undersigned represents and warrants that he or she is duly authorized to execute and deliver this Amendment No. I and that such execution is binding upon the entity for which he or she is executing this document.

IN WITNESS WHEREOF, the Parties have caused Amendment No. 1 to the Consulting Services Agreement are to be executed as of the day and year first above written.

CONSULTANT CITY OF PLACENTIA
By: I►it-b. QL By:

Mike Akhavan Damien Arulla
President City Administrator
ATTEST: .fiv
Robert S. McKinnel
City Clerk
APPROVED AS TO FORM:

Christian L. Bettenhausen
City Attorney

Page 2 of 2 ends

CITY OF PLACENTIA

MAINTENANCE SERVICES AGREEMENT
WITH
TEAM ONE MANAGEMENT, INC.

THIS AGREEMENT is made and entered into this 1s' day of July, 2021 ("Effective Date"), by and between the CITY OF PLACENTIA, a municipal corporation ("City"), and TEAM ONE MANAGEMENT, INC. a California corporation ("Contractor").

WITNESSETH:

A. WHEREAS, City proposes to utilize the services of Contractor as an independent contractor to provide park restroom janitorial servives, as more fully described herein; and B. WHEREAS, Contractor represents that it has that degree of specialized expertise contemplated within California Government Code Section 37103, and holds all necessary licenses to practice and perform the services herein contemplated; and C. WHEREAS, City and Contractor desire to contract for the specific services described in Exhibit "A" (the "Project") and desire to set forth their rights, duties and liabilities in connection with the services to be performed; and
D. WHEREAS, no official or employee of City has a financial interest, within the provisions of Sections 1090-1092 of the California Government Code, in the subject matter of this Agreement.

NOW, THEREFORE, for and in consideration of the mutual covenants and conditions contained herein, the parties hereby agree as follows:

1.0. SERVICES PROVIDED BY CONTRACTOR

1.1. Scope of Services. Contractor shall provide the professional services described in Contractor's Proposal ("Proposal"), attached hereto as Exhibit "A" and incorporated herein by this reference.

1.2. Professional Practices. All professional services to be provided by Contractor pursuant to this Agreement shall be provided by personnel experienced in their respective fields and in a manner consistent with the standards of care, diligence and skill ordinarily exercised by professional Contractors in similar fields and circumstances in accordance with sound professional practices. Contractor also warrants that it is familiar with all laws that may affect its performance of this Agreement and shall advise City of any changes in any laws that may affect Contractor's performance of this Agreement. Contractor shall keep itself informed of State and Federal laws and regulations which in any manner affect those employed by it or in any way affect the performance of its service pursuant to this Agreement. The Contractor shall at all times observe and comply with all such laws and regulations. Officers and employees shall not be liable at law or in equity occasioned by failure of the Contractor to comply with this section.

1.3. Performance to Satisfaction of City. Contractor agrees to perform all the work to the complete satisfaction of the City and within the hereinafter specified. Evaluations of the work will be done by the City Administrator or his or her designee. If the quality of work is not satisfactory, City in its discretion has the right to:
(a) Meet with Contractor to review the quality of the work and resolve the

matters of concern;
(b) Require Contractor to repeat the work at no additional fee until it is satisfactory; and/or
(c) Terminate the Agreement as hereinafter set forth.

1.4. Warranty. Contractor warrants that it shall perform the services required by this Agreement in compliance with all applicable Federal and California employment laws, including, but not limited to, those laws related to minimum hours and wages; occupational health and safety; fair employment and employment practices; workers' compensation insurance and safety in employment; and all other Federal, State and local laws and ordinances applicable to the services required under this Agreement. Contractor shall indemnify and hold harmless City from and against all claims, demands, payments, suits, actions, proceedings, and judgments of every nature and description including attorneys' fees and costs, presented, brought, or recovered against City for, or on account of any liability under any of the above -mentioned laws, which may be incurred by reason of Contractor's performance under this Agreement.

1.5. Non-discrimination. In performing this Agreement, Contractor shall not engage in, nor permit its agents to engage in, discrimination in employment of persons because of their race, religion, color, national origin, ancestry, age, physical handicap, medical condition, marital status, sexual gender or sexual orientation, except as permitted pursuant to Section 12940 of the Government Code. Such actions shall include, but not be limited to the following:
employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation and selection for training, including apprenticeship. Contractor agrees to post in conspicuous places, available to employees and applicants for employment, a notice setting forth provisions of this non-discrimination clause.

Contractor shall, in all solicitations and advertisements for employees placed by, or on behalf of Contractor shall state that all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, marital status, national origin, or mental or physical disability. Contractor shall cause the paragraphs contained in this Section to be inserted in all subcontracts for any work covered by the Agreement, provided that the foregoing provisions shall not apply to subcontracts for standard commercial supplies or raw materials.

1.6. Non -Exclusive Agreement. Contractor acknowledges that City may enter into agreements with other Contractors for services similar to the services that are subject to this Agreement or may have its own employees perform services similar to those services contemplated by this Agreement.

1.7. Delec ation and Assicnment. This is a personal service contract, and the duties set forth herein shall not be delegated or assigned to any person or entity without the prior written consent of City. Contractor may engage a subcontractor(s) as permitted by law and may employ other personnel to perform services contemplated by this Agreement at Contractor's sole cost and expense. All insurance requirements contained in this Agreement are independently applicable to any and all subcontractors that Contractor may engage during the term of this Agreement.

1.8. Confidentiality. Employees of Contractor in the course of their duties may have 2 TEAM ONE MANAGEMEMT
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access to financial, accounting, statistical, and personnel data of private individuals and employees of City. Contractor covenants that all data, documents, discussion, or other information developed or received by Contractor or provided for performance of this Agreement are deemed confidential and shall not be disclosed by Contractor without wriften authorization by City. City shall grant such authorization if disclosure is required by law. All City data shall be returned to City upon the termination of this Agreement. Contractor's covenant under this Section shall survive the termination of this Agreement.

2.0. COMPENSATION AND BILLING

2.1. Compensation. Contractor shall be paid in accordance with the fee schedule set forth in Exhibit "A." Contractor's total compensation shall not exceed a cumulative amount of Two Hundred Thirteen Thousand Five Hundred Twenty -Five Dollars ($213,525.00) over the initial three-year contract term.

2.2. Additional Services. Contractor shall not receive compensation for any services provided outside the scope of services specified in the Contractor's Proposal or which is inconsistent with or in violation of the provisions of this Agreement unless the City or the Project Manager for this Project, prior to Contractor performing the additional services, approves such additional services in writing. It is specifically understood that oral requests and/or approvals of such additional services or additional compensation shall be barred and are unenforceable.

Should the City request in writing additional services that increase the hereinabove described "SCOPE OF SERVICES", an additional fee based upon the Contractor's standard hourly rates shall be paid to the Contractor for such additional services. Such increase in additional fees shall be limited to 10% of the total contract sum. The City Administrator is authorized to approve a Change Order for such additional services. Any increases, taken either separately or cumulatively, that result in the Contract Sum exceeding ten percent (10%) of the Contract Sum must be approved by the City Council.

2.3. Method of Billing. Contractor may submit invoices to the City for approval on a progress basis, but no more often than two times a month. Said invoice shall be based on the total of all Contractor's services which have been completed to City's sole satisfaction. City shall pay Contractor's invoice within forty-five (45) days from the date City receives said invoice.

Each invoice shall describe in detail, the services performed, the date of performance, and the associated time for completion. Any additional services approved and performed pursuant to this Agreement shall be designated as "Additional Services" and shall identify the number of the authorized change order, where applicable, on all invoices.

2.4. Records and Audits. Records of Contractor's services relating to this Agreement shall be maintained in accordance with generally recognized accounting principles and shall be made available to City or its Project Manager for inspection and/or audit at mutually convenient times for a period of three (3) years from the Effective Date.

3.0. TIME OF PERFORMANCE

3.1. Commencement and Completion of Work. The professional services to be performed pursuant to this Agreement shall commence within five (5) days from the Effective Date of this Agreement. Said services shall be performed in strict compliance with the Project Schedule approved by City as set forth in Exhibit "A." The Project Schedule may be amended by mutual agreement of the parties. Failure to commence work in a timely manner and/or diligently pursue work to completion may be grounds for termination of this Agreement. 3 TEAM ONE MANAGEMEMT
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3.2. Excusable Delays. Neither party shall be responsible for delays or lack of performance resulting from acts beyond the reasonable control of the party or parties. Such acts shall include, but not be limited to, acts of God, fire, strikes, material shortages, compliance with laws or regulations, riots, acts of war, or any other conditions beyond the reasonable control of a party. If a delay beyond the control of the Contractor is encountered, a time extension may be mutually agreed upon in writing by the City and the Contractor. The Contractor shall present documentation satisfactory to the City to substantiate any request for a time extension.

4.0. TERM AND TERMINATION

4.1. Term. This Agreement shall commence on the Effective Date and continue for a period of 36 months, ending on July 31, 2024, unless previously terminated as provided herein or as otherwise agreed to in writing by the parties. The term of the agreement may be extended by two one-year term based on contractor performance and at the discretion of the City.

4.2. Notice of Termination. The City reserves and has the right and privilege of canceling, suspending or abandoning the execution of all or any part of the work contemplated by this Agreement, with or without cause, at any time, by providing at least fifteen (15) days prior written notice to Contractor. The termination of this Agreement shall be deemed effective upon receipt of the notice of termination. In the event of such termination, Contractor shall immediately stop rendering services under this Agreement unless directed otherwise by the City. If the City suspends, terminates or abandons a portion of this Agreement such suspension, termination or abandonment shall not make void or invalidate the remainder of this Agreement.

If the Contractor defaults in the performance of any of the terms or conditions of this Agreement, it shall have ten (10) days after service upon it of written notice of such default in which to cure the default by rendering a satisfactory performance. In the event that the Contractor fails to cure its default within such period of time, the City shall have the right, notwithstanding any other provision of this Agreement, to terminate this Agreement without further notice and without prejudice to any other remedy to which it may be entitled at law, in equity or under this Agreement.

The City shall have the right, notwithstanding any other provisions of this Agreement, to terminate this Agreement, at its option and without prejudice to any other remedy to which it may be entitled at law, in equity or under this Agreement, immediately upon service of written notice of termination on the Contractor, if the latter should:
a. Be adjudged a bankrupt;
b. Become insolvent or have a receiver of its assets or property appointed because of insolvency;
c. Make a general assignment for the benefit of creditors; d. Default in the performance of any obligation or payment of any indebtedness under this Agreement;
e. Suffer any judgment against it to remain unsatisfied or unbonded of record for thirty (30) days or longer; or
4 TEAM ONE MANAGEMEMT
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f. Institute or suffer to be instituted any procedures for reorganization or rearrangement of its affairs.

4.3. Compensation. In the event of termination, City shall pay Contractor for reasonable costs incurred and professional services satisfactorily performed up to and including the date of City's written notice of termination within thirty-five (35) days after service of the notice of termination. Compensation for work in progress shall be prorated based on the percentage of work completed as of the effective date of termination in accordance with the fees set forth herein. In ascertaining the professional services actually rendered hereunder up to the effective date of termination of this Agreement, consideration shall be given to both completed work and work in progress, to complete and incomplete drawings, and to other documents pertaining to the services contemplated herein whether delivered to the City or in the possession of the Contractor. City shall not be liable for any claim of lost profits.

4.4. Documents. In the event of termination of this Agreement, all documents prepared by Contractor in its performance of this Agreement including, but not limited to, finished or unfinished design, development and construction documents, data studies, drawings, maps and reports, shall be delivered to the City within ten (10) days of delivery of termination notice to Contractor, at no cost to City. Any use of uncompleted documents without specific written authorization from Contractor shall be at City's sole risk and without liability or legal expense to Contractor.

5.0. INSURANCE

5.1. Minimum Scope and Limits of Insurance. Contractor shall obtain, maintain, and keep in full force and effect during the life of this Agreement all the following minimum scope of insurance coverages with an insurance company admitted to do business in California, rated "A," Class X, or better in the most recent Best's Key Insurance Rating Guide, and approved by City:
(a) Broad -form commercial general liability, in a form at least as broad as ISO from #CG 00 01 04 13, including premises -operations, products/completed operations, broad form property damage, blanket contractual liability, independent contractors, personal injury or bodily injury with a policy limit of not less than One Million Dollars ($1,000,000.00), combined single limits, per occurrence. If such insurance contains a general aggregate limit, it shall apply separately to this Agreement or shall be twice the required occurrence limit. If Contractor maintains higher limits that the specified minimum limits, City requires and shall be entitled to coverage for the high limits maintained by the Contractor.
(b) Business automobile liability for owned vehicles, hired, and non -owned vehicles, with a policy limit of not less than One Million Dollars ($1,000,000.00), combined single limits, each incident for bodily injury and property damage.
(c) Workers' compensation insurance as required by the State of California and Employers Liability Insurance with a minimum limit of $1,000,000 per accident for any employee or employees of Contractor. Contractor agrees to waive, and to obtain endorsements from its workers' 5 TEAM ONE MANAGEMEMT
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compensation insurer waiving subrogation rights under its workers' compensation insurance policy against the City, its officers, agents, employees, and volunteers for losses arising from work performed by Contractor for the City and to require each of its subcontractors, if any, to do likewise under their workers' compensation insurance policies.

Before execution of this Agreement by the City, the Contractor shall file with the Public Works Director/City Engineer the following signed certification:

I am aware of, and will comply with, Section 3700 of the Labor Code, requiring every employer to be insured against liability of Workers' Compensation or to undertake self-insurance before commencing any of the work.

The Contractor shall also comply with Section 3800 of the Labor Code by securing, paying for and maintaining in full force and effect for the duration of this Agreement, complete Workers' Compensation Insurance, and shall furnish a Certificate of Insurance to the Public Works Director/City Engineer before execution of this Agreement by the City.

The City, its officers and employees shall not be responsible for any claims in law or equity occasioned by failure of the Contractor to comply with this section.

Neither the CITY nor any of its elected or appointed officials, officers, agents, employees, or volunteers makes any representation that the types of insurance and the limits specified to be carried by Contractor under this Agreement are adequate to protect Contractor.

If Contractor believes that any such insurance coverage is insufficient, Contractor shall provide, at its own expense, such additional insurance as Contractor deems adequate.

5.2. Endorsements. The commercial general liability insurance policy and business automobile liability policy shall contain or be endorsed to contain the following provisions as worded below:
(a) Additional insureds: "The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are addition- al insureds with respect to: liability arising out of activities performed by or on behalf of the Contractor pursuant to its contract with the City; products and completed operations of the Contractor; premises owned, occupied or used by the Contractor; automobiles owned, leased, hired, or borrowed by the Contractor."
(b) Notice: "Contractor shall provide immediate written notice if (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; (3) or the deductible or self -insured retention is increased. In the event of any cancellation or reduction in coverage or limits of any insurance, Contractor shall forthwith obtain and submit proof of substitute insurance. Should Contractor fail to immediately procure other insurance, as specified, to substitute for any canceled policy, the City may procure such insurance at Contractor's sole 6 TEAM ONE MANAGEMEMT
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cost and expense."
(c) Other insurance: "The Contractor's insurance coverage shall be primary insurance as respects the City of Placentia, its officers, officials, agents, employees, and volunteers. Any other insurance maintained by the City of Placentia shall be excess and not contributing with the insurance provided by this policy."
(d) Any failure to comply with the reporting provisions of the policies shall not affect coverage provided to the City of Placentia, its officers, officials, agents, employees, and volunteers.
(e) The Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability.

5.3. Deductible or Self -Insured Retention. If any of such policies provide for a deductible or self -insured retention to provide such coverage, the amount of such deductible or self -insured retention shall be approved in advance by City. No policy of insurance issued as to which the City is an additional insured shall contain a provision which requires that no insured except the named insured can satisfy any such deductible or self -insured retention.

5.4. Certificates of Insurance. Contractor shall provide to City certificates of insurance showing the insurance coverages and required endorsements described above, in a form and content approved by City, prior to performing any services under this Agreement. The certificates of insurance and endorsements shall be attached hereto as Exhibit "B" and incorporated herein by this reference.

5.5. Non-limitinc. Nothing in this Section shall be construed as limiting in any way, the indemnification provision contained in this Agreement, or the extent to which Contractor may be held responsible for payments of damages to persons or property.

6.0. GENERAL PROVISIONS

6.1. Entire Agreement. This Agreement constitutes the entire agreement between the parties with respect to any matter referenced herein and supersedes any and all other prior writings and oral negotiations. This Agreement may be modified only in writing and signed by the parties in interest at the time of such modification. The terms of this Agreement shall prevail over any inconsistent provision in any other contract document appurtenant hereto, including exhibits to this Agreement.

6.2. Representatives. The City Administrator or his or her designee shall be the representative of City for purposes of this Agreement and may issue all consents, approvals, directives and agreements on behalf of the City, called for by this Agreement, except as otherwise expressly provided in this Agreement.

Contractor shall designate a representative for purposes of this Agreement who shall be authorized to issue all consents, approvals, directives and agreements on behalf of Contractor called for by this Agreement, except as otherwise expressly provided in this Agreement.
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6.3. Pro ect Managers. City shall designate a Project Manager to work directly with Contractor in the performance of this Agreement. It shall be the Contractor's responsibility to assure that the Project Manager is kept informed of the progress of the performance of the services and the Contractor shall refer any decision, which must be made by City, to the Project Manager. Unless otherwise specified herein, any approval of City required hereunder shall mean the approval of the Project Manager.

Contractor shall designate a Project Manager who shall represent it and be its agent in all consultations with City during the term of this Agreement and who shall not be changed by Contractor without the express written approval by the City. Contractor or its Project Manager shall attend and assist in all coordination meetings called by City.

6.4. Notices. Any notices, documents, correspondence or other communications concerning this Agreement, or the work hereunder may be provided by personal delivery, facsimile or if mailed, shall be addressed as set forth below and placed in a sealed envelope, postage prepaid, and deposited in the United States Postal Service. Such communication shall be deemed served or delivered: a) at the time of delivery if such communication is sent by personal delivery; b) at the time of transmission if such communication is sent by facsimile; and c) 72 hours after deposit in the U.S. Mail as reflected by the official U.S. postmark if such communication is sent through regular United States mail.

IF TO CONTRACTOR: IF TO CITY:

Team One Management, Inc.
27324 Camino Capistrano unit 209
Laguna Niguel, CA 92677
Tel: 949-348-144-1446
Fax: 949-348-1722
City of Placentia
401 E. Chapman
Placentia, CA 92870
Tel: 714-993-8245
Attn: Mike Akhavan, President Attn: Joel Cardenas, Public Works Superintendent

6.5. Attorneys' Fees. In the event that litigation is brought by any party in connection with this Agreement, the prevailing party shall be entitled to recover from the opposing party all costs and expenses, including reasonable attorneys' fees, incurred by the prevailing party in the exercise of any of its rights or remedies hereunder or the enforcement of any of the terms, conditions, or provisions hereof.

6.6. Governing Law. This Agreement shall be governed by and construed under the laws of the State of California without giving effect to that body of laws pertaining to conflict of laws. In the event of any legal action to enforce or interpret this Agreement, the parties hereto agree that the sole and exclusive venue shall be a court of competent jurisdiction located in Orange County, California. Contractor agrees to submit to the personal jurisdiction of such court in the event of such action.

6.7. Assignment. Contractor shall not voluntarily or by operation of law assign, transfer, sublet or encumber all or any part of Contractor's interest in this Agreement without City's prior written consent. Any attempted assignment, transfer, subletting or encumbrance shall be void and shall constitute a breach of this Agreement and cause for termination of this Agreement. Regardless of City's consent, no subletting or assignment shall release Contractor 8 TEAM ONE MANAGEMEMT
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of Contractor's obligation to perform all other obligations to be performed by Contractor hereunder for the term of this Agreement.

6.8. Indemnification and Hold Harmless. Contractor agrees to defend, indemnify, hold free and harmless the City, its elected and appointed officials, officers, agents and employees, at Contractor's sole expense, from and against any and all claims, demands, actions, suits or other legal proceedings brought against the City, its elected and appointed officials, officers, agents and employees arising out of the performance of the Contractor, its employees, and/or authorized subcontractors, of the work undertaken pursuant to this Agreement. The defense obligation provided for hereunder shall apply whenever any claim, action, complaint or suit asserts liability against the City, its elected and appointed officials, officers, agents and employees based upon the work performed by the Contractor, its employees, and/or authorized subcontractors under this Agreement, whether or not the Contractor, its employees, and/or authorized subcontractors are specifically named or otherwise asserted to be liable. Notwithstanding the foregoing, the Contractor shall not be liable for the defense or indemnification of the City for claims, actions, complaints or suits arising out of the sole active negligence or willful misconduct of the City. This provision shall supersede and replace all other indemnity provisions contained either in the City's specifications or Contractor's Proposal, which shall be of no force and effect.

6.9. Independent Contractor. Contractor is and shall be acting at all times as an independent contractor and not as an employee of City. Contractor shall have no power to incur any debt, obligation, or liability on behalf of City or otherwise act on behalf of City as an agent.

Neither City nor any of its agents shall have control over the conduct of Contractor or any of Contractor's employees, except as set forth in this Agreement. Contractor shall not, at any time, or in any manner, represent that it or any of its or employees are in any manner agents or employees of City. Contractor shall secure, at its sole expense, and be responsible for any and all payment of Income Tax, Social Security, State Disability Insurance Compensation, Unemployment Compensation, and other payroll deductions for Contractor and its officers, agents, and employees, and all business licenses, if any are required, in connection with the services to be performed hereunder. Contractor shall indemnify and hold City harmless from any and all taxes, assessments, penalties, and interest asserted against City by reason of the independent contractor relationship created by this Agreement. Contractor further agrees to indemnify and hold City harmless from any failure of Contractor to comply with the applicable worker's compensation laws. City shall have the right to offset against the amount of any fees due to Contractor under this Agreement any amount due to City from Contractor as a result of Contractor's failure to promptly pay to City any reimbursement or indemnification arising under this paragraph.

6.10. PERS Eligibility Indemnification. In the event that Contractor or any employee, agent, or subcontractor of Contractor providing services under this Agreement claims or is determined by a court of competent jurisdiction or the California Public Employees Retirement System (PERS) to be eligible for enrollment in PERS as an employee of the City, Contractor shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PERS benefits on behalf of Contractor or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of City.

Notwithstanding any other agency, state or federal policy, rule, regulation, law or ordinance to the contrary, Contractor and any of its employees, agents, and subcontractors providing service under this Agreement shall not qualify for or become entitled to, and hereby 9 TEAM ONE MANAGEMEMT
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agree to waive any claims to, any compensation, benefit, or any incident of employment by City, including but not limited to eligibility to enroll in PERS as an employee of City and entitlement to any contribution to be paid by City for employer contribution and/or employee contributions for PERS benefits.
611. Cooperation. In the event any claim or action is brought against City relating to Contractor's performance or services rendered under this Agreement, Contractor shall render any reasonable assistance and cooperation which City might require.

6.12. Ownership of Documents. All findings, reports, documents, information and data including, but not limited to, computer tapes or discs, preliminary notes, working documents, files and tapes furnished or prepared by Contractor or any of its subcontractors in the course of performance of this Agreement, shall be and remain the sole property of City. Contractor agrees that any such documents or information shall not be made available to any individual or organization without the prior consent of City but shall be made available to the City within ten (10) days of request or within ten (10) days of termination. Any use of such documents for other projects not contemplated by this Agreement, and any use of incomplete documents, shall be at the sole risk of City and without liability or legal exposure to Contractor. City shall indemnify and hold harmless Contractor from all claims, damages, losses, and expenses, including attorneys' fees, arising out of or resulting from City's use of such documents for other projects not contemplated by this Agreement or use of incomplete documents furnished by Contractor.

Contractor shall deliver to City any findings, reports, documents, information, data, preliminary notes and working documents, in any form, including but not limited to, computer tapes, discs, files audio tapes or any other Project related items as requested by City or its authorized representative, at no additional cost to the City. Contractor or Contractor's agents shall execute such documents as may be necessary from time to time to confirm City's ownership of the copyright in such documents.

6.13. Public Records Act Disclosure. Contractor has been advised and is aware that this Agreement and all reports, documents, information and data, including, but not limited to, computer tapes, discs or files furnished or prepared by Contractor, or any of its subcontractors, pursuant to this Agreement and provided to City may be subject to public disclosure as required by the California Public Records Act (California Government Code Section 6250 et seq.).

Exceptions to public disclosure may be those documents or information that qualify as trade secrets, as that term is defined in the California Government Code Section 6254.7, and of which Contractor informs City of such trade secret. The City will endeavor to maintain as confidential all information obtained by it that is designated as a trade secret. The City shall not, in any way, be liable or responsible for the disclosure of any trade secret including, without limitation, those records so marked if disclosure is deemed to be required by law or by order of the Court.

6.14. Conflict of Interest. Contractor and its officers, employees, associates and subcontractors, if any, will comply with all conflict of interest statutes of the State of California applicable to Contractor's services under this agreement, including, but not limited to, the Political Reform Act (Government Code Sections 81000, et seq.) and Government Code Section 1090. During the term of this Agreement, Contractor and its officers, employees, associates and subcontractors shall not, without the prior written approval of the City Representative, perform work for another person or entity for whom Contractor is not currently performing work that would require Contractor or one of its officers, employees, associates or subcontractors to abstain from a decision under this Agreement pursuant to a conflict of interest statute.
10 TEAM ONE MANAGEMEMT
Rev. 06/2018

6.15. Responsibility for Errors. Contractor shall be responsible for its work and results under this Agreement. Contractor, when requested, shall furnish clarification and/or explanation as may be required by the City's representative, regarding any services rendered under this Agreement at no additional cost to City. In the event that an error or omission attributable to Contractor occurs, then Contractor shall, at no cost to City, provide all necessary design drawings, estimates and other Contractor professional services necessary to rectify and correct the matter to the sole satisfaction of City and to participate in any meeting required with regard to the correction.

6.16. Prohibited Employment. Contractor will not employ any regular employee of City while this Agreement is in effect.

6.17. Order of Precedence. In the event of an inconsistency in this Agreement and any of the attached Exhibits, the terms set forth in this Agreement shall prevail. If, and to the extent this Agreement incorporates by reference any provision of any document, such provision shall be deemed a part of this Agreement. Nevertheless, if there is any conflict among the terms and conditions of this Agreement and those of any such provision or provisions so incorporated by reference, the conflict shall be resolved by giving precedence in the following order, if applicable: This Agreement, the City's Request for Proposals, the Contractor's Proposal.

6.18. Costs. Each party shall bear its own costs and fees incurred in the preparation and negotiation of this Agreement and in the performance of its obligations hereunder except as expressly provided herein.

6.19. No Third Party Beneficiary Richts. This Agreement is entered into for the sole benefit of City and Contractor and no other parties are intended to be direct or incidental beneficiaries of this Agreement and no third party shall have any right in, under or to this Agreement.

6.20. Headings. Paragraphs and subparagraph headings contained in this Agreement are included solely for convenience and are not intended to modify, explain or to be a full or accurate description of the content thereof and shall not in any way affect the meaning or interpretation of this Agreement.

6.21. Construction. The parties have participated jointly in the negotiation and drafting of this Agreement. In the event an ambiguity or question of intent or interpretation arises with respect to this Agreement, this Agreement shall be construed as if drafted jointly by the parties and in accordance with its fair meaning. There shall be no presumption or burden of proof favoring or disfavoring any party by virtue of the authorship of any of the provisions of this Agreement.

6.22. Amendments. Only a writing executed by the parties hereto or their respective successors and assigns may amend this Agreement.

6.23. Waiver. The delay or failure of either party at any time to require performance or compliance by the other of any of its obligations or agreements shall in no way be deemed a waiver of those rights to require such performance or compliance. No waiver of any provision of this Agreement shall be effective unless in writing and signed by a duly authorized representative of the party against whom enforcement of a waiver is sought. The waiver of any right or remedy in respect to any occurrence or event shall not be deemed a waiver of any right 11 TEAM ONE MANAGEMEMT
Rev. 06/2018

or remedy in respect to any other occurrence or event, nor shall any waiver continuing waiver.
constitute a

6.24. Severity If any provision of this Agreement is determined by competent jurisdiction to be unenforceable in any circumstance, such determination affect the validity or enforceability of the remaining terms and provisions a court of offending provision in any other circumstance. Notwithstanding the foregoing, shall fnot Agreement, based upon the substantial benefit of the bargain for any hereof or of the impaired, which determination made by the presiding court or arbitrator of competent g if the value of this shall be bindin p g p party is msdicti n
g, then both arties a ree to substitute such rovision(s) through good dicaith negotiations.
faith

6.25. Counter This Agreement may be executed in one or more counterparts, each of which shall be deemed an original. All counterparts shall be construe shall constitute one agreement.
d together and

6.26. Corporate Authority. The persons executing
parties hereto warrant that they are duly authorized to execute this Agreement this Agreement on behalf of the
Agrees and that by doing so the parties hereto are formally bound to the r Agreement. on behalf of said
provisions of this
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their respective authorized officers, as of the date first above written. 12 TEAM ONE MANAGEp4EMT
Rev. 06/2018

CITY OF PLACENTIA,
A municipal corporation
5fnien R. Arrula. City � i) inistrator
ATTEST:
for
©I� 0
Robert S, McKinnell, City Clerk and ex -officio Clerk
of the City of Placentia

CONTRACTOR
/.

Signature
Name and Title Lam"
3 1 8s6c
Social Security or Taxpayer ID Number
APPROVED AS TO FORM:

Christian L. Bettenhausen, City Attorney
APPROVED AS TO INSURANCE:
-3
Ropanna Ramirez, Depu yt
��y Administrator
APPRC ED AS TO CONTENT:

Joel CardenT, Project Manager
DEPARTMEN"I'Al Al4"1-20 AL:

Luis Estevez, Deputy City A lministrator
13 Date: `d2-1
Date: ILL/ 2 0
Date:

Date: Q(D -02-&Z-/
Date:

Date: 7,.
1EAM ONE MANAGE:WWI
Rev, 08/2018

EXHIBIT A

CONTRACTOR'S PROPOSAL AND SCOPE OF WORK
14 TEAM ONE MANAGEMEMT
Rev. 06/2018

City of Placentia
Calif°tilia
131l) FOR
Park Restroom Janitorial Services
PARK
Kraemer Park
201 N. Bradford
Avenue
McFadden
Park
974 S. Melrose Avenue
Tuffree Park
2I01 N. Tuffree Boulevard
Koch Park 2210 N.

Valencia
Avenue
Vaqueros Park 1200 N.

Carlsbad Street
Arroyo Verde Park 1001 E. Palm
Drive
Atwood Park
1701 Atwood Avenue
Placentia
Champions
Sports Park (2) restroom north and south
505 Jefferson
EST. QTY
365
365
365
365
365
365
365
365
Grand Total Bid Amount:

Page C-2

UNIT PRICE
4)a -so

ITEM COST
7S7 oci

EXHIBIT B

CERTIFICATES OF INSURANCE AND ENDORSEMENTS
15 TEAM ONE MANAGEMEMT
Rev. 06/2018

A .---- �" CERTIFICATE OF

LIABILITY INSURANCE
THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION
oaTe IMMrDDIYYyY)

ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS BELOW.THISCERTIFICATE OESOT IRMN VELY OE DOES
NOT LYAMECONSTITUTED, A CONTRACT EXTEND OR 00!16/2020
BRELOW. THIS OR P OF IN, AURA THECERTIFICATE

ALTER WE N THE ISSUING
BY THE
IMPURTANi; II the corlll)cRte holder Is an ADDITIONAL INSURED,

BETWEEN THE ISSUING INSURER(S), A POLICIES
If SUBROGATION IS AUTHORIZED
Idle certificate does not
subject to (he terms end conditions of ththe e IIcH(les) must have ADDITION confer rlpflls to the ce111flcste holder In lieu of suchIlocy,I�ertalnoP (�11es AI. INSURED provisions or do endorsed.

PRODUCER
TTley require an endorsement
Insurance Solutions A statement on
O'rA•T
License*0748539 rrauE Robin Holloway
Pti.__
(O''�G (948) 348.74an �-
33302 Valle raw o..,,- ___ l.. No. E.,I,
San Jul

INSURED
Team One Management Inc
PO Box 203
Lake Forest
CA 02875
__ INSURE NISI M4'WtuiNO COVERAOE
„surreqA ; West AUloncan Ins Co.
„NStumFA B California AU10moblle Insurance Co.

LusURER C : CNA Surety
).,SURER D :

COVERAGES CA 92809
CERTIFICATE NUMBER: 20.21 Vsu RJR E c
N�IlHPR F

THIS IS TO CERTIFY THAT TIME P
INDICATED. NOTWITHSTANDING
OFINSUfv1\CE LISTED BELOWCERTIFICATE BE I !AVE BEEN ISSUED TO THE INSURED NAMED REVISION NUMBER:

EXCLUSIONS AND CONDITIONS O SUCH POLICIESSUED OR MAY PERTAIN, . TERM

CONDITION OF ANY CONTRACT ABOVE
INSURANCE AFFORDED C E CRIBSOTHEDOREINSTUBJ FOR THE POLICY.

TEPERIOD
itiSii BY THE POLICIES DESCRIBED RESPECT TOVVHjCHTHIS
Lrn TYPE OF INSURANCE ADOL Sean --_W<d MAY HAVE BEEN REDUCED BY PAID C HEREIN IS SUBJECT TO ALL THE TERMS, X COMMERCIAL GENERA L LIAR�,TM Lri. ry lam? _..._ •.... ..` POLrCr RUNNER AIMS. riiSC/e'i e - voLZT Efd% N.MmILyYYrI 1M llIoiY. YYYI _� CLAIMS -MADE a OCCUR A
-----
I.

GUI POLICY •�� J'C U APP LOC
ER
OHIllS

AUTOMOBILE LIABILITY

X ANY AUTO

B OWNED

AUTOS ONLY
HIRED

AUTOS ONLY

SCHEDULED
AUTOS
NON•OWNED

AUTOS ONLY
UMBRELLA LIAR j
EXCESS LIAR i
OCCUR
CLMMg.MAOF.

DAD RETENTION 3

WORKERS COMPENSATION

ANC EMPLOYERS' L AI IUTY
ANY PROPRIETOIUPArr TfVEf1IEAEC U:iVE Y/N
OI°FICrrrMEMQEIi EXCLUDED? ❑
(Mandatory InEN)
II yo 3, dutC,l5u „nd.

OPSCRIPTION Or OPERATIONS Wilt,.

NIA
BKW55746613
8A0400000098g6
NAIC ■
44393 -'
—�._._
38342,
524126 __
--- LIMI18
EACH OCCURRENCE r I,il00.U0U
nnr(AILSF51fa+ucr ,y^,, L 500000
0 7124 /2 0 2 0 1,1•71, YAP fhr, anu u,raw S 10,000 — — — 07/24/2021
PERSONAL 6 14.)V INJURY 127A:.000 Q • � —"
t . 00
GENE.NAI ACiNITEGAT� O,O
PIIODUCIS.__COMRTIP A1;;; $ 2,000,000
CUrdINNL�� EE LVdlf

1.000.000
BODILY INJURY (Per parson) j 10/03/2020 10/03/2021
BODILYINJURY (Panccldana
I'Nf.1PEliT iA-A Wa
act' rN:CUrIrrL`_
AL:O EGATF
_____-L111
-
_-___0.„, Uiir. 1.7.________I
_ C L UIE,;J y'PL: E . E� f OYEF. a
C Jalntoriat Bond Including Employee �4—Dishonesty E Disc lSE . P(L CY a:,ur s 80410585 Link 5100,000 —" '—
-
07/24/2020 07/24/2021
DESCRIPTION OF OPERATIONS, LOCATIONS 1 VEHICLES (ACORD lei, Additional Rams Ms Sch.tlub, mop De snicked If mere apace I. RNIKA d The City of Placentia and Its elected and D —
ofr
ors,
ls.

RFOion b f of hie Nam Named
Insured
agents. pursuant
nt to its
col Ea volunteers are products insureds with orespectsrato5 CI arising out of Endliles perfuracted and O or the Named Insured; promises Owned. Occupied or used by the Named Insured; Automobiles owned, leased, hired, cr borrow by the Named Y on behalfaf Ih0 Namud Insured pursuant to ds contract wilt. the Cily; products and completed operations of Insurance coverage shall be primary Insurance as respects the City of Placentia. Its officers. officials, n gents, employees, and volunteers. A11isured. This
Insurance maintained by pie Oily of Placenlia shall be excess and no) conlrlbulory y Other

CERTIFICATE HOLDER
City of Placentia Attn: City Adminlalralor
401 E. Chapman
Place n lie
ACORD 26 (2016/03)

CANCELLATION

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
CA 92870
Thu ACORD name and are registered marks of ACORD
logo © 1988'2015 ACORD CORPORATION. All rights reserved,

CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MA CON 0 FN ERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Ir nuo0/YyyY)

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PO LICIES

ER OF INFORMATION ONLY A S
07/1312020
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONT RAC'f BETWEEN THE ISSUING INSURER(S), AUTHORIZED
IMPORTANT: If lho certificate holdor le en ADDITIONAL INSURED, the pOtteylee haveADDITIONAL INSURED provlslona or ha (indorsed.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 Ileu of suchandorsament(s)

PRODUCER
Capllal Providers Insurance cONrncr NnrnE, Vesta Grigoryan License #OH52316
20750 Venture Blvd.. Sle 305
Woodland Hills

INSURED
Team One Management
27324 Camino Capistrano
209
Laguna Niguel
PHONE
I_� J�yF•l)VOShI ) 676.0016 L/ �: Plq�: (
AODRLSs: 81(dlcp s rou com ) 676.0015
818 .._.__ _ .. ._.. _
CA 91364 PNEURERISIAFFORDIND COVERAGE ___-
INSURER A . National Casualty Insurance Company
INSURER e ;
INSURER C :

INSURER 0:

INSURER E:

COVERAGES CA e2677
CERTIFICATE NUMBER: 20 21 WC INSURER F:

THIS IS 1 O CERTIFY THAT THE POLICIES OF INSURANCE LISTED DELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT N TH REVISION CT TO 1ICH TtIIS

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

LT!r TYPEOFINSUtiANC! ADDCSUON """—
N!in VND POLICY ErE— -ii f
COMMSRC4lf7ENERALLIABILITY L_ —_.POLICY PRAISER MatiODIYYYY I r,y,tatmr a. t--�"�--- LIMITS
E XI

CLAIMS WO,
_� C:CCUt9
l:t_+rLnGG1+E(r+v l: LIMIT'PPUES PER:

OLICY PRO.

P
IECT ❑ LOC
O)HEH

AUTOMOMLE LIAIIUTY

AMY AUTO

OWNED SCHEDULED

AUI(W UNLY AUTOS

HIRED NON -OWNED

AUTOS ONLY AUTOS ONLY

UMBRELLA LIAS

EXCESS LAB
Jag)] RETENTION_;

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
A ANY PROPRIE roiePARTNERrEXECIIIIVE
Ui fICGHr6'Ft'111ER EXCLUoro7
th:ondalary in mu
II vac aasnll+e wider
DF.SCRIPTION OF OPERATIONS balaw
OCCUR
CI AIMS•MAIIE
YIN
N/AI I WCNCC31242400
07/24/2020
07/24/2021
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES )ACORD tai, Addltlontl Remarks SchedWe, maybe attached Omani spas Is required) City of Placentia, ifs elected and appointed boardS, officials, agents, employees, and volulaers are named as addtional InsureU

CERTIFICATE HOLDER
City of Placentia
401 E. Chapman
Placentia
ACORD 25 (2016/03)

CANCELLATION
EACH OCCURNE NCE 3
D7;4AGF TD7tERTm"—
IrNPk!I.1'S11_a......rancel,
mED EXV aar
IA-nv one sort{
1>L•Ii50leAl A ARV INJURY S
GENERAL AGGREGATE.,`
PROGUCrS-COMINOPACC
tfar—aRJEOS K41 E LRdlt
.LI daarl,.r�nn
BOJILY INJURY (Pnr parson)
- 5
8001LY INJURY (Per acd(1UNI
PROPER' 5' imuAiiL
EACh OCCURRENCE

AGGREGATE
NAIL M
$
3 El. € CH CCIDENT t t,00a,006 _
E.L DISLISE - LA EMPLOYEE S 1,000,000
EL Dl;rµ-F. POLICY LIMIT S 1,000,000

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THERCOF NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS,

AUTHORIZED REPRESENTATIVE
CA 92870
5 ACORD CORPORATION. All rights reserved,
The ACORD name and logo are registered marks of ACORD

Policy Number: BA040000009648
Insured: Teem One Management, Inc.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREF ULLY.

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) li. 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/LEASE GAP COVERAGE
Xl. 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 MCABS100817-Cq
Copyright 2017 Mercury Insurance Services, LIC. AU rights reserved.

Includes copyrighted material of Insurance Services Office, Inc., with its Permission

Page 1 ends

I• NEWLY ACQUIRED OR FORMED ENTITY (Broad Form Named Insured) SECTION II - LIABILITY COVERAGE, A. Covera a 1.
d. Any business entity newt g � Who Is An Insured, the following is added:
y 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 fol/owing 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.
e An „ Coverage, 1. Who Is An Insured, the following is added:

Yemployee" of yours is an "insured" while usin
own, hire or borrow in your business or g a covered "auto" you don't your personal affairs,
o
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 " ro in effect during the policy period ,,, pnsured" for 1petty damage" occurs and that is damages to which this Insurance applies and only to the ext nty ot that pCoverage, but only for
organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. P
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, while performing duties related to the conduct of with your permission, V SUPPLEMENTARY PAYMENTS Your bus business.

SECTION II — LIABILITY COVERAGE, A.

Payments, Sub Coverage, 2. Coverage Extensions, a. Supplementary paragraphs (2) and (4) are replaced by the following:
(2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law furnish these bonds.
violations) required because of an "accident" we cover. We are not obligated to (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.

BUSINESS AUTO COVERAGE FORM
MCA85100817-CA
Copyright 2017 Mercury Insurance Services, LLC, All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc.,with Its Permission

Page 2 of 6 ends

VI. FELLOW EMPLOYEE COVERAGE:

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 Comprehensive or Specified Causes of Loss Coverage. carry either transportation expenses incurred during the g We will pay for temporary ending, regardless of the policy's expiration, when dthe beginning i ' auto" is rhours eturned neder the o theft 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 Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis 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.

MCA85100817LA
Copyright 2o17 Mercury Insurance Services, LLC. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc., with Its Permission

Page 3 of 6 ends

Xl. 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 III -PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added:

If two or more "company" policies or coverage forms a

1. If the applicable Business Auto deductible is the smallest, it will be waived; or 2 ly to the same accident:

If the applicable Business Auto deductible is not the srnallest, it will be reduced b the amount of the smallest deductible; or

3. If the loss involves two or y
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.

P
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", "accident" applies only when the "accident" is known to:
you must notify us of an
(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.

MCA85100817-CA

LOAN/LEASE GAP COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE C. Limit of Insurance, the following is added:
'% In the event of a "total loss" to a covered "auto" shown in the schedule or declarations which Collision and Comprehensive Coverage a I ,
the lease or loan for that covered "auto," less: pp y we Well pay any unpaid amount due on a. The amount paid under the Physical Damage Coverage Section of the policy; and
b. Any:
(1) Overdue (ease/loan payments at the time of the "loss" (2) Financial penalties imposed under a (ease 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.

The most we will pay under Auto Loan/Lease Gap
Coverage for
the actual cash value of that insured auto at thet me of the loss. an insured auto is 25% of Copyright 2017 Mercury Insurance Services, LLC. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc,, with Its Permission

Page 4 of 6 ends

XIV. WAIVER OF SUBROGATION
SECTION IV- BUSINESS AUTO CONDITIONS, A. Loss Conditions, S. Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following:

S. 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, 8.

GeneMisrepresentation, or Fraud, the following is added:
dded ral Conditions, 2, Concealment,
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 This provision does not affect our right to collect additional premiu exercise c
m or exer iseourg right
of cancellation or non -renewal.

XVI. EMPLOYEE HIRED AI.RO 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 Dama
'autos" you own; Se Coverage, the following are deemed to be covered

1. Any covered "auto" you (ease, hire, rent or borrow; and

2. Any covered "auto" hired or rented b
your "employee" nder a contract in
that individual "employee's" name, with your perrm s onU 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, S. 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.

MCA85100817-CA
Copyright 2017 Mercury Insurance Services, LLC. All rights reserved, Includes copyrighted material of Insurance Services Office, Inc., with Its Permission

Page 5 of 6 ends

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 period of 30 days or less; and for a
(2) The "insured's" responsibility to pay damages is determined in a "suit" the merits, in the United States of America on
, the territories and
of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. P sessions

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 onl
other bodily injury, sickness, or disease. Y when the mental anguish arises from MCAB5100817.<A
Copyright 2017 Mercury Insurance Services, LLC. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc., with its Permission

Page 6 of 6 ends

Policy Number BKW55749813

COMMERCIAL GENERAL UABILITY
THIS ENDORSEMENT CHANGES THE POLICY. p CG 10 04 13
LEASE READ IT CAREFULLY.

COMMERCIAL GENERAL LIABILITY EXTENSION
This endorsement modtfles Insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
B

NON -OWNED AIRCRAFT

NON -OWNED WATERCRAFT

PROPERTY DAMAGE LIABILITY - ELEVATORS
EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property D MEDICAL PAYMENTS EXTENSION amage)
INDEX

EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B

ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT

PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE"

WHO IS AN INSURED - INCIDENTAL

SRD - FELLOW NCI MEDICAL ERRORS/MALPRACTICE AND WHO IS AN

EMPLOYEEINUE EXTENSION - MANAGEMENT EMPLOYEES

NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES

FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES

KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT

LIBERALIZATION CLAUSE

BODILY INJURY REDEFINED

EXTENDED PROPERTY DAMAGE

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST

WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH T OTHERS TO US YOU
CG 88 10 04 13
PAGE
2 2
2 2
3 3
3 5
8 6
7 7
7 7
7 8
8 Includes co 2013Libur(y Mutual Ineurunce
PYrighted material of Insurance Services Office, Inc., with ils permission.

Page 7 ends

With respect to coverage afforded by this endorsement, the the endorsement.
the
of the policy apply unless modified by
A. NON -OWNED AIRCRAFT
Under Pararyr�rph 2. Exclusions of Section I -
UnderJon g, /1lreraft, Auto Or Watercraft Coverage A - Borlll exclus does net apply to an airs Y Ift pro And Property Damage

1. It is not owned by provided:

Liability,
any insured;
2, if is hired, chartered or loaned with a trained paid crew; _ 3• The pilot in command holds a currently effective certificate issued by the duly constituted authority of the United Status of America or Canada, designating her oro r him property for a charge a commercial or airline pilot; and

4. ft is not being used to carry persons or
However. the insurance afforded by this provision does not apply =• valid and i:vllcolible
trt tacos insurance. whether primer li if their, is available to the insured of this policy), contingent or on Y. extras (other Ilion insurance written to apps other this provision.
any, other b;r;;fs: that would also apply •I
1+ I U y to the to covered specifically
B. NON -OWNED WATERCRAFT
Under Paragraph 2. Exclusions of Section t -
Subparagraph (h)2. exclusion Coverage A - Bodily I
g. Aircraft, Auto Or Watercraft Is re llary And Property Damage Liability, This exclusion does not apply to: P cad by the following:
(2) A watercraft you do not own that is:
(a) Less than 52 feet long; and
(b) Not being used to carry persons or pro
C. PROPERTY P perh' for a charge.

DAMAGE LIABILITY - ELEVATORS
1 Under Paragraph 2• Exclusions of Section 1 _
Under
Subparagraphs 3 ,(4) nd Coverage A - Bodily Injury Liabil- ity, damage" results frorO( use o (6) of exclusion J.Damage D magepurpose or ro And Property I uch
vehicle U To Property provision,
not apply DamageLlude
lifts. Vehicle lifts are lifts or twists used in automobile pP ti If such "property a provision, elevators do not include

2. The following is added to Section 1V - service or re Insurance, Para Commercial General Liability nary operations Graph b. Excess Insurance; ty Conditions,
The insurance Condition 4. Other
whether afforded by this provision of this endorsement is excess primary, excess contingent or on any other basis.

D. EXTENDED DAMAGE TO ov®f any property insurance,
RTY
If Damage To Premises RentedToYou RlsNnoE otherwise
D O YOU (Tenant's Property Damage)
1, Under P excluded from this Coverage
Paragraph Z. Exclusions of Section I - Coverage Part;
a• The fourth from the last paragraph g A ' Bodily Injury and Property Damage Liability:
of exclusion J. Damage To Property Is replaced by the follow- ing:

Paragraphs (1), (3) and (4) of this exclusion
by fire, lightning,1), expland
(4) smoke, do not apply to "property
or leakage from an auto,atic firecprotection (othst m) damage (I) Premises rented to you fora period of 7
(II) Contents or fewer system) to:
that you rent or lease as part of a consecutive days; or more than 7 days. premises rental or lease
agreement for a period of
Paragraphs (1), (3) and (4) of this exclusion
do not a
period of 7 or fewer co utiv to "property damage" to contents of premises rented lo you for a
A anseparate limit nsecutive days
surra of insurance applies to this coverage as described In Section III - Limits of
CG 88 10 04 13
Includes co r' ® 2013 Liberty Mutual Insurance
py ighted material of Insurance Services Office, Inc., with its permission.

Pace 2 of 8

b. The last paragraph of subsection 2. Exclusions is replaced by the following:

Exclusions c. through n. do not apply to damage by firer, lightning, explosion, smoke or Iuakaye from automatic fire protection systems to prernises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section In - Limits Of Insurance.

2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following:

6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to:
a. Any one premise:
(1) While rented to you: or
(2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire. lightning, explosion, smoke or leakage from automatic protection sys- tems; or
b. Contents that you rent or lease as part of a premises rental or lease agreement.

3. As regards coverage provided by this provision D. EXTENDED DAMAGE TD PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following:

9.a. A contract fora lease of premises, However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion. smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupiod by you with the permission or the owner, or for damage to contents of such prernises that are included In your premises rental or lease agreement, is not an "insured contract".

E. MEDICAL PAYMENTS EXTENSION
If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows:

Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medlcal Payments, Subparagraph (b) of Paragraph a, is replaced by the following:
(b) The expenses are Incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B

1. Under Supplementary Payments • Coverages A and B, Paragraph 1.b. is replaced by the following:
b. Up to 53,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do nol nave to furnish these bonds.

2. Paragraph 1.d. Is replaced by the following:
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to S500 a clay oecause of time off from work.

G. ADDITIONAL INSUREDS • BY CONTRACT, AGREEMENT OR PERMIT 1, Paragraph 2. under Soction II - Who Is An Insured is amended to include as an insured any person or organization whore you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization Is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by:
a. Your acts or omissions, cr the acts or omissions of those acting on your behalf, In the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or 'property damage" occurs, or trio "per- sonal and advertising !njury" is committed, ;subsequent to the signing or such written contract or written agreement; or
CG 88 10 04 13
0 2013 Liberty Mutual Insurance
Includes copyrighted material of Insurance Services Office, Inc., with "its permission. Page 3 of 8

b.. Premises or facilities rented by you or used by you, or c. The maintenance, operation or use by you of equipment rented or leased to you h sue Organization; or
y h person or
d. Operations performed by you or on your behalf for which the stale or political subdivision has
Issued a permit subject to the following additional provisions:
(1) This insurance, noes not apply to "bodily in�Iur
ad-
vertising
injury" arising out of the operations fro-fonne pd tor ythe state or political subdivision; J or "personal and does
(2) This "Comp Bled insuranoperi f ons ohazaapply
rcf . to "bodily InJury or "propenY damage" Included within the (3) Insurance applies to premises you own, rent, or control but only with respect to the following (a) Tie existence, rnagllent9,i repair, construction,
signs, awnings, canopies, cellar entrances', e,radriv or renwval of advertising hoist away openings, �. coal notes, driveways, manholes, sidewalk vaults, street banners, or docoralions
surest or marques,
and similar expo -
(b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this Insurance. 1, The insurance afforded to such additional insured only applies to the extent permitted

2. It coverage provided to the additional insured is re by law; and once afforded to such additional insured will not required broader a contract i agreement, the insur- the contract or agreement to provide for such additionl insured, that which you
when -
With respect are required by
pest to Paragraph 1.a. above, a person's or orpanizalion's status as an additional insured Wrier this endorsement Paragraph
when
(1) All work, including materials,
parts or equipment furnished in connection with such work, on the protect (other than
additional insured(s) et the location lnte time covnce eredoperations e has e performed by or on behalf of the
(2) That portion of been completed; or
intended one b r your work" out of which the injury or damage arises has by any person or organization other than another contractor or b subcontractoreen put engagedengaged In performing operations for a principal as a With respect to paragraph 1.b. above, part of the same project, Wrier the endorsement ends when their p rso,,'s or organization's premises tten statues as an additional insured
or facilities ends. contract or written agreement with
With respects to Paragraph 1.c. above, this Insurance does not apply to any " you for such Mace slur the equiprrtant rental or lease agreement has expired to the lessor, "occurrence" which takes P or you have returned such equipment
is signed prior to the "bodily injury" or
The insurance provided by this endorsement a
r � pPllas only if the written contract or written
"properly pony damage" agreement
We have no duly to defend an additional insured
notice of a "suit" by the additional Insured as required sin r (Paragraph his b. of until we receive written Event Of Occurrence, Offense, Claim Or Suit under b. of Condition 2. Duties In the Eons. Section IV - Commercial General Liability Condl-
CG 88 10 04 13
However:

Includes copyrighted melerie2 13 surance liberty Mutual Insurance Services UU1ce, Inc., with its permission.

Page 4 of 8 ends

2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2.

Exclusions under Section I - Coverage A -Bodily Injury And Property damage Liability:

Thls Insurance does not apply to:
a• "Bodily injury" or "property damage" arising from the sole negligence of the additional insured, b. "Bodily Injury" or "property damage" that occurs prior to location where such "bodily injury or u ed.
"properly daina1ae" occuoti commencing operations at the c. "Hodily injury", ^
ing of or the failure proptoe yyenda iaan" or "personal and advertising injury" arising Y Protessiunal architectural, 9 out of the render_
engineering or surveying services,
including;
(1) The preparing, approving, or failing to prepare or approve ma reports, surveys, field orders, psi shop drawings,
change orders or drawings and g opinions,
(2) Supervisory, I 9 specifications; or
Inspection, architectural or engineering activities.

This exclusion applies ev
en ven if the claims against any Insured allege negligence or other wrongdoing in the supervision, hiring, employment, training
ily
or monitoring of others byadvertising Injury", "property that insured, if the "occ-ur- "persenal a engineering a tisin or surveying , volved the f rendering damage", or the aor the offense which caused the services. °f, or failure to render, any professional
d. "Bodily injury" or "property damage" occurring after; (1) All work, including materials, parts or equipment furnished In connection with such work °n
the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(5) at the location of the covered operations has been completed: or (2) po
That arllon of "your wank"
inter t our of which the injury or damage arises has
been put lo its
use by any person or organization other than another contractor or sub engaged In pep -fanning operations for a
principal as a part of the same project, contractor
e. Any person or organization specifically designalec( as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement sued by us and made a pe ns
policy.

3. With respect to the insurance afforded s to these is- sued
- Limits OF Insurance: additional insureds, the following is added to Section III If coverage provided to the additional Insured
require by a contract or agreement, the most we tivfll
pay on behalf of the additional insured is the amount of d insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less.

Thls endorsement shall not tncraase the a
ppllcable Limits of Insurance shown in the Declaratlo ns.

N. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED
This provision applies to any person or organization PENSION or endorsement under this policy. who qualffles as an additional Insured under any form Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIO C nfollows:

NS Is amend -
a. The following is added to Paragraph a, Primary insurance:
if an additional insured's policy has an Other Insurance provision have agreed in a written contract or written agreement to provide the additional insured coverage Pnnrary and noncontributory making its policy excess, and you basis, this policy shall be primary 3 Y
the additional insured's policy for damages we cover. p rY and we will not see contribution + from a
CG 88 10 04 13
Liberty Includes copyrighted material of31 Suur Mutual
ancoS rvicus 09 c , Inc., with its permission.

Page 5 ends

b. The following is added to Paragraph b. Excess Insurance:

Whoa a written contract or written
Whoa or
a agreement, an equipment rental or agreement, a ttho� agreement, meat, or subdivision between you and an additional Insured does
promises lease, facilities rental contract l
primarysubdivision
and etweenUibutor permit issued by aotate or politicalylcal Y. this Insurance is r any th this insurance to Clonal Insured is designated as a Na excess other Insurance for which e p the adds r Named Insured, over
Regardless of the written
over d; agreement between you and an additional insured, any other insurance whether primary, excess, contingent or on any other basis for w additional Insured has been added as an additional Insured me) other this insurance Is excess ADDITIONAL INSUREDS policies- which the
- EXTENDED PROTECTION OF YOUR "
This provision LIMITS OF INSURANCE"
under this or endorsement h s policy.
any person or organization who qualifies as an additional insured applies to

1. The following is added to Condition under any form

2. Duties e In The Event Of Occurrence, Offense, Claim or Suit:

An additional Insured under this endorsement
a. Give written notice of an "occurrence" will as soon as practicable:
this insurance to us; 0r an offense that may result In
b• Tender the defense soil indemnity a claim or "suit" ndor insurance available to the additional insured; and claim or "suit" to all insurers whom C. Agree to also have
g make available any other insurance which the additional Insured has fora loss cover under this Coverage Part.
d, We have no duty to defend or indemnify we
we receive written notice of a "suit" an additional insured under this endorsement unlit

2. The limits of insurance applicable to by the additional insured. or mitten oaf
or the the additional insured are those specified in a written or wlid in Section Itl limits of insurance as stated In the Declarations of this Limits of Insurance contract
defined
of and not in .- Limit to the limits of of this policy, policy are whichever are less. These (traits are
J. WHO IS AN INSURED • INCIDENTAL MEDICAL available under this WHO IS AN INSURED . ERRORS ! MALPRACTICE
policy.

FELLOW EMPLOYEE EXTENSION .

Paragraph 2.a, 1 MANAGEMENT EMPLOYEES
() ❑f Section II - Who Is An Insured is replaced with the fallowing:
(1) "Bodily Injury" or "personal and advertising injury":
(a) To you. to your partners or members (it you are a
you ore a limned rtneilY mnlmrt partnership or numl ur pc-,rforrrrinl duties rotated to Ui conduct or ycurr trusir glary vuniff y to company), to r� co -"employee" while in this course) of his oor herur emplobors y (if workers" while performing duties related to the
(b) To the s conduct of your business; your other "volunteer spouse, child, parent, brother or sister of that ca"
consequence of Paragraph (1) (a) above; ernplo ee
Y or "volunteer worker" as a
(c) For which there Is any obligation to share darns
damages because of the injury described damages with (a)or repay someone also who (d) Arising out of his or her providing in Paragraphs (1) (b) above; or must pay
if you n are not in the business or failing to provide
of providing professional health care services. However, profes-
sional health care personnel J professional health care services or providing vices is not otherwise p excluded thers, or if coverage for providing frofes- apply, by separate endorsement, this provisiorof (Paragraph heath doe Beet
Paragraphs � ( aragraph (d)) does not
(a)
and (b) above do not ap
ply"employee" to "bodily injury" or "persona the em toe action Fl Supervisory capacity for I andcapacity i
"employee's" a � job responsibilities you. Supervisory advertising injury" caused by ens" of yours_ However, assigned by you. includes the direct supervisioan cofEother N"employ-s none of these "employees" are Insureds for "bodily injury" or "personal and CG 88 10 04 13
Includes CO 2013 Liberty Mutual InsurancePyrighted material of Insurance Services Office;, Inc., with its permission.

PagoBrYfg

advertising injury" arising uul of their willful conduct, which is ad ees shodily injury" or "personal air willful
one defined as the purposeful
tion by liquor or controlled s advertising injury", or caused in whole oron part bytltlreir intoxica- 1 Intent tion
substances.

The coverage provided by provision J. Is excess over any other valid and collectable Insur your "employes"
K NEWLY FORMED ance available to

OR ADDITIONALLY ACQUIRED ENTITIES
Paragraph 3. of Section 0 - Who Is An Insured Is replaced by the following:

3. Any organization
you newly acquire or form and over which you rnr,intein ownership or majority Interest, will quell
ty
organization, as a Named Insured if there Is no other similar insurance available to that However;
a. Coverage under this provision is afforded only until the expiration of the b. Coverage A does not apply y you; policy Period in
acquired or formed the organization; "bodily injury"
and or damage" that occurred before you
c. Coverage 8 does not a
committed ppl to "personal and advertising injury" arising out of an offense before you acquired or formed the organization.
d. Records and descriptions of operations must be maintained by the first Named Insured.

No poison or organization �; an Insured with respect to the conductof d venture or limited liability cis an any that it not sect t as an insured any current or past ions rshlP, joint
under this provision, as a Nauu:rl Insured in the Declarations or L. FAILURE TO DISCLOSE HAZARDS qualifies

AND PRIOR OCCURRENCES
Undo' Section IV - Commercial General LI86fli eontntions: ty Conditions, the following is added to Condition 6. Repre.

Your failure to disclose all hazards or prior "occurrences" g shalt not it prejudice the coverage afforded b existin p y this policy provided such failure to disclose t all o hazardst ieQ prior "occurrences" is not intentional,
M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under Section IV - Commercial General Liability
In The Event of Occurrence, Offense, Claim Or Sult Conditions, the following is added to Condition 2. Outlets knowledge "occurrence". offense. claim or "suit" b,
9 of an r r.

Insured shall not in itself constitute knowledge of the insured unk:ss an insured listed and

1. of Section H - Who is An Insured or n person who } do agent, .urv;urt or er
"employee" of any
"occurrences",octio, offenses. claims or "suits" has been designated by there to receive roiioritsrfof " yeo", shall have received such notice from the agent, servant el N. LIBERALIZATION CLAUSE
If we revise this Commercial Genera! Liability Extension Endorsement to provide more co additional el premium chary©, your policy will automatically provide the coverage as of the day the effective in premium
state,
coverage without
O. BODILY INJURY REDEFINED revision is
Under Section V - Definitions, Definition 3. Is replaced by the following:

3. "Bodily Injury" means
mental physical injury, sickness or disease sustained by arnyuish, mental injury, shock, fright or death that results from a person. men l disease. This Induces such physical injury, sick -
CG 88 10 04 13
m 2013 Liberty Mutual Insurance
Includes copyrighted material of Insurance Services (Mice, Inc., with its permission.

Page 7 of 8 ends

Policy Number: $KW55748813
a
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EACH LOCATION GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
For all sums which the insured becomes legallySection Coverage obligated to g A - Bodily Injury pay as Liability,
caused "occurrences"
e
penses caused by accidents under Section j And Property Damage Liabtii only to operations at a dingle under
Coverage C Medical Payments,
and for all be medical d

1. A separate owned by or rented to you: mments, which can attributed 'P Location General Aggregate PP
A the e ra eut Each Location
ioneGl q g Limit applies to each "location",

2. The Each Location General Aggregate 9s Limit shown In the Declarations. and That limit Is equal tounder Coverage Limit is the most we will e
9 A, except damages becauscr of "bodily
_? - - the "products -completed A, pay for the sum of
y injury" or "property all damages
teas of the number et operations hazard", and for medical expenses under Coverage nC included in a. Insureds; C regard -
b. Claims made or "sults" brought or
c. Persons or organizations making claims or bringing "suits".

3. Any payments made under Coverage A reduce the Each Location General for damages or under Coverage shall
nhe the General Aggregate ggregate Limit for that "location". Such for medical payments
shall
not reduce oh General Limit shown in the Declarations Such paymenty shall Aggregate Limit for any nor shall Ihey reduce any other

4. The limits shown In the p other "location"
continue lie to a Declarations for Each Occurrence,
apply. However, instead of being Fire Damage and Declarations, such limits will be subject to the applicablet Each Location General Aggregate M aal Expense B. For all sums which the insured the General Aggregate Limit shown in the under Section 1 - becomes legally obligated b Limit.

Coverage A - Bodily Injury And ed to pay as damages caused by all medical ex-
penses caused by accidents under Section I - Property Damage only to operations ac eata single Sect io" Coverage C g Liability, i for all medical ex - 9 Medical Payments, which cannot be attrib-
uted 1• Any payments made under Coverage owned by or rented to you:
shall reduce the amount available 9 A for damages or under Coverage C for medical Operations Aggregate Limit, whichever its applicable; under the General Aggregate Limit or the Products -Completed s

2. Such payments shall not reduce any and
C. When coverage for liability arising Each Location General Aggregate Limit. payments damages because out of the "products -completed completed for operations ca bodily injury" P operations hazard" is the "prod, any reduce the General Aggregate will reduce the Products -Completed Operatdamage" included in " Limit nor the Each Location General Aggregate
i re Products -
99 Aggregate Limit, and not
D. For the purposes of this endorsement, the following 9gfeQate Limit. "Location" means premises Involving definition Is added to Sectio n V - Definitions; interrupted only by a street, mie roadway, I g the same or connecting tots, or premises whose connection is E. The waterway or right-of-way of a railroad.
provisions of Section III - Limits Of Ineurance not otherwise continue to apply as stipulated.
modified by this endorsement shall
CG 88 60 12 08

COMMERCIAL GENERAL LIABILITY
CG 88 60 12 08
Includes copyrighted materiel of ISOProperties, Inc., with Its permission,

Page 1 of 1 ends

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALI FORNIA
We have the right to recover our payments from anyone liable for an injury covered by our right against the person or organization named in the Schedule. you perform work under a written contract that requires you to obtain this agreement fromus policy. We will not enforce
(This agreement applies only to the extent that
work Yoe must maintain payroll records accurately segregating the remuneration of our s ) described in s nhp Schedule.

Y employees while engaged in the
Blanket Waiver
This endorsement changes the policy to which it le attached and le effective on the date Issued unless otherwise (The Information below Is required only when this endorsement is Issued subsequent to preparation Endorsement Effective: 07/24/2020 staled.

Insured: Policy No.: P Perelion of the policy,)
Team One Management WCNCC 312424
Insurance Company: Endorsement No.:

National Casualty Premium $ INCL
Company Countersigned by
m1990 by the Workers' Compensation insurance Rating Bureau of California. All rights reserved.

From the WCIRB's California Worker' Compensation Insurance Forms Manual Z00f.

WC 04 03 06
(Ed. 4.84)

Ac0Ro�' CERTIFICATE OF LIABILITY INSURANCE
ki...../

DATE(MM/DD/YYYY)
09/30/2022
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.

PRODUCER
Insurance Solutions
License #0746539
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT Angela Dancy
NAME:

PHONE (949) 348-7400 FAX (949) 201-4515
No, Eta): (A/C, No):

E-MAIL
ADDRESS: [email protected]

INSURER(S) AFFORDING COVERAGE
NAIC a
INSURER A West American Ins. Co.
44393

INSURED
Team One Management Inc
DBA: Team One Management Services
PO Box 203
Lake Forest CA 92609
INSURER B : California Automobile Insurance Co.
38342
INSURER C : CNA Surety
524126

INSURER D
INSURER E :

INSURER F :

COVERAGES
CERTIFICATE NUMBER: 22-23
•

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
AUUL
INSD
SUBH
WVD

POLICY NUMBER

POLICY EFF
(MM/ODfYYYY)

POLICY EXP
(MM/OD/YYYY)
LIMITS
A
X

COMMERCIAL GENERAL LIABILITY
BKW55748813
07/24/2022
07/24/2023

EACH OCCURRENCE
5 1,000,000

CLAIMS -MADE
�/
/�.

OCCUR

DAMAGE TO RENTED
PREMISES (Ea occurrence)
S 500,000
MED EXP (Any one person)
5 10,000

PERSONAL&ADVINJURY
S 1,000,000
GEN'L

AGGREGATE

LIMIT APPLIES
PRO
JECT
X
PER:

LOC

GENERAL AGGREGATE
S 2,000,000

PRODUCTS-COMP/OP AGG
5 2,000,000
5 B

AUTOMOBILE
X
_
-

LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY
_
_,

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
BA040000009648
10/03/2022
10/03/2023

COMBINED SINGLE LIMIT
(Ea accident)
s 1,000,000
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
S

PROPERTY DAMAGE
(Per accident)
5 5

UMBRELLA LIAB

EXCESS LIAB
OCCUR

CLAIMS -MADE

EACH OCCURRENCE
S

AGGREGATE
S
DED

RETENTION S
5 WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y r N

ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PER

STATUTE
OTH-
ER
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYEE
5 E.L. DISEASE - POLICY LIMIT
1 5
C
Janitorial Bond including Employee
Dishonesty
69410585
07/24/2022
07/24/2023
Limit:
$100,000
DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are additional insureds with respects to liability arising out of activities performed by or on behalf of the Named Insured pursuant to its contract with the City; products and completed operations of the Named Insured; premises owned, occupied or used by the Named Insured; Automobiles owned, leased, hired, or borrow by the Named Insured. This insurance coverage shall be primary insurance as respects the City of Placentia, its officers, officials, agents, employees, and volunteers. Any other insurance maintained by the City of Placentia shall be excess and not contributory.

CERTIFICATE HOLDER
City of Placenta Attn: City Administrator
401 E. Chapman
Placentia
1 CA 92870

CANCELLATION

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
© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD

ACORE" CERTIFICATE OF LIABILITY INSURANCE
L-----

DATE(MM/DD/YYYY)
07/22/2022
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.

PRODUCER
Capital Providers Insurance
License #0H52316
20750 Ventura Blvd., Ste 305
Woodland Hills CA 91364
CONTACT Meyer Chadorchi
PAHONNE, Eat): (818) 676-0016 FAX jq/c, No): (818) 676-0015 A0D iLss: [email protected]

INSURER(S) AFFORDING COVERAGE
NAIC it
INSURER A: National Casualty Insurance Company

INSURED
Team One Management
27324 Camino Capistrano
209
Laguna Niguel CA 92677
INSURER B :

INSURER C :

INSURER D
INSURER E :

INSURER F :

CERTIFICATE NUMBER: 22-
•

INSR
LTR

TYPE OF INSURANCE
AUUL
INSD
SUBH
WVD

POLICY NUMBER

POLICY EFF
(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY)
LIMITS

COMMERCIAL GENERAL LIABILITY

EACH OCCURRENCE
S

CLAIMS -MADE
OCCUR

DAMAGE TO REN LED
PREMISES (Ea occurrence)
5 MED EXP (Any one person)
5 PERSONAL S.ADV INJURY
$
GEN'L

AGGREGATE

LIMIT APPLIES
PRO-
JECT
PER.

LOC

GENERAL AGGREGATE
5 PRODUCTS - COMP/OPAGG
5 5

AUTOMOBILE

LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY
_
^

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY

COMBINED SINGLE LIMIT
Ea accident)
5 BODILY INJURY (Per person)
S

BODILY INJURY )
(Per accident
S

PROPERTY DAMAGE
(Per accident)
5 S

UMBRELLA LIAB

EXCESS LIAB
OCCUR

CLAIMS -MADE

EACH OCCURRENCE
S

AGGREGATE
S
DED

RETENTION S
S
A

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WCNCC31242403
07/24/2022
07/24/2023
v

X STATUTE
EORH _
E.L. EACH ACCIDENT
S 1,000,000
E.L. DISEASE - EA EMPLOYEE
S 1,000,000
E.L. DISEASE - POLICY LIMIT
5 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached it more space is required) City of Placentia, its elected and appointed boards, officials, agents, employees, and voluteers are named as addtional insured City of Placentia
401 E. Chapman
Placentia
CA 92870

CANCELLATION

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
© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD

Team One Management
Insurance Company:

National Casualty Company
Policy No.: WCNCC 312424 Endorsement No.:

Premium $ INCL
Countersigned by
©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.

COMMERCIAL GENERAL LIABILITY
CG 88 60 12 08
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EACH LOCATION GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:

1. A separate Each Location General Aggregate Limit applies to each "location", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.

Insureds;
Claims made or "suits" brought; or
Persons or organizations making claims or bringing "suits".

2. Such payments shall not reduce any Each Location General Aggregate Limit.

E. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated.

CG 88 60 12 08
Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 1

Policy Number. BKW55748813

COMMERCIAL GENERAL LIABILITY
CG 88 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COMMERCIAL GENERAL LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
INDEX

SUBJECT

NON -OWNED AIRCRAFT

NON -OWNED WATERCRAFT

PROPERTY DAMAGE LIABILITY - ELEVATORS
EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)

MEDICAL PAYMENTS EXTENSION

EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B

ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT

PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE"

WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN

INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES

NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES

FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES

KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT

LIBERALIZATION CLAUSE

BODILY INJURY REDEFINED

EXTENDED PROPERTY DAMAGE

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -

With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement.

1. It is not owned by any insured;

2. It is hired, chartered or loaned with a trained paid crew;

4. It is not being used to carry persons or property for a charge.

This exclusion does not apply to:
(2) A watercraft you do not own that is:
(a) Less than 52 feet long; and
(b) Not being used to carry persons or property for a charge.

C. PROPERTY DAMAGE LIABILITY - ELEVATORS

2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance:

The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis.

D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part.

Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days.

A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance.

CG 88 10 04 13
© 2013 Liberty Mutual Insurance
Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8

b. The last paragraph of subsection 2. Exclusions is replaced by the following:

2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following:

3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following:

E. MEDICAL PAYMENTS EXTENSION
If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows:

Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following:
(b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1, Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following:
b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds.

G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT

Insurance applies to premises you own, rent, or control but only with respect to the following hazards:
(3)
(a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or
(b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when theft written contract or written agreement with you for such premises or facilities ends.