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Agenda Item No: 1.0
PLACENTIA CITY COUNCIL AGENDA REPORT
Meeting Date: June 16, 2026
Submitted by: Ontoine Lewis
From: Public Works
Subject:
AWARD OF CONTRACT FOR CITY POOL AND FOUNTAIN MAINTENANCE SERVICES TO CALIFORNIA WATERS DEVELOPMENT, INC.
Financial Impact:
Annual expense: $ 15,675 ($47,025 for three years of service) Budgeted: $326,943 Proposed FY 2026/27 (101-80402-6300) Summary:
This proposed agreement provides for maintenance services for the City's fountain located at City Hall and the swimming pool located at the Gomez Community Center. The scope of work for this contract includes annual preventative and seasonal monthly pool maintenance, along with repairs and emergency response. An extension of the current agreement with the City's current contractor, HASA, entered on July 1, 2023, included a 2 -year extension. However, the City contacted HASA about extending the agreement, and they responded with requesting a 33% rate increase.
The City then decided to issue a Request for Proposal (RFP) on May 18, 2026, to seek more competitive pricing for pool and fountain maintenance services. On June 1, 2026, the City received three (3) responsive proposals. This action will award a contract to California Waters Development, Inc (California Waters).
After reviewing proposals, California Waters is recommended by staff to be the awarded company. This action will award a three-year agreement with the option to extend for an additional one (1) two-year term extension to California Waters in an annual not -to -exceed amount of $15,675 and a cumulative three-year contract not -to -exceed amount of $47,025.
Recommended Action:
It is recommended that the City Council:
1. Approve a Maintenance Services Agreement with California Waters Development, Inc. for Pool and Fountain Maintenance Services for an amount not -to -exceed $47,025 over an initial three-year contract term ending on June 30, 2029, with the option to extend for one (1) additional two-year term based upon contractor performance and at the discretion of the City for an amount not -to -exceed $15,675 per year; and
2. Authorize the City Administrator to approve contract change orders up to 10% of the 1 annual contract; and
3. Authorize the City Administrator and/or her designee to execute all necessary documents, in a form approved by the City Attorney.
Strategic Plan Statement:
This item aligns with Strategic Goal No. 3: Infrastructure, Facilities, and Public Spaces.
Awarding this contract ensures our public spaces are clean, attractive, and reflective of the City's commitment to quality.
Discussion:
The City offers free recreational swim at the Gomez Community Center. Free recreational swim is a nine (9) week program open to all residents and non-residents, which begins on June 1 and ends on August 31. Between September 1 and May 31, the pool is open on a per - reservation basis. The contract scope of work for pool and fountain maintenance services will include annual preventative and seasonal maintenance, such as filter servicing, vacuuming, on-site inspections, and monitoring of the pump room equipment and the chlorine and pH levels. An extension of the current agreement with the City's current contractor, HASA, entered on July 1, 2023, included a 2 -year extension. However, the City contacted HASA about extending the agreement, and they responded with requesting a 33% rate increase.
The City then issued a Request for Proposal (RFP) on May 18, 2026, to seek more competitive pricing for pool and fountain maintenance services. On June 1, 2026, the City received three (3) responsive proposals as shown in the table below.
Company Name
California Waters
Development, Inc.
USA Pools of California $6,500.00
City Hall Fountain
$4,350.00
HASA Inc. $13,370.00
Gomez Pool
$11,325.00
$35,860.00
$33,100.00
Total Bid
$15,675.00
$42,360.00
$46,470.00
After a review of the proposals, California Waters was determined to be the most responsive and responsible contractor for performing the pool and fountain maintenance service. Staff recommends the City Council award a Maintenance Service Agreement to California Waters for an an annual not -to -exceed amount of $15,675 and a cumulative three-year contract not - to -exceed amount of $47,025.
Financial Summary:
The agreement with California Waters Development is for three (3) years for a cumulative not - to -exceed contract amount of $47,025 with the option to extend for one (1) additional two-year term for an amount not -to -exceed 15,675 per year, based upon contractor performance and at the discretion of the City. Funding for the Pool and Fountain Maintenance Services is included in the proposed Fiscal Year 2026-27 Operating Budget of $326,943.
Attachments
California Waters Development (Vendor signed) Pool Maintenance service agreement 2026.pdf
California Waters Development - COl.pdf
2 CITY OF PLACENTIA
MAINTENANCE SERVICES AGREEMENT
WITH
California Waters Development, Inc.
THIS AGREEMENT is made and entered into this 1st day of July 2026("Effective Date"), by and between the CITY OF PLACENTIA, a municipal corporation ("City"), and California Waters Development, a California S corporation ("Contractor").
WITNESSETH:
A. WHEREAS, City proposes to utilize the services of Contractor as an independent contractor to provide Pool and fountain maintenance service, 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 3 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, 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. Delegation and Assignment. 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.
4 1.8. Confidentiality. Employees of Contractor in the course of their duties may have access to financial, accounting, statistical, and personnel data of private individuals and employees of City. Contractor covenants that all data, documents, discussion, or information developed or received by Contractor or provided for performance of this Agreement are deemed confidential and shall not be disclosed by Contractor without written 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 Fifteen thousand six hundred and seventy-five Dollars ($ 15,675.00) annually or a cumulative not -to -exceed of Forty -Seven Thousand Twenty -Five Dollars ($ 47,025). Any request for pricing adjustment shall be submitted in writing by Contractor at least sixty (60) days prior to the proposed effective date of such adjustment. Each request shall include reasonable supporting documentation substantiating the basis for the adjustment, including but not limited to, applicable wage determinations, payroll impact analyses, supplier pricing changes, or other relevant cost data. The request is subject to approval, rejection, or modification by the City in its sole discretion. Such increase shall be limited to 10% of the annual contract sum and shall occur no more than once in any twelve (12) month period. The first such request shall not occur until after the first full year of the contract. The City Council has final approval.
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 25% of the total contract sum or $25,000, whichever is more. The City Engineer is authorized to approve a Change Order for such additional services.
2.3. Method of Billing. Contractor may submit invoices to the City for approval on a per -progress basis, but no more than twice 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. 5 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.
3.2. 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 Contractor's control is encountered, a time extension may be mutually agreed 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 June 30, 2029, unless previously terminated as provided herein or as otherwise agreed to in writing by the parties.
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. Termination of this Agreement shall be deemed effective upon receipt of 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; 6 d. Default in the performance of any
indebtedness under this Agreement;
e. Suffer any judgment against it to remain
for thirty (30) days or longer; or
f. Institute or suffer to be instituted any
rearrangement of its affairs.
obligation or payment of any
unsatisfied or unbonded of record
procedures for reorganization or
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 of the following minimum scope of insurance coverages with an insurance company admitted doing 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.
7 (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' 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, which requires every employer to be insured against liability for Workers' Compensation or to undertake self-insurance before commencing any 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:
(a) Additional insureds: "The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are additional 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 policies 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 8 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 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-limitinq. 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 9 Agreement.
6.3. Proiect 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 ensure that the Project Manager is kept informed of the progress of the services and the Contractor shall refer any decision that must be made by the 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 of the City. The Contractor or its Project Manager shall attend and assist in all coordination meetings called by the 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.
Contractor
California Waters Development, Inc.
23311 E. La Palma Ave.
Yorba Linda, California 92887
Tel: 949 468-8755
Attn: Rheanna Connor
City
City of Placentia
401 E Chapman
Placentia, CA 92870
Tel (714) 993-8111
Attn: Ontoine Lewis, Public Works Manager
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 of Contractor's 10 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 payments 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 workers' 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 11 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.
6.11. 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 the confidentiality of 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.
6.15. Responsibility for Errors. Contractor shall be responsible for its work and results 12 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 Partv Beneficiary Rights. 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 or remedy in respect to any other occurrence or event, nor shall any waiver constitute a continuing waiver.
6.24. Severabilitv. If any provision of this Agreement is determined by a court of 13 competent jurisdiction to be unenforceable in any circumstance, such determination shall not affect the validity or enforceability of the remaining terms and provisions hereof or of the offending provision in any other circumstance. Notwithstanding the foregoing, if the value of this Agreement, based upon the substantial benefit of the bargain for any party, is materially impaired, which determination made by the presiding court or arbitrator of competent jurisdiction shall be binding, then both parties agree to substitute such provision(s) through good faith negotiations.
6.25. Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original. All counterparts shall be construed together and shall constitute one agreement.
6.26. Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said parties and that by doing so the parties hereto are formally bound to the provisions of this Agreement.
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.
CITY OF PLACENTIA,
A municipal corporation
Jennifer Lampman, City Administrator
ATTEST:
City Clerk and ex officio Clerk
of the City of Placentia
CONTRACTOR
Signature
Mark Pitman, President
Name and Title
27-4963481
Social Security or Taxpayer ID Number
Date:
Date: 6/11/2026
14 APPROVED AS TO FORM:
Date:
City Attorney
APPROVED AS TO INSURANCE:
Date:
Cyndi Alvarenga, Risk Management Analyst
APPROVED AS TO CONTENT:
Date:
Ontoine Lewis, Public Works Manager
DEPARTMENTAL APPROVAL:
Date:
Chris Tanio, Director of Public Works/City
Engineer
15 EXHIBIT A
CONTRACTOR'S PROPOSAL AND SCOPE OF WORK
12 [Name of Contractor]
Rev. 01/2024 16
SECTION C
PROPOSAL
for the
PUBLIC SWIMMING POOL MAINTENANCE SERVICES
in the
CITY OF PLACENTIA
TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF
PLACENTIA:
In compliance with this Request for Proposal, the undersigned hereby proposes and agrees to perform all the work therein described and to furnish all labor, material, equipment, and incident insurance necessary therefor in accordance with the Scope of Work as described in the bid documents. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Placentia, and to enter into a contract at the following prices. Contractor shall perform all work under this contract for a period of 60 months starting from the day indicated in the Notice to Proceed.
BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders, and all other contract documents.
If this proposal is accepted for award, BIDDER agrees to enter into a contract with the City at the prices set forth in the Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to City of the guaranty accompanying this proposal.
BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE CITY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of 90 days from the bid opening date. If, at that time, the contract is not awarded, the City will reject all bids and re -advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures.
If awarded the contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the City's Notice of Award of Contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the City and this bid and the acceptance hereof may, at the City's option, be considered null and void.
Page - 10
17 A. General Description
PUBLIC SWIMMING POOL MAINTENANCE SERVICES
The minimum qualifications:
• All Pool Technicians must be certified as AFO (Aquatics Facility Operator) or CPO (Certified Pool Operator).
• Extensive experience maintaining municipal aquatic facilities. • Experience working with Automated Chemical Monitoring Systems, specifically the Chemtrol 2000 series.
• Experience working with multiple high-rate sand filters. • Must have experience working with municipal pools. Three references from municipal facilities must accompany your bid.
Scope of Work (September 1ST — May 31sT)
• One site visit per WEEK to the facility to remove tarp and perform pool cleaning and pump room services.
• Monitor pool chemicals and maintain them at the correct levels. • Perform detailed chemical tests (chlorine, acid, TDS, total alkalinity, etc.) during each visit.
• Maintain pool chemical Togs in compliance with OC Health Department Standards.
• Vacuum pool twice per month.
• Treat for algae as needed.
• Backwash as needed.
• Inspect and monitor all pump room equipment during each visit. • Clean probes as needed
• Calibrate Chemtrol 2000 system as needed
• Inform the aquatics supervisor of any problems or areas of concern related to the pump room.
• Monitor levels of chemicals and inform Public Works Supervisor when ordered supplies are needed.
Scope of Work (June 1st — August 31st)
• Two site visits per WEEK to the facility to perform pool cleaning and pump room services.
• Monitor pool chemicals and maintain them at the correct levels. • Perform detailed chemical tests (chlorine, acid, TDS, total alkalinity, etc.) during each visit.
• Maintain pool chemical logs in compliance with OC Health Department Standards.
• Vacuum pool twice per week.
• Treat for algae as needed.
Page - 11
18 • Inspect and monitor all pump room equipment for each visit. • Clean probes as needed.
• Calibrate Chemtrol 2000 system as needed.
• Inform aquatics supervisor of any problems or areas of concern related to the pump room.
• Monitor levels of chemicals and inform Public Works Supervisor when more chemicals need to be ordered
Add to both
• Maintain chlorine at 2ppm
• Maintain ph. at 7.2 — 7.8
• cyanuric acid must never exceed 3ppm
• Keep pool water level at correct height
• Except for a small amount of granular chlorine, (COMPANY) must not store any chemicals in the pump room
Routine Maintenance Payment for Services
• Cost for extra maintenance & repairs shall be controlled by the priced hourly rates provided in the bid schedule.
• Cost for all chemicals & supplies needed for routine maintenance shall be included in the bid pricing provided.
• No additional compensation shall be allowed.
• Cost for material & supplies used for extraordinary maintenance & repairs shall be billed along with the hourly rates on a time & materials basis, with a 15% material markup allowed. Evidence of material purchased must be provided with all invoices.
• The time computed to determine the total hours spent on extraordinary repairs shall begin upon arrival to the job site & will not include drive time nor truck charges.
Page - 12
19 Scope of Work:
City Hall Fountain Maintenance Services
The minimum qualifications:
• All Pool Technicians must be certified as AFO (Aquatics Facility Operator) or CPO (Certified Pool Operator).
• Extensive experience maintaining municipal aquatic facilities. • Experience working with Automated Chemical Monitoring Systems, specifically the Chemtrol 2000 series.
• Experience working with multiple high -rate sand filters. • Must have experience working with municipal pools. Three references from municipal facilities must accompany your bid.
Scope of Work weekly
• Perform water fountain cleaning and pump room service weekly. • Monitor water fountain chemicals and maintain at the correct levels. • Perform detailed chemical tests (chlorine, acid, TDS, total alkalinity, etc.) during each visit.
• Maintain water fountain chemical logs in compliance with OC Health Department Standards.
• Vacuum water fountain weekly or as needed.
• Treat for algae as needed.
• Backwash as needed.
• Inspect and monitor all pump room equipment during each visit. • Clean probes as needed
• Inform the aquatics supervisor of any problems or areas of concern related to the pump room.
• Monitor levels of chemicals and inform Public Works Supervisor when ordered supplies are needed.
• Keep the water fountain water level at the correct height Routine Maintenance Payment for Services
• Cost of extra maintenance & repairs shall be controlled by the prices hourly rates provided in the bid schedule.
• Cost for all chemicals & supplies needed for routine maintenance shall be included in the bid pricing provided.
• No additional compensation shall be allowed.
• Cost for material & supplies used for extraordinary maintenance & repairs shall be billed along with the hourly rates on a time & materials basis, with a 15 % material markup allowed.
• The time computed to determine the total hours spent on extraordinary repairs shall begin upon arrival at the job site & shall not include drive time.
Page - 13
20 B. Specifications
BIDDER'S PROPOSAL FORM
POOL AND FOUNTAIN MAINTENANCE SERVICES
PROJECT BID SCHEDULE
The undersigned declares that they have carefully examined the specifications, have read the accompanying instructions to bidders, and hereby propose to provide the gloves, in accordance with City needs and/or fund availability and the specifications provided herein.
Indicate unit price for each line item. Total quotation is to be firm offer for no less than ninety (90) days and will be regarded by the City as bidder's best and final offer.
City of Placentia
glijten Center Community Pool
9OOS. Melrose St.
ANNUAL PREVENTATI , 41, TENANCE AND MONTHLY SERVICE
1. ANNUAL PREVENTATIVE MAINT4
e)
• Filter Service
O $ n/a
• Chemical Control Service$ n/a
TOTAL COST FOR ANNUALPREVENTATIVE
O
U
MAINTENANCE $ n/a /li
2. SEASONAL COSTS FOR MONTHLY POOL MAINTENANCE
MONTHLY SERVICE:
• June 1st - August 31st (2 visits per week) per month
$ n/a
• September 1st — May 31st (1 visit per week) per
month$ n/a
TOTAL ANNUAL COST FOR MONTHLY POOL
MAINTENANCE $ n/a
GRAND TOTAL ANNUAL COST FOR MONTHLY POOL
MAINTENANCE $ n/a
Page - 14
21 City of Placentia
Gomez Center
Community Pool
1701 Atwood Ave
ANNUAL PREVENTATIVE MAINTENANCE AND MONTHLY SERVICE
1. ANNUAL PREVENTATIVE MAINTENANCE
• Filter Service
• Chemical controller service
TOTAL COST FOR ANNUAL PREVENTATIVE
MAINTENANCE $300.00
2. SEASONAL COSTS FOR MONTHLY POOL MAINTENANCE
MONTHLY SERVICE:
• June 1St - August 31st (2 visits per week) per month
$ 2,100.00
• September 1St — May 31st (1 visit per week) per
month$ 525.00
TOTAL ANNUAL COST FOR MONTHLY POOL
MAINTENANCE $ 11,025
GRAND TOTAL ANNUAL COST FOR MONTHLY POOL
MAINTENANCE $__11,325
Page - 15
$ 150.00
$ 150.00
22 City of Placentia
401 E. Chapman Ave
City Hall Water Fountain
ANNUAL PREVENTATIVE MAINTENANCE AND MONTHLY SERVICE
1. ANNUAL PREVENTATIVE MAINTENANCE
• FILTER SERVICE $_150.00
TOTAL COST FOR ANNUAL PREVENTATIVE
MAINTENANCE $_150.00
2. SEASONAL COSTS FOR MONTHLY FOUNTAIN MAINTENANCE
MONTHLY SERVICE:
• (1 visit per week) per month $_350.00
TOTAL ANNUAL COST FOR MONTHLY FOUNTAIN
MAINTENANCE $_4,350
Labor Rates
Normal Business Rate
$ 225/hour + $150 Flat Travel
Emergency After -Hours Rate
$ 340/hour (two hour minimum)+ $150 Flat Travel
Through submission on PlanetBids, the bidder certifies that he/she has followed the bidder instructions, acknowledges the requirements set forth in this proposal form for bid submission, and has thoroughly checked the figures set forth in the proposal and inputted into PlanetBids, that they are correct to the best of his/her knowledge and constitute his/her proposal to perform all the work called out and implied throughout these contract documents.
***BID ITEMS TO BE INPUTED ON-LINE IN PLANET BIDS***
Page - 16
23 INFORMATION REQUIRED OF BIDDER
Bidder certifies under penalty of perjury under the laws of the State of California that the following information is true and correct:
Name of individual Contractor, Company or Corporation: California Waters Development, Inc Business Address: 23311 E. La Palma Ave, Yorba Linda, CA 92887 Telephone and Fax Number: 949-528-0900 / 949-528-0910
California State Contractor's License No. and Class: 958960 C53, C61/D35 (REQUIRED AT TIME OF AWARD)
Original Date Issued: Expiration Date: 03/31/2027
List the name and title/position of the person(s) who inspected for your firm the site of the work proposed in these contract documents: n/a
The following are the names, titles, addresses, and phone numbers of all individuals, firm members, partners, joint ventures, and company or corporate officers having a principal interest in this proposal: Name Title Address Telephone
Mark Pitman, President, 23311 E. La Palma Ave, Yorba Linda, CA 92887 949-528-0900x101 Corporation organized under the laws of the State of California The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this proposal are as follows: N/A
Page - 17
24 All current and prior D.B.A.'s, aliases, and fictitious business names for any principal having interest in this proposal are as follows:
California Waters
For all arbitrations, lawsuits, settlements, or the like (in or out of court) you have been involved in with project owners (public agencies, private companies, etc.) in the past five years (Attach additional Sheets if necessary), provide:
Provide the names, addresses, and telephone numbers of the parties.
N/A
Briefly summarize the parties' claims and defenses.
State the tribunal (Le., Superior Court, American Arbitration Association, etc.), the matter number, and the outcome.
Have you ever had a contract terminated by the owner/agency? If so, explain.
No
Page - 18
25 Have you ever failed to complete a project? If so, explain.
No
Have you ever been terminated for cause and then had it converted to a "termination of convenience"? If so, explain.
No
For any projects you have been involved with in the last 5 years, did you have any claims or actions:
Circle One
1. By you against the owner? Yes / Eo
2. By the owner against you? Yes /E)
3. By any outside agency or individual for labor compliance (i.e. failure to pay prevailing wage, falsifying certified payrolls, etc.)
4. Yes/�
5. By Subcontractors (Stop Notices, etc.) Yes / E)
6. Are any claims or actions unresolved or outstanding? Yes /® If yes to any of the above, explain. (Attach additional sheets, if necessary)
Failure of the bidder to provide ALL requested information in a complete and accurate manner may be considered non-responsive.
Subscribed and sworn to before me
By This day of _ , 2016. (print name of Owner or
President of Corporation/Company)
(Signature of Notary Public) (Signature)
(SEAL)
(Date
(Signature of Secretary of the Corporation)
Page - 19
lit' c14
(Title) /Hawk. /
/1,4c. Affewim, S7c-ci-tirt?
26 CALIFORNIA JURAT
rs .mac - Sl dz3
GOVERNMENT CODE § 8202
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of 41-44- i-
AMABEL B. AMOJEDO.CONCEPCION
Notary Public - California
Orange County
Commission t 2517116
My Comm. Expires May 10, 2029
Place Notary Seal and/or Stamp Above
Subscribed and sworn to (or affirmed) before me on
this day of ��%le_ 20"` 6 , by
Date
Month Year
(1) lief % %� i' 14.1›
(and (2)
Name(s) of Signer(s)
proved to me on the basis of satisfactory evidence to
be the person(s) who appeared before me.
Signature
OPTIONAL
Signature of Nota Public
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an uninten ed document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
©20'19 National Notary Association
Number of Pages:
�__l'��Sfa�-•ia7aa� .'.:i=ri��..�w:a:o�.s�s`tl"'���
27 REFERENCES: Contractor''must use this form!!!
Please print�or type.
Bidders Name _ Cifsb to/�r�'6 / GL 1i✓A'/C, 4 e4/-1- "�/��h
FAILURE OF THE BIDDER TO PROVIDE ALL REQUIRED INFORMATION IN A COMPLETE AND ACCURATE MANNER MAY BE CONSIDERED NON-RESPONSIVE.
For all public agency contracts you have worked on (or are currently working on) in the past 2 years in excess of $15,000, provide the following information:
1 Agency Name City of Calabasas - Tennis and Swim Center Contact Person Telephone 818 -222-2782 William Rose
( Original Contract Amount $60,000 Final Contract Amount $ $100,000 If the final amount is different from the original, please explain (change orders, extra work, etc.) Monthly service with repairs changed to include all equipment PM services and emergency availablity Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate outcome of claims. n/a
2 Agency Name County of Riverside
Contact Person Telephone (951 ) 955-3313 David Alvarez
Original Contract Amount $ $15,300
Final Contract Amount $ $19,125
Page - 20
28 If the final amount is different from the original, please explain (change orders, extra work, etc)
Increases and additional work
Did you file any claims against the Agency? Did the
Agency file any claims against you/Contractor? If yes,
briefly explain and indicate the outcome of claims.
n/a
3 Agency Name City of Santa Monica
Contact Person Raul Bravo, 310-458-2201
Original Contract Amount $ 1,285,596 Final Contract Amount $ 1,285,596 If the final amount is different from the original, please explain (change orders, extra work, etc.) Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate the outcome of claims. n/a
4 Agency Name City of Oceanside
Contact Person Amanda Roswell
Telephone (760) 760-435-5230
Page - 21
29 Original Contract Amount $7,200 Final Contract Amount $ 7,200 If the final amount is different from the original, please explain (change orders, extra work, etc.) Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate the outcome of claims. n/a
5 Agency Name City of Coronado
Contact Person Telephone Eddit Torres (619) 522-7389
Original Contract Amount $19,020 Final Contract Amount $ If the final amount is different from the original, please explain (change orders, extra work, etc) Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate the outcome of claims. 6 Agency Name City of Huntington Beach
Contact Person Telephone Frabnk Drevdahl (657) 408-9138 Original Contract Amount $49.200 Final Contract Amount $ If the final amount is different from the original, please explain (change orders, extra work, etc.) Page - 22
30 Did you file any claims against the Agency? Did the Agency file any claims against you/Contractor? If yes, briefly explain and indicate the outcome of claims. n/a
Attach additional sheets if necessary.
Attach to this Bid the experience resume of the person who will be designated as Superintendent for the Contractor.
Upon request, the Contractor shall attach a financial statement and other information sufficiently comprehensive to permit an appraisal of the Contractor's current financial conditions.
Page - 23
31 DESIGNATION OF SURETIES
Bidder's name California Waters Development, Inc.
Provide the names, addresses, and phone numbers for all brokers and sureties from whom Bidder intends to procure insurance and bonds (list by insurance/bond type):
Bonds: Julia Bales, Hub International, E-mail: [email protected] Ph: (951) 779-8572
Page -24
32 ACKNOWLEDGEMENT OF ADDENDA
Bidder's name _California Waters Development, Inc., dba California Waters The bidder shall signify receipt of all Addenda here, if any:
Addendum No.
#1
Date Received
05/21/2026
Page - 25
Signature
fiOLI
1 1
33 CONTRACTOR'S INDUSTRIAL SAFETY RECORD TO ACCOMPANY PROPOSAL Bidder's Name
Record the last five (5) Full Years
Current Year of Record
Current
Year of 2025 2023 2021 Total
Record 2024 2022
No. of contracts 12
Total dollar
Amount
of
(nntrantc
No. of fatalities
20 22 18 14 12 86
$8.5M $17. 20.8 $15 104M 183 $80,600,000.00
6M M M
0 No. of lost
Workday Cases 0
0 0 0 0 0 0
0 0 0 2 0 2
Year
No. of lost
workday cases
involving
permanent 0 0 0
0 0 0
transfer to
another job or
termination of
cimpIJymc.ilt
The information required for these items is the same as required for columns 3 to 6, Code 10, Occupational Injuries, Summary --Occupational Injuries and Illnesses, OSHA No. 102.
Legal Business Name of Bidder California Waters Development, Inc., dba California Waters Business Address: Business Tel. No.: 23311 E. La Palma Ave, Yorba Linda, CA 92887 / 949-528-0900 State Contractor's License No. and Classification:
President
Title
958960 C53, C61/D35
The above information was compiled from the records that are available to me at this time and I declare under penalty of perjury that the information is true and accurate within the limitations of those records.
Signature of bidder
06/01/2026
Date Title 6/01/20 6, President
Signature of bidder
Date Title
06/01/2026, f esidtTlt 5 c,(
Page -42111
34 Signature of bidder
Date Title
Signature of bidder
Date Title
Page - 27
35 If bidder is an individual, name and signature of individual must be provided, and, if he is doing business under a fictitious name, the fictitious name must be set forth. If bidder is a partnership or joint venture, legal name of partnership/joint venture must be provided, followed by signatures of all of the partners/joint ventures or of fewer than all of the partners/joint ventures if submitted with evidence of authority to act on behalf of the partnership/joint venture. If bidder is a corporation, legal name of corporation must be provided, followed by notarized signatures of the corporation President or Vice President or President and Secretary or Assistant Secretary, and the corporate seal.
Signatures of partners join venturers, or corporation officers must be acknowledged before a Notary Public, who must certify that such partners/joint venturers, or officers are known to him or her to be such, and, in the case of a corporation, that such corporation executed the instrument pursuant to its bylaws or a resolution of its Board of Directors.
Page - 28
36 NON -COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ) SS.
County of
, being first duly sworn, deposes and says that he or she is of , the party making the foregoing bid, in accordance with Public Contracts Code Section 7106, declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.
Project Name:
California Waters Development, Inc., dba California Waters Legal Business Name of Bidder
23311 E. La Palma Ave, Yorba Linda, CA 92887
Business Address
949-528-0900
Busine s Tel. No.
ignature of bidder
President
Title
06/01/2026
Date.
ignatu a of bidder
Title ✓✓✓ ^^���JJ�,
06/01/2026
Date:
Subscribed and Sworn to before me on
Page - 29
37 CALIFORNIA JURAT
GOVERNMENT CODE § 8202
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of air7
AMABEL B.AMOJEDO-CONCEPCION
Notary Public - California
Orange County
Commission it 2517116
My Comm. Expires May 10, 2029 /
Place Notary Seal and/or Stamp Above
Subscribed and sworn to (or affirmed) before me on
this %t— day of 20_4_, by
Date Month
Year
CO
c,/
(and (2)
Name(s) of Signer(s)
proved to me on the basis of satisfactory evidence to
be the person(s) who appeared before me.
),
Signature an-welaiz. Pub
Si �citure of N��ublic
9 �Y
OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other T n Named Above:
©2019 National Notary Association
Number of Pages:
38 (Notary Seal) Signature Notary Public
Page - 30
39 LIST OF SUBCONTRACTORS TO ACCOMPANY PROPOSAL
In compliance with the provisions of Public Contract Code Section -4104, the undersigned bidder submitting this bid proposal sets forth the name, place of business and the portion of the work to be performed by: (1) -each subcontractor who will perform work or labor or render service to the bidder (as general Contractor) in or about the construction of the work or improvement; and (2) -each subcontractor licensed by the State of California who, under subcontract to the bidder, specially fabricates and installs a portion of the work or improvement according to detailed drawings contained in the plans and specifications, in an amount in excess of one-half of one percent of the bidder's total bid or, in the case of bids or offers for the construction of streets, highways or bridges, in excess of one-half of one percent of the bidder's total bid or ten thousand dollars ($10,000), whichever is greater.
Subcontractor's Name, Address, Bid Item Percent of Description of Work Telephone # Number Total Bid
N/A
Page -31
Percent of
Total Bid
40 EXHIBIT B
INSURANCE REQUIREMENTS
13 [Name of Contractor
Rev. 01/2024 41
EXHIBIT B
INSURANCE REQUIREMENTS
A. Minimum Scope and Limits of Insurance
City reserves the right to review any and all of the required insurance policies and/or endorsements, but has no obligation to do so. Failure to demand evidence of full compliance with the insurance requirements set forth in this Agreement or failure to identify any insurance deficiency shall not relieve Consultant from, nor be construed or deemed a waiver of, its obligation to maintain the required insurance at all times during the performance, including any extension thereof, of this Agreement.
Consultant shall obtain, maintain, and keep in full force and effect during the life of this Agreement, including any extension thereof, all of the following minimum scope of insurance coverages:
1. Commercial General Liability Insurance
Broad -form commercial general liability, with coverage at least as broad as the most current version of ISO Commercial General Liability coverage form CG 00 01, in a form at least as broad as ISO form CG 00 01 04 13, and shall include insurance for premises and operations, products/completed operations, broad form property damage, blanket contractual liability, independent contractors, personal injury or bodily injury, and personal and advertising injury with a policy limit of not less than Two Million Dollars ($2,000,000.00) per occurrence and Four Million Dollars ($4,000,000.00) general aggregate. The aggregate limit, encompassing the above coverage, shall apply separately to this project/location. If Consultant maintains higher limits than the specified minimum limits, City requires and shall be entitled to coverage for the higher limits maintained by the Consultant.
2. Business Automobile Liability Insurance
Business automobile liability for all owned, hired, leased, and non -owned vehicles at least as broad as the most current version of ISO Business Auto Coverage form CA 00 01, with a policy limit of not less than Two Million Dollars ($2,000,000.00) combined single limit per accident. If Consultant maintains higher limits than the specified minimum limits, City requires and shall be entitled to coverage for the higher limits maintained by the Consultant.
3. Workers' Compensation and Employer's Liability Insurance Workers' compensation insurance as required by the State of California and Employer's Liability Insurance with a minimum limit of One Million Dollars ($1,000,000.00) per accident for any employee or employees of Consultant. Consultant agrees to waive and to obtain endorsements from its workers' compensation insurer waiving subrogation rights under its workers' compensation insurance policy against the City, its officers, officials, agents, employees, and volunteers for losses arising from work performed by Consultant for the City and to require each of its subcontractors, if any, to do likewise under their workers' compensation insurance policies.
By signing this Agreement, the Consultant acknowledges and agrees to the following:
42 I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for Workers' Compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract.
The Consultant 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 Project Manager before execution of this Agreement by the City. The City, its officers, officials, agents, employees, and volunteers shall not be responsible for any claims in law or equity occasioned by failure of the Consultant to comply with this Section.
4. Standards for Insurance Companies
All insurance policies shall be issued by an insurance company currently authorized by the Insurance Commission to transact business of insurance or is on the List of Approved Surplus Line Insurers in the State of California, with an assigned policyholders' rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide.
B. Documentation and Other Provisions
1. The commercial general liability insurance policy and business automobile liability policy shall be endorsed to contain the following: The City of Placentia, its officers, officials, agents, employees, and volunteers are additional insureds with respect to: liability arising out of activities performed by or on behalf of the Consultant pursuant to its contract with the City; products and completed operations of the Consultant; premises owned, occupied, or used by the Consultant; and automobiles owned, leased, hired, or borrowed by the Consultant. General liability coverage can be provided in the form of an endorsement to the Contractor's insurance at least as broad as one of the following ISO ongoing operations forms: CG 20 10 or CG 20 26 or CG 20 33 (not allowed from subcontractors), or CG 20 38; and one of the following ISO completed operations forms:
CG 20 37, 2039 (not allowed from subcontractors), or CG 20 40.
2. Said policies shall not terminate, nor shall they be cancelled or coverage reduced, without at least thirty (30) days' written notice to the City. In the event of any cancellation or reduction in coverage or limits of any insurance, Consultant shall forthwith obtain and submit proof of substitute insurance. Should Consultant fail to immediately procure other insurance, as specified, to substitute for any cancelled policy or reduction in the required coverage limits, the City may procure such insurance at Consultant's sole cost and expense.
3. The Consultant's insurance coverage shall be primary insurance coverage at least as broad as ISO CG 20 01 04 13 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.
4. 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. 43 5. Defense fees and costs shall not deplete the limits of any insurance provided under this Agreement.
6. The Consultant'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.
7. Consultant shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Consultant shall ensure the City is an additional insured on insurance required from subcontractors.
8. Consultant agrees to waive, and to obtain endorsements from insurers waiving, subrogation rights against the City, its officers, officials, agents, employees, and volunteers for losses arising from work performed by Consultant for the City and to require each of its subcontractors, if any, to do likewise under their insurance policies.
9. Coverage shall be on a standard occurrence form. Claims -made forms are not acceptable, except under the Professional Errors & Omissions ("E&O") Liability policy.
Modified, limited, or restricted occurrence forms are not acceptable. 44 EXHIBIT C
CERTIFICATES OF INSURANCE AND ENDORSEMENTS
14 [Name of Contractor
Rev. 01/2024 45
AccoR o® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY) 6/4/2026
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 this certificate does not confer rights to the certificate holder in lieu of
PRODUCER
Acrisure Southwest Partners Insurance Services, LLC
611 Anton Blvd., Suite #1400
Costa Mesa, CA 92626
www.patrisk.com OK07568
INSURED
California Waters LLC
California Waters Development, Inc.
23311 E. La Palma Avenue
Yorba Linda CA 92887
COVERAGES
the policy, certain policies may require an endorsement. A statement on such endorsement(s).
ICONTACT
NAME:
IPHONE
(A/C. No. Extl:
IE-MAIL
ADDRESS:
INSURER A :
INSURER B :
I INSURER C :
I INSURER D :
I INSURER E :
I INSURER F :
CERTIFICATE NUMBER: 90918346 REVISION NUMBER:
Annette Romero
949-486-7904
aromeroacrisure.com
INSURER(S) AFFORDING COVERAGE
Accelerant Specialty Insurance Company
BITCO General Insurance Corporation
Lloyd's Insurance Company of S.A.
State National Insurance Company, Inc.
Underwriters at Lloyd's London
FAX
(A/C, No):
NAIC #
16890
20095
12831
15792
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
A � COMMERCIAL GENERAL LIABILITY ✓ ✓ DACP000043901 7/31/2025 7/31/2026 EACH OCCURRENCE A
CLAIMS -MADE
OCCUR
✓ Ded $10,000 BI & PD Combined
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ✓ JECT LOC
OTHER: POLLUTION LIABILITY
B AUTOMOBILE LIABILITY
✓ ANY AUTO
OWNED
AUTOS ONLY
HIRED
✓ AUTOS ONLY
No SIR
A UMBRELLA LIAB
✓ EXCESS LIAB
■
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
OCCUR
CLAIMS -MADE
✓ DED RETENT ON $0
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
If yes, describe under
pEScRIPTIONrofessiona 9Fpbility TIOJVS below
C ppro esslona la I ltyPtAD - 07/31/22
D Cyber Liability
E Sexual Abuse & Molestation Liability
SEE ADDENUM FOR LSD-EQPT COV
Y/N
N
DACP000043901
✓ ✓ CAP3761151
✓ DACPX0000058-01
N/A
✓ WC3761152
ANE520808125
EHJAD001449363
B0621PCAL1012425
7/31/2025 7/31/2026
7/31/2025 7/31/2026
7/31/2025 7/31/2026
7/31/2025 7/31/2026
7/31/2025
7/31/2025
3/26/2025
7/31/2026
7/31/2026
7/31/2026
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
Limit: $1,000,000
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident)
EACH OCCURRENCE
AGGREGATE
$1,000,000
$ 100,000
$ 5,000
$ 1,000,000
$ 2,000,000
$ 2,000,000
$ 2,000,000 AGG
$1,000,000
$ 5,000,000
$ 5,000,000
✓ STATUTE ERH
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1.000.000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
Ea Occ: $2,000,000/Ded $10,000 Ea Claim
Aggregate Limit: $1,000,000 / Ret. $5,000
Per Claim $1,000,000 / Agg $2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: MAINTENANCE SERVICES FOR PUBLIC SWIMMING POOL AND FOUNTAIN RFP No. PW -26-04 / Multiple Locations:
Whitten Center Community Pool, 900 S. Melrose St.; Gomez Center Community Pool, 1701 Atwood Ave. and City Hall Water Fountain, 401 E. Chapman Ave.
The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are named as Additional Insureds, Coverage includes Primary and Non-contributory and Waiver of subrogation applies and in favor of the additional insureds per endorsements attached as required by written contract. *30 -Day notice of cancellation / 10 -days for non-payment of premium.
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
Dave Jacobson
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 46 90918346 25/26 GL/AU/UMB/WC/PROF/POLL/LSD/SXL MOL Annette Romero 6/4/2026 10:44:29 AM (PDT) Pagc 1 of 16 This certificate cancels and supersedes ALL previously issued certificates.
ACORO®
AGENCY
AGENCY CUSTOMER ID:
LOC #:
ADDITIONAL REMARKS SCHEDULE
Acrisure Southwest Partners Insurance Services, LLC
POLICY NUMBER
CARRIER
NAIC CODE
NAMED INSURED
California Waters LLC
California Waters Development, Inc.
23311 E. La Palma Avenue
Yorba Linda CA 92887
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (03/16) HOLDER: City of Placentia
ADDRESS: 401 E. Chapman Placentia CA 92870
LEASED/RENTED EQUIPMENT
CARRIER: OHIO SECURITY INSURANCE COMPANY
POLICY TERM: 07/31/2025 — 07/31/2026
POLICY NUMBER: BKS66176623
LIMIT: $250,000 / DEDUCTIBLE $500
Page of
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD ATTACHMEI47 90918346 1 25/26 GL/AU/UMB/WC/PROF/POLL/LSD/SXL MOL 1 Annette Romero 1 6/4/2026 10:44:29 AM (PDT) 1 Page 2 of 16 This certificate cancels and supersedes ALL previously issued certificates.
POLICY NUMBER: DACP0000439-01 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
Any person or organization where required by written contract. In respect to any location where the named insured is performing "your work".
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.
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
insurance 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.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "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.
CG 20 10 04 13 © Insurance Services Office, Inc., 2012
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C. 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:
1. Required by the contract or agreement; or
2. 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 Declarations.
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CG 20 10 04 13
POLICY NUMBER: DACP0000439-01 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED
OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location And Description Of Completed Operations Any person or organization where required by written In respect to any location where the named insured is contract. performing "your work".
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury" or
"property damage" caused, in whole or in part, by
"your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and included
in the "products -completed operations hazard".
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
insurance 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.
B. 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:
1. Required by the contract or agreement; or
2. 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 Declarations.
CG 20 37 04 13 © Insurance Services Office, Inc., 2012
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COMMERCIAL GENERAL LIABILITY
CG 20 01 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available
to an additional insured under your policy
provided that:
(1) The additional insured is a Named Insured
under such other insurance; and
CG 20 01 04 13
(2)
You have agreed in
agreement that this
and would not seek
insurance available
© Insurance Services Office, Inc., 2012
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insurance would be primary
contribution from any other
to the additional insured.
POLICY NUMBER: DACP0000439-01 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):
IAny person or organization where required by written contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV — Conditions:
We waive any right of recovery against the person(s)
or organization(s) shown in the Schedule above
because of payments we make under this Coverage
Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against
such person(s) or organization(s) prior to loss. This
endorsement applies only to the person(s) or
organization(s) shown in the Schedule above.
90918396 25/262GL/Ayi 12/19PROF/POLL/LSD/SXL MOL Ann©I P.r.aro Te6/n6c i0S94:2 cA, !ftcp Page 7 of 16 This certificate cancels and supersedes ALL previously issued certificates.
BITCO GENERAL INSURANCE CORPORATION
BITCO NATIONAL INSURANCE COMPANY
California Waters Development, Inc.
California Waters LLC
CAP3761151
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BROADENED COVERAGE - AUTOMOBILES
The following modifies insurance provided under:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.
1 - Broad Form Named Insured
2 - Automatic Waiver of Subrogation
3 - Automatic Additional Insured
4 - Primary and Noncontributory - Other
Insurance Condition
5 - Unintentional Failure to Disclose Hazards
6 - Extended Notice of Cancellation,
Non -Renewal
7 - When We Do Not Renew
8 - Notice of Knowledge of Accident or Loss
9 - Employees as Insured
10 - Employee Hired Autos
1. BROAD FORM NAMED INSURED
11 - Bodily Injury Extension
12 - Hired Auto Physical Damage
13 - Enhanced Supplementary Payments
14 - Fellow Employee Coverage for Designated
Positions
15 - Physical Damage — Transportation Expenses
16 - Rental Reimbursement Coverage
17 - Loan/Lease Gap Coverage
18 - Accidental Air Bag Discharge Coverage
19 - Glass Repair — Waiver of Deductible
SECTION II. A. 1. -WHO IS AN INSURED - Paragraph d. is added:
d. Any organization you newly acquire or form, except for a partnership, joint venture or limited liability company, and over which you maintain majority ownership or interest (51% or more) or for which you have assumed the active management, will qualify as a Named Insured if there is no other similar insurance available to that organization. However, coverage under this provision is only afforded until the end of the policy period or the 12 -month anniversary of the policy inception date, whichever is earlier.
2. AUTOMATIC WAIVER OF SUBROGATION
Section IV — Business Auto Conditions, Paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is deleted and replaced with the following:
a. If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them.
b. If required by a written contract executed prior to loss, we waive any right of recovery we may have against any person or organization because of payments we make for damages under this coverage form.
AP -0401 (10/17) -1-
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3. AUTOMATIC ADDITIONAL INSURED
SECTION II — WHO IS AN INSURED, Paragraph A.1, is amended to include as an "insured" any person or organization who is required by written contract or agreement to be an additional insured on your policy, but only with respect to liability arising out of operations performed by you or on your behalf for the additional insured.
4. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:
1. Such "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 such "insured".
5. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Although we relied on your representations as to existing and past hazards, if unintentionally you should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure.
6. EXTENDED NOTICE OF CANCELLATION, NON -RENEWAL
The COMMON POLICY CONDITIONS, Item A.2.b. is deleted and replaced with the following:
A.2.b. 60 days before the effective date of the cancellation if we cancel for any other reason.
7. WHEN WE DO NOT RENEW
SECTION IV — BUSINESS AUTO CONDITIONS, is amended to add Item B.9.:
a. If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date.
b. If we do not give notice of our intent to nonrenew as prescribed in a. above, it is agreed that you may extend the period of this policy for a maximum additional sixty (60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not otherwise prohibited by law, this one-time sixty-day extension is the sole remedy and liquidated damages available to the insured as a result of our failure to give the notice as prescribed in 9. a. above.
8. NOTICE OF KNOWLEDGE OF ACCIDENT OR LOSS
SECTION IV - BUSINESS AUTO CONDITIONS, Item A.2.a. is deleted and replaced with the following:
2. Duties in the Event of Accident, Claim Suit or Loss:
a. You must see to it that we are notified of an "accident", "claim", "suit" or "loss" which may result in a claim as soon as practicable after the "occurrence" has been reported to you, a partner, a member, an officer, or an employee designated to give notice to us.
Notice should include:
AP -0401 (10/17) -2-
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(1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
9. EMPLOYEES AS INSURED
The following is added to the Section II - Covered Autos Liability Coverage, Paragraph A.1. Who Is An Insured provision:
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.
10. EMPLOYEE HIRED AUTOS
A. Changes In Covered Autos Liability Coverage
The following is added to the Who Is An Insured Provision:
An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business.
B. Changes In General Conditions
Paragraph 5.b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph 5.f. of the Other Insurance - Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following:
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 an "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".
11. BODILY INJURY EXTENSION
SECTION V - DEFINITIONS, Paragraph C. is deleted and replaced by the following:
C. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these, at any time. Mental anguish means any type of mental or emotional illness or disease.
12. HIRED AUTO PHYSICAL DAMAGE
SECTION III.A.4. - Coverage Extensions - Paragraph c. is added:
c. Hired Auto Physical Damage
If Comprehensive, Specified Causes of Loss or Collision coverage is provided under this policy, then Hired Auto Physical Damage is provided for that coverage part subject to the following:
AP -0401 (10/17) -3-
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(1) The most we will pay for any one "accident" or "loss" under this Hired Auto Physical Damage Coverage is the lesser of:
(a) The any one "Accident" or "Loss" amount of $100,000; (b) The actual cash value; or
(c) Cost of repair.
Our obligation to pay for a loss in c.(1) above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for "loss" caused by fire or lightning. (2) Subject to paragraph c.(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the declarations. (3) When you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired "auto" resulting from a covered "accident" or "loss", we will cover that financial loss subject to the limit specified in paragraph c.(1).
13. ENHANCED SUPPLEMENTARY PAYMENTS
SECTION II.A.2.a. COVERAGE EXTENSIONS, Supplementary Payments (2) and (4) are replaced by the following:
(2) Up to $2,500 for the cost of bail bonds (including bonds for related traffic laws violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $350 a day because of time off from work.
14. FELLOW EMPLOYEE COVERAGE FOR DESIGNATED POSITIONS
The Fellow Employee Exclusion contained in Section II.B.5. does not apply to the following positions or job titles: foreman, supervisor, manager, officer, partner or other senior level "employee". Coverage is excess over all other collectible insurance.
15. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES
SECTION III.A.4.a. Transportation Expenses is replaced by the following:
a. Transportation Expenses
We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto". We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Cause 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 expirations, when the covered "auto" is returned to use or we pay for its "loss".
For autos provided with temporary transportation expense, the following physical damage coverage will apply:
(1) The most we will pay for any one "accident" or "loss" under the temporary transportation expense physical damage coverage is the lessor of:
(a) The any one "Accident" or "Loss" amount of $100,000; (b) The actual cash value; or
AP -0401 (10/17) -4-
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(c) Cost of repair.
Our obligation to pay for a loss in a.(1) above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for "loss" caused by fire or lightning. (2) Subject to paragraph a.(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the declarations. (3) When you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired "auto" resulting from a covered "accident" or "loss", we will cover that financial loss subject to the limit specified in paragraph a.(1).
16. RENTAL REIMBURSEMENT COVERAGE
SECTION III.A.4. - Coverage Extensions - Paragraph d. is added. d. If you carry Comprehensive, Specified Causes of Loss or Collision coverage for the damaged covered "auto" as provided under this policy, then Rental Reimbursement Coverage is provided for that coverage part subject to the following:
1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" other than theft, to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage.
2. We will only pay for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days:
(a) The number of days reasonably required to repair or replace the covered "auto"; or,
(b) 30 days.
(c) Our payment is limited to the lesser of the following amounts:
(1) Necessary and actual expenses incurred; or
(2) $50 per day.
17. LOAN/LEASE GAP COVERAGE
Physical Damage Coverage is amended by the addition of the following:
In the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the loss and the "outstanding balance" of the loan/lease, not to exceed $2,500 for any one vehicle or $25,000 annually in aggregate.
For the purposes of this endorsement, "outstanding balance" means the amount you owe on the loan/lease at the time of loss less any amounts representing taxes, overdue payments, penalties, interest or charges resulting from overdue payments, additional mileage charges, excess wear and tear charges or lease termination fees, costs for extended warranties, credit Life Insurance; Health, Accident or Disability Insurance purchased with the loan or lease; and carry-over balances from previous loans or leases.
18. ACCIDENTAL AIR BAG DISCHARGE COVERAGE
SECTION III.B.3.a - Exclusions. This exclusion does not apply to the accidental discharge of an air bag.
AP -0401 (10/17) -5-
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19. GLASS REPAIR - WAIVER OF DEDUCTIBLE
SECTION III.D - Deductible is replaced with the following:
For each covered "auto", our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning. The deductible does not apply to glass damage if the glass is repaired rather than replaced.
AP -0401 (10/17) -6-
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POLICY NUMBER: CAP3761151
COMMERCIAL AUTO
CA 20 48 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: California Waters LLC
California Waters Development, Inc.
Endorsement Effective Date: 07/31/2025
SCHEDULE
Name Of Person(s) Or Organization(s):
Any person(s) or organization(s) whom you are required to add as an additional insured on this policy under a written contract or written agreement.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured
provision contained in Paragraph A.1. of Section II —
Covered Autos Liability Coverage in the Business
Auto and Motor Carrier Coverage Forms and
Paragraph D.2. of Section I — Covered Autos
Coverages of the Auto Dealers Coverage Form.
CA 20 48 10 13
© Insurance Services Office, Inc., 2011 Page 1 of 1
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BITCO GENERAL INSURANCE CORPORATION
BITCO NATIONAL INSURANCE COMPANY
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE 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.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
WHEN REQUIRED BY WRITTEN CONTRACT.
The premium charge for this endorsement is $
Named Insured California Waters LLC
falifnrnia \Natprc npvpinnmpnt Inc
Policy Number WC3761152 Endorsement No.
Policy Period 07/31/2025 to 07/31/2026 Endorsement Effective Date: 06/04/2026 Producer's Name: Acrisure Southwest Partners Insurance Services, LLC Producer Number:
06/04/2026
AUTHORIZED REPRESENTATIVE DATE
99 90918346 25/26VGL/AO/ MBB/WC/ RO(/ OLLL/L0D/SXL MOL Annette Romero 6/4/2026 10:44:29 AM (PDT) Page 15 of 16 This certificate cancels and supersedes ALL previously issued certificates.
California Waters LLC
California Waters Development, Inc.
ACCELERANT
Accelerant Specialty Insurance Company
400 Northridge Road
Sandy Springs, GA 30350
SCHEDULE A - SCHEDULE OF UNDERLYING INSURANCE
COMMERCIAL EXCESS LIABILITY COVERAGE
This schedule forms a part of Policy Number: DACPX0000058-01
TYPE OF POLICY LIMITS OF LIABILITY
Controlling Underlying Insurance Policies
Commercial General Liability Occurrence
Company Accelerent Specialty Insurance Company
Policy Number DACP0000439-01
Effective 7/31/2024
Expiration 7/31/2025
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $2,000,000 Personal and Advertising Injury Limit $1,000,000
Each Occurence Limit $1,000,000
Contractors Pollution Liability Occurrence
Company Accelerent Specialty Insurance Company
Policy Number DACP0000439-01
Effective 7/31/2024
Expiration 7/31/2025
Aggregate Limit
Each Pollution Condition Limit
Commercial Automobile Liability
Company TBD
Policy Number TBD
Effective 7/31/2025
Expiration 7/31/2026
Employers Liability
$2,000,000
$1,000,000
Combined Single Limit $1,000,000
Company TBD
Policy Number TBD
Effective 7/31/2025
Expiration 7/31/2026
Each Accident
Disease Each Employee
Disease Policy Limit
DACPX 10 00 11 23
Date Created: 9/4/2025
Accelerant Specialty Insurance Company, Limited Copyright 2024 $1,000,000
$1,000,000
$1,000,000
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AccoR o® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY) 6/4/2026
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 this certificate does not confer rights to the certificate holder in lieu of
PRODUCER
Acrisure Southwest Partners Insurance Services, LLC
611 Anton Blvd., Suite #1400
Costa Mesa, CA 92626
www.patrisk.com OK07568
INSURED
California Waters LLC
California Waters Development, Inc.
23311 E. La Palma Avenue
Yorba Linda CA 92887
COVERAGES
the policy, certain policies may require an endorsement. A statement on such endorsement(s).
ICONTACT
NAME:
IPHONE
(A/C. No. Extl:
IE-MAIL
ADDRESS:
INSURER A :
INSURER B :
I INSURER C :
I INSURER D :
I INSURER E :
I INSURER F :
CERTIFICATE NUMBER: 90918346 REVISION NUMBER:
Annette Romero
949-486-7904
aromeroacrisure.com
INSURER(S) AFFORDING COVERAGE
Accelerant Specialty Insurance Company
BITCO General Insurance Corporation
Lloyd's Insurance Company of S.A.
State National Insurance Company, Inc.
Underwriters at Lloyd's London
FAX
(A/C, No):
NAIC #
16890
20095
12831
15792
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
A � COMMERCIAL GENERAL LIABILITY ✓ ✓ DACP000043901 7/31/2025 7/31/2026 EACH OCCURRENCE A
CLAIMS -MADE
OCCUR
✓ Ded $10,000 BI & PD Combined
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ✓ JECT LOC
OTHER: POLLUTION LIABILITY
B AUTOMOBILE LIABILITY
✓ ANY AUTO
OWNED
AUTOS ONLY
HIRED
✓ AUTOS ONLY
No SIR
A UMBRELLA LIAB
✓ EXCESS LIAB
■
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
OCCUR
CLAIMS -MADE
✓ DED RETENT ON $0
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
If yes, describe under
pEScRIPTIONrofessiona 9Fpbility TIOJVS below
C ppro esslona la I ltyPtAD - 07/31/22
D Cyber Liability
E Sexual Abuse & Molestation Liability
SEE ADDENUM FOR LSD-EQPT COV
Y/N
N
DACP000043901
✓ ✓ CAP3761151
✓ DACPX0000058-01
N/A
✓ WC3761152
ANE520808125
EHJAD001449363
B0621PCAL1012425
7/31/2025 7/31/2026
7/31/2025 7/31/2026
7/31/2025 7/31/2026
7/31/2025 7/31/2026
7/31/2025
7/31/2025
3/26/2025
7/31/2026
7/31/2026
7/31/2026
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
Limit: $1,000,000
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident)
EACH OCCURRENCE
AGGREGATE
$1,000,000
$ 100,000
$ 5,000
$ 1,000,000
$ 2,000,000
$ 2,000,000
$ 2,000,000 AGG
$1,000,000
$ 5,000,000
$ 5,000,000
✓ STATUTE ERH
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1.000.000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
Ea Occ: $2,000,000/Ded $10,000 Ea Claim
Aggregate Limit: $1,000,000 / Ret. $5,000
Per Claim $1,000,000 / Agg $2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: MAINTENANCE SERVICES FOR PUBLIC SWIMMING POOL AND FOUNTAIN RFP No. PW -26-04 / Multiple Locations:
Whitten Center Community Pool, 900 S. Melrose St.; Gomez Center Community Pool, 1701 Atwood Ave. and City Hall Water Fountain, 401 E. Chapman Ave.
The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers are named as Additional Insureds, Coverage includes Primary and Non-contributory and Waiver of subrogation applies and in favor of the additional insureds per endorsements attached as required by written contract. *30 -Day notice of cancellation / 10 -days for non-payment of premium.
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
Dave Jacobson
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 62 90918346 25/26 GL/AU/UMB/WC/PROF/POLL/LSD/SXL MOL Annette Romero 6/4/2026 10:44:29 AM (PDT) Pagc 1 of 16 This certificate cancels and supersedes ALL previously issued certificates.
ACORO®
AGENCY
AGENCY CUSTOMER ID:
LOC #:
ADDITIONAL REMARKS SCHEDULE
Acrisure Southwest Partners Insurance Services, LLC
POLICY NUMBER
CARRIER
NAIC CODE
NAMED INSURED
California Waters LLC
California Waters Development, Inc.
23311 E. La Palma Avenue
Yorba Linda CA 92887
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (03/16) HOLDER: City of Placentia
ADDRESS: 401 E. Chapman Placentia CA 92870
LEASED/RENTED EQUIPMENT
CARRIER: OHIO SECURITY INSURANCE COMPANY
POLICY TERM: 07/31/2025 — 07/31/2026
POLICY NUMBER: BKS66176623
LIMIT: $250,000 / DEDUCTIBLE $500
Page of
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD ATTACHMEI63 90918346 1 25/26 GL/AU/UMB/WC/PROF/POLL/LSD/SXL MOL 1 Annette Romero 1 6/4/2026 10:44:29 AM (PDT) 1 Page 2 of 16 This certificate cancels and supersedes ALL previously issued certificates.
POLICY NUMBER: DACP0000439-01 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
Any person or organization where required by written contract. In respect to any location where the named insured is performing "your work".
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.
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
insurance 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.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "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.
CG 20 10 04 13 © Insurance Services Office, Inc., 2012
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C. 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:
1. Required by the contract or agreement; or
2. 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 Declarations.
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CG 20 10 04 13
POLICY NUMBER: DACP0000439-01 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED
OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location And Description Of Completed Operations Any person or organization where required by written In respect to any location where the named insured is contract. performing "your work".
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury" or
"property damage" caused, in whole or in part, by
"your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and included
in the "products -completed operations hazard".
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
insurance 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.
B. 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:
1. Required by the contract or agreement; or
2. 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 Declarations.
CG 20 37 04 13 © Insurance Services Office, Inc., 2012
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COMMERCIAL GENERAL LIABILITY
CG 20 01 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available
to an additional insured under your policy
provided that:
(1) The additional insured is a Named Insured
under such other insurance; and
CG 20 01 04 13
(2)
You have agreed in
agreement that this
and would not seek
insurance available
© Insurance Services Office, Inc., 2012
90918346 1 25/26 GL/AU/UMB/WC/PROF/POLL/LSD/SXL MOL 1 Annette Romero 1 6/4/2026 10:99:29 AM (PDT) 1 Page 6 of 16 This certificate cancels and supersedes ALL previously issued certificates. writing in a contract or
insurance would be primary
contribution from any other
to the additional insured.
POLICY NUMBER: DACP0000439-01 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):
IAny person or organization where required by written contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV — Conditions:
We waive any right of recovery against the person(s)
or organization(s) shown in the Schedule above
because of payments we make under this Coverage
Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against
such person(s) or organization(s) prior to loss. This
endorsement applies only to the person(s) or
organization(s) shown in the Schedule above.
90918396 25/262GL/Ayi 12/19PROF/POLL/LSD/SXL MOL Ann©I P.r.aro Te6/n6c i0S94:2 cA, !ftcp Page 7 of 16 This certificate cancels and supersedes ALL previously issued certificates.
BITCO GENERAL INSURANCE CORPORATION
BITCO NATIONAL INSURANCE COMPANY
California Waters Development, Inc.
California Waters LLC
CAP3761151
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BROADENED COVERAGE - AUTOMOBILES
The following modifies insurance provided under:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.
1 - Broad Form Named Insured
2 - Automatic Waiver of Subrogation
3 - Automatic Additional Insured
4 - Primary and Noncontributory - Other
Insurance Condition
5 - Unintentional Failure to Disclose Hazards
6 - Extended Notice of Cancellation,
Non -Renewal
7 - When We Do Not Renew
8 - Notice of Knowledge of Accident or Loss
9 - Employees as Insured
10 - Employee Hired Autos
1. BROAD FORM NAMED INSURED
11 - Bodily Injury Extension
12 - Hired Auto Physical Damage
13 - Enhanced Supplementary Payments
14 - Fellow Employee Coverage for Designated
Positions
15 - Physical Damage — Transportation Expenses
16 - Rental Reimbursement Coverage
17 - Loan/Lease Gap Coverage
18 - Accidental Air Bag Discharge Coverage
19 - Glass Repair — Waiver of Deductible
SECTION II. A. 1. -WHO IS AN INSURED - Paragraph d. is added:
d. Any organization you newly acquire or form, except for a partnership, joint venture or limited liability company, and over which you maintain majority ownership or interest (51% or more) or for which you have assumed the active management, will qualify as a Named Insured if there is no other similar insurance available to that organization. However, coverage under this provision is only afforded until the end of the policy period or the 12 -month anniversary of the policy inception date, whichever is earlier.
2. AUTOMATIC WAIVER OF SUBROGATION
Section IV — Business Auto Conditions, Paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is deleted and replaced with the following:
a. If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them.
b. If required by a written contract executed prior to loss, we waive any right of recovery we may have against any person or organization because of payments we make for damages under this coverage form.
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3. AUTOMATIC ADDITIONAL INSURED
SECTION II — WHO IS AN INSURED, Paragraph A.1, is amended to include as an "insured" any person or organization who is required by written contract or agreement to be an additional insured on your policy, but only with respect to liability arising out of operations performed by you or on your behalf for the additional insured.
4. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:
1. Such "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 such "insured".
5. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Although we relied on your representations as to existing and past hazards, if unintentionally you should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure.
6. EXTENDED NOTICE OF CANCELLATION, NON -RENEWAL
The COMMON POLICY CONDITIONS, Item A.2.b. is deleted and replaced with the following:
A.2.b. 60 days before the effective date of the cancellation if we cancel for any other reason.
7. WHEN WE DO NOT RENEW
SECTION IV — BUSINESS AUTO CONDITIONS, is amended to add Item B.9.:
a. If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date.
b. If we do not give notice of our intent to nonrenew as prescribed in a. above, it is agreed that you may extend the period of this policy for a maximum additional sixty (60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not otherwise prohibited by law, this one-time sixty-day extension is the sole remedy and liquidated damages available to the insured as a result of our failure to give the notice as prescribed in 9. a. above.
8. NOTICE OF KNOWLEDGE OF ACCIDENT OR LOSS
SECTION IV - BUSINESS AUTO CONDITIONS, Item A.2.a. is deleted and replaced with the following:
2. Duties in the Event of Accident, Claim Suit or Loss:
a. You must see to it that we are notified of an "accident", "claim", "suit" or "loss" which may result in a claim as soon as practicable after the "occurrence" has been reported to you, a partner, a member, an officer, or an employee designated to give notice to us.
Notice should include:
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(1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
9. EMPLOYEES AS INSURED
The following is added to the Section II - Covered Autos Liability Coverage, Paragraph A.1. Who Is An Insured provision:
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.
10. EMPLOYEE HIRED AUTOS
A. Changes In Covered Autos Liability Coverage
The following is added to the Who Is An Insured Provision:
An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business.
B. Changes In General Conditions
Paragraph 5.b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph 5.f. of the Other Insurance - Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following:
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 an "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".
11. BODILY INJURY EXTENSION
SECTION V - DEFINITIONS, Paragraph C. is deleted and replaced by the following:
C. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these, at any time. Mental anguish means any type of mental or emotional illness or disease.
12. HIRED AUTO PHYSICAL DAMAGE
SECTION III.A.4. - Coverage Extensions - Paragraph c. is added:
c. Hired Auto Physical Damage
If Comprehensive, Specified Causes of Loss or Collision coverage is provided under this policy, then Hired Auto Physical Damage is provided for that coverage part subject to the following:
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(1) The most we will pay for any one "accident" or "loss" under this Hired Auto Physical Damage Coverage is the lesser of:
(a) The any one "Accident" or "Loss" amount of $100,000; (b) The actual cash value; or
(c) Cost of repair.
Our obligation to pay for a loss in c.(1) above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for "loss" caused by fire or lightning. (2) Subject to paragraph c.(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the declarations. (3) When you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired "auto" resulting from a covered "accident" or "loss", we will cover that financial loss subject to the limit specified in paragraph c.(1).
13. ENHANCED SUPPLEMENTARY PAYMENTS
SECTION II.A.2.a. COVERAGE EXTENSIONS, Supplementary Payments (2) and (4) are replaced by the following:
(2) Up to $2,500 for the cost of bail bonds (including bonds for related traffic laws violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $350 a day because of time off from work.
14. FELLOW EMPLOYEE COVERAGE FOR DESIGNATED POSITIONS
The Fellow Employee Exclusion contained in Section II.B.5. does not apply to the following positions or job titles: foreman, supervisor, manager, officer, partner or other senior level "employee". Coverage is excess over all other collectible insurance.
15. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES
SECTION III.A.4.a. Transportation Expenses is replaced by the following:
a. Transportation Expenses
We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto". We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Cause 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 expirations, when the covered "auto" is returned to use or we pay for its "loss".
For autos provided with temporary transportation expense, the following physical damage coverage will apply:
(1) The most we will pay for any one "accident" or "loss" under the temporary transportation expense physical damage coverage is the lessor of:
(a) The any one "Accident" or "Loss" amount of $100,000; (b) The actual cash value; or
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(c) Cost of repair.
Our obligation to pay for a loss in a.(1) above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for "loss" caused by fire or lightning. (2) Subject to paragraph a.(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the declarations. (3) When you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired "auto" resulting from a covered "accident" or "loss", we will cover that financial loss subject to the limit specified in paragraph a.(1).
16. RENTAL REIMBURSEMENT COVERAGE
SECTION III.A.4. - Coverage Extensions - Paragraph d. is added. d. If you carry Comprehensive, Specified Causes of Loss or Collision coverage for the damaged covered "auto" as provided under this policy, then Rental Reimbursement Coverage is provided for that coverage part subject to the following:
1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" other than theft, to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage.
2. We will only pay for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days:
(a) The number of days reasonably required to repair or replace the covered "auto"; or,
(b) 30 days.
(c) Our payment is limited to the lesser of the following amounts:
(1) Necessary and actual expenses incurred; or
(2) $50 per day.
17. LOAN/LEASE GAP COVERAGE
Physical Damage Coverage is amended by the addition of the following:
In the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the loss and the "outstanding balance" of the loan/lease, not to exceed $2,500 for any one vehicle or $25,000 annually in aggregate.
For the purposes of this endorsement, "outstanding balance" means the amount you owe on the loan/lease at the time of loss less any amounts representing taxes, overdue payments, penalties, interest or charges resulting from overdue payments, additional mileage charges, excess wear and tear charges or lease termination fees, costs for extended warranties, credit Life Insurance; Health, Accident or Disability Insurance purchased with the loan or lease; and carry-over balances from previous loans or leases.
18. ACCIDENTAL AIR BAG DISCHARGE COVERAGE
SECTION III.B.3.a - Exclusions. This exclusion does not apply to the accidental discharge of an air bag.
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19. GLASS REPAIR - WAIVER OF DEDUCTIBLE
SECTION III.D - Deductible is replaced with the following:
For each covered "auto", our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning. The deductible does not apply to glass damage if the glass is repaired rather than replaced.
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POLICY NUMBER: CAP3761151
COMMERCIAL AUTO
CA 20 48 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: California Waters LLC
California Waters Development, Inc.
Endorsement Effective Date: 07/31/2025
SCHEDULE
Name Of Person(s) Or Organization(s):
Any person(s) or organization(s) whom you are required to add as an additional insured on this policy under a written contract or written agreement.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured
provision contained in Paragraph A.1. of Section II —
Covered Autos Liability Coverage in the Business
Auto and Motor Carrier Coverage Forms and
Paragraph D.2. of Section I — Covered Autos
Coverages of the Auto Dealers Coverage Form.
CA 20 48 10 13
© Insurance Services Office, Inc., 2011 Page 1 of 1
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BITCO GENERAL INSURANCE CORPORATION
BITCO NATIONAL INSURANCE COMPANY
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE 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.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
WHEN REQUIRED BY WRITTEN CONTRACT.
The premium charge for this endorsement is $
Named Insured California Waters LLC
falifnrnia \Natprc npvpinnmpnt Inc
Policy Number WC3761152 Endorsement No.
Policy Period 07/31/2025 to 07/31/2026 Endorsement Effective Date: 06/04/2026 Producer's Name: Acrisure Southwest Partners Insurance Services, LLC Producer Number:
06/04/2026
AUTHORIZED REPRESENTATIVE DATE
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California Waters LLC
California Waters Development, Inc.
ACCELERANT
Accelerant Specialty Insurance Company
400 Northridge Road
Sandy Springs, GA 30350
SCHEDULE A - SCHEDULE OF UNDERLYING INSURANCE
COMMERCIAL EXCESS LIABILITY COVERAGE
This schedule forms a part of Policy Number: DACPX0000058-01
TYPE OF POLICY LIMITS OF LIABILITY
Controlling Underlying Insurance Policies
Commercial General Liability Occurrence
Company Accelerent Specialty Insurance Company
Policy Number DACP0000439-01
Effective 7/31/2024
Expiration 7/31/2025
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $2,000,000 Personal and Advertising Injury Limit $1,000,000
Each Occurence Limit $1,000,000
Contractors Pollution Liability Occurrence
Company Accelerent Specialty Insurance Company
Policy Number DACP0000439-01
Effective 7/31/2024
Expiration 7/31/2025
Aggregate Limit
Each Pollution Condition Limit
Commercial Automobile Liability
Company TBD
Policy Number TBD
Effective 7/31/2025
Expiration 7/31/2026
Employers Liability
$2,000,000
$1,000,000
Combined Single Limit $1,000,000
Company TBD
Policy Number TBD
Effective 7/31/2025
Expiration 7/31/2026
Each Accident
Disease Each Employee
Disease Policy Limit
DACPX 10 00 11 23
Date Created: 9/4/2025
Accelerant Specialty Insurance Company, Limited Copyright 2024 $1,000,000
$1,000,000
$1,000,000
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