Placentia City Council
September 8, 2026

3;kc,25,Eggolk
Agenda Item No: 1.i

PLACENTIA CITY COUNCIL AGENDA REPORT
Meeting Date: September 8, 2026
Submitted by: Jesus Avila
From: Public Works
Subject:

AMENDMENT NO. 2 TO PUBLIC WORKS AGREEMENT WITH R.J. NOBLE COMPANY FOR CONSTRUCTION SERVICES RELATED TO THE FY 24-25 RESIDENTIAL STREET REHABILITATION PROJECT PROJECT NO. 26-104
Financial Impact:

Additional $ 60,171.64 Extra work for soil stabilization and pavement Expense: reconstruction
Budget: $654,176.00 Fiscal Year 2025-26 CIP, Measure M
(211-90300-9600)
Summary:

On October 7, 2025, the City Council entered into a Public Works Agreement (PWA) with RJ Noble Company for $1,972,915.05, for the Fiscal Year ("FY") 2024-25 Residential Street Rehabilitation Project. The scope of work for this Project entailed the rehabilitation of selected residential streets bounded by Bastanchury Road, Valencia Avenue, Placentia Avenue, and Yorba Linda Boulevard. In general, the work consisted of pavement rehabilitation; replacement of damaged sidewalk, curb, and gutter; two driveways in front of Brookhaven Elementary School; and new pavement striping, markings, and legends.

Additionally, the project team encountered several unforeseen conditions during project construction, including areas of unsuitable subgrade identified during roadway construction, additional concrete repairs requested by city constituents, and a request from the Fire and Life Safety Department to repave the existing parking lot at Fire Station 1. These items were addressed under Amendment No. 1 in the amount of $340,692.53, amending the total construction contract not -to -exceed amount to $2,313,607.58, and as approved by City Council on April 21, 2026.

The project team then encountered additional unforeseen challenges during construction when repaving at Fire Station 1. The contractor encountered clayey subgrade unsuitable for final paving that required mechanical soil stabilization. Staff recommends the approval of Amendment No. 2 to the subject agreement for construction services related to the FY 24-25 Residential Street Rehabilitation Project. As a result of these changes, construction costs are expected to go beyond the current not -to -exceed amount by $60,171.64, for a new total construction contract not -to -exceed amount of $2,373,779.22. 1 Recommended Action:

It is recommended that the City Council:

1. Approve Amendment No. 2 to a Public Works Agreement with RJ Noble Company for an additional $60,171.64 for a cumulative not -to -exceed amount of $2,373,779.22; and

2. Authorize the Acting City Administrator, and/or her designee, to execute the necessary documents, in a form approved by the City Attorney.

Strategic Plan Statement:

The item conforms to Strategic Plan Goal No. 3: Maintain and enhance streets, parks, and public facilities to ensure they are well-appointed, clean, attractive, and reflective of the City's commitment to quality.

Discussion:

On October 7, 2025, the City Council entered into a Public Works Agreement with RJ Noble Company for $1,972,915.05 for Fiscal Year ("FY") 2024-25 Residential Street Rehabilitation Project which included the construction of pavement rehabilitation; replacement of damaged sidewalk, curb, gutter; two driveways in front of Brookhaven Elementary School; and new pavement striping, markings, and legends.

Additionally, the project team encountered several unforeseen conditions during project construction, including areas of unsuitable subgrade identified during roadway construction, additional concrete repairs requested by city constituents, and a request from the Fire Department to repave the existing parking lot at Fire Station 1. These items were addressed under Amendment 1 in the amount of $340,692.53, amending the total construction contract not -to -exceed amount to $2,313,607.58 and as approved by City Council on April 21, 2026.

During repaving at Fire Station 1, the contractor encountered clayey subgrade that was not suitable for final paving and would have compromised the long term performance of the pavement section. To ensure a stable foundation for the final pavement surface, mechanical soil stabilization was required. This work included additional excavation and the installation of a geogrid reinforcement layer, aggregate base material, and supplemental asphalt base material.

As noted in the previously approved staff report dated October 7, 2025, staff understood sufficient project funding was available to cover the cost of this additional work. To avoid added expenses associated with contractor re -mobilization and to maintain the project on schedule, staff authorized the contractor to proceed with the repairs immediately. Completing this work will enhance the lifespan of the new pavement and reduce the likelihood of near term pavement failures.

Staff recommends the approval of Amendment No. 2 to the subject agreement for construction services related to the FY 24-25 Residential Street Rehabilitation Project. As a result of these changes, construction costs are expected to go beyond the not to exceed amount by $60,171.64, for a new total construction contract not -to -exceed amount of $2,373,779.22.

Financial Summary:

The construction cost for the FY 24-25 Residential Street Rehabilitation Project amounts to $2,373,779.22. This includes the current Amendment No.1 contract amount plus an additional $60,171.64 necessary to complete additional soil stabilization work for the project. A total of $654,176.00 is available within the project budget Measure M account (211-90300-9600), 2 therefore sufficient funds exist for the recommended actions.

Attachments
RJ Noble Company - Amendment 2.pdf
(Fully Executed) RJ Noble Company - Amendment No. 1 (FY 24-25 Res. Street Rehab).pdf RJ Noble Company - 24-25 Residential Street Rehab Agreement.pdf 3 AMENDMENT NO. 2 TO

PUBLIC WORKS AGREEMENT

WITH RJ NOBLE COMPANY
This Amendment No. 2 ("Amendment") to the Agreement is made and entered into effective the 1st day of September 2026, by and between the CITY OF PLACENTIA, a Charter City and Municipal Corporation ("CITY"), and R.J. Noble Company, a California corporation (hereinafter "CONTRACTOR"). CITY and CONTRACTOR are sometimes hereinafter individually referred to as "Party" and or collectively referred to as the "Parties." A. Recitals.
(i) CITY and CONTRACTOR entered into a Public Works Agreement ("Agreement") effective October 7, 2025, through which CONTRACTOR has been providing construction services as more fully explained in the Scope of Services attached to the Agreement as Exhibit (ii) The Parties now seek to amend the Agreement to increase the compensation by $60,171.64 for additional work related to the soil stabilization of unsuitable subgrade during paving and construction of new asphalt pavement at Fire Station 1. Including previously approved change orders, the total not to exceed amount is $2,373,779.22. (iii) All legal prerequisites to the making of this Amendment have occurred.

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

B. Amendment to Agreement.

1. Section 3.1, Paragraph 1 of the Agreement is hereby amended to read as follows:

Contract Sum For the services rendered pursuant to this Agreement, the Contractor shall be compensated as specified herein, but not exceeding the maximum contract amount of two million three hundred seventy-three thousand seven hundred seventy-nine dollars and twenty- two cents ($2,373,779.22) (herein "Contract Sum"), except as provided in Section 2.9. The Contract Sum shall include the attendance of Contractor at all project meetings reasonably deemed necessary by the City; Contractor shall not be entitled to any additional compensation for attending said meetings.

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

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

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

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

CONSULTANT
By:

Steven L. M
ndoza' Wce President

CITY OF PLACENTIA
By:

Rosanna Ramirez
Acting City Administrator
ATTEST:

By:

Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:

By:

Christian L. Bettenhausen, City Attorney

5 AccoR o® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY) 7/6/2026
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 the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

PRODUCER
Acrisure Southwest Partners Insurance Services, LLC
611 Anton Blvd., Suite #1400
Costa Mesa, CA 92626
www.patrisk.com OK07568

INSURED
R. J. Noble Company
15505 Lincoln Avenue
P.O. Box 620
Orange CA 92856-9020

COVERAGES

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: 91366629 REVISION NUMBER:

Annette Romero
949-486-7904
aromeroacrisure.com

INSURER(S) AFFORDING COVERAGE
FAX
(A/C, No):

NAIC #
Travelers Property Casualty Company of America 25674
Evanston Insurance Company 35378

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 ✓ VTJ-EXGL-9F338142-TIL-26 7/1/2026 7/1/2027 EACH OCCURRENCE

CLAIMS -MADE
✓ $25,000 Deductible
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY ✓ PRO-

JECT LOC
OTHER:

A AUTOMOBILE LIABILITY
✓ ANY AUTO
OWNED

AUTOS ONLY
HIRED
✓ AUTOS ONLY
A � UMBRELLA LIAB

EXCESS LIAB
■

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
OCCUR

CLAIMS -MADE
DED RETENT ON $

A WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
If yes, describe under
ESCRIPTION OF 9P4RATMS below
BContractor's Pollution Liability
Y/N
N/A
VTC2E-CAP-9F338154-TCT-26 7/1/2026 7/1/2027
CUP -4R630983-26-25
Policy Follows Form Over
Underlying General Liab.

UB -7N939386 -26-25-K
No Deductible for Workers
Compensation
7/1/2026 7/1/2027
7/1/2026 7/1/2027
MKLV5ENV105765 7/1/2026 7/1/2029

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

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

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

PROPERTY DAMAGE
(Per accident)

EACH OCCURRENCE

AGGREGATE
✓ STATUTE ERH
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$ 2,000,000
$ 2,000,000
$ 5,000
$ 2,000,000
$ 4,000,000
$ 4,000,000
$ 2,000,000
$ 10,000,000
$ 10,000,000
$
$ 1,000,000
$1.000.000
$ 1,000,000
Each Occurrence: $5,000,000
General Aggregate: $5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Placentia and its elected and appointed boards, officers, officials, agents, employees, and volunteers 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; automobiles owned leased, hired, or borrowed by the Consultant. Coverage includes Primary & Non -Contributory per endorsement attached where required by written contract. 30 days notice of cancellation, 10 days for non-payment of premium.

CERTIFICATE HOLDER CANCELLATION
City of Placentia
401 E. Chapman Avenue
Placentia CA 92870
ACORD 25 (2016/03)

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.

The ACORD name and logo are registered marks of ACORD
91366629 26/27 - GL/AU/EXC/WC - 26/29 POLL Annette Romero 7/6/2026 1:24:21 PM (PDT) Page 1 of 4 6 VTJ-EXG L -9F338142 -TIL -26
R. J. Noble Company

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

BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:

Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. With respect to liability for "bodily injury' or
"property damage" that occurs, or for "personal
injury' caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omissions of such
person or organization.

The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.

This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
b. The insurance provided to such additional
insured does not apply to:
(1)
Any "bodily injury", "property damage" or
"personal injury' arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury" or "property damage"
caused by "your work" and included in the
"products -completed operations hazard"
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an "occurrence or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
(2) If a claim is made or "suit" is brought against
the additional insured:

CG D2 46 0419 0 2018 The Travelers Indemnity Company. All rights reserved. 91366629 26/27 - GL/AU/EXC/WC - 26/29 POLL Annette Romero 7/6/2026 1:24:21 PM (PDT) Page 2 of 4

7 COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit" as soon as practicable.
(3) Immediately send us copies of all legal
papers received in connection with the claim
or "suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit', and otherwise
comply with all policy conditions.

(4) Tender the defense and indemnity of any
claim or "suit" to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
® 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 8 91366629 126/27 - GL/AU/EXC/WC - 26/29 POLL I Annette Romero 17/6/2026 1:29:21 PM (PDT) I Page 3 of 4

R. J. Noble Company
POLICY NUMBER: VTJ-EXGL-9F338142-TIL-26

COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 07/01/2026
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

OTHER INSURANCE - DESIGNATED ADDITIONAL

INSUREDS - PRIMARY WITH RESPECT TO CERTAIN

OTHER INSURANCE
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS

PROVISIONS
The following is added to Paragraph 4.a., Primary
Insurance, of SECTION IV — COMMERCIAL
GENERAL UABILITY CONDITIONS:

The insurance afforded under this Coverage Part to
any additional insured shown in the Schedule Of
CG D4 26 0219
Designated Additional Insureds is primary to any of
the other insurance, whether primary, excess,
contingent or on any other basis, that is available to
such additional insured which covers such additional
insured as a named insured, and we will not share
with that other insurance.
2017 The Travelers Indemnity Company. All rights reserved.

Includes copyrighted material or Insurance Services Office, Inc. with its permission. 91366629 26/27 - GL/AU/EXC/WC - 26/29 POLL Annette Romero 7/6/2026 1:24:21 PM (PDT) Page 4 of 4

9 AMENDMENT NO. 1 TO

PUBLIC WORKS AGREEMENT

WITH RJ NOBLE COMPANY
This Amendment No. 1 ("Amendment") to the Agreement is made and entered into effective the 21st day of April 2026, by and between the CITY OF PLACENTIA, a Charter City and Municipal Corporation ("CITY"), and R.J. Noble Company, a California corporation (hereinafter "CONTRACTOR"). CITY and CONTRACTOR are sometimes hereinafter individually referred to as "Party" and or collectively referred to as the "Parties." A. Recitals.
(i) CITY and CONTRACTOR entered into a Public Works Agreement (Agreement") effective October 7, 2025, through which CONTRACTOR has been providing construction services as more fully explained in the Scope of Services attached to the Agreement as Exhibit (ii) The Parties now seek to amend the Agreement to increase the compensation by $340,692.53 for additional work related to the unsuitable subgrade during paving, construction of new asphalt pavement at Fire Station 1 and Drainage Structure Concrete Repairs Including previously approved change orders, the total not to exceed amount is $2,313,607.58 (iii) AH legal prerequisites to the making of this Amendment have occurred.

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

B. Amendment to Agreement.

1. Section 3.1, Paragraph 1 of the Agreement is hereby amended to read as follows:

Contract Sum For the services rendered pursuant to this Agreement, the Contractor shall be compensated as specified herein, but not exceeding the maximum contract amount of two million three hundred thirteen thousand six hundred seven dollars and fifty-eight cents ($2,313,607.58) (herein "Contract Sum"), except as provided in Section 2.9. The Contract Sum shall include the attendance of Contractor at all project meetings reasonably deemed necessary by the City; Contractor shall not be entitled to any additional compensation for attending said meetings.

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

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

4. Each of the undersigned represents and warrants that he or she is duly authorized to execute and deliver this Amendment No. 1 and that such execution is binding upon the entity for which he or she is executing this document.

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

CONSULTANT CITY OF PLACENTIA
By:

By: r -
Steven L. Mendoza, Vice President Jennifer Lampman
City Administrator
ATTEST:

By: /1S:K (
Robert S. McKinnell, City Clerk

APPROVED AS T
Christian L. Bettenhausen, City Attorney

ACRD

CERTIFICATE OF LIABILITY INSURANCE
DATE ;MMIDOA/ YY Y I
9118.2025
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 INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certif tate holder is an ADDITIONAL INSURED, the policy(Ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not con`er rights to the certificate holder In lieu of such endorsement(s).

PRODUCER
Acrisjre Southwest Partners Insurance Services, LLC
611 Anton Bvo., Suite #1400
Costa Mesa, CA 92626
v.Iw.v palnsk.ccm OK07568

INSURED
R. J. Noble Company
15505 Lincoln Avenue
P.O. Box 620
Orange CA 92856-9020
CONrAct
NAME-

PI,H'ONL
LA No,ERMI..

E -W L
ADORESS.

A.nnetio Romero,
949.486-7904 FAX
arome okr acrlsure.com
INSURERIS) AFFORDING COVERAGE ',AIC a
INSURER Travelers Property Casua;y Company of America ?5674 mucirR

INSURER C
INSURER 0

INSURER E

INSURER F
Cs!
COVERAGES CERTIFICATE NUMBER: 97225583 REVISION NUMBER:

THIS IS ID CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW F•AVE 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 ISSI:ED CR MAY PERTAIN, THE INSURANCE AFF'CRDED BY t 1E POLICES DESCRIBEC HEREIN IS SUBJECT TO ALL THE TERMS.

EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMI ES SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS Mit • IA3L §0art ' PO -ICY EFF POLICY EXP
LTR TYPE OF INSURANCE a,Sty WVD POLtCY NUk19F.R i OAM:DDfYYYY) iliMODNYWI LIMITS A l , COMMERCIAL GENERALLIABILITY I ✓ / VTJ-EXGL-9F33B142•'r!t_-25 70112025 CLAIMS -MAUI:
!_i 1
• Contractual Liabitity
OCCUR
GEN'L AGGREGATE Jh11T APPLIES PER
FOL;CY [/ ! Jt COT [ LOC
OTHER

A I AUTOMOBILE LIABILITY

ANY AUTO
OWNED s^HEOULEC
AUTOS Ok�Y
, AUTOS

HIRED NON-OWNED
AUTOS ONLY r% AUTOS ONLY
A
A
UMBRELLA LIAB OCC:1I2
/ EXCESS LIAR CLAMS -MACE
DEO RET_NT•ON 5

WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y r N
ANYPR0P-2ITORIPARTN_3:TXECUTI':E L
O FICER,L1EMBEREXCLUCED7
VTC2E-CAP•9F338154•TCT 25
✓ iCUP•e.Rn30983-24-25
Policy Follow Form Over
Underlying Genera( Liab
! J UB -7N939386 -25-25-K
N: A;
Mandatory in NH)
I Yet, doled»It ;.rebr
'.E1ESCRLPTION OF OF ERATIG5 S two.

A !Auto Physical Damage
711+2026
EACH DC;:URRENCE S1.000,000
DAr1A3E TO'RENTED S 1.000.00
oRE`ASES;Ea occ..rrWtcej .

MEED EX' (Any onrr person) S 5,000
P'rRSONAL d ADV IN_LARY 51,000,000
1 7;112025 17f1/2026
71112025 7r1/2326
7;1/2025 7/102026
VIE,BAP 9F338166 -TCT -25 7;1/2025 7+102026
GENERAL AGGREGATE I 52.000,000
,ROOJCrS-COMP•OPAGO I S2:000,000
CGURth'EC SINGLE LIMIT
;cera acr,Menq_ —.5 2.000,000
soca Y MU.1RY :Per :errT,G ; $
BODILY INJURY ;Per accdera, S
eRoPERTY DAMAGE _ 5
Por .act.d,ns;
EACH DCCoRRENC.E S10.000.000
AGGREGATE 510.000,000
PER OTR•
_SVT,UTE j_ _ cR
E L. EACH A::CiDENT S 1,003,00C
LE'-.3ISEASE-EA EMPLOYEE 1001G00
C.'', DISEASE - POLICY UNIT s 1 .003.000
$10,000 Ded Comp & Col isior
DESCR,PTION OF OPERATIONS 1 LOCATIONS 1 VEIiICLES IACORD'01, Addalenal Remarks Schvdale may be afla thud .f mere spice roq..:,red) Re: FY 2024-2025 Residentia: Street Rehabilitation 0 City Project 1f26-104 City of Placentia, its officers, emp:oyees, representatives, attorneys, and vclunt_ers are names as Additional insured as respects to General Liebdity and Auto Liability per endorsement attached where required by written contract. Coverage is Primary and Ncn-contributory and Waiver of subrogation applies and in favor of Addiiionai Insureds. Excess;UmbreLa follows corm over GL. Auto and EL 30 days notice of cancellation -3 days for ncn-payment of premium

CERTIFICATE HOLDER CANCELLATION
City of Placentia
401 E. Chapman Ave.

Placentia CA 92870
ACORD 25 (2016103)

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
��o-�.—f .•cf.

Dave .acobson
@ 1968-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD
I :S( n GL/A'J/OXCluC Anne,:r erns;ra t ar:e/.:l.2e :2.!9:31 rR ti•L'C'1

VTJ-EXGL 9F338142-711 -25
R, J Noble Company

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

BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Cotntrao This endorsement modifies insurance provided under tee failawine:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PROVISIONS
The following is added to SECTION 11 — WHO 15 AN
INSURED:

Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. With respect to liablity for "bodily injury' or
"property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while the: part of the contract or
agreement is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissons of you or
your subcontractor in the performance of "your
worts" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omssions of seen
person or organization.

The insurance provided to such additional insured is
subject to the followinc provisions:
a. if the Limits of Insurance of this Coverage Part
Shown in the Declarations exceed the minimum
limits required by the written contract cr
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.

This provision will not increase the limits of
ins'erance desccbed in Section III — Limits Of
Insurance.
b. The insurance provided to such additional
insured does not apply to:
(1) Any 'bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a) The preparing, approving, or fading to
prepare or approve, maps, shop
drawincs, opinions, reports, surdays,
field orders or change orders, or the
preparing, approving, or failirc to
prepare or approve. drawings and
specifications: and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury' or "property damage"
caused by "your work" and included in the
"produces -completed operations hazard"
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties'
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense too place;
(b) The names and addresses of any injured
persons and witnesses; ane
(c) The nature and location of any injury or
damage arising out of the "cccurence"
or offense.
(2) If a claim is made or "suit" is brought against
the additional insured:

CG D2 46 04 19 C2018 The Truvelers Indemnty Comaany, All rghts reserved. a::r.,ss I ._,:. a.rnu,e,' ;= ar;i":ce : 9, Lai=]'S t_:lf:n JM c:; • P.4

COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to iI that we receive written notice of the
claim or "suit' as soon as practicable.
(3) ;mmediatoly send us copies of all legal
paper receiver: in connection with the claim
ar "suit". cooperate with us in the
investigation or settlement of the claim or
defense against the "suit", and otherwise
comply with all policy conditions.

Pace 2 of 2
(4)
Tender the defense and indemnity of any
claim or "suit" to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such ado tional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other insurance, of Section — Commercial
General Liability Conditions.
2015 The Travelers IndeTn;.y Company. All nghts n_sarved. CG D2 40" 04 19 8'+22^51117 1 e5,2( ft:.i AU IE.7.'Ci We hnnttte Rnrca:cs I ,!:.i/ice", :2:10 :,0T; 1 Page 7 of :4

R. J Noble Company_
POLICY NUMBER: VT..;-EXGI. 9F33t3142- s IL. 25
COMMERCIAL. GENERAL LIABILITY
ISSUE DATE: 9J1gM2025
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NONCONTRIBUTORY -

OTHER INSURANCE CONDITION - DESIGNATED

ADDITIONAL INSUREDS
This endorsement modifies insurance provided under :he following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART
PRODUCTS?COMPLETED OPERAT ONS LIABILITY COVERAGE PART

SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS

PROVISIONS
The following is added to the Other Insurance
Condition ane supersedes any provision to the
contrary.

Primary And Noncontributory Insurance
This insurance :s primary to and wi'I not seek
contribution from any other insurance available to an
additional insured under your policy that is shown in
the Schedule Of Designated Additional Insureds
provided that:
(1) The additional insured is a Named Insured under
such other insurance: and
(2) You have agreed in writing in a contract or
agreement that Lhis insurance would be primary
and would not seek contribution from any other
insurance available to the additional insured.

CG D8 84 04 20 2020 The Travelers Indemnity Company. All rights reserved.

Includes copyrighted material of Inscrance Services Office, Inc., with its pernission. ea22+4Su I zsVa
GL:,11/.:).0 WC f ,uu'.r.:.cP AGMCIo ! 4/18IZ 2y :2:72:33 24.1 Ant

R Noble Ccrnp,::,y
POLICY NUMBER: VTJ•EXGL-9F338142-TIL-25

COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 07.01/2325
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

OTHER INSURANCE - DESIGNATED ADDITIONAL

INSUREDS -- PRIMARY WITH RESPECT TO CERTAIN

OTHER INSURANCE
-his endorsement modifes insurance provided under the folio Ing:

COMMERCIAL GENERAL 'LIABILITY COVERAGE PART

SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS

PROVISIONS
The following is added to Paragraph 4.a.. Primary
Insurance, of SECTION IV — COMMERCIAL
GENERAL LIABILITY CONDITIONS;
The insurance afforded under this Coverage Part to
any additional insured shown in the Schedule Of
Designated Additional Insureds is primary to any of
the other insurance, whether primary, excess,
contingent or on any other basis, that is available to
such additional insured which covers such additional
insured as a narned insured, and we will not share
with that other insurance.

CG D4 2$ D2 19 Gs 2017 The Trema ers IMderrmriy Company. A!I ngnis reserved.

Includes copyrighted material of Irsu.ance Services C€ice. Inc will its parribn-slon, n.21:'014.1 2S :5 nWAG/ XC/NC ;.ncrttn ?.cress 9: ]S,2.2S :2-18 1°. 1.. :'VT1

V1J•EXGL-F338142-TIt.•25
R J. Noble Company
07;01%2025

COMMERCIAL GENERAL LIAB'LITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modifies insurance provided under the folloiaing:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTIONS CF. COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read ail the provisions of the endorsement and the rest of your po'cy carefully to determine rights, duties, and what is and is not covered.

A. Who Is An Insured —Unnamed Subsidiaries
E. Blanket Additional Insured -- Governmental
Entities — Permits Or Authorizations Relating To
Operations

PROVISIONS
A. WHO IS AN INSURED — UNNAMED

SUBSIDIARIES
The following is added to SECTION!! — WHO 15
AN INSURED:

Any of your subsidiaries, other than a partnership,
joint venture or limited liability company. that is
not shown as a Named Insured in the
Declarations is a Named Insured if:
a. You are the sole owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured under
similar other insurance.

No such subsidiary Ls an insured for "bodily injury'
or "property damage' that occurred, or "personal
and advertising injury" caused by an offense
committed:
a. 3efore you maintained an ownership interest
of more than 50% in such subsidiary, or
b. After the date, if any, during the policy period
that you no longer maintain an ownership
interest of more than 50% in such subsidiary.

For purposes of Paragraph 1. of Section II — Who
Is An insured, each such subsidiary will be
deemed to be designated in the Declarations 25:

CG 03 16 0219
C. Incidental Medical Malpractice
Blanket Waiver Of Subrogation
E. Contractual L.iabil;ty — Railroads
F. Damage To Prentiss Rented To You
a. An organization other than a partnership, joint
venture or limited liability company; or
b. A trust;
as indicated in its name or the documents that
govern its structure.

B. BLANKET ADDITIONAL INSURED —
GOVERNMENTAL ENTITIES — PERMITS OR

AUTHORIZATIONS RELATING TO OPERATIONS
The following is added to SECTION I — WHO IS
AN INSURED:

Any governmental entity that has issued a permit
or authorization with respect to operations
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liability for "bodily injury", "property damage' or "personal and
advertising injury" arising out of such operations.

The insurance provided to such governmental
entity does not apply to:
a. Any "bodily injury", 'property damage" or
"personal and advertising injury' arising out of
operations performed for the governmental
entity: or
b. Any "bodily injury" or "properEy damage"
included in the "products -completed
operations hazard".
t 2017 The Trave els Indemnity Company. All rights reserved Ir,c'.udes copinghteJ met.riar o` Ins'Jrancc ser'ices Chce, Ira., wltn its perm!ssion. lcY.C'WC ! Anr+,cr.- Portwo I ..
3 3.3 sW, S PUT: Vasey G u_ :A
Pagel of3

COMMERCIAL GENERAL LIABILITY
C. INCIDENTAL MEDICAL MALPRACTICE

1. The following replaces Paragraph b. of the
definition of "cccurrence" in the
DEFINITIONS Section:
b. An act or omission committed in providing
or failino to provide "incidental medical
services", first aid or "Good Samaritan
services" to a person, unless you are in
the business or occupation of providing
professional health care services.

2. The following replaces the last paragraph of
Paragraph 2.a.(1) of SECTION II — WHO iS
AN INSURED:

Unless you are in the busir.ess or occupation
of providing professional health care services,
Paragraphs (1)(a), (b), (c) and (d) above do
not apply to "bodily injury' arising out of
providing or failing to provide:
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor. Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
services" during their work hours for you
will be deemed to he acting within the
scope of their employment by you or
performing duties related to the conduct
of your business.

3. The following replaces the last sentence of
Paragraph 5. of SECTION III — LIMITS OF
INSURANCE.

For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or omissions committed in providing or
failing to provide "incidental medical
services" first aid or 'Good Samaritan
services' to any one person will be deemed to
be one "occurrence".

4. The following exclusion is added to
Paragraph 2., Exclusions, of SECTION I —
CDVERAGES — COVERAGE A — BODILY

INJURY AND PROPERTY DAMAGE
LIABILITY:

Safe Of Pharmaceuticals
"Bodily injury" or "property damage" arising
OLA of the violation of a penal statute or
ordinance relating to the sale of

pharmace;rtscals committed by, or with the
knowledge or consent of, the insured.

5. The following is added to the DEFINITIONS
Section:
"Incidenta: medical services" means:
a. Medical, surgical, dental, laboratory, x-ray
or nursing service or treatment, advice or
instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.
e. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV —
COMMERCIAL GENERAL LIAR:LITY
CONDITIONS.

This insurance is excess over any valid and
co:lectible other insurance, w.vhether primary,
excess, contingent or on any other basis. that
is available to any of your "employees" for
"bodily injury' that arises out of providing or
failing to provide "incidental medical services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section 11 —' Who Is An
Insured.

D. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph a., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
LABILITY CONDITIONS;
If the insured hos agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization, but only for payments we make
because of:
a. "Bodily injury" or "property damage" that
occurs; or
b. "Personal and advertising injury" caused by
an offense that is committed;
subsequent to the execution of the contract or
agreement
E. CONTRACTUAL IJABILtTY RAILROADS

1. The following replaces Paragraph 0. of the
definition of "insured contract" in the
DEFINITIONS Section:
c. Any easement or license agreement;
itt)2017 The Travelers Indemnity Company. All -fights reserved. CG D3 16 0219 Includes copyrigrued materiel of insurance services Office, Inc„ with its permission. 8,2244N3 I .»2G GL/AU!£XC.'WC . Annette h r..._ I _.. ... .o 12 .33133 .M 'PI , P4qe of tl

VIC2E-CAP-9F338154-TCT 25
R J Notle Company COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifiinsurance provided under the following:

BUSINESS AUTO COVERAGE FORM
VLrrth respect to coverage provided by this endorsement, the provisions of :he Coverage Form apply unless modified by the endorsement.

GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. BROAD FORM NAMED INSURED
E. BLANKET ADDITIONAL INSURED

EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
r.

SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
HIRED AUTO — LIMITED WORLDWIDE
COVERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE— GLASS
?ROVEStONS
A

BROAD FORM NAMED INSURED
The following is added to Paragraph .1.1., Who Is
An Insured, of SECTION Il — LIABILITY
COVERAGE:

Any organization you newly acquire or form
during the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.

Coverage under this provision is afforded only
until the 180th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier_
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. In A.t,
Who Is Are Insured, of SECTION II LIABILITY
COVERAGE:

This includes any person or organization who you
are required under a written contract or
agreement between you and That person or
organization, that is signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE— INCREASED LIMIT
I, PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
J. PERSONAL EFFECTS
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
as an additional insured for Liabilly Coverage,
but only for damages to which this insurance
applies and only to the extent of that person's or
organization's liability for the conduct of another
"insured".

C. EMPLOYEE HIRED AUTO

1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION II —
LIABILITY COVERAGE:

An 'employee" of yours is an "insured' while
operating en "auto' hired or rented under a
contract or agreement in that "'employee's"
name, with your permission, while performing
duties related to the conduct of your
business.

2. The following Tapiocas Paragraph b. in B.5
Other Insurance, of SECTION IV —
BUSINESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage
Coverage, the following are deemed to be
covered "autos" you own:

CA T3 53 08 17 CO 2016 The Travelers lnderin y Company_ W1 right reserved.

Includes copyrighted material of Insurance Services office, tic. with rts permission E !�211N:1 2!•/26 • QL, u/k'X'.'/Mc T.11-<ttit i' "' I 9113J2Or, Mir) 1 .'.tag. 10 of 1•i Page I of 4
rn

COMMERCIAL AUTO
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
that individual "employee's" name,
with your permission, while
performing duties related to the
conduct of your business.

However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto",
D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — LIABILITY
COVERAG E:

Any "employee" of yours is an "insured" while
using a covered "auto" you don't own, hire or
borrow in your business or your personal affairs,
E_ SUPPLEMENTARY PAYMENTS — INCREASED
LtMtTS

1. The following replaces Paragraph A.2.a.(2),
of SECTION ti — LIABILITY COVERAGE:
12) Up to 53,000 for cost of bail bonds
(including bonds for related traffic law
violations) required because of an
"accident" we cover. We do not have to
furnish these bonds.

2. The following replaces Paragraph A.2.a.(4),
of SECTION II — LIABILITY COVERAGE:

All reasonable expenses incurred by the
"insured" at our request, including actual
loss of earnings up to 5500 a day
because of time off from work.

F. HIRED AUTO — LIMITED WORLDWIDE
COVERAGE — INDEMNITY BASIS
The following replaces Subparagraph e. in
Paragraph 3.7., Policy Term, Coverage
Territory, of SECTION IV — BUSINESS AUTO
CONDITIONS:
e. Anywhere in the world, except any country or
jurisdiction while any trade sanction,
embargo, or similar regulation imposed by the
United States of America applies to and
prohibits the transaction of business with or
within such country or jurisdiction, for Liability
Coverage for any covered "auto' that you
lease, hire, rent or borraw without a driver for
a period of 30 days or Tess and that is not an
"auto" you tease, hire, rent or borrow from
any of your "employees", partners (if you are
a partnership). members (if you are a limited

57 Z22, NE3
liability company) or members of their
h ouseholds.
(1) With respect to any claim made or "suit"
brought outside the United States of
America, :he territories and possessions
of the United States of America, Puerto
Rico and Canaoa:
(a) You must arrange to defend the
"insured" against, and investigate or
settle any such claim or "suit" and
keep us advised of alt pro:,eed:ngs
and actions.
(b) Meitner you nor any other involved
"insured" will make any settlement
without cur consent.
(c) We may, at cur discretion, participate
in defending the "insured" against, or
in tho settlement of, any claim or
"suit".
(d) We vrill reimburse the "insured":
(1) For sums that the "insured'
legally must pay as damages
because of"bodily injury' a;
"property damage" to which this
insurance applies, that the
"insured" pays with our consent,
but only up to the limit described
in Paragraph C., Limit Of
Insurance, of SECTION II —
LIABILITY COVERAGE;
(ii) For the reasonable expenses
incurred with our consent for your
investigation of such claims and
your defense of the "insured"
against any such "suit", but only
up to and included within the limit
described in Paragraph C., Limit
Of Insurance, of SECTION II —
LIABILITY COVERAGE, and not
in addition to such limit_ Our duty
to make such payments ends
when we have used up the
applicable limit of insurance in
payments for damages,
settlements or defense expenses.

This insurance is excess over any valid
and collectible other insurance available
to the "insured" whether primary, excess
contingent or on any other basis.

This insurance is not a substitute for
required or compulsory insurance in any
country outside the United States, its
(2)
(3)
M 2016 The Travelers InCemnity Company. All rights reserved. CA T3 53 03 17 Includes copyrighted material of Irsurence Services OI'c.e, Inc. Orth Its pernlisslon crr.:z 9,14,+'202., 12:18:1'3 'M :P17:1 rAgr 11

territories and possessions, Puerto Rico
and Canada.

Ycu agree to maintain all required or
compulsory insurance in any such
county up to the minimum limits required
by local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory
insurance requirements.
(4) It is understood that we are not an
admitted or authorized insurer outside the
United States of America, its territories
and possessions., Puerto Rico end
Canada. We assume no responsibility for
the furnishing of certficates of insurance,
or for compliance in any way with the
laws of other countries relating to
insurance,
G. WAIVER OF DEDUCTIBLE - GLASS
The following is added to Paragraph D.,
Deductible, of SECTION III - PHYSICAL
DAMAGE COVERAGE:

No deductible for a covered "auto' will apply to
glass damage if the glass is repaired rather tnan
replaced.

H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF

USE -- INCREASED LIMIT
The following replaces the last sentence of
Paragraph A.4.b., Loss Of Use Expenses, of

SECTION III - PHYSICAL DAMAGE
COVERAGE:

However, the most we will pay for any expenses
for Toss of use is $65 per clay, to a maximum of
5750 for any one "accident".

I. PHYSICAL DAMAGE - TRANSPORTATION

EXPENSES - INCREASED LIMIT
The following replaces the first sentence in
Paragraph A.4.a., Transportation Expenses, of

SECTION IH - PHYSICAL DAMAGE
COVERAGE:
\Ne will pay up to $50 per day to a maximum of
51,500 for temporary transportation expense
incurred by you because of the total theft cf a
covered "auto" of the private passenger type.

J. PERSONAL EFFECTS
The following is added to Paragraph A.4.,
Coverage Extensions, of SECTION III -
PHYSICAL DAMAGE COVERAGE:

T"630317

COMMERCIAL AUTO
Personal Effe> is
We will pay up to 5400 for "loss" to wearing
apparel and other personal effects which are:
(1) Owned by an "insured"; and
(2) In or on your covered "auto'.

This coverage apples only in the event of a total
theft of your covered "auto".

No deductibles apply to this Personal Effects
coverage.

K. AIRBAGS
The following is added to Paragraph B.3.,
Exclusions, of SECTION 111 - PHYSICAL
DAMAGE COVERAGE:

Exclusion 3.3. docs not apply to "loss" to one or
more airbags in a covered "auto" you own that
inflate due to a cause other than a cause of "loss"
set forth in Paragraphs A 1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for
Comprehensive Coverage under this policy;
b. The airbags are not covered under any
warranty; and
c. The airbags were not intentionally inflated.

We will pay up to a maximum of $1,000 for any
one "loss".

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV - BUSINESS AUTO CONDITIONS:

Your duty to give us or our authorized
representative prompt notice of the "accident" or
"loss" applies only when the "accident" or 'loss" is
known to:
(a) You (if you are an individual):
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability
core pa ny);
(d) An executive officer, director or insurance
manager (if you are a corporation or other
organization); or
Any "employee" authorized by you to give
notice of the "accident" or "loss".

M. BLANKETWAIVER OF SUBROGATION
The following replaces Paragraph A.5., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV - BUSINESS AUTO
CONDITIONS:
(e)
0 20i6 The Travelers Indemnity Company. NI rights reserved. inetudes udes copyrighted matertat of Insurance Services Cffice. Inc. with its perm.sslOrl 4421%441 1.i2e , Apiece, !4;1Fi22,2S .2 '.F;' 9Y. 17C:', Page 12 c:

C3iU VIERCIAL AUTO

5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right cf recovary we may have
against any person or organization to tate
extent required of you by a written contract
sinned and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
such contract. The waiver applies only to the
person or organization designated in such
contract.

N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph 6,2.,
Concealment, Misrepresentation, Or Fraud, of
SECTION IV — BUSINESS AUTO CONDITIONS:

The unintentional omission of, or unintentional
error in. any information giver by you shall not
prejudice your rights under this insurance.

However this provision does not affect our right to
collect additional premium or exercise our right of
cancellation or non -renewal.

ncl.des copyrighted materiel of Insurance Sera ces fl ice, Inc. vrti its permission 8'.225B1 126/2e GL.%AJIEX iKC I AAr.Inte lr.,..r, 9j18/202b 12.1201 ?M 1PQT) I ?aye 11 u: :1 CA T3 S3 CI& 17

TRAVELERS.!

OKE TOWER SQUARE
iM TFCRDJ CT o 1a3
WORKERS CO,MAPENS.4 T IDN
AND
EMPLOYERS LIABtL ITY POLICY
ENDORSEMENT WC 00 03 13 (00)-o,
POLICY NUMBER: LB -7N939386 -2b -25-K

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone Ilabte for an injury covered by this policy. We will not enforce our rght against the person or organization named In the Schedule. (This agreement apples only to the extent that you perform work undor a +,vrittun contract that requires you to obtain this agreement from us.;i This. agreement shall not operate directly or indirectly to ftonotit any ono not named In V -1C SchaduIp.

SCHEDULE
DESIGNATED PERSON:

DESBGNATED ORGANIZATION:

ANY PERSON GR ORGANIZATION FOR WHICH THE INSURED HAS :AGREED

BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH
THIS WA=VER
DATE OF ISSUE: 9/18/2025
ST ASSIGN:
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CITY OF PLACENTIA

PUBLIC WORKS AGREEMENT FOR
FY 2024-2025 RESIDENTIAL STREET REHABILITATION PROJECT
CITY PROJECT NO. 26-104
THIS AGREEMENT (herein "Agreement") is made and entered into this 7th day of October, 2025 by and between the CITY OF PLACENTIA, a municipal corporation and charter city, (herein "City") and R.J. Noble Company (herein "Contractor"). The parties hereto agree as follows:

WITNESSETH:

A. WHEREAS, City requires the construction of residential street improvements as set forth more fully in this Agreement.

B. WHEREAS, Contractor represents to City that Contractor is qualified to perform said work and has submitted a proposal to City for the same.

C. WHEREAS, City desires to have Contractor perform said services on the terms and conditions set forth herein.

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 and for good and valuable consideration, the receipt and sufficiency of which is acknowledged by both parties, City and Contractor hereby agree as follows:

1.0 DEFINITIONS

1.1 Definitions. As used in this Agreement, the following definitions shall be applicable:
(a) Contractor. Contractor shall mean R.J. Noble Company a (California corporation, partnership, individual) located at 15505 E. Lincoln Avenue Orange, CA 92865.
(b) City. City shall mean the City of Placentia, a Municipal Corporation and Charter City, located at 401 E. Chapman Ave., Placentia, California 92870. (c) City Council. City Council shall mean the City Council of the City of Placentia.
(d) Contract Officer. Contract Officer shall mean the person designated by the City Administrator or City Engineer of City and shall have the duties set forth in Section 5.2.
(e) Services. Services shall mean the services to be performed by the Contractor pursuant to this Agreement.
(f) Satisfactory. Satisfactory shall mean satisfactory to the City Administrator D-2

or his/her designee.

2.0 SERVICES OF CONTRACTOR

2.1 Scope of Services. In compliance with all terms and conditions of this Agreement, the Contractor shall provide those services specified in the "Scope of Services" attached hereto as Exhibit "A" and incorporated herein by this reference, which services may be referred to herein as the "services" or "work" hereunder. As a material inducement to the City entering into this Agreement, Contractor represents and warrants that Contractor is a provider of first class work and services and Contractor is experienced in performing the work and services contemplated herein and, in light of such status and experience, Contractor covenants that it shall follow the highest professional standards in performing the work and services required hereunder and that all materials will be of good quality, fit for the purpose intended.

2.2 Documents Included in Contract. This contract consists of this Agreement and any Exhibits, which are incorporated herein by this reference. In the event of an inconsistency, the terms of this Agreement shall govern.

2.3 Compliance with Law. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of the City and any Federal, State, or local governmental agency having jurisdiction in effect at the time service is rendered, including but not limited to, the claims procedure set forth in Public Contract Code Section 9204, a summary of which is attached to this agreement as Exhibit "E".

2.4 Licenses, Permits, Fees, and Assessments. Contractor shall obtain at its sole cost and expense such licenses, permits, and approvals as may be required by law for the performance of the services required by this Agreement, including registration with the Department of Industrial Relations of the State of California as required by Labor Code Section 1725.5 before commencing performance under this Agreement. Contractor shall have the sole obligation to pay for any fees, assessments, and taxes, plus applicable penalties and interest, which may be imposed by law and arise from or are necessary for the Contractor's performance of the services required by this Agreement, and shall indemnify, defend, and hold harmless City against any such fees, assessments, taxes penalties, or interest levied, assessed, or imposed against City hereunder.

Contractor shall be responsible for all subcontractors' compliance with this Section 2.4.

2.5 Familiarity with Work. By executing this Contract, Contractor warrants that Contractor (a) has thoroughly investigated and considered the scope of services to be performed, (b) has carefully considered how the services should be performed, and (c) fully understands the facilities, difficulties, and restrictions attending performance of the services under this Agreement. If the services involve work upon any site, Contractor warrants that Contractor has or will investigate the site and is or will be fully acquainted with the conditions there existing, prior to commencement of services hereunder. Should Contractor discover any latent or unknown conditions, which will materially affect the performance of the services hereunder, Contractor shall immediately inform the City of such fact and shall not proceed except at Contractor's risk until written instructions are received from the Contract Officer.

2.6 Standard of Performance. Contractor, its subcontractors, and their employees, in the performance of Contractor's work under this Agreement, shall be responsible for exercising the D-3

degree of skill and care required by customarily accepted good professional practices and procedures used in the Contractor's field.

Any costs for failure to meet the foregoing standard or to correct otherwise defective work that requires re -performance of the work, shall be borne in total by the Contractor and not by the City. The failure of a project to achieve the performance goals and objectives stated in this Agreement is not a basis for requesting re -performance unless the work conducted by Contractor and/or its subcontractors is deemed by the City to have failed the foregoing standard of performance.

In the event Contractor fails to perform in accordance with the above standard:

1. Contractor will re -perform, at its own expense, any task which was not performed to the reasonable satisfaction of City. Any work re -performed pursuant to this paragraph shall be completed within the time limitations originally set forth for the specific task involved. Contractor shall work any overtime required to meet the deadline for the task at no additional cost to the City;

2. The City shall provide a new schedule for the re -performance of any task pursuant to this paragraph in the event that re -performance of a task within the original time limitations is not feasible; and

3. The City shall have the option to direct Contractor not to re -perform any task which was not performed to the reasonable satisfaction of the City Project Manager pursuant to application of (1) and (2) above. In the event the City directs Contractor not to re -perform a task, the City shall negotiate a reasonable settlement for satisfactory work performed. No previous payment shall be considered a waiver of the City's right to reimbursement.

Nothing contained in this section is intended to limit any of the rights or remedies which the City may have under law.

2.7 Care of Work. The Contractor shall adopt reasonable methods during the life of the Agreement to furnish continuous protection to the work, and the equipment, materials, papers, documents, plans, studies, and/or other components thereof to prevent losses or damages, and shall be responsible for all such damages, to persons or property, until acceptance of the work by City, except such losses or damages as may be caused by City's own negligence.

2.8 Further Responsibilities of Parties. Both parties agree to use reasonable care and diligence to perform their respective obligations under this Agreement. Both parties agree to act in good faith to execute all instruments, prepare all documents and take all actions as may be reasonably necessary to carry out the purposes of this Agreement. Unless hereafter specified, neither party shall be responsible for the service of the other. Contractor shall require all subcontractors to comply with the provisions of this agreement.

2.9 Additional Services. City shall have the right at any time during the performance of the services, without invalidating this Agreement, to order extra work beyond that specified in the Scope of Services or make changes by altering, adding to, or deducting from said work. No such extra work may be undertaken unless a written change order is first given by the Contract Officer to the Contractor, incorporating therein any adjustment in (i) the Contract Sum as set forth in Section

3.1, and/or (ii) the time to perform this Agreement, which said adjustments are subject to the written approval of the Contractor. Any increase in compensation of ten percent (10%) or less of the Contract Sum, or in the time to perform of one hundred eighty (180) days or less, may be approved D-4

by the Contract Officer. It is expressly understood by Contractor that the provisions of this Section shall not apply to services specifically set forth in the Scope of Services or reasonably contemplated therein. Contractor hereby acknowledges that it accepts the risk that the services to be provided pursuant to the Scope of Services may be more costly or time consuming than Contractor anticipates and that Contractor shall not be entitled to additional compensation therefore.

2.10 Prevailing Wage Laws. Contractor represents and warrants that it is registered with the Department of Industrial Relations as required by SB 854 and Labor Code 1725.5 and understands that this project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor shall ensure that its subcontractors comply with said requirements. Contractor shall comply with Labor Code Section 1771.4 and shall post all legally required job site notices. In accordance with Labor Code Section 1770 et seq., the Director of the Department of Industrial Relations of the State of California has ascertained a general prevailing rate of wages, which is the minimum amount, which shall be paid to all workers employed to perform the work pursuant to this Agreement. A copy of the general prevailing wage rate determination is on file in the Office of the City Clerk and is hereby incorporated by reference into this Agreement. In accordance with the provisions of Labor Code Section 1810 et seq., eight (8) hours is the legal working day. Contractor must forfeit to the City Twenty Five Dollars ($25.00) a day for each worker who works in excess of the minimum working hours when Contractor does not pay overtime.

Contractor is required to post a copy of such wage rates at all times at the contract site. The statutory penalties for failure to pay prevailing wage or to comply with State wage and hour laws will be enforced. Contractor also shall comply with State law requirements to maintain payroll records and shall provide for certified records and inspection of records as required by California Labor Code Section 1770 et. seq., including Section 1776. Contractor shall comply with all statutory requirements relating to the employment of apprentices.

3.0 COMPENSATION

3.1 Contract Sum. For the services rendered pursuant to this Agreement, the Contractor shall be compensated as specified herein, but not exceeding the maximum contract amount of one million nine hundred seventy two thousand nine hundred fifteen dollars with five cents ($ 1,972,915.05) (herein "Contract Sum"), except as provided in Section 2.9. The Contract Sum shall include the attendance of Contractor at all project meetings reasonably deemed necessary by the City; Contractor shall not be entitled to any additional compensation for attending said meetings.

3.2 Progress Payments. Prior to the first day of the month, during the progress of the work, commencing on the day and month specified in the Agreement, Contractor shall submit to the Contract Officer a complete itemized statement of all labor and materials incorporated into the work during the preceding month and the portion of the contract sum applicable thereto. Upon approval in writing by the Contract Officer, payment shall be made in thirty (30) days. City shall pay Contractor a sum based upon ninety-five percent (95%) of the contract price apportionment of the labor and materials incorporated into the work under the contract during the month covered by said statement. The remaining five percent (5%) thereof shall be retained as performance security. Refer to Section 8.4 of this Agreement for retention of funds.

4.0 PERFORMANCE SCHEDULE

4.1 Time of Essence. Time is of the essence in the performance of this Agreement.

4.2 Schedule of Performance. Contractor shall commence the services pursuant to this Agreement upon receipt of a written notice to proceed and shall perform all services within the time D-5

period(s) established in the "Schedule of Performance" attached hereto as Exhibit "B", and incorporated herein by this reference. When requested by the Contractor, extensions to the time period(s) specified in the Scope of Services may be approved in writing by the Contract Officer.

4.3 Force Majeure. The time period(s) specified in the Scope of Services for performance of the services rendered pursuant to this Agreement shall be extended because of any delays due to unforeseeable causes beyond the control and without the fault or negligence of the Contractor, including, but not restricted to, acts of God or of the public enemy, unusually severe weather, fires, earthquakes, floods, epidemics, quarantine restrictions, riots, strikes, freight embargoes, wars, litigation, and/or acts of any governmental agency, including the City, if the Contractor shall within ten (10) days of the commencement of such delay notify the Contract Officer in writing of the causes for the delay. The Contract Officer shall ascertain the facts and the extent of delay, and extend the time for performing the services for the period of the enforced delay when and if in the judgment of the Contract Officer such delay is justified. The Contract Officer's determination shall be final and conclusive upon the parties to this Agreement.

4.4 Term. Unless earlier terminated in accordance with Section 8.9 of this Agreement, this Agreement shall continue in full force and effect until final approval and acceptance of the project by the Contract Officer. Notwithstanding the foregoing, this Agreement shall terminate no later than October 7, 2026, unless the parties mutually agree in writing to extend the term.

5.0 COORDINATION OF WORK

5.1 Representative of Contractor. The following principals of Contractor are hereby designated as being the principals and representatives of Contractor authorized to act in its behalf with respect to the work specified herein and make all decisions in connection therewith:

R.J. Noble Company
ATTN: Steven L. Mendoza
15505 E. Lincoln Ave.

Orange, CA 92865
It is expressly understood that the experience, knowledge, capability and reputation of the foregoing principals were a substantial inducement for City to enter into this Agreement. Therefore, the foregoing principals shall be responsible during the term of this Agreement for directing all activities of Contractor and devoting sufficient time to personally supervise the services hereunder.

For purposes of this Agreement, the foregoing principals may not be replaced nor may their responsibilities be substantially reduced by Contractor without the express written approval of City.

5.2 Contract Officer. The Contract Officer shall be such person as may be designated by the City Administrator or City Engineer of City. It shall be the Contractor's responsibility to assure that the Contract Officer is kept informed of the progress of the performance of the services and the Contractor shall refer any decisions that must be made by City to the Contract Officer. Unless otherwise specified herein, any approval of City required hereunder shall mean the approval of the Contract Officer. The Contract Officer shall have authority to sign all documents on behalf of the City required hereunder to carry out the terms of this Agreement.

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5.3 Prohibition Against Assignment. The experience, knowledge, capability, and reputation of Contractor, its principals and employees were a substantial inducement for the City to enter into this Agreement. Neither this Agreement nor any interest herein may be transferred, assigned, conveyed, hypothecated, or encumbered voluntarily or by operation of law, whether for the benefit of creditors or otherwise, without the prior written approval of City. Transfers restricted hereunder shall include the transfer to any person or group of persons acting in concert of more than twenty five percent (25%) of the present ownership and/or control of Contractor, taking all transfers into account on a cumulative basis. In the event of any such unapproved transfer, including any bankruptcy proceeding, this Agreement shall be void. No approved transfer shall release the Contractor or any surety of Contractor of any liability hereunder without the express consent of City.

5.4 Independent Contractor. Neither the City nor any of its employees shall have any control over the manner, mode, or means by which Contractor, its subcontractors, agents, or employees, performs the services required herein, except as otherwise set forth herein. City shall have no voice in the selection, discharge, supervision, or control of Contractor's employees, subcontractors, servants, representatives, or agents, or in fixing their number, compensation, or hours of service. Contractor shall perform all services required herein as an independent contractor of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role. Contractor shall not at any time or in any manner represent that it or any of its subcontractors, agents, or employees are agents or employees of City.

City shall not in any way or for any purpose become or be deemed to be a partner of Contractor in its business or otherwise or a joint venture or a member of any joint enterprise with Contractor.

5.5 Identity of Persons Performing Work. Contractor represents that it employs or will employ at its own expense all personnel required for the satisfactory performance of any and all tasks and services set forth herein. Contractor represents that the tasks and services required herein will be performed by Contractor or under its direct supervision, and that all personnel engaged in such work shall be fully qualified and shall be authorized and permitted under applicable State and local law to perform such tasks and services.

5.6 Utility Relocation. City is responsible for removal, relocation, or protection of existing main or trunkline utilities to the extent such utilities were not identified in the invitation for bids or specifications. City shall reimburse contractor for any costs incurred in locating, repairing damage not caused by contractor, and removing or relocating such unidentified utility facilities, including equipment idled during such work. Contractor shall not be assessed liquidated damages for delay arising from the removal or relocation of such unidentified utility facilities.

5.7 Trenches or Excavations. Pursuant to California Public Contract Code Section 7104, in the event the work included in this Agreement requires excavations more than four (4) feet in depth, the following shall apply.
(a) Contractor shall promptly, and before the following conditions are disturbed, notify City, in writing, of any: (1) material that Contractor believes may be material that is hazardous waste, as defined in Section 25117 of the Health and Safety Code, that is required to be removed to a Class I, Class II, or Class 111 disposal site in accordance with provisions of existing law; (2) Subsurface or latent physical conditions at the site different from those indicated; or (3) Unknown physical conditions at the site of any unusual nature, different materially from those ordinarily encountered and D-7

generally recognized as inherent in work of the character provided for in the contract.
(b) City shall promptly investigate the conditions, and if it finds that the conditions do materially so differ, or do involve hazardous waste, and cause a decrease or increase in Contractor's cost of, or the time required for, performance of any part of the work shall issue a change order per Section 2.9 of this Agreement.
(c) That, in the event that a dispute arises between City and Contractor whether the conditions materially differ, or involve hazardous waste, or cause a decrease or increase in Contractor's cost of, or time required for, performance of any part of the work, Contractor shall not be excused from any scheduled completion date provided for by the contract, but shall proceed with all work to be performed under the contract. Contractor shall retain any and all rights provided either by contract or by law, which pertain to the resolution of disputes and protests between the contracting parties.

6.0 INSURANCE, INDEMNIFICATION, AND BONDS

6.1 Insurance. The Contractor and all subcontractors, if any, shall procure and maintain, at its sole cost and expense, in a form and content satisfactory to City, during the entire term of this Agreement, including any extension thereof, insurance as set forth in Exhibit "C" attached hereto and incorporated herein by this reference.

Conditions:

In accordance with Public Contract Code Section 20170, the insurance of surety companies who provide or issue the policy shall have been admitted to do business in the State of California with a credit rating of A- or better.

The City of Placentia, its officers, officials, employees, agents, and volunteers shall be named as additional insureds.

Prior to commencement of any work under this contract, Contractor shall deliver to the City insurance endorsements confirming the existence of the insurance required by this contract, and including the applicable clauses as set forth in Exhibit "C" attached hereto and incorporated herein by this reference.

Such endorsements shall be signed by an authorized representative of the insurance company and shall include the signatory's company affiliation and title. Should it be deemed necessary by the City, it shall be Contractor's responsibility to see that the City receives documentation, acceptable to the City, which sustains that the individual signing said endorsements is indeed authorized to do so by the insurance company.

If the Contractor fails to maintain the aforementioned insurance, or secure and maintain the aforementioned endorsement, the City may obtain such insurance, and deduct and retain the amount of the premiums for such insurance from any sums due under the agreement. However, procuring of said insurance by the City is an alternative to other remedies the City may have, and is not the exclusive remedy for failure of Contractor to maintain said insurance or secure said endorsement. In addition to any other remedies D-8

the City may have upon Contractor's failure to provide and maintain any insurance or policy endorsements to the extent and within the time herein required, the City shall have the right to order Contractor to stop work hereunder, and/or withhold any payment(s) which became due to Contractor hereunder until Contractor demonstrates compliance with the requirements hereof.

Nothing herein contained shall be construed as limiting in any way the extent to which Contractor may be held responsible for payments of damages to persons or property resulting from Contractor's or its subcontractor's performance of the work covered under this agreement.

Each contract between the Contractor and any subcontractor shall require the subcontractor to maintain the same policies of insurance that the Contractor is required to maintain pursuant to this Section 6.1.

6.2 Certificates of Insurance. Contractor shall provide to City certificates of insurance showing the insurance coverages, as well as providing the City with the required endorsements, 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 to this Agreement as Exhibit "D" and are incorporated herein by this reference.

6.3 Indemnification. Contractor shall protect, defend, indemnify, and hold free and harmless the City of Placentia, its officers, officials, employees, agents, and volunteers, at Contractor's sole expense, from and against any and all actions, suits, claims, damages to persons or property, losses, costs, penalties, obligations, errors, omissions, or liabilities (herein "claims or liabilities") that may be asserted or claimed by any person, firm, or entity arising or alleged to arise out of or in any way connected with the performance of the work, operations, or activities of Contractor, its agents, employees, subcontractors, or invitees, provided for herein, or arising or alleged to arise from the acts or omissions of Contractor hereunder, or arising or alleged to arise from Contractor's performance of or failure to perform any term, provision, covenant or condition of this Agreement including all acts or omissions, willful misconduct or negligent conduct, whether active or passive, on the part of the Contractor, its employees, and/or subcontractors. (a) Contractor will defend any action or actions filed in connection with any of said claims or liabilities and will pay all costs and expenses, including legal costs and attorneys' fees incurred in connection therewith. (b) Contractor will promptly pay any judgment rendered against the City, its officers, officials, employees, agents, or volunteers for any such claims or liabilities arising or alleged to arise out of or in connection with Contractor's (or its agents', employees', subcontractors', or invitees') negligent performance of or failure to perform such work, operations, or activities hereunder; and Contractor agrees to save and hold the City, its officers, officials, employees, agents, and volunteers harmless therefrom. (c)
In the event the City, its officers, officials, employees, agents, or volunteers are made a party to any action or proceeding filed or prosecuted against Contractor for such damages or other claims arising or alleged to arise out of or in connection with the performance of or failure to perform the work, operation or activities of Contractor hereunder, Contractor shall pay to the City, its officers, officials, employees, agents, or volunteers any and all costs D-9

and expenses incurred by the City, its officers, officials, employees, agents, or volunteers in such action or proceeding, including but not limited to, legal costs and attorneys' fees for counsel selected by City. (d) Contractor's duty to defend and indemnify as set out in this Section 6.3 shall include any claims, liabilities, obligations, losses, demands, actions, penalties, suits, costs, expenses or damages or injury to persons or property arising or alleged to arise from, in connection with, as a consequence of or pursuant to any State or Federal law or regulation regarding hazardous substances, including but not limited to the Federal Insecticide, Fungicide and Rodenticide Act ("FIFRA"), Comprehensive Environmental Response, Compensation and Liability Act of 1980 ("CERCLA"), Resource Conservation and Recovery Act of 1976 ("RCRA"), the Hazardous and Solid Waste Amendments of 1984, the Hazardous Material Transportation Act, the Toxic Substances control Act, the Clean Air Act, the Clean Water Act, the California Hazardous Substance Account Act, the California Hazardous Waste Control Law or the Porter -Cologne Water Quality Control Act, as any of those statutes may be amended from time to time.

Notwithstanding the foregoing, 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.

The Contractor's indemnification obligations pursuant to this Section 6.3 shall survive the termination of this Agreement. Contractor shall require the same indemnification from all subcontractors.

6.4 Labor and Materials and Performance Bonds. Concurrently with execution of this Agreement, Contractor shall deliver to City a labor and materials bond and a performance bond each in the sum of the amount of this Agreement, in the forms provided by the City Clerk, which secures the faithful performance of this Agreement. The bonds shall contain the original notarized signature of an authorized officer of the surety and affixed thereto shall be a certified and current copy of his power of attorney. The bonds shall be unconditional and remain in force during the entire term of the Agreement and shall be null and void only if the Contractor promptly and faithfully performs all terms and conditions of this Agreement.

6.5 Sufficiency of Insurer or Surety. Insurance required by this Agreement shall be satisfactory only if issued by companies qualified to do business in California, rated "A-" or better in the most recent edition of Best's Key Rating Guide or in the Federal Register, and only if they are of a Financial Size Category Class VII or larger, unless such requirements are waived by the Risk Manager of the City due to unique circumstances. In the event the Project Manager and Risk Manager determine that the work or services to be performed under this Agreement creates an increased risk of loss to the City, the Contractor agrees that the minimum limits of the insurance policies required by this Section 6 may be changed accordingly upon receipt of written notice from the Project Manager provided that the Contractor shall have the right to appeal a determination of increased coverage by the Project Manager to the City Council of City within ten (10) days of receipt of notice from the Project Manager.

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6.6 Substitution of Securities. Pursuant to California Public Contract Code Section 22300, substitution of eligible equivalent securities for any monies withheld to ensure performance under the contract for the work to be performed will be permitted at the request and expense of the successful bidder.

7.0 RECORDS AND REPORTS

7.1 Reports. Contractor shall periodically prepare and submit to the Contract Officer such reports concerning the performance of the services required by this Agreement as the Contract Officer shall require. Contractor hereby acknowledges that the City is greatly concerned about the cost of work and services to be performed pursuant to this Agreement. For this reason, Contractor agrees that if Contractor becomes aware of any facts, circumstances, techniques, or events that may or will materially increase or decrease the cost of the work or services contemplated herein or, if Contractor is providing design services, the cost of the project being designed, Contractor shall promptly notify the Contract Officer of said fact, circumstance, technique or event and the estimated increased or decreased cost related thereto and, if Contractor is providing design services, the estimated increased or decreased cost estimate for the project being designed.

7.2 Records. Contractor shall keep, and require subcontractors to keep, such books and records (including but not limited to payroll records as required herein) as shall be necessary to perform the services required by this Agreement and enable the Contract Officer to evaluate the performance of such services. The Contract Officer shall have full and free access to such books and records at all times during normal business hours of City, including the right to inspect, copy, audit and make records and transcripts from such records. Such records shall be maintained for a period of three (3) years following completion of the services hereunder, and the City shall have access to such records in the event any audit is required.

7.3 Ownership of Documents. All drawings, specifications, reports, records, documents, and other materials prepared by Contractor, its employees, subcontractors, and agents in the performance of this Agreement shall be the property of City and shall be delivered to City upon request of the Contract Officer or upon the termination of this Agreement, and Contractor shall have no claim for further employment or additional compensation as a result of the exercise by City of its full rights of ownership of the documents and materials hereunder. Contractor may retain copies of such documents for its own use. Contractor shall have an unrestricted right to use the concepts embodied therein. All subcontractors shall provide for assignment to City of any documents or materials prepared by them, and in the event Contractor fails to secure such assignment, Contractor shall indemnify City for all damages resulting therefrom.

7.4 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 7920.000 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 7924.510, and of which Contractor informs City of such trade secret. The City will endeavor to maintain as confidential all information obtained by it that is designated as a trade secret. The City shall not, in any way, be liable or responsible for the disclosure of any trade secret including, without limitation, those records so marked if disclosure is deemed to be required by law or by order of the Court.

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8.0 GENERAL PROVISIONS

8.1 Governing Law. This Agreement shall be construed and interpreted both as to validity and to performance of the parties in accordance with the laws of the State of California. Legal actions concerning any dispute, claim, or matter arising out of or in relation to this Agreement shall be instituted in the Superior Court of the County of Orange, State of California, or any other appropriate court in such county, and Contractor covenants and agrees to submit to the personal jurisdiction of such court in the event of such action.

8.2 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.

The Principal set forth in Section 5.1 above shall be the representative for Contractor for purposes of this Agreement, and shall be authorized to issue all consents, approvals, directives, and agreements on behalf of Contractor called for by this Agreement, except as otherwise expressly provided in this Agreement.

8.3 Disputes. In the event either party fails to perform its obligations hereunder, the nondefaulting party shall provide the defaulting party written notice of such default. The defaulting party shall have ten (10) days to cure the default; provided that, if the default is not reasonably susceptible to being cured within said ten (10) day period, the defaulting party shall have a reasonable time to cure the default, not to exceed a maximum of thirty (30) days, so long as the defaulting party commences to cure such default within ten (10) days of service of such notice and diligently prosecutes the cure to completion; provided further that if the default is an immediate danger to the health, safety and general welfare, the defaulting party shall take such immediate action as may be necessary. Notwithstanding the foregoing, the nondefaulting party may, in its sole and absolute discretion, grant a longer cure period. Should the defaulting party fail to cure the default within the time period provided in this Section, the nondefaulting party shall have the right, in addition to any other rights the nondefaulting party may have at law or in equity, to terminate this Agreement.

Compliance with the provisions of this Section 8.3 shall be a condition precedent to bringing any legal action, and such compliance shall not be a waiver of any party's right to take legal action in the event that the dispute is not cured.

8.4 Retention of Funds. Progress payments shall be made in accordance with the provisions of Section 3.2 of this Agreement. In accordance with said section, City shall pay Contractor a sum based upon ninety-five percent (95%) of the contract price apportionment of the labor and materials incorporated into the work under the contract during the month covered by said statement. The remaining five percent (5%) thereof shall be retained as performance security to be paid to the Contractor within sixty (60) days after final acceptance of the work by the City Council, after Contractor shall have furnished City with a release of all undisputed contract amounts if required by City. In the event there are any claims specifically excluded by Contractor from the operation of the release, the City may retain proceeds (per Public Contract Code 7107) of up to 150% of the amount in dispute. City's failure to deduct or withhold shall not affect Contractor's obligations hereunder.

8.5 Waiver. No delay or omission in the exercise of any right or remedy by a nondefaulting party on any default shall impair such right or remedy or be construed as a waiver. A party's consent to or approval of any act by the other party requiring the party's consent or approval shall not be deemed to waive or render unnecessary the other party's consent to or approval of any D-12

subsequent act. Any waiver by either party of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of this Agreement.

8.6 Rights and Remedies. Rights and Remedies are cumulative except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative and the exercise by either party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other party.

8.7 Legal Action. In addition to any other rights or remedies, either party may take legal action, in law or in equity, to cure, correct or remedy any default, to recover damages for any default, to compel specific performance of this Agreement, to obtain declaratory or injunctive relief, or to obtain any other remedy consistent with the purposes of this Agreement.

8.8 Liquidated Damages. Since the determination of actual damages for any delay in performance of this Agreement would be extremely difficult or impractical to determine in the event of a breach of this Agreement, the Contractor and its sureties shall be liable for and shall pay to the City Five Thousand and Two Hundred Dollars ($5,200.00) as liquidated damages for each working day of delay in the performance of any service required hereunder, as specified in the Scope of Services (Exhibit "A") or Schedule of Performance (Exhibit "B"). The City may withhold from any monies payable on account of services performed by the Contractor any accrued liquidated damages.

8.9 Termination for Default of Contractor. If termination is due to the failure of the Contractor to fulfill its obligations under this Agreement, Contractor shall vacate any City owned property which Contractor is permitted to occupy hereunder and City may, after compliance with the provisions of Section 8.3, take over the work and prosecute the same to completion by contract or otherwise, and the Contractor shall be liable to the extent that the total cost for completion of the services required hereunder exceeds the compensation herein stipulated (provided that the City shall use reasonable efforts to mitigate such damages), and City may withhold any payments to the Contractor for the purpose of setoff or partial payment of the amounts owed the City as previously stated.

8.10 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party or any other person shall be in writing and shall be deemed to be given when served personally or deposited in the U.S. Mail, prepaid, first-class mail, return receipt requested, addressed as follows:

To City:

City of Placentia
401 E. Chapman Ave.

Placentia, California 92870
Attn.: Chris Tanio
To Contractor: R.J. Noble Company
ATTN: Steven L. Mendoza
15505 E. Lincoln Ave.

Orange, CA 92865

8.11 Non -liability of City Officers and Employees. No officer or employee of the City shall be personally liable to the Contractor, or any successor in interest, in the event of any default or D-13

breach by the City or for any amount which may become due to the Contractor or to its successor, or for breach of any obligation of the terms of this Agreement.

8.12 Conflict of Interest. The Contractor warrants that it has not paid or given and will not pay or give any third party any money or other consideration for obtaining this Agreement.

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 subcontractor 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. Contractor's duties and services under this Agreement shall not include preparing or assisting the City with any portion of the City's preparation of a request for proposals, request for qualifications, or any other solicitation regarding a subsequent or additional contract with the City. The City shall at all times retain responsibility for public contracting, including with respect to any subsequent phase of this project. Contractor's participation in the planning, discussions, or drawing of project plans or specifications shall be limited to conceptual, preliminary, or initial plans or specifications. Contractor shall cooperate with the public entity to ensure that all bidders for a subsequent contract on any subsequent phase of this project, if any, have access to the same information, including all conceptual, preliminary, or initial plans or specifications prepared by Contractor pursuant to this Agreement.

8.13 Covenant Against Discrimination. Contractor covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, or ancestry in the performance of this Agreement.

To the extent required by law, contractor shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, or ancestry.

8.14 Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of this Agreement or any other rule of construction which might otherwise apply.

8.15 Severability. In the event that any one or more of the phrases, sentences, clauses, paragraphs, or sections contained in this Agreement shall be declared invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs, or sections of this Agreement which are hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder unless the invalid provision is so material that its invalidity deprives either party of the basic benefit of their bargain or renders this Agreement meaningless.

8.16 Hiring of Illegal Aliens Prohibited. Contractor shall not hire or employ any person to perform work within the City of Placentia or allow any person to perform work required under this D-14

Agreement unless such person is properly documented and legally entitled to be employed within the United States. Further, Contractor shall comply with the following:
(a) Unauthorized Aliens. Contractor hereby represents and warrants that it will comply with all of the provisions of the Federal Immigration and Nationality Act, 8 U.S.C.A. §§ 1101, et seq., as amended, and in connection therewith, shall not employ unauthorized aliens as defined therein. Should Contractor so employ such unauthorized aliens for the performance of any work and/or services under this Agreement, and should any liability or sanctions be imposed against City for such use of unauthorized aliens, Contractor hereby agrees to reimburse City for any and all liabilities, actions, suits, claims, demands, losses, costs, judgments, arbitration awards, settlements, damages, demands, orders, or penalties which arise out of or are related to such employment, together with any and all costs, including attorneys' fees, incurred by City.
(b) E-Verifv. If Contractor is not already enrolled in the U.S. Department of Homeland Security's E -Verify program, Contractor shall enroll in the E -Verify program within fifteen (15) days of the effective date of this Agreement to verify the employment authorization of employees assigned to perform work hereunder. Contractor shall verify employment authorization within three (3) days of hiring a new employee to perform work under this Agreement. Information pertaining to the E -Verify program can be found at http://www.uscis.gov , or access the registration page at https://e- verify.uscis.gov/enroll. Contractor shall certify its registration with E -Verify and provide City its registration number within sixteen days of the effective date of this Agreement. Failure to provide certification will result in withholding payment until full compliance is demonstrated.

8.17 Unfair Business Practices Claims. In entering into a public works contract or a subcontract to supply goods, services, or materials pursuant to a public works contract, the contractor or subcontractor offers and agrees to assign to the awarding body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C.

Sec. 15) or under the Cartwright Act (Chapter 2, (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, services, or materials pursuant to the public works contract or the subcontract. This assignment shall be made and become effective at the time the awarding body renders final payment to the contractor without further acknowledgment by the parties. (Sec. 7103.5, California Public Contract Code).

8.18 Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Agreement on behalf of said party, (iii) by so executing this Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the entering into this Agreement does not violate any provision of any other Agreement to which said party is bound.

8.19 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 D-15

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 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.

8.20 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.

8.21 Legal Responsibilities. The Contractor shall keep itself informed of City, State, and Federal laws, ordinances, and regulations, which may in any manner affect the performance of its services pursuant to this Agreement. The Contractor shall at all times observe and comply with all such laws, ordinances, and regulations. Neither the City, nor its officers, agents, or employees shall be liable at law or in equity as a result of the Contractor's failure to comply with this section.

8.22 Termination for Convenience. The City may terminate this Agreement without cause for convenience of the City upon giving contractor 30 days prior written notice of termination of the Agreement. Upon receipt of the notice of termination the Contractor shall cease all further work pursuant to the Agreement. Upon such termination by the City the Contractor shall not be entitled to any other remedies, claims, actions, profits, or damages except as provided in this paragraph. Upon the receipt of such notice of termination Contractor shall be entitled to the following compensation:

1. The contract value of the work completed to and including the date of receipt of the notice of termination, less the amount of progress payments received by contractor.

2. Actual move -off costs including labor, rental fees, equipment transportation costs, the costs of maintaining on-site construction office for supervising the mover -off.

3. The cost of materials custom made for this Agreement which cannot be used by the Contractor in the normal course of his business, and which have not been paid for by City in progress payments.

4. All costs shall not include any markups as might otherwise be allowed by any plans or specifications which were a part of the Agreement.

The provisions of this paragraph shall supersede any other provision of the Agreement or any provision of any plans, specification, addendums, or other documents which are or may become a part of this Agreement. City and Contractor agree that the provisions of this paragraph are a substantive part of the consideration for this Agreement.

8.23 Responsibility for Errors. Contractor shall be responsible for its work and results under this Agreement. Contractor, when requested, shall furnish clarification and/or explanation as may be required by the City's representative, regarding any services rendered under this Agreement at no additional cost to City. In the event that an error or omission attributable to D-16

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.

8.24 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, this Agreement shall govern over the document referenced.

8.25 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.

8.26 No Third Party 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.

8.27 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.

8.28 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.

8.29 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.

8.30 Funding Source Conditions — Contractor's Obligation. Contractor acknowledges that the City may be paying for the Project by using funds it receives or will receive from various funding sources in the form of grants and/or subsidies, and the like under certain terms and conditions. Contractor warrants that it is not suspended or debarred from doing business with the United States government and can legally be paid from federal funds. Contractor acknowledges and agrees that any failure of the Contractor and/or its subcontractors to perform its obligations under the Contract, including, but not limited to, timely submitting accurate reports and records, that in any way results in the City not meeting the terms and conditions placed on the funds by the funding source, or forfeiting its entitlement to or, otherwise, not receiving, the funds, then the Contractor shall be liable to pay the City for the funds not granted to the City on the Project.

8.31 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 D-17

inconsistent provision in any other contract document appurtenant hereto, including exhibits to this Agreement.

IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the date first written above.

CITY OF PLACENTIA,
A municipal corporation and Charter City
Jennifeeafnpman, City Administrator
ATTEST:
441 Rikl,'4
Robert S. McKinnell, City Clerk
CONTRACTOR:

X S2 -
Signature
STEVEN L. MENDOZA, VICE PRESIDENT
Name and Title
33-8662.993 866299
Social Security or Taxpayer ID Number
APPROVED AS TO FORM:

Christian L. Bettenhausen, City Attorney
APPROVED AS TO INSURANCE:

Rosagfna Ramir-z, Risme anager
D-18
Date: //
Date: 09/18/2025
Date:

Date: /D- 2-7-ZO 2<

APPROVED AS TO CONTENT:

Date: I,Q 17/r
Shelley L. K nell, Project Manager
DEPARTMENTAL APPROVAL:

Date:

Chris Tanio, Director of Public Works/
City Engineer
\A 4A.-5

CALIFORNIA ACKNOWLEDGMENT
CIVIL CODE § 1189
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 ORANGE
On 09/18/2025
Date
personally appeared
}
before me,

JADELIN PIOHIA, NOTARY PUBLIC
Here Insert Name and Title of the Officer
STEVEN L. MENDOZA
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(X) whose name( is/ cKsubscribed to the within instrument and acknowledged to me that hej.€1executed the same in his/IXLiI authorized capacity( g, and that by his}ji rX €X signature(X) on the instrument the personN, or the entity upon behalf of which the personN acted, executed the instrument.

JADELIN PIOHIA
Notary Public - California
Orange County
° Commission # 2486732
My Comm. Expires Apr 12, 2028
Place Notary Seal and/or Stamp Above
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.

WITNESS my hand and official seal.

Signatur
Signature of Notary Public

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Description of Attached Document
Title or Type of Document:

Document Date:

Signer(s) Other Than Named Above:

Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:
2019 National Notary Association
Number of Pages:

Signer's Name:

O Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
O Individual ❑ Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

Bond No. 30259221
Executed in Triplicate

(Use of City Bond Form is Required)

LABOR AND MATERIAL PAYMENT BOND

PUBLIC WORK (CALIFORNIA)
KNOW ALL MEN BY THESE PRESENT:

WHEREAS, R.J. NOBLE COMPANY , as Principal, has
entered into a contract dated October 7th, 2025 , with the City of Placentia (Obligee) referred to and made a part hereof to perform the following work, to wit: FY 2024-2025 RESIDENTIAL STREET REHABILITATION and all appurtenant work in accordance with PROJECT NO. 26-104 , which requires Principal to file this bond to secure claims made in relation to the project.

NOW THEREFORE, we, R.J. NOBLE COMPANY , as Principal,
and Western Surety Company , a corporation organized under the laws of South Dakota and duly authorized to transact business in the State of California, as Surety, are held firmly bound unto the City of Placentia, as Obligee, and all sub- contractors, laborers, material persons and other persons employed in the performance of the referenced agreement, in the sum of * Dollars ($.** ),
lawful money of the United States of America, for the payment whereof well and truly to be made the Principal and Surety bind themselves, their heirs, executors, administrators, successors, and * assigns, jointly and severally, firmly by these presents. ** One Million Nine Hundred Seventy -Two Thousand Nine Hundred Fifteen Dollars and 05/100 Cents ($1,972,915.05) If the above bounden PRINCIPAL, his or its heirs, executors, administrators, successors, assigns, or any of his or its sub -contractors, fails to pay for any materials, provisions, provender, or other supplies, or teams, implements or machinery, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor to persons named in Section 9100 or the Civil Code, thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work or labor deducted, withheld and paid over to the Employment Development Department from the wages of employees of the contractor and sub -contractors pursuant to Section 13020 of the Unemployment Insurance Code, that the SURETY on this bond will pay the same, in an amount not exceeding the sum specified in this bond, AND ALSO, in case suit is brought upon this bond, a reasonable attorney's fee, which shall be awarded by the court to the prevailing party in said suit, said attorney's fee to be taxed as costs in said suit and to be included in the judgment herein rendered.

As part of the obligation secured hereby, the SURETY shall not be exonerated or released from the obligation of the bond by any change, alteration, or modification in or of any contract, plans, specifications, or agreement pertaining or relating to any scheme or work of improvement or pertaining or relating to the furnishing of labor, materials, or equipment therefor, nor by any change or modification of any terms of payment or extension of the time for any payment pertaining or relating to any scheme of work of improvement, nor by any rescission or attempted rescission of the contract, agreement or bond, nor by any conditions precedent or subsequent in the bond attempting to limit the right of recovery of claimants otherwise entitled to recover under D-20

CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
-__: ,.::.,..�_ .�...:':;� �,k�^��'=4�.?-;;.y �*se.':=�-��3:>'��:y�5� `�. �r_F.3��.� Fs_'��..�.:kk'']a��`5rs�����.S��F7�s;�.:..£-,• 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 ORANGE
On
09/19/2025
Date
personally appeared
}
before me,

JADELIN PIOHIA, NOTARY PUBLIC
Here Insert Name and Title of the Officer
STEVEN L. MENDOZA
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(X) whose name(X) is/subscribed to the within instrument and acknowledged to me that heNYeltnaexecuted the same in his/areXMICK authorized capacity(k14, and that by hisk)ErX13a signature(X} on the instrument the person, or the entity upon behalf of which the person(X) acted, executed the instrument.

JADELIN PIOHIA
Notary Public - California
Orange County n
Commission # 2486732
My Comm. Expires Apr 12, 2028
Place Notary Seal and/or Stamp Above
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.

WITNESS my hand and official seal.

Signature
Signature of Notary Public

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Description of Attached Document
Title or Type of Document:

Document Date:

Signer(s) Other Than Named Above:

Capacity(ies) Claimed by Signer(s)
Signer's Name:
0 Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
O Individual 0 Attorney in Fact
0 Guardian or Conservator
❑ Trustee
O Other:

Signer is Representing:
':2019 National Notary Association
Number of Pages:

Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
o Trustee 0 Guardian or Conservator
O Other:

Signer is Representing:

14.5. 'A. az a - `w

CALIFORNIA ACKNOWLEDGMENT
CIVIL CODE § 1189
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 ORANGE
On 09/19/2025
Date
personally appeared
before me,
JENNIFER M. VEGA
}

JADELIN PIOHIA, NOTARY PUBLIC
Here Insert Name and Title of the Officer
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(X) whose name(x) is/subscribed to the within instrument and acknowledged to me that j Ishe7 (executed the same inkX/herlticali authorized capacity( , and that by NNherXtYai signature(X) on the instrument the person, or the entity upon behalf of which the personN) acted, executed the instrument.

JADELIN PIOHIA
Notary Public - California
Orange County
• Commission # 2436732 r
My Comm. Expires Apr 12, 2022
Place Notary Seal and/or Stomp Above
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.

WITNESS my hand and official seal.

Signature
A4,,„
Signature of Notary Public

OPTIONAL
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Description of Attached Document
Title or Type of Document:

Document Date:

Signer(s) Other Than Named Above:

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Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

Number of Pages:

Signer's Name:

O Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
O Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:
i :3;5L &a.g�E4-.t-�...,k-`•C.t ti:;g-.� £ � � .,. -04. .„ a _ , �: .,-jkk:6.2019 National Notary Association

ALL- PURPOSE

CERTIFICATE OF ACKNOWLEDGMENT
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 Orange
}
}
On - ` c/ before me, Susan E. Morales, Notary Public
(Here insert name and itle of the officer)
personally appeared Kelly Vincent
who proved to me on the basis of satisfactory evidence to be the person{) whose name() is/afe subscribed to the within instrument and acknowledged to me that heishe/they executed the same in his/her/their authorized capacity(ies), and that by iris-/her/their signature on the instrument the person fsj, or the entity upon behalf of which the persons) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.
. ma..��csc1
Notary Public Signature (Notary Public Seal)
W
SUSAN E. MORALES
COMM. #2444309
NOTARY PUBLIC- CALIFORNIA 0
ORANGE COUNTY ._a
MY COMM. Expires April 154, 2027
s •

ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, if needed, should be completed and attached 10 the document. Acknohredgenls from other states may be completed for documents being sent to that slate so long as the wording does not require the California nolmy to violate California notary lair. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible.

Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form • Signature of the notary public must match the signature on file with the office of the county clerk.

Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. • Indicate title or type of attached document, number of pages and date. • Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple.

DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of attached doe m
Z4.466,1 (-44/et)
(Title or description of attached document continued)
Number of Pages • Document Date
q—fs ar

CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
D
(Title)
Partner(s)
Attorney -in -Fact
Trustee(s)
Other
2015 Version www.NotaryClasses.com 800-873-9865

Western Surety Company

POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint David S Jacobson, Kelly Vincent, Individually
of Anaheim, CA, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.

This Power of Attorney is made and executed pursuant to and by authority of the Authorizing By -Laws and Resolutions printed at the bottom of this page, duly adopted, as indicated, by the shareholders of the corporation.

In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 29th day of July, 2024.

State of South Dakota
County of Minnehaha
}
ss

WESTERN SURETY COMPANY
0:44. • • 7 • • -/
Larry Kasten, Vice President
ti
On this 29th day of July, 2024, before me personally came Larry Kasten, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation.

My commission expires
March 2, 2026
{0..,..4h.+♦i4Vb...44.,......%*,,.. j
M. BENT 3
e�NOTARY PUBLIC /� f
SOUTH DAKOTA4,.,.,/j
M. Bent, Notary Public

CERTIFICATE
1, Paula Kolsrud, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law and Resolutions of the corporatiQ+iprinted below this certificate are still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this /�jr www.cnasuretv.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity.

Form F4280-6-2023

(Use of City Form is Required)

SUPPLEMENTAL INFORMATION TO BE COMPLETED BY PRINCIPAL
If an individual, so state. If a firm or co -partnership, state the firm and give the names of all individual co-partners composing the partnership. If a Corporation, state legal name of corporation; state also the names of the president, secretary, treasurer and manager thereof.

R.J. NOBLE COMPANY A CALIFORNIA CORPORATION
AUSTIN M. CARVER, PRESIDENT JENNIFER M. VEGA,SECRETARY
JAMES N. DUCOTE, C.F.O.

Business Address:
15505 E. LINCOLN AVE.,
ORANGE, CA 92865
Telephone Number: 714-637-1550
Date: 09/18/2025
Print Name: R.J. NOBLE COMPANY
Principal
Signature: X
Title
STEVEN L. MENDOZA, VICE PRESIDENT
D-22

(Use of City Form is Required)

TAX IDENTIFICATION NUMBER
The Tax Equity and Fiscal Responsibility Act of 1982 requires the payer (City of Placentia) to report to the Internal Revenue Service taxable payments to payees.

You (as a payee) are required by law to provide us with your Taxpayer Identification Number (if an individual or partnership, your Social Security Number). If you do not provide us with your correct identification number, you may be subject to a penalty imposed by the Internal Revenue Service. The payments subject to withholdings may include, but are not limited to, interest, dividends, or other payments the City of Placentia and/or the Placentia Redevelopment Agency made to you. Other payments may include rents, royalties, commissions and fees for service of non -employees.

If you are exempt from income tax, we are still required, by law, to maintain a Tax Identification Number on file. PLEASE PROVIDE YOUR TAX IDENTIFICATION NUMBER next to the appropriate listing below, sign, date and return to:

CITY OF PLACENTIA FINANCE DEPARTMENT
401 E. Chapman Ave.

Placentia, CA 92870
Exempt: Yes No XX Telephone ( 714 ) 637-1550
CORPORATION: R.J. NOBLE COMPANY TAX ID 33-0866299
U.S.A. OR ANY AGENCIES THEREOF: N/A
IRS CODE #501 TAX-EXEMPT ORGANIZATION: N/A
A NON-COMMISSIONED CITY OF PLACENTIA EMPLOYEE: N/A
SOLE PROPRIETOR: N/A
A PARTNERSHIP: N/A
OTHER: N/A (Explain)
Signature/Title: X
STEVEN .MEI46OZA,

VICE P ESIDENT
D-23
Date: 09/18/2025

Bond No. 30259221
Executed in Triplicate

CITY OF PLACENTIA

PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENT: That,
WHEREAS, the CITY OF PLACENTIA (hereinafter called the "City") has awarded to R.J. NOBLE COMPANY a California corporation (hereinafter "Principal"), an Agreement, dated October 7th,2025, 20 ("Agreement"), whereby Principal agreed to provide construction services including FY 2024-2025 Residential Street Rehabilitation Proiect / City Proigct No. 26-104.

WHEREAS, the Public Work to be performed by the Principal is more particularly set forth in the Agreement which is incorporated herein by reference and made a part hereof; and WHEREAS, said Principal is required under the terms of the Agreement to furnish a bond for the faithful performance of the Agreement;
R.J. NOBLE Western
NOW, THEREFORE, we, COMPANY , as Principal, and Surety Company as Surety, are held and firmly bound unto the City in the sum of * Dollars ($** ), this amount being not less than one hundred percent (100%) of the total contract price under Agreement, lawful money of the United States of America for payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors jointly and severally, firmly by these presents.
*One Million Nine Hundred Seventy -Two Thousand Nine Hundred Fifteen Dollars and 05/100 Cents **($1,972,915.05) THE CONDITION OF THIS OBLIGATION IS SUCH THAT, the obligation shall become null and void if the above -bounded Principal, his or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and abide by well and truly keep and perform all the undertakings, terms, covenants, conditions, and agreements in the said Agreement and any alteration thereof, made as therein provided, all within the time and in the manner therein designated and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City, its officer, agents and employees, as therein stipulated; otherwise it shall be and remain in full force and virtue.

As a part of the obligation secured hereby, and in addition to the face amount specified, costs and reasonable expenses and fees shall be included, including reasonable attorneys' fees, incurred in successfully enforcing the obligation on the bond, all to be taxed as costs and included in any judgment rendered.

The said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or modification of the Agreement, the contract documents or of the work to be performed thereunder, shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extensions of time, alteration or modification of Agreement, the contract documents or of the work to be performed thereunder.

Surety's obligation shall be a guarantee of payment and performance and shall not be diminished by any bankruptcy or reorganization in bankruptcy or liquidation or the result of the foregoing or otherwise of Principal. Accordingly, the filing of any petition in bankruptcy or for rearrangement or reorganization or liquidation (or proceedings similar in purpose or effect) of Principal under any Federal or State laws ("Insolvency Case") will not toll or delay the date due for payment or performance hereunder as more particularly specified in of the Construction Management Agreement. The City shall be not be required to await the outcome of an Insolvency Case or to enforce any of their respective rights under the Agreement, respectively, prior to D-24

1.7 obtaining payment in full from Surety. If for any reason payment received by the City in respect of the obligations of the Principal under the Agreement guaranteed pursuant to this bond is rescinded or must be returned or restored by the City, this bond shall be automatically reinstated and shall continue to be in effect as if such payment had not been made.

Collection of liquidated damages by City due to Principal's failure to timely achieve Substantial Completion shall not limit, modify, or act as an offset or credit against Surety's obligation to arrange for or cause the completion of the Public Work as and when required by the Agreement.

IN WITNESS WHEREOF three (3) identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety named herein, on the 18th day of September , 2025 , the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative pursuant to authority of its governing body. (Seal)
SURETY: Western Surety Company
Kelly Vincent, Attorney -in -Fact
2 Park Plaza, Suite 400
Irvine, CA 92614

ADDRESS
APPROVED:

CEJ k --c}\

CITY ATTOR EY
(Seal)
PRINCIPAL:R.J. NOBLE COMPANY
By

INSTRUCTIONS
STEVENL/. MENOZA, VICE PRESIDENT
X
JENNIF, R M. LEGA, SECRETARY
15505 E. LINCOLN AVE. ORANGE, CA 92865

ADDRESS
Two (2) Notarized Signatures required
from all Corporations.

1. The above bond must be executed by both the Principal and the Surety.

2. If the Principal is a corporation, the bond must be executed in the corporate name and signed by the President or a Vice -President and the Secretary or Assistant Secretary, and the corporate seal affixed. If the Principal is a partnership, all partners must sign it. If the Principal is an individual doing business under a fictitious name, it must be signed by all persons having an interest in the business, and the fictitious name must be signed also.

The bond must be notarized by both the Principal and the Surety.

3. The City Attorney of the City of Placentia must approve the bond.

4. The bond, after approval, must be filed with the City Clerk of the City of Placentia.

D-25

CALIFORNIA ACKNOWLEDGMENT
CIVIL CODE § 1189
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 ORANGE
On
09/19/2025
Date
personally appeared
E
before me,

JADELIN PIOHIA, NOTARY PUBLIC
Here Insert Name and Title of the Officer
STEVEN L. MENDOZA
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(' whose name() is/subscribed to the within instrument and acknowledged to me that he1NP lexecuted the same in his/i[tli {iK authorized capacity(M , and that by hisMrXeet signature(X) on the instrument the person(X), or the entity upon behalf of which the person% acted, executed the instrument.

JADELIN PIOHIA
Notary Public - California
Orange County >_
°i Commission # 2486732 `
My Comm. Expires Apr 12, 2028 9
Place Notary Seal and/or Stamp Above
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.

WITNESS my hand and official seal.

Signature
Signature of Notary Public

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 Than Named Above:

Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):

O Partner — 0 Limited 0 General
O Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

Number of Pages:

Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
0 Guardian or Conservator
❑ Trustee
❑ Other:

Signer is Representing:
2019 National Notary Association
?qtr -.gin

ALL- PURPOSE

CERTIFICATE OF ACKNOWLEDGMENT
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 Orange
}
}
On !/°`;

Western Surety Company

POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint David S Jacobson, Kelly Vincent, Individually
of Anaheim, CA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.

This Power of Attorney is made and executed pursuant to and by authority of the Authorizing By -Laws and Resolutions printed at the bottom of this page, duly adopted, as indicated, by the shareholders of the corporation.

In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 29th day of July, 2024.

State of South Dakota
County of Minnehaha
}
ss

WESTERN SURETY COMPANY
c3�
Larry Kasten, Vice President
e7
On this 29th day of July, 2024, before me personally came Larry Kasten, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation.

My commission expires
March 2, 2026
+........ ,,,tic4..4444Y4.,bh
M. BENT ;
'5.-" •-• PUBLIC SEAL
r SOUTH DAKOTA r
4„hhh\Y•,,, 4Yh...0b.,hv..Y�a, +
t)2
M. Bent, Notary Public

CERTIFICATE
I, Paula Kolsrud, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law and Resolutions of th corporation printed below this certificate are still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this/ C day ogif y. - +sr'�o WESTERN SURETY COMPANY
I* �/ l Y Y)`3 "'�.3
aW: K- �1
*sTti ppit,�+ • Paula Kolsrud, Assistant Secretary
uunmu«�we
Authorizing By -Laws and Resolutions

ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company.

Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile.

This Power of Attorney is signed by Larry Kasten, Vice President, who has been authorized pursuant to the above Bylaw to execute power of attorneys on behalf of Western Surety Company.

This Power of Attorney may be signed by digital signature and sealed by a digital or otherwise electronic -formatted corporate seal under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 27' day of April, 2022:
"RESOLVED: That it is in the best interest of the Company to periodically ratify and confirm any corporate documents signed by digital signatures and to ratify and confirm the use of a digital or otherwise electronic -formatted corporate seal, each to be considered the act and deed of the Company." Go to www.cnasuretv.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity.

Form F4280-6-2023

BID GUARANTEE

TO THE CITY OF PLACENTIA
PROJECT NO. 26-104
As a material inducement to the City to award the contract for Project No. 26-104 to R.J. NOBLE COMPANY the undersigned ("Guarantor") has agreed to enter into this guarantee. The Guarantor hereby unconditionally guarantees to the fullest extent allowed by law the following work included in this project: FY 2024-205 RESIDENTIAL ("the work").

STREET REHABILITATION
Guarantor guarantees that the materials and equipment used by itself and its subcontractors will be free from defects and that the work will conform to the plans and specifications. Should any of the materials or equipment prove defective or should the work as a whole, or any part thereof, prove defective for any reason whatsoever (except due to intentional torts by the City), or should the work as a whole or any part thereof fail to operate properly or fail to comply with the plans and specifications, Guarantor will, at the City's sole election: 1) reimburse the City, upon written demand, for all of the City's expenses incurred replacing or restoring any such equipment or materials, including the cost of any work necessary to make such replacement or repairs; or 2) replace any such defective material or equipment and repair said work completely, all without any cost to the City. Guarantor further guarantees that any such repair work will conform to the plans and specifications for the project. This guarantee will remain in effect for five years from the date on which the contracted for work is accepted for use by the City.

Guarantor understands and agrees that the City shall have the unqualified option to make any replacements or repairs itself or to have such replacement, repair, performed by the undersigned.

The City shall have no obligation to consult with Guarantor before the City proceeds to perform any repair, replacement, or work itself. If the City elects to have Guarantor perform said repair, replacement, or work, Guarantor agrees that the repair, replacement, or work shall be performed within 15 days after receipt of a written demand from the City.

If the City elects to perform the replacement, repairs itself, Guarantor agrees to make reimbursement payment within 15 days after receipt of a written demand for payment from the City.

If the Guarantor fails or refuses to comply with this guarantee, the City shall be entitled to all costs and expenses, including attorneys and expert fees, reasonably incurred by reason of Guarantor's failure or refusal.

Guarantor Date: 09/18/2025
Contractor: R.J. NOBLE COMPANY By: X
Title: STEVEN L. MENDOZA, VICE PRESIDENT
D-26

STATEMENT OF NON COLLUSION BY CONTRACTOR
The undersigned who submits herewith to the City of Placentia a bid or proposal does hereby certify:
a. That all statements of fact in such bid or proposal are true. b. That such bid or proposal was not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization or corporation. c. That such bid or proposal is genuine and not collusive or sham. d. That said bidder has not, directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interest of the City of Placentia or of any other bidder or anyone else interested in the proposed procurement. e. Did not, directly or indirectly, collude, conspire, connive or agree with anyone else that said bidder or anyone else would submit a false or sham bid or proposal, or that anyone should refrain from bidding or withdraw his bid or proposal.
f. Did not in any manner, directly or indirectly seek by agreement, communication or conference with anyone to raise or fix the bid or proposal price of said bidder or of anyone else, or to raise or fix any overhead, profit or cost element of his bid or proposal price, or that of anyone else.

Did not, directly or indirectly, submit his bid or proposal price or any breakdown thereof, or the contents thereof, or divulge information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member agent thereof, or to any individual or group of individuals, except to the City of Placentia, or to any person or persons who have a partnership or their financial interest with said bidder in his business. h. Did not provide, directly or indirectly to any officer or employee of the City of Placentia any gratuity, entertainment, meals, or anything of value, whatsoever, which could be objectively construed as intending to invoke any form of reciprocation or favorable treatment. i. That no officer or principal of the undersigned firm is related to any officer or employee of the city by blood or marriage within the third degree or is employed, either full or part time, by the City of Placentia either currently or within the last two (2) years.

That no officer or principal of the undersigned firm nor any subcontractor to be engaged by the principal has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy or any other act in violation of any State or Federal antitrust law in connection with the bidding upon award of, or performance of, any public work contract, with any public entity, within the last three years.
g.
j.

I certify, under penalty of perjury under the laws of the State of California, that the foregoing is true and correct and that this certification was executed:

On 09/18/2025
at ORANGE California.
igna'ture)
STEVE L. MENDOZA, VICE PRESIDENT
(Print Name & Title)
Firm R.J. NOBLE COMPANY
Street 15505 E. LINCOLN AVENUE
City ORANGE State CA Zip 92865
D-27

CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
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 ORANGE
On 09/18/2025
Date
personally appeared
t
before me.

JADELIN PIOHIA, NOTARY PUBLIC
Here Insert Nome and Title of the Officer
STEVEN L. MENDOZA
Names) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(K) whose name() is/ subscribed to the within instrument and acknowledged to me that heMfeeltKexecuted the same in his/1(AiX authorized capacity(NX , and that by hisk)Er7030i signature(} j on the instrument the person, or the entity upon behalf of which the persons acted, executed the instrument.

JADELIN PIOHIA
Notary Public - California
0range County
Commission rl 2416732
My Comm. Expires Apr 12, 2028
Place Notary Seal and/or Stomp Above
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.

WITNESS my hand and official seal.
„(2,4
Signature of Notary Public

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 Than Named Above:

Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

Number of Pages:

Signer's Name:

O Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
O Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
O Other:

Signer is Representing:
. ..,:........... „.. .. ,... ..-...:,
:2019 National Notary Association

EXHIBIT A

SCOPE OF SERVICES
The general items of work consist of: construction of ARHM pavement, cold mill, AC pavement reconstruction, striping, markings, and pavement legends, adjust to grade existing manholes, adjust to grade existing water valves, protect existing utilities, and such other items or details, not mentioned above, that are required to complete the project. All construction work shall be in accordance with the project bid documents, plans, technical specifications and all other references as depicted in strict adherence to the latest Greenbook, City's standards and all other State and utility agency specifications.

D-28
58 EXHIBIT B

SCHEDULE OF PERFORMANCE
All work must be complete within sixty (601 working days from the issuance of the Notice to Proceed.

Time of Essence. Time is of the essence in the performance of this Agreement.

Schedule of Performance. Contractor shall commence the services pursuant to this Agreement upon receipt of a written notice to proceed and shall perform all services within the time period(s) established in the "Schedule of Performance" attached hereto as Exhibit "B", and incorporated herein by this reference. When requested by the Contractor, extensions to the time period(s) specified in the Scope of Services may be approved in writing by the Contract Officer.

Force Maieure. The time period(s) specified in the Scope of Services for performance of the services rendered pursuant to this Agreement shall be extended because of any delays due to unforeseeable causes beyond the control and without the fault or negligence of the Contractor, including, but not restricted to, acts of God or of the public enemy, unusually severe weather, fires, earthquakes, floods, epidemics, quarantine restrictions, riots, strikes, freight embargoes, wars, litigation, and/or acts of any governmental agency, including the City, if the Contractor shall within ten (10) days of the commencement of such delay notify the Contract Officer in writing of the causes for the delay. The Contract Officer shall ascertain the facts and the extent of delay, and extend the time for performing the services for the period of the enforced delay when and if in the judgment of the Contract Officer such delay is justified. The Contract Officer's determination shall be final and conclusive upon the parties to this Agreement.

Term. Unless earlier terminated in accordance with Section 8.9 of this Agreement, this Agreement shall continue in full force and effect until final approval and acceptance of the project by the Contract Officer. Notwithstanding the foregoing, this Agreement shall terminate no later than October 7, 2026, unless the parties mutually agree in writing to extend the term.

D-29

EXHIBIT C

INSURANCE REQUIREMENTS
Contractor shall maintain and shall require all its subcontractors, consultants, and other agents to maintain the insurance listed below. Any requirement for insurance to be maintained after completion of the work shall survive this agreement.

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 Contractor from, nor be construed or deemed a waiver of, its obligation to maintain the required insurance at all times during the performance of this agreement.

A. Workers Compensation & Employers Liability Insurance • Workers Compensation insurance with statutory limits as required by the Labor Code of the State of California.
• Employers Liability with limits of $1,000,000 per Accident; $1,000,000 Disease per employee; $1,000,000 Disease per policy.
• The policy shall include a written waiver of the insurer's right to subrogate against CITY.
• Required Evidence of Coverage:

1. Subrogation waiver endorsement; and

2. Properly completed Certificate of Insurance.

B. General Liability Insurance
•
•
•
Commercial General Liability Insurance no less broad than Insurance Services Office (ISO) form CG 00 01.

Coverage shall be on a standard occurrence form. Claims -Made forms are not acceptable without prior written consent. Modified, limited or restricted Occurrence forms are not acceptable without prior written consent.

Minimum Limits: $1,000,000 per Occurrence; $2,000,000 General Aggregate; $2,000,000 Products/Completed Operations Aggregate. The General Aggregate D-30

t0
shall apply separately to each project. The required limits may be provided by a combination of General Liability Insurance and Commercial Excess or Umbrella Liability Insurance. If contractor maintains higher limits than the specified minimum limits, CITY requires and shall be entitled to coverage for the higher limits maintained by contractor.
• Any deductible or self-insured retention shall be shown on the Certificate of Insurance. If the deductible or self-insured retention exceeds $25,000 it must be approved in advance by CITY. Contractor is responsible for any deductible or self-insured retention and shall fund it upon CITY'S written request, regardless of whether Contractor has a claim against the insurance or is named as a party in any action involving CITY.
• Coverage shall be continued for one (1) year after completion of the work. • CITY shall be endorsed as an additional insured for liability arising out of ongoing and completed operations by or on behalf of the contractor. CITY shall continue to be an additional insured for completed operations for (1) year after completion of the work.
• The policy definition of "insured contract" shall include assumptions of liability arising out of both ongoing operations and the products -completed operations hazard ("f" definition of insured contract in ISO form CG 00 01, or equivalent). • The insurance provided to the additional insureds shall be primary to, and non- contributory with, any insurance or self-insurance program maintained by them. • The policy shall cover inter -insured suits and include a "Separation of Insureds" or "severability" clause which treats each insured separately. • The policy shall be endorsed to include a written waiver of the insurer's right to subrogate against all persons or entities that are, or are required to be, additional insureds.
• The policy shall not contain a Contractors' Warranty or other similar language which eliminates or restricts insurance because of a subcontractor's failure to carry specific insurance or to supply evidence of such insurance. • Required Evidence of Coverage:

1. Copy of the additional insured endorsement or policy language granting additional insured status; (The City of Placentia, its officers, employees, representatives, attorneys, and volunteers shall be named D-31

• The insurance provided to the additional insureds shall apply on a primary and non-contributory basis with respect to any insurance or self-insurance program maintained by them.
• If the insurance is on a Claims -Made basis, the retroactive date shall be no later than the commencement of work.
• The insurance shall be continued for one (1) year after completion of the work. If the insurance is on a Claims -Made basis, the continuation coverage may be provided by: (a) renewal of the existing policy; (b) an extended reporting period endorsement; or (c) replacement insurance with a retroactive date no later than the commencement of the work.
• Required Evidence of Coverage:

1. Copy of the additional insured endorsement or policy language granting additional insured status;

2. Copy of the endorsement or policy language indicating that coverage for the additional insureds is primary and non-contributory;

3. Properly completed Certificate of Insurance.

E. Surety Bonds
• Bid bond.
• Performance and payment bonds for the entire contract price. • The surety must be authorized to issue these bonds in the State of California.

F. Standards for Insurance Companies
• Insurers, other than the California State Compensation Insurance Fund, shall have an A.M. Best's rating of at least A:VII.

G. Documentation
• The Certificate of Insurance shall include the following reference: FY 2024-2025 RESIDENTIAL STREET REHABILITATION PROJECT, CITY PROJECT NO. 26-104
• The name and address for Additional Insured endorsements and Certificates of Insurance is: City of Placentia
• Contractor shall provide immediate written notice if: (1) any of the required D-33

EXHIBIT D

CLAIMS PROCEDURE
SUMMARY OF PUBLIC CONTRACT CODE § 9204
The following procedure will apply to any claims by the Contractor on the City:

A "claim" is a separate demand on the City by a contractor on a public works project and sent by registered mail or certified mail with return receipt requested, for one or more of the following:
• A time extension, including relief from penalties for delay • Payment by the City of money damages under the terms of the contract • Payment of an amount that is disputed by the City
Initial Review
The claim must be supported by appropriate documentation. The City has 45 days within which to review the claim and provide the contractor with a written statement identifying the disputed and undisputed portions of the claim. If the City does not issue a written statement, the claim is deemed rejected in its entirety. The City will pay any undisputed portion of the claim within 60 days of issuing the statement.

Meet & Confer
If the contractor disputes the City's written response, or if the City does not issue one, the contractor may request in writing an informal conference to meet and confer for possible settlement of the claim. The City will schedule the meet and confer conference within 30 days of this request and provide a written statement identifying the remaining disputed and undisputed portions of the claim within 10 business days of the meet and confer. The City will pay the undisputed portion within 60 days of issuing this statement.

Mediation
With respect to any disputed portion remaining after the meet and confer, the City and contractor will submit the matter to nonbinding mediation, agree to a mediator within 10 business days after issuing the written statement, and share mediation costs equally. If mediation is unsuccessful, then the terms of the public works agreement and applicable law will govern resolution of the dispute.

Miscellaneous Provisions
Amounts not paid by the City in a timely manner bear interest at 7% per annum. Subcontractors may submit claims via this procedure through the general contractor. The City and contractor may waive the requirement to mediate but cannot otherwise waive these claim procedures.

D-35

co
ACORD®
9/18/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

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

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

PRODUCER
Acrisure Southwest Partners Insurance Services, LLC
611 Anton Blvd., Suite #1400
Costa Mesa, CA 92626
www.patrisk.com OK07568

INSURED
R. J. Noble Company
15505 Lincoln Avenue
P.O. Box 620
Orange CA 92856-9020

CONTACT
NAME:

PHONE
111C. No. Extl:

E-MAIL
ADDRESS:

Annette Romero
949-486-7904
aromeroacrisure.com

INSURER(S) AFFORDING COVERAGE
FAX
(A/C. No):

NAIC #
INSURER A: Travelers Property Casualty Company of America 25674 INSURER B :
1 INSURER C :
1 INSURER D :

I INSURER E :

INSURER F :

COVERAGES CERTIFICATE NUMBER: 87225583 REVISION NUMBER:

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

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

INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP/YLIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDYYY1
A ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ VTJ-EXGL-9F338142-TIL-25 7/1/2025 7/1/2026

CLAIMS -MADE
OCCUR
✓ Contractual Liability
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-
JECT
OTHER:

A AUTOMOBILE LIABILITY
✓ ANY AUTO
OWNED

AUTOS ONLY
HIRED
✓ AUTOS ONLY

A UMBRELLA LIAR
✓ EXCESS LIAB
DED I RETENTION $

A WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANYPROP RIETOR/PARTN ER/EXEC UTI VE
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
A Auto Physical Damage

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
✓ ✓ VTC2E-CAP-9F338154-TCT-25 7/1/2025 7/1/2026
OCCUR ✓

CLAIMS -MADE
YIN
N
N/A
✓ CUP -4R630983-24-25
Policy Follows Form Over
Underlying General Liab.
✓ UB -7N939386 -25-25-K
7/1/2025 7/1/2026
7/1/2025 7/1/2026
EACH OCCURRENCE I 01,000,000

DAMAGE TO RENTED
PREMISES (Ea occurrence) I S 1,000,000
MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG
55,000
51,000,000
s 2,000, 000
S 2,000,000
S

COMBINED SINGLE LIMIT
(Ea accident) 52,000,000
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $

PROPERTY DAMAGE
(Per accident)

EACH OCCURRENCE

AGGREGATE
PER
✓ STATUTE
OTH-
ER
S 10,000,000
s 10,000,000
E.L. EACH ACCIDENT S 1,000,000
E.L. DISEASE - EA EMPLOYEE S 1.000.000
E.L. DISEASE - POLICY LIMIT S 1,000,000
VTE-BAP-9F338166-TCT-25 7/1/2025 7/1/2026 $10,000 Ded Comp & Collision DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: FY 2024-2025 Residential Street Rehabilitation / City Project #26-104 City of Placentia, its officers, employees, representatives, attorneys, and volunteers are named as Additional Insured as respects to General Liability and Auto Liability per endorsement attached where required by written contract. Coverage is Primary and Non-contributory and Waiver of subrogation applies and in favor of Additional Insureds. Excess/Umbrella follows form over GL, Auto and EL. 30 days notice of cancellation, 10 days for non-payment of premium.

CERTIFICATE HOLDER CANCELLATION
City of Placentia
401 E. Chapman Ave.

Placentia CA 92870
ACORD 25 (2016/03)

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.

The ACORD name and logo are registered marks of ACORD
87225583 1 25/26 GL/AU/EXC/WC 1 Annette Romero 1 9/18/2025 12:38:33 PM (PDT) I Page 1 of 14

VTJ-EXG L-9 F338142 -TIL -25
R. J. Noble Company

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

BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:

Any person or organization that you agree in a
written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only:
a. With respect to liability for "bodily injury' or
"property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement Is in effect; and
b. If, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of "your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omissions of such
person or organization.

The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement, the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.

This provision will not increase the limits of
insurance described in Section III — Limits Of
Insurance.
b. The insurance provided to such additional
insured does not apply to:
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury' or "property damage"
caused by "your work" and included in the
"products -completed operations hazard"
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
(2) If a claim is made or "suit" is brought against
the additional insured:

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COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit" as soon as practicable.
(3) Immediately send us copies of all legal
papers received in connection with the claim
or "suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit", and otherwise
comply with all policy conditions.

(4) Tender the defense and indemnity of any
claim or "suit" to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.
® 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 87225583 1 25/26 - GL/AU/EXC/WC 1 Annette Romero 1 9/18/2025 12:38:33 PM (PDT) 1 Page 3 of 14

R. J. Noble Company
POLICY NUMBER: VTJ-EXGL-9F338142-TIL-25

COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 9/18/2025
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NONCONTRIBUTORY -

OTHER INSURANCE CONDITION - DESIGNATED

ADDITIONAL INSUREDS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS

PROVISIONS
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 that is shown in
the Schedule Of Designated Additional Insureds
provided that:
(1) The additional insured is a Named Insured under
such other insurance; and
(2) You have agreed in writing in a contract or
agreement that this insurance would be primary
and would not seek contribution from any other
insurance available to the additional insured.

CG D8 84 04 20 © 2020 The Travelers Indemnity Company. All rights reserved.

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R. J. Noble Company
POLICY NUMBER: VTJ-EXGL-9F338142-TIL-25

COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 07/01/2025
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

OTHER INSURANCE - DESIGNATED ADDITIONAL

INSUREDS - PRIMARY WITH RESPECT TO CERTAIN

OTHER INSURANCE
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS

PROVISIONS
The following is added to Paragraph 4.a., Primary
Insurance, of SECTION IV — COMMERCIAL
GENERAL LIABILITY CONDITIONS:

The insurance afforded under this Coverage Part to
any additional insured shown in the Schedule Of
Designated Additional Insureds is primary to any of
the other insurance, whether primary, excess,
contingent or on any other basis, that is available to
such additional insured which covers such additional
insured as a named insured, and we will not share
with that other insurance.

CG D4 26 02 19 © 2017 The Travelers Indemnity Company. All rights reserved.

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VTJ-EXGL-9F338142-TIL-25
R. J. Noble Company
07/01/2025 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. Who Is An Insured — Unnamed Subsidiaries
B. Blanket Additional Insured — Governmental
Entities — Permits Or Authorizations Relating To
Operations

PROVISIONS
A.

WHO IS AN INSURED — UNNAMED

SUBSIDIARIES
The following is added to SECTION II — WHO IS
AN INSURED:

Any of your subsidiaries, other than a partnership,
joint venture or limited liability company, that is
not shown as a Named Insured in the
Declarations is a Named Insured if:
a. You are the sole owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured under
similar other insurance.

No such subsidiary is an insured for "bodily injury'
or "property damage" that occurred, or "personal
and advertising injury" caused by an offense
committed:
a. Before you maintained an ownership interest
of more than 50% in such subsidiary; or
b. After the date, if any, during the policy period
that you no longer maintain an ownership
interest of more than 50% in such subsidiary.

For purposes of Paragraph 1. of Section II — Who
Is An Insured, each such subsidiary will be
deemed to be designated in the Declarations as:

CG D3 16 0219
C. Incidental Medical Malpractice
D. Blanket Waiver Of Subrogation
E. Contractual Liability — Railroads
F. Damage To Premises Rented To You
a. An organization other than a partnership, joint
venture or limited liability company; or
b. A trust;
as indicated in its name or the documents that
govem its structure.

B. BLANKET ADDITIONAL INSURED —
GOVERNMENTAL ENTITIES — PERMITS OR

AUTHORIZATIONS RELATING TO OPERATIONS
The following is added to SECTION II — WHO IS
AN INSURED:

Any governmental entity that has issued a permit
or authorization with respect to operations
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liability for "bodily injury", "property damage" or "personal and
advertising injury" arising out of such operations.

The insurance provided to such govemmental
entity does not apply to:
a. Any "bodily injury', "property damage" or
"personal and advertising injury" arising out of
operations performed for the governmental
entity; or
b. Any "bodily injury" or "property damage"
included in the "products -completed
operations hazard".
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COMMERCIAL GENERAL LIABILITY
C. INCIDENTAL MEDICAL MALPRACTICE

1. The following replaces Paragraph b. of the
definition of "occurrence" in the
DEFINITIONS Section:
b. An act or omission committed in providing
or failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to a person, unless you are in
the business or occupation of providing
professional health care services.

2. The following replaces the last paragraph of
Paragraph 2.a.(1) of SECTION 11 — WHO IS
AN INSURED:

Unless you are in the business or occupation
of providing professional health care services,
Paragraphs (1)(a), (b), (c) and (d) above do
not apply to "bodily injury' arising out of
providing or failing to provide:
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor. Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
services" during their work hours for you
will be deemed to be acting within the
scope of their employment by you or
performing duties related to the conduct
of your business.

3. The following replaces the last sentence of
Paragraph 5. of SECTION III — LIMITS OF
INSURANCE:

For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or omissions committed in providing or
failing to provide "incidental medical
services", first aid or "Good Samaritan
services' to any one person will be deemed to
be one "occurrence".

4. The following exclusion is added to
Paragraph 2., Exclusions, of SECTION 1 —
COVERAGES — COVERAGE A — BODILY

INJURY AND PROPERTY DAMAGE
UABILITY:

Sale Of Pharmaceuticals
"Bodily injury" or "property damage" arising
out of the violation of a penal statute or
ordinance relating to the sale of

pharmaceuticals committed by, or with the
knowledge or consent of, the insured.

5. The following is added to the DEFINITIONS
Section:
"Incidental medical services" means:
a. Medical, surgical, dental, laboratory, x-ray
or nursing service or treatment, advice or
instruction, or the related fumishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.

6. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV —

COMMERCIAL GENERAL LIABILITY
CONDITIONS:

This insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other basis, that
is available to any of your "employees" for
"bodily injury" that arises out of providing or
failing to provide "incidental medical services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section II — Who Is An
Insured.

D. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph 8., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:

If the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization, but only for payments we make
because of:
a. "Bodily injury" or "property damage" that
occurs; or
b. "Personal and advertising injury" caused by
an offense that is committed;
subsequent to the execution of the contract or
agreement.

E. CONTRACTUAL LIABILITY — RAILROADS

1. The following replaces Paragraph c. of the
definition of "insured contract" in the
DEFINITIONS Section:
c. Any easement or license agreement;
© 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 87225583 1 25/26 - GL/AU/EXC/WC 1 Annette Romero 19/18/2025 12:38:33 PM (PDT) 1 Page 7 of 14

VTC2E-CAP-9F338154-TCT-25
R. J. Noble Company

COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
F. HIRED AUTO — LIMITED WORLDWIDE
COVERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE — GLASS

PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — LIABILITY
COVERAGE:

Any organization you newly acquire or form
during the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.

Coverage under this provision is afforded only
until the 180th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier.

B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — LIABILITY
COVERAGE:

This includes any person or organization who you
are required under a written contract or
agreement between you and that person or
organization, that is signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED UMIT
J. PERSONAL EFFECTS
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
as an additional insured for Liability Coverage,
but only for damages to which this insurance
applies and only to the extent of that person's or
organization's liability for the conduct of another
"insured".

C. EMPLOYEE HIRED AUTO

1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION II —
LIABILITY COVERAGE:

An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in that "employee's"
name, with your permission, while performing
duties related to the conduct of your
business.

2. The following replaces Paragraph b. in B.5.,
Other Insurance, of SECTION IV —
BUSINESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage
Coverage, the following are deemed to be
covered "autos" you own:

CA T3 53 08 17 © 2016 The Travelers Indemnity Company. All rights reserved, Includes copyrighted material of Insurance Services Office, Inc. with its permission 87225583 1 25/26 - GL/AU/EXC/WC 1 Annette Romero 1 9/18/2025 12:38:33 PM (PDT) 1 Page 10 of 14

COMMERCIAL AUTO
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
that individual "employee's" name,
with your permission, while
performing duties related to the
conduct of your business.

However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto".

D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — LIABILITY
COVERAGE:

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.

E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS

1. The following replaces Paragraph A.2.a.(2),
of SECTION II — LIABILITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds
(including bonds for related traffic law
violations) required because of an
"accident" we cover. We do not have to
furnish these bonds.

2. The following replaces Paragraph A.2.a.(4),
of SECTION II — LIABILITY COVERAGE:
(4) All reasonable expenses incurred by the
"insured" at our request, including actual
loss of earnings up to $500 a day
because of time off from work.

F. HIRED AUTO — LIMITED WORLDWIDE
COVERAGE — INDEMNITY BASIS
The following replaces Subparagraph e. in
Paragraph B.7., Policy Term, Coverage
Territory, of SECTION IV — BUSINESS AUTO
CONDITIONS:
e. Anywhere in the world, except any country or
jurisdiction while any trade sanction,
embargo, or similar regulation imposed by the
United States of America applies to and
prohibits the transaction of business with or
within such country or jurisdiction, for Liability
Coverage for any covered "auto" that you
lease, hire, rent or borrow without a driver for
a period of 30 days or less and that is not an
"auto" you lease, hire, rent or borrow from
any of your "employees", partners (if you are
a partnership), members (if you are a limited

liability company) or members of their
h ouseholds.
(1) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and possessions
of the United States of America, Puerto
Rico and Canada:
(a) You must arrange to defend the
"insured" against, and investigate or
settle any such claim or "suit" and
keep us advised of all proceedings
and actions.
(b) Neither you nor any other involved
"insured" will make any settlement
without our consent.
(c) We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
(d) We will reimburse the "insured":
(i)
For sums that the "insured"
legally must pay as damages
because of "bodily injury" or
"property damage" to which this
insurance applies, that the
"insured" pays with our consent,
but only up to the limit described
in Paragraph C., Limit Of
Insurance, of SECTION II —
LIABILITY COVERAGE;
(ii) For the reasonable expenses
incurred with our consent for your
investigation of such claims and
your defense of the "insured"
against any such "suit", but only
up to and included within the limit
described in Paragraph C., Limit
Of Insurance, of SECTION II —
LIABILITY COVERAGE, and not
in addition to such limit. Our duty
to make such payments ends
when we have used up the
applicable limit of insurance in
payments for damages,
settlements or defense expenses.
(2) This insurance is excess over any valid
and collectible other insurance available
to the "insured" whether primary, excess
contingent or on any other basis.

This insurance is not a substitute for
required or compulsory insurance in any
country outside the United States, its
(3)
© 2016 The Travelers Indemnity Company. Ail rights reserved. CA T3 53 08 17 Includes copyrighted material of Insurance Services Office, Inc. with Its permission 87225583 125/26 - GL/AU/EXC/WC 1 Annette Romero 19/18/2025 12:38:33 PM (PDT) 1 Page 11 of 14

territories and possessions, Puerto Rico
and Canada.

You agree to maintain all required or
compulsory insurance in any such
country up to the minimum limits required
by local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory
insurance requirements.
(4) It is understood that we are not an
admitted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and
Canada. We assume no responsibility for
the furnishing of certificates of insurance,
or for compliance in any way with the
laws of other countries relating to
insurance.

G. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D.,
Deductible, of SECTION III — PHYSICAL
DAMAGE COVERAGE:

No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.

H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
The following replaces the last sentence of
Paragraph A.4.b., Loss Of Use Expenses, of
SECTION III — PHYSICAL DAMAGE
COVERAGE:

However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".

I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence in
Paragraph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE
COVERAGE:

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" of the private passenger type.

J. PERSONAL EFFECTS
The following is added to Paragraph A.4.,
Coverage Extensions, of SECTION III —
PHYSICAL DAMAGE COVERAGE:

COMMERCIAL AUTO
Personal Effects
We will pay up to $400 for "loss" to wearing
apparel and other personal effects which are:
(1) Owned by an "insured"; and
(2) In or on your covered "auto".

This coverage applies only in the event of a total
theft of your covered "auto".

No deductibles apply to this Personal Effects
coverage.

K. AIRBAGS
The following is added to Paragraph B.3.,
Exclusions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:

Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that
inflate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for
Comprehensive Coverage under this policy;
b. The airbags are not covered under any
warranty; and
c. The airbags were not intentionally inflated.

We will pay up to a maximum of $1,000 for any
one "loss".

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV — BUSINESS AUTO CONDITIONS:

Your duty to give us or our authorized
representative prompt notice of the "accident" or
"loss" applies only when the "accident" or "loss" is
known to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability
company);
(d) An executive officer, director or insurance
manager (if you are a corporation or other
organization); or
(e) Any "employee" authorized by you to give
notice of the "accident" or "loss".

M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.6., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO
CONDITIONS:

CA T3 63 08 17 © 2016 The Travelers Indemnity Company. All rights reserved.

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COMMERCIAL AUTO

5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to the
extent required of you by a written contract
signed and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
such contract. The waiver applies only to the
person or organization designated in such
contract.

N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2.,
Concealment, Misrepresentation, Or Fraud, of
SECTION IV — BUSINESS AUTO CONDITIONS:

The unintentional omission of, or unintentional
error in, any information given by you shall not
prejudice your rights under this insurance.

However this provision does not affect our right to
collect additional premium or exercise our right of
cancellation or non -renewal.

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TRAVELERS)

ONE TOWER SQUARE
HARTFORD, CT 06183

WORKERS COMPENSATION
AND

EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 00 03 13 (00)-01
POLICY NUMBER: UB -7N939386 -25-25-K

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by thls 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 obtaln this agreement from us.) This agreement shall not operate directly or Indirectly to benefit any one not named In the Schedule.

SCHEDULE
DESIGNATED PERSON:

DESIGNATED ORGANIZATION:

ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED

BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH
THIS WAIVER.

DATE OF ISSUE: 9/18/2025
ST ASSIGN:
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