FIRST AMENDMENT TO
PROFESSIONAL CONSULTANT SERVICES AGREEMENT
PEAK TECHNICAL SERVICES, INC.
Temporary Employment Services — RFP No. 1726
THIS FIRST AMENDMENT TO PROFESSIONAL CONSULTANT SERVICES AGREEMENT (" First Amendment") is made and entered into this 19 th day of August , 2019, by and between the CITY OF RIVERSIDE, a California charter city and municipal corporation (" City"), and PEAK TECHNICAL SERVICES, INC., a Pennsylvania corporation authorized to business in California (" Consultant"), with respect to the following:
RECITALS
WHEREAS, the City and Consultant entered into that certain Professional Consultant Services Agreement dated June 12, 2018 (" Agreement"); and WHEREAS, the Agreement is currently going to end on June30, 2019; and WHEREAS, the City has been satisfied with Consultant's performance under the Agreement and desires to have Consultant continue providing the services referenced in that Agreement; and
WHEREAS, the City and Consultant desire to amend the Agreement to extend the term to June 30, 2020.
NOW, THEREFORE, in consideration of the foregoing recitals which are incorporated herein by this reference, City and Consultant agreeas follows:
I . The term of the Agreement is hereby extended to June 30, 2020.
2. All other terms and conditions of the Agreement between the parties which are not inconsistent with the terms of this First Amendment shall remain in full force and effect as if fully set forth herein.
IN WITNESS WHEREOF, the parties hereto have caused this First Amendment to Professional Consultant ServicesAgreement to be duly executedthe day and year first above written.
CITY OF RIVERSIDE,
a California charter city and municipal
corporation
By: —
5'f7jt4' TCity Mger
Attest:
C0114J. NcolCity
Approved as to Form:
By: C/ Rose ary B. Koo
Senior Deputy City Attorney
CERTIFIED TO F NDS AVAILABILITY:
3Y _
thief mancial 0 er/ CK r surer
18- 0048. 1 RBK 04/ 15/ 19
0a
PEAK TECHNICAL SERVICES, INC.,
a Pennsylvania corporation authorized to
do business in California
Its: LE C
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CITY COUNCIL,
SUCCESSOR AGENCY,
AND
HOUSING AUTHORITY
i MINUTES
Cit farts 8` Inno rcrtion TUESDAY, JUNE 18, 2019, 2 P. M.
ART PICK COUNCIL CHAMBER
CITY HALL
3900 MAIN STREET WARDS
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7 orde, management software subscription with Dude Solutions, Inc., in the amount of $ 241, 327. 10 from Measure Z funds - Deferred Mair tenance Account for five years through Fiscal Year 2023- 24; and 2) authorized the upfront payment of $ 241, 327. 10 to cover the sixty - mon - i term encompassing Fiscal Years 2019- 20 through 2023- 24.
CHA' JGE ORDER - PURCHASE AND DELIVERY OF FUEL PRODUCTS - CITY
VEHICLES AND EQUIPMENT
The City Council ( 1) approved change order number two with The SoC,:: Group, Inc., Riverside, in the amount of $ 235, 000, for a total revisf d amount of $ 1,665, 000 from General Services - Central Garage Funa for purchase and delivery of fuel products for City vehicles and equipment through June 30, 2019; ( 2) approved two optional one- year renewal periods with The SoCo Group, Inc., for purchase and delivc! ry of fuel products in the amount of $ 1,831, 500 for Fiscal Year 2019 20 and $ 2, 014, 650 for Fiscal Year 2020- 21; and ( 3) authorized the City , tanager, or his designee, to execute all documents necessary to appr we the change order and renewal of the purchase and delivery Of fu, f1products with The SoCo Group, Inc., including making minor and - on- substantive changes.
AGR: EMENT AMENDMENT - TEMPORARY EMPLOYMENT SERVICES
The (:: ity Council ( 1) approved the First Amendment to Professional Coni ultant Services Agreements with Howroyd- Wright Employment Agency, Inc., dba AppleOne Employment Services; Kimco Staffing Services, Inc.; and Peak Technical Staffing, Inc., to extend services through June 30, 2020; and ( 2) authorized the City Manager, or his designee, to execute the Professional Consultant Services Agreements with Howroyd- Wright Employment Agency, Inc., dba AppleOne Employment Services, Kimco Staffing Services, Inc., and Peak Technical Staffing, Inc., including additional extensions to the agreement or making minor and non - substantive changes.
PROF ESSIONAL CONSULTANT SERVICES AGREEMENT - PRE-
EMPL0YMENT PHYSICALS
The ': ity Council ( 1) approved the Professional Consultant Services Agreement with Inland Empire Occupational Medicine for pre - 104 - 425
AC( 7RbF
CERTIFICATEOFLIABILITYINSURANCE77/ 25/ 2019
TE( MM/ DDNYYY)
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 SUBROGATIONISWAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Assurance Agency, Ltd1750 E Golf Road
Suite 1100
Schaur-lburg IL 60173
CONTACTSamanthaMecciaPHONE FAX
ac No Ext : 312- 625- 5957 A/c No : 847 440- 9126
ADDE-
MRESS: smeCciaaSSUranceaenc .Com
INSURER( S) AFFORDING COVERAGE NAIC#
INSURERA: Philadelphia Indemnity Ins Co 18058
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADET OCCUR
INSURED
Peak -" echnical Services, Inc.
INSURER B: American Zurich Insurance CO 40142
1/ 1/ 2020
583 El;silon Drive INSURERC:
INSURER D: RIDC :' ark, O'Hara Township
Pittsb.. Igh PA 15238 INSURER E:
INSURER F
GUVtKAGtS CFRTIFICATF NIIMII 135ggR51 or - 111 lu All1" 112Co.
THIS S, TO CERTIFYTHATTHE POLICIESOF INSURANCELISTEDBELOWHAVEBEENISSUEDTO THE INSUREDNAMEDABOVEFORTHE POLICYPERIOD INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITIONOF ANY CONTRACTOR OTHERDOCUMENTWITH RESPECTTO WHICH THIS
CERT ICATEMAYBE ISSUEDOR MAYPERTAIN, THE INSURANCEAFFORDEDBY THE POLICIESDESCRIBEDHEREINIS SUBJECTTO ALL THE TERMS, EXCLI.,SIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSRLTR TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD POLICY NUMBER
POLICY EFF
MM/ DD
POLICY EXP
MM/ D LIMITS
A X COMMERCIALGENERAL LIABILITY
CLAIMS -MADET OCCUR
PHPKI916436 1/ 1/ 2019 1/ 1/ 2020 EACH OCCURRENCE $ 1, 000, 000
DAMAGE TO RENTED
PREMISES Ea occurrence $ 1, 000, 000
MED EXP ( Any one person) $ 20, 000
PERSONAL & ADV INJURY $ 1,000, 000
PPROVEDGE _ AGGREGATE LIMIT APPLIES PER:
X 171PRO -
POLICY JECT [:] LOC
GENERAL AGGREGATE $ 2, 000, 000
PRODUCTS - COMP/ OP AGG $ 2, 000, 000
OTHER:
A AU? OMOBILELIABILITY PHPK1916436 1/ 1/ 2019 1/ 1/ 2020 COMBINED SINGLE LIMIT $ 1, 000, 000Ea accident ANY AUTO BODILY INJURY ( Per person) $
OWNED X SCHEDULEDAUTOS ONLY AUTOS BODILY INJURY Per accident $
X HIRED X NON -OWNEDAUTOS ONLY AUTOS ONLY
PROPERTYDAMAGE $
Per accident
A X UMBRELLA LIAB X OCCUR PHUB657328 1/ 1/2019 1/ 1/ 2020 EACH OCCURRENCE $ 1, 000, 000 AGGREGATE $ 1, 000, 000
EXCESS LIAB CLAIMS - MADE
DED X RETENTION $
B WORKERS COMPENSATION
ANC ( EMPLOYERS' LIABILITY Y / N
AN`, -' R OPRIETOR/ PARTNER/ EXECUTIVE
OFF : ER/ MEMBEREXCLUDED? NIA
WC343482813 1/ 1/ 2019 1/ 1/2020 X STERATUTE
EORH
E. L. EACH ACCIDENT $ 1, 000, 000
E. L. DISEASE - EA EMPLOYEE $ 1, 000, 000Mandatory in NH) If ye s describe under
E. L. DISEASE - POLICY LIMIT $ 1, 000, 000DES RIPTION OF OPERATIONS below A Prct< ssional Liability ( E80) PHPK1916436 1/ 1/ 2019 1/ 1/ 2020 11 occ. / $ 2M agg. $ 5, 000 deductible DESCRIPTIONOFOPERATIONS / LOCATIONS / VEHICLES (ACORD101, AdditionalRemarksSchedule, maybeattachedif morespaceis required) CityofRiverside, itsofficers, employeesandagentsarenamedasadditionalinsuredsontherequiredgeneralliabilityandautomobileliabilitypolicies, solelyforwork done by and on behalfof the named insuredand for the City of Riverside.
AWaiverof SubrogationinfavoroftheAdditionalInsuredsappliesto theWorker's Compensation, GeneralLiabilityandAutomobilepolicies, whenrequiredbywritten contract and where allowed by law.
CERTIFICATE HOLDER rANll I ATInId
1988- 2015 ACORD CORPORATION. All rights reserved.
ACORD 25 ( 2016/ 03) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
The City of Riverside
3900 Main Street AUTHORIZED REPRESENTATIVE
Riverside CA 92522
1988- 2015 ACORD CORPORATION. All rights reserved.
ACORD25 ( 2016/ 03) The ACORD name and logo are registered marksof ACORD PI- GLD- TS ( 11/ 15)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
TEMPORARY STAFFING
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance
Page
Damage to Premises Rented to You 1, 000, 000 2
Expected or Intended Injury— Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability 50, 000 2 Non - Owned Watercraft Less than 58 feet 3
Damageto PropertyYou Own, Rent or Occupy 30, 000 3
Medical Payments 20, 000 3
Medical Payments Reporting Period 3 Years 3
Athletic Activities Amended 3
Supplementary Payments — Bail Bonds 2, 500 4
Supplementary Payments — Loss of Earnings 500 per day 4 Employee Indemnification Defense Coverage 25, 000 4
Who Is An Insured
Additional Insured — Newly Acquired or Formed Organization Additional Insured — Broadened Named Insured
Additional Insured — Blanket Additional Insureds When Required by Contract
Included 4
Duties in the Event of Occurrence, Offense, Claim or Suit Included 4 Transfer of Rights of Recovery Against Others To Us Clarification 5 Liberalization Included 5
Unintentional Failure to Disclose Hazards Included 5
Bodily Injury— Includes Mental Anguish Included 5
Personal and Advertising Injury — Includes Abuse of Process, Discrimination
Included 6
Other Insurance — Primary Clarification Clarification 6 PI- GLD- TS ( 11/ 15)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI- GLD- TS ( 11/ 15)
Staffing Services Exclusions Clarification 7
Staffing Services Definitions Clarification 8
A. Damage to Premises Rented to You
If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part:
1. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:
a. $ 1,000, 000; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the mostwe will payfor all damageproximatelycausedby the same event, whether such damage resultsfrom fire, lightning, explosion, smoke, or leaksfrom automaticfire protective systems or any combination thereof;
2. The word fire is changed to fire, lightning, explosion, smoke, or leakage from automaticfire protective systems where it appears in:
a. The last paragraph of SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions;
b. SECTION III — LIMITS OF INSURANCE, Paragraph 6.; and c. SECTION V — DEFINITIONS, Paragraph 9. a.; and
3. Thewordsfire insuranceare changedto insuranceforfire, lightning, explosion, smoke, or leakage from automatic fire protective systems where it appears in SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance.
B. Expected or Intended Injury — Property Damage
SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragrapha. ExpectedOrIntendedInjuryisdeletedinitsentiretyand replaced by the following:
a. Expected Or Intended Injury
Bodily injury" or "property damage" expected or intended from the standpoint of the insured.
Thisexclusiondoesnotapplyto "bodilyinjury" or "propertydamage" resultingfromthe useof reasonableforce to protectpersonsor property.
C. Limited Rental Lease Agreement Contractual Liability SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, Paragraphb. ContractualLiabilityisamendedbyaddingthefollowing:
Basedon the namedinsured's requestat thetimeof claim, we agreeto indemnifythenamedinsured fortheirliabilityassumedin a contractor agreementregardingtherentalor leaseof a premiseson behalf of their client, up to $50,000.
PI- GLD- TS ( 11/ 15)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI- GLD- TS ( 11/ 15)
This coverage extensiononly applies to rental lease agreements and is excess over any renter's liability insurance of the client.
D. Non - Owned Watercraft
SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, Paragraph (2) is amendedto readas follows:
2) A watercraft you do not own that is:
a) Less than 58 feet long; and
b) Not being usedto carry personsor propertyfor a charge; Thisprovisionappliesto anyperson, whowithyourconsent, eitherusesor is responsiblefor the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent.
E. Damage to Property You Own, Rent or Occupy
SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, j. Damage To Property, Paragraph (1) is deleted in its entirety and replaced with the following:
1) Propertyyou own, rentor occupy, includingany costsor expensesincurredby you, or any other person, organizationor entity, for repair, replacement, enhancement, restorationor maintenanceof such property for any reason, including preventionof injury to a personor damageto another's property, unlessthe damageto propertyis causedby your client, up to a $30,000 limit. A client is definedas a personunder your direct care and supervision.
F. Medical Payments
1. If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part the Medical Expense Limit is changed subject to all of the terms of SECTION III — LIMITS OF INSURANCE to the greater of:
a. $ 20, 000; or
b. The Medical Expense Limit shown in the Declarations of this Coverage Part.
2. Under SECTION I — COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 1.
Insuring Agreement, Paragrapha., Item (b) is amendedto read:
b) The expenses are incurred and reported to us within three years of the date of the accident; and
G. Athletic Activities
SECTION I — COVERAGES, COVERAGE C MEDICAL PAYMENTS, 2. Exclusions, Paragraph e.
Athletics Activities is deleted in its entirety and replacedwith the following:
PI- GLD- TS ( 11/ 15)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI- GLD- TS ( 11/ 15)
e. Athletics Activities
To a person injured while taking part in athletics.
H. Supplementary Payments
SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B, Items 1.b. and 1.d. are amended as follows:
b. The limit for the cost of bail bonds is changed from $ 250 to $2,500; and d. Thelimitfor lossof earningsis changedfrom $250a dayto $500a day.
Employee Indemnification Defense Coverage
SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended to include the following:
Wewillpay, onyourbehalf, defensecostsincurredbyan "employee" inacriminalproceeding.
Themostwewillpayforany "employee" whoisdirectlyinvolvedinacriminalproceedingis $25,000regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing " suits."
J. Who is An Insured
SECTION II — WHO IS AN INSURED is amended as follows:
1. Newly Acquired or Formed Organization
If coveragefor newly acquired or formed organizations is not otherwise excludedfrom this Coverage Part, Paragraph 3.a. is amended to read:
a.
Coverageunderthisprovisionisaffordeduntiltheendofthepolicyperiod;
2. Each of the following is also an insured:
a. Broadened Named Insured — Any organizationand subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if theyarealsoinsuredunderanothersimilarpolicy, butfor its terminationor the exhaustionof its limits of insurance. b. Blanket Additional Insureds When Required by Contract — Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organizationis an additionalinsuredfor "bodilyinjury," "property damage" or " personal and advertisinginjury" but only for liabilityarisingout of the negligenceof the namedinsured. The limitsofinsuranceapplicabletotheseadditionalinsuredsarethelesserofthepolicylimitsorthose limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations.
The Additional Insured's limits of insurance do not increaseour limits of insurance, as described in SECTION III — LIMITS OF INSURANCE.
PI- GLD- TS ( 11/ 15)
Includescopyrighted material of Insurance Services Office, Inc., with its permission.
PI- GLD- TS ( 11/ 15)
c. Interns — Yourinternsonlywhileperformingdutiesrelatedto the conductof yourbusiness. d. Contractors — Any individual or organization under written contract or written agreement with youwhoprovides "staffingservices" on yourbehalfandat yourdirectionfor yourclients.
K. Duties in the Event of Occurrence, Offense, Claim or Suit
1. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. a. the requirement that you must see to it that we are notified as soon as practicable of an " occurrence" or an offense, appliesonly whenthe "occurrence" or offenseis knownto:
a. You, if you are an individual;
b. A partner, if you are a partnership; or
c. An " executive officer" or insurance manager, if you are a corporation.
2. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. b. the requirement that you must see to it that we receive noticeof a claim or "suit" as soon as practicablewill not be considered breached unless the breach occurs after such claim or "suit" is known to:
a. You, if you are an individual;
b. A partner, if you are a partnership; or
c. An " executive officer" or insurance manager, if you are a corporation.
L. Transfer of Rights of Recovery Against Others To Us
SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer Of Rights Of RecoveryAgainst Others To Us includesthefollowingclarification:
Therefore, the insuredcanwaive the insurer's rightsof recoverypriorto the occurrenceof a loss, provided the waiver is made in a written contract.
M. Liberalization
SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition:
Liberalization
If we revise this endorsement to provide more coverage without additional premium charge, we willautomaticallyprovidetheadditionalcoverageto all endorsementholdersasofthedaythe revision is effective in your state.
N. Unintentional Failure To Disclose Hazards
SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following additional condition:
Unintentional Failure To Disclose Hazards
It is agreedthat, basedon our relianceon your representationsas to existinghazards, if you shouldunintentionallyfailtodiscloseallsuchhazardspriorto thebeginningofthepolicyperiod PI- GLD- TS ( 11/ 15)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI- MANU- 1 ( 01/ 00)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CG2010
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Name Of Additional Insured Person( s) Or Organization( s):
Any person or organization where required by written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for " bodily injury", " property damage" or " personal and advertising injury" but only for liability arising out of the negligence of the named insured.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section. II - Who Is An Insured is amended to include as an additional insured the person( s) or organization( s) shown in the Schedule, but only with respect to liability for " bodily injury", " property damage" or personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured( s) at the locaticn( s) designated above.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insured' s, the following additional exclusions apply:
This insurance does not apply to " bodily injury" or " property damage" All other terms and conditions of this Policy remain unchanged.
PI- MANU- 1 ( 01/ 00)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the project ( other than service, maintenance or repairs) to be performed by or on behalf of the additional insured( s) at the location of the covered operations has been completed; or
2. That portion of " your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
C. With respect to the insurance afforded to these additional insured' s, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms and conditions of this Policy remain unchanged.
PI -CA - 003 ( 04/ 14)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
Thisendorsementmodifiesinsuranceprovidedunderthefollowing:
BUSINESS AUTO COVERAGE FORM
Withrespectto coverageprovidedby thisendorsement, theprovisionsoftheCoverageFormapplyunless modified by the endorsement.
A. SECTION II — COVEREDAUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended by addingthe following:
The following are also "insureds":
Anypersonororganizationforwhomyouarerequiredbyan "insuredcontract" toprocure "bodily injury" or "propertydamage" liability insurancearising outof theoperationof a covered "auto" with yourpermission. However, this additionalinsurancedoesnotapplyto:
1. The owner or anyone else from whom you hire or borrow a covered " auto." This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own;
2. Your "employee" if the covered "auto" isownedby that "employee" or a memberof hisor herhousehold;
3. Anyoneusingacovered "auto" whileheorsheisworkinginabusinessofselling, servicing, repairing, parking or storing " autos" unless that business is yours;
4. Anyoneotherthanyour "employees," partners (ifyouarea partnership), members (if youarea limitedliabilitycompany), ora lesseeorborroweroranyoftheir "employees," whilemovingproperty to or from a covered " auto"; or
5. A partner (ifyouarea partnership), oramember (ifyouarealimitedliabilitycompany) forcovered " auto" owned by him or her or a member of his or her household.
B. The "insuredcontract" mustbeineffectduringthepolicyperiodshownintheDeclarationsandmust havebeenexecutedpriorto the "bodilyinjury" or "propertydamage".
C. Thispersonororganizationisan "insured" onlytotheextentyouareliableduetoyourongoing operationsforthat "insured", whethertheworkisperformedbyyouorforyou, andonlytotheextent youareheldliableforan "accident" occurringwhilea covered "auto" isbeingdrivenbyyouoroneofyour employees.
D. Thereisnocoverageprovidedtothispersonororganizationfor "bodilyinjury" to itsemployeesorfor property damage" to its property.
E. Coveragefor this personor organizationshallbe limitedto the extentof your negligenceor fault according to the applicable principles of comparative negligence or fault.
F. Thedefenseof anyclaimor "suit" mustbetenderedbythispersonor organizationassoonas practicableto all other insurerswhich potentiallyprovideinsurancefor such claim or "suit".
G. A person's or organization's status as an "insured" under this endorsement ends when your operations for that " insured" are completed.
PI - CA - 003 ( 04/ 14)
H. Thecoverageextendedto anyadditionalinsuredbythisendorsementis limitedto, andsubjectto all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached.
In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any "insured," or to procure insurance.
I. The following additional exclusions apply:
The insurance afforded to any person or organization as an " insured" under this endorsement does not apply to "loss":
1. Which occurs prior to the date your contract is effective with such person or organization;
2. Arisingoutofthesolenegligenceof anypersonororganizationthatwouldnotbean "insured" except for this endorsement; or
3. Which occurs after you returned the leased or rented " auto" to the lessor or the policy period ends, whichever occurs first.
POLICY NUMBER: PHPK1916436 COMMERCIAL AUTO
CA 04 44 03 10
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US ( WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: Peak Technical Services, Inc.
Endorsement Effective Date: 01/ 01/ 2019
SCHEDULE
Name( s) Of Person( s) Or Organization( s):
Any person or organization where required by written contract executed prior to the occurrence of a loss.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Oth-
ers To Us Condition does not apply to the person( s)
or organization( s) shown in the Schedule, but only to
the extent that subrogation is waived prior to the " ac- cident" or the ' loss" under a contract with that person or organization.
CA 04 44 03 10 0 Insurance Services Office, Inc., 2009 Page 1 of 1 0 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 Ed. 4- 84)
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 this policy. We will not enforce our right against the person or organization named in the Schedule. ( This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
ALL PERSONS AND/ OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN
CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE
ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS
POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/ OR ORGANIZATION
EXCEPT THE FOLLOWING STATES WI, KY, NH, NJ, ND, OH
WC 00 03 13
Ed. 4- 84)
1983 National Council on Compensation Insurance.
DEPARTMENT HEAD APPROVAL FORM
Contracts/ Agreements
DATE: 05/ 06/ 19
k4y
PARTIES: Peak Technical Services
PROJECTDESCRIPTION: Temporary Employment Services
SCOPEOFCONTRACT/SERVICE: TemporaryEmploymentServices
IFAN AMENDMENT, REASONFORAMENDMENT (e.g., more time needed, additional scope added, extension permitted from original contract, etc.): Extension to extend term.
DEPARTMENT: Human Resources
BUDGETACCOUNT (GL Keyand Object): . 210CCC C)OC)
DEPT. HEAD APPROVAL:
PROCUREMENT:
Verification that procurement of goods, services, construction, etc., was done in conjunction with the City' s purchasing policies and procedure:
Formal Procurement ( Bid #, RFP #, panel, etc.):
Informal Procurement ( Three quotes, single/ sole source, under non -biddingthreshold, etc.):
Emergency Procurement ( date, event, etc.):
Requisition Number:
Date Approved by City Council/ Board: __ 3 ONf- ) 8- -, ZO) I Purchasing Division Validation:
UkLAvA-Tf biL M6,4:1
Date:
PLEASERETURNTO: City Clerk' s Office, Ext. 4276, DAlegria@tiversideca. gov g:\ deptcommon\master5\cigreements\Dept HeadApprovalSlip-] 22017