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K. Key and Lock Replacement – Janitorial Services Client Coverage SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS – COVERAGES A AND B is amended to include the following:
We will pay for the cost to replace keys and locks at the “clients” premises due to theft or other loss to keys entrusted to you by your “client,” up to a $10,000 limit per occurrence and $10,000 policy aggregate.
We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, “employees”, “managers”, directors, trustees, authorized representatives or any one to whom you entrust the keys of a “client” for any purpose commit, whether acting alone or in collusion with other persons.
The following, when used on this coverage, are defined as follows:
a. "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. " Employee" means:
1) Any natural person:
a) While in your service or for 30 days after termination of service; b) Who you compensate directly by salary, wages or commissions; and c) Who you have the right to direct and control while performing services for you; or 2) Any natural person who is furnished temporarily to you:
a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or
b) To meet seasonal or short-term workload conditions;
while that person is subject to your direction and control and performing services for you. 3) " Employee" does not mean:
a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or
b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee."
c. " Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional Insureds
SECTION II – WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
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Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.
2. Each of the following is also an insured:
a. Medical Directors and Administrators – Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.
b. Managers and Supervisors – Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your “employees” are also insureds for “bodily injury” to a co - employee” while in the course of his or her employment by you or performing duties related to the conduct of your business.
This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company.
c. Broadened Named Insured – Any organization and 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 they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.
d. Funding Source – Any person or organization with respect to their liability arising out of:
1) Their financial control of you; or
2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers – At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises – Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:
This insurance does not apply to:
1) Any “occurrence” which takes place after you cease to be a tenant in that premises; or 2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
g. Lessor of Leased Equipment – Automatic Status When Required in Lease Agreement With You – Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or
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organization is an insured only with respect to liability for “bodily injury,” “property damage” or personal and advertising injury” caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.
A person’s or organization’ s status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not apply to any “occurrence” which takes place after the equipment lease expires. h. Grantors of Permits – Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:
1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:
a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;
b) The construction, erection, or removal of elevators; or c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors – Only with respect to “bodily injury” or “property damage” arising out of “your products” which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions:
1) The insurance afforded the vendor does not apply to:
a) " Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;
b) Any express warranty unauthorized by you;
c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product;
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g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
i) The exceptions contained in Sub-paragraphs (d) or (f); or ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.
j. Franchisor – Any person or organization with respect to their liability as the grantor of a franchise to you.
k. As Required by Contract – Any person or organization where required by a 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. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those 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
l. Owners, Lessees or Contractors – Any person or organization, 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 when required by a contract.
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
a) 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
b) 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.
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m. State or Political Subdivisions – Any state or political subdivision as required, subject to the following provisions:
1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.
2) This insurance does not apply to:
a) " Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or
b) "Bodily injury" or "property damage" included within the "products- completed operations hazard."
M. Duties in the Event of Occurrence, Claim or Suit
SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows:
a. is amended to include:
This condition applies only when the “occurrence” or offense is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation. b. is amended to include:
This condition will not be considered breached unless the breach occurs after such claim or “suit” is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of
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Recovery Against Others To Us is deleted in its entirety and replaced by the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them.
Therefore, the insured can waive the insurer’s rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
P. Liberalization
SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.
Q. Bodily Injury – Mental Anguish
SECTION V – DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:
Bodily injury” means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time.
R. Personal and Advertising Injury – Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of “personal and advertising injury” is amended as follows:
1. SECTION V – DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following:
b. Malicious prosecution or abuse of process;
2. SECTION V – DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
1) Any insured; or
2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
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c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Person or Organization Job Description
With respect to all employees subject to the
workers' compensation laws of the state of
California, any person or organization for whom
the Named Insured has agreed by written
contract to furnish this waiver.
This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11/ 01/ 2025 at 12: 01 AM standard time, forms a part of Policy No. EIG 4651339 05 Of the EMPLOYERS PREFERRED INS. CO.
Carrier Code 00920
Issued to THE ENERGY COALITION Endorsement No.
Premium $ 61,93
Countersigned at on By:
Authorized Representative
WC 04 03 06
Ed. 4-84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
ACORO® CERTIFICATE OF LIABILITY INSURANCE
DATE ( MM/ DD/ YYYY)
3/ 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).
PRODUCER
Acrisure Southwest Partners Insurance Services, LLC
4000 Westerly Place
Suite 110
Newport Beach CA 92660
License#: BR -1801370
CONTACT
NAME: Angela Dancy
PHONE FAX
A/ C. No. Eat): 949- 348- 2086 A/ C, No): 949- 201 4515 ADDRESS: AnDancy@Acrisure. com
INSURER( S) AFFORDING COVERAGE NAIC#
INSURERA: Philadelphia Indemnity Insurance Company 18058 INSURED ENERCOA- 01
The Energy Coalition
525 Technology Dr Ste 350
Irvine CA 92618
INSURER B: Employers Preferred Insurance Company 10346
INSURER C: Underwriters at Lloyd' s, London ( IL) 15792 INSURER D:
INSURER E r
INSURER F :
COVERAGES CERTIFICATE NUMBER: 184083018 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD POLICY NUMBER
POLICY EFF
MM/ DD/ YYYY)
POLICY EXP
MM/ DD/ YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY
CLAIMS - MADE , X OCCUR
GEN' L AGGREGATE LIMIT APPLIES PER:
PROJECT X POLICY
OTHER:
LOC
PHPK2644776- 01 3/ 1/ 2025 3/ 1/ 2026 EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES ( Ea occurrence)
1, 000,00
MED EXP ( Any one person)
100, 00
5, 000
PERSONAL & ADV INJURY 1, 000,00
GENERAL AGGREGATE 2, 000,00
PRODUCTS - COMP/ OAGG 2, 000,00
A AUTOMOBILE LIABILITY
X
ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
X
NON - OWNED
AUTOS ONLY
PHPK2644776- 01 3/ 1/ 2025 3/ 1/ 2026 COMBINED SINGLE LIMIT Ea accident)
BODILY INJURY ( Per person)
1, 000,00
BODILY INJURY ( Per accident)
PROPERTY DAMAGE
Per accident)
A
B
X UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS -MADE
DED X
RETENTON$ 1n pm
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYP ROPRI ETO R/ PARTNER/ EXC UTIVE
OFF ICER/ MMBEREXCLUDED?
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y/ N
N/ A
PHUB897446- 016
EIG465 133904
3/ 1/ 2025
11// 2024
3/ 1/ 2026
11// 2025
EACH OCCURRENCE 4, 000,00
AGGREGATE 4, 000,00
X
PER
STATUTE
OTHER
E. L. EACH ACCIDENT 1, 000,00
E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
C Errors & Ommisions MPL5306109. 25 3/ 1/ 2025 3/ 1/ 2026 Limit Aggregate
Deductible
2, 000,00
2, 000,00
10, 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City and its officers, officials, employees, and agents, and volunteers are included as additional insured per the attached endorsement.
CERTIFICATE HOLDER CANCELLATION
City of South El Monte
1415 N. Santa Anita Avenue
South El Monte CA 91733
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/ 03)
1988- 2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
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 coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance Page #
Extended Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability 50, 000 limit 2 Non - Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy 30, 000 limit 2 Damage to Premises Rented to You 1, 000,00 3
HIPAA Clarification 4
Medical Payments 20, 000 5
Medical Payments — Extended Reporting Period 3 years 5
Athletic Activities Amended 5
Supplementary Payments — Bail Bonds 5, 000 5
Supplementary Payment — Loss of Earnings 1, 000 per day 5 Employee Indemnification Defense Coverage 25, 000 5
Key and Lock Replacement — Janitorial Services Client Coverage 10, 000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors ( with Fellow Em ) loyee Coverace)
Included 7
Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7
Additional Insured — Home Care Providers Included 7
Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8
Additional Insured — Vendor Included 8
Additional Insured — Franchisor Included 9
Additional Insured — When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10
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Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10
Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11
Bodily Injury — includes Mental Anguish Included 11
Personal and Advertising Injury — includes Abuse of Process, Discrimination
Included 11
A. Extended Property Damage
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following:
a. Expected or Intended Injury
Bodily injury" or property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to " bodily injury" or " property damage" resulting from the use of reasonable force to protect persons or property.
B. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following:
3) Based on the named insured' srequest at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $ 50, 000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter' s liability insurance of the client.
C. Non -Owned Watercraft
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following:
2) A watercraft you do not own that is:
a) Less than 58 feet long; and
b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for 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.
D. Damage to Property You Own, Rent or Occupy
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
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LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item ( 1) is deleted in its entirety and replaced with the following:
1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another' sproperty, unless the damage to property is caused by your client, up to a $ 30, 000 limit. A client is defined as a person under your direct care and supervision.
E. Damage to Premises Rented to You
1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word " fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire 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; is deleted in its entirety and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. b. SECTION III - LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following:
Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V - DEFINITIONS, Paragraph 9. a., is deleted in its entirety and replaced by the following:
A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract";
2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following:
That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner;
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:
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PI- GLD- HS (10/ 11)
a. $ 1, 000,00; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.
F. HIPAA
SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows:
1. Paragraph 1. Insuring Agreement is amended to include the following:
We will pay those sums that the insured becomes legally obligated to pay as damages because of a " violation( s)" of the Health Insurance Portability and Accountability Act ( HIPAA). We have the right and the duty to defend the insured against any " suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any " suit" seeking damages, " investigation," or "civil proceeding" to which this insurance does not apply.
2. Paragraph 2. Exclusions is amended to include the following additional exclusions:
This insurance does not apply to:
a. Intentional, Willful, or Deliberate Violations
Any willful, intentional, or deliberate " violation( s)" by any insured. b. Criminal Acts
Any " violation" which results in any criminal penalties under the HIPAA. c. Other Remedies
Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits
Any compliance reviews by the Department of Health and Human Services.
3. SECTION V - DEFINITIONS is amended to include the following additional definitions:
a. " Civil proceeding" means an action by the Department of Health and Human Services ( HHS) arising out of " violations."
b. " Investigation" means an examination of an actual or alleged " violation( s)" by HHS. However, investigation" does not include a Compliance Review.
c. " Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA.
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PI- GLD- HS (10/ 11)
G. Medical Payments — Limit Increased to $ 20, 000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:
1. 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. SECTION I - COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following:
b) The expenses are incurred and reported to us within three years of the date of the accident.
H. Athletic Activities
SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics.
I. Supplementary Payments
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows:
1. b. is deleted in its entirety and replaced by the following:
1. b. Up to $ 5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these.
1. d. is deleted in its entirety and replaced by the following:
1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $ 1, 000 a day because of time off from work.
J. Employee Indemnification Defense Coverage
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B the following is added:
We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of employment.
The most we will pay for any " employee" who is alleged to be directly involved in a criminal proceeding is $ 25, 000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing " suits.
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K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended to include the following:
We will pay for the cost to replace keys and locks at the " clients" premises due to theft or other loss to keys entrusted to you by your " client," up to a $ 10, 000 limit per occurrence and $ 10, 000 policy aggregate.
We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a " client" for any purpose commit, whether acting alone or in collusion with other persons.
The following, when used on this coverage, are defined as follows:
a. " Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. " Employee" means:
1) Any natural person:
a) While in your service or for 30 days after termination of service; b) Who you compensate directly by salary, wages or commissions; and c) Who you have the right to direct and control while performing services for you; or 2) Any natural person who is furnished temporarily to you:
a) To substitute for a permanent " employee" as defined in Paragraph ( 1) above, who is on leave; or
b) To meet seasonal or short- tem workload conditions;
while that person is subject to your direction and control and performing services for you. 3) "Employee" does not mean:
a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or
b) Any " manager," director or trustee except while performing acts coming within the scope of the usual duties of an " employee."
c. " Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional Insureds
SECTION II - WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
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PI- GLD- HS (10/ 11)
Coverage Part, Paragraph 3. a. is deleted in its entirely and replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.
2. Each of the following is also an insured:
a. Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.
b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your " employees" are also insureds for "bodily injury" to a co - employee" while in the course of his or her employment by you or performing duties related to the conduct of your business.
This provision does not change Item 2. a.( 1)( a) as it applies to managers of a limited liability company.
c. Broadened Named Insured — Any organization and 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 they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.
d. Funding Source — Any person or organization with respect to their liability arising out of:
1) Their financial control of you; or
2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers — At the first Named Insured' soption, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:
This insurance does not apply to:
1) Any " occurrence" which takes place after you cease to be a tenant in that premises; or 2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
g. Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or
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PI- GLD- HS (10/ 11)
organization is an insured only with respect to liability for " bodily injury," "property damage" or personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.
A person' sor organization' sstatus as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not apply to any " occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:
1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:
a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;
b) The construction, erection, or removal of elevators; or c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors — Only with respect to " bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor' sbusiness, subject to the following additional exclusions:
1) The insurance afforded the vendor does not apply to:
a) Bodily injury" or " property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;
b) Any express warranty unauthorized by you;
c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor' s premises in connection with the sale of the product;
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PI- GLD- HS (10/ 11)
g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
h) "Bodily injury" or " property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
i) The exceptions contained in Sub -paragraphs (d) or ( f); or ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.
j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you.
k. As Required by Contract — Any person or organization where required by a 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. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those 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
I. Owners, Lessees or Contractors — Any person or organization, 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 when required by a contract.
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to " bodily injury" or "property damage" occurring after:
a) 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
b) 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.
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PI- GLD- HS (10/ 11)
m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions:
1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.
2) This insurance does not apply to:
a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or
b) "Bodily injury" or " property damage" included within the " products - completed operations hazard."
M. Duties in the Event of Occurrence, Claim or Suit
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows:
a. is amended to include:
This condition applies only when the " occurrence" or offense is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation. b. is amended to include:
This condition will not be considered breached unless the breach occurs after such claim or " suit" is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of
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PI- GLD- HS (10/ 11)
Recovery Against Others To Us is deleted in its entirety and replaced by the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring " suit" or transfer those rights to us and help us enforce them.
Therefore, the insured can waive the insurer' srights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
P. Liberalization
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.
Q. Bodily Injury — Mental Anguish
SECTION V - DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:
Bodily injury" means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing ( Item a. above) at any time.
R. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows:
1. SECTION V - DEFINITIONS, Paragraph 14. b. is deleted in its entirety and replaced by the following:
b. Malicious prosecution or abuse of process;
2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
1) Any insured; or
2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
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c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed. 4- 84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Person or Organization Job Description
With respect to all employees subject to the
workers' compensation laws of the state of
California, any person or organization for whom
the Named Insured has agreed by written
contract to furnish this waiver.
This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11/ 01/ 2024 at 12: 01 AM standard time, forms a part of Policy No. EIG 4651339 04 Of the EMPLOYERS PREFERRED INS. CO.
Carrier Code 00920
Issued to THE ENERGY COALITION
Premium
Countersigned at on By:
Endorsement No.
Authorized Representative
WC 04 03 06
Ed. 4- 84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
A o® CERTIFICATE OF LIABILITY INSURANCE
DATE ( MM/ DD/ YYYY)
11/ 08/ 2024
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 po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Insurance Solutions
License # 0K07568
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT
NAME: Angela Dancy
A/ C, NNo. Ext): ( 949) 348- 7400 FAX No): ( 949) 201- 4515
E- MAIL
ADDRESS: AngelaD@ins- solutions. com9
INSURER( S) AFFORDING COVERAGE NAIC #
INSURER A: Philadelphia Indemnity Ins. Co 18058
INSURED
The Energy Coalition
525 Technology Dr Ste 350
Irvine CA 92618
INSURER B : Employers Preferred Insurance Company 10346 INSURER C : Landmark American Ins Co 33138
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 24-5ALL 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD POLICY NUMBER
POLICY EFF
MM/ DD/ YYYY)
POLICY EXP
MM/ DD/ YYYY) LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
PHPK2644776 03/1/ 2024 03/1/ 2025
EACH OCCURRENCEDAMAGE
1000' 00
CLAIMS -MADE X OCCUR
T RENTE PREMISESO( Eaoccurence) 100, 00
MED EXP (Any one person) 5, 000
PERSONAL & ADV INJURY 1, 000,00
GEN' L
X
AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
PRO
JECT 2, 000,00
PER:
LOC
GENERAL AGGREGATE 2, 000,00
PRODUCTS - COMP/ OPAGG
A
AUTOMOBILE
XHIRED
LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
AUTOS ONLY X
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
PHPK2644776 03/1/ 2024 03/1/ 2025
COMBINED SINGLE LIMIT
Ea accident) 1, 000,00
BODILY INJURY ( Per person)
BODILY INJURY ( Per accident)
PROPERTY DAMAGE
Per accident)
A
X
UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS -MADE PHUB897446 03/1/ 2024 03/1/ 2025
EACH OCCURRENCE 4, 000,00
AGGREGATE 4, 000,00
DED X RETENTION $ 10, 000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBER EXCLUDED?
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y f N
NIA EIG465133904 11/ 01/ 2024 11/ 01/ 2025
PER
STATUTE
OTHER
E. L. EACH ACCIDENT 1, 000,00
E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
C
Errors & Ommisions
LHR856221 03/1/ 2024 03/1/ 2025
Limit
Aggregate
Deductible
2, 000,00
2, 000,00
10, 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City and its officers, officials, employees, and agents, and volunteers are included as additional insured per the attached endorsement.
CERTIFICATE HOLDER
City of South El Monte
1415 N. Santa Anita Avenue
South El Monte CA 91733
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
1988- 2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/ 03) The ACORD name and logo are registered marks of ACORD
PI- GLD- HS (10/ 11)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
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 coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance Page #
Extended Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability 50, 000 limit 2 Non -Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy 30, 000 limit 2 Damage to Premises Rented to You 1, 000,00 3
HIPAA Clarification 4
Medical Payments 20, 000 5
Medical Payments — Extended Reporting Period 3 years 5
Athletic Activities Amended 5
Supplementary Payments — Bail Bonds 5, 000 5
Supplementary Payment— Loss of Earnings 1, 000 per day 5 Employee Indemnification Defense Coverage 25, 000 5
Key and Lock Replacement — Janitorial Services Client Coverage 10, 000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors ( with Fellow Employee Coverage)
Included 7
Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7
Additional Insured — Home Care Providers Included 7
Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8
Additional Insured — Vendor Included 8
Additional Insured — Franchisor Included 9
Additional Insured — When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10
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Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10
Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11
Bodily Injury — includes Mental Anguish Included 11
Personal and Advertising Injury — includes Abuse of Process, Discrimination
Included 11
A. Extended Property Damage
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following:
a. Expected or Intended Injury
Bodily injury" or property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to " bodily injury" or " property damage" resulting from the use of reasonable force to protect persons or property.
B. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following:
3) Based on the named insured' srequest at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $ 50, 000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter' s liability insurance of the client.
C. Non -Owned Watercraft
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following:
2) A watercraft you do not own that is:
a) Less than 58 feet long; and
b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for 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.
D. Damage to Property You Own, Rent or Occupy
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
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PI- GLD- HS (10/ 11)
LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item ( 1) is deleted in its entirety and replaced with the following:
1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another' sproperty, unless the damage to property is caused by your client, up to a $ 30, 000 limit. A client is defined as a person under your direct care and supervision.
E. Damage to Premises Rented to You
1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire 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; is deleted in its entirety and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. b. SECTION III - LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following:
Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V - DEFINITIONS, Paragraph 9. a., is deleted in its entirety and replaced by the following:
A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract";
2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, ( 1) (a) (ii) is deleted in its entirety and replaced by the following:
That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner;
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:
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PI- GLD- HS (10/ 11)
a. $ 1, 000,00; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.
F. HIPAA
SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows:
1. Paragraph 1. Insuring Agreement is amended to include the following:
We will pay those sums that the insured becomes legally obligated to pay as damages because of a " violation( s)" of the Health Insurance Portability and Accountability Act ( HIPAA). We have the right and the duty to defend the insured against any " suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any " suit" seeking damages, "investigation," or " civil proceeding" to which this insurance does not apply.
2. Paragraph 2. Exclusions is amended to include the following additional exclusions:
This insurance does not apply to:
a. Intentional, Willful, or Deliberate Violations
Any willful, intentional, or deliberate " violation( s)" by any insured. b. Criminal Acts
Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies
Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits
Any compliance reviews by the Department of Health and Human Services.
3. SECTION V - DEFINITIONS is amended to include the following additional definitions:
a. "Civil proceeding" means an action by the Department of Health and Human Services ( HHS) arising out of " violations."
b. "Investigation" means an examination of an actual or alleged " violation( s)" by HHS. However, investigation" does not include a Compliance Review.
c. " Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA.
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PI- GLD- HS (10/ 11)
G. Medical Payments — Limit Increased to $ 20, 000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:
1. 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. SECTION I - COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following:
b) The expenses are incurred and reported to us within three years of the date of the accident.
H. Athletic Activities
SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics.
I. Supplementary Payments
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows:
1. b. is deleted in its entirety and replaced by the following:
1. b. Up to $ 5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these.
1. d. is deleted in its entirety and replaced by the following:
1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $ 1, 000 a day because of time off from work.
J. Employee Indemnification Defense Coverage
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B the following is added:
We will pay, on your behalf, defense costs incurred by an " employee" in a criminal proceeding occurring in the course of employment.
The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $ 25, 000 regardless of the numbers of "employees," claims or " suits" brought or persons or organizations making claims or bringing " suits.
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PI- GLD- HS (10/ 11)
K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended to include the following:
We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loss to keys entrusted to you by your " client," up to a $ 10, 000 limit per occurrence and $ 10, 000 policy aggregate.
We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a " client" for any purpose commit, whether acting alone or in collusion with other persons.
The following, when used on this coverage, are defined as follows:
a. " Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" means:
1) Any natural person:
a) While in your service or for 30 days after termination of service; b) Who you compensate directly by salary, wages or commissions; and c) Who you have the right to direct and control while performing services for you; or 2) Any natural person who is furnished temporarily to you:
a) To substitute for a permanent " employee" as defined in Paragraph ( 1) above, who is on leave; or
b) To meet seasonal or short- tem workload conditions;
while that person is subject to your direction and control and performing services for you. 3) "Employee" does not mean:
a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or
b) Any " manager," director or trustee except while performing acts coming within the scope of the usual duties of an " employee."
c. " Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional Insureds
SECTION II - WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
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PI- GLD- HS (10/ 11)
Coverage Part, Paragraph 3. a. is deleted in its entirely and replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.
2. Each of the following is also an insured:
a. Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.
b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your " employees" are also insureds for "bodily injury" to a co - employee" while in the course of his or her employment by you or performing duties related to the conduct of your business.
This provision does not change Item 2. a.( 1)( a) as it applies to managers of a limited liability company.
c. Broadened Named Insured — Any organization and 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 they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.
d. Funding Source — Any person or organization with respect to their liability arising out of:
1) Their financial control of you; or
2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers — At the first Named Insured' soption, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:
This insurance does not apply to:
1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or 2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
g. Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or
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PI- GLD- HS (10/ 11)
organization is an insured only with respect to liability for "bodily injury," "property damage" or personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.
A person' s or organization' sstatus as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not apply to any " occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:
1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:
a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;
b) The construction, erection, or removal of elevators; or c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors — Only with respect to " bodily injury" or " property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor' sbusiness, subject to the following additional exclusions:
1) The insurance afforded the vendor does not apply to:
a) "Bodily injury" or " property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;
b) Any express warranty unauthorized by you;
c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor' s premises in connection with the sale of the product;
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PI- GLD- HS (10/ 11)
g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
h) "Bodily injury" or " property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
i) The exceptions contained in Sub -paragraphs ( d) or (f); or ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.
j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you.
k. As Required by Contract — Any person or organization where required by a 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. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those 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
I. Owners, Lessees or Contractors — Any person or organization, 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 when required by a contract.
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to " bodily injury" or " property damage" occurring after:
a) 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
b) 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.
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PI- GLD- HS (10/ 11)
m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions:
1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.
2) This insurance does not apply to:
a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or
b) "Bodily injury" or " property damage" included within the " products - completed operations hazard."
M. Duties in the Event of Occurrence, Claim or Suit
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows:
a. is amended to include:
This condition applies only when the " occurrence" or offense is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation. b. is amended to include:
This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of
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PI- GLD- HS (10/ 11)
Recovery Against Others To Us is deleted in its entirety and replaced by the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring " suit" or transfer those rights to us and help us enforce them.
Therefore, the insured can waive the insurer' srights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
P. Liberalization
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.
Q. Bodily Injury — Mental Anguish
SECTION V - DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:
Bodily injury" means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing ( Item a. above) at any time.
R. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of " personal and advertising injury" is amended as follows:
1. SECTION V - DEFINITIONS, Paragraph 14. b. is deleted in its entirety and replaced by the following:
b. Malicious prosecution or abuse of process;
2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
1) Any insured; or
2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
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PI- GLD- HS (10/ 11)
c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed. 4- 84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Person or Organization Job Description
With respect to all employees subject to the
workers' compensation laws of the state of
California, any person or organization for whom
the Named Insured has agreed by written
contract to furnish this waiver.
This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11/ 01/ 2024 at 12: 01 AM standard time, forms a part of Policy No. EIG 4651339 04 Of the EMPLOYERS PREFERRED INS. CO.
Carrier Code 00920
Issued to THE ENERGY COALITION
Premium
Countersigned at on By:
Endorsement No.
Authorized Representative
WC 04 03 06
Ed. 4- 84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
A o® CERTIFICATE OF LIABILITY INSURANCE
DATE ( MM/ DD/ YYYY)
03/7/ 2024
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 po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Insurance Solutions
License # 0K07568
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT
NAME: Angela Dancy
A/ C, NNo. Ext): ( 949) 348- 7400 FAXX, No): ( 949) 201- 4515
E- MAIL
ADDRESS: AngelaD@ins- solutions. comg
INSURER( S) AFFORDING COVERAGE NAIC #
INSURER A: Philadelphia Indemnity Ins. Co 18058
INSURED
The Energy Coalition
525 Technology Dr Ste 350
Irvine CA 92618
INSURER B : Employers Preferred Insurance Company 10346 INSURER C : Landmark American Ins Co 33138
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 24-5 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 POLIO ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD POLICY NUMBER
POLICY EFF
MM/ DD/ YYYY)
POLICY EXP
MM/ DD/ YYYY) LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
PHPK2644776 03/1/ 2024 03/1/ 2025
EACH OCCURRENCEDAMAGE
1000' 00
CLAIMS -MADE X OCCUR
T RENTE PREMISESO( Eaoccurence) 100, 00
MED EXP (Any one person) 5, 000
PERSONAL & ADV INJURY 1, 000,00
GEN' L
X
AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
PRO
JECT 2, 000,00
PER:
LOC
GENERAL AGGREGATE 2, 000,00
PRODUCTS - COMP/ OPAGO
A
AUTOMOBILE
XHIRED
LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
AUTOS ONLY X
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
PHPK2644776 03/1/ 2024 03/1/ 2025
COMBINED SINGLE LIMIT
Ea accident) 1, 000,00
BODILY INJURY ( Per person)
BODILY INJURY ( Per accident)
PROPERTY DAMAGE
Per accident)
A
X
UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS -MADE PHUB897446 03/1/ 2024 03/1/ 2025
EACH OCCURRENCE 4, 000,00
AGGREGATE 4, 000,00
DED X RETENTION $ 10, 000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBER EXCLUDED?
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y / N
N NIA EIG465133903 11/ 01/ 2023 11/ 01/ 2024
X STATUTE EOTH
E. L. EACH ACCIDENT 1, 000,00
E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
C
Errors & Ommisions
LHR856221 03/1/ 2024 03/1/ 2025
Limit
Aggregate
Deductible
2, 000,00
2, 000,00
10, 000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City and its officers, officials, employees, and agents, and volunteers are included as additional insured per the attached endorsement.
CERTIFICATE HOLDER
City of South El Monte
1415 N. Santa Anita Avenue
South El Monte CA 91733
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
1988- 2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/ 03) The ACORD name and logo are registered marks of ACORD
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed. 4- 84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Person or Organization Job Description
With respect to all employees subject to the
workers' compensation laws of the state of
California, any person or organization for whom
the Named Insured has agreed by written
contract to furnish this waiver.
This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11/ 01/ 2023 at 12: 01 AM standard time, forms a part of Policy No. EIG 4651339 03 Of the EMPLOYERS PREFERRED INS. CO.
Carrier Code 00920
Issued to THE ENERGY COALITION
Premium
Countersigned at on By:
Endorsement No.
Authorized Representative
WC 04 03 06
Ed. 4- 84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
PI- GLD- HS (10/ 11)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
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 coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance Page #
Extended Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability 50, 000 limit 2 Non -Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy 30, 000 limit 2 Damage to Premises Rented to You 1, 000,00 3
HIPAA Clarification 4
Medical Payments 20, 000 5
Medical Payments — Extended Reporting Period 3 years 5
Athletic Activities Amended 5
Supplementary Payments — Bail Bonds 5, 000 5
Supplementary Payment— Loss of Earnings 1, 000 per day 5 Employee Indemnification Defense Coverage 25, 000 5
Key and Lock Replacement — Janitorial Services Client Coverage 10, 000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors ( with Fellow Employee Coverage)
Included 7
Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7
Additional Insured — Home Care Providers Included 7
Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8
Additional Insured — Vendor Included 8
Additional Insured — Franchisor Included 9
Additional Insured — When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10
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PI- GLD- HS (10/ 11)
Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10
Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11
Bodily Injury — includes Mental Anguish Included 11
Personal and Advertising Injury — includes Abuse of Process, Discrimination
Included 11
A. Extended Property Damage
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following:
a. Expected or Intended Injury
Bodily injury" or property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to " bodily injury" or " property damage" resulting from the use of reasonable force to protect persons or property.
B. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following:
3) Based on the named insured' srequest at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $ 50, 000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter' s liability insurance of the client.
C. Non -Owned Watercraft
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following:
2) A watercraft you do not own that is:
a) Less than 58 feet long; and
b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for 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.
D. Damage to Property You Own, Rent or Occupy
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
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PI- GLD- HS (10/ 11)
LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item ( 1) is deleted in its entirety and replaced with the following:
1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another' sproperty, unless the damage to property is caused by your client, up to a $ 30, 000 limit. A client is defined as a person under your direct care and supervision.
E. Damage to Premises Rented to You
1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire 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; is deleted in its entirety and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. b. SECTION III - LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following:
Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V - DEFINITIONS, Paragraph 9. a., is deleted in its entirety and replaced by the following:
A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract";
2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, ( 1) (a) (ii) is deleted in its entirety and replaced by the following:
That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner;
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:
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a. $ 1, 000,00; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.
F. HIPAA
SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows:
1. Paragraph 1. Insuring Agreement is amended to include the following:
We will pay those sums that the insured becomes legally obligated to pay as damages because of a " violation( s)" of the Health Insurance Portability and Accountability Act ( HIPAA). We have the right and the duty to defend the insured against any " suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any " suit" seeking damages, "investigation," or " civil proceeding" to which this insurance does not apply.
2. Paragraph 2. Exclusions is amended to include the following additional exclusions:
This insurance does not apply to:
a. Intentional, Willful, or Deliberate Violations
Any willful, intentional, or deliberate " violation( s)" by any insured. b. Criminal Acts
Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies
Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits
Any compliance reviews by the Department of Health and Human Services.
3. SECTION V - DEFINITIONS is amended to include the following additional definitions:
a. "Civil proceeding" means an action by the Department of Health and Human Services ( HHS) arising out of " violations."
b. "Investigation" means an examination of an actual or alleged " violation( s)" by HHS. However, investigation" does not include a Compliance Review.
c. " Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA.
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G. Medical Payments — Limit Increased to $ 20, 000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:
1. 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. SECTION I - COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following:
b) The expenses are incurred and reported to us within three years of the date of the accident.
H. Athletic Activities
SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics.
I. Supplementary Payments
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows:
1. b. is deleted in its entirety and replaced by the following:
1. b. Up to $ 5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these.
1. d. is deleted in its entirety and replaced by the following:
1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $ 1, 000 a day because of time off from work.
J. Employee Indemnification Defense Coverage
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B the following is added:
We will pay, on your behalf, defense costs incurred by an " employee" in a criminal proceeding occurring in the course of employment.
The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $ 25, 000 regardless of the numbers of "employees," claims or " suits" brought or persons or organizations making claims or bringing " suits.
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K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended to include the following:
We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loss to keys entrusted to you by your " client," up to a $ 10, 000 limit per occurrence and $ 10, 000 policy aggregate.
We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a " client" for any purpose commit, whether acting alone or in collusion with other persons.
The following, when used on this coverage, are defined as follows:
a. " Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" means:
1) Any natural person:
a) While in your service or for 30 days after termination of service; b) Who you compensate directly by salary, wages or commissions; and c) Who you have the right to direct and control while performing services for you; or 2) Any natural person who is furnished temporarily to you:
a) To substitute for a permanent " employee" as defined in Paragraph ( 1) above, who is on leave; or
b) To meet seasonal or short- tem workload conditions;
while that person is subject to your direction and control and performing services for you. 3) "Employee" does not mean:
a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or
b) Any " manager," director or trustee except while performing acts coming within the scope of the usual duties of an " employee."
c. " Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional Insureds
SECTION II - WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
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Coverage Part, Paragraph 3. a. is deleted in its entirely and replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.
2. Each of the following is also an insured:
a. Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.
b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your " employees" are also insureds for "bodily injury" to a co - employee" while in the course of his or her employment by you or performing duties related to the conduct of your business.
This provision does not change Item 2. a.( 1)( a) as it applies to managers of a limited liability company.
c. Broadened Named Insured — Any organization and 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 they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.
d. Funding Source — Any person or organization with respect to their liability arising out of:
1) Their financial control of you; or
2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers — At the first Named Insured' soption, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:
This insurance does not apply to:
1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or 2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
g. Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or
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organization is an insured only with respect to liability for "bodily injury," "property damage" or personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.
A person' s or organization' sstatus as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not apply to any " occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:
1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:
a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;
b) The construction, erection, or removal of elevators; or c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors — Only with respect to " bodily injury" or " property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor' sbusiness, subject to the following additional exclusions:
1) The insurance afforded the vendor does not apply to:
a) "Bodily injury" or " property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;
b) Any express warranty unauthorized by you;
c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor' s premises in connection with the sale of the product;
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g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
h) "Bodily injury" or " property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
i) The exceptions contained in Sub -paragraphs ( d) or (f); or ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.
j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you.
k. As Required by Contract — Any person or organization where required by a 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. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those 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
I. Owners, Lessees or Contractors — Any person or organization, 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 when required by a contract.
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to " bodily injury" or " property damage" occurring after:
a) 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
b) 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.
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m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions:
1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.
2) This insurance does not apply to:
a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or
b) "Bodily injury" or " property damage" included within the " products - completed operations hazard."
M. Duties in the Event of Occurrence, Claim or Suit
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows:
a. is amended to include:
This condition applies only when the " occurrence" or offense is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation. b. is amended to include:
This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of
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Recovery Against Others To Us is deleted in its entirety and replaced by the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring " suit" or transfer those rights to us and help us enforce them.
Therefore, the insured can waive the insurer' srights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
P. Liberalization
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.
Q. Bodily Injury — Mental Anguish
SECTION V - DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:
Bodily injury" means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing ( Item a. above) at any time.
R. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of " personal and advertising injury" is amended as follows:
1. SECTION V - DEFINITIONS, Paragraph 14. b. is deleted in its entirety and replaced by the following:
b. Malicious prosecution or abuse of process;
2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
1) Any insured; or
2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
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c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
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A o® CERTIFICATE OF LIABILITY INSURANCE
DATE ( MM/ DD/ YYYY)
04/ 11/ 2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Insurance Solutions
License # 0746539
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT
NAME: Angela Dancy
A/ C, NNo. Ext): ( 949) 348- 7400 FAX No): ( 949) 201- 4515
E- MAIL
ADDRESS: AngelaD@ins- solutions. comg
INSURER( S) AFFORDING COVERAGE NAIC #
INSURER A: Philadelphia Indemnity Ins. Co 18058
INSURED
The Energy Coalition
525 Technology Dr Ste 350
Irvine CA 92618
INSURER B : Employers Preferred Insurance Company 10346 INSURER C : Landmark American Ins Co 33138
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 23-4 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 POLIO ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD POLICY NUMBER
POLICY EFF
MM/ DD/ YYYY)
POLICY EXP
MM/ DD/ YYYY) LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
PHPK2525054 03/1/ 2023 03/1/ 2024
EACH OCCURRENCEDAMAGE
1000' 00
CLAIMS -MADE X OCCUR
T RENTE PREMISESO( Eaoccurence) 100, 00
MED EXP (Any one person) 5, 000
PERSONAL & ADV INJURY 1, 000,00
GEN' L
X
AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
PRO
JECT 2, 000,00
PER:
LOC
GENERAL AGGREGATE 2, 000,00
PRODUCTS - COMP/ OPAGO
A
AUTOMOBILE
XHIRED
LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
AUTOS ONLY X
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
PHPK2525054 03/1/ 2023 03/1/ 2024
COMBINED SINGLE LIMIT
Ea accident) 1, 000,00
BODILY INJURY ( Per person)
BODILY INJURY ( Per accident)
PROPERTY DAMAGE
Per accident)
A
X
UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS -MADE PHUB853688 03/1/ 2023 03/1/ 2024
EACH OCCURRENCE 4, 000,00
AGGREGATE 4, 000,00
DED X RETENTION $ 10, 000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBER EXCLUDED?
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y / N
NIA EIG465133902 11/ 01/ 2022 11/ 01/ 2023
X STATUTE EOTH
E. L. EACH ACCIDENT 1, 000,00
E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
C
Errors & Ommisions
LHR801686 03/1/ 2023 03/1/ 2024
Limit
Aggregate
Deductible
1, 000,00
2, 000,00
10, 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City and its officers, officials, employees, and agents, and volunteers are included as additional insured per the attached endorsement.
CERTIFICATE HOLDER
City of South El Monte
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
1988- 2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/ 03) The ACORD name and logo are registered marks of ACORD
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed. 4- 84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Person or Organization Job Description
With respect to all employees subject to the
workers' compensation laws of the state of
California, any person or organization for whom
the Named Insured has agreed by written
contract to furnish this waiver.
This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11/ 01/ 2022 at 12: 01 AM standard time, forms a part of Policy No. EIG 4651339 02 Of the EMPLOYERS PREFERRED INS. CO.
Carrier Code 00920
Issued to THE ENERGY COALITION
Premium
Countersigned at on By:
Endorsement No.
Authorized Representative
WC 04 03 06
Ed. 4- 84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
Policy #: PHPK2525054 PI- GLD- HS (10/1)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
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 coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance Page #
Extended Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability 50, 000 limit 2 Non - Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy 30, 000 limit 2 Damage to Premises Rented to You 1, 000,00 3
H I PAA Clarification 4
Medical Payments 20, 000 5
Medical Payments — Extended Reporting Period 3 years 5
Athletic Activities Amended 5
Supplementary Payments — Bail Bonds 5, 000 5
Supplementary Payment — Loss of Earnings 1, 000 per day 5 Employee Indemnification Defense Coverage 25, 000 5
Key and Lock Replacement — Janitorial Services Client Coverage 10, 000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors ( with Fellow Employee Coverage)
Included 7
Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7
Additional Insured — Home Care Providers Included 7
Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8
Additional Insured — Vendor Included 8
Additional Insured — Franchisor Included 9
Additional Insured — When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10
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Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10
Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11
Bodily Injury — includes Mental Anguish Included 11
Personal and Advertising Injury — includes Abuse of Process, Discrimination
Included 11
A. Extended Property Damage
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following:
a. Expected or Intended Injury
Bodily injury" or property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to " bodily injury" or " property damage" resulting from the use of reasonable force to protect persons or property.
B. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following:
3) Based on the named insured' srequest at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $ 50, 000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter' s liability insurance of the client.
C. Non -Owned Watercraft
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following:
2) A watercraft you do not own that is:
a) Less than 58 feet long; and
b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for 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.
D. Damage to Property You Own, Rent or Occupy
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
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PI- GLD- HS (10/ 11)
LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item ( 1) is deleted in its entirety and replaced with the following:
1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another' sproperty, unless the damage to property is caused by your client, up to a $ 30, 000 limit. A client is defined as a person under your direct care and supervision.
E. Damage to Premises Rented to You
1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire 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; is deleted in its entirety and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. b. SECTION III - LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following:
Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of " property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V - DEFINITIONS, Paragraph 9. a., is deleted in its entirety and replaced by the following:
A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract";
2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, ( 1) (a) (ii) is deleted in its entirety and replaced by the following:
That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner;
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
a. $ 1, 000,00; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.
F. HIPAA
SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows:
1. Paragraph 1. Insuring Agreement is amended to include the following:
We will pay those sums that the insured becomes legally obligated to pay as damages because of a " violation( s)" of the Health Insurance Portability and Accountability Act ( HIPAA). We have the right and the duty to defend the insured against any " suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any "suit" seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply.
2. Paragraph 2. Exclusions is amended to include the following additional exclusions:
This insurance does not apply to:
a. Intentional, Willful, or Deliberate Violations
Any willful, intentional, or deliberate " violation( s)" by any insured. b. Criminal Acts
Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies
Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits
Any compliance reviews by the Department of Health and Human Services.
3. SECTION V - DEFINITIONS is amended to include the following additional definitions:
a. " Civil proceeding" means an action by the Department of Health and Human Services ( HHS) arising out of " violations."
b. " Investigation" means an examination of an actual or alleged " violation( s)" by HHS. However, investigation" does not include a Compliance Review.
c. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA.
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
G. Medical Payments — Limit Increased to $ 20, 000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:
1. 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. SECTION I - COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following:
b) The expenses are incurred and reported to us within three years of the date of the accident.
H. Athletic Activities
SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics.
I. Supplementary Payments
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows:
1. b. is deleted in its entirety and replaced by the following:
1. b. Up to $ 5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these.
1. d. is deleted in its entirety and replaced by the following:
1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $ 1, 000 a day because of time off from work.
J. Employee Indemnification Defense Coverage
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B the following is added:
We will pay, on your behalf, defense costs incurred by an " employee" in a criminal proceeding occurring in the course of employment.
The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $ 25, 000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing " suits.
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended to include the following:
We will pay for the cost to replace keys and locks at the " clients" premises due to theft or other loss to keys entrusted to you by your " client," up to a $ 10, 000 limit per occurrence and $ 10, 000 policy aggregate.
We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a " client" for any purpose commit, whether acting alone or in collusion with other persons.
The following, when used on this coverage, are defined as follows:
a. " Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. " Employee" means:
1) Any natural person:
a) While in your service or for 30 days after termination of service; b) Who you compensate directly by salary, wages or commissions; and c) Who you have the right to direct and control while performing services for you; or 2) Any natural person who is furnished temporarily to you:
a) To substitute for a permanent " employee" as defined in Paragraph ( 1) above, who is on leave; or
b) To meet seasonal or short- tem workload conditions;
while that person is subject to your direction and control and performing services for you. 3) "Employee" does not mean:
a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or
b) Any " manager," director or trustee except while performing acts coming within the scope of the usual duties of an " employee."
c. " Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional Insureds
SECTION II - WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
Coverage Part, Paragraph 3. a. is deleted in its entirely and replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.
2. Each of the following is also an insured:
a. Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.
b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your "employees" are also insureds for "bodily injury" to a co - employee" while in the course of his or her employment by you or performing duties related to the conduct of your business.
This provision does not change Item 2. a.( 1)( a) as it applies to managers of a limited liability company.
c. Broadened Named Insured — Any organization and 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 they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.
d. Funding Source — Any person or
1) Their financial control of you;
2) Premises they own, maintain
organization with respect to their liability arising out of:
or
or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers — At the first Named Insured' soption, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:
g.
This insurance does not apply to:
1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or 2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
organization is an insured only with respect to liability for " bodily injury," "property damage" or personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.
A person' s or organization' sstatus as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not apply to any " occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:
1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:
a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;
b) The construction, erection, or removal of elevators; or c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors — Only with respect to " bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor' sbusiness, subject to the following additional exclusions:
1) The insurance afforded the vendor does not apply to:
a) "Bodily injury" or " property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;
b) Any express warranty unauthorized by you;
c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor' spremises in connection with the sale of the product;
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
h) "Bodily injury" or " property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
i) The exceptions contained in Sub -paragraphs ( d) or (f); or ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.
J. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you.
k. As Required by Contract — Any person or organization where required by a 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. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those 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
I. Owners, Lessees or Contractors — Any person or organization, 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 when required by a contract.
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to " bodily injury" or "property damage" occurring after:
a) 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
b) 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.
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions:
1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.
2) This insurance does not apply to:
a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or
b) "Bodily injury" or " property damage" included within the " products - completed operations hazard."
M. Duties in the Event of Occurrence, Claim or Suit
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows:
a. is amended to include:
This condition applies only when the "occurrence" or offense is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation. b. is amended to include:
This condition will not be considered breached unless the breach occurs after such claim or " suit" is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
PI- GLD- HS (10/ 11)
Recovery Against Others To Us is deleted in its entirety and replaced by the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring " suit" or transfer those rights to us and help us enforce them.
Therefore, the insured can waive the insurer' srights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
P. Liberalization
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.
Q. Bodily Injury — Mental Anguish
SECTION V - DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:
Bodily injury" means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing ( Item a. above) at any time.
R. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of " personal and advertising injury" is amended as follows:
1. SECTION V - DEFINITIONS, Paragraph 14. b. is deleted in its entirety and replaced by the following:
b. Malicious prosecution or abuse of process;
2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
1) Any insured; or
2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
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PI- GLD- HS (10/ 11)
c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2011 Philadelphia Indemnity Insurance Company
A o® CERTIFICATE OF LIABILITY INSURANCE
DATE ( MMIDD/ YYYY)
03/ 2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Insurance Solutions
License # 0746539
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT Angela Dancy NAME:
PAHiONri , Ext): ( 949) 348- 7400 FAX
No): ( 949) 201- 4515
E- MAIL
ADDRESS: AngelaD@ins- solutions. comg
INSURER( S) AFFORDING COVERAGE NAIC #
INSURERA: Philadelphia Indemnity Ins. Co 18058
INSURED
The Energy Coalition
525 Technology Dr Ste 350
Irvine CA 92618
INSURER B : Employers Preferred Insurance Company 10346 INSURER C : Landmark American Ins Co 33138
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 22-3 GL BA UMB E&O REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD POLICY NUMBER
POLICY EFF
MM/ DD/ YYYY)
POLICY EXP
MM/ DD/ YYYY) LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
PHPK2368060 03/1/ 2022 03/1/ 2023
EACH OCCURRENCE 1, 000,000 DAMAGE TO RETED
PREMISES Ea occEence) CLAIMS - MADE X OCCUR 100, 00
MED EXP ( Any one person) 5, 000
PERSONAL & ADV INJURY 1, 000,00
GEN' L
X
AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
JECT
PROPER:
LOC
GENERAL AGGREGATE 2, 000,00
PRODUCTS - COMP/ O AGG 2, 000,00
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
HIRED XNONO- OWNED
SCHEDULED
AUTOS
AUTOS ONLY
PHPK2368060 03/1/ 2022 03/1/ 2023
COMBINED SINGLE LIMIT
Ea accident) 1, 000,00
BODILY INJURY ( Per person)
BODILY INJURY ( Per accident)
PROPERTY DAMAGE
Per accident)
A
X
UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS - MADE
PHUB799697 03/1/ 2022 03/1/ 2023
EACH OCCURRENCE 4, 000,00
AGGREGATE 4, 000,00
DED X RETENTION $ 10, 000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBER EXCLUDED?
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y/ N
NIA EIG465133901 11/ 01/ 2021 11/ 01/ 2022
X STATUTE 0TH
E. L. EACH ACCIDENT
1 E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
C
Errors & Omissions
LHR845497 03/1/ 2022 03/1/ 2023
Limit: $1, 000,00
Aggregate: $ 2, 000,00
Ded: $10, 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City and its officers, officials, employees, and agents, and volunteers are included as additional insured per the attached endorsement.
CERTIFICATE HOLDER CANCELLATION
City of South El Monte
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 ( 2016/ 03)
1988- 2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
A o® CERTIFICATE OF LIABILITY INSURANCE
DATE ( MMIDD/ YYYY)
12/ 07/ 2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).
PRODUCER
Insurance Solutions
License # 0746539
33302 Valle Rd, Suite 200
San Juan Capistrano CA 92675
CONTACT Angela Dancy NAME:
PAHiONri , Ext): ( 949) 348- 7400 FAX
No): ( 949) 201- 4515
E- MAIL
ADDRESS: AngelaD@ins- solutions. comg
INSURER( S) AFFORDING COVERAGE NAIC #
INSURERA: Philadelphia Indemnity Ins. Co 18058
INSURED
The Energy Coalition
525 Technology Ste 350
Irvine CA 92618
INSURER B : Employers Preferred Insurance Company 10346 INSURER C : ACE American Ins Co 22667
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 21-2 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD POLICY NUMBER
POLICY EFF
MM/ DD/ YYYY)
POLICY EXP
MM/ DD/ YYYY) LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
PHPK2222825 03/1/ 2021 03/1/ 2022
EACH OCCURRENCE 1, 000,000
CLAIMS - MADE X OCCUR
DAMAGE TO RETED
PREMISES Ea occEence) 100, 00
MED EXP ( Any one person) 5, 000
PERSONAL & ADV INJURY 1, 000,00
GEN' L
X
AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
JECT
PROPER:
LOC
GENERAL AGGREGATE 2, 000,00
PRODUCTS - COMP/ O AGG 2, 000,00
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
PHPK2222825 03/1/ 2021 03/1/ 2022
COMBINED SINGLE LIMIT
Ea accident) 1, 000,00
BODILY INJURY ( Per person)
BODILY INJURY ( Per accident)
PROPERTY DAMAGE
Per accident)
A
X
UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIMS - MADE
PHUB752685 03/1/ 2021 03/1/ 2022
EACH OCCURRENCE 4, 000,00
AGGREGATE 4, 000,00
DED X RETENTION $ 10, 000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBER EXCLUDED?
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y/ N
NIA EIG465133901 11/ 01/ 2021 11/ 01/ 2022
X STATUTE 0TH
E. L. EACH ACCIDENT
1 E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
C
Errors & Omissions
G27570537 007 03/1/ 2021 03/1/ 2022
Limit: $1, 000,00
Aggregate: $ 2, 000,00
Ded: $10, 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City and its officers, officials, employees, and agents, and volunteers are included as additional insured per the attached endorsement.
CERTIFICATE HOLDER CANCELLATION
City of South El Monte
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 ( 2016/ 03)
1988- 2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured
The Energy Coalition
Endorsement Number
Policy Symbol
EON
Policy Number
G27570537 006
Policy Period
03/1/ 2020 to 03/1/ 2021
Effective Date of Endorsement
03/1/ 2020
Issued By ( Name of Insurance Company)
ACE American Insurance Company
Additional Insured ( Automatic Pursuant to Contract)
It is agreed that:
1. Section II, Definitions, subsection I, the definition of Insured, is amended by adding the following:
Insured also means any client or customer of the Named Insured, but only if a written contract entered into by the Named Insured specifically requires that such client or customer be added as an additional Insured for professional liability or errors and omissions insurance, and only for Claims ( i) first made on or after the effective date of this endorsement and ( ii) for vicarious or imputed liability of such client or customer which results from Wrongful Acts committed solely by the Named Insured.
The Policy will not provide coverage for any Wrongful Act committed by such client or customer referenced above which is added to this Policy as an additional Insured.
2. Section I II , Exclusions, is amended by deleting exclusion E, but solely with respect to Claims asserted by such client or customer referenced above for Wrongful Acts actually or allegedly committed by an Insured in the performance of or failure to perform Professional Services.
All other terms and conditions of this Policy remain unchanged.
Authorized Representative
PF- 19806 (02/ 06) EO Page 1 of 1
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. ( This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Person or Organization Job Description
With respect to all employees subject to the
workers' compensation laws of the state of
California, any person or organization for whom
the Named Insured has agreed by written
contract to furnish this waiver.
This policy is subject to a minimum charge of $250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 11101/ 2021 at 12: 01 AM standard time, forms a part of Policy No. EIG 4651339 01 Of the EMPLOYERS PREFERRED INS. CO.
Carrier Code 00920
Issued to THE ENERGY COALITION
Premium
Countersigned at on By:
Endorsement No.
Authorized Representative
WC 04 03 06
Ed. 4- 84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
PI- GLD- HS (10/ 11)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
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 coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable Limit of Insurance Page #
Extended Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability 50, 000 limit 2 Non - Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy 30, 000 limit 2 Damage to Premises Rented to You 1, 000,00 3
HIPAA Clarification 4
Medical Payments 20, 000 5
Medical Payments — Extended Reporting Period 3 years 5
Athletic Activities Amended 5
Supplementary Payments — Bail Bonds 5, 000 5
Supplementary Payment— Loss of Earnings 1, 000 per day 5 Employee Indemnification Defense Coverage 25, 000 5
Key and Lock Replacement — Janitorial Services Client Coverage 10, 000 limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors ( with Fellow Employee Coverage)
Included 7
Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7
Additional Insured — Home Care Providers Included 7
Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8
Additional Insured — Vendor Included 8
Additional Insured — Franchisor Included 9
Additional Insured — When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10
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Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10
Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11
Bodily Injury — includes Mental Anguish Included 11
Personal and Advertising Injury — includes Abuse of Process, Discrimination
Included 11
A. Extended Property Damage
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following:
a. Expected or Intended Injury
Bodily injury" or property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to " bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property.
B. Limited Rental Lease Agreement Contractual Liability SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following:
3) Based on the named insured' srequest at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $ 50, 000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter' s liability insurance of the client.
C. Non -Owned Watercraft
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following:
2) A watercraft you do not own that is:
a) Less than 58 feet long; and
b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for 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.
D. Damage to Property You Own, Rent or Occupy
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
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LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item ( 1) is deleted in its entirety and replaced with the following:
1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another' sproperty, unless the damage to property is caused by your client, up to a $ 30, 000 limit. A client is defined as a person under your direct care and supervision.
E. Damage to Premises Rented to You
1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word " fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire 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; is deleted in its entirety and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. b. SECTION III - LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following:
Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of " property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V - DEFINITIONS, Paragraph 9. a., is deleted in its entirety and replaced by the following:
A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract";
2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following:
That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner;
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:
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a. $ 1, 000,00; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.
F. HIPAA
SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows:
1. Paragraph 1. Insuring Agreement is amended to include the following:
We will pay those sums that the insured becomes legally obligated to pay as damages because of a " violation( s)" of the Health Insurance Portability and Accountability Act ( HIPAA). We have the right and the duty to defend the insured against any " suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any " suit" seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply.
2. Paragraph 2. Exclusions is amended to include the following additional exclusions:
This insurance does not apply to:
a. Intentional, Willful, or Deliberate Violations
Any willful, intentional, or deliberate " violation( s)" by any insured. b. Criminal Acts
Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies
Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits
Any compliance reviews by the Department of Health and Human Services.
3. SECTION V - DEFINITIONS is amended to include the following additional definitions:
a. " Civil proceeding" means an action by the Department of Health and Human Services ( HHS) arising out of "violations."
b. " Investigation" means an examination of an actual or alleged "violation( s)" by HHS. However, investigation" does not include a Compliance Review.
c. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA.
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G. Medical Payments — Limit Increased to $20, 000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:
1. 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. SECTION I - COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following:
b) The expenses are incurred and reported to us within three years of the date of the accident.
H. Athletic Activities
SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics.
I. Supplementary Payments
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows:
1. b. is deleted in its entirety and replaced by the following:
1. b. Up to $ 5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these.
1.d. is deleted in its entirety and replaced by the following:
1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $ 1, 000 a day because of time off from work.
J. Employee Indemnification Defense Coverage
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B the following is added:
We will pay, on your behalf, defense costs incurred by an " employee" in a criminal proceeding occurring in the course of employment.
The most we will pay for any " employee" who is alleged to be directly involved in a criminal proceeding is $ 25, 000 regardless of the numbers of "employees," claims or " suits" brought or persons or organizations making claims or bringing " suits.
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K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended to include the following:
We will pay for the cost to replace keys and locks at the " clients" premises due to theft or other loss to keys entrusted to you by your " client," up to a $ 10, 000 limit per occurrence and $ 10, 000 policy aggregate.
We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a " client" for any purpose commit, whether acting alone or in collusion with other persons.
The following, when used on this coverage, are defined as follows:
a. " Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. " Employee" means:
1) Any natural person:
a) While in your service or for 30 days after termination of service; b) Who you compensate directly by salary, wages or commissions; and c) Who you have the right to direct and control while performing services for you; or 2) Any natural person who is furnished temporarily to you:
a) To substitute for a permanent " employee" as defined in Paragraph ( 1) above, who is on leave; or
b) To meet seasonal or short- tem workload conditions;
while that person is subject to your direction and control and performing services for you. 3) "Employee" does not mean:
a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or
b) Any " manager," director or trustee except while performing acts coming within the scope of the usual duties of an " employee."
c. " Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional Insureds
SECTION II - WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
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Coverage Part, Paragraph 3. a. is deleted in its entirely and replaced by the following:
a. Coverage under this provision is afforded until the end of the policy period.
2. Each of the following is also an insured:
a. Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.
b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your " employees" are also insureds for "bodily injury" to a co - employee" while in the course of his or her employment by you or performing duties related to the conduct of your business.
This provision does not change Item 2. a.( 1)( a) as it applies to managers of a limited liability company.
c. Broadened Named Insured — Any organization and 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 they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.
d. Funding Source — Any person or organization with respect to their liability arising out of:
1) Their financial control of you; or
2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers — At the first Named Insured' soption, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:
This insurance does not apply to:
1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or 2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
g. Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or
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organization is an insured only with respect to liability for "bodily injury," "property damage" or personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.
A person' s or organization' sstatus as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not apply to any " occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:
1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:
a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;
b) The construction, erection, or removal of elevators; or c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors — Only with respect to " bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor' sbusiness, subject to the following additional exclusions:
1) The insurance afforded the vendor does not apply to:
a) "Bodily injury" or " property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;
b) Any express warranty unauthorized by you;
c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor' s premises in connection with the sale of the product;
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g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
h) "Bodily injury" or " property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:
I) The exceptions contained in Sub -paragraphs ( d) or (f); or ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.
j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you.
k. As Required by Contract — Any person or organization where required by a 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. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those 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
I. Owners, Lessees or Contractors — Any person or organization, 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 when required by a contract.
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to " bodily injury" or " property damage" occurring after:
a) 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
b) 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.
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m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions:
1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.
2) This insurance does not apply to:
a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or
b) "Bodily injury" or " property damage" included within the " products -completed operations hazard."
M. Duties in the Event of Occurrence, Claim or Suit
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows:
a. is amended to include:
This condition applies only when the "occurrence" or offense is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation. b. is amended to include:
This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to:
1) You, if you are an individual;
2) A partner, if you are a partnership; or
3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of
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Recovery Against Others To Us is deleted in its entirety and replaced by the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring " suit" or transfer those rights to us and help us enforce them.
Therefore, the insured can waive the insurer' srights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
P. Liberalization
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.
Q. Bodily Injury — Mental Anguish
SECTION V - DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:
Bodily injury" means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing ( Item a. above) at any time.
R. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows:
1. SECTION V - DEFINITIONS, Paragraph 14. b. is deleted in its entirety and replaced by the following:
b. Malicious prosecution or abuse of process;
2. SECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
1) Any insured; or
2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
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c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
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RESOLITI1ON NO. 25- 051
A RESOLUTION OF THE SOUTH EL MONTE CITY COUNCIL
APPROVING AMENDMENT NO. 1 TO THE PROFESSIONAL
SERVICES AGREEMENT BETWEEN THE CITY AND THE
ENERGY COALITION, INC., TO PROVIDE PROJECT DESIGN
AND MANAGEMENT SERVICES FOR SOUTH EL MONTE
AUTONOMOUS BUILDING CONTROLS RETROFIT
PROJECT.
WHEREAS, in September 2020, The Energy Coalition in partnership with Passive Logic, applied for a grant through the Building Technologies Proving Ground — Public Sector Field Validation Funding Opportunity, a program administered by the United States Department of Energy (" DOE"); and
WHEREAS, on June 4, 2021, DOE awarded the City of South El Monte (" City") 1,52,44. 00in reimbursable funds, that includes a $ 404, 650. 0cost share requirement for the South El Monte Autonomous Building Controls Retrofit Project ("Project"); and WHEREAS, on June 22, 2021, City Council approved the South El Monte Autonomous Building Controls Retrofit Project Funding Agreement between the City and DOE; and WHEREAS, on October 12, 2021 the City Council approved a three (3) year Professional Services Agreement (" Agreement") with The Energy Coalition, Inc., in order to implement the Project; and
WHEREAS, the Project required electrical and system monitoring after all of the equipment was installed which caused delays exceeding the original term identified on the contract; and
WHEREAS, notwithstanding the expiration of the initial term, with mutual acknowledgement and for consideration, The Energy Coalition, Inc. continued to perform in accordance with the terms of the Agreement;
WHEREAS, the City and The Energy Coalition Inc. mutually acknowledge that all rights, duties, and obligations remained in full force and effect from July 13, 2024, to June 3, 2025; and WHEREAS, the City finds it necessary to extend the term of the Agreement to June 1, 2026, to complete the Project at no additional cost.
NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF SOUTH EL MONTE DOES HEREBY FIND, RESOLVE, DETERMINE AND ORDER AS FOLLOWS:
SECTION 1. The above recitals are true and correct and incorporated by reference.
SECTION 2. The City Council hereby extends the term ofthe Agreement for an additional two ( 2) years retroactively from July 13, 2024 and concluding on June 01, 2026, and directs the City Manager to execute the Amendment No. 1 to the Agreement in substantially the form attached as Attachment " A" to the June 03, 2025 staff report accompanying this Resolution. The Council further directs the City Manager to take all actions necessary to effectuate this agreement.
SECTION 3. The City Clerk shall certify to the passage and adoption of this Resolution.
ATTACHMENT D
PASSED, APPROVED AND ADOPTED this 3rd day of June 2025.
A 1"' EST:
Adrian Garcia, MMC, City Clerk
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
CITY OF SOUTH EL MONTE
SS:
G oria Olmos, Mayor
I, Adrian Garcia, City Clerk of the City of South El Monte, hereby certify that the foregoing Resolution, being Resolution No. 25- 051, was duly passed and approved by the City Council of the City of South El Monte at a
regular meeting of said Council held on the 3` d day of June 2025, and that said Resolution was adopted by the following vote:
AYES: Councilmember( s): Acosta, Bojorquez, Rodriguez, Mayor Pro Tem Delgado and Mayor Olmos
NOES: Councilmember( s): None
ABSENT: Councilmember( s): None
Adrian Garcia, MMC, City Clerk
Docusign Envelope ID: 5CB7C29C- 8EBB- 4321- 8821- 9847BA4D006C Assigned by City Clerk' s Office:
Agreement No.
2025-7
AMENDMENT NO. 1 TO THE CONTRACT SERVICES AGREEMENT BETWEEN THE CITY OF SOUTH EL MONTE AND THE ENERGY COALITION.
This First Amendment (" Amendment No. 1 ") to that certain agreement entitled " Contract Services Agreement," Contract No. 2025-7, dated July 13, 2021 (" Agreement"), by and between the City of South El Monte, a California municipal corporation (" City") and The Energy Coalition., a California non- profit corporation (" Consultant") ( collectively, the " Parties") is hereby entered into as of this 3rd day of June, 2025 (" Effective Date"). For purposes of this Amendment No. 1, the capitalized term " Parties" shall be a collective reference to both City and Consultant. The capitalized term " Party" may refer to either City or Contractor, interchangeably as appropriate.
RECITALS
A. City and Consultant entered into that certain Agreement for Contract Services dated July 13, 2023 whereby Consultant agreed to provide services related to deploying, testing, and validating the performance of an autonomous building platform and utilize a digital twin model in concurrence with the installation of energy efficiency measures in three municipal buildings ( the Services").
B. The Agreement is attached and incorporated hereto as " Exhibit A." C. The Term of the Agreement was from July 13, 2021 to July 13, 2024.
D. Notwithstanding the expiration of the initial term, the parties continued to perform in accordance with the terms of the prior Agreement with mutual acknowledgement and for consideration. The Parties hereby agree and acknowledge that all rights, duties, and obligations remained in full force and effect from July 13, 2024 to June 3, 2025 ( the " Interim Period").
E. The total maximum compensation due under the Agreement is $ 90, 000..
F. By this Amendment No. 1, City and Consultant now desire to extend the Agreement for two ( 2) additional years, inclusive of the Interim Period from July 13, 2024 to June 1, 2026 at no additional cost.
G. Except as specifically amended by this Amendment No. 1, all other provisions of the Agreement shall remain in full force and effect. This Amendment No. 1, together with the Agreement shall constitute the entire, complete, final, and exclusive expression of the Parties with respect to the matters addressed in both documents.
TERMS
1. Contract Changes. The Agreement is amended as provided herein. a. Section 3.4, "Term," is hereby amended and shall now read as follows:
Unless earlier terminated in accordance with Article 7 of this Agreement, this Agreement shall continue in full force and effect until completion of the services but not exceeding two (2) years from the date hereof, except as otherwise provided 1
Docusign Envelope ID: 5CB7C29C- 8EBB- 4321- 8821- 9847BA4D006C in the Schedule of Performance ( Exhibit " D"). [The City may, in its sole discretion, extend the Term for 1 additional one- year terms.]."
b. Section I. of Exhibit " C," is hereby amended and shall now read as follows:
Consultant shall perform the following tasks at the following rates:
Budget
Period Task SCOPE Budget
Start
Date
End
Date
1 1
Work with City and team members to finalize project
design and design specifications for all EEMs and
controller equipment.
60, 000
07/ 2021 09/ 2021
2 Support City on developing specifications and
procedures for equipment procurement. 09/ 2021 01/ 2022 3 Work with project team to support system installation of new equipment and control devices. 01/ 2022 12/ 2024 2 4
Assist with developing City acceptance criteria for
system commissioning of the new building energy
management system and ensure connection to the
Hive Controller.
15, 000
12/ 2024 02/ 2025
5 Support team with data collection, launch digital twin model and implement control strategies 02/ 2025 4/ 2025 6 BP1
Work with engineering team to develop and begin
Measurement and Verification ( M&V) against a
weather normalized baseline model. This includes
developing a M&V plan that outlines all M&V
activities 4/ 2025 12/ 2025
3 6
BP2
Work with engineering team to finalize Measurement
and Verification ( M&V) against a weather normalized
baseline model.
15, 000
10/ 2025 12/ 2025
7 Work with team to develop reports on Performance
Analysis. Collect and analyze results of the
measurement and verification period 12/ 2025 2/026
8 Dissemination plan — Assist with Technology and
Transition Plan creation to highlight the range of
energy savings impacts, methods for calculating
savings, and strategies for successful
implementation. Consultant will prepare a
combination of papers and/ or presentations to
highlight the project findings and showcase how
successes can be replicated by other public
agencies. 02/ 2026 06/ 2026
Total 90, 000
2-
Docusign Envelope ID: 5CB7C29C- 8EBB- 4321- 8821- 9847BA4D006C c. Section I. of Exhibit "D," is hereby amended and shall now read as follows:
I. Consultant shall perform all services timely in accordance with the following schedule:
Deadline Date
A. Performance Period 1 07/1/ 2025
B. Performance Period 2 02/1/ 2026
C. Performance Period 3 06/1/ 2026
d. Section II. of Exhibit " D," is hereby amended and shall now read as follows:
II. Consultant shall deliver the following tangible work products to the City by the following dates.
A. System Installation no later than July 01, 2025.
B. Measurement & Verification Analysis no later than February 01, 2026.
C. Final Report no later than June 01, 2026.
2. Continuing Effect of Agreement. Except as amended by this Amendment, all provisions of the Agreement shall remain unchanged and in full force and effect. From and after the date of this Amendment, whenever the term " Agreement" appears in the Agreement, it shall mean the Agreement, as amended by this Amendment to the Agreement.
3. Affirmation of Agreement; Warranty Re Absence of Defaults. City and Consultant each ratify and reaffirm each and every one of the respective rights and obligations arising under the Agreement. Each party represents and warrants to the other that there have been no written or oral modifications to the Agreement other than as provided herein. Each party represents and warrants to the other that the Agreement is currently an effective, valid, and binding obligation.
Consultant represents and warrants to City that, as of the date of this Amendment, City is not in default of any material term of the Agreement and that there have been no events that, with the passing of time or the giving of notice, or both, would constitute a material default under the Agreement.
City represents and warrants to Consultant that, as of the date of this Amendment, Consultant is not in default of any material term of the Agreement and that there have been no 3-
Docusign Envelope ID: 5CB7C29C- 8EBB- 4321- 8821- 9847BA4D006C events that, with the passing of time or the giving of notice, or both, would constitute a material default under the Agreement.
4. Adequate Consideration. The parties hereto irrevocably stipulate and agree that they have each received adequate and independent consideration for the performance of the obligations they have undertaken pursuant to this Amendment.
5. Authority. The persons executing this Amendment 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 Amendment on behalf of said party, (iii) by so executing this Amendment , such party is formally bound to the provisions of this Amendment , and ( iv) the entering into this Amendment does not violate any provision of any other agreement to which said party is bound.
SIGNATURES ON FOLLOWING PAGE]
4-
Docusign Envelope ID: 5CB7C29C- 8EBB- 4321- 8821- 9847BA4D006C IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date and year first -above written.
CITY:
CITY OF SOUTH EL MONTE, a municipal
corporation
DocuSigned by:
6/4/ 2025
etene5 ' alas; City Manager
ATTEST:
Signed by:
0,- dnietk, 6/4/ 2025
530F51 5704EB..
Adrian Marcia, MMC, City Clerk
APPROVED AS TO FORM:
OLIVAREZ MADRUGA LAW ORGANIZATION, LLP
Signed by:
S. sii h. aµmo, 0 6/4/ 2025
Susirgltamirrano, City Attorney
CONSULTANT:
THE ENERGY COALITION, INC., a
California non- profit corporation
By:
By:
Signed by:
Brail P VC A. S
E7A, BL 65oQv4D..
Name: Craig Perkins
6/4/ 2025
Title: President and Executive
Director
Signed by:
Voris Vb 6/9/ 2025
A06BD02 D1343B.
ame: ions Do
Title: Vice President
Address: 525 Technology, Suite 350
Irvine, CA 92618
Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: 1) Chairman of the Board, President or any Vice President; and 2) Secretary, any Assistant Secretary, Chief Financial Officer or any Assistant Treasurer. CONSULTANT' SSIGNATURES
SHALL BE DULY NOTARIZED, AND APPROPRIATE ATTESTATIONS SHALL BE INCLUDED AS
MAY BE REQUIRED BY THE BYLAWS, ARTICLES OF INCORPORATION, OR OTHER RULES OR REGULATIONS APPLICABLE TO CONSULTANT' SBUSINESS ENTITY. 5-
Docusign Envelope ID: 5CB7C29C- 8EBB- 4321- 8821- 9847BA4D006C EXHIBIT " A"
City Council Agenda Report
Agenda Item No. 7.c.
DATE: September 1, 2026
TO: Honorable Mayor and Members of the City Council
APPROVED BY: Rene Salas, City Manager
SUBMITTED BY: Gerardo Marquez, Director of Community Development & Public Works
SUBJECT: CONSIDERATION AND APPROVAL OF RESOLUTION NO.
26-062, AWARDING A PROFESSIONAL SERVICES
AGREEMENT (PSA) TO BUCKNAM INFRASTRUCTURE
GROUP, INC. FOR PROFESSIONAL SERVICES FOR THE
PAVEMENT MANAGEMENT PROGRAM (PMP) UPDATE
SUMMARY: Award of contract to provide Professional Services for the Pavement Management Program (PMP) Update.
RECOMMENDED ACTION: Staff recommends City Council:
1. Adopt Resolution No. 26-062, awarding a professional services agreement to Bucknam Infrastructure Group, Inc. for the Pavement Management Program (PMP) Update in the amount of $29,853.00;
2. Approve $29,853.00 in Prop C Funds for the requested services; and
3. Authorize City Manager or designee to negotiate and execute the agreement FISCAL/FINANCIAL IMPACT: Staff recommends these services are provided through eligible Prop C Funds, in the amount of $29,853.00. The following is the project’s anticipated cost:
Professional Services (Bucknam Infrastructure Group, Inc.) $29,853.00 Total $29,853.00
DISCUSSION: Pavement Management Program (PMP) is a planning and budgeting tool used to prioritize street paving and maintenance projects over a five-year period. The requested professional services to update the City’s Pavement Management Program (PMP) includes reviewing the existing program and completing necessary tasks to update the program to include recommendations for the next 5 year’s pavement maintenance and rehabilitation program.
On April 21, 2026, the City Council authorized staff to issue a Request for Proposals (RFP) for Professional Services for the Pavement Management Program (PMP) Update.
On May 6, 2026, the City issued a Request for Proposal (RFP) for Professional Services for the Pavement Management Program (PMP) Update with a proposal due date of June 11, 2026. One (1) firm submitted a proposal: Bucknam Infrastructure Group, Inc. The proposal was evaluated based on the established criteria identified in the RFP including compliance with the RFP requirements, proposal quality, project understanding, approach, methodology including responsiveness and flexibility, experience of assigned staff, similar project experience, schedule efficiency, and references.
Staff reviewed the proposal and determined that Bucknam’s proposal was comprehensive, demonstrated the best understanding of the requested services, and proved to be well qualified. Bucknam showed, in its proposal, their related project experience with other cities, including Monterey Park, Alhambra, and Rosemead. Also, Bucknam has experience within the City of South El Monte as it was the firm that completed the prior City of South El Monte PMP. Bucknam’s total cost for the proposed services is $29,853.00.
Staff recommends the City Council approve a professional services agreement with Bucknam Infrastructure Group, Inc., as the well-qualified consultant, to provide professional services for the Pavement Management Program (PMP) Update for a total amount of $29,853.00.00 and authorize the City Manager to execute the agreement.
ATTACHMENT(S):
A. Resolution No. 26-062
B. Exhibit A - Bucknam Proposal - Pavement Management Program (PMP) 2026 Update
C. Exhibit B - Fee Proposal - PMP 2026
D. Professional Services Agreement with Bucknam PMP 2026
ATTACHMENT A
RESOLUTION NO. 26-062
A RESOLUTION OF THE SOUTH EL MONTE CITY COUNCIL
AWARDING A PROFESSIONAL SERVICE AGREEMENT TO
BUCKNAM INFRASTRUCTURE GROUP, INC. FOR THE
PAVEMENT MANAGEMENT PROGRAM (PMP) UPDATE
WHEREAS, on April 21, 2026, the City Council authorized staff to issue a Request for Proposals (RFP) for Professional Services for the Pavement Management Program (P MP) Update; and
WHEREAS, on May 6, 2026, the City issued an RFP for professional services for the PMP update with a proposal due date of June 11, 2026, and received one (1) proposal; and WHEREAS, the City staff evaluated the proposal and determined that Bucknam Infrastructure Group, Inc. submitted a qualified and comprehensive proposal to provide the subject services for the project, has prior PMP experience with the City; and WHEREAS, the City staff determined that Bucknam Infrastructure Group, Inc. is a wellqualified consultant for the project.
NOW, THEREFORE, THE SOUTH EL MONTE CITY COUNCIL HEREBY
RESOLVES AS FOLLOWS:
SECTION 1: The above recitals are true and correct and incorporated by reference.
SECTION 2: Upon reviewing the proposal submitted for professional services for the PMP update, the City Council hereby finds that Bucknam Infrastructure Group, Inc. has submitted a well-qualified proposal, and desires to award a professional services agreement in the amount of $29,853.00.
SECTION 3: The City Council hereby approves $29,853.00 in Prop C funds for the requested services.
SECTION 4: The City Council hereby authorizes the City Manager to execute and take all actions necessary to effectuate a professional service agreement with Bucknam Infrastructure Group, Inc. in the amount of $29,853.00, subject to the approval as to form of the City Attorney.
SECTION 5: The City Clerk shall certify to the passage and adoption of this resolution.
PASSED, APPROVED AND ADOPTED this 1st day of September 2026. _________________________
Gloria Olmos, Mayor
ATTEST:
__________________________
Adrian Garcia, MMC, City Clerk
STATE OF CALIFORNIA )
COUNTY OF LOS ANGELES ) SS:
CITY OF SOUTH EL MONTE )
I, Adrian Garcia, City Clerk of the City of South El Monte, hereby certify that the foregoing Resolution, being Resolution No. 26-062, was duly passed and approved by the City Council of the City of South El Monte at a regular meeting of said Council held on the 1st day of September 2026, and that said Resolution was adopted by the following vote:
AYES: Councilmember(s):
NOES: Councilmember(s):
ABSENT: Councilmember(s):
___________________________
Adrian Garcia, MMC, City Clerk
PROPOSAL TO PROVIDE PROFESSIONAL SERVICES
FOR THE PAVEMENT MANAGEMENT
PROGRAM (PMP) 2026 UPDATE
City of South El Monte, CA
June 10, 2026
Submitted by:
Bucknam Infrastructure Group, Inc.
ATTACHMENT B
Table of Contents
City of South El Monte TOC
Pavement Management Program 2026 Update
Section Page
Table of Contents, Cover Letter TOC
Approach and Scope of Work .......................... 1-1 Project Understanding/Approach................................................... 1-1 Pavement Management Program Scope of Work.......................... 1-4 Schedule......................................................... 2-1 Critical Path Project Schedule......................................................... 2-1 Project Team, Key Personnel, and Resumes..... 3-1
Project Team / Key Staff Members................................................. 3-1 Organization Chart.......................................................................... 3-1 Resumes.......................................................................................... 3-4 Company Qualifications.................................. 4-1 Bucknam Firm Profile / Qualifications............................................ 4-1 Delineation of Bucknam Infrastructure Group’s Strengths............ 4-2 References...................................................... 5-1 Relevant Project Experience ........................................................... 5-1 City’s Standard Professional Services
Agreement...................................................... 6-1 Sample Professional Services Agreement Statement..................... 6-1 Addenda Acknowledgment............................. 7-1 Addenda Acknowledgment Statement........................................... 7-1 Required Attachments.................................... 8-1 Attachment A – Affidavit of Non-Collusion .................................... 8-X Attachment B - Claims History........................................................ 8-1 Fee Proposal ................................................... 9-1 Separate Sealed Envelope ....................................................................
Hourly Rate Schedule...................................................................... 9-2 3 7
8 4
5 6
9 1
2
June 10th, 2026
Mr. Gerardo Marquez
Director of Community Development / Public Works
City of South El Monte
1415 Santa Anita Avenue
South El Monte, CA 91733
Subject: Proposal to Provide Professional Services for the Pavement Management Program (PMP) Update
Dear Mr. Marquez,
It is our pleasure to submit our proposal to assist the City of South El Monte in the proactive, continued management of your Pavement Management Program (PMP). With the City seeking to move toward stronger infrastructure management methodologies through advanced pavement inspections, zone maintenance, Capital Improvement Programming (CIP), asset management correlation, and accurate GIS publication, Bucknam Infrastructure Group has identified a proactive and cost-efficient method to assist the City in updating your PMP. Our team will focus our long-term PMP knowledge, extensive City of South El Monte – Los Angeles County experience and GIS/GPS technologies to optimize the City’s maintenance dollars by implementing a manageable and reliable PMP methodology.
Four key factors deliver an accurate PMP; 1) segment true area accuracy, 2) up-to-date work history, 3) accurate PCI’s and 4) applicable unit costs. Bucknam utilized these key factors while serving as the City’s PMP consultant for the 2021/22 PMP project; our project team can be relied upon again to deliver these essential services to the City based upon the following factors:
Relevant and accurate PMP services based on Bucknam’s ongoing/current work with numerous Los Angeles , Orange and San Diego local agencies such as:
o 37 of 88 Los Angeles County local agencies (42%); South El Monte, Rosemead, Temple City, Commerce, Bell, Whittier, La Habra Heights, Covina, West Covina, Duarte, South Pasadena, Norwalk, Downey, Sierra Madre, Monrovia, etc. o 21 Orange County local agencies; 60%;
o Recent OCTA Pavement Preservation Program project where Bucknam assessed and generated a countywide 10-yr economic forecast for all 35 Orange County local agencies (MicroPAVER/StreetSaver assessments);
o 20 San Diego/Inland Empire local agencies; and
o Army Corps of Engineers ASTM D6433 certified compliant surveying, reporting and pavement analysis on an annual basis;
Our project manager has worked within the SoCal Pavement Management industry for over twenty-eight (28) years and has worked extensively with MicroPAVER PMP software through turn-key data conversion projects to long-term, proactive pavement CIP scheduling that relies on accurate and cost-efficient CIP recommendations;
Project/engineering experience that brings the understanding that MicroPAVER results are not set in stone; we proactively use the available data to enhance budget forecasting and CIP/O&M project planning;
Cost effective management methodologies, from the project kickoff through final reporting, gained through our Project Manager’s experience and applied through the use of Bucknam’s MyRoads® dynamic PMP-GIS web-portal;
As Project Manager, my goal is not just to meet the requirements of this project but establish a living document that will be used throughout the term of the CIP as well as implement achievable long-term infrastructure management goals in coordination with City schedules.
Offeror: Bucknam Infrastructure Group, 3548 Seagate Way, Suite 230, Oceanside, CA 92056; Company FID # 45-2723662 (S-Corp)
Mr. Peter Bucknam (Project Manager) will be providing day-to-day operational / management services and deliverables; he is authorized to sign the agreement for this contract. He can be contacted at 760-216-6529 (work) 714-501-1024 (cell) or email at [email protected]. Mr. Steve Bucknam, P.E. (Principal) will be responsible for all project oversight.
By selecting Bucknam Infrastructure Group, Inc., the City of South El Monte will continue to receive a strong, knowledgeable, innovative, and communicative team with the experience to implement a cost-effective pavement management program. Our handpicked pavement management professionals are committed to delivering quality services to the City. We have already scheduled time for your project and eagerly await our kick-off meeting with City staff and you.
The City’s RFP is incorporated in its entirety as part of our proposal and all information submitted within our proposal is true and correct. Bucknam will comply with all aspects of the agreement. Our proposal is valid for a minimum of 120 days.
Respectfully submitted,
Bucknam Infrastructure Group, Inc.
Peter J. Bucknam
President/Project Manager
Approach and Scope of Work
City of South El Monte 1-1
Pavement Management Program 2026 Update
Project Understanding / Approach
As the City of South El Monte infrastructure matures, the City’s staff is striving to update the City’s Pavement Management Program (PMP) through cost effective condition surveys, engineering cost evaluation, Arterial CIP prioritization, “residential neighborhood” budgetary reporting and work history updates within the PMP database. The City requires a team that will continue to not only survey the defined sections using cost-conscious methodologies but will create a comprehensive program that includes the enhancement of your multi-year PMP CIP, neighborhood maintenance, essential data for PS&E bid document preparation, stewardship of the PMP, GIS links to the PMP, and the knowledge of the inner workings of the MicroPAVER software.
Bucknam will continue to provide these services through our proactive and accurate update of your PMP; we will address the City’s primary goals of:
• Establishing project kickoff meeting to finalize scope of work, all team members, project schedule and deliverables;
• Creating an updated, comprehensive PMP MicroPAVER database that includes all public owned streets within the City’s network;
o Assessing current PMP data to validate all street classifications, segmentation and segment square footages;
• Enhancing the South El Monte MicroPAVER database with 2022 to 2026 work history data entries; • Surveying 43.8 miles of Arterial, Collector, Local and Alley streets; provide variance PCI reporting based upon 2022 PCI’s vs. 2026;
o Verifying / Updating pavement centerline and metric data (PMP vs. GIS); Through the use of Bucknam pavement segmentation true area calculations; o Generating 2026 Pavement Condition Index (PCI) ratings for each segment and overall; • Developing a proactive preventative slurry seal / overlay maintenance schedules based on existing capital funding;
• Establishing solid recommendations for current / future maintenance needs; • Utilizing the City’s existing funding to generate a baseline five (5) year Capital Improvement Program (CIP);
• Recommending alternative maintenance budgets that demonstrate realistic return-oninvestments (ROI), i.e. “improve PCI” and “maintain PCI” budget models, etc. • Publishing PMP-GIS layer within the City’s GIS Enterprise and the South El Monte MyRoads™ webportal (i.e. PCI maps, proposed rehabilitation program, etc.) We have defined detailed phases to the scope of work in accordance to the City’s RFP;
1. Project Implementation
Approach and Scope of Work
City of South El Monte 1-2
Pavement Management Program 2026 Update
2. Client Satisfaction
3. Scope of Work (Major Tasks)
4. Project Schedule (see Section 2)
1) Project Implementation
TASK 1.1: Project Kickoff
The first step in implementing a successful pavement management program truly resides in frequent communication and timely scheduled data updates. For the City of South El Monte it will be essential to establish, up front, the Public Works (Engineering & Maintenance) pavement management priorities. Our team will set a Project Kickoff meeting with City staff to further discuss and review in detail the expectations of the project, technical approach, section ID / GIS management & surveys, district/quadrant maintenance, software upgrades & use, deliverables within the scope of work and the review of schedule.
This effort will build consensus between the Engineering and Maintenance staff as well as build stronger ARTERIAL CIP and LOCAL neighborhood maintenance programs that complement large Public Works CIP projects and annual maintenance projects.
The first key topics to be discussed will include the review and assessment of the existing pavement plan/data; its current and future use, work histories, survey areas based on recent maintenance work and schedules, new construction, data quality, current pavement procedures, historical expenditure levels, software implementation and desired service levels.
Deliverable: Meeting minutes, revised project schedule (if necessary) TASK 1.2: Project Status Meetings - Quality Control Program Status Meetings and Progress Reports
• Minimum of three meetings during the project (kickoff, field, and status meetings) – minimum of eight (8) hours; Field review meetings; Monthly progress status reports will be delivered to City project manager.
Quality Control (QC)
We will use a statistical sampling approach for measuring the quality of our field technician’s work. In this manner, 10 percent of the original annual surveys will be re-surveyed by an independent survey crew, supervised by a field supervisor, and the results will be compared to the original surveys (this will include 4 miles QC). Our QC process involves checking the field crews’ work in a “blind study” fashion. This will ensure that all field personnel are properly collecting distresses and pavement quantities for all street segments. PCI variance reporting will be performed where previous PCI data will be compared to newly inspected 2026 PCI data; if PCI’s vary more than ten (10) points per year Bucknam staff will assess the potential cause through unrecorded work history, accelerated pavement deterioration, etc.
Approach and Scope of Work
City of South El Monte 1-3
Pavement Management Program 2026 Update
Bucknam will record/log any discrepancies between the previous and current PMP databases (any corrections/changes to the database shall not be made without prior City staff approval).
Since we are collecting distress information on our field MicroPAVER tablets with the South El Monte PMP database live, our staff will perform several quality control tests within MicroPAVER using a sample set of the City of South El Monte’s street distress data.
This will ensure that all system and analysis settings as well as City recommendations and standards are being followed. Over the past two years, Bucknam has submitted over fifty (50+) METRO/OCTA compliant reports for LA and Orange County municipalities, they include:
Our surveys follow the accepted ASTM D6433 procedure requirements. A copy of the QA/QC plan utilized by our staff during the project will be submitted along with the PMP certification documents. Our staff attends the OCTA PMP Distress Training Classes held each year, 2011 thru 2026.
In February 2026 our staff was acknowledged as “qualified inspectors and firm” to prepare PMP’s compliant with the OCTA Countywide Pavement Management Guidelines (this certification/compliance runs through June 2028).
Additionally, Bucknam was selected by the Orange County Transportation Authority (OCTA) in July, 2022 to perform a 10-year Pavement Management Plan analysis on ALL 35 Orange County local agencies PMP’s. Essentially, a Countywide Pavement Management Plan!
Approach and Scope of Work
City of South El Monte 1-4
Pavement Management Program 2026 Update
2) Client Satisfaction
TASK 2.1: Project Deliverables
Shown throughout our Scope of Work, each Task is summarized with project deliverables. Client satisfaction will derive from frequent communication with the Project Manager and key staff members from the Engineering and Public Works departments. Project success is created by delivering on three main factors;
1) Adherence to scope tasks and deliverables
2) Performing to the standard set by the Project Schedule; and 3) Controlling costs. Our Project Manager will follow each of these factors throughout the duration of the project
Deliverable: Project Status Updates, as stated in Task 1.2 3) Scope of Work (Major Tasks)
TASK 3.1: Update Maintenance and Rehabilitation Activities The City will provide Bucknam a complete listing of all major work (overlay, slurry, etc.) in hard copy format to Bucknam for updating specific section work histories and PCI ratings. Bucknam will review all maintenance and rehabilitation projects completed and/or scheduled by the City since the last update in 2022; this will include work history updates on arterial, locals and alleys.
Our staff will enter the necessary work history updates as mentioned above (i.e. data entry of maintenance / rehabilitation activities) into your MicroPAVER software. Once the project is completed, our staff will upload the necessary PMP database files at the City.
Deliverable: Update PMP data, Work History report
TASK 3.2: Pavement Condition Surveys
First and foremost, the assessment of the City’s pavement segmentation is one of the key priorities for this project.
With four years between major inspections, it will be
essential to verify that all PMP segmentation are up-to-date and that section true area SF quantities are verified,
accurate and reliable.
This will be completed by utilizing Bucknam’s cloud-based learning technology to correctly quantify square footages for each pavement section (see sample above). Bucknam’s use of cloud-based learning technology is initiated by providing the AI with the City of South El Monte most recent aerial image; in doing so, AC and PCC pavement true areas are initially calculated. These calculations are possible due to the cloud-based learning tech’s inherent working knowledge of how to recognize edge-of-pavement,
Approach and Scope of Work
City of South El Monte 1-5
Pavement Management Program 2026 Update
surface types, medians, bus pads and AC/PCC surface limits. This ability will allow Bucknam to obtain the necessary quality control measurements for defined South El Monte PMP segments and to perform segment true area digitization / variance reports. This will in turn create more accurate PCI’s, engineering project cost estimations, total centerline mileage / square footages of the network as well as for unique pavement segments. We will review/assess new and/or missing streets previously excluded from the last PMP update and create the necessary segmentation within the South El Monte PMP database + GIS links Once the pavement segmentation has been assessed and verified, the necessary 43.8 miles of Arterial, Collector, Local and Alley inspections will be performed. It is the City’s desire to survey all pavement sections this fiscal year.
Our survey methodology will include the following approach based on the ASTM D6433 guidelines:
1. Walking - All sections are surveyed through “two-pass test” walking methodologies. AC/PCC distress types will be collected based upon actual surface conditions and physical characteristics of the segment.
Surveying methods will be conducted by remaining consistent with ASTM D6433 & the Army Corp of Engineers AC/PCC sampling guidelines while being flexible to current City requirements.
All sample locations are observed through walking surveys; samples areas will cover a minimum of 20% of the total section area and will be 2,500 SF +/- 1,000 SF in size. According to the City’s RFP the following pavement sections are to be surveyed for the upcoming 2026 PMP update:
• The inspection of approximately 43.8 centerline miles of Arterial / Collector, Local and Alley segments will be performed;
Our use of MicroPAVER Tablet-based units allows our staff to collect pavement data with the City of South El Monte’s PMP database live in the field. All electronic data is transferred to the working master MicroPAVER account and reviewed from our office for quality control and management.
Roadway Verification Survey - A listing of the field attribute data that is updated/verified during the survey for the pavement management database is listed below:
2. Field Attribute Data (updated and/or verified)
• From/to, indicating the assigned limits of the section, sample test areas, street name • Historical PCI tracking from previous inspections and 2026 PCI inspections • Segment rank, length, width, and total true area of the section
3. Conditional data will be evaluated for all street segments and will include:
• MicroPAVER 20 AC & 19 PCC distresses by type, severity and sample area • Sampling/conditional data collected within edge-of-pavement to edge-of pavement • PCI ratings (0-100), taking into account the surface condition, level of distress
4. Section Distress and PCI Reporting
Upon 50% and 100% completion of the required condition surveys, we will prepare draft PCI Reports and PCI GIS maps that document the conditions of all pavement segments. This report will provide the necessary data for Bucknam and the City to use and determine projected street rehabilitation and
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maintenance project locations. The City and our staff will review the PCI reports to ensure that all inventory data is correct and the project is running smoothly. Our PCI Reporting will include:
• PCI Report – Sorted by Name (A to Z), PCI Order (0-100), Zone (1, 2, 3); • Work history report; and
• GIS Maps presenting PCI’s by section.
Once the City has reviewed, assessed and commented on the draft report, we will address all requested revisions and deliver the final reports.
Deliverable: Citywide PCI reports, compliant METRO PCI reports, PCI Variance report
DEVELOP RECOMMENDED IMPROVEMENT PROGRAM
TASK 3.3: Maintenance and Rehabilitation Assessment – Budget Analysis We will assist the City in developing the most cost-effective preventative maintenance and rehabilitation strategies necessary to achieve the desired level of serviceability. Initially, Bucknam will assess overall condition trends and perform an performance predication model; this will lead to Bucknam meeting with the City to discuss and strategize maintenance activities that are currently being used by the City. Based on the City’s current AC & PCC applications and other maintenance practices used we will conduct an historical and prospective analysis on the conditional and financial impact these practices have on the network.
We will establish/update the South El Monte MicroPAVER maintenance “decision tree” that will be used to generate pavement recommendations that match current fiscal year maintenance approaches/City practices. This will be accomplished by assessing/updating the unique and individual PCI ranges and deterioration curves within PMP software based on functional class (i.e. arterial, collector, local) and age.
Our staff will review the South El Monte deterioration curves that have been developed based on historical pavement condition, inspection, surface type, and road class.
All maintenance practices/unit costs will be integrated into the PMP and will be derived from the most recent construction bids for pavement rehabilitation. We will account for inflation rates when long-term revenue projections are made. Our Project Manager and Principal will work closely with the City in defining repair and rehabilitation strategies for each fiscal year as well as establish PMP zones for the street/alley networks. Once the repair/rehabilitation strategies have been defined, the identification of a five-year Forecasted Maintenance schedule will be generated.
The recommended budget scenarios will be identified on the basis of several criteria:
• Assessment and review of the City’s 2023 Pavement CIP • Present pavement conditions; Desired levels of service and available resources • Projected / Forecasted PCI’s per section
• Cost benefit of individual strategies (minimum of three (3) scenarios) • Scheduling with the City’s major CIP projects (water, sewer; if any)
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• Budgetary recommendations that satisfy METRO guidelines • Local “Neighborhood” fiscal year reporting/improvement scheduling • Future routine maintenance needs based on projected deterioration rates The primary emphasis of this task is to maximize the scheduling of street maintenance using the most cost-effective strategies available and taking into account a life-cycle cost analysis.
TASK 3.4: Citywide CIP / METRO Compliance Budget Reports We will deliver a sound PMP Final Report to the City which will be essential for staff reference / use as well as presented in a way that is beneficial for elected officials/upper management. This report will assist the City in complying with METRO.
The report will be prepared in a format that uses the information delivered by the PMP database in conjunction with the information and analysis performed by our team. The report will provide the City with information on:
• Current inventory and pavement conditions indices (PCI) for all road classes • Projected annual rehabilitation programs for street maintenance for a 5-yr period (ARTERIAL, LOCAL and ALLEY Forecast Maintenance Reports) that show the largest return on investment and acceptable levels of service;
• Modeling and comparison of budget scenarios typically include:
o Current City proposed PMP budget; FY 2027-32;
o Maintain PCI for five years;
o Increase PCI within five years;
• Strategies and recommendations for the City’s maintenance programs and procedures, including a preventative maintenance schedule (Arterials / Locals by year); • Publication of budget scenarios within MyRoads™ and GIS (Bucknam web-portal/dashboard); • Supporting documentation required by METRO;
• A detailed breakdown of deferred maintenance (backlog); and • Quality Management Plan document.
Our recommendations will provide guidance to the City on how to implement better preventative maintenance / rehabilitation strategies and/or increase funding through PMP data examples.
We will make a 15 minute (non-technical) presentation of the results from the 2026 PMP update to City personal and/or City Council if necessary; pro bono.
Registered Engineer
Mr. Steve Bucknam, P.E. will review all completed data and final report incorporating the results of our pavement evaluation and conditions. We will provide recommendations for pavement rehabilitation and replacement design based upon field data and analysis.
Deliverable: Two (2) copies of the approved Final PMP Report, METRO compliance form and digital delivery of final project files.
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TASK 3.5: PMP – GIS / PMP Mapping
As an enhancement and proactive approach to this project, our staff will update the Pavement-GIS link between
MicroPAVER and the City’s GIS system. Our staff will review all ongoing upcoming capital projects that may impact the GIS mapping delivered for this project. The maps described below will be incorporated into the City’s Final PMP report:
• PCI values for every section
• Work History identifications
• 5-yr Arterial / Local Rehabilitation and Slurry
Seal Programs
• Functional classification maps
By using the unique ID’s within the PMP and the City’s ESRI street shapefile ID’s, we will update the one-to-one match for each pavement section in the GIS. Our staff will
coordinate all project deliveries with the Public Works and the GIS division to ensure that the most current and
accurate PMP-GIS maps are represented within the City’s GIS enterprise. Once the City has approved the Pavement Condition Report, we will update the necessary MicroPAVER-GIS linkages.
Deliverable: Complete GIS files/themes based on list above (project shapefiles).
TASK 3.6: South El Monte MyRoads™ PMP Web-Portal
South El Monte MyRoads™ Web-Portal –
Bucknam’s proprietary option of MyRoads™ is a
great match for the South El Monte PMP today and
the future. This brings your PMP data to life
within a dynamic PMP dashboard!
Bucknam now provides all our PMP clients with a
unique and agency driven “MyRoads™” web-portal
that provides instantaneous access to your
pavement management database. This
“dashboard” allows users to toggle through
individual sections via GIS mapping selections, zone
queries, rank selection, PCI ranges, etc. to review
all section metrics, latest/previous inspections,
work histories generate filtered PCI reports and
identify potential maintenance costs based upon
your unique needs. Bucknam has shown to the
right, your current, active MyRoads™ PMP portal!
2023 S. El Monte PCI
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This tool will be accessed by City staff simply through a Username/Password methodology. As changes are made to the South El Monte PMP database the MyRoads™ dataset is changed to reflect work history edits, PCI inspections and section changes.
In summary, MyRoads™ allows the user perform the following dynamic functions:
• Query specific pavement segment(s) to view current/historic PCI, work history inspection; • Filter for pavement sections within a defined zone, PCI range and/or functional class; • Select a pavement section or grouping of section through the on-board GIS tool; • Enter slurry, overlay & reconstruction unit costs to determine preliminary cost of maintenance and resulting citywide PCI
o Display critical street / sidewalk / ROW assets along pavement section(s) that are critical to Engineering Bid development and solicitation (ADA ramps, utilities, manholes, trees, etc.
• Displays all final GIS project maps (PCI, work history, 5-yr forecasted maintenance, etc.) • Bucknam will train South El Monte staff on the simply use of the MyRoads™ dashboard.
TASK 3.7: MicroPAVER / MyRoads™ PMP Training
PMP Training
With MicroPAVER use being one of the key components to a successful PMP implementation, we will provide City staff with quality, certified training and the necessary skills needed to maintain the PMP.
Bucknam will provide City staff with all collected pavement/GIS data, as well as updated operation manuals for both field data collection and software training use.
Peter Bucknam and Cade Bucknam will conduct a comprehensive training session covering PMP implementation, PMP methodologies, field survey practices, PCI calculations, MicroPAVER/MyRoads™ use, editing/updating the database, budget needs analysis, and how to publish PMP data to GIS.
Training typically involves one (1) day of training on the MicroPAVER software and GIS UI / Apps. There is no minimum or maximum amount of people that can be trained under this methodology.
Deliverable: PMP software and field training
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Optional Services
TASK 3.8: On-Call PMP – GIS Services
Pavement Management Program Support
With the City implementing a triennial PMP management schedule Bucknam will provide annual PMP support that will cover data previously submitted by our staff. If additional services outside the identified scope of work above are requested Bucknam will provide timely and proactive services to the City. Our typical On-Call services include:
• Additional budget scenarios, general reporting, deterioration studies • Additional visual inspections above the mileage amount indicated in Task 3.2 • Additional pavement management – GIS mapping
• Additional MicroPAVER training, operational use
• GIS Enterprise assessment, management, implementation, support The agreement will include the provision of onsite and telephone support for the City staff.
Deliverable: Remote and on-site technical support
TASK 3.9: Citywide Sidewalk Management Services
Sidewalk Management Program Support
With the City continuing its triennial PMP requirement Bucknam will provide optional Sidewalk Management services at a volume-based reduced fee based on the combined PMP and sidewalk survey schedules. Bucknam will initially develop a clear and accurate citywide Sidewalk GIS layer that represents where known sidewalk locations are. This will require Bucknam to digitize sidewalk locations that will be represented by GIS polylines. This first effort will be to update the existing citywide sidewalk polyline layer that will in turn support our sidewalk inspections.
Our staff will utilize the City’s available street segmentation data within MicroPAVER to establish the sidewalk segmentation, survey and schedule. Our staff will utilize additional data such as the City’s GIS centerline, aerial imagery and other viable GIS data that will assist our sidewalk GIS layer development and field operations.
All sidewalk inventory and distress data will be collected through the use of our hand-held GPS units.
Through the use of ArcPad, our Trimble GPS unit utilizes a data capture screen to record all inventory and inspection data define by the scope of work. Once the street/pavement segmentation has been assessed and verified, the inspection of approximately 70.1 miles of sidewalk segments will be performed (based on 80% of each segment having sidewalk on both sides). Bucknam will coordinate the sidewalk and pavement management surveys together for efficiency.
Based on previous sidewalk management programs performed for various cities, we have provided the list below demonstrating typical layers and attributes collected during sidewalk inspections:
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Sidewalk Distresses Attributes / GIS Data
• House Number – House number closest to distress, if
applicable;
• Street Name – Street Name;
• Surface Type – i.e. AC, Brick, Paver, PCC;
• Distress Location – sidewalk, C&G, Ramp;
• Vertical displacement – i.e. 1/2” to 1”, 1” to 2”, 2” or higher
o Displacement ranges – Defined by City’s current
Sidewalk Inspection Program (may be changed
per discussions with City);
o Distress Type – i.e. joint faulting, linear cracking, divided slab, buckled slab;
• Sensitive Location – Schools, Parks, City Facilities, etc.
Locations to be determined by City Staff;
• Tree – If distress is caused by a tree;
• Length / Slab count – Length of distress, # of slabs, if applicable; • Recommended Work – i.e. Grind, Ramp, Replace;
• MicroPAVER ID – Unique ID that corresponds with PMP Street GIS Layer; • Any hazards or sidewalk damage that may not meet requirements of repair to be noted for future inspections;
• Comments – Field for any necessary comments about the distress.
Our use of mobile GPS Handheld/Tablet units allows our staff to collect sidewalk data with the City of South El Monte’s database live in the field. At the end of the day all electronic data is transferred to our office for quality control and management. We can produce Sidewalk GIS Distress locations at any time during the survey for City QC and/or review.
Section Distress and Condition Reporting
At 50% and 100% Bucknam will generate Sidewalk / ADA Ramp Location / Distress Reports for City staff review. The City and our staff will review these reports to ensure that all inventory data is correct and the project is running smoothly.
Deliverable: Defined Priority criteria, updated citywide Sidewalk GIS layer, Citywide Sidewalk Distress Reports, Recommended repairs; GIS Distress/Deficiency maps.
Schedule
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Project Schedule
Our Critical Path Method (CPM) project schedule shows each major task identified in our scope of work, as well as quality control milestones and meetings. Our Project Manager will oversee all aspects of the project schedule including annual accountability, adjustment and management as well as support the project schedule and management through weekly updates and internal project meetings.
See key “annual” milestone dates from the project schedule above:
• PMP Project Kickoff – August 3, 2026
• Survey Start and Completion – August, 2026 thru October, 2026 • Delivery of draft PMP – late mid-October, 2026
• City comments returned to Consultant – early November, 2026 • Delivery of City CIP Final Report – November, 2026
o South El Monte CIP data/Final Report, reporting and revenue projections will be submitted by early Nov. 2026
• All pavement and GIS data pertinent to the project deliverables will be submitted with the Final PMP report, Nov. 2026
Project Team, Key Personnel, and Resumes
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Project Team – Key Staff
The Bucknam pavement management team’s local
agency expertise is demonstrated through:
Our experience of managing pavement
projects over the past twenty-eight years;
Assisting cities comply with Orange County
PMP Propositions/Measures;
Implementing MicroPAVER/StreetSaver
throughout Southern California;
Extensive Orange, Los Angeles, San Diego
and Inland Empire PMP project
management experience;
Our understanding of public works projects from the “City” side through City Engineer and Public Works Director experience;
Implementing a realistic, proactive and sustainable PMP methodology that matches your agencies needs and goals.
Bucknam will bring our extensive experience to the City of South El Monte by building upon our knowledge and understanding of your PMP goals. Mr. Peter Bucknam’s pavement team includes ten (10) dedicated, qualified managers, GIS and field technicians that have served under his management for over twenty-eight years on PMP projects. Our office is located in Oceanside, CA 3548 Seagate Way, Suite 230.
His team of inspectors will update your PMP through sound Army Corps of Engineers – ASTM inspection methodologies. Mr. Bucknam’s experience covers the implementation and management of infrastructure management programs that exceed 65,500 miles of pavement for more than 75 cities and 750+ PMP projects.
Bucknam – Key Project Team / Experience
PETER BUCKNAM, Project Manager, will be responsible for the day-to-day management, daily performance of the project, conditional review and provide budgetary modeling / analysis. He has managed 750+ pavement management projects over the past 28 years in the Southern California region and will be the Project Manager for South El Monte’s PMP project.
Within this time, he has served as project manager for over seventy-five agencies in Southern California. Peter is committed to the project from the receipt of the notice-to-proceed through completion and furthermore he is a PMP software trainer on MicroPAVER/StreetSaver and has performed numerous training sessions for local agencies. He has performed numerous training All key personnel will be
available for the project; no
key person designated to
this project will be removed
or replaced w/o prior
written consent from the
City.
Project Team, Key Personnel, and Resumes
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workshops covering software’s such as MicroPAVER and StreetSaver. He brings his expertise to cities through converting, implementing, updating, and enhancing pavement management programs; this covers 20+ years (18 with Bucknam Infrastructure Group, 5 with Bucknam & Associates and 5 with Berryman and Henigar).
For example, Mr. Bucknam recently completed and provided a 10-yr Pavement Management Plan for the Orange County Transportation Authority (OCTA) which covered all 35 local agencies datasets, PCI evaluations, unit cost/annual revenue allocations and GIS. A Countywide evaluation that projected PMP needs for each agency and the County itself through 2032! Mr. Bucknam will bring new, fresh and proactive recommendations to this project and will identify realistic program management and fiscal goals to assist the City in its upcoming CIP.
South El Monte will continue to receive recommendations that are achievable, rather than unrealistic.
STEVE BUCKNAM, P.E., Principal-in-Charge, will be responsible for the overall performance of the project and will provide quality assurance review. Mr. Steve Bucknam is a licensed Civil Engineer (LIC #20903) and will oversee all tasks for this project. Mr. Bucknam is a former Deputy City Manager for Public Works and City Engineer of Norwalk, and City Engineer in Arcadia and Pacifica, California. He has over 45 years of professional experience and has managed street maintenance, reconstruction and improvement programs. He has developed and administered Street maintenance and improvement programs in those cities as well as the City of Newport Beach where he served as Design Division head.
AARON SUTTON, GIS Manager, will oversee all GIS and PMS data migration prior and during the project. He drives all GIS creation, PMS mapping, editing and deliverables for the project and is our key staffer for the ArcGIS Online web-hosting services that we provide. Mr. Sutton has been involved with over 65 pavement management projects within Orange, Los Angeles, San Bernardino, Riverside, San Diego counties.
CADE BUCKNAM, Lead Field Technician, will be the lead field surveyor for this project. His responsibilities will include scheduling, quality control, surveying, training and working with our management staff to ensure the updated PMP database is complete. He has been involved with over 50 pavement management projects and brings his wealth of PMP inspection, GIS and software experience to this project.
Cade is a certified OCTA/ASTM D6433 inspector thru 2027.
AARON COHODAS, Field Technician, will be a supportive field surveyor for this project. His responsibilities will include surveying, quality control, and working with our management staff to ensure the updated PMP database is complete. Mr. Cohodas has been involved with over 90 pavement management projects and brings his wealth of PMP software, GIS and inspection experience to this project. Aaron is a certified ASTM D6433-20 inspector thru 2027.
Project Team, Key Personnel, and Resumes
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CHRIS CAMPBELL, Field Technician, will be a supportive field surveyor for this project. His responsibilities will include surveying, quality control, and working with our management staff to ensure the updated PMP database is complete. Mr. Campbell has been involved with over 25 pavement management projects and brings his wealth of PMP software, GIS and inspection experience to this project. Chris is a certified OCTA/ASTM D6433 inspector thru 2028.
Our team will be able to survey the entire 43.8 miles of pavement within three (3) weeks’ time due to our familiarity with the South El Monte PMP network, experience, availability and man-power.
In case of heavy rain that can potentially delay scheduled street inspections, our team includes two (2) additional certified PMP inspectors that can be added to our Field Technician team above, if necessary.
Team Resumes on the following pages
Peter J. Bucknam / Project Manager
Director of Infrastructure Management – GIS
EDUCATION
B.A., Geography – Urban Planning, San Diego State University, 1997
PROFESSIONAL DATA
Member, American Public Works Association
Member, Maintenance Superintendents Association
Chair, Transportation Committee, Inland Empire Report Card (ASCE) – 2005/06 & 2008/09 Co-Chair, Member APWA Committee for Street and Technology 2003-2015 Certificate of Professional Development – ASTM D6433-18; MicroPAVER Certificate of Completion – OCTA MicroPAVER / StreetSaver Distress Training (2011 thru 2026) NASSCO – Certificate, National Pipeline Assessment Certification Program (PACP)
QUALIFICATIONS / EXPERIENCE OVERVIEW
Peter Bucknam is an expert in infrastructure project management, pavement management program (PMP), PMP-GIS planning, resource management, implementation and long-term program management. He has over twenty-five years’ experience in the area of infrastructure asset management and Geographic Information Systems. Mr. Bucknam has managed a wide range of Pavement Management infrastructure project tasks including the collection and input of PMP - ROW conditional survey data, preparation of Public Works capital improvement program projections and reports, infrastructure/software need assessments, GIS/GPS data collection, data conversion and quality control.
Mr. Bucknam has performed infrastructure management services to over 100+ local agencies and is currently serving as project manager for numerous pavement management programs throughout Southern California.
He has personally served as project manager for 750+ PMP projects throughout Riverside, San Diego, San Bernardino, Orange and Los Angeles counties. He has worked with over 20 San Diego/Inland Empire County cities, 36 of the 88 Los Angeles cities and he is currently working with 21 of the 35 Orange County agencies regarding Measure M2 StreetSaver/MicroPAVER compliance.
His project level and management experience covers: pavement/sidewalk management, ArcGIS Online infrastructure app development/use, Traffic Control Device Inventories (TCDI), GIS implementation, Traffic Signal surveys, Right-of-Way (ROW) surveys, and ADA survey/compliance. In managing over 750+ infrastructure projects in the past twenty-eight years, Mr. Bucknam has used a diverse amount of software to assist local agencies implement infrastructure management programs and GIS solutions. These programs include MicroPAVER, MTC StreetSaver, MyRoads®, Zoom’s GPSVision, CartéGraph, ESRI products, Crossroads, Lucity, Energov, Spillman, GBA Master Series, and MapInfo.
Prior to joining Bucknam Infrastructure Group, Inc., Mr. Bucknam served as Director of Infrastructure Management-GIS with an Engineering consulting firm where he managed numerous public works infrastructure/ROW projects ranging from surveying, maintenance life-cycles, cost & benefit analysis, financing and construction cost estimating. This included researching, surveying, converting and implementing multiple phase pavement management projects which provided better management practices, data efficiencies and GIS functionality within local governments and maintenance facilities. In addition, he provided technical (software) support for the on-going citywide PMP projects as well as developing capital improvement plans/budgets for integrating Tablet-GIS data management functionality into future maintenance efforts.
SAMPLE OF PETER BUCKNAM’S PROJECT MANAGEMENT EXPERIENCE (1997-2026) • 2026 Pavement Management Program, City of Westminster • 2026 Sign Management Program, City of Garden Grove
• 2025-30 Pavement Management Program, City of Ontario
• 2026 Pavement Management Program, City of Covina
• 2026 Pavement Management Program, City of Placentia
• 2026 Pavement Management Program, City of Orange
• 2026 Pavement Management Program, City of Costa Mesa
• 2026 Pavement Management Program, City of Huntington Beach • 2026 Pavement Management Program, City of Los Alamitos • 2026 Pavement Management Program, City of Placentia
• 2026 Pavement Management Program, City of Fullerton
• 2026 Pavement Management Program, La Cresta (POA)
• 2026 Pavement Management Program, Del Lago (HOA)
• 2026 Pavement Management Program, City of Laguna Beach • 2025 Pavement Management Program, City of Garden Grove • 2025 Pavement Management Program, City of Buena Park
• 2025 Pavement Management Program, City of Redlands
• 2025 Pavement Management Program, City of Vista
• 2025 Pavement Management Program, City of Culver City • 2025 Pavement Management Program, City of Rosemead
• 2025 Pavement Management Program, City of Laguna Hills • 2025 GIS Support Services, City of Alhambra
• 2025 GIS Support Services, City of Duarte
• 2025 Sidewalk Mngt. / GIS Support Services, City of Lakewood • 2025 Pavement Management Program, City of Fullerton
• 2024-25 Pavement Management Program (Alleys/Parking Lots), City of Garden Grove • 2025 GIS Services Program (Potholes, Signs, Sidewalks, City of Lakewood • 2025 Pavement Management Program, City of Lawndale
• 2025 Pavement Management Program, City of El Segundo
• 2025 Pavement Management Program, City of Covina
• 2025 Pavement Management Program, City of Bell
• 2025 Pavement Management Program, City of Big Bear Lake • 2025 Pavement Management Program/GIS Services, City of Fountain Valley • 2025 Pavement Management Program, City of Signal Hill • 2025 Pavement Management Program, City of Barstow
• 2025 Pavement Management Program, City of Murrieta
• 2025 Pavement Management Program, City of Diamond Bar • 2025 Pavement Management Program, City of Cypress
• 2025 Pavement Management Program, City of Brea
• 2025 Pavement Management Program, City of Santa Ana
• 2025 Pavement Management Program, City of Tustin
• 2025 Pavement Management Program, City of Glendora
• 2025 Pavement Management Program, City of San Juan Capistrano • 2025 Pavement Management Program, City of Perris
• 2025 Pavement Management Program, City of La Habra
• 2024 Pavement Management Program, City of Temple City • 2024 Pavement Management Program, City of Bellflower
• 2024 Pavement Management Program, City of Downey
• 2024 Pavement Management Program, City of Rancho Palos Verdes • 2024 Pavement Management Program, City of Menifee
• 2024 GIS Support Services, City of Alhambra
• 2024 GIS Support Services, City of Duarte
• 2024 Sidewalk Mngt. / GIS Support Services, City of Lakewood • 2024 Pavement Management Program, City of Vista
• 2024 Pavement Management Program, Indian Wells CC, FAMD #1 • 2022-27 Pavement Management Program, City of Indian Wells • 2024 Pavement Management Program, City of Monrovia
• 2024 Pavement Management Program, City of Whittier
• 2024 Pavement Management Program, City of Vista
• 2024-29 Pavement Management Program, City of Ontario
• 2019-24 Pavement Management Program, City of Ontario
• 2024-29 Sidewalk Management Program, City of Ontario (OMUC) • 2023 Sidewalk Management Program-Pilot Study, City of Ontario (OMUC) • 2024 Pavement Management Program, City of Gardena
• 2023-24 Sidewalk-ROW Management Program, City of Lakewood • 2024 Pavement Management Program, City of Manhattan Beach • 2023-24 Sidewalk Management Program, City of Fullerton • 2024 Pavement Management Program, City of La Palma
• 2023-24 GIS Enterprise Support Services, City of Fountain Valley • 2024 Pavement Management Program, City of Laguna Beach • 2024 Pavement Management Program, City of Westminster • 2024 Pavement Management Program, City of Norwalk
• 2024 Pavement Management Program, City of Buena Park
• 2024 Pavement Management Program, City of Duarte
• 2023 Pavement Management Program, City of Santa Ana
• 2023 Pavement Management Program, City of Orange
• 2023 Pavement Management Program, City of RSM
1 C. Stephen Bucknam, Jr., P.E., Principal-in-Charge
EDUCATION
B.S., Civil Engineering, Loyola University of Los Angeles, 1967 M.S., Environmental Engineering, Loyola University of Los Angeles, 1972
PROFESSIONAL DATA
Registered Professional Engineer, States of California (No.20903) and Washington (No.17310) California State Community College Teaching Credential
Fellow, American Society of Civil Engineers
Former, City Engineer,Deputy City Manager, City of Norwalk Member, Board of Directors – Urban Water Institute
Life Member, American Public Works Association
Member, Water Environment Foundation
Member, University of California Irvine, Civil&Environmental Engineering Affiliates Honorary Member, Chi Epsilon
EXPERIENCE OVERVIEW
Over forty years’ experience in the administration, management, planning, design and construction management of public works and development programs and projects including: water and wastewater projects, pavement management programs, transportation, drainage, including: program management, master planning, infrastructure planning and maintenance programming, environmentalstudies, street, highway, alley, storm drain, water and sewer system design, rate studies, emergency planning, facilities design, groundwater studies, wells, reservoirs, site studies, pump stations, lift stations, intergovernmental negotiations and agreements, hydrology, treatment facilities, building design, grants, regulatory permitting, system appraisals, R/W negotiations, acquisitions and documentation, project management, production control, operations studies, capital improvement programming and budgeting, hydroelectric projects, underground utilities, assessment districts, surveying, mapping, legal testimony to public boards, commissions and councils, and direction of technical advisory committees to joint powers agencies and water districts.
Transportation / Streets – Highways - Traffic
Served as Contract City Engineer for the City of Arcadia responsible for long range advanced planning of the City’s transportation engineering program. Directed the preparation of the City’s Transportation Master Plan which identified, consistent with the City’s General Plan the transportation related needs under these requirements so of AB 1600 nexus constraints.
Acted as Principal in charge over a Pacific Coast Highway (SR-1)/Newport Boulevard (SR-55) interchange, City of Newport Beach. Project involves a study of various alternatives, conventional and unconventional, for improvements to the existing interchange.
Restraints include limited right-of-way, environmental challenges (e.g., Newport channel bridge widening, "Arches" liquor store and restaurant property acquisition, and existing bridge aesthetics), and potential hazardous waste issues. Alternatives were evaluated and selected to include in the PSR. Included project coordination with various agencies and sub consultants, and oversight of concept geometries, cost estimating, and report preparation.
2 Conceptual study, Project Study Report, and Project Report for I-710/Firestone Boulevard interchange modification and Firestone Boulevard improvements for City of South Gate. Also involved a feasibility study which included preparation of a traffic study, conceptual plans for several types of interchanges, construction cost estimates, and preliminary Caltrans Project Study Report. Prepared ISTEA National Highway System funding application for authorization and appropriation. Coordination with Caltrans District 7.
Mr. Bucknam hasserved asthe working Principal/ Civil Engineer for all pavement management related projects that Bucknam has performed. This includes projects listed below:
• 2026 Pavement Management Program, City of Westminster • 2025-30 Pavement Management Program, City of Ontario
• 2026 Pavement Management Program, City of Covina
• 2026 Pavement Management Program, City of Placentia
• 2026 Pavement Management Program, City of Orange
• 2026 Pavement Management Program, City of Costa Mesa
• 2026 Pavement Management Program, City of Huntington Beach • 2026 Pavement Management Program, City of Los Alamitos • 2026 Pavement Management Program, City of Placentia
• 2026 Pavement Management Program, City of Fullerton
• 2026 Pavement Management Program, La Cresta (POA)
• 2026 Pavement Management Program, Del Lago (HOA)
• 2026 Pavement Management Program, City of Laguna Beach • 2025 Pavement Management Program, City of Garden Grove • 2025 Pavement Management Program, City of Buena Park
• 2025 Pavement Management Program, City of Redlands
• 2025 Pavement Management Program, City of Vista
• 2025 Pavement Management Program, City of Culver City • 2025 Pavement Management Program, City of Rosemead
• 2025 Pavement Management Program, City of Laguna Hills • 2025 GIS Support Services, City of Alhambra
• 2025 GIS Support Services, City of Duarte
• 2025 Sidewalk Mngt. / GIS Support Services, City of Lakewood • 2025 Pavement Management Program, City of Fullerton
• 2024-25 Pavement Management Program (Alleys/Parking Lots), City of Garden Grove • 2025 GIS Services Program (Potholes, Signs, Sidewalks, City of Lakewood • 2025 Pavement Management Program, City of Lawndale
• 2025 Pavement Management Program, City of El Segundo
• 2025 Pavement Management Program, City of Covina
• 2025 Pavement Management Program, City of Bell
• 2025 Pavement Management Program, City of Big Bear Lake • 2025 Pavement Management Program/GIS Services, City of Fountain Valley • 2025 Pavement Management Program, City of Signal Hill • 2025 Pavement Management Program, City of Barstow
• 2025 Pavement Management Program, City of Murrieta
• 2025 Pavement Management Program, City of Diamond Bar • 2025 Pavement Management Program, City of Cypress
Company Qualifications
City of South El Monte 4-1
Pavement Management Program 2026 Update
Firm Profile and Qualifications
Bucknam Infrastructure Group, Inc.
(est. 2011, CA S-Corporation) has a fullservice office in Southern California and is committed to building stronger
relationships with government organizations through frequent communication and team building. Our Project Manager has twenty-eight years of PMP management and delivery.
We build long-term partnerships with agencies that expect and require accuracy, efficiency, and integrity in all aspects of community services. Our experienced staff is committed to ensuring that immediate and long-term goals are met and are a top priority in the development of pavement management, infrastructure management, financial, geographic information systems (GIS), and facility management projects.
Our full-service Infrastructure Management - GIS Division provides comprehensive engineering and infrastructure/GIS management services, as well as database management, pavement / ROW field inspection services, and GIS automation / management.
Our extensive professional service offerings include:
Regarding Pavement Management Programs, our firm is currently assisting 75+ local agencies complying with Orange, Riverside, San Bernardino, LA and SD County’s pavement reporting requirements.
Regarding Pavement Management Programs, our firm is currently assisting 75+ SoCal local agencies comply with the County pavement reporting requirements. In addition to the extensive knowledge and experience of our infrastructure management professionals, Bucknam provides a broad scope of administrative, inspection, civil engineering, and GIS services to public agencies.
We look forward to working with you on your project. Our handpicked management professionals are committed to delivering quality services to the City. Our office is located in Oceanside, CA 3548 Seagate Way, Suite 230 (10 employees).
Company Qualifications
City of South El Monte 4-2
Pavement Management Program 2026 Update
Delineation of Bucknam Infrastructure Group’s Strengths As Bucknam approaches twenty-eight (28) years of pavement management experience, our firm is distinct and unique in the fact that we have continued to improve upon our long-term local agency client based throughout Los Angeles County. Building and establishing long-term client relationships through PMP management is a clear delineation of our professional services.
Bucknam’s experience and qualifications directly related to this project and other key delineation strengths include:
• 37 of 88 Los Angeles County local
agencies; 42% of LA County local
agencies (e.g. Pomona, Rosemead,
Temple City, Alhambra, South El
Monte, South Pasadena, Sierra
Madre, La Verne, Covina,
Whittier, Downey, Lawndale,
Manhattan Beach, Gardena,
Rancho Palos Verdes, Compton,
Lomita, Signal Hill, Lakewood,
South Gate, Culver City, Monrovia, Lynwood, Long Beach, etc.) • Providing PMP services for 20 of the 35 Orange County local agencies in the past two years (57%);
• 20 San Diego/Inland Empire local agencies;
• Bucknam now implements Cloud-based Artificial Intelligence (AI) Learning Technology to calculate pavement section AC/PCC True Area quantities; • Updating the South El Monte MyRoads® – PMP mapping (web-based access/use); requires no GIS software to view your PMP online (See Task 3.6 within Scope of Work); • Staff / Firm is certified through MTC and OCTA for use and management of MicroPAVER / StreetSaver respectively
o Bucknam is ASTM D6433 certified through OCTA until June, 2028 for PMP services/inspections to local agencies;
• Focused managers / field technicians that perform infrastructure management services at cost-competitive rates and deliver quality products; • Local presence (Oceanside office) allows our firm to be on-site within one hour to respond to South El Monte’s requests and needs;
• Proven Southern California PMP economic ROI regarding long-term Pavement CIP’s recommendations, implementation, maintenance applications and increased PCI’s
References
City of South El Monte 5-1
Pavement Management Program 2026 Update
Relevant PMP Project Experience
The following project experience presents our description of work, its relevance in completing similar projects for numerous other agencies, Proposition C / LA County METRO compliance, OCTA Measure M2 PMP compliance, PMP software training expertise, and the broad knowledge of our pavement project team. Our project team brings over 75 years of public/private engineering and data management experience to the City of South El Monte. This includes over 750+ PMP projects covering turn-key projects, simply training of Agency staff with pavement management methods, County Measure/Proposition compliancy, financial strategies and CIP’s.
Over the past twenty-seven (27) years, we have worked on numerous projects similar to South El Monte’s current PMP project. We have listed five (5) similar “long-term” pavement management projects that cover the same task descriptions as listed in your RFP:
Bucknam Infrastructure Group, Inc.
Citywide Pavement Management Program
City of Manhattan Beach (2024-25)
Mr. Gilbert Ramos, Associate Engineer – (310) 802-5362; 3621 Bell Avenue, Manhattan Beach, CA, 90266 [email protected]
Bucknam was recently selected for the 2024 PMP update that included City-wide pavement inspections for 100 miles of Arterial/Collector, Local and pedestrian-oriented streets. Mr. Peter Bucknam served as the City’s consultant PMP Project Manager. Our pavement inspections will also be utilized to evaluate the ride quality for all vehicle streets.
Bucknam updated the City’s StreetSaver “decision tree” that will be used to generate pavement recommendations that match current fiscal year maintenance/rehabilitation approaches/City practices. These efforts led to the implementation of the Manhattan Beach MyRoads® account that we have shown actively working in Task 4.7 within our scope of work.
Citywide Pavement Management Program
City of Rancho Palos Verdes (2013-25)
Mr. James O’Neill, Project Manager – (310) 544-5247; 30940 Hawthorne Blvd., RPV, CA, 90275 [email protected]
Bucknam was recently selected for the 2025 PMP update that also includes ROW asset collection (sidewalks, C&G, guardrails, etc.) Historically, Bucknam was contracted with the City in 2013 for Pavement Management services and has performed triennial PMP updates for the past 12 years. Mr. Peter Bucknam has served as the City’s consultant PMP Project Manager since 2013. Our annual pavement inspection and
References
City of South El Monte 5-2
Pavement Management Program 2026 Update
reporting services for the City’s Engineering and Operations PMP has led to yearly, proactive increases in both the City’s Arterial and Local conditions.
Citywide Pavement Management Program-GIS, City of Duarte (2018-2024) Mr. Stephanie Sandoval, (626) 357-7931 x233; 1600 Huntington Dr., Duarte, CA 91010 ([email protected])
Since 2018 Bucknam has been contracted to perform citywide infrastructure management inventories for the City of Duarte (six years). Our initial project consisted of a complete turn-key effort in “re-segmenting” the City’s pavement management network, converting previous PCI inspection data, performing an ASTM D6433 based survey, implementation of PMP software and PMP-GIS integration. Additionally, our services included a complete evaluation of the City’s PMP budget, short-term and long-term budgetary analysis (Actual, Maintain and Recommended budgets) and GIS services that linked the City’s PMP database to the City’s GIS enterprise. Our team just contracted with the City for 2024 PMP services; additionally, since 2019 Bucknam has provided annual GIS support services to the City.
Citywide Pavement Management Program
City of Huntington Beach (FY 2001-2025)
Mr. Joe Fuentes, City Engineer – (714) 374-1732
17371 Gothard St, Huntington Beach, CA 92647 [email protected] Over the past twenty-five years, our Project Manager (Mr. Peter Bucknam) has overseen/managed twelve (12) biennial PMP projects for the City of Huntington Beach. The City has over 450 miles of streets to maintain and proactive manage. Bucknam has assisted the City staff with biennial surveys, GIS development and PMP compliance reporting resulting in annual PCI increases and reduction of deferred overlay maintenance. Bucknam was recently awarded the FY 2023-24 PMP update where we will be performing 315 miles of survey (MPAH + a portion of their Locals), implementation of MyRoads® web-portal PMP and the use of IBM-Watson SF calculations for AC / PCC pavements. Bucknam utilizes the most current ESRI ArcGIS Pro, ArcGIS Online, ArcMap for the management of the City’s pavement, sidewalk and utility datasets; as well as within Bucknam’s MyRoads® GIS web-portal app.