DocuSign Envelope ID: D6D03502-8CSE-4590-B381-C19A59483F94
CONTRACT/AGREEMENT APPROVAL FORM
Date: 12/8/21
Name of Contract/Agreement First Amendment to Consulting Services Agreement Originating Department/Responsible Person, ext.
Vendor
Public Works / Marissa Garren, ext. 8549
Precision Concrete Cutting
Routing Instructions: Eunejune > City Attorney > City Clerk> Marissa at PW TYPE OF CONTRACT: Consulting / Design Professional
Renewal Time Extension
Have there been any changes to the Contract Template? ~No []Yes CONTRACT AMOUNTS: Specified Amount(s) indicated below
Original
1st Amendment
2nd Amendment
APPROVAL AUTHORITY:
DATE AMOUNT
10/15/19
10/14/20
263,277.00
0.00 City Manager
INSURANCE REQUIREMENTS:
3rd Amendment
4th Amendment
TOTAL
DATE AMOUNT
263,277.00
Waivers requested ~No CYes (If Yes, Route to Risk Manager for signature first) BUDGETARY: [i]lncluded in Budget (Simpler report attached showing amounts) Amount Project String Accounting String
ATTACHMENTS:
[i] Agreement and all Exhibits [i] Resolution (all contracts over $150k) D SIR Questionnaire [i]certificate of Insurance, naming City of South San Francisco as an Additional Insured DocuSigned by:
DEPARTMENT HEAD ACKNOWLEDGEMENT:
The contract, amendments, exhibits, insura ,. nmnts/waivers and attachments have been reviewed and included.
RISK MANAGER APPROVAL OF INSURANCE WAIVER:
CITY ATTORNEY APPROVAL OF ENTIRE AGREEMENT: Cf
DocuSigned by:
Cwn.- lAi 951A604F45D4468 ...
Comments:
D Approval of Agreement D Approval of Insurance OAdd Agreement to Contract Tracker ASSISTANT CITY MANAGER'S APPROVAL:
FINAL APPROVAL:
(Only if amount is over $25,000)
~ DocuSigned by:
lltil:t- f t4n1t
CITY CLERK: sss21341s1cA4@ity Manager
D Please attest, keep a copy for your files, and return to Originating Department D Please upload to Laserfiche and return to Originating Department COPY SENT TO VENDOR:
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94
FIRST AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SOUTH
SAN FRANCISCO AND PRECISION CONCRETE CUTTING
THIS FIRST AMENDMENT TO THE CONSUL TING SERVICES AGREEMENT is made at South San Francisco, California, as of October 14; 2020 by and between THE CITY OF SOUTH SAN FRANCISCO ("City"), a municipal corporation, and Precision Concrete Cutting ("Contractor"), (sometimes referred together as the "Parties") who agree as follows:
RECITALS
A. On October 15, 2019, City and Contractor entered that certain Consulting Services Agreement ("Agreement") whereby Contractor agreed to perform assessment and inventory of city sidewalks, streetlight poles, and traffic signal poles. A true and correct copy of the Agreement and its exhibits is attached as Exhibit A.
B. City and Contractor now desire to amend the Agreement.
NOW, THEREFORE, for and in consideration of the promises and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, City and Contractor hereby agree as follows:
I . All terms which are defined in the Agreement shall have the same meaning when used in this Amendment, unless specifically provided herein to the contrary.
2. Section I: Term. The October 15, 2020 end date for the term of services identified in Section
1.1 of the Agreement is hereby replaced with December 31, 2024.
All other terms, conditions and provisions in the Agreement remain in full force and effect. If there is a conflict between the terms of this Amendment and the Agreement, the terms of the Agreement will control unless specifically modified by this Amendment. [SIGNATURES ON THE FOLLOWING PAGE]
Dated: _______________ _
CITY OF SOUTH SAN FRANCISCO
6852134787CA40B ...
Mike Futrell
City Manager
Approved as to Form:
DocuSigned by:
By: C1Aivi, l.ru
~Af\ffil'lffly
PRECISION CONCRETE CUTTING
ilDocuSIQned by:
By:~~8A~
Joseph Ortega
Vice President
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 ,------,
I DATE (MM/DD/YYYY) ACORD8
~ CERTIFICATE OF LIABILITY INSURANCE 12/3/2021
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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(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 ~~:i~cT Select Commercial
Assurance, a Marsh & McLennan Agency LLC company r4~~N~~ i=.• 1, (847) 797-5700 IFAX 20 N Martin gale Road IA/C Nol: (847) 440-9133
Suite 100 ~~l~~ss: [email protected]
Schaumburg IL 60173 INSURER($) AFFORDING COVERAGE NAIC # INSURER A : National Fire Insurance Co. of 20478
INSURED PRECEMP-02 INSURER B : Transportation Insurance Compa 20494 Precision Emprise, LLC INSURER c : Continental Casualty Co 20443 OBA Precision Concrete Cutting 335 Beach Road INSURER D : Berkshire Hathawav Homestate I 20044 Burlingame CA 9401 0 INSURER E : Columbia Casualtv Co 31127 INSURER F :
COVERAGES CERTIFICATE NUMBER: 1633362077 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 ADDL SUBR POLICYEFF POLICY EXP
LTR TYPE OF INSURANCE •~~n =•n POLICY NUMBER /MM/DD/YYYYI /MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY y 6076088378 4/30/2021 4/30/2022 EACH OCCURRENCE $ 1,000,000 - D CLAIMS-MADE [8J OCCUR UAMAL>E TO RENTED
PREMISES /Ea occurrence\ $ 100,000
MED EXP (Any one person) $ 15,000 -
PERSONAL & ADV INJURY $ 1,000,000 -
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ~ POLICY [8J ~r& D Loc PRODUCTS · COMP/OP AGG $ 2,000,000 OTHER: $
B AUTOMOBILE LIABILITY 6078588084 4/30/2021 4/30/2022 COMBINED SINGLE LIMIT $ 1,000,000 /Ea accident\ X ANY AUTO BODILY INJURY (Per person) $ - OWNED - SCHEDULED G~.~-.. BODILY INJURY (Per accident) $ - AUTOS ONLY AUTOS
O::!F0s'L68 .. X HIRED X NON-OWNED iP~~~~~r,,';RAMAGE $ AUTOS ONLY AUTOS ONLY $
C X UMBRELLA LIAB H OCCUR 6076088364 4/30/2021 4/30/2022 EACH OCCURRENCE $ 3,000,000 - EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED I X I RETENTION $ 1 n ~M $
D WORKERS COMPENSATION y PRWC229906 4/30/2021 4/30/2022 X I ; ,i:f TuTE I I OTH- ER AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE ~ N / A E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLU DED?
(Mandatory In NH) E.L. DISEASE • EA EMPLOYEE $ 1,000,000 ~i~~ t~t~ o1~PERATIONS below E.L. DISEASE - POLICY LIMIT $1 ,000,000 A Inland Marine 6076088378 4/30/2021 4/30/2022 Limit: $65,000 E Professional Liability CE0679006970 4/30/2021 4/30/2022 0 cc: $1 ,000,000 Agg: $2,000,000 E Pollution Liability CSB679036549 4/30/2021 4/30/2022 0cc: $1 ,000,000 Agg: $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) Workers Compensation and Employers' Liability: Any Proprietor/Partner/Executive Officer/Member, as listed on the policy, (Marc Cussenot) is excluded.
It is agreed that the following are added as Additional Insured, when required by written contract. on the General Liability on a primary basis with respect to operations performed by the named insured in connection with this project:
City of South San Francisco and its officers , employees, agents, and volunteers A Waiver of Subrogation in favor of the Additional Insureds applies to the Worker's Compensation policy only, when required by written contract and where allowed by law.
CERTIFICATE HOLDER 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.
City of South San Francisco
400 Grand Ave. t,;::~JJ~~ South San Francisco CA 94080
I
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: D6D03502-8C5E-4590-8381 -C 19A59483F94 -
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. If any other endorsement attached to this policy amends any provision also amended by this endorsement, then that other endorsement controls with respect to such provision, and the changes made by this endorsement with respect to such provision do not apply.
TABLE OF CONTENTS
1. Additional Insureds
2. Additional Insured - Primary And Non-Contributory To Additional lnsured's Insurance
3. Bodily Injury - Expanded Definition
4. Broad Knowledge of Occurrence/ Notice of Occurrence
5. Broad Named Insured
6. Broadened Liability Coverage For Damage To Your Product And Your Work
7. Contractual Liability - Railroads
8. Electronic Data Liability
9. Estates, Legal Representatives and Spouses
10. Expected Or Intended Injury - Exception for Reasonable Force
11. General Aggregate Limits of Insurance - Per Project
12. In Rem Actions
13. Incidental Health Care Malpractice Coverage
14. Joint Ventures/Partnership/Limited Liability Companies
15. Legal Liability - Damage To Premises / Alienated Premises / Property In The Named lnsured's Care, Custody or Control
16. Liquor Liability
17. Medical Payments
18. Non-owned Aircraft Coverage
19. Non-owned Watercraft
20. Personal And Advertising Injury - Discrimination or Humiliation
21. Personal And Advertising Injury - Contractual Liability
22. Property Damage - Elevators
23. Supplementary Payments
24. Unintentional Failure To Disclose Hazards
25. Waiver of Subrogation - Blanket
26. Wrap-Up Extension: OCIP CCIP, or Consolidated (Wrap-Up) Insurance Programs CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30 / 2021
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-8381 -C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
1. ADDITIONAL INSUREDS
a. WHO 15 AN INSURED is amended to include as an Insured any person or organization described in paragraphs A. through H. below whom a Named Insured is required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part; and (2) was executed prior to:
(a) the bodily injury or property damage; or
(b) the offense that caused the personal and advertising injury, for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or (2) coverage broader than required by such contract or agreement, and in no event broader than that described by the applicable paragraph A. through H. below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controlling Interest
Any person or organization with a controlling interest in a Named Insured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury arising out of:
1. such person or organization's financial control of a Named Insured; or
2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of Insured Premises
A co-owner of a premises co-owned by a Named Insured and covered under this insurance but only with respect to such co-owner's liability for bodily injury, property damage or personal and advertising injury as co-owner of such premises.
C. Lessor of Equipment
Any person or organization from whom a Named Insured leases equipment, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named lnsured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease.
D. Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such land, provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. The CNA74705XX (1-15)
VALLEY FORGE I NSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6 07 60 88 3 7 8
Endorsement No: 2
Effective Date: o 4 /3 o / 2 021
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94 -
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
E. Lessor of Premises
An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate manager, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided that the occurrence giving rise to such bodily injury or property damage, or the offense giving rise to such personal and advertising injury, takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
F. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's liability for bodily injury, property damage or personal and advertising injury arising out of the Named lnsured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
G. State or Governmental Agency or Subdivision or Political Subdivisions - Permits A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodily injury, property damage or personal and advertising injury arising out of:
1. the following hazards in connection with premises a Named Insured owns, rents, or controls 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, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or b. the construction, erection, or removal of elevators; or c. the ownership, maintenance or use of any elevators covered by this insurance; or
2. the permitted or authorized operations performed by a Named Insured or on a Named lnsured's behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily injury, property damage or personal and advertising injury arising out of operations performed for the state or governmental agency or subdivision or political subdivision; or b. Bodily injury or property damage included within the products-completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the Named Insured to add the governmental entity as an additional insured.
H. Trade Show Event Lessor
1. With respect to a Named lnsured's participation in a trade show event as an exhibitor, presenter or displayer, any person or organization whom the Named Insured is required to include as an additional insured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury caused by:
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECIS I ON EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04 / 30 / 202 1
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its pemiission.
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
a. the Named lnsured's acts or omissions; or
b. the acts or omissions of those acting on the Named lnsured's behalf, in the performance of the Named lnsured's ongoing operations at the trade show event premises during the trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within the products-completed operations hazard.
2. ADDITIONAL INSURED • PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and noncontributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess of any other insurance available to such person or organization.
3. BODILY INJURY - EXPANDED DEFINITION
Under DEFINITIONS, the definition of bodily injury is deleted and replaced by the following:
Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical injury, sickness or disease.
4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is amended to add the following provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer's authorized representative notice of an occurrence, offense or claim only when the occurrence, offense or claim is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or an employee designated by any of the above to give such notice.
B. NOTICE OF OCCURRENCE
The Named lnsured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give the Insurer notice of an occurrence, offense or claim and that failure is solely due to the Named lnsured's reasonable belief that the bodily injury or property damage is not covered under this Coverage Part. However, the Named Insured shall give written notice of such occurrence, offense or claim to the Insurer as soon as the Named Insured is aware that this insurance may apply to such occurrence, offense or claim.
5. BROAD NAMED INSURED
WHO IS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4. below, any organization in which a Named Insured has management control:
a. on the effective date of this Coverage Part; or
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04 / 30/2021
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 = iiiiiiii
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
b. by reason of a Named Insured creating or acquiring the organization during the policy period, qualifies as a Named Insured, provided that there is no other similar liability insurance, whether primary, contributory, excess, contingent or otherwise, which provides coverage to such organization, or which would have provided coverage but for the exhaustion of its limit, and without regard to whether its coverage is broader or narrower than that provided by this insurance.
But this BROAD NAMED INSURED provision does not apply to:
(a) any partnership, limited liability company or joint venture; or (b) any organization for which coverage is excluded by another endorsement attached to this Coverage Part.
For the purpose of this provision, management control means:
A. owning interests representing more than 50% of the voting, appointment or designation power for the selection of a majority of the Board of Directors of a corporation; or B. having the right, pursuant to a written trust agreement, to protect, control the use of, encumber or transfer or sell property held by a trust.
4. With respect to organizations which qualify as Named Insureds by virtue of Paragraph 3. above, this insurance does not apply to:
a. bodily injury or property damage that first occurred prior to the date of management control, or that first occurs after management control ceases; nor
b. personal or advertising injury caused by an offense that first occurred prior to the date of management control or that first occurs after management control ceases.
5. The insurance provided by this Coverage Part applies to Named Insureds when trading under their own names or under such other trading names or doing-business-as names (dba) as any Named Insured should choose to employ.
6. BROADENED LIABILITY COVERAGE FOR DAMAGE TO YOUR PRODUCT AND YOUR WORK A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusions k. and I. and replace them with the following:
This insurance does not apply to:
k. Damage to Your Product
Property damage to your product arising out of it, or any part of it except when caused by or resulting from :
(1) fire;
(2) smoke;
(3) collapse; or
(4) explosion.
I. Damage to Your Work
Property damage to your work arising out of it, or any part of it and included in the products-completed operations hazard.
This exclusion does not apply:
(1) If the damaged work, or the work out of which the damage arises, was performed on the Named lnsured's behalf by a subcontractor; or
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE , LLC
Policy No: 6 0 7 6 088 3 78
Endorsement No: 2
Effective Date: 0 4 /30/20 2 1
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Offioe, Inc., wrth its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
(2) If the cause of loss to the damaged work arises as a result of:
(a) fire;
(b) smoke;
(c) collapse; or
(d) explosion.
B. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $100,000 is the most the Insurer will pay under Coverage A for the sum of damages arising out of any one occurrence because of property damage to your product and your work that is caused by fire, smoke, collapse or explosion and is included within the product-completed operations hazard. This sublimit does not apply to property damage to your work if the damaged work, or the work out of which the damage arises, was performed on the Named lnsured's behalf by a subcontractor.
C. This Broadened Liability Coverage For Damage To Your Product And Your Work Provision does not apply if an endorsement of the same name is attached to this policy.
7. CONTRACTUAL LIABILITY- RAILROADS
With respect to operations performed within 50 feet of railroad property, the definition of insured contract is replaced by the following:
Insured Contract means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to a Named Insured or temporarily occupied by a Named Insured with permission of the owner is not an insured contract; b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to the Named lnsured's business (including an indemnification of a municipality in connection with work performed for a municipality) under which the Named Insured assumes the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage;
(2) Under which the Insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities.
8. ELECTRONIC DATA LIABILITY
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30 / 20 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94 -iiiiiia
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusion p. Electronic Data and replace it with the following:
This insurance does not apply to:
p. Access Or Disclosure Of Confidential Or Personal Information And Data-related Liability Damages arising out of:
(1) any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data that does not result from physical injury to tangible property.
However, unless Paragraph (1) above applies, this exclusion does not apply to damages because of bodily injury.
This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relation expenses or any other loss, cost or expense incurred by the Named Insured or others arising out of that which is described in Paragraph (1) or (2) above.
B. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $100,000 is the most the Insurer will pay under Coverage A for all damages arising out of any one occurrence because of property damage that results from physical injury to tangible property and arises out of electronic data.
C. The following definition is added to DEFINITIONS:
Electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.
D. For the purpose of the coverage provided by this ELECTRONIC DATA LIABILITY Provision, the definition of property damage in DEFINITIONS is replaced by the following:
Property damage means:
a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it; or
c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate electronic data, resulting from physical injury to tangible property. All such loss of electronic data shall be deemed to occur at the time of the occurrence that caused it.
For the purposes of this insurance, electronic data is not tangible property.
E. If Electronic Data Liability is provided at a higher limit by another endorsement attached to this policy, then the $100,000 limit provided by this ELECTRONIC DATA LIABILITY Provision is part of, and not in addition to, that higher limit.
9. ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES
The estates, heirs, legal representatives and spouses of any natural person Insured shall also be insured under this policy; provided, however, coverage is afforded to such estates, heirs, legal representatives, and spouses only for CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/202 1
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C 19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
claims arising solely out of their capacity or status as such and, in the case of a spouse, where such claim seeks damages from marital community property, jointly held property or property transferred from such natural person Insured to such spouse. No coverage is provided for any act, error or omission of an estate, heir, legal representative, or spouse outside the scope of such person's capacity or status as such, provided however that the spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership Named Insureds are Insureds with respect to such spouses' acts, errors or omissions in the conduct of the Named lnsured's business.
10. EXPECTED OR INTENDED INJURY-EXCEPTION FOR REASONABLE FORCE Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace it with the following:
This insurance does not apply to:
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. 11 . GENERAL AGGREGATE LIMITS OF INSURANCE - PER PROJECT A. For each construction project away from premises the Named Insured owns or rents, a separate Construction Project General Aggregate Limit, equal to the amount of the General Aggregate Limit shown in the Declarations, is the most the Insurer will pay for the sum of:
1. All damages under Coverage A, except damages because of bodily injury or property damage included in the products-completed operations hazard; and
2. All medical expenses under Coverage C,
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, nor the Construction Project General Aggregate Limit of any other construction project.
B. All:
1. Damages under Coverage B, regardless of the number of locations or construction projects involved;
2. Damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing operations at a single construction project, except damages because of bodily injury or property damage included in the products-completed operations hazard; and
3. Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing operations at a single construction project,
will reduce the General Aggregate Limit shown in the Declarations.
C. The limits shown in the Declarations for Each Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to apply, but will be subject to either the Construction Project General Aggregate Limit or the General Aggregate Limit shown in the Declarations, depending on whether the occurrence can be attributed solely to ongoing operations at a particular construction project.
D. When coverage for liability arising out of the products-completed operations hazard is provided, any payments for damages because of bodily injury or property damage included in the products-completed operations hazard will reduce the Products-Completed Operations Aggregate Limit shown in the Declarations, regardless of the number of projects involved.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE' LLC
Policy No: 607 6 088 3 78
Endorsement No: 2
Effective Date: 0 4 /30/ 20 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 -
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
E. If a single construction project away from premises owned by or rented to the Insured has been abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project.
F. The provisions of LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated.
12. IN REM ACTIONS
A quasi in rem action against any vessel owned or operated by or for the Named Insured, or chartered by or for the Named Insured, will be treated in the same manner as though the action were in personam against the Named Insured.
13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Insuring Agreement is amended to replace Paragraphs 1.b.(1) and 1.b.(2) with the following:
b. This insurance applies to bodily injury provided that the professional health care services are incidental to the Named lnsured's primary business purpose, and only if:
(1) such bodily injury is caused by an occurrence that takes place in the coverage territory. (2) the bodily injury first occurs during the policy period. All bodily injury arising from an occurrence will be deemed to have occurred at the time of the first act, error, or omission that is part of the occurrence; and
B. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to:
i. add the following to the Employers Liability exclusion:
This exclusion applies only if the bodily injury arising from a health care incident is covered by other liability insurance available to the Insured (or which would have been available but for exhaustion of its limits).
ii. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Contractual Liability
the lnsured's actual or alleged liability under any oral or written contract or agreement, including but not limited to express warranties or guarantees.
iii. add the following additional exclusions:
This insurance does not apply to:
Discrimination
any actual or alleged discrimination, humiliation or harassment, including but not limited to claims based on an individual's race, creed, color, age, gender, national origin, religion, disability, marital status or sexual orientation.
Dishonesty or Crime
Any actual or alleged dishonest, criminal or malicious act, error or omission.
Medicare/Medicaid Fraud
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 60 7 60883 7 8
Endorsement No: 2
Effective Date: 0 4 / 3 o / 2 o 21
Copyright CNA All Rights Reserved. Includes copyrighted materia l of Insurance Services Office, Inc., wtth its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal, state or local governmental program.
Services Excluded by Endorsement
Any health care incident for which coverage is excluded by endorsement.
C. DEFINITIONS is amended to:
i. add the following definitions:
Health care incident means an act, error or omission by the Named lnsured's employees or volunteer workers in the rendering of:
a. professional health care services on behalf of the Named Insured or b. Good Samaritan services rendered in an emergency and for which no payment is demanded or received.
Professional health care services means any health care services or the related furnishing of food, beverages, medical supplies or appliances by the following providers in their capacity as such but solely to the extent they are duly licensed as required:
a. Physician;
b. Nurse;
c. Nurse practitioner;
d. Emergency medical technician;
e. Paramedic;
f. Dentist;
g. Physical therapist;
h. Psychologist;
i. Speech therapist;
j. Other allied health professional; or
Professional health care services does not include any services rendered in connection with human clinical trials or product testing.
ii. delete the definition of occurrence and replace it with the following:
Occurrence means a health care incident. All acts, errors or omissions that are logically connected by any common fact, circumstance, situation, transaction, event, advice or decision will be considered to constitute a single occurrence;
iii. amend the definition of Insured to:
a. add the following:
the Named lnsured's employees are Insureds with respect to:
(1) bodily injury to a co-employee while in the course of the co-employee's employment by the Named Insured or while performing duties related to the conduct of the Named lnsured's business; and
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04 / 30 / 20 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C1 9A59483F94 --
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
(2) bodily injury to a volunteer worker while performing duties related to the conduct of the Named lnsured's business;
when such bodily injury arises out of a health care incident. the Named lnsured's volunteer workers are Insureds with respect to:
(1) bodily injury to a co-volunteer worker while performing duties related to the conduct of the Named lnsured's business; and
(2) bodily injury to an employee while in the course of the employee's employment by the Named Insured or while performing duties related to the conduct of the Named lnsured's business; when such bodily injury arises out of a health care incident. b. delete Subparagraphs (a), (b), (c) and (d) of Paragraph 2.a.(1) of WHO IS AN INSURED.
D. The Other Insurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the following:
Other Insurance
b. Excess Insurance
(1) To the extent this insurance applies, it is excess over any other insurance, self insurance or risk transfer instrument, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by the Named Insured to be excess of this coverage.
14. JOINT VENTURES/ PARTNERSHIP/ LIMITED LIABILITY COMPANIES WHO IS AN INSURED is amended to delete its last paragraph and replace it with the following :
No person or organization is an Insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations, except that if the Named Insured was a joint venturer, partner, or member of a limited liability company and such joint venture, partnership or limited liability company terminated prior to or during the policy period, such Named Insured is an Insured with respect to its interest in such joint venture, partnership or limited liability company but only to the extent that:
a. any offense giving rise to personal and advertising injury occurred prior to such termination date, and the personal and advertising injury arising out of such offense first occurred after such termination date; b. the bodily injury or property damage first occurred after such termination date; and c. there is no other valid and collectible insurance purchased specifically to insure the partnership, joint venture or limited liability company; and
If the joint venture, partnership or limited liability company is or was insured under a consolidated (wrap-up) insurance program, then such insurance will always be considered valid and collectible for the purpose of paragraph c. above. But this provision will not serve to exclude bodily injury, property damage or personal and advertising injury that would otherwise be covered under the Contractors General Liability Extension Endorsement provision entitled WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS.
Please see that provision for the definition of consolidated (wrap-up) insurance program.
15. LEGAL LIABILITY - DAMAGE TO PREMISES / ALIENATED PREMISES / PROPERTY IN THE NAMED
INSURED'S CARE, CUSTODY OR CONTROL
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusion j. Damage to Property in its entirety and replace it with the following:
This insurance does not apply to:
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISI ON EMPRI SE, LLC
Policy No: 60 7 60883 7 8
Endorsement No: 2
Effective Date: 0 4 /30/2 0 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
j. Damage to Property
Property damage to:
(1) Property the Named Insured owns, rents, or occupies, 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's property;
(2) Premises the Named Insured sells, gives away or abandons, if the property damage arises out of any part of those premises;
(3) Property loaned to the Named Insured;
(4) Personal property in the care, custody or control of the Insured; (5) That particular part of real property on which the Named Insured or any contractors or subcontractors working directly or indirectly on the Named lnsured's behalf are performing operations, if the property damage arises out of those operations; or
(6) That particular part of any property that must be restored, repaired or replaced because your work was incorrectly performed on it.
Paragraphs (1), (3) and (4) of this exclusion do not apply to property damage (other than damage by fire) to premises rented to the Named Insured or temporarily occupied by the Named Insured with the permission of the owner, nor to the contents of premises rented to the Named Insured for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in LIMITS OF INSURANCE.
Paragraph (2) of this exclusion does not apply if the premises are your work.
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement.
Paragraph (6) of this exclusion does not apply to property damage included in the products-completed operations hazard.
Paragraphs (3) and (4) of this exclusion do not apply to property damage to:
i. tools, or equipment the Named Insured borrows from others, nor ii. other personal property of others in the Named lnsured's care, custody or control while being used in the Named lnsured's operations away from any Named lnsured's premises.
However, the coverage granted by this exception to Paragraphs (3) and (4) does not apply to:
a. property at a job site awaiting or during such property's installation, fabrication, or erection; b. property that is mobile equipment leased by an Insured; c. property that is an auto, aircraft or watercraft;
d. property in transit; or
e. any portion of property damage for which the Insured has available other valid and collectible insurance, or would have such insurance but for exhaustion of its limits, or but for application of one of its exclusions.
A separate limit of insurance and deductible apply to ~uch property of others. See LIMITS OF INSURANCE as amended below.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04 / 30 / 20 21
Copyright CNA All _Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94 --
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete its last paragraph and replace it with the following:
Exclusions c. through n. do not apply to damage by fire to premises while rented to a Named Insured or temporarily occupied by a Named Insured with permission of the owner, nor to damage to the contents of premises rented to a Named Insured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in LIMITS OF INSURANCE.
C. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $25,000 is the most the Insurer will pay under Coverage A for damages arising out of any one occurrence because of the sum of all property damage to borrowed tools or equipment, and to other personal property of others in the Named lnsured's care, custody or control, while being used in the Named lnsured's operations away from any Named lnsured's premises. The Insurer's obligation to pay such property damage does not apply until the amount of such property damage exceeds $1,000. The Insurer has the right but not the duty to pay any portion of this $1,000 in order to effect settlement. If the Insurer exercises that right, the Named Insured will promptly reimburse the Insurer for any such amount.
D. Paragraph 6., Damage To Premises Rented To You Limit, of LIMITS OF INSURANCE is deleted and replaced by the following:
6. Subject to Paragraph 5. above, (the Each Occurrence Limit), the Damage To Premises Rented To You Limit is the most the Insurer will pay under Coverage A for damages because of property damage to any one premises while rented to the Named Insured or temporarily occupied by the Named Insured with the permission of the owner, including contents of such premises rented to the Named Insured for a period of 7 or fewer consecutive days. The Damage To Premises Rented To You Limit is the greater of:
a. $500,000; or
b. The Damage To Premises Rented To You Limit shown in the Declarations.
E. Paragraph 4.b.(1 )(a)(ii) of the Other Insurance Condition is deleted and replaced by the following:
(ii) That is property insurance for premises rented to the Named Insured, for premises temporarily occupied by the Named Insured with the permission of the owner; or for personal property of others in the Named lnsured's care, custody or control;
16. LIQUOR LIABILITY
Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Liquor Liability.
This LIQUOR LIABILITY provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
17. MEDICAL PAYMENTS
A. LIMITS OF INSURANCE is amended to delete Paragraph 7. (the Medical Expense Limit) and replace it with the following:
7. Subject to Paragraph 5. above (the Each Occurrence Limit), the Medical Expense Limit is the most the Insurer will pay under Coverage C - Medical Payments for all medical expenses because of bodily injury sustained by any one person. The Medical Expense Limit is the greater of:
(1) $15,000 unless a different amount is shown here: $N,NNN,NNN,NNN; or (2) the amount shown in the Declarations for Medical Expense Limit.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2021
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94
CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Under COVERAGES, the Insuring Agreement of Coverage C - Medical Payments is amended to replace Paragraph 1.a.(3)(b) with the following:
(b) The expenses are incurred and reported to the Insurer within three years of the date of the accident; and
18. NON-OWNED AIRCRAFT
Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended as follows:
The exclusion entitled Aircraft, Auto or Watercraft is amended to add the following:
This exclusion does not apply to an aircraft not owned by any Named Insured, provided that:
1. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the United States of America or Canada, designating that person as a commercial or airline transport pilot;
2. the aircraft is rented with a trained, paid crew to the Named Insured; and
3. the aircraft is not being used to carry persons or property for a charge.
19. NON-OWNED WATERCRAFT
Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and replace it with the following.
This exclusion does not apply to:
(2) a watercraft that is not owned by any Named Insured, provided the watercraft is:
(a) less than 75 feet long; and
(b) not being used to carry persons or property for a charge.
20. PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR HUMILIATION A. Under DEFINITIONS, the definition of personal and advertising injury is amended to add the following tort:
Discrimination or humiliation that results in injury to the feel ings or reputation of a natural person.
B. Under COVERAGES, Coverage B - Personal and Advertising Injury Liability, the paragraph entitled Exclusions is amended to:
1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following:
This insurance does not apply to:
Knowing Violation of Rights of Another
Personal and advertising injury caused by or at the direction of the Insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury. This exclusion shall not apply to discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is not done intentionally by or at the direction of:
(a) the Named Insured; or
(b) any executive officer, director, stockholder, partner, member or manager (if the Named Insured is a limited liability company) of the Named Insured.
2. add the following exclusions:
CNA74705XX (1-15)
VALLEY FORGE I NSURANCE COMPANY
Insured Name: PRECIS I ON EMPRISE , LLC
Policy No: 6 0 7 608 8 3 78
Endorsement No: 2
Effective Date: 04 / 3 o / 2 o 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94 -
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
This insurance does not apply to:
Employment Related Discrimination
Discrimination or humiliation directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person by any Insured.
Premises Related Discrimination
discrimination or humiliation arising out of the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any Insured.
Notwithstanding the above, there is no coverage for fines or penalties levied or imposed by a governmental entity because of discrimination.
The coverage provided by this PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR HUMILIATION Provision does not apply to any person or organization whose status as an Insured derives solely from Provision 1. ADDITIONAL INSURED of this endorsement; or attachment of an additional insured endorsement to this Coverage Part.
This PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR HUMILIATION Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
21. PERSONAL AND ADVERTISING INJURY· CONTRACTUAL LIABILITY A. Under COVERAGES, Coverage B -Personal and Advertising Injury Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Contractual Liability.
B. Solely for the purpose of the coverage provided by this PERSONAL AND ADVERTISING INJURY • CONTRACTUAL LIABILITY provision, the following changes are made to the section entitled SUPPLEMENTARY PAYMENTS - COVERAGES A AND B:
1. Paragraph 2.d. is replaced by the following:
d. The allegations in the suit and the information the Insurer knows about the offense alleged in such suit are such that no conflict appears to exist between the interests of the Insured and the interests of the indemnitee;
2. The first unnumbered paragraph beneath Paragraph 2.f.(2)(b) is deleted and replaced by the following:
So long as the above conditions are met, attorneys fees incurred by the Insurer in the defense of that indemnitee, necessary litigation expenses incurred by the Insurer, and necessary litigation expenses incurred by the indemnitee at the Insurer's request will be paid as defense costs. Such payments will not be deemed to be damages for personal and advertising injury and will not reduce the limits of insurance.
C. This PERSONAL AND ADVERTISING INJURY • CONTRACTUAL LIABILITY Provision does not apply if Coverage B -Personal and Advertising Injury Liability is excluded by another endorsement attached to this Coverage Part.
This PERSONAL AND ADVERTISING INJURY • CONTRACTUAL LIABILITY Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
22. PROPERTY DAMAGE- ELEVATORS
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and (6) of the Damage to Property Exclusion do not apply to property damage that results from the use of elevators.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRI SE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04 / 30/2021
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its pennission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381 -C 19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE - ELEVATORS Provision, the Other Insurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis that is Property insurance covering property of others damaged from the use of elevators.
23. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS- COVERAGES A AND Bis amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000. limit; and
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a $1,000. limit.
24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named lnsured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure.
25. WAIVER OF SUBROGATION· BLANKET
Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of:
1. the Named lnsured's ongoing operations; or
2. your work included in the products-completed operations hazard.
However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement, and only if such contract or agreement:
1. is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the claim.
26. WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up) insurance program by applicable state statute or regulation.
If the endorsement EXCLUSION - CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance Programs (C.C.I.P.) is attached, then the following changes apply:
A. The following wording is added to the above-referenced endorsement:
With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as damages because of:
1. Bodily injury, property damage, or personal or advertising injury that occurs during the Named lnsured's ongoing operations at the project, or during such operations of anyone acting on the Named lnsured's behalf; nor
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04 / 30 / 20 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its penmission.
DocuSign Envelope ID: O6O03502-8C5E-4590-B381-C 19A59483F94 --
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
2. Bodily injury or property damage included within the products-completed operations hazard that arises out of those portions of the project that are not residential structures.
B. Condition 4. Other Insurance is amended to add the following subparagraph 4.b.(1)(c):
This insurance is excess over:
(c) Any of the other insurance whether primary, excess, contingent or any other basis that is insurance available to the Named Insured as a result of the Named Insured being a participant in a consolidated (wrap-up) insurance program, but only as respects the Named lnsured's involvement in that consolidated (wrap-up) insurance program.
C. DEFINITIONS is amended to add the following definitions:
Consolidated (wrap-up) insurance program means a construction, erection or demolition project for which the prime contractor/project manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors involved in the project, such as an Owner Controlled Insurance Program (O.C.I.P.) or Contractor Controlled Insurance Program (C.C.I.P.).
Residential structure means any structure where 30% or more of the square foot area is used or is intended to be used for human residency, including but not limited to:
1. single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit developments; and
2. the common areas and structures appurtenant to the structures in paragraph 1. (including pools, hot tubs, detached garages, guest houses or any similar structures).
However, when there is no individual ownership of units, residential structure does not include military housing, college/university housing or dormitories, long term care facilities, hotels or motels. Residential structure also does not include hospitals or prisons.
This WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2 021
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 -
CNA CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products-Completed
Operations Coverage Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed as follows:
I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf:
A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products-completed operations hazard, and only if:
1. the written contract requires you to provide the additional insured such coverage; and
2. this coverage part provides such coverage.
II. But if the written contract requires:
A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10- 01 edition of CG2037; or
B. additional insured coverage with "arising out of' language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following:
WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract.
Ill. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with:
A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract.
IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of:
A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including:
1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and
2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part.
V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part:
CNA75079XX (10-16)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 3
Effective Date: 04/30/20 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381 -C19A59483F94 ~NA CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products-Completed
Operations Coverage Endorsement
Primary and Noncontributory Insurance
With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be:
1. primary and non-contributing with other insurance available to the additional insured; or
2. primary and to not seek contribution from any other insurance available to the additional insured.
But except as specified above, this insurance will be excess of all other insurance available to the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and
3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self-insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured.
VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition:
Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement:
A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to:
1. the bodily injury or property damage; or
2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy.
CNA75079XX (10-16)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECIS ION EMPRISE, LLC
Policy No: 60 7 608 8 3 7 8
Endorsement No: 3
Effective Date: 0 4 /30/20 21
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0410 C (Ed. 01-19)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
BLANKET BASIS
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.) The additional premium for this endorsement shall be calcu lated by applying a factor of 2% to the total manual premium , with a minimum initial charge of $350 , then applying all other pricing factors for the policy to this calculated cha rge to derive the final cost of this endorsement.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Blanket Waiver
Perso n/Orga nizatio n
Job Description
All CA Operations
Schedule
Blanket Waiver - Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
Waiver Premium (prior to adjustments)
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 04/30/2021
Insured: Precision Emprise, LLC
Precision Emprise, Inc.
Policy No.: PRWC229906
Insurance Company: Cypress Insurance Company
Countersigned by ___ "b __ ~ __ ·_z_._~------
WC 99 0410 C
(Ed. 01 -19)
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 City of South San Francisco
City Council
Resolution: RES 128-2019
P.O. Box 71 1 (City Hall,
400 Grand Avenue)
South San Francisco. CA
File Number: 19-690 Enactment Number: RES 128-2019
RESOL ION APPROVING A PROFESSIO AL S RVlCES
AGREEMENT WJTH PRECISJO O CRETE CUTTING
FOR A ITYWJDE SIDEWALK STREET SIGN, AND
SIG AL POLE ASSESSMENT AND INVENTORY, NOT TO
EXCEED 263,277 AND AUTHORIZING THE CJTY
MANAGER TO EXECUTE THE PROFESSIONAL
SERVJCE AGREEMENT.
Wl-IEREA , sidewalk are vital components of a Ii able, afe community; and WHEREA , maintenance of idewalk and addressing safety issues is essential to en uring such a community; and
WHEREAS, identification of gaps and deficiencies aids the ity in creating a pedestrian-friendly community and enables the City to prioritize areas of the sidewalk system that require repair and notify property owners of their responsibility to maintain their respective section of the sidewalk; and WHEREAS, establi lung an inventory and prioritization method · can improve the ity's ability to more swiftly addres potential hazard and reduce the potential for liability; and WHEREAS, in addition to a idewalk inventory and as essment, the City seeks an inventory and asse sment of its traffic signal pole and street ign and an assessment of its streetlight poles; and WHEREAS, the inventory and assessment of the traffic ignal poles. street igns, and treetlight poles will also aid the City in identifying potential hazards, damage, and opportunities for replacement, reducing potential for liability; and
WHEREAS, City taff licited quotes and written propo al from five companie specializing in sidewalk or utility pole testing to gather proposal and cost estimates for a city-wide assessment and inventory;
WHEREAS, of the propo al rec ived, Preci ion oncrete Cutting provided a comprehen ive proposal for the inventory and a se sment of the City's sidewalks, traffic signal poles, street signs, and streetlight pole , that most efficiently captured the scope of the project and the level of detail needed by the ity to assess the e infrastructure elements; and
WHEREAS, the inventory and a sessments described in the Preci ion Concrete utting proposal will benefit multiple ongoing City project ; and
City of South San Francisco Page 1
DocuSign Envelope ID: D6D03502-8C5E-4590-B381 -C19A59483F94 File Number: 19-690 Enactment Number- RES 128-2019
WHEREAS Precision Concrete Cutting pos es es the expe1tise and qualifications necessary to conduct the inventory and asses men! of the specified City infrastructure; and WHEREAS, there is sufficient funding in the existing CIP allocations for project that will directly benefit from this inventory and assessment, and there aJe no additional cost associated with this project:
and
\VHEREAS, staff recommends that the City Council approve a Professional Services Agreement between the City of South San Francisco and Precision Concrete Cutting to conduct the inventories and assessments for an amount not to exceed $263.277.
NOW, THEREFORE, BE IT RESOLVED that the ity ouncil of the City of South San Francisco does hereby take the following action:
l. Appro es the Professional Services Agreement, attached herein as Exhibit A, with Precision oncrctc Cutting in an amow1t not to exceed $263,277, conditioned on Preci ion Concrete Cutting s timely execution of the Profe sional Services Agreement and ubmission of all required documents, including but not limited to certificates of in urance and endorsements.
2. Authorizes the City Manager to execute the Professional Services Agreement in sub tantially the same fonn as that in Exhibit A, and any other related documents on behalf of the Cily, upon timely submission by Precision Concrete Cutting' signed agreement and all other document , subject to approval as to fonn by the City Attorney.
3. Authorize the City Manager to take any other actions neces ary to carry out the intent of this resolution.
Exhibit A: DRAFT Professional Services Agreement.
* * * *
At a meeting of the Special City Council on 10/9/2019, a motion was made by Richard Garbarino, seconded by Buenaflor Nicolas, that this Resolution be approved. The motion passed.
Yes: 5 Councilmember Nagales, Mayor Matsumoto, Councilmember Addiego, Councilmember Nicolas, and Vice Mayor Garbarino
Attest by
City of South San Francisco Page2
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94
CONSUL TING SERVICES AGREEMENT BETWEEN
THE CITY OF SOUTH SAN FRANCISCO AND
PRECISION CONCRETE CUTTING
THIS AGREEMENT for consulting services is made by and between the City of South San Francisco ("City'') and Precision Concrete Cutting ("Consultant") (together sometimes referred to as the "Partiesn) as of October 15, 2019 (the "Effective Date").
Section 1. SERVICES. Subject to the terms and conditions set forth in this Agreement, Consultant shall provide to City the services described in the Scope of Work attached as Exhibit A, attached hereto and incorporated herein, at the time and place and in the manner specified therein. In the event of a conflict in or inconsistency between the terms of this Agreement and Exhibit A, the Agreement shall prevail.
1.1 Term of Services. The term of this Agreement shall begin on the Effective Date and shall end on October 15, 2020, and Consultant shall complete the work described in Exhibit A prior to that date, unless the term of the Agreement is otherwise terminated · or extended, as provided for in Section 8. The time provided to Consultant to complete the services required by this Agreement shall not affect the City's right to terminate the Agreement, as provided for in Section 8.
1.2 Standard of Performance. Consultant shall perform all services required pursuant to this Agreement in the manner and according to the standards observed by a competent practitioner of the profession in which Consultant is engaged in the geographical area in which Consultant practices its profession. Consultant shall prepare all work products required by this Agreement in a substantial, first-class manner and shall conform to the standards of quality normally observed by a person practicing in Consultant's profession.
1.3 Assignment 1>f Personnel. Consultant shall assign only competent personnel to perform services pursuant to this Agreement. In the event that City, in its sole discretion, at any time during the term of this Agreement, desires the reassignment of any such persons, Consultant shall, immediately upon receiving notice from City of such desire of City, reassign such person or persons.
1.4 Time. Consultant shall devote such time to the performance of services pursuant to this Agreement as may be reasonably necessary to meet the standard of performance provided in Sections 1J and ~ above and to satisfy Consultant's obligations hereunder.
Sectio·n 2. COMPENSATION. City hereby agrees to pay Consultant a sum not to exceed $263,277 notwithstanding any contrary indications that may be contained in Consultant's proposal, for services to be performed and reimbursable costs incurred under this Agreement. In the event of a conflict between this Agreement and. Consultant's proposal or compensation schedule, attached as Exhibit A, regarding the amount of compensation, the Agreement shall prevail. City shall pay Consultant for services rendered pursuant to this Agreement at the time and in the manner set forth herein. The payments specified below shall be the only payments from City to Consultant for services rendered pursuant to this Agreement.
Consulting Services Agreement between [Rev:11 .14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C 19A59483F94 Consultant shall submit all invoices to City in the manner specified herein. Except as specifically authorized by City, Consultant shall not bill City for duplicate services performed by more than one person.
Consultant and City acknowledge and agree that compensation paid by City to Consultant under this Agreement is based upon Consultant's estimated costs of providing the services required hereunder, including salaries and benefits of employees and subcontractors of Consultant. Consequently, the parties further agree that compensation hereunder is intended to include the costs of contributions to any pensions and/or annuities to which Consultant and its employees, agents, and subcontractors may be eligible. City therefore has no responsibility for such contributions beyond compensation required under this Agreement.
2.1 Invoices. Consultant shall submit invoices, not more often than once per month during the term of this Agreement, based on the cost for services performed and reimbursable costs incurred prior to the invoice date. Invoices shall contain the following information:
• Serial identifications of progress bills (i.e., Progress Bill No. 1 for the first invoice, etc.);
• The beginning and ending dates of the billing period; • A task summary containing the original contract amount, the amount of prior billings, the total due this period, the balance available under the Agreement, and the percentage of completion;
• At City's option, for each work item in each task, a copy of the applicable time entries or time sheets shall be submitted showing the name of the person doing the work, the hours spent by each person, a brief description of the work, and each reimbursable expense;
• The total number of.hours of work performed under the Agreement by Consultant and each employee, agent, and subcontractor of Consultant performing services hereunder, as well as a separate notice when the total number of hours of work by Consultant and any individual employee, agent, or subcontractor of Consultant reaches or exceeds eight hundred (800) hours, which shall include an estimate of the time necessary to complete the work described in Exhibit A; • The amount and purpose of actual expenditures for which reimbursement is sought;
• The Consultant's signature.
2.2 Monthly Payment. City shall make monthly payments, based on invoices received, for services satisfactorily performed, and for authorized reimbursable costs incurred. City shall have thirty (30} days from the receipt of an invoice that complies with · all of the requirements above to pay Consultant. City shall have no obligation to pay invoices submitted ninety (90) days past the performance of work or incurrence of cost.
2.3 Flnal Payment. City shall pay the last ten percent (10%} of the total sum due pursuant to this Agreement within sixty (60} days after completion of the services and submittal to City of a final invoice, if all services required have been satisfactorily performed.
Consulting Services Agreement between [Rev:11.14.2016)
City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94
2.4 Total Payment. City shall pay for the services to be rendered by Consultant pursuant to this Agreement. City shall not pay any additional sum for any expense or cost whatsoever incurred by Consultant in rendering services pursuant to this Agreement. City shall make no payment for any extra, further, or additional service pursuant to this Agreement.
In no event shall Consultant submit any invoice for an amount in excess of the maximum amount of compensation provided above either for a task or for the entire Agreement, unless the Agreement is modified prior to the submission of such an invoice by a properly executed change order or amendment.
2.5 Hourly Fees. Fees for work performed by Consultant on an hourly basis shall not exceed the amounts shown on the compensation schedule attached hereto and incorporated herein as Exhibit B.
2.6 Payment of Taxes, Tax Withholding. Consultant is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes.
To be exempt from tax withholding, Consultant must provide City with a valid California Franchise Tax Board form 590 ("Form 590"), as may be amended and such Form 590 shall be attached hereto and incorporated herein as Exhibit C. Unless Consultant provides City with a valid Form 590 or other valid, written evidence of an exemption or waiver from withholding, City may withhold California taxes from payments to Consultant as required by law. Consultant shall obtain, and maintain on file for three (3) years after the termination of this Agreement, Form 590s (or other written evidence of exemptions or waivers) from all subcontractors. Consultant accepts sole responsibility for withholding taxes from any nonCalifornia resident subcontractor and shall submit written documentation of compliance with Consultant's withholding duty to City upon request. .
2.7 Payment upon Termination. In the event that the City or Consultant terminates this Agreement pursuant to Section 8, the City shall compensate the Consultant for all outstanding costs and reimbursable expenses incurred for work satisfactorily completed as of the date of written notice of termination. Consultant shall maintain adequate logs and timesheets in order to verify costs incurred to that date.
2.8 Authorization to Perform Services. The Consultant is not authorized to perform any services or incur any costs whatsoever under the terms of this Agreement until receipt of authorization from the Contract Administrator.
2.9 Prevailing Wage. Where applicable, the wages to be paid fqr a day's work to all classes of laborers, workmen, or mechanics on the work contemplated by this Agreement, shall be not less than the prevailing rate for a day's work in the same trade or occupation in the locality within the state where the work hereby contemplates to be performed as determined by the Director of Industrial Relations pursuant to the Director's authority under Labor Code Section 1770, et seq. Each laborer, worker or mechanic employed by Consulting Services Agreement between [Rev:11.14.2016]
City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94 Consultant or by any subcontractor shall receive the wages herein provided for. The Consultant shall pay two hundred dollars ($200), or whatever amount may be set by Labor Code Section 1775, as may be amended, per day penalty for each worker paid less than prevailing rate of per diem wages. The difference between the prevailing rate of per diem wages and the wage paid to each worker shall be paid by the Consultant to each worker.
An error on the part of . an awarding body does not relieve the Consultant from responsibility for payment of the prevailing rate of per diem wages and penalties pursuant to Labor Code Sections 1770 1775. The City will not recognize any claim for additional compensation because of the payment by the Consultant for any wage rate in excess of prevailing wage rate set forth. The possibility of wage increases is one of the elements to be considered by the Consultant.
a. Posting of Schedule of Prevailing Wage Rates and Deductions. If the schedule of prevailing wage rates is not attached hereto pursuant to Labor Code Section 1773.2, the Consultant shall post at appropriate conspicuous points at the site of the project a schedule showing all determined prevailing wage rates for the various classes of laborers and mechanics to be engaged in work on the project under this contract and all ,, deductions, if any, required by law to be made from unpaid wages actually earned by the laborers and mechanics so engaged.
b. Payroll Records. Each Consultant and subcontractor shall keep an accurate payroll record, showing the 'name, address, social security number, work week, and the actual per diem wages paid to each journeyman, apprentice, worker, or.other employee employed by the Consultant in connection with the pubHc work. Such records shall be certified and submitted weekly as required by Labor Code Section 1776." Section 3. FACILITIES AND EQUIPMENT. Except as set forth herein, Consultant shall, at its sole cost and expense, provide all facilities and equipment that may be necessary to perform the services required by this Agreement. City shall make available to Consultant only the facilities and equipment listed in this section, and only under the terms and conditions set forth herein.
City shall furnish physical facilities such as desks, filing cabinets, and conference space, as may be reasonably necessary for Consultant's use while consulting with City employees and reviewing records and the information in possession of the City. The location, quantity, and time of furnishing those facilities shall be in the sole discretion of City. In no event shall City be obligated to furnish any facility that may involve incurring any direct. expense, including but not limited to computer, long-distance telephone or other communication charges, vehicles, and reproduction facilities.
Section 4. INSURANCE REQUIREMENTS. Before beginning any work under this Agreement, Consultant, at its own cost and expense, unless otherwise specified below, shall procure the types and amounts of insurance listed below against claims for injuries to persons or damages to property that may arise from or in connection with the performance of the work hereunder by the Consultant and its agents, representatives, employees, and subcontractors. Consistent with the following provisions, Consultant shall Consulting Services Agreement between [Rev: 11.14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 provide Certificates of Insurance, attached hereto and incorporated herein as Exhibit B, indicating that Consultant has obtained or currently maintains insurance that meets the requirements of this section and under forms of insurance satisfactory, in all respects, to the City. Consultant shall maintain the insurance policies required by this section throughout the term of this Agreement. The cost of such insurance shall be included in the Consultant's bid. Consultant shall not allow any subcontractor to commence work on any subcontract until Consultant has obtained all insurance required herein for the subcontractor(s).
4.1 Workers' Compensation. Consultant shall, at its sole cost and expense, maintain Statutory Workers' Compensation Insurance and Employer's Liability Insurance for any and all persons employed directly or indirectly by Consultant. The Statutory Workers' Compensation Insurance and Employer's Liability Insurance shall be provided with limits of not less than ONE MILLION DOLLARS ($1,000,000) per accident. In the alternative, Consultant may rely on a self-insurance program to meet those requirements, but only if the program of self-insurance complies fully with the provisions of the California Labor Code. Determination of whether a self-insurance program meets the standards of the Labor Code shall be solely in the discretion of the Contract Administrator (as defined in Section 10.9). The insurer, if insurance is provided, or the Consultant, if a program of selfinsurance is provided, shall waive all rights of subrogation against the City and its officers, officials, employees, and volunteers for loss arising from work performed under this Agreement.
4.2 Commercial General and Automobile Liability Insurance.
4.2.1 General requirements. Consultant, at its own cost and expense, shall maintain commercial general and automobile liability insurance for the term of this Agreement in an amount not less than ONE MILLION DOLLARS ($1,000,000.00) per occurrence, combined single limit coverage for risks associated with the work contemplated by this Agreement. If a Commercial General Liability Insurance or an Automobile Liability form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this Agreement or the general aggregate limit shall be at least twice the required occurrence limit. Such coverage shall include but shall not be limited to, protection against claims arising from bodily and personal injury, including death resulting there from, and damage to property resulting from activities contemplated under this Agreement, including the use of owned and nonowned automobiles.
4.2.2 Minimum scope of coverage. Commercial general. coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 or GL 0002 (most recent editions) covering comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. Automobile coverage shall be at least as broad as Insurance Services Office Automobile Liability form CA 0001 (ed. 12/90) Code 8 and 9. No endorsement shall be attached limiting the coverage.
Consulting Services Agreement between [Rev:11 . 14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
4.3 4.2.3 Additional requirements. Each of the following shall be included in the in~urance coverage or added as a certified endorsement to the policy:
a. The insurance shall cover on an occurrence or an accident basis, and not on a claims-made basis.
b. Any failure of Consultant to comply with reporting provisions of the policy shall not affect coverage provided to City and its officers, employees, agents, and volunteers.
Professional Liability Insurance.
4.3.1 General requirements. Consultant, at its own cost and expense, shall maintain for the period covered by this Agreement professional liability insurance for licensed professionals performing work pursuant to this Agreement in an amount not less than ONE MILLION DOLLARS ($1,000,000) covering the licensed professionals' errors and omissions. Any deductible or self-insured retention shall not exceed ONE HUNDRED FIFTY THOUSAND DOLLARS $150,000 per claim.
4.3.2 Claims-made limitations. The following provisions shall apply if the professional liability coverage is written on a claims-made form:
a. The retroactive date of the policy must be shown and must be before the date of the Agreement.
b. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the Agreement or the work, so long as commercially available at reasonable rates. c. If coverage is canceled or not renewed and it is not replaced with another claims-made policy form with a retroactive date that precedes the date of this Agreement, Consultant must provide extended reporting coverage for a minimum of five (5) years after completion of the Agreement or the work.
The City shall have the right to exercise, at the Consultant's sole cost and expense, any extended reporting provisions of the policy, if the Consultant cancels or does not renew the coverage.
d. A copy of the claim reporting requirements must be submitted to the City prior to the commencement of any work under this Agreement.
4.4 All Policies Requirements.
4.4.1 Acceptability of insurers. All insurance required by this section is to be placed with insurers with a Bests' rating of no less than A:VII.
Consulting Services Agreement between [Rev: 11 .14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
4.4.2 Verification of coverage. Prior to beginning any work under this Agreement, Consultant shall furnish City with complete copies of all policies delivered to Consultant by the insurer, including complete copies of all endorsements attached to those policies. All copies of policies and certified endorsements shall show the signature of a person authorized by that insurer to bind coverage on its behalf. If the City does not receive the required insurance documents prior to the Consultant beginning work, it shall not waive the Consultant's obligation to provide them. The City reserves the right to require complete copies of all required insurance policies at any time.
4.4.3 Notice of Reduction in or Cancellation of Coverage. A certified endorsement shall be attached to all insurance obtained pursuant to this Agreement stating that coverage shall not be suspended, voided, canceled by either party, or reduced in coverage or in limits, except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to the City. In the event that any coverage required by this section is reduced, limited, cancelled, or materially affected in any other manner, Consultant shall provide written notice to City at Consultant's earliest possible opportunity and in no case later than ten (10) working days after Consultant is notified of the change in coverage.
4.4.4 Additional insured: primary insurance. City and its officers, employees, agents, and volunteers shall be covered as additional insureds with respect to each of the following: liability arising out of activities performed by or on behalf of Consultant, including the insured's general supervision of Consultant; products and completed operations of Consultant, as applicable; premises owned, occupied, or used by Consultant; and automobiles owned, leased, or used by the Consultant in the course of providing services pursuant to this Agreement. The coverage shall contain no special limitations on ·the scope of protection afforded to City or its officers, employees, agents, or volunteers.
A certified endorsement must be attached to all polities stating that coverage is primary insurance with respect to the City and its officers, officials, employees and volunteers, and that no insurance or self-insurance maintained by the City shall be called upon to contribute to a loss under the coverage.
4.4.5 Deductibles and Self-Insured Retentions. Consultant shall disclose to and obtain the approval of City for the self-insured retentions and deductibles before beginning any of the services or work called for by any tenn of this Agreement.
Further, if the Consultant's insurance policy includes a self-insured retention that must be paid by a named insured as a precondition of the insurer's liability, or which has the effect of providing that payments of the self-insured retention by others, including additional insureds or insurers do not serve to satisfy the selfinsured retention, such provisions must be modified by special e_ndorsement so as to not apply to the additional insured coverage required by this agreement so as to not prevent any of the parties to this agreement from satisfying or paying the selfConsulting Services Agreement between [Rev:11.14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94 insured retention required to be paid as a precondition to the insurer's liability.· Additionally, the certificates of insurance must note whether the policy does or does not include any self-insured retention and also must disclose the deductible.
During the period covered by this Agreement, only upon the prior express written authorization of Contract Administrator, Consultant may increase such deductibles or self-insured retentions with respect to City, its officers, employees, agents, and volunteers. The Contract Administrator may condition approval of an increase in deductible or self-insured retention levels with a requirement that Consultant procure a bond, guaranteeing payment of losses and related investigations, claim administration, and defense expenses that is satisfactory in all respects to each of them.
4.4.6 Subcontractors. Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and certified endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the requirements stated herein.
4.4.7 Wasting Policy. No insurance policy required by Section 4 shall include a "wasting" policy limit.
4.4.8 Variation. The City may approve a variation in the foregoing insurance requirements, upon a determination that the coverage, scope, limits, and forms of such insurance are either not commercially available, or that the City's interests are otherwise fully protected.
4.5 Remedies. In addition to any other remedies City may have if Consultant fails to provide or maintain any insurance policies or policy endorsements to the extent and within the time herein required, City may, at its sole option exercise any of the following remedies, which are alternatives to other remedies City may have and are not the exclusive remedy for Consultant's breach:
a. Obtain such insurance and deduct and retain the amount of the premiums for such insurance from any sums due under the Agreement;
b. Order Consultant to stop work under this Agreement or withhold any payment that becomes due to Consultant hereunder, or both stop work and withhold any payment, until Consultant demonstrates compliance with the requirements hereof; and/or c. Terminate this Agreement.
Section 5. INDEMNIFICATION AND CONSULTANT'S RESPONSIBILITIES. To the fullest extent permitted by law, Consultant shall indemnify, defend with counsel selected by the City, and hold harmless the City and its officials, officers, employees, agents, and volunteers from and against any and all losses, liability, claims, suits, actions, damages, and causes of action arising out of any personal injury, bodily Consulting Services Agreement between [Rev:11 .14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-BCSE-4590-B381-C 19A59483F94 injury, loss of life, or damage to property, or any violation of any federal, state, or municipal law or ordinance, to the extent caused, in whole or in part, by the willful misconduct or negligent acts or omissions of Consultant or its employees, subcontractors, or agents, by acts for which they could be held strictly liable, or by the quality or character of their work. The foregoing obligation of Consultant shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises wholly from the gross negligence or willful misconduct of the City or its officers, employees, agents, or volunteers and (2) the actions of Consultant or its employees, subcontractor, or agents have contributed in no part to the injury, loss of life, damage to property, or violation of law. It is understood that the duty of Consultant to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 of the California Civil Code.
Acceptance by City of insurance certificates and endorsements required under this Agreement does not relieve Consultant from liability under this indemnification and hold harmless clause. This indemnification and hold harmless clause shall apply to any damages or claims for damages whether or not such insurance policies shall have been determined to apply. By execution of this Agreement, Consultant acknowledges and agrees to the provisions of this Section and that it is a material element of consideration.
In the event that Consultant or any employee, agent, or subcontractor of Consultant providing services under this Agreement is determined by a court of competent jurisdiction or the California Public Employees Retirement System (PERS) to be eligible for enrollment in PERS as an employee of City, Consultant shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PERS benefits on behalf of Consultant or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of City.
Section 6. STATUS OF CONSULT ANT.
6.1 Independent Contractor. At all times during the term of this Agreement, Consultant shall be an independent contractor and shall not be an employee of City. City shall have the right to control Consultant only insofar as the results of Consultant's services rendered pursuant to this Agreement and assignment of personnel pursuant to Subparagraph 1.3; however, otherwise City shall not have the right to control the means by which Consultant accomplishes services rendered pursuant to this Agreement. Notwithstanding any other City, state, or federal policy, rule, regulation, law, or ordinance to the contrary, Consultant and any of its employees, agents, and subcontractors providing services under this Agreement shall not qualify for or become entitled to, and hereby agree to waive any and all claims to, any compensation, benefit, or any incident of employment by City, including but not limited to eligibility to enroll in the California Public Employees Retirement System (PERS) as an employee of City and entitlement to any contribution to be paid by City for employer contributions and/or employee contributions for PERS benefits.
6.2 Consultant No Agent. Except as City may specify in writing, Consultant shall have no authority, express or implied, to act on behalf of City in any capacity whatsoever as an agent or to bind City to any obligation whatsoever.
Section 7. LEGAL REQUIREMENTS.
Consulting Services Agreement between [Rev: 11 .14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94 7 .1 Governing Law. The laws of the State of California shall govern this Agreement.
7.2 Compliance with Applicable Laws. Consultant and any subcontractors shall comply with all laws applicable to the performance of the work hereunder.
7.3 Other Governmental Regulations. To the extent that this Agreement may be funded by fiscal assistance from another governmental entity, Consultant and any subcontractors shall comply with all applicable rules and regulations to which City is bound by the terms of such fiscal assistance program.
7.4 Licenses and Permits. Consultant represents and warrants to Ctty that Consultant and its employees, agents, and any subcontractors have all licenses, permits, qualifications, and approvals, including from City, of what-so-ever nature that are legally required to practice their respective professions. Consultant represents and warrants to City that Consultant and its employees, agents, any subcontractors shall, at their sole cos.t and expense, keep in effect at all times during the term of this Agreement any licenses, permits, and approvals that are legally required to practice their respective professions. In addition to the foregoing, Consultant and any subcontractors shall obtain and maintain during the term of this Agreement valid Business Licenses from City.
7.5 Nondiscrimination and Equal Opportunity. Consultant shall not discriminate, on the basis of a person's race, religion, color, national origin, age, physical or mental handicap or disability, medical condition, marital status, sex, or sexual orientation, against any employee, applicant for employment, subcontractor, bidder for a subcontract, or participant in, recipient of, or applicant for any services or programs provided by Consultant under this Agreement. Consultant shall comply with all applicable federal, state, and local laws, policies, rules, and requirements related to .equal opportunity ·and nondiscrimination in employment, contracting, and the provision of any services that are the subject of this Agreement, including but not limited to the satisfaction of any positive obligations required of Consultant thereby.
Section 8.
8.1 Consultant shall include the provisions of this Subsection in any subcontract approved by the Contract Administrator or this Agreement.
TERMINATION AND MODIFICATION.
Termination. City may cancel this Agreement at any time and without cause upon written notification to Consultant.
Consultant may cancel this Agreement for cause upon 30 days' written notice to City and shall include in such notice the reasons for cancellation.
Consulting Services Agreement between [Rev:11 .14.2016] 08/06/2019 City of South San Francisco and Precision Concrete Cutting Page 10 of 16 DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 In the event of termination, Consultant shall be entitled to compensation for services performed to the date of notice of termination; City, however, may condition payment of such compensation upon Consultant delivering to City all materials described in Section
9.1. 8.2 Extension. City may, in its sole and exclusive discretion, extend the end date of this Agreement beyond that provided for in Subsection 1.1 . Any such extension shall require a written amendment to this Agreement, as provided for herein. Consultant understands and agrees that, if City grants such an extension, City shall have no obligation to provide Consultant with compensation beyond the maximum amount provided for in this Agreement. Similarly, unless authorized by the Contract Administrator, City shall have no obligation to reimburse Consultant for any otherwise reimbursable expenses incurred during the extension period.
8.3 Amendments. The parties may amend this Agreement only by a writing signed by all the parties.
8.4 Assignment and Subcontracting. City and Consultant recognize and agree that this Agreement contemplates personal performance by Consultant and is based upon a determination of Consultant's unique personal competence, experience, and specialized personal knowledge. Moreover, a substantial inducement to City for entering into this Agreement was and is the professional reputation and competence of Consultant.
Consultant may not assign this Agreement or any interest therein without the prior written approval of the Contract Administrator. Consultant shall not assign or subcontract any portion of the performance contemplated and provided for herein, other than to the subcontractors noted in the proposal, without prior written approval of the Contract Administrator.
8.5 Survival. All obligations arising prior to the termination of this Agreement and all provisions of this Agreement allocating liability between City and Consultant shall survive the termination of this Agreement.
8.6 Options upon Breach by Consultant. If Consultant materially breaches any of the terms of this Agreement, City's remedies shall include, but not be limited to, the following:
8.6.1 Immediately terminate the Agreement;
8.6.2 Retain the plans, specifications, drawings, reports, design documents, and any other work product prepared by Consultant pursuant to this Agreement;
8.6.3 Retain a different consultant to complete the worlk described ih Exhibit A not finished by Consultant; or
8.6.4 Charge Consultant the difference between the cost to complete the work described in Exhibit A that is unfinished at the time of breach and the amount that Consulting Services Agreement between [Rev:11.14.2016]
City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94 City would have paid Consultant pursuant to Section 2 if Consultant had completed the work.
Section 9. KEEPING AND STATUS OF RECORDS.
9.1 Records Created as Part of Consultant's Perfonnance. All reports, data, maps, models, charts, studies, surveys, photographs, memoranda, plans, studies, specifications, records, files, or any other documents or materials, in electronic or any other form, that Consultant prepares or obtains pursuant to this Agreement" and that relate to the matters covered hereunder shall be the property of the City. Consultant hereby agrees to deliver those documents to the City upon termination of the Agreement. It is understood and agreed that the documents and other materials, including but not limited to those described above, prepared pursuant to this Agreement are prepared specifically for the City and are not necessarily suitable for any future or other use. City and Consultant agree that, until final approval by City, all data, plans, specifications, reports and other documents are confidential and will not be released to third parties without prior written consent of both parties unless required by law. ·
9.2 Consultant's Books and Records. Consultant shall maintain any and all ledgers, books of account, invoices, vouchers, canceled checks, and other records or documents evidencing or relating to charges for services or expenditures and disbursements charged to the City under this Agreement for a minimum of three (3) years, or for any longer period required by law, from the date of final payment to the Consultant to this Agreement.
9.3 Inspection and Audit of Records. Any records or documents that Section 9.2 of this Agreement requires Consultant to maintain shall be made available for inspection, audit, and/or copying at any time during regular business hours, upon oral or written request of the City. Under California Government Code Section 8546. 7, if the amount of public funds expended under this Agreement exceeds TEN THOUSAND DOLLARS ($10,000.00), the Agreement shall be subject to the examination and audit of the State Auditor, at the request of City or as part of any audit of the City, for a period of three (3) years after final payment under the Agreement.
9.4 Records Submitted in Response to an Invitation to Bid or Request for Proposals. All responses to a Request for Proposals (RFP) or invitation to bid issued by the City become the exclusive property of the City. At such time as the City selects a bid, all proposals received become a matter of public record, and shall be regarded as public records, with the exception of those elements in each proposal that are defined by Consultant and plainly marked as "Confidential," "Business Secret" or "Trade Secret." The City shall not be liable or in any way responsible for the disclosure of any such proposal or portions thereof, if Consultant has not plainly marked it as a "Trade Secret" or "Business Secret," or if disclosure is required under the Public Records Act.
Consulting Services Agreement between [Rev:11 .14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 Although the California Public Records Act recognizes that certain confidential trade secret information may be protected from disclosure, the City may not be in a position to establish that the information that a prospective bidder submits is a trade secret. If a request is made for information marked "Trade Secret" or "Business Secret," and the requester takes legal action seeking release of the materials it believes does not constitute trade secret information, by submitting a proposal, Consultant agrees to indemnify, defend and hold harmless the City, its agents and employees, from any judgment, fines, penalties, and award of attorneys fees awarded against the City in favor of the party requesting the information, and any and all costs connected with that defense. This obligation to indemnify survives the City's award of the contract. Consultant agrees that this indemnification survives as long as the trade secret information is in the City's possession, which includes a minimum retention period for such documents.
Section 10 MISCELLANEOUS PROVISIONS.
10.1 Attorneys' Fees. If a party to this Agreement brings any action, including arbitration or an action for declaratory relief, to enforce or interpret the provision of this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees in addition to any other relief to which that party may be entitled. The court may set such fees in the same action or in a separate action brought for that purpose.
10.2 Venue. In the event that either party brings any action against the other under this Agreement, the parties agree that trial of such action shall be vested exclusively in the state courts of California in the County San Mateo or in the United States District Court for the Northern District of California.
10.3 Severability. If a court of competent jurisdiction finds or rules that any provision of this Agreement is invalid, void, or unenforceable, the provisions of this Agreement not so adjudged shall remain in full force and effect. The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement.
10.4 No Implied Waiver of Breach. The waiver of any breach of a specific provision of this Agreement does not constitute a waiver of any other breach of that term or any other term of this Agreement.
10.5 Successors and Assigns. The provisions of this Agreement shall inure to the benefit of and shall apply to and bind the successors and assigns of the parties.
10.6 Use of Recycled Products. Consultant shall prepare and submit all reports, written studies and other printed material on recycled paper to the extent it is available at equal or less cost than virgin paper.
10.7 Conflict of Interest. Consultant may serve other clients, but none whose activities within the corporate limits of City or whose business, regardless of location, would place Consulting Services Agreement between [Rev:11.14.2016]
City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94 Consultant in a "conflict of interest," as that term is defined in the Political Reform Act, codified at California Government Code Section 81000 et seq.
Consultant shall not employ any City official in the work performed pursuant to this Agreement. No officer or employee of City shall have any financial interest in this Agreement that would violate California Government Code Sections 1090 et seq.
Consultant hereby warrants that it is not now, nor has it been in the previous twelve (12) months, an employee, agent, appointee, or official of the City. If Consultant was an employee, agent, appointee, or official of the City in the previous twelve (12) months, Consultant warrants that it did not participate in any manner in the forming of this Agreement. Consultant understands that, if this Agreement is made in violation of Government Code §1090 et.seq., the entire Agreement is void and Consultant will not be entitled to any compensation for services performed pursuant to this Agreement, including reimbursement of expenses, and Consultant will be required to reimburse the City for any sums paid to the Consultant. Consultant understands that, in addition to the foregoing, it may be subject to criminal prosecution for a violation of Government Code§ 1090 and, if applicable, will be disqualified from holding public office in the State of California.
10.8 Solicitation. Consultant agrees not to solicit business at any meeting, focus group, or interview related to this Agreement, either orally or through any written materials.
10.9 Contract Administration. This Agreement shall be administered by Louis Langi ("Contract Administrator"). All correspondence shall be directed to or through the Contract Administrator or his or her designee.
10.10 Notices. All notices and other communications which are required or may be given under this Agreement shall be in writing and shall be deemed to have been duly given (i) when received if personally delivered; (ii) when received if transmitted by telecopy, if received during normal business hours on a business day (or if riot, the next business day after delivery) provided that such facsimile is legible and that at the time such facsimile is sent the sending Party receives written confirmation of receipt; (iii) if sent for next day delivery to a domestic address by recognized overnight delivery service (e.g., Federal Express); and (iv) upon receipt, if sent by certified or registered mail, return receipt requested. In each case notice shall be sent to the respective Parties as follows:
Consultant:
City:
Precision Concrete Cutting
335 Beach Road
Burlingame, CA 94010
City Clerk
City of South San Francisco
400 Grand Avenue
South San Francisco, CA 94080
Consulting Services Agreement between [Rev:11 .14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
10.11 Professional Seal. Where applicable in the determination of the contract administrator, the first page of a technical report, first page of design specifications, and each page of construction drawings shall be stamped/sealed and signed by the licensed professional responsible for the report/design preparation. The stamp/seal shall be in a block entitled "Seal and Signature of Registered Professional with report/design responsibility," as in the following example.
Seal and Signature of Registered Professional with
report/design responsibility.
10.12 Integration. This Agreement, including all Exhibits attached hereto, and incorporated herein, represents the entire and integrated agreement between City and Consultant and supersedes all prior negotiations, representations, or agreements, either written or oral pertaining to the matters herein.
10.13 Counterparts. This Agreement may be executed in counterparts and/or by facsimile or other electronic means, and when each Party has signed and delivered at least one such counterpart, each counterpart shall be deemed an original, and, when taken together with other signed counterpart, shall constitute one Agreement, which shall be binding upon and effective as to all Parties ..
10.14 Construction. The headings in this Agreement are for the purpose of reference only and shall not limit or otherwise affect any of the terms of this Agreement. The parties have had an equal opportunity to participate in the drafting of this Agreement; therefore any construction as against the drafting party shall not apply to this Agreement.
The Parties have executed this Agreement as of the Effective Date.
Consulting Services Agreement between [Rev: 11 .14.2016] City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94
CITY OF SOUTH SAN FRANCISCO
NAME:
Approved as to Form:
2729962.1
Consulting Services Agreement between [Rev: 11 .14.2016) City of South San Francisco and Precision Concrete Cutting 08/06/2019
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94
EXHIBIT A
SCOPE OF SERVICES
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 335 B•ch Road Burlingame. CA 94010/ l'hon•: (6501 861 -8157 I Fax (650} 240-3Btsa I CL# 1032474 PROPOSAL FOR 11NOT TO ExCEED" AGREEMENT BETWEEN:
THE Crrv OF SOUTH SAN FRANCISCO AND PRECISION CONCRETE CUTTING (PCC) Overview
Uneven sidewalks caused by ground settling and tree roots cause a potential hazard to pedestrians. Displaced sidewalks cause problems for both public and private entities In the form of trip and fall llablllty exposure.
It Is proposed that the City of SOUTH SAN FRANCISCO and PCC enter Into an agreement whereby PCC wlit inspe<:t sidewalks as identified by City staff. The price for these services shall not to exceed the proposed dollar amount and quantity defined ~ the "Proposal Detail'" NCtion below.
Background Information on Precision Concrete Cutting
PCC has been repairing and Inspecting sidewalks since 1990. The company does work throughout the Unitec:! States and with dozens of cities In California.
Precision Concrete Cutting is leader In sidewalk asset management We specialize In surveying sidewalk infrastructure and repairing uneven sidewalks. Our unique saw-cutting method. for correcting off-set sidewalk panels leaves behind ADA compliant results for a fraction of the cost of new concrete. Our clients benefit from delalled GIS maps that allows them to create a GIS data base lo cost eff8ctively manage their sidewalk Infrastructure;
· INSPECTION SERVICES
Precision Concrete Cutting tecmicians will walk every pai:-et in the project area and visual inspect for potential 1J1)plng hazards a'!d damage. PCC will provide a GIS compatible report that list each location identified including a photo, exact location, off-set height and square foot amount for replacement ~lions.
PROPRJETARYMOB~EPHONESOFTWARE
Precision Concrete Cutting has developed a proprietary moblle software that 18 useable across multiple platfonns (Android, !Phone, IPad, Smart Phone, etc.)
Provldea GPS Coonllna1as- lnlagratlls with GIS systans
Mapping - Plovides dalaled location data plotted with Google Mapa Detalled Reporting-Provides spedficand ·detaled data on maacnmants far every trip hazMI Addresaes - The aoftware glYes the address and longitude / latitllde of each bip hazard locallon Addltlonal Dala - Records addltlDnal sidewalk data. (le. apalllng, cracks, replecement spots, and _,y other data you need) Sidewalk Asset Management-PNclslon Concreta Cutting otrars complete sldewalk asset management services City of SOlITH SAN FRANCISCO "Not to E,ooeed" Proposal - May 9, 2018 DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94 P.O. Box 25265, San Mateo, CA 94401/ Phone: (650) B81 -8857 I Fax (650> 2.fo-3866 / Cl.# 1032474 Proposal 0,tall
Base Inspection Services Unit Price: ~250 per Mlle
Base inspection includes: Street address, latitude/longitude, date/time, identification of all vertical displacements ½ inches and greater, max height of off-set, identlflcation of all locations that require removal and replacement including SQFT and identify If It ls caused by city tree. All data will be provided In a GI$ compatlble format including ·excel, KML and/or shape file.
Add-on Inspection Options:
Price Per
Options Mlle
Identify corners that require curb ramp or that do not $SO have truncated domes Identify streets that don't have sidewalk $15
Identify areas that don't have 48 Inches of passable $25 space
Inspect Curb and Gutter $150
Take Photos/map each street sign $150
Inspections and documentation of streetlight poles anc
traffic signal poles to include photo-documentation
(high-res photos of entire pole and base with $200
documentation of bolts, attachments, call boxes,
panels, etc.) Heioht and thickness measurements
Streets with Sidewalks to be Inspected: areas to be identified by the city of South San Francisco.
Precision Concrete Cutting is committed to providing the highest quality service to our clients. Should you have any questions of comments, please do not hesitate to contact us.
PCC Representative: YOUR HERE REPRESENTATIVE:
X
------------ July 16, 2019 Tit I e
DocuSign Envelope ID: D6D03502-8C5E-4590-B381 -C19A59483F94 Page2of3 City ofSOU1ll SAN FRANCISCO "Notto Exceed" Proposa)- 7/16/19 Federal Reclster I Vol. 56. No. 144 /Friday.Jul)' 24, 1991 I Rules and Rc:g11wions Federal Resrulatlons on Trip Hazard Removal
Part Ill
Department of
Justice
Office of the
At1omey General
28 CFR Part 36
Ncmdlscriminatlon on
the Buis of Dl&ablllly
Publlc Accommoclallons
and in Gommerclal
Facilities; Final nJle
4.5 Ground and Floor Surfaces
tsttrpcs from FecleniJ Register
I 3 a I \ o
I !111' ~sc u
I . 3 ~ t • t A slope bcm c
IU-\ 11o r. cofJ,
~011' o cd
16 l•J01ullo\l.rdf01a '
A~ J)tstec Iii,& I 81
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
EXHIBIT B
INSURANCE CERTIFICATES
DocuSign Envelope ID: D6D03502-8C5E-4590-8381-C19A59483F94 ,..---,
ACORD• CERTIFICATE OF LIABILITY INSURANCE l DATE (MM/DD/YYYY) ~ Sn/2019
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 pollcy(les) must have ADDITIONAL 1NSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Heu of such endorsement{s).
PRODUCER ~~~~"' Select Convnercial
Assurance Agency, Ltd.
20 North Martingale Road
PHONE - 700 (~.l\!2..il!!]: 1847) 797-~ l PAX (A/C, Nol: t847) 440-9133 Suite 100 I:oA~sS: [email protected]
Schaumburg IL 60173 - INSURER($) AFFORDING COVERAGE NAIC# I INSURER A : Hiscox Insurance Company Inc. 1 10200 -- INSURED PRECEMP-<12 INSURER a : Valley Forge Insurance_ 20508 Precision Emprise, LLC - INSURERC: Continental Insurance Compan,,, 35289 DBA Precision Concrete Cutting ' 335 Beach Road INSURER o: Cypress Insurance Com_P.an . j 10855 Burlingame CA 94010 INSURER E : CNA 20443 j
INSURERF:
COVERAGES CERTIFICATE NUMBER: 1379408384 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. ti~:] TYPEOFINSURANCE !ADDL-SUBR~ POLICYNUMBER :0..MW~ LIMITS B I X I COMMERCIALGENERALLIABILITY Y I 6076088378 4/30/2020 EACH OCCURRENCE fxl o;Q;IAGEIO RENTED
CLAIMS-MADE ~ OCCUR PREMISES ~ occurrenceJ
1 1
_I ----=-
, $1,000,000
j S 100,000
_!_!5,000
I GEN'L AGGREGATE LIMIT APPLIES PER:
I POLICY [Kl ~~ • LOC
OlliER:
B I AUTOMOBILEUABILITY
X] ANY AUTO
OWNED I SCHEDULED AUTOS ONLY AUTOS
X HIRED X I NON-OWNED
AUTOS ONLY ~ AUTOS ONLY
C X UMBRELLA LIAB I X OCCUR
ll!XCESS LIAB CLAIMS-MADE
OED X RETENTIONS
D WORKERS COMPENSATION
AND EMPLOYERS' LIABILrrv Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE r..7
I
OFFICER/MEMBEREXCLUDEO? ~ N/A
(Mandatory In NH)
grssC=~ ~~PERATIONS below
B Inland Marine A Prcre11ional Liability E Pollution LlabUtty PERSONAL& ADV INJURY ~ 1,000,000 I GENERAL AGGREGATE _ .!3_~0,000 PROOUCTS • COMP/OP AGG ~000,000
s
_ _!..=..,p;~.p'-'-+>-'--~ 6/30 2020
--~~r=== n~ey:-:-- · \
OMBINED SINGL LIMIT $ 1 000 000 , tEa acddent _ • ·
I CUE6076088364
Y I PRVVC022226
PMT6078088378
MPL 178488018
6079036549
I . I
I .. ,3012019
6/3012019
4/30/2019
9/2812018
7/1612019
BODILY INJURY (Per person) $
f
BODILY ~~ (Per accident) j $
PROPERTY DAMAGE I S (Per accident) __
4/30/2020 I EACH OCCURRENCE
AGGREGATE
I
6/3012020 X
E.L. EACH ACCIDENT
ER
$
$ 2.p_,00,000
g_o~o.ooo
s
_ $1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
I EL DISEASE - POLICY LIMIT S 1.000,000
4/30/2020 Limit $50,000
9/28/2019 Aggregale: $1 ,000,000
9/28/2020 · Occurence: Sl ,OOO,OOO Agg. $2,000,000
DESCRIPTION o, OPl:RATIONS /LOCATIONS/VEHICLES (ACORD 101, Addltlonal Remarks Schedule, ,.,.y be llltached If more •pace• required) It is agreed that the following are added as Additional Insured, when required by written contract, on the General Liability on a primary basis with respect to operations performed by the named insured in connection with this project:
City of South San Francisco and its officers, employees, agents, and volunteers A Waiver of Subrogation in favor of the Additional Insureds applies to 1he Worker's Compensation policy only, when required by written contract and where allowed by law.
CERTIFICATE HOLDER 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.
City of South San Francisco
400 Grand Ave. AUTHORIZED REPRESENTATIVE South San Francisco CA 94080 b~Z-~r II © 1988-2015ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94 I
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. If any other endorsement attached to this policy amends any provision also amended by this endorsement, then that other endorsement controls with respect to such provision, and the changes made by this endorsement with respect to such provision do not apply.
TABLE OF CONTENTS
1. Additional Insureds
2. Additional Insured - Primary And Non~Contributory To Additional lnsured's Insurance
3. Bodily Injury - Expanded Definition
4. Broad Knowledge of Occurrence/ Notice of Occurrence
5. Broad Named Insured
6. Broadened Liability Coverage For Damage To Your Product And Your Work
7. Contractual Liability - Railroads
8. Electronic Data Llablllty
9. Estates, Legal Representatives and Spouses
10. Expected Or Intended Injury- Exception for Reasonable Force
11. General Aggregate Limits of Insurance - Per Project
12. In Rem Actions
13. Incidental Health Care Malpractice Coverage
14. Joint Ventures/Partnership/Limited Liability Companies
15. Legal Liability - Damage To Premises/ Alienated Premises/ Property In The Named lnsured's Care, Custody or Control
16. Liquor !,.lablllty
17. Medical Payments
18. Non-owned Aircraft Coverage
19. Non-owned Watercraft
20. Personal And Advertising Injury - Discrimination or Humiliation
21. Personal And Advertising Injury - Contractual Liability
22. Property Damage - Elevators
23. Supplementary Payments
24. Unintentional Failure To Disclose Hazards
25. Waiver of Subrogation - Blanket
26. Wrap-Up Extension: OCIP CCIP, or Consolidated (Wrap-Up) Insurance Programs CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA Aft Rights Reserved. Includes copyrighted material ot Insurance Services Office, Inc., with Its pennission.
DocuSign Envelope ID: O6O03502-8C5E-4590-B381-C19A59483F94 I
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
1. ADDITIONAL INSUREDS
a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs A. through H. below whom a Named Insured is required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part; and (2) was executed prior to:
(a) the bodily Injury or property damage; or
(b) the offense that caused the personal and advertising injury, for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or (2) coverage broader than required by such contract or agreement, and in no event broader than that described by the applicable paragraph A. through H. below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controlling Interest
Any person or organization with a controlling interest in a Named Insured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury arising out of:
1. such person or organization's financial control of a Named Insured; or
2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of Insured Premises
A co-owner of a premises co-owned by a Named Insured and covered under this insurance but only with respect to such co-owner's liability for bodily injury, property damage or personal and advertising injury as co-owner of such premises.
C. Lessor of Equipment
Any person or organization from whom a Named Insured leases equipment, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named lnsured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising Injury takes place prior to the termination of such lease.
D. Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such land, provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such · Iease. The CNA74705XX (1-15)
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. · DocuSign Envelope ID: D6O03502-8C5E-4590-B381 -C19A59483F94 eNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
E. Lessor of Premises
An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate manager, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided that the occurrence giving rise to such bodily injury or property damage, or the offense giving rise to such personal and advertising injury, takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
F. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's liability for bodily injury, property damage or personal and advertising injury arising out of the Named lnsured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured.
G. State or Governmental Agency or Subdivision or Political Subdivisions - Permits · A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodlly injury, property damage or personal and advertising injury arising out of:
1. the following hazards in connection with premises a Named Insured owns, rents, or controls 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, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or b. the construction, erection, or removal of elevators; or c. the ownership, maintenance or use of any elevators covered by this insurance; or
2. the permitted or authorized operations performed by a Named Insured or on a Named lnsured's behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily injury, property damage or personal and advertising injury arising out of operations performed for the state or governmental agency or subdivision or political subdivision; or b. Bodily injury or property damage included within the products-completed operations hazard.
With respect to this provision's requirement that additional insured status must ~ requested under a written contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the Named Insured to add the governmental entity as an additional insured.
H. Trade Show Event Lessor
1. With respect to a Named lnsured's participation in a trade show event as an exhibitor, presenter or displayer, any person or organization whom the Named Insured is required to include as an additional insured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury caused by:
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04 / 3 o-; 2 o 19
Copyright CNA All Righ1s Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
a. the Named lnsured's acts or omissions; or
b. the acts or omissions of those acting on the Named lnsured's behalf, in the performance of the Named lnsured's ongoing operations at the trade show event premises during the trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within the products-completed operations hazard.
2. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'$ INSURANCE The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and noncontributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess of any other insurance avaih3ble to such person or organization.
3. BODILY INJURY - EXPANDED DEFINITION
Under DEFINITIONS, the definition of bodily injury is deleted and replaced by the following:
Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical injury, sickness or disease.
4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is amended to add the following provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer's authorized representative notice of an occurrence, offense or clalm only when the occurrence, offense or claim is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or an employee designated by any of the above to give such notice. ·
B. NOTICE OF OCCURRENCE
The Named lnsured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give the Insurer notice of an occurrence, offense or claim . and that failure is solely due to the Named lnsured's reasonable belief that the bodily injury or property damage is not covered under this Coverage Part. However, the Named Insured shall give written notice of such occurrence, offense or claim to the Insurer as soon as the Named Insured is aware that this insurance may apply to such occurrence, offense or claim.
5. BROAD NAMED INSURED
WHO IS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4. below, any organization in which a Named Insured has management control:
a. on the effective date of this Coverage Part; or
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material c1 Insurance Services Office. Inc .• with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 ~
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=
eNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
b. by reason of a Named Insured creating or acquiring the organization during the policy period, qualifies as a Named Insured, provided' that there is no other similar liability insurance, whether primary, contributory, excess, contingent or otherwise, which provides coverage to such organization, or which would have provided coverage but for the exhaustion of its limit, and without regard to whether its coverage is broader or narrower than that provided by this insurance.
But this BROAD NAMED INSURED provision does not apply to:
(a) any partnership, limited liability company or joint venture; or (b) any organization for which coverage Is excluded by another endorsement attached to this Coverage Part.
For the purpose of this provision, management control means:
A. owning interests representing more than 50% of the voting, appointment or designation power for the selection of a majority of the Board of Directors of a corporation; or B. having the right, pursuant to a written trust agreement, to protect, control the use of, encumber or transfer or sell property held by a trust.
4. With respect to organizations which qualify as Named Insureds by virtue of Paragraph 3. above, this insurance does not apply to:
a. bodily injury or property damage that first occurred prior to the date of management control, or that first occurs after management control ceases; nor
b. personal or advertising Injury caused by an offense that first occurred prior to the date of management control or that first occurs after management control ceases.
5. The Insurance provided by this Coverage Part applies to Named Insureds when trading under their own names or under such other trading names or doing~business-as names (dba) as any Named Insured should choose to employ.
6. BROADENED LIABILITY COVERAGE FOR DAMAGE TO YOUR PRODUCT AND YOUR WORK A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusions k. and I. and replace them with the following:
This insurance does not apply to:
k. Damage to Your Product
Property damage to your product arising out of it, or any part of it except when caused by or resulting from:
(1) fire;
(2) smoke;
(3) collapse; or
(4) explosion.
I. Damage to Your Work
Property damage to your work arising out of it, or any part of it and included in the products-completed operations hazard.
This exclusion does not apply:
(1) If the damaged work, or the work out of which the damage arises, was performed on the Named lnsured's behalf by a subcontractor; or
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECI SION EMPRI SE, LLC
Policy No: 6076088378
Endorsement No: · 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with Its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
(2) If the cause of loss to the damaged work arises as a result of:
(a) fire;
{b) smoke;
(c) collapse; or
{d) explosion.
B. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $100,000 is the most the Insurer will pay under Coverage A for the sum of damages arising out of any one occurrence because of property damage to your product and your work that is caused by fire, smoke, collapse or explosion and is included within the product-completed operations hazard. This sublimit does not apply to property damage to your work if the damaged work, or the work out of which the damage arises, was performed on the Named lnsured's behalf by a subcontractor.
C. This Broadened Liability Coverage For Damage To Your Product And Your Work Provision does not apply if an endorsement of the same name is attached to this policy.
7. CONTRACTUAL LIABILITY- RAILROADS
With respect to operations performed within 50 feet of railroad property, the definition of insured contract is replaced by the following:
Insured Contract means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to a Named Insured or temporarily occupied by a Named Insured with permission of the owner is not an insured contract; b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to the Named lnsured's business (including an indemnification of a municipality in connection with work performed for a municipality) under which the Named Insured assumes the tort liability of another party to pay for bodily Injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage;
(2) Under which the Insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities.
8. ELECTRONIC DATA LIABILITY
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. lnctudes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 =
eNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusion p. Electronic Data and replace it with the following:
This insurance does not apply to:
p. Access Or Disclosure Of Confidential Or Personal Information And Data-related Liability Damages arising out of:
(1) any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data that does not result from physical injury to tangible property.
However, unless Paragraph (1) above applies, this exclusion does not apply to damages because of bodily injury.
This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relation expenses or any other loss, cost or expense incurred by the Named Insured or others arising out of that which is described in Paragraph (1) or (2) above.
B. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $100,000 is the most the Insurer will pay under Coverage A for all damages arising out of any one occurrence because of property damage that results from physical injury to tangible property and arises out of electronic data.
C. The following definition is added to DEFINITIONS:
Electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.
D. For the purpose of the coverage provided by this ELECTRONIC DATA LIABILITY Provision, the definition of property damage in DEFINITIONS is replaced by the following:
Property damage means:
a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it; or
c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate electronic data, resulting from physical injury to tangible property. All such loss of electronic data shall be deemed to occur at the time of the occurrence that caused it.
For the purposes of this insurance, electronic data is not tangible property.
E. If Electronic Data Liability is provided at a higher limit by another endorsement attached to this policy, then the $100,000 limit provided by this ELECTRONIC DATA LIABILITY Provision is part of, and not in addition to, that higher limit.
9. ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES
The estates, heirs, legal representatives and spouses of any natural person Insured shall also be insured under this policy; provided, however, coverage is afforded to such estates, heirs, legal representatives, and spouses only for CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with tts permission.
DocuSign Envelope ID: D6D03502-BCSE-4590-B381-C 19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
clalms arising solely out of their capacity or status as such and, in the case of a spouse, where such claim seeks damages from marital community property, jointly held property or property transferred from such natural person Insured to such spouse. No coverage is provi_ded for any act, error or omission of an estate,. heir, legal representative, or spouse outside the scope of such person's capacity or status as such, provided however that the spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership Named Insureds are Insureds with respect to such spouses' acts, errors or omissions in the conduct of the Named lnsured's business.
10. EXPECTED OR INTENDED INJURY - EXCEPTION FOR REASONABLE FORCE Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace it with the following:
This insurance does not apply to:
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.
11. GENERAL AGGREGATE LIMITS OF INSURANCE - PER PROJECT A. For each construction project away from premises the Named Insured owns or rents, a separate Construction Project General Aggregate Limit, equal to the amount of the General Aggregate Limit shown in the Declarations, is the most the Insurer will pay for the sum of:
1. All damages under Coverage A, except damages because of bodily injury or property damage included in the products-completed operations hazard; and
2. All medical expenses under Coverage C,
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, nor the Construction Project General Aggregate Limit of any other construction project.
B. All_:
1. Damages under Coverage B, regardless of the number of locations or construction projects involved;
2. Damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing operations at a single construction project, except damages because of bodily injury or property damage included in the products-completed operations hazard; and
3. Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing operations at a single construction project,
will reduce the General Aggregate Limit shown in the Declarations.
C. The limits shown in the Declarations for Each Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to apply, but will be subject to either the Construction Project General Aggregate Limit or the General Aggregate Limit shown in the Declarations, depending on whether the occurrence can be attributed solely to ongoing operations at a particular construction project.
D. When coverage for liability arising out of the products-completed operations hazard is provided, any payments for damages because of bodily injury or property damage included in the products-completed operations hazard will reduce the Products-Completed Operations Aggregate Limit shown in the Declarations, regardless of the number of projects involved.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. lndudes copyrighted material of Insurance Services Office, Inc .• with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 iiiiiiiiii
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
E. If a single construction project away from premises owned by or rented to the Insured has been abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project.
F. The provisions of LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated.
12. IN REM ACTIONS
A quasi In rem action against any vessel owned or operated by or for the Named Insured, or chartered by or for the Named Insured, will be treated in the same manner as though the action were in personam against the Named Insured.
13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Insuring Agreement is amended to replace Paragraphs 1.b.(1) and 1.b.(2) with the following:
b. This insurance applies to bodily injury provided that the professional health care services are incidental to the Named lnsured's primary business purpose, and only if:
(1) such bodily injury is caused by an occurrence that takes place in the coverage territory. (2) the bodily injury first occurs during the policy period. All bodily injury arising from an occurrence will be deemed to have occurred at the time of the first act, error, or omission that is part of the occurrence; and
B. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to:
i. add the following to the Employers Liability exclusion:
This exclusion applies only if the bodily injury arising from a health care inci_dent is covered by other liability insurance available to the Insured (or which would have been available but for . exhaustion of its limits).
ii. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Contractual Liability
the lnsured's actual or alleged liability under any oral or written contract or agreement, including but not limited to express warranties or guarantees.
iii. add the following additional exclusions:
This insurance does not apply to:
Discrimination
any actual or alleged discrimination, humiliation or harassment, including but not limited to claims based on an individual's race, creed, color, age, gender, national origin, religion, disability, marital status or sexual orientation.
Dishonesty or Crime
Any actual or alleged dishonest, criminal or malicious act, error or omission.
Medicare/Medicaid Fraud
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with Its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal, state or local governmental program.
Services Excluded by Endorsement
Any health care Incident for which coverage is excluded by endorsement.
C. DEFINITIONS is amended to:
i. add the following definitions:
Health care incident means an act, error or omission by the Named lnsured's employees or volunteer workers in the rendering of:
a. professional health care services on behalf of the Named Insured or b. Good Samaritan services rendered in an emergency and for which no payment is demanded or received.
Professional health care services means any health care services or the related furnishing of food, beverages, medical supplies or appliances by the following providers in their capacity as such but solely to the extent they are duly licensed as required:
a. Physician;
b. Nurse;
c. Nurse practitioner;
d. Emergency medical technician;
e. Paramedic;
f. Dentist;
g. Physical therapist;
h. Psychologist;
i. Speech therapist;
j. Other allied health professional; or
Professional health care services does not include any services rendered in connection with human clinical trials or product testing.
ii. delete the definition of occurrence and replace it with the following:
Occurrence means a health care incident. All acts, errors or omissions that are logically connected by any common fact, circumstance, situation, transaction, event, advice or decision will be considered to constitute a single occurrence;
iii. amend the definition of Insured to:
a. add the following:
the Named lnsured's employees are Insureds with respect to:
(1) bodily injury to a co-employee while in the course of the co-employee's employment by the Named Insured or while performing duties related to the conduct of the Named lnsured's business; and
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc .• with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94 8 g
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= = iii
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CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
(2) bodily injury to a volunteer worker while performing duties related to the conduct of the Named lnsured's business;
when such bodily injury arises out of a health care incident. the Named lnsured's volunteer workers are Insureds with respect to:
(1) bodily injury to a co-volunteer worker while performing duties related to the conduct of the Named lnsured's business; and
(2) bodily injury to an employee while in the course of the employee's employment by the Named Insured or while performing duties related to the conduct of the Nam,d lnsured's business; when such bodlly Injury arises out of a health care Incident. b. delete Subparagraphs (a}, (b), (c) and (d) of Paragraph 2.a.(1} of WHO IS AN INSURED.
D. The Other Insurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the following:
Other Insurance
b. · Excess Insurance
(1) To the extent this insurance applies, it is excess over any other insurance, self insurance or risk transfer instrument, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by the Named Insured to be excess of this coverage.
14. JOINT VENTURES / PARTNERSHIP / LIMITED LIABILITY COMPANIES WHO IS AN INSURED is amended to delete its last paragraph and replace it with the following:
No person or organization is an Insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations, except that if the Named Insured was a joint venturer, partner, or member of a limited liability company and such joint venture, partnership or limited liability company terminated prior to or during the policy period, such Named Insured is an Insured with respect to its interest in such joint venture, partnership or limited liability company but only to the extent that:
a.
b.
c.
any offense giving rise to personal and advertising injury occurred prior to such termination date, and the personal and advertising injury arising out of such offense first occurred after such termination date; the bodily injury or property damage first occurred after such termination date; and . there is no other valid and collectible insurance purchased specifically to insure the partnership, joint venture or limited liability company: and
If the Joint venture, partnership or limited liability company is or was insured under a consolidated {wrap-up) Insurance program, then such Insurance will always be considered valid and collectible for the purpose of paragraph c. above. But this provision will not serve to exclude bodily injury, property damage or personal and advertising Injury that would otherwise be covered under the Contractors General Liability Extension Endorsement provision entitled WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS.
Please see that provision for the definition of consolidated (wrap-up) insurance program.
15. LEGAL LIABILITY - DAMAGE TO PREMISES / ALIENATED PREMISES / PROPERTY IN THE NAMED
INSURED'S CARE, CUSTODY OR CONTROL
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusion j. Damage to Property in its entirety and replace it with the following:
This insurance does not apply to:
CNA74705XX (1 -15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No.: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6O03502-8C5E-4590-8381-C19A59483F94
CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
j. Damage to Property
Property damage to:
(1) Property the Named Insured owns, rents, or occupies, 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's property;
(2) Premises the Named Insured sells, gives away or abandons, if the property damage arises out of any part of those premises;
(3) Property loaned to the Named Insured;
(4) Personal property in the care, custody or control of the Insured; (5) That particular part of real property on which the Named Insured or any contractors or subcontractors working directly or indirectly on the Named lnsured's behalf are performing operations, if the property damage arises out of those operations; or
(6) That particular part of any property that must be restored, repaired or replaced because your work was incorrectly performed on it.
Paragraphs (1), (3) and (4) of this exclusion do not apply to property damage (other than damage by fire) to premises rented to 'the Named Insured or temporarily occupied by the Named Insured with the permission of the owner, nor to the contents of premises rented to the Named Insured for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in LIMITS OF INSURANCE.
Paragraph (2) of this exclusion doe;, not apply if the premises are your work.
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement.
Paragraph (6) of this exclusion does not apply to property damage included in the products-completed operations hazard.
Paragraphs (3) and (4) of this exclusion do not apply to property damage to:
i. tools, or equipment the Named Insured borrows from others, nor ii. other personal property of others in the Named lnsured's care, custody or control while being used in the Named lnsured's operations away from any Named lnsured's premises.
However, the coverage granted by this exception to Paragraphs (3) and (4) does not apply to:
a. property at a job site awaiting or during such property's installation, fabrication, or erection; b. property that is mobile equipment leased by an Insured; c. property that is an auto, aircraft or watercraft;
d. property in transit; or
e. any portion of property damage for which the Insured has available other valid and collectible insurance, or would have such insurance but for exhaustion of its limits, or but for application of one of its exclusions.
A separate limit of insurance and deductible apply to such property of others. See LIMITS OF INSURANCE as amended below.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. lndudes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381 -C19A59483F94 i
i
= =
-
=
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete its last paragraph and replace it with the following:
Exclusions c. through n. do not apply to damage by fire to premises while rented to a Named Insured or temporarily occupied by a Named Insured with permission of the owner, nor to damage to the contents of premises rented to a Named Insured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in LIMITS OF INSURANCE.
C. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $25,000 is the most the Insurer will pay under Coverage A for damages arising out of any one occurrence because of the sum of all property damage to borrowed tools or equipment, and to other personal property of others in the Named lnsured's care; custody or control, while being used in the Named lnsured's operations away from any Named lnsured's premises. The Insurer's obligation to pay such property damage does not apply until the amount of such property damage exceeds $1 ,000. The Insurer has the right but not the duty to pay any portion of this $1,000 in order to effect settlement. If the Insurer exercises that right, the Named Insured will promptly reimburse the Insurer for any such amount.
D. Paragraph 6., Damage To Premises Rented To You Limit, of LIMITS OF INSURANCE is deleted and replaced by the following:
6. Subject to Paragraph 5. above, (the Each Occurrence Limit), the Damage To Premises Rented To You Limit is the most the Insurer will pay under Coverage A for damages because of property damage to any one premises while rented to the Named Insured or temporarily occupied by the Named Insured with the permission of the owner, including contents of such premises rented to the Named Insured for a period of 7 or fewer consecutive days. The Damage To Premises Rented To You Limit is the greater of:
a. $500,000; or
b. The Damage To Premises Rented To You Limit shown in the Declarations.
E. Paragraph 4.b.(1)(a)(II) of the Other Insurance Condition Is deleted and replaced by the following:
(ii) That is property Insurance for premises rented to the Named Insured, for premises temporarily occupied by the Named Insured with the permission of the owner; or for personal property of others in the Named lnsured's care, custody or control;
16. LIQUOR LIABILITY
Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Liquor Llablllty.
This LIQUOR LIABILITY provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
17. MEDICAL PAYMENTS
A. LIMITS OF INSURANCE is amended to delete Paragraph 7. (the Medical Expense Limit) and replace it with the following:
7. Subject to Paragraph 5. above (the Each Occurrence Limit), the Medical Expense Limit is the most the Insurer will pay under Coverage C - Medical Payments for all medical expenses because of bodily injury sustained by any one person. The Medical Expense Limit is the greater of:
(1) $15,000 unless a different amount is shown here: $N,NNN,NNN,NNN; or (2) the amount shown in the Declarations for Medical Expense Limit.
CNA74705XX (1 -15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with Its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Under COVERAGES, the Insuring Agreement of Coverage C - Medical Payments is amended to replace Paragraph 1.a.(3)(b) with the following:
(b) The expe.nses are incurred and reported to the Insurer within three years of the date of the accident: and
18. NON-OWNED AIRCRAFT
Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended as follows:
The exclusion entitled Aircraft, Auto or Watercraft is amended to add the following:
This exclusion does not apply to an aircraft not owned by any Named Insured, provided that:
1. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the United States of America or Canada, designating that person as a commercial or airtine transport pilot;
2. the aircraft is rented with a trained, paid crew to the Named Insured; and
3. the aircraft is not being used to carry persons or property for a charge.
19. NON-OWNED WATERCRAFT
Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and replace it with the following.
This exclusion does not apply to:
(2) a watercraft that is not owned by any Named Insured, provided the watercraft is:
(a) less than 75 feet long; and
·(b) not being used to carry persons or property for a charge.
20. PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR HUMILIATION A. Under DEFINITIONS, the definition of personal and advertising injury is amended to add the following tort:
Discrimination or humiliation that results· in Injury to the feelings or reputation of a natural person.
B. Under COVERAGES, Coverage B - Personal and Advertising Injury Liability, the paragraph entitled Exclusions is ~mended to:
1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following:
This insurance does not apply to:
Knowing Violation of Rights of Another
Personal and advertising injury caused by or at the direction of the Insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising Injury. This exclusion shall not apply to discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is not done intentionally by or at the direction of:
(a) the Named Insured; or
(b) any executive officer, director, stockholder, partner, member or manager (if the Named Insured is a limited liability company) of the Named Insured.
2. add the following exclusions:
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc .. with its permission.
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
This insurance does not apply to:
Employment Related Discrimination
Discrimination or humiliation directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person by any Insured.
Premises Related Discrimination
discrimination or humiliation arising out of the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any Insured.
Notwithstanding the above, there is no coverage for fines or penalties levied or imposed by a governmental entity because of discrimination.
The coverage provided by this PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR HUMILIATION Provision does not apply to any person or organization whose status as an Insured derives solely from Provision 1. ADDITIONAL INSURED of this endorsement; or attachment of an additional insured endorsement to this Coverage Part.
This PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR HUMILIATION Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
21. PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY A. Under COVERAGES, Coverage B -Personal and Advertising Injury Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Contractual Liability.
B. Solely for the purpose of the coverage provided by this PERSONAL AND ADVERTISING . INJURY • CONTRACTUAL LIABILITY provision, the following changes are made to the section entitled SUPPLEMENTARY PAYMENTS - C_OVERAGES A AND 8:
1. Paragraph 2.d. is replaced by the following:
d. The allegations in the suit and the information the Insurer knows about the offense alleged in such suit are such that no conflict appears to exist between the interests of the Insured and the interests of the· indemnitee;
2. The first unnumbered paragraph beneath Paragraph 2.f.(2)(b) is deleted and replaced by the following:
So long as the above conditions are met, attorneys fees Incurred by the Insurer in the defense of that indemnitee, necessary litigation expenses incurred by the Insurer, and necessary litigation expenses incurred by the indemnitee at the Insurer's request will be paid as defense costs. Such payments will not be deemed to be damages for personal and advertising injury and will not reduce the limits of insurance.
C. This PERSONAL AND ADVERTISING INJURY • CONTRACTUAL LIABILITY Provision does not apply if Coverage B -Personal and Advertising Injury Liability is excluded by another endorsement attached to this Coverage Part.
This PERSONAL AND ADVERTISING INJURY • CONTRACTUAL LIABILITY Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
22. PROPERTY DAMAGE- ELEVATORS
A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and (6) of the Damage to Property Exclusion do not apply to property damage that results from the use of elevators.
CNA74705XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRI SE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with i1s permission.
DocuSign Envelope ID: D6O03502-8C5E-4590-B381-C19A59483F94 eNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE - ELEVATORS Provision, the Other Insurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis that is Property insurance covering property of others damaged from the use of elevators.
23. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS-COVERAGES A AND Bis amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000. limit; and ·
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a $1,000. limit.
24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named lnsured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure.
25. WAIVER OF SUBROGATION· BLANKET
Under CONDITIONS, the condition enti11ed Transfer Of Rights Of Recovery Against Others To Us is amended to add the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of:
1. the Nam.ed lnsured's ongoing operations; or
2. your work included in the products-completed operations hazard.
However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement, and only if such contract or agreement:
1. is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the claim.
26. WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up) Insurance program by applicable state statute or regulation.
If the endorsement EXCLUSION - CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance Programs (C.C.I.P.) Is attached, then the following changes apply: · A. The following wording is added to the above-referenced endorsement:
With respect to a consolidated (wrap-up) Insurance program project in which the Named Insured is or was involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as damage$ because of:
1. Bodily injury, property damage, or personal or advertising Injury that occurs during the Named lnsured's · ongoing operations at the project, or during such operations of anyone acting on the Named lnsured's behalf; nor
CNA74705XX {1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 2
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 iiiiiiii
-
iiiiiiiii
=
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
2. Bodily injury or property damage included within the products-completed operations hazard that arises out of those portions of the project that are not residential structures.
B. Condition 4. Other Insurance is amended to add the following subparagraph 4.b.(1)(c):
This insurance is excess over:
(c) Any of the other insurance whether primary, excess, contingent or any other basis that is insurance available to the Named Insured as a result of the Named Insured being a participant in a consolidated (wrap-up) insurance program, but only as respects the Named lnsured's involvement in that consolidated (wrap-up) insurance program.
C. DEFINITIONS is amended to add the following definitions:
Consolldated (wrap-up) insurance program means a construction, erection or demolition project for which the prime contractor/project manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors Involved in the project, such as an Owner Controlled Insurance Program (O.C.I.P.) or Contractor Controlled· Insurance Program (C.C.I.P.).
Residential structur, means any structure where 30% or more of the square foot area is used or is intended to be used for human residency, including but not limited to:
1. single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit developments; and
2. the common areas and structures appurtenant to the structures in paragraph 1. (including pools, hot tubs, detached garages, guest houses or a_ny similar structures).
However, when there is no individual ownership of units, residential structure does not include military housing, college/university housing or dormitories, long term care facilities, hotels or motels. Residential structure also does not include hospitals or prisons.
This WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy.
CNA74705.XX (1-15)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 60760883 78
Endorsement No: 2
Effective Date: 04 / 3 o / 2 o 19
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with 11s permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C 19A59483F94 I
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= iiiiiiii.i
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illiiiiiiiiiii
=
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iiiiiiii=:
-illiiiiiiiiiii
CNA CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products-Completed
Operations Coverage Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed as follows:
I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily Injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf:
A. in the performance of your ongoing operations subject to such written contract; or B. iri the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products-completed operations hazard, and only if:
1. the written contract requires you to provide the additional insured such coverage; and
2. this coverage part provides such coverage.
II. But if the written contract requires:
A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10- 01 edition of CG2037; or
B. additional insured coverage with "arising out of' language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following:
WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily Injury, property damage or personal and advertising Injury arising out of your work that is subject to such written contract.
Ill. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with:
A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract.
IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of:
A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including:
1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and
2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part.
V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part:
CNA75079XX (10-16)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRISE, LLC
Policy No: 6076088378
Endorsement No: 3
Effective Date: 04/30/2019
Copyright .CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381 -C19A59483F94
CNA CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors • with Products-Completed
Operations Coverage Endorsement
Primary and Noncontributory Insurance
With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be:
1. primary and non-contributing with other insurance available to the additional insured; or
2. primary and to not seek contribution from any other insurance available to the additional insured.
But except as specified above, this insurance will be excess of all other insurance available to the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and
3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self-insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured.
VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition:
Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement:
A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to:
1. the bodily injury or property damage; or
2. the offense that caused the· personal and advertising Injury; for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy.
CNA75079:XX (10-16)
VALLEY FORGE INSURANCE COMPANY
Insured Name: PRECISION EMPRI SE, LLC
Policy No: 6076088378
Endorsement No: 3
Effective Date: 04/30/2019
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
DocuSign Envelope ID: D6D03502-8C5E-4590-B381 -C19A59483F94 (Ed. 01-19)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
BLANKET BASIS
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.) The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Blanket Waiver
Person/Organization
Job Description
All CA Operations
Schedule
Blanket Waiver - Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
Waiver Premium (prior to adjustments)
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequentto preparation of the policy.) Endorsement Effective: 06/30/2019
Insured: Precision Emprise, LLC
Policy No.: PRWC022226 Endorsement No.:
Precision Emprise, Inc.
Insurance Company: Cypress Insurance Company
WC990410C
(Ed. 01-19)
Premium$
))~Rf-1,4_ . . Countersigned by _________ '-~ -----
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94
EXHIBIT C
FORM 590
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 TAXABLE YEAR • CALIFORNIA FORM
2019 Withholding Exemption Certificate 590
The payee completes this form and submits It to the withholding agent. The withholding agent keeps this form with their records.
Withholding Agent lnfonnaUon
Name
Pavee Information
Name 0 SSN or ITIN ~ FEIN D CA Colp no. D CA sos Ille no.
Precision Emprise LLC 8. 2 • . 1 3 5 . 3 4 7 2
Address (apt./ste., room, PO box, or PMS no.)
335 Beach Rd
City (H you have a forelgn addrlJ66, see instructions.) Burling~me
Exemption Reason
Check only one box.
State ZIP code
c A 9.4 o 1 O
By checking the appropriate box below, the payee certifies the reason for the exemption from the California Income tax withholding requirements on payment(s) made to the entity or individual.
D lndlvlduals - Certification of Residency:
I am a resident of California and I reside at the address shown above. If I become a nonresident at any time, I will promptly notify the withholding agent. See instructions for General Information D, Definitions. · • Corporations:
The corporation has a permanent place of business in California at .the address shown above or is qualified through the California Secretary of State (SOS) to do business in California. The corporation will file a California tax return. If this corporation ceases to have a pennanent place of business in California or ceases to do any of the above, I will promptly notify the withholding agent. See instructions for General Information D, Definitions. 1i1 Partnerships_ or Limited Liability Companies (LLCs):
The partnership or LLC has a permanent place of business in California at the address shown above or Is registered with the California SOS, and is subject to the laws of California. The partnership or LLC .will file a California tax retu.rn. If the partnership or LLC ceases to do any of the above, I will promptly inform the withholding agent. For withholding purposes, a limited llabllty partnership {LLP) is treated like any other partnership.
D Tax-Exempt-Entitles:
The entity is exempt from tax under California Revenue and Taxation Code (A& TC) Section 23701 ___ (insert letter) or Internal Revenue Code Sectio!l 501 (c) __ (insert number). If this entity ceases to be exempt from tax, I will promptly notify the withholding agent. Individuals cannot be tax-exempt entities.
D lnsuran~ Companies, Individual Retirement Arrangements (IRAs), or Qualified Pension/Profit-Sharing Plans:
The entity is an insurance company, IRA; or a federally qualified pension or profit-sharing plan.
D California Trusts:
At least one trustee and one noncontingent beneficiary of the above-named trust is a California resident. The trust will file a California fiduciary tax ret!,.Jrn. If the trustee or noncontingent beneficiary becomes a nonresident at any time, I will promptly notify the withholding agent.
D Estates - Certification of Residency of Deceased Person:
I am the executor of the above-named person's estate or trust. The decedent was a California resident at the time of death.
The estate wm file a California fiduciary tax return.
D NonmllHary Spouse of a MIIHary Servicemember:
. I am a nonmilitary spouse of a mUltary servlcemember and I meet the Military Spouse Residency Relief Act (MSRRA) requirements. See instructions for General Information E, MSRRA.
CERTIFICATE Of PAYEE: Payee must complete and sign below.
To learn about your privacy, rights; how we may use your information, and the consequences for not providing the requested information, go toftb.ca.gov/forms and search for 1131 . To request this notice by mail, call 800.852.5711 .
Under penalties of perjury, I declare that I have examined the information on this form, Including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare under penalties .of perjury that if the facts upon which this form are based ct,ange, I wlfl promptly notify the withholding agent.
Type o, print payee's name ?!ue : •ndra Teai/Controlk>r Telephone ~5-0424 Payee's signature • ~--h'-=--~-'----_.._ _________________ Date 04/16/2019 7061193 Form 590 2018 •
DocuSign Envelope ID: D6D03502-8C5E-4590-B381-C19A59483F94 Fc.TnW-9 Request for Taxpayer Give Fann to the
(Rev. October 2018) Identification Number and Certification requester. Do not 0epartrnalltoftheTreaury send to the IRS.
Internal Ravenue Ser.tea • Go to www.lr&govlFormWfl for lnatruclion• and the lalNt lnfonnlltlon. 1 Name (as shown an yot,r 111001'118 tax Allum). N.,.. la raqund on 1h18 lne; do nol leaYe tt1i1 line blade.
Precision Emprfse LLC
2 Bllllnaa rwnafdJsragarde antlty name, W e!itfflnt from abCMI ~
Precision Concrete Cutting
GI a Check appn,pnate box far fedn tax~ o11he pet1011 whose name 1a antered on lne 1. Check only one or the 4 Exemptions lcodes apply only to i folloWlnglllV9hbolces. certain entltlN, not lndMduafs; NII lnstNctlonlanpage8): C D lndlvldual/sole proprietor or 0 C COrporallon DsCo11J01at1on 0 Pertnenihlp •• Tl'\lllllel1ate . o JI! alngla-member u.c Exempt payee code Of any) 0 Limited Oablllly conpiny. Enter the tax claa8lficatlon (CaC CG1p01111io11, 8a8 GOrJ)Onltlon, P=Perlraahlp) • p ii Nola: Oled( the approprtale box~ the line abcMI forlhe laX clalllficalon ol the angle-member ownw. Do not d,ed( ExempUon from FATCA reporting U.C H the UC II c:Ullllled aa a &Ingle-member LLC thalle dllr9pldld from 1he owner unleR the owra of the U.C II cacleOf~ anolhw LLC lhat" not dllnlgllded from the owner tor U.S. fednl tax purpc11111. Otherwllle, a lingle-member UC tllal t Is cllngarded from the owner should Gheck the apprvprlale bax fur the tax c:laulflcalian of Its owner. • 0lher (Ne lnltructlonll • ,__ .. ___ ,.u.&J
a. 5 Address~. ltnllt, and ll)l or SUlte noJ Sae lnlllnlcllons. Reqllllltll's name and address (optlonaQ co ., 335 Beach Rd r'-1
I City, a1Ble, and ZIP coda
Burtlngame, CA 94010
7 List ecoount number(I) hn (opllonal)
-~· -- Taxpayer Identification Number (TIN)
Enter your TIN In the appropriate box. The TIN provided must match the name given on Hne 1 to avoid backup withholding. For Individuals, this Is generally yoursoclal seourtty number (SSN). However, for a resident alen, sole proprietor, or disregarded entity, see the Instructions for Part I, later. For other entitles, It Is your employer Identification number (BN). If you do not have a nl.mber, see How to get a TIN, later.
Note: If the IICCXUlt Is In more than one name, see the Instructions .for One 1. Also see What Name and MJmber To Give the Reques!9' for guidelines on whole number to enter. •@Ii• Certfflcat1on
Under penalties of pe~ury, I certify that
I Soclal secartty number
[IJJ-[1]-1
1, The number shown on this form Is my oonect taxpayer Identification number (or I am wafting for a number to be Issued to me); and I I I
2. I am not subject to backup withholding because: (a) I am exempt from backup withhold Ing, or (b) I have nol been notilled by the Internal Revenue Service ORS) that I am subject to backup wlthholdlng as a mutt of a fallure to report el Interest or dividends, or (c) the IRS hu notllled me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (If any) Indicating that I am exempt from FATCA reporting Is correct.
I
I
Certlftcatlon Instructions. You must cross out Item 2 above H you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividund& 00 your tax return. For real estate transactions, Item 2 does not apply. For mortgage interest paid, acqui5i1ion or abandonment of secured property, c:;ancelJallon of deb!, contributions to an Individual retirement arrangement (IRA). and generally, payments olh« lhan interest Sid dividends, you are not requinid to &ign the certification, but you must provide your correct TIN, See tfle lns1rUCtlons for Part II, laler, = I ~d}d; ..... 'i7 /.zo,°'
General Instructions
Section references are to the lntemaJ Revenue Code unless otherwise notad.
Future ct.velopmenta. For the lateat information about developments related to Fonn W-9 and Its Instructions, such as leglelatlon enacted after they were published, go to www.irs.gov/FonnW9.
Purpose of Form
An Individual or entity (Form W--9 request81) who Is raqulrvd to file an Information retum with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your 80Clal securtty number (SSN), Individual taxpayer Identification number (JTIN), adoption taxpayer Identification number (ATIN), or employer Identification nunber (ElN), to report on an Information return the amount paid to you, or other amount reportable on an lnfonnation ratlA'Tl. Examples of Information retuma Include, but ant not Drnlted to, the following.
• Form 1099-INT pnterest earned or paid)
Cat. ND. 10231X
• Fonn 1099-0IV (dividends, Including those from stocka or mutual funds)
• Form 1099-MISC (various types of Income, prizes, awards, or gl'0811 proceeds)
• Fonn 1099-B (stock or mutual fund sales and certain other transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network b'anlactlone) • Form 1098 (home mortgage Interest), 1~ (student loan lntereet), 1098-T (tuition)
• Fann 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of &eCUnld property) u.e Fonn w~ only If you n a U.S. peniOll Pncludlng a l'98ldent allan), to provide your correct TIN.
II you do not mtum Form W-9 to the ,aquester with a TIN, you might be subject to backup wttMoldlng. See What la backup wlthholdlng, later.
Form w-e,-.10-2018)
DocuSign
Certificate Of Completion
Envelope Id: D6D035028C5E4590B381C19A59483F94 Status: Completed Subject: Please DocuSign: Contract Routing Form 2021.pdf, Updated COi 2021-22 - Precision-Empri_21-22-GL ...
Source Envelope:
Document Pages: 70
Certificate Pages: 5
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US &
Canada)
Record Tracking
Status: Original
12/22/2021 5:32:29 PM
Security Appliance Status: Connected
Storage Appliance Status: Connected
Signer Events
Eunejune Kim
[email protected]
Public Works Director
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 6/1/2020 2:10:07 PM
ID: 09c34a55-e298-4c87-9f18-2e9185df7 481
Claire Lai
[email protected]
Approved as to Form- City Attorney
Signing Group: City Attorney
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 12/22/2021 5:56:12 PM
ID: f61a6819-77a6-4818-9bb5-f17406f22a47
Mike Futrell
[email protected]
City Manager
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 12/23/202110:44:16 AM
ID: c3d421e3-23b6-46cc-b260-ccfa57d5ab2a
Signatures: 7
Initials: 1
Stamps: 1
Holder: Marissa Garren
[email protected]
Pool: StateLocal
Pool: Carahsoft OBO City of South San Francisco
Signature
G~;:6K\
.M15FDCE1B2M13 ...
Signature Adoption: Pre-selected Style
Using IP Address: 199.181 .122.2
i,Oocullgned by.
~rt,~
fi51MI04F4504468 ...
Signature Adoption: Pre-selected Style
Using IP Address: 206.169.145.130
Signature Adoption: Pre-selected Style
Using IP Address: 99.67.69.52
Envelope Originator:
Marissa Garren
329 Miller Ave
South San Francisco, CA 94080
[email protected]
IP Address: 199.181 .122.2
Location: DocuSign
Location: DocuSign
Timestamp
Sent: 12/22/2021 5:40:49 PM
Viewed: 12/22/2021 5:45:22 PM
Signed: 12/22/2021 5:45:42 PM
Sent: 12/22/2021 5:45:48 PM
Viewed: 12/22/2021 5:56:12 PM
Signed: 12/22/2021 5:57:1 1 PM
Sent: 12/22/2021 5:45:48 PM
Viewed: 12/23/2021 10:44:16 AM
Signed: 12/23/202110:44:23 AM
Signer Events
Rosa Govea Acosta
rosa [email protected]
City Clerk
City of South San Francisco
Signing Group: City Clerk
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Certified Delivery Events
Carbon Copy Events
Witness Events
Notary Events
Envelope Summary Events
Envelope Sent
Certified Delivered
Signing Complete
Completed
Payment Events
Signature
~ :··:.: fost~ ~S908815FF63F418 ...
Signature Adoption: Pre-selected Style
Using IP Address: 199.181 .122.2
Signature
Status
Status
Status
Status
Status
Signature
Signature
Status
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Status
Electronic Record and Signature Disclosure
Timestamp
Sent: 12/23/202110:44:26 AM
Resent: 12/28/2021 8:24:32 AM
Resent: 12/29/2021 8:59:42 AM
Viewed: 12/29/2021 9:01 :20 AM
Signed: 12/29/2021 9:01 :30 AM
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamps
12/22/2021 5:40:49 PM
12/29/2021 9:01 :20 AM
12/29/2021 9:01 :30 AM
12/29/2021 9:01 :30 AM
Timestamps
Electronic Record and Signature Disclosure created on: 6/4/2019 3:56:20 PM Parties agreed to: Eunejune Kim, Claire Lai, Mike Futrell
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Carahsoft OBO City of South San Francisco (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to 'I agree to use electronic records and signatures' before clicking 'CONTINUE' within the DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.
How to contact Carahsoft OBO City of South San Francisco:
You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:
To contact us by email send messages to: [email protected] To advise Carahsoft OBO City of South San Francisco of your new email address To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at [email protected] and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your account preferences.
To request paper copies from Carahsoft OBO City of South San Francisco To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with Carahsoft OBO City of South San Francisco To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process ..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guidesigning-system-reguirements.
Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to 'I agree to use electronic records and signatures' before clicking 'CONTINUE' within the DocuSign system.
By selecting the check-box next to 'I agree to use electronic records and signatures', you confirm that:
• You can access and read this Electronic Record and Signature Disclosure; and • You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and
• Until or unless you notify Carahsoft OBO City of South San Francisco as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by Carahsoft OBO City of South San Francisco during the course of your relationship with Carahsoft OBO City of South San Francisco.