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23B132 - CALTEC CORPORATION COMPLETE
STATE COMPENSATION INSURANCE F=UND JUNE 18, 2025 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 -6959 IN REPLY REFER TO: CERTIFICATE OF WORKERS' COMPENSATION INSURANCE CANCELLATION WITHDRAWAL NOTICE RE: CERTIFICATE DATED NOVEMBER 1, 2024 THE CANCELLATION HAS BEEN WITHDRAWN FOR THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW. THIS LETTER SUPERSEDES THE NOTICE OF CANCELLATION SENT TO YOU ON MAY 15, 2025 . THIS EMPLOYER'S WORKERS' COMPENSATION INSURANCE COVERAGE CONTINUED UNINTERRUPTED . EMPLOYER: CALTEC CORP 9980 IRVINE CENTER DR IRVINE, CA 92618 POLICY 9030254-24 CUSTOMER SERVICE REPRESENTATIVE CUSTOMER SERVICE CENTER (888) 782-8338 STE 100 RECEIVED JUN 2 5 2025 OFFICE OF THE CITY CLERK 5860 Owens Dr Pleasanton. CA 94588-3900 Mailing Address: P.O. Box 8192 • Pleasanton, CA 9 4588-9682 SCIF 19102 STATE COMPENSATION INSURANCE FUND MAY 15, 2025 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262-6959 RECEIVED MAY 2 2 2025 OFFICE OF THE CITY CLERK CERTIFICATE OF WORKERS ' COMPENSATION INSURANCE CANCELLATION NOTICE RE: CERTIFICATE DATED NOVEMBER 1, 2024 IN REPLY REFER T 0 : THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW WILL BE CANCELLED EFFECTIVE JUNE 19, 2025 AT 12:01 A.M . IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE EMPLOYER NAMED BELOW EMPLOYER: CALTEC CORP 9980 IRVINE CENTER DR STE 100 IRVINE, CA 92618 POLICY 9030254-24 CUSTOMER SERVICE REPRESENTATIVE CUSTOMER SERVICE CENTER (888) 782-8338 5860 Owens Dr Pleasanton. CA 94588-3900 Mail ing Address: P.O. Box 8192 • Pleasanton. CA 94588-9682 SCIF 19102 Recording Fe�guested By: City of Palm Springs 2024-0320717 10/24/2024 10,42 AM Fee: $ 0.00 When Recorded Mall To: Name Brenda Pree, City Clerk Street Address 3200 E. Tahquitz Canyon Way City 8 State Palm Springs, CA 92262 Page 1 of 2 Recorded in Official Records County of Riverside Peter Aldana Assessor -County Clerk -Recorder 1I �IrY'rl'Ir�Yiir'��r�MY��illil' III 2�02 SPACE ABOVE THIS LINE FOR RECORDERS USE NOTICE OF COMPLETION (CA Civil Code § § 8180-8190, 8100-8118, 9200-9208) NOTICE IS HEREBY GIVEN THAT: 1. The undersigned is an owner of an interest of estate in the hereinafter described real property, the nature of which interest or estate is: Fee (e.g. fee, leasehold, joint tenancy, etc.) 2. The full name and address of the undersigned owner or reputed owner and of all co -owners or reputed co -owners are: Name Street and No. City State City of Palm Springs 3200 E. Tahquitr Canyon Way Palm Springs CA 92262 3. The name and address of the direct contractor for the work of improvement as a whole is: CALTEC Corp. 8732 Westminster Blvd. Suite 2, Westminster, CA 92685 4 This notice is given for (check one): 8 Completion of the work of improvement as a whole. 0 Completion of a contract for a particular portion of the work of improvement (per CA Civ. Code § 8186). 5. If this notice is given only of completion of a contract for a particular portion of the work of improvement (as provided in CA Civ. Code § 8186), the name and address of the direct contractor under that contract is: Not Applicable 6. The name and address of the construction lender, 9 any, is: Not Applicable 7. On the 27 day of June PO 24 , there was completed upon the herein described property a work of improvement as a whole (or a particular portion of the work of improvement as provided in CA Civ. Code § 8186) a general description of the work provided: the removal and installation of new customer service millwork, removal and replacement of carpet, new gate signage and new lighting. CP 21-28 8. The real property herein referred to is situated in the City of Palm Springs County of Riverside State of California, and is described as follows: Palm Springs Intemational Airport 9. The street address of said property is: 3400 E. Tahquitz Canyon Way, Palm Springs, CA 92262 10. If this Notice of Completion is signed by the owners successor in interest, the name and address of the successor's transferor is: Not applicable I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: /0 ey: ;7 Signature of Owner or Owner's Authorized Agent Joel Montalvo/City Engineer City of Palm Springs Page 1 of 2 _y. VERIFICATION I, Joel Montalvo , state: I am the City Engineer _ (`Owner", "President", "Authorized Agent", "Partner", etc.) of the Owner identified in the foregoing Notice of Completion. I have read said Notice of Completion and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on /0 — /'d 1 2 Y(date), at Palm Springs (City), CA (Stably Si nature of Owner or Owner's Authorized Agent Joel Montalvo/City Engineer City of Palm Springs A Notary Public or other officer completing this certificate verges only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. ANITA L. FIELDS Notary Public • CalNornia Rtrerside County Commission a I151750 •" My Comm. Expires Apr 13, 2025 STATE OF CALIFORNIA COUNTY OF�— On, " � (date), before me, N to r Rublic ame and title of officer) personally appeared 1 LC r who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islare subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PURJURY under the laws of the State of California that the foregoing paragraph is true and corre Witness my hand and official sea Page 2 of 2 Signature JULY 30, 2024 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262-6959 IN REPLY REFER TO: RECEIVED AUG 05 2024 OFFICE OF THE CITY CLERK CERTIFICATE OF WORKERS' ----------------------- COMPENSATION INSURANCE ---------------------- CANCELLATION WITHDRAWAL NOTICE ------------------------------ RE: CERTIFICATE DATED NOVEMBER 1, 2023 THE CANCELLATION HAS BEEN WITHDRAWN FOR THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW. THIS LETTER SUPERSEDES THE NOTICE OF CANCELLATION SENT TO YOU ON JULY 12, 2024. THIS EMPLOYER'S WORKERS' COMPENSATION INSURANCE COVERAGE CONTINUED UNINTERRUPTED. EMPLOYER: CALTEC CORP 8732 WESTMINSTER BLVD STE 2 WESTMINSTER, CA 92683 POLICY 9030254-23 POLICYHOLDER SERVICES SPECIALTY OPERATIONS DISTRICT OFFICE (925) 523-5199 5860 Owens Or Pleasanton, CA 94588-3900 Mailing Address: P.O. Box 8192 - Pleasanton, CA 94588-9682 $CIF 19102 IN REPLY REFER TO: JULY 12, 2024 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262-6959 RECEIVED JUL 16 2024 OFFICE OF THE CITY CLERK CERTIFICATE OF WORKERS' ----------------------- COMPENSATION INSURANCE ---------------------- CANCELLATION NOTICE RE: CERTIFICATE DATED NOVEMBER 1, 2023 THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW WILL BE CANCELLED EFFECTIVE AUGUST 16, 2024 AT 12:01 A.M. IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE EMPLOYER NAMED BELOW EMPLOYER: CALTEC CORP 8732 WESTMINSTER BLVD STE 2 WESTMINSTER, CA 92683 POLICY 9030254-23 POLICYHOLDER SERVICES SPECIALTY OPERATIONS DISTRICT OFFICE (925) 523-5199 5860 Owens Or Pleasanton, CA 94588-3900 Mailing Address: P.O. Box 8192 - Pleasanton, CA 94588-9682 RECEIVED IN REPLY REFER TO JUNE 24, 2024 JUL 01 2024 OFFICE OF THE CITY CLERK CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262-6959 CERTIFICATE OF WORKERS' ----------------------- COMPENSATION INSURANCE ---------------------- CANCELLATION NOTICE ------------------- RE: CERTIFICATE DATED NOVEMBER 1, 2023 THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW WILL BE CANCELLED EFFECTIVE JULY 29, 2024 AT 12:01 A.M. IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE EMPLOYER NAMED BELOW EMPLOYER: CALTEC CORP 8732 WESTMINSTER BLVD STE 2 WESTMINSTER, CA 92683 POLICY 9030254-23 POLICYHOLDER SERVICES SPECIALTY OPERATIONS DISTRICT OFFICE (925) 523-5199 5860 Owens Or Pleasanton, CA 94588-3900 Mailing Address: P.O. Box 8192 - Pleasanton, CA 94588-9682 SCIF 19102 CONTRACT ABSTRACT Contract/Amendment Name of Contract: Company Name: Company Contact: Email: Summary of Services: Contract Price: Contract Term: Public Integrity/ Business Disclosure Forms: Contract Administration Lead Department: Contract Administrator/ Ext: Contract Approvals Council/City Manager Approval Date: Agreement Number: Amendment Number: Contract Compliance Exhibits: Insurance: Routed By: Bonds: Business License: Sole Source Co-Op CoOp Agmt #: Sole Source Documents: CoOp Name: CoOp Pricing: By: Submitted on: Contract Abstract Form Rev 8.16.23 Authorized Signers: Name, Email (Corporations require 2 signatures) Agreement (Construction Contract) CALTEC Corporation Henry Abghari, President henry@calteccorp.com Airport Common Use Podiums – Bono Concourse, City Project 21-28 $2,071,922.37 (including this CCO#4 for $30,252.15) Completion date 06/27/2024 On file Henry Abghari, henry@calteccorp.com Engineering Services Joel Montalvo / Andrew Crider X8738 May 11, 2023, Item 1.E. 23B132 Contract Change Order No. 4 - Yes Yes Department Yes No Final Balancing Contract Change Order No. 4 is attached. N/A 10/16/2024 Vonda Teed Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Page 1 of 2 CITY OF PALM SPRINGS CONTRACT CHANGE ORDER No. 4 CP 21-28 Airport Common Use Podiums – Bono Concourse Contractor: CALTEC Corporation Date: October 10, 2024 CONTRACT CHANGE ORDER SUMMARY Contract Change Order No. 4 is a final balancing change order. The City of Palm Springs Airport requested CALTEC to provide additional services to complete the project. CALTEC requested compensation for staging to complete the project. Items were not completed so CALTEC provided a credit back to the Project. Meeting notes and backup documents are available at the Engineering Services Department. CONTRACT CHANGE ORDER COST ID Description Qty Unit Cost 01 Additional work requested, and miscellaneous work needed to finish the project 1 LS $33,414.55 02 Credit for work not performed, changed or deleted from original contract 1 LS ($3,162.40) Total Lump Sum Change Order Amount: $30,252.15 CHANGES TO CONTRACT TIME: The Contractor is requesting an additional 136 working days. Source of Funds: Sufficient funds are available in Department of Aviation Fund 416 Account No. 4167065-80000. Summary of Costs: Original Contract Amount: $1,805,000.00 Construction Start Date: 08/07/2023 Previous Change Orders: $236,670.22 Previous Agreed Completion 12/15/2023 This Change Order Amount: $30,252.15 Working Days Added: 136 Revised Contract Amount: $2,071,922.37 Actual Completion: 06/27/2024 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Page 2 of 2 I have received a copy of this Change Order, and the above AGREED PRICES are acceptable to Contractor. CALTEC Hamid Abghari, President Date City of Palm Springs Recommended By: Harry Barrett Jr., Executive Director PSP Date Approved By: Scott Stiles, City Manager Date Attest By: Brenda Pree, City Clerk Date Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 10/17/2024 10/28/2024 10/28/2024 10/28/2024 CITY COUNCIL STAFF REPORT DATE: OCTOBER 10, 2024 CONSENT CALENDAR SUBJECT: ACCEPTANCE OF AIRPORT COMMON USE PODIUMS – BONO CONCOURSE, CITY PROJECT 21-28 FROM: Scott C. Stiles, City Manager BY: Engineering Services Department SUMMARY: Formal City Council acceptance of the Airport Common Use Podiums – Bono Concourse, City Project 21-28, is required to document the completion of public works improvements to allow the City’s filing of a Notice of Completion with the Riverside County Recorder in accordance with Section 9200 of the California Civil Code. RECOMMENDATION: 1. Accept the public works improvement identified as the Airport Common Use Podiums – Bono Concourse, City Project 21-28 (“Project”), as completed in accordance with the plans and specifications; 2. Authorize the City Engineer to execute and file for recordation with the Riverside County Recorder a Notice of Completion for the Airport Common Use Podiums – Bono Concourse, City Project 21-28; and 3. Appropriate $30,252.15 from the Airport Special Capital Projects fund balance. BACKGROUND: On May 11, 2023, the City Council awarded a construction contract to CALTEC Corporation in the amount of $1,805,000 with a 10% contingency for the Project in the amount of $180,500. The initial scope of work included: • Demolition and removal of existing customer service millwork and fixed gate podiums. • Removal and replacement of carpet, gate signage, and gate portal flooring. • Reconfiguration of existing holdroom seating and stanchions. • Power to seating and gate podiums. Item 1J - Page 1 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 City Council Staff Report October 10, 2024 -- Page 2 Accept Airport Common Use Podiums • Installation of new lighting, painting of gate portals, rubber tiles and wall bases, ceiling mounted gate information, display systems, and new customer service millwork with data/power connections and common use podium equipment (i.e., computers, printers, monitors, scanners, etc.). Construction started on August 7, 2023, and since then there have been three contract change orders approved per the following: • Contract Change Order No. 1 – Addressed additional cost to reframe the soffits where the light fixtures L2 and L3 interfere with the existing ceiling joists in the lump sum amount of $53,240.96. • Contract Change Order No. 2 – Addressed additional FIDS mount, patch drywall, and display monitor. Provide power, data, and patch back and install additional monitors at the Customer Service credenzas in the lump sum amount of $119,731.06. • Contract Change Order No. 3 – Addressed additional floor coring for IDFs and additional conduit runs to the IDF rooms through the 2nd floor from the existing T- Bar soffits in the lump sum amount of $63,698.20. STAFF ANALYSIS: Construction of the Project started August 7, 2023, and was determined to be substantially complete on June 27, 2024. Staff recommends City Council accept the completed Project as required by Section 9200 of the California Civil Code and authorize the City Engineer to file and record a Notice of Completion to be submitted to the County. A copy of the Notice of Completion is included as Attachment A. ENVIRONMENTAL ASSESSMENT: In accordance with the California Environmental Quality Act (“CEQA”) Guidelines Section 15301 “Existing Facilities”, Class 1 projects consist of the operation, repair, maintenance, permitting, leasing, licensing or minor alteration of existing public structures, facilities, mechanical equipment, or topographical features involving negligible or no expansion of existing or former use. Therefore, Staff has determined that Airport Common Use Podiums – Bono Concourse, City Project 21-28, is considered categorically exempt from CEQA and a Notice of Exemption has been filed with the Riverside County Clerk. ALIGNMENT WITH STRATEGIC PLANNING: This Project aligns with City Council Priority 2A – Improve City Facilities – Prioritize Deferred Maintenance. Item 1J - Page 2 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 City Council Staff Report October 10, 2024 -- Page 3 Accept Airport Common Use Podiums FISCAL IMPACT: There is one (1) balancing change order in the amount of $30,252.15, included as Attachment B, related to increased and decreased scope of work. Sufficient funds are available in the Department of Aviation Fund 416 Account 4167065-80000 to cover the appropriation for this final balancing change order. With the modifications to the Project, the final construction cost is $2,071,922.37. The City is holding retention funds in the amount of $103,596.12 for CALTEC Corporation pending the filing of the Notice of Completion with the County Recorder’s Office. REVIEWED BY: City Engineer: Joel Montalvo Aviation Executive Director: Harry Barrett Jr. Deputy City Manager: Flinn Fagg City Manager: Scott Stiles ATTACHMENTS: A. Notice of Completion B. Final Balancing Change Order Item 1J - Page 3 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Attachment A Item 1J - Page 4 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Name Street Address City & State SPACE ABOVE THIS LINE FOR RECORDERS USE NOTICE OF COMPLETION (CA Civil Code §§ 8180-8190, 8100-8118, 9200-9208) NOTICE IS HEREBY GIVEN THAT: 1.The undersigned is an owner of an interest of estate in the hereinafter described real property, the nature of which interest or estate is: _________________________________________________________________________________ (e.g. fee, leasehold, joint tenancy, etc.) 2.The full name and address of the undersigned owner or reputed owner and of all co-owners or reputed co-owners are: Name Street and No. City State __________________________________________________________________________________________________________ 3.The name and address of the direct contractor for the work of improvement as a whole is: __________________________________________________________________________________________________________ 4.This notice is given for (check one): Completion of the work of improvement as a whole. Completion of a contract for a particular portion of the work of improvement (per CA Civ. Code § 8186). 5.If this notice is given only of completion of a contract for a particular portion of the work of improvement (as provided in CA Civ. Code §8186), the name and address of the direct contractor under that contract is: ___________________________________________________________________________________________________________ 6.The name and address of the construction lender, if any, is: ___________________________________________________________________________________________________________ 7.On the ____________ day of ___________, 20___, there was completed upon the herein described property a work of improvement as a whole (or a particular portion of the work of improvement as provided in CA Civ. Code § 8186) a general description of the work provided: ___________________________________________________________________________________________________________ 8.The real property herein referred to is situated in the City of __________________________, County of ________________________ State of California, and is described as follows: ___________________________________________________________________________________________________________ 9.The street address of said property is: ___________________________________________________________________________________________________________ 10.If this Notice of Completion is signed by the owner’s successor in interest, the name and address of the successor’s transferor is: ___________________________________________________________________________________________________________ I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: _______________________________________ By: ________________________________________________________ Signature of Owner or Owner’s Authorized Agent City of Palm Springs Page 1 of 2 Recording Requested By: When Recorded Mail To: Item 1J - Page 5 City of Palm Springs Brenda Pree, City Clerk 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 Fee City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs CA 92262 CALTEC Corp. 8732 Westminster Blvd. Suite 2, Westminster, CA 92685 4 Not Applicable Not Applicable 27 June 24 the removal and installation of new customer service millwork, removal and replacement of carpet, new gate signage and new lighting. CP 21-28 Palm Springs Riverside Palm Springs International Airport 3400 E. Tahquitz Canyon Way, Palm Springs, CA 92262 Not applicable Joel Montalvo/City Engineer Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Page 2 of 2 VERIFICATION I, _______________________________________________, state: I am the ________________________________ __ (“Owner”, “President”, “Authorized Agent”, “Partner”, etc.) of the Owner identified in the foregoing Notice of Completion. I have read said Notice of Completion and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on _______________________, _______ (date), at _____________________________________________________ (City), ________ (State). ______________________________________________________ Signature of Owner or Owner’s Authorized Agent Joel Montalvo/City Engineer City of Palm Springs STATE OF CALIFORNIA COUNTY OF ______________________________________ On _________________________________________, ________ (date), before me, ____________________________________________, Notary Public (name and title of officer) personally appeared __________________________________________who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PURJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. _____________________________________________ Signature A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. Item 1J - Page 6 Joel Montalvo City Engineer Palm Springs CA Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Attachment B Item 1J - Page 7 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Page 1 of 2 CITY OF PALM SPRINGS BALANCING CONTRACT CHANGE ORDER CP 21‐28 Airport Common Use Podiums – Bono Concourse Contractor: CALTEC Corporation Date: September 18, 2024 CONTRACT CHANGE ORDER SUMMARY The City of Palm Springs Airport requested CALTEC to provide additional services to complete the project. CALTEC requested compensation for staging to complete the project. The items were not completed so CALTEC provided a credit back to the Project. Meeting notes and backup documents are available at the engineering department. CONTRACT CHANGE ORDER COST ID Description Qty Unit Cost 01 Additional work requested and miscellaneous work needed to finish the project 1 LS $33,414.55 02 Credit for work not performed, changed or deleted from original contract 1 LS ($3,162.40) Total Lump Sum Change Order Amount: $30,252.15 CHANGES TO CONTRACT TIME: The Contractor is requesting any additional 136 working days. Source of Funds: Sufficient funds are available in Department of Aviation Fund 416 Account No. 4167065‐80000. Summary of Costs: Original Contract Amount: $1,805,000.00 Construction Start Date: 08/07/2023 Previous Change Orders: $236,670.22 Previous Agreed Completion 12/15/2023 This Change Order Amount: $30,252.15 Working Days Added: 136 Revised Contract Amount: $2,071,922.37 Revised Completion: 06/27/2024 ‐‐Signature on the following page‐‐ Item 1J - Page 8 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 Page 2 of 2 I have received a copy of this Change Order, and the above AGREED PRICES are acceptable to Contractor. CALTEC Hamid Abghari, President Date City of Palm Springs Recommended By: Joel Montalvo, City Engineer Date Approved By: Scott Stiles, City Manager Date Attest By: Brenda Pree, City Clerk Date Item 1J - Page 9 Docusign Envelope ID: F6B6C622-3638-48E7-9FB2-EC257B29E1B3 CONTRACT ABSTRACT 1 Original: Contract Change Order No. 3 Contract Company Name: Company Contact: Summary of Services: Contract Price: Funding Source: Contract Term: CALTEC Corporation Hamid Abghari, President Airport Common Use Podiums – Bono Concourse, City Project 21-28 $2,041,670.22 (includes CCO#3 for $63,698.20) Airport Special Capital Projects funds To be determined by the Notice to Proceed Contract Administration Lead Department: Contract Administrator: Engineering Services Joel Montalvo / Andrew Crider Contract Approvals Council Approval Date: Contract Change Order #1: Contract Change Order #2: Contract Change Order #3: Agreement Number: May 11, 2023, Item 1.E. September 13, 2023 September 28, 2023 October 26, 2023, Item 1.P. 23B132 Contract Compliance Exhibits: Signatures: Insurance: Bonds: On file Attached On file On file Contract prepared by: Engineering Services Submitted on: 10/31/2023 By: Vonda Teed DocuSign Envelope ID: 59062704-4CEA-4DDD-99A2-8DC655AD1A2B Page 1 of 1 CITY OF PALM SPRINGS CONTRACT CHANGE ORDER No. 3 CP 21-28 Airport Common Use Podiums – Bono Concourse Contractor: CALTEC Date: October 26, 2023 CONTRACT CHANGE ORDER SUMMARY: The City of Palm Springs Airport requested CALTEC provide a proposal for additional floor coring for IDFs and additional conduit runs to the IDF rooms through the 2nd floor from the existing T-Bar soffits. CONTRACT CHANGE ORDER COST: ID Description Qty Unit Cost 01 Cost for additional flooring coring for the IDFs and additional conduit runs to the IDF rooms from the existing T-Bar soffits. 1 LS $63,698.20 Total Lump Sum Change Order Amount: $63,698.20 CHANGES TO CONTRACT TIME: The contractor is not requesting any additional days at this time. Source of Funds: Sufficient funds are available in Department of Aviation Fund 416 Account No. 4167065-80000. Summary of Costs: Original Contract Amount: $1,805,000.00 Construction Start Date: 08/07/2023 Previous Change Orders: $172,972.02 Previous Agreed Completion Date: 12/15/2023 This Change Order Amount: $63,698.20 Calendar Days Added: 0 Revised Contract Amount: $2,041,670.22 Revised Completion: 12/15/2023 I have received a copy of this Change Order and the above AGREED PRICES are acceptable to Contractor. CALTEC Hamid Abghari, President Date City of Palm Springs Recommended By: Harry Barrett Jr., Executive Director PSP Date Recommended By: Scott C. Stiles, City Manager Date Attest By: Brenda Pree, City Clerk Date DocuSign Envelope ID: 59062704-4CEA-4DDD-99A2-8DC655AD1A2B 11/6/2023 11/6/2023 11/6/2023 11/7/2023 CONTRACT ABSTRACT 1 Original: Contract Change Order No. 2 Contract Company Name: Company Contact: Summary of Services: Contract Price: Funding Source: Contract Term: CALTEC Corporation Hamid Abghari, President Airport Common Use Podiums – Bono Concourse, City Project 21-28 1,977,972.02 (includes CCO#2 for $119,731.06) Airport Special Capital Projects funds To be determined by the Notice to Proceed Contract Administration Lead Department: Contract Administrator: Engineering Services Joel Montalvo / Andrew Crider Contract Approvals Council Approval Date: Contract Change Order #1: Contract Change Order #2: Agreement Number: May 11, 2023, Item 1.E. September 13, 2023 TBD 23B132 Contract Compliance Exhibits: Signatures: Insurance: Bonds: On file Attached On file On file Contract prepared by: Engineering Services Submitted on: 09/28/2023 By: Vonda Teed DocuSign Envelope ID: 371EF31B-5834-41CA-85A3-406853F32C7D Page 1 of 1 CITY OF PALM SPRINGS CONTRACT CHANGE ORDER No. 2 CP 21-28 Airport Common Use Podiums – Bono Concourse Contractor: CALTEC Date: September 28, 2023 CONTRACT CHANGE ORDER SUMMARY: The City of Palm Springs Airport requested CALTEC to provide a proposal for an additional FIDS mount, patch drywall, and display monitor. The Airport also requested a proposal to provide power, data, and patch back and install additional monitors at the Customer Service credenzas. There is additional cost for conduit runs only from existing cable tray to new podiums on Bono concourse and coring into the 2nd Floor IDF. CONTRACT CHANGE ORDER COST: ID Description Qty Unit Cost 01 Cost for additional FIDS mount, patch drywall and display monitor. Cost to provide power, data and patch back and install additional monitors at Customer Service credenzas. Cost for conduit runs and new coring. 1 LS $119,731.06 Total Lump Sum Change Order Amount: $119,731.06 CHANGES TO CONTRACT TIME: The contractor is not requesting any additional days at this time. Source of Funds: Sufficient funds are available in Department of Aviation Fund 416 Account No. 4167065-80000. Summary of Costs: Original Contract Amount: $1,805,000.00 Construction Start Date: 08/07/2023 Previous Change Orders: 53,240.96 Previous Agreed Completion Date: 12/15/2023 This Change Order Amount: $119,731.06 Calendar Days Added: 0 Revised Contract Amount: $1,977,972.02 Revised Completion: 12/15/2023 I have received a copy of this Change Order and the above AGREED PRICES are acceptable to Contractor. CALTECH Hamid Abghari, President Date City of Palm Springs Recommended By: Harry Barrett Jr., Executive Director PSP Date Recommended By: Scott Stiles, City Manager Date Attest By: Brenda Pree, City Clerk Date DocuSign Envelope ID: 371EF31B-5834-41CA-85A3-406853F32C7D 9/28/2023 9/28/2023 9/28/2023 9/28/2023 CONTRACT ABSTRACT 1 Original: Agreement, Performance & Payment Bonds, and Insurance Contract Company Name: Company Contact: Summary of Services: Contract Price: Funding Source: Contract Term: CALTEC Corporation Hamid Abghari, President Airport Common Use Podiums – Bono Concourse, City Project 21-28 1,805,000.00 Department of Aviation Fund 416 To be determined by the Notice to Proceed Contract Administration Lead Department: Contract Administrator: Engineering Services Joel Montalvo / Andrew Crider Contract Approvals Council Approval Date: Agreement Number: May 11, 2023, Item 1.E. 23B132 Contract Compliance Exhibits: Signatures: Insurance: Bonds: Attached Attached Attached Attached Contract prepared by: Engineering Services Submitted on: 06/05/2023 By: Anil Cholakkara DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT A/C, No): FAX E-MAILADDRESS: PRODUCER A/C, No, Ext): PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: Per accident) Ea accident) N / A SUBR WVD ADDL INSD 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. PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOSONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY) POLICY EXP( MM/DD/YYYY) POLICYEFFPOLICYNUMBERTYPEOFINSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE AGGREGATE OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG GENERAL AGGREGATE PERSONAL & ADV INJURY MED EXP (Any one person) EACH OCCURRENCE DAMAGE TO RENTED $ PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 6/1/2023 Orr &Associates Insurance Services 28780 Single Oak Dr Ste 255 Temecula CA 92590 Certificates 951-506-5859 800-474-3003 certs@orrandassociates.com License#:0E63493 Infinity Select Insurance Co.20260 CALTCOR-01 Mt.Hawley Insurance Company37974CaltecCorp 8732 Westminster Blvd Ste #2 Westminster CA 92683 Lloyds of London 1467794851 2 B X 1,000,000 X 50,000 1,000 1,000,000 2,000,000 X Y Y MGL0197714 5/13/2023 5/13/2024 2,000,000 A 1,000,000 X X X 504610158586001 6/14/2022 6/14/2023 B X 1,000,000 X MXL0437715 5/13/2023 5/13/2024 1,000,000 C C Pollution Liability Professional Liability PF00902A22 PF00902A22 5/15/2023 5/15/2023 5/15/2024 5/15/2024 Aggregate Aggregate 1,000,000 1,000,000 Certificate is subject to policy limits,conditions and exclusions. The City of Palm Springs,its officials,employees and agents are named as Additional Insured as per attached endorsement form(s).Insurance is Primary and Non Contributory.General Liability Notice of Cancellation:Carrier will provide written notice at least thirty(30)days before the effective date of cancellation to the designated person or organization in the above schedule.For cancellation due to nonpayment of premium the Carrier will provide written notice at least ten 10)days before the effective date of cancellation to the designated person or organization in the above schedule.(Endorsement:IL 00 17 11 98 and CGL 388 02/11)attached. RE:AIRPORT COMMON USE PODIUMS –BONO CONCOURSE CITY PROJECT NO.21-28 3400 East Tahquitz Canyon Way Palm Springs CA 92262 The City of Palm Springs 3200 East Tahquitz Canyon Way Palm Springs CA 92262 DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 2.If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these addi- tional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or re- pairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or A. Section II – Who Is An Insured is amended to in- clude as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused by: 1.Your negligence; or 2.The negligence of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and CGL 20 10 08 15 Page 1 of2ContainscopyrightedmaterialofInsuranceServicesOffice, Inc. with its permission. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Location(s) Of Covered Operations SCHEDULE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Name Of Additional Insured Person(s) Or Organization(s) Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organi All persons or organizations where required by written contract executed prior to the commencement of your work. All Locations Mt. Hawley InsuranceCompanyMGL0197714 Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 2.That portion of "your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C.With respect to the insurance afforded to these addi- tional insureds,the following is added to Section III – Limits Of Insurance: CGL 20 10 08 15 Page 2 of2ContainscopyrightedmaterialofInsuranceServicesOffice, Inc. with its permission. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. The most we will pay on behalf of the additional insured is: 1.The minimum amount required by any contract or agreement you have entered into to provide additional insured coverage;or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. Section II – Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused by your negligence at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CGL 20 37 08 16 Page 1 of1ContainscopyrightedmaterialofInsuranceServicesOffice, Inc. with its permission. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Information required to complete this Schedule, if not shown above, will be shown in the Declarations. SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) (Vendor)Location And Description Of Completed Operations B.With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional in- sured is: 1.The minimum amount required by any contract or agreement you have entered into to provide addi- tional insured coverage; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Additional Insured - Owners, Lessees Or Contractors - Completed Operations All persons or organizations where required by written contract executed prior to the commencement of your work. All "Commercial Construction Projects". For the purpose of this Endorsement, "Commercial Construction Projects" are defined as buildings or structures constructed for commercial use and also include apartments, hotels, homes for the aged, dormitories or barracks. However, "Commercial Construction Projects" shall not include any building or structure which, in whole or in part,contains individual owner occupied units or dwellings. MGL0197714 Mt. Hawley Insurance Company Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ADDITIONAL INSURED – LESSOR OF LEASED EQUIPMENT – AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU A person’s or organization’s status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. B.With respect to the insurance afforded to these addi- tional insureds, this insurance does not apply to any occurrence" which takes place after the equipment lease expires. C.With respect to the insurance afforded to these addi- tional insureds, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement you have entered into with the additional insured; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organiza- tion(s) is an insured only with respect to liability for bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: 1.Only applies to the extent permitted by law; and 2.Will not be broader than that which you are re- quired by the contract or agreement to provide for such additional insured. Insurance Services Office, Inc., 2012CG20340413 Page 1 of 1 Additional Insured - Lessor Of Leased Equipment - Automatic Status When Required MGL0197714 Mt. Hawley Insurance Company Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 04 12 19 Page 1 of 1© Insurance Services Office, Inc., 2018 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Name of Person(s) or Organization(s): SCHEDULE Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subroga All persons or organizations where required by written contract executed prior to the commencement of your work. MGL0197714 Mt. Hawley Insurance Company Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek con- tribution from any other insurance available to an additional insured under your policy provided that: 1)The additional insured is a Named Insured under such other insurance; and 2)You have agreed in writing in a contract or agree- ment that this insurance would be primary and would not seek contribution from any other in- surance available to the additional insured. PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy Number: CG 20 01 04 13 Page 1 of 1© Insurance Services Office, Inc., 2012 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Primary And Noncontributory - Other Insurance Condition MGL0197714 Mt. Hawley Insurance Company Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 Policy Number: COMMON POLICY CONDITIONS A. Cancellation 1.The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deliver- ing to us advance written notice of cancellation. 2.We may cancel this policy by mailing or delivering to the first Named Insured written notice of can- cellation at least: a.10 days before the effective date of cancella- tion if we cancel for nonpayment of premium; or b.30 days before the effective date of cancella- tion if we cancel for any other reason. 3.We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4.Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5.If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6.If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is author- ized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the poli- cy period and up to three years afterward. D. Inspections And Surveys 1.We have the right to: a.Make inspections and surveys at any time; b.Give you reports on the conditions we find; and c.Recommend changes. 2.We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to insur- ability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a.Are safe or healthful; or b.Comply with laws, regulations, codes or standards. 3.Paragraphs 1.and 2.of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insur- ance inspections, surveys, reports or recommen- dations. 4.Paragraph 2.of this condition does not apply to any inspections, surveys, reports or recommenda- tions we may make relative to certification, under state or municipal statutes, ordinances or regula- tions, of boilers, pressure vessels or elevators. IL 00 17 11 98 Page 1 of2Copyright, Insurance Services Office, Inc., 1998 All Coverage Parts included in this policy are subject to the following conditions. Common Policy Conditions Mt. Hawley InsuranceCompanyMGL0197714 Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 E.Premiums The first Named Insured shown in the Declarations: 1.Is responsible for the payment of all premiums; and 2.Will be the payee for any return premiums we pay. F.Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die,your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative.Until your legal representative is appointed,anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 00 17 11 98 Page 2 of2Copyright, Insurance Services Office, Inc., 1998 Insured DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8 PageCGL388 (02/11) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART CONTRACTORS SPECIAL FORM EXCESS GENERAL LIABILITY INSURANCE POLICY OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART If this policy is cancelled by us,we will send a notice by mail to the certificate holder(s)scheduled below at the scheduled address at the same time that notice is sent to you.If the policy is cancelled by you or an entity with power of attorney for this policy,we will send a notice by mail to the certificate holder(s)scheduled below at the scheduled address at the time that we process the cancellation request. If notice is mailed, proof of mailing will be sufficient proof of notice. Certificate Holder/Address: NOTICE OF CANCELLATION – CERTIFICATE HOLDER Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Notice Of Cancellation - Certificate Holder MGL0197714 Mt. Hawley Insurance Company 1 of 1 Insured The City of Palm Springs 3200 East Tahquitz Canyon Way Palm Springs CA 92262 DocuSign Envelope ID: 4AC69B60-B382-4C2A-87DC-46883486FCA8