Loading...
HomeMy WebLinkAbout23B092 - SELECT ELECTRIC INC.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) Select Electric, Inc. Michael Lichtenwalter Michael.Lichtenwalter@selectelectricinc.com Traffic Signal Improvements (14 Intersections), City Project 16-18 $3,582,528.98 (includes this CCO#1 for $96,685.98) 04/03/2025 On file James Staab, James.Staab@selectelectricinc.com Engineering Services Joel Montalvo / Allen Janisch X8734 March 23,2023, Item 1.M. 23B092 Contract Change Order No. 1 - TBD - Yes Yes Department Yes No Contract Change Order No. 1 is attached. N/A 05/27/2025 Vonda Teed Docusign Envelope ID: 022728B3-6191-47D4-A43F-5379E3836B1F Page 1 of 5 CITY OF PALM SPRINGS FINAL BALANCING CONTRACT CHANGE ORDER NO. 1 CP 16-18, Traffic Signal and ADA Improvement Project, HSIP Cycle 8 – Federal Project No. HSIPL 5282(047) Contractor: Select Electric, Inc. Date: May 27, 2025 CONTRACT CHANGE ORDER SUMMARY This final balancing Change Order No. 1 sets forth decreases in costs due to “Actual” measured Final Quantities that were used being different than the estimated Bid Quantities shown on the Bid Proposal due to changes on plans or quantities lesser than engineers estimate. This also addresses the additional work that was required to be completed due to a change in Scope of Work caused by design issues with overlap from other projects, verified utility conflicts, issues with existing conduits, plan changes, and other reasons identified below for work not in contract. After verifying the issues and conflicts, the Contractor was either instructed to perform work on Time and Materials and / or provide price quotes. After the work was completed and approved, the Contractor submitted his cost for the work and the prices were negotiated and revised. CONTRACT CHANGE ORDER COST COR# Description of Extra Work Type Unit Cost 1 Palm Canyon / San Rafael – Contractor had to break out &chip foundation down at Poles G & E that conflicted with the new foundation after re-potholing. Work was out of contract and performed on T&M. One (1) day added to contract time. Price negotiated and revised from original amount of $5,614.98. T&M Time & Material $4,249.88 2 Palm Canyon / San Rafael – Contractor had to break out & chip foundation down at Poles J & F that conflicted with the new foundation after re-potholing. Work was out of contract and performed on T&M. One (1) day added to contract time. Price negotiated and revised from original amount of $5,246.15. T&M Time & Material $3,881.04 3 Palm Canyon / San Rafael – Contractor had re-potholed Pole A to relocate due to utility conflict that conflicted with the new foundation. Encountered existing 10”-12” steel water line. Needed to backfill and meet with Water Company (DWA) to confirm. Work was out of contract and performed on T&M. One (1) day added to contract time. Verified in the field by Inspector. Price negotiated and revised from original amount of $5,508.62. T&M Time & Material $4,143.52 6 Palm Canyon / San Rafael – On 11/14/2023, Contractor added 2” Conduit SCH 80 for a new loop run on the south/east corner going east down Palm Cyn. Due to existing conduit to be used being full and old corroded steel. Work not in contract and performed on T&M. One (1) day added to contract time. Work verified in the field by Inspector. Price negotiated and revised from original amount of $9,822.39. T&M Time & Material $8,457.30 8 Palm Canyon / San Rafael – Contractor cut and connected 2” conduit that was added from previous box install and added a No. 5 Pull box that was not on plans and in contract. T&M. One (1) day added. Work performed on T&M and verified in the field by Inspector. T&M Time & Material $2,445.25 9 Palm Canyon/Mesquite – Contractor had to saw cut around existing pull boxes to remove # 3 and #5 boxes to allow for new cable to be rerouted and installed to new pull box #5 location added. Contractor backfilled, compacted and placed asphalt. Work was not in contract and One (1) day added to contract time. All work verified by field inspector. T&M Time & Material $1,927.14 Docusign Envelope ID: 022728B3-6191-47D4-A43F-5379E3836B1F Page 2 of 5 COR# Description of Extra Work Type Unit Cost 12 S. Palm Canyon / Mesquite – Boring Operation could not be performed on 12/18/2023 due to large boulders encountered which required open cut of the street to try to remove boulders and continue boring for conduit run across street. The contractor tried to continue to only get part way across the street. It started to rain this day and the contractor needed to stop and reschedule. NO days added to contract time for this work since future T&M work was approved to open cut street and trench across same location to add conduit. T&M Time & Material $8,332.00 13 S. Palm Canyon / Mesquite – Boring Operation was rescheduled for 12/19/2023 and again could not be performed due to more large boulders encountered which required open cut of street to try to remove boulders and continue boring for conduit run across street. The contractor tried to continue to only get part way across the street. Field decision made to open cut the street to complete the work. No Days added to contract time for this work since future T&M work was approved to open cut the street and trench across same location to add the conduit. Work verified by field inspector. T&M Time & Material $8,332.00 14 Palm Canyon / San Rafael – Contractor cut out abandoned Water Line 12” Steel to allow for Pole A and Re-potholed for irrigation lines to be re-routed clear of foundation and grouted the end of the water line that was abandoned per DWA. One (1) Day added to contract time for this work. Work verified by Field Inspector. T&M Time & Material $6,142.05 15 Palm Canyon / San Rafael – Trenched and Installed 2” conduit for Loop Run due to crews being unable to pull through existing conduit that was full and blocked. The existing run was 1 ½” GRC and rusted. Work was not a part of contract and performed on T&M and observed by the Field Inspector. One (1) Day added to contract Time. T&M Time & Material $2,555.03 18 S. Palm Canyon / Mesquite – Boring operation for new service run could not be completed again due to boulders encountered on S/E corner heading across Palm Canyon. Decision made to proceed with future T&M to open cut the street and install conduit. Work not part of contract. One (1) day added to contract time and all work observed by the Field Inspector. T&M Time & Material $4,697.71 19 S. Palm Canyon / Mesquite – Contractor saw cut existing sidewalk, removed sidewalk on S/E corner heading south and open trenched the street section with a backhoe, installed 2” conduit for section of new Edison run to cabinet. Work not part of contract and performed on T&M and observed by the Field Inspector. One (1) day added to contract time for work. T&M Time & Material $6,848.28 20 S. Palm Canyon / Mesquite – Contractor performed saw cut across Palm Canyon for added crossing for conduit and wires from S/E corner to S/W corner to be completed after. Work is not part of contract and performed on T&M and observed by Field Inspector. One (1) day added to contract days. T&M Time & Material $2,880.07 21 S. Palm Canyon / Mesquite – On 3/20/2024, Contractor removed sawcut asphalt at a portion of the street crossing, addition of 30’ of new 4” conduit for traffic signal run. Crew trenched with a backhoe and started from the existing pull box #5. Work is not part of contract and is being performed on T&M and observed by the Field Inspector. One (1) Day added to contract days. Price negotiated and revised from original amount of $5,122.25 due to rate. T&M Time & Material $4,950.86 22 S. Palm Canyon / Mesquite – On 3/21/2024, Contractor removed sawcut asphalt at a portion of the street crossing for the addition of 20’ of new 4” conduit for traffic signal run. Crew trenched with a backhoe and continued across Palm Canyon from the existing pull box #5. Work is not part of contract and was performed on T&M and observed by the Field Inspector. One (1) Day added to contract. Work offset by other work credit at Palm Canyon/Ramon. T&M Time & Material $5,078.06 Docusign Envelope ID: 022728B3-6191-47D4-A43F-5379E3836B1F Page 3 of 5 COR# Description of Extra Work Type Unit Cost 23 S. Palm Canyon / Mesquite – On 3/26/2024, Contractor removed sawcut asphalt at the last section of the street crossing for the addition of 30’ of new 4” conduit for traffic signal run. Crew trenched with a backhoe and started from the existing pull box #5. Backfilled trench section and installed temporary asphalt. Work is not part of contract and performed on T&M and observed by the Field Inspector. One (1) Day added to contract days. T&M Time & Material $5,574.01 24 Palm Canyon / San Rafael and Tramway – Contractor saw cut and removed sidewalk panels to install a 2” PVC Conduit loop run on S/W side of San Rafael. Work was not in contract and performed on T&M. One (1) additional day added to contract time and work observed by inspector in the field. Work negotiated and revised from $3,993.48 due to work being done per contract in multiple locations at other intersections T&M Time & Material $2,584.39 25 S. Palm Canyon / Mesquite – On 5/06/24, Contractor completed asphalt restoration after trenching & conduit installation was completed. Removed existing temporary asphalt, t- cut trench and installed new asphalt at 1/3 of the street to allow continuous traffic flow. Work is not part of contract and performed on T&M and observed by the Field Inspector. One (1) Day added to contract days. T&M Time & Material $11,027.03 26 S. Palm Canyon / Mesquite – On 5/07/24, Contractor completed the asphalt restoration after the trenching and conduit installation was completed. Removed existing temporary asphalt, t-cut trench and installed new asphalt at 1/3 of the street to allow continuous traffic flow. Work is not part of contract and performed on T&M and observed by the Field Inspector. One (1) Day added to contract days. T&M Time & Material $10,518.54 27 S. Palm Canyon / Mesquite – On 5/08/24, Contractor completed the asphalt restoration after the trenching and conduit installation was completed. Removed existing temporary asphalt, t-cut trench and installed new asphalt at 1/3 of the street to allow continuous traffic flow. Work is not part of contract and performed on T&M and observed by the Field Inspector. One (1) Day added to contract days. T&M Time & Material $10,014.43 28 S. Palm Canyon / Mesquite – Contractor saw cut and removed sidewalk and re-poured sidewalk after adding 2” conduit for Edison. Work is not part of contract and performed on T&M and observed by the Field Inspector. One (1) Day added to contract days. See attached backup documentation. T&M Time & Material $7,291.20 29 Ramon Rd./San Luis Rey – Contractor separated electrical circuits, installed No. 5 Pull Box, and pulled new wires for streetlights, controller and signal lights on the north-east corner. Work is not part of contract and performed on T&M and observed by the Field Inspector. One (1) Day added to contract. See attached documentation and T&M work tickets. T&M Time & Material $4,720.22 30.0- 36.0 N. Palm Canyon and Tramway – Contractor completed work at this location to open cut the existing street, excavate a trench, install new conduit and wire to existing Edison Pedestal to provide power due to design error that showed a different pick-up point and conduit that was not existing as shown. Original estimate for the work was $65,000.00 And Time and Materials work resulted in a savings of over $13,400.00. Ticket No. 30 – Sawcut, pothole on S/C for Conduit - $5,863.63 Ticket No. 31 – Trench for new 2” Sch 80 at 50’, added service run - $7,347.70 Ticket No. 32 – Open trenched for new 2” SCH 80 at 88’ lin. Feet - $7,426,98 Ticket No. 33 - Open trenched for new 2” SCH 80 at 50’ lin. Feet - $7,208.74 Ticket No. 34 – Install base coarse AC at utility trench after conduit - $10,276.36 Ticket No. 35 – Installed Cap Coarse asphalt at 2” service run - $8,880.71 Ticket No. 36 – Installed new service wires into new conduit. - $4,542.62 Seven (7) Days added to contract. See attached documentation and T&M work Tickets. T&M Time & Material $51,546.74 Docusign Envelope ID: 022728B3-6191-47D4-A43F-5379E3836B1F Page 4 of 5 COR# Description of Extra Work Type Unit Cost 37.0- 40.0 Ramon Road and Gene Autry – Contractor removed existing sidewalk and pull box that was two (2”) too high, cut down the box and new concrete pad was poured. Concrete was poured around added pull box, installed a new push button foundation. Existing APS wires and conductors were abandoned and 1” conduit was terminated and conduit in box cut down. Work took place on T&M from 11/13/2024 – 11/18-2024 for a total of (4) added days to contract. Work was not in original contract and observed by the field inspector. T&M Time & Material $12,028.89 41 Dinah Shore and Gene Autry – Contractor added push button post on the N/W corner at this location due to design error where Pole A having to be relocated and was no longer in ADA compliance. Work included foundation, pole installed, wire, and set new post. Work was completed on T&M and observed in the field by the inspector. One (1) day added to contract days. T&M Time & Material $4,283.44 42 Dinah Shore and Gene Autry – Contractor added push button and post on N/E corner due to Pole D not on plans. Work included foundation, pole installed, wire, and set new post. Work was completed on T&M and observed in the field by the inspector. One (1) day added to contract days. T&M Time & Material $2,887.50 43 Tramway and San Rafael – Contractor relocated one (1) existing Pull Box out of new designed ADA ramp that was NOT shown on plans due to conflict. Included relocate 3” conduit and wire to new box location. Work was completed on T&M and observed in the field by the inspector. One (1) day added to contract. T&M Time & Material $3,179.91 44 N. Palm Canyon and Tramway – Contractor relocated existing pull box and service conductor out of new designed ADA ramp that was NOT shown on plans due to conflict. Included relocate 3” conduit and wire to new box location. Work was completed on T&M and observed in the field by the inspector. One (1) day added to contract days. T&M Time & Material $6,228.49 45 Revised Cost for Cameras ONLY cost for Revised Delta for Re-Ordering Cameras. (Add to this Change Order). No days added to contract days. LS 1 $5,282.00 46 This Change is due to the relocation of all planned equipment and work required on the original plans at the intersection of Indian Canyon Drive and Tachevah Drive - Item #39 (Page 23-Plans) having to be relocated to Gene Autry Trail and E. Vista Chino (Page 21- As-built plans) due to conflicts with other CVAG and City project work that had already been installed as per the City’s direction. All work was verified in the field and tracked. LS 1 $52,356.00 47 This change was due to work that was completed at various locations as work that was exchanged for work not completed at S. Palm Cyn./ Ramon Road intersection due to project overlap with CVAG and City projects. The As-built plans reflect the added quantities and the quantities were deducted from this location as identified below as a cost savings to the City. All work was verified and measured in the field as shown below: - Added 3” Schedule 80 PVC – 200’ LF - Added 4” Schedule 80 PVC – 100’ LF - Added #6 Pull Boxes – 5 Each - Added #6E Pull Box – 1 Each $12,750.00 Total of Project Change Orders $277,192.98 Item Description of Credits Bid Cost Total Billed Decrease 13 Relocate Existing Water Meter per DWA Std. Dwg. W127 $16,581.00 $0.00 ($16,581.00) 33 N. Palm Canyon Drive (Hwy 111)/San Rafael Dr. $418,145.00 $412,145.00 ($6,000.00) 36 E. Vista Chino (Hwy 111) / N. Sunrise Way $148,069.00 $145, 569.00 ($2,500.00) 39 N. Indian Canyon Drive / Tachevah Drive $52,365.00 $0.00 ($52,356.00) 40 S. Palm Canyon Drive / Ramon Road $98,070.00 $5,000.00 ($93,070.00) 50 Field Orders $10,000.00 $0.00 ($10,000.00) Total Project Credits to City from unused Bid Items Total ($180,507.00) Docusign Envelope ID: 022728B3-6191-47D4-A43F-5379E3836B1F Page 5 of 5 Total Extra Work = $277,192.98 / Total Project Credit = $180,507.00 / Total Change Order = $96,685.98 CHANGES TO CONTRACT TIME Thirty-five (35) Calendar Days were be added to the contract time due to unforeseen utility conflicts, design errors, plan revisions, items not in scope, and changes requested by the City. SUMMARY OF COSTS Original Contract Amount: $3,485,843.00 Construction Start Date: 9/25/2023 Previous Change Orders: $0.00 Previous Agreed Completion Date: 08/13/2024 This Change Order Amount: $96,685.98 Calendar Days Added: 35 Revised Contract Amount: $3,582,528.98 Revised Completion with pauses 04/03/2025 I have received a copy of this Change Order and the above AGREED PRICES are acceptable to Contractor. Select Electric, Inc. James Staab, President Date City of Palm Springs Recommended By: Joel Montalvo, City Engineer Date Approved By: Scott C. Stiles, City Manager Date Attest By: Brenda Pree, City Clerk Date Docusign Envelope ID: 022728B3-6191-47D4-A43F-5379E3836B1F 5/27/2025 5/27/2025 5/27/2025 5/27/2025 10 10 ,4c oR CERTIFICATE OF LIABILITY INSURANCE I 1/17/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . CONTACT PRODUCER NAME: Account Manager Spectrum Risk Management PHONE 949-756-5730 AIC No : 949 756 5740 c 74 Discoveryy RECEIVED E-MAIL otfce s ectrumrisk.com Irvine, CA 92618 ADDRESS: ,.,�e.�, wvcnonrur rnVrRAr.F NAIC # INSURED DCS Plastering, Inc. 2851 East Via Martens OFFICE OF THE CITY Anaheim CA 92806 E: o CvrClAu uIIMRFR• DATE (MMIDDIYYYY) 7 COVERAGES GEKIIYIGAIt NUMIMMrc: 6s01.1301Z • BEEN ISSUED TO THE INSURED -------- NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE Awa POLICY NUMBER IMMIDDNYYYI (MMIDDfYYYY) LIMITS LTR A COMMERCIAL GENERAL LIABILITY VCGP033183 12/31/2024 12/31/2025 EACH OCCURRENCE $1 000000 �/ �/ �/ DAMA ET RENTED PREMISES Ea occurrence $100 000 CLAIMS -MADE [�] OCCUR MED EXP (Any one person) s5,000 ✓ Pollution Liability - included PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: LOC IV] PRODUCTS - COMP/OP AGG $2000,000 POLICY JECT Deductible $ 5 000 OTHER: BW03-STR-2400369-01 12/31/2024 12/31/2025 COMBINED SINGLE LIMIT Ea accident $ 1 000 000 BODILY INJURY (Per person) $ B AUTOMOBILE LIABILITY ✓ ✓ ✓ ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ AUTOS ONLY AUTOS HIRED NON -OWNED Per accident $ AUTOS ONLY AUTOS ONLY UMBRELLALIAB ,/ OCCUR SF24EXCZ09UY21C 12/31/2024 12/31/2025 EACH OCCURRENCE $5000000 C EXCESS LIAB CLAIMS -MADE AGGREGATE s5,000,000 ✓ WSD 5074681 01 1/1/2025 1/1/2026 H ✓ STATUTE I I ER $ DIED ✓ RETENTION$0 WORKERS COMPENSATION D E.L. EACH ACCIDENT $1 ,000 000 AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE NIA OFFICER/MEMBEREXCLUDED7 Y E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1 000 000 E DESCRIPTION OF OPERATIONS below Contract's EquipmenUlnland Marine BMO (25) 58 47 28 96 12/31/2024 12/31/2025 $44,043 Limit DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) #24-017 - MRG - Palm Springs Airport See Attached Addendum for additional insureds. tK I IFIL A I t r1U1_ur-rc #24-017 - MRG - Palm Springs Airport City of Palm Springs Risk Manager 3200 East Tahquitz Canyon Way Palm Springs CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9uwj Jim Waterhouse on nnMnf%0ATIr1L1 All A. h*c r a—arl ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 83605572 1 2024 GL/POLL/BAOT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 1 of 13 AGENCY CUSTOMER ID: LOC #: AC")?" ADDITIONAL REMARKS SCHEDULE V AGENCY Spectrum Risk Management NAMED INSURED DCS Plastering' Inc. 2851 East Via Martens Anaheim CA 92806 POLICY NUMBER CARRIER I NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability 03/16) HOLDER: City of Palm Springs Risk Manager ADDRESS: 3200 East Tahquitz Canyon Way Palm Springs CA 92262 The following parties are included as additional insured on primary and non-contributory basis with respect to General Liability and Auto Liability, where required by written contract per attached policy forms. Waiver of subrogation applies in favor of additional insureds with respect to General Liability, Auto Liability and Worker's Compensation. Umbrella and/or Excess policies follow forms of underlying General Liability, Auto and Worker's Compensation policies, where required by written contract per attached policy forms. 1. JRM Construction Management, LLC 2. JRM Holdco, Inc. 3. JRM Construction Management Holdings, LLC 4. JRM Construction Management New Jersey, LLC 5. JRM Construction West LLC 6. JRM Construction Management Florida LLC 7. Transparent Construction, LLC 8. and each of their respective parent, member, related, affiliate or subsidiary companies, officers, directors, shareholders, members, board members, principals, partners, managers, agents, representatives, employees, and each's successors and assigns 9. The City of Palm Springs, its officers, officials, employees and volunteers 10. Marshall Retail Group, LLC 11. its parent, related and affiliated companies and each's successors and assigns ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 83605572 1 2024 GL/POLL/BAUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 2 of 13 PolicyNumber: CG 20 37 12 19 VCGP033183 Insured Name: DCS Plastering, Inc. Effective Date:12i31izoza THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: (:nmmercial General Liability Coverage Part Schedule Name Of Additional Insured Person(s) Location And Description Of Or Or anization s Completed Operations Any person or organization when you have agreed in All locations and completed operations for a written and executed contract, prior to an which you have agreed in a written and contract to an "occurrence." "occurrence", that such person or organization be executed prior added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 83605572 12024 GL/POLL/BRUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 3 of 13 Policy Number: VCGP033183 CG 20 10 12 19 Insured Name: DCS Plastering, Inc. Effective Date:12i31/zp2a THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Additional Insured Person(s) Or Or anization s Locations Of Covered Operations Any person or organization when you have agreed in All locations for which you have agreed in a a written and executed contract, prior to an written and executed contract prior to an "occurrence", that such person or organization be "occurrence." added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional 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 repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 83605572 1 2024 GL/POLL/BAOT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 4 of 13 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 2 of 2 83605572 1 2024 GL/POLL/BAUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 5 of 13 VCGP033183 1 /17/2025 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 1 83605572 1 2024 GL/POLL/BAUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 6 of 13 Policy Number: VCGP033183 CG 24 04 12 19 Insured Name:DCS Plastering, Inc. Effective Date:12i31i2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Person(s) Or Organization(s): Any person or organization you have agreed in a written and executed contract, prior to an "occurrence", that you would provide such person or organization a waiver of transfer of rights of recovery against others to us on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The followina 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. All other terms and conditions of this Policy remain unchanged. CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 83605572 1 2024 GL/POLL/BAUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 7 of 13 POLICY NUMBER: BW03-STR-2400369-01 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: DCS Plastering, Inc. Endorsement Effective Date: 12/31/2024 SCHEDULE Name Of Person(s) Or Organization(s): Blanket Additional Insureds for Covered Autos Liability Coverage include: Any person or organization, when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, but only with respect to the operation, maintenance, or use of a covered "auto" for "bodily injury" or "property damage" caused, in whole or in part, by you or those acting on your behalf. Information required to complete this Schedule if not shown above will be shown in the Declarations. I Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA20481013 © Insurance Services Office, Inc., 2011 83605572 1 2024 GL/POLL/BAOT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 8 of 13 Page 1 of 1 BV\103-STR-2400369-01 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". CA 04 49 11 16 83605572 1 2024 GL/POLL/BAUT, 2025 WC B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". ©Insurance Services Office, Inc., 2016 INSURED I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 9 of 13 Page 1 of 1 POLICY NUMBER: BW03-STR-2400369-01 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: DCS Plastering, Inc. Endorsement Effective Date: 12/31/2024 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any and all jobs/projects of the insured, where required by written contract, executed prior to a claim. Information required to complete this Schedule if not shown above will be shown in the Declarations. I The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 83605572 1 2024 GL/POLL/BRUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 10 of 13 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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 otherwise due. Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER 2 % of the total California Workers' Compensation premium Schedule Job Description CALIFORNIA OPERATIONS ONLY 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 Effectiveo1/of k5j No. wSD 5074681 01 Insured DCS Plastering, Inc. Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) INSURED 83605572 1 2024 GL/POLL/BAUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 11 of 13 Endorsement No. Premium $ INCL . Policy Number: VCGP033183 Insured Name: DCS Plastering, Inc. VE 01 84 12 13 Effective Date:12/31/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECTS(S A GENERAL AGGREGATE LIMIT SUBJECT TO MAXIMUM AGGREGATE This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Designated Construction Project(s): All construction projects for which you have agreed in writing in a contract, prior to an occurrence that causes "bodily injury", "property damage" or "personal and advertising injury", to provide project specific limits. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. VE 01 84 12 13 Page 1 of 2 83605572 1 2024 GL/POLL/BAUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 12 of 13 To YOU Damage To Premises Rented re ate and imit I However, instead of being subject to the General Agg 9 4, The limits showne continuetoapp y Declarations for Each Occurrence, applicable Designated Construction Project Medical Expense shown in the Declarations, such limits will be subject to the General Aggregate Limit. Limit of! 5 All payments under this endorsement are subject to the Maximum Aggregate $ 5,000,000 will pay under this endorsement regardless of the number The Maximum Aggregate Limit is the most we re ate Limits. The Maximum Aggregate Limit is not of Designated Construction Project General Agg 9 available to pay for damages or expenses other than as set forth in the endorsement. occurrences" under ava as damages caused by all obligated to pay accidents under Section I — shown Coveragen the B. For all sums which the insured becomes legally le designated construction project Section I —Coverage tedonly to Ond for nl medical expet going ng operations at caused s ng by which cannot be attri C for medical expenses shall Schedule above: es or under Coverageleted operations 1. Any payments made under Coverage A for damages the amount available under the General Aggregate Limit or the Products-com reduce licable; and Aggregate Limit, whichever is app Limit. shall not reduce any Designated Construction Project General Aggregaterovided, any 2. Such payments "products -completed operations hazard" is p leted out of the p e included in the ,products -comp for liability arising , or „property damage" and not reduce the C. When coverage es because of "bodily injury' leted Operations Aggregate Limit, payments for damag re ate Limit. Construction Project General Agg g operations hazard" will reduce the Products-com delayed, or abandoned and then General Aggregate Limit nor the Designatedspecifications n ro ect has been abandoned,plans, blueprints, designs, D. If the applicable designated construction parties deviate from restarted, or if the authorized contracting p ro ect. timetables, the project will still be deemed to be the same �moditruction fied by this endorsement shall continue E. The provisions of Section tll — Limits of Insurance not otherwise to apply as stipulated. Page 2 of 2 VE 01 8412 13 83605572 1 2024 GL/POLL/BRUT, 2025 WC I Ellen Lau 1 1/17/2025 2:00:39 PM (PST) I Page 13 of 13 ACil CERTIFICATE OF LIABILITY INSURANCE DAM(MM DDMV ) 1 `/ 12/30/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . vaooucER CONTACT N MEp Account Manager Spectrum Risk Management PHONE sas 75s-573o a c Na: 94s 75s 5740 a 74 Discoverryy - Irvine, CA 92618 ADRAIL officeasllectrumnsk.com _ RECEIVED INSURERS AFFORDING COVERAGE NAM INSURERA: Gemini Insurance Company 10833 www.spectrumrisk.com OC77485 INSURED JAN 13 2025 DCS Plastering,Inc. INSURER B: Clear Blues Specialty Insurance Coma 37745 INSURER C: Navigators SPecially Insurance Company 36056 2651 EastastVia Martens INSURER : Insurance Company of the West 27847 Anaheim CA 92806 OFFICE OF THE CITY CLERK INsuNER E: Ohio Casualty Insurance Company 24074 INSURER F : COVERAGES CERTIFICATE NUMBER: R'i�Rnnain 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. WAR TR TYPE OF INSURANCE A DL lNsn SUBIR wwvri POLICYNUMBER POLICY EFF IMMIDDIYYYYI POLICY EXP IMMAXYYYYY)LIMITS A COMMERCMLGENERALLOBILITY ,� VCGPO33183 12/31/2024 12/31/2025 EACH OCCURRENCE $1000000 CLAIMS -MADE 1-1/1 OCCUR PR MI E a ocwmensa 31D0,000 MED EXP (Airy one Pelson) $5 000 Pollution liability - included PERSONAL SADV INJURY S1000000 AGGREGATE LIMIT APPLIES PER: POLICY O JE0 LOC GENERALAGGREGATE s2,000,000 GEN'L PRODUCTS- COMP/OP AGO s2000000 Deductible S5000 OTHER B AUTOMOBILE UABwtt BW03-STR-2400369-01 12/3VY024 12131/2025 C�OMaI�N�ISINGLE LIMIT $1 OOOOW BODILY INJURY (Per person) S ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per actideN) $ PROPERTY DAMAGE Para dent S HIRED NON OWNED AUTOS ONLY AUTOSONLV S C UMBRELLA LIAR r/ OCCUR SF24FXCZ09UY21C 12/31/2024 12/31/2025 EACHOCCURRENCE s5000000 EXCESS DAB CIAIMSdAADE AGGREGATE s 5,0D0,000 DED RETENTION$0 $ D INORNERSCOMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETOMPARTNEWEXECU ME OFFICERIMEMBEREXCLUDED9 NIA WSD 5074681 01 1/1/2025 1/1/2026 ,r °TAT T ERH E.L EACH ACCIDENT $1000000 E.L DISEASE - EA EMPLOYE $ (MmmuHnry In NH) II yes, dund escnW er DESCRIPTION OF OPERATIONS helm E.L. DISEASE -POLICY LIMIT $1 00D 000 E Contract's Equipment/inland Marine BMO (25) 58 47 28 96 12/31/2024 12/31/2025 $44,043 Limit MWRIPPM OF OPERATIONS I LOCAnMS I VEHICLES (ACORD 101, Additional Rarllaft ScbadVle, may W aeacMO X mom space Ia rpuin !) #24015 - MRG - Palm Springs Airport Purchase Order#80-011447 See Attached Addendum for additional insureds. Purchase Order#80-011447 City, of Palmgg Springs Risk Mana 3200 East Tatqitz Canyon Way Palm Springs CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORUMDREPRESENTATIVE ,s Al Jim Waterhouse l////1�_`'_{q,{.aI ,�/` n1 All H.Infe In..I d ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: A� o ADDITIONAL REMARKS SCHEDULE Page of AGENCY S echum Risk Management NAMEDINSURED DCS Plastering' Inc. 2851 East Via Martens Anaheim CA 92806 POUCYNUMBER CARRIER "IC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Palm Springs Risk Manager ADDRESS: 3200 East Tahquitz Canyon Way Palm Springs CA 92262 The City of Palm Springs, its officers, officials, employees and volunteers, Marshall Retail Group, LLC its parent, related and affiliated companies and each's successors and assigns are included as additional insured on primary, non-contributory basis with waiver of subrogation applies in favor of additional insureds with respect to CGL, Umbrella/ Excess and Auto liability insurance, where required by written contract per attached policy forms. Waiver of subrogation applies in favor of additional insureds with respect to Worker's Compensation. Umbrella and/or Excess policies follow forms of underlying CGL, Auto and Employers Liability policies, where required by written contract per attached policy forms. ACORD 101 1200R/n11 The ACORD name and logo are registered marks of ACORD ADDENDUM 8336005D 1 2024 WPOLL/EAUT, 2025 NC I Ellen Lae 1 12/30/2024 2:01:03 PM (PST) I Page 2 of 13 Policy Number: VCGP033183 CG 20 37 1219 Insured Name: DCs Plastering, Inc. Effective Date:12i3v2oza THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Additional Insured Person(s) Location And Description Of Or Organization(s) Completed Operations Any person or organization when you have agreed in All locations and completed operations for a written and executed contract, prior to an which you have agreed in a written and "occurrence", that such person or organization be executed contract prior to an "occurrence." added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 83360050 1 2024 GL/POLL/BAOT, 2025 WC I Ellen La" 1 12/30/2024 2:01:03 PM (PST) I Page 3 of 13 Policy Number: VCGP033183 Insured Name: DCS Plastering, Inc. CG 20 10 12 19 Effective Date: 12/31/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Schedule Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization when you have agreed in All locations for which you have agreed in a a written and executed contract, prior to an written and executed contract prior to an "occurrence", that such person or organization be occurrence." added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or"personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG20101219 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. © Insurance Services Office, Inc., 2018 Page 1 of 2 83360050 1 2024 GL/POLL/BAOT, 2025 We I Ellen Lau 1 12/30/2024 2:01:03 PM (PST) I Page 4 of 13 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of this Policy remain unchanged. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 2 of 2 83360050 1 2024 WPOLL/PAOT, 2025 WE I Ellen LOU 1 12/30/2024 2:01:03 PM (PST) I Page 5 of 13 VCGP033183 12/30/2024 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 1 63360050 1 2024 WPOLL/BAUT, 2025 WC I Ellen Lau 1 12/30/2024 2:01:03 PM (PST) ) Page 6 of 13 Policy Number: vcOP033183 Insured Name:Dcseias(erjns,Inc. CG 24 04 12 19 Effective Date:12/31/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part Name Of Person(s) Or Organization(s): Any person or organization you have agreed in a written and executed contract, prior to an "occurrence", that you would provide such person or organization a waiver of transfer of rights of recovery against others to us on your policy. Information required to complete this Schedule if not shown above will be shown in the Declarations. 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. All other terms and conditions of this Policy remain unchanged. CG 24 04 12 19 © Insurance Services Office, Inc., 2018 03360050 1 2024 GL/POLL/BAUT, 2025 MC I Ellen Lau 1 12/30/2024 2:01:03 PM (PST) I Page 7 of 13 Page 1 of 1 POLICY NUMBER:; BW03-STR-2400369-01 COMMERCIAL AUTO CA 20 4810 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured:; DCS Plastering, Inc. Endo sement Effective Date:) 1213112024 SCHEDULE Name Of Person(s) Or Organization(s): Blanket Additional Insureds for Covered Autos Liability Coverage include: Any person or organization, when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, but only with respect to the operation, maintenance, or use of a covered "auto" for "bodily injury" or "property damage" caused, in whole or in part, by you or those acting on your behalf. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 1013 © Insurance Services Office, Inc., 2011 83360050 1 2024 GL/POLLEAUT, 2025 NC I Ellen Lau 1 12/30/2024 2:01:03 PM (PST) I Page 8 of 13 Page 1 of 1 BM3-STR-2400369-01 COMMERCIAL AUTO CA 04 49 1116 INaI[A=I1I.Z.]Z*�W11=, Idle] :r_1,M*111111:141.7111[a-Aa1111:M-MANNF_v]If9_1741a1111wig PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". CA 04 4911 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 . INSURED 63360050 1 2024 GL/POLL/MW, 2025 WC I Ellen Lau 1 12/30/2024 2:01:03 PM (PST) I Page 9 of 13 :POLICY NUMBER:i BW03-STR-2400369-01 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: DCS Plastering, Inc. Endorsement Effective Dated 12/31/2024 SCHEDULE Names) Of Person(s) Or Organization(s): Any and all jobs/projects of the insured, where required by written contract, executed prior to a claim. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 4410 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 83360050 1 2024 GL/POLL/BRUT, 2025 WC I Ellen Lau 1 12/30/2024 2:01:03 PH (PST) I Page 10 of 13 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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 otherwise due. Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED IS REQUIRED UNDER WRITTEN CONTRACT TO FURNISH THIS WAIVER 2 % of the total California Workers' Compensation premium Schedule Job Description CALIFORNIA OPERATIONS ONLY 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 Effectivemvof lisy No. wSD5074681 01 Endorsement No. Insured DCS Plastering, Inc. Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) NSURm 83360050 1 2024 GL/POLL/BAUT, 2025 WC I Ellen Lau 1 12/30/2029 2:01:03 PM (PST) ) Page 11 of 13 Policy Number: VCCP033183 VE 01 8412 13 Insured Name: DCs Plastering, Inc. Effective Date:1231/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECTS(S) GENERAL AGGREGATE LIMIT - SUBJECT TO A MAXIMUM AGGREGATE This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Designated Construction Project(s): All construction projects for which you have agreed in writing in a contract, prior to an occurrence that causes "bodily injury", "property damage' or "personal and advertising injury", to provide project specific limits. A. For all sums which the insured becomes legally obligated to pay as damages caused by 'occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. VE 01 8412 13 Page 1 of 2 83360050 1 2024 GL/POLL/BAIIT, 2025 KC I Ellen Lau 1 12/30/2024 2:01:03 PM (PST) I Page 12 of 13 you urrence, Damage To Premisesneral Rented fe ate Lin subject to thGe Designated Construction Project I However, instead of being livable 4, The limits s 1 L17 Declarations for Each cc Medical Expense shown in they Declaration ate Limit. ts� such limits will be subject to the aP Limit of'. General Ag9 9 5 qp payments under this endorsement are subject to the Maximum Aggregate ardless of the number $ 5,000,000 A re ate Limit is not The Maximum Aggregate Limit is the most we will pay under this endorsement Maxim re General Aggregate Limits. The Maximum 99 9 expenses other than at set forth in the endorsement. oceurrences under of Designated Cor damages oroexp es caused by " Coverage C, available to p Y obligated to pay as damages expenses caused by acc dents under Section lect shown in the operations at a single designated construction p 1 Coverage A, and for all medical era B. For all sums which the insured becomesicallegally Section 1 — to ongoing P expenses shall which cannot be attributed only p for medical Operations Schedule above. e A for damages or under Coverage made under Coverage re ate Limit or the Products -comp 1. Any payments reduce the amount available and i cable and r the General Ag9 re ate Limit. Aggregate Limit, whichever is ceAggregate provided, any Designated Construction Project General Ag9 operations hazard"is roducts-comPleted y. Such payments shall not reduce any "products -completed „ included in the ' p arising out of the damagere ate Limit, and not reduce the e for liability use of "bodily injury" or "Propertyerations Ag9 g C. men coverag because completed Op re ate Limit. payments for damagesthe Products operations hazard" will reduce nated Construction Project General Adelayed, or abandoeCdicalonshen ° General Aggregate Limit nor the Desig riots, designs sp project has been abanlansebluep arties deviate from P . ro ect. p. If the applicable designated construction p 1. restarted, or if the authorized contracting P this endorsement shall continue timetables, the Project will still be deemed to be the o otherwi re m1oditied by E. The provisions of Section 111— Limits Of Insurance to apply as stipulated* ve-of of TZ TJ �� .,I Sy �P91j / va9r F7 of li CONTRACT ABSTRACT 1 Original: Agreement, Performance & Payment Bond, and Insurance Contract Company Name: Company Contact: Summary of Services: Contract Price: Funding Source: Contract Term: Select Electric, Inc. Allen McLane, President Traffic Signal Improvements (14 Intersections), City Project 16-18 $3,458,843.00 Capital, SB1, and Gas Tax Funds To be determined by the Notice to Proceed Contract Administration Lead Department: Contract Administrator: Engineering Services Joel Montalvo Contract Approvals Council Approval Date: Agreement Number: March 23, 2023, Item 1.M. 23B092 Contract Compliance Exhibits: Signatures: Insurance: Bonds: Attached Attached Attached Attached Contract prepared by: Engineering Services Submitted on: 04/20/2023 By: Anil Cholakkara DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB AGREEMENT 23B092 (CONSTRUCTION CONTRACT) THIS AGREEMENT made this __ day of _______ , 2023, by and between the City of Palm Springs, a charter city, organized and existing in the County of Riverside, under and by virtue of the laws of the State of California, hereinafter designated as the City, and Select Electric, Inc., a California corporation, hereinafter designated as the Contractor. The City and the Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: ARTICLE 1 •• THE WORK For and in consideration of the payments and agreements to be made and performed by City, Contractor agrees to furnish all materials and perform all work required to complete the Work as specified in the Contract Documents, and as generally indicated under the Bid Schedule(s) for the Project entitled: TRAFFIC SIGNAL IMPROVEMENTS (14 INTERSECTIONS) CITY PROJECT NO.16-18 FEDERAL AID PROJECT NO. HSIPL 5282(047) The Work comprises of improving fourteen (14) signalized intersections within the City of Palm Springs, in Riverside County, California, and includes, but is not limited to: •modifying existing intersection traffic control devices to conform to the latest edition of the California Manual on Uniform Traffic Control Devices (CA MUTCD) standards where deficient including signal pole(s), mast arm(s), and related equipment •installing new traffic control devices •relocating existing or installing new signal pole(s) and mast arm(s) and constructing new foundations •improving signal alignment and visibility to reduce collisions •installing advance dilemma zone detectors to improve signal timing and to reduce collisions •removing and replacing conflicting striping •removing and reconstructing curb and gutter, median, and sidewalk •removing and reconstructing pavement related to curb return and signal work •removing and reconstructing existing, non-ADA conforming features inc luding curb returns and ramps within project intersections •utility verification by potholing or other means and protecting existing utilities (including overhead facilities) in place The above work will be executed within the limits of each intersection and within the City right­ of-way with minimal environmental and economic impact. TRAFFIC SIGNAL IM PROVEMENTS (14 INTERSECTIONS) CITY PROJECT NO. 16-18 FEDERAL PROJECT NO. HSIPL 5282(047) DECEMBER 2022 AGREEMENT FORM AGREEMENT AND BONDS -PAGE 1 DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB4/27/2023 DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB 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 AUTOSAUTOS ONLY 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)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR 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 4/20/2023 Construction Risk Partners Campus View Plaza 1250 Route 28, Suite 201 Branchburg, NJ 08876 908-566-1010 908-566-1020 www.constructionriskpartners.com Peter Forenza Gabriel Stellar certs@constructionriskpartners.com Select Electric Inc. 2790 Business Park Drive Vista CA 92081 73955691 The City of Palm Springs, its officials, employees and agents are additional insured as required by written contract. 30 days notice of cancellation applies per policy provisions. City of Palm Spring 3200 E. Tahquitz Canyon Way Palm Springs CA 92262 Re: 3590 - Traffic Signal Improvements (14 Intersections) City Project No. 16-18, Federal Aid Project No. HSIPL 5282(047) Waiver of subrogation applies per policy provisions. Coverage is primary and non contributory as required by written contract. A 2,000,00010000254672313/1/2023 3/1/2024 500,000 3 10,000 3 2,000,000 4,000,000 4,000,0003 A 1000198716231 3/1/2023 3/1/2024 2,000,000 3 3 3 A 100000127013 3/1/2023 3/1/2024 3 1,000,000N 1,000,000 1,000,000 Starr Indemnity & Liability Company 38318 73955691 | MERUGRO-01 | 23/24 GL AU UMB 5M WC L/R SCHED EQ POLL PROF | Sara Bunsco | 4/20/2023 9:07:49 AM (EST) | Page 1 of 6 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Named Insured: COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s):Location(s) Of Covered Operations As required by written contract.As required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional 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 repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C.With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaration Policy Number: Select Electric Inc. 1000025467231 73955691 | MERUGRO-01 | 23/24 GL AU UMB 5M WC L/R SCHED EQ POLL PROF | Sara Bunsco | 4/20/2023 9:07:49 AM (EST) | Page 2 of 6 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s)Location And Description Of Completed Operations As required by written contract.As required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III – Limits Of Insurance:with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we"your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance:performed for that additional insured and included in the "products-completed operations 1.Required by the contract or agreement; or hazard".2. Available under the applicable Limits of However: 1.The insurance afforded to such additional Insurance shown in the Declarations; whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. Policy Number: Named Insured:Select Electric Inc. 1000025467231 73955691 | MERUGRO-01 | 23/24 GL AU UMB 5M WC L/R SCHED EQ POLL PROF | Sara Bunsco | 4/20/2023 9:07:49 AM (EST) | Page 3 of 6 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB Charles H. Dangelo, President Nehemiah E. Ginsburg, General Counsel Dallas, TX 1-866-519-2522 Primary and Non-Contributory Condition Policy Number: Named Insured: Effective Date: This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A.SECTION IV – CONDITIONS, condition 4. Other Insurance is amended as follows: 1.The following is added to paragraph 4.a. of the Other Insurance condition: This insurance is primary insurance as respects our coverage to the additional insured, where the written contract or written agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured is a Named Insured. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY & LIABILITY COMPANY OG 107 (04/11)Page 1 of 1 Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Select Electric Inc. 1000025467231 03/01/2023 73955691 | MERUGRO-01 | 23/24 GL AU UMB 5M WC L/R SCHED EQ POLL PROF | Sara Bunsco | 4/20/2023 9:07:49 AM (EST) | Page 4 of 6 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations 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 we may have against the person or organization shown in the Schedule above because of paym ents we ma ke for injury o r damage arising out of yo ur ongoing operations or "your work" done under a contract with that person or organization and in cluded in the "products- completed operations hazard". This waiver applies only to the person or organi zation shown in th e Schedule above. Policy Number: Named Insured:Select Electric Inc. 1000025467231 73955691 | MERUGRO-01 | 23/24 GL AU UMB 5M WC L/R SCHED EQ POLL PROF | Sara Bunsco | 4/20/2023 9:07:49 AM (EST) | Page 5 of 6 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB POLICY NUMBER: COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. Select Electric Inc. 1000198716231 03/01/2023 Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. 73955691 | MERUGRO-01 | 23/24 GL AU UMB 5M WC L/R SCHED EQ POLL PROF | Sara Bunsco | 4/20/2023 9:07:49 AM (EST) | Page 6 of 6 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: C2A226B4-BBC0-43BB-B8F7-1B2B644358FB PRELIMINARY NOTICE CALIFORNIA 01 0 Ca USE PROOF OF SERVICE AFFIDAVIT OF CALIFORNIA 20-DAY PRELIMINARY NOTICE (PRIVATE AND PUBLIC WORK) IN ACCORDANCE WITH SECTIONS 8102, 8200.8202 and 9300-9303, CALIFORNIA CIVIL CODE CONSTRUCTION LENDER (Or Reputed Construction Lender, If Any) Construction loan no. (if known) OWNER or PUBLIC AGENCY (Or Reputed Owner) AND DISBURSING OFFICER (On Private Work) (On Public Work) CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS, CA 92262 DIRECT CONTRACTOR (Or Reputed Direct Contractor) SELECT ELECTRIC, INC. 2790 BUSINESS PARK DR. VISTA, CA 92081 SELECT ELECTRIC, INC. 1700 E. VIA BURTON VISTA, CA 92081 SUBCONTRACTOR (Or Reputed Subcontractor) TEK SERVICES, LLC PO BOX 2096 YORBA LINDA, CA 92885 SUB -SUBCONTRACTOR (Or Reputed Sub -Subcontractor) BOND COMPANY FIDELITY DEPOSIT CO. OF MARYLAND 1299 ZURICH WAY 5TH FLOOR SCHAUMBURG, IL 60196 An estimate of the total price of the labor, services, equipment or materials furnished or to be furnished is: $325,000.00 Statement or estimate of the Claimant's demand for sums currently due after deducting all just credits and offsets: YOU ARE HEREBY NOTIFIED THAT... ITERIS, INC. 1700 CARNEGIE AVENUE, SUITE 100 SANTA ANA, CA 92705-5551 (MS. KAREN SORRELL at (949) 270 - 9407 - KSORRELL@ITERI S.COM) (name and address of person or firm — sender) has furnished or will furnish MATERIALS AND LABOR of the following general description: VIDEO TRAFFIC DETECTION EQUIPMENT for the building, structure or other work of improvement located at: TRAFFIC SIGNAL IMPROV. PALM SPRINGS PROJECT 3590 / PO #302-0501 R PALM SPRINGS, CA 92262 The name of the person or firm who contracted for the purchase of such labor, services, equipment or materials: TEK SERVICES, LLC NOTICE TO PROPERTY OWNER EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if the person or firm that has given you this notice is not paid in full for labor, service, equipment, or material provided or to be provided to your construction project, a lien may be placed on your property. Foreclosure of the lien may lead to loss of all or part of your property. You may wish to protect yourself against this by (1) requiring your contractor to provide a signed release by the person or firm that has given you this notice before making payment to your contractor, or (2) any other method that is appropriate under the circumstances. This notice is required by law to be served by the undersigned as a statement of your legal rights. This notice is not intended to reflect upon the financial condition of the contractor or the person employed by you on the construction project. If you record a notice of cessation or completion of your construction project, you must within 10 days after recording, send a copy of the notice of completion to your contractor and the person or firm that has given you this notice. The notice must be sent by registered or certified mail. Failure to send the notice will extend the deadline to record a claim of lien. You are not required to send the notice if you are a residential homeowner of a dwelling containing four or fewer units. $325,000.00 Claimant's Notice of unpaid compensation & employer payments owing to laborers & entities (described in Civil Code §8202(b)): The names and addresses of the laborer(s) and the Trust Fund to whom compensation and employer payments is/are due and payable are: (Names) (Addresses) RECEIVED MAR 28 2024 OFFICE OF THE CITY CLERK Mailed this date: MARCH 19, 220024 Agent (Signature) Our Reference:(N775190) IN f REQUEST FOR INFORMATION Pursuant to California Civil Code §8208 and §8210 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS, CA 92262 SELECT ELECTRIC, INC. 2790 BUSINESS PARK DR. VISTA, CA 92081 2 SELECT ELECTRIC, INC. 1700 E. VIA BURTON VISTA, CA 92081 Re: TRAFFIC SIGNAL IMPROV. PALM SPRINGS PROJECT 3590 / PO #302-0501 R PALM SPRINGS, CA ITERIS, INC., 1700 CARNEGIE AVENUE, SUITE 100 , SANTA ANA, CA 92705-5551 is furnishing materials and/or labor in connection with the above project. It is our understanding that you are the owner, part owner, or lessee and/or the direct contractor on that project. In accordance with §8208 and §8210 of the California Civil Code, please provide the following information if not already correctly identified within the attached notice: Owner Name: Owner Address: Owner City State Zip For privately owned projects: Lender Name: Lender Address: Lender City State Zip Direct Contractor Name: Direct Contractor Address: Direct Contractor City: State Zip If a Construction Loan has not been obtained for this project at the time of the receipt of this request, please consider this an ongoing request and provide the name and address of the construction lender once the loan has been obtained. Please return this information to the undersigned, including a copy of this Request for Information to permit us to reference the proper file. Please also provide a copy of any payment bonds, not already provided to ITERIS, INC., for this project. Dated: MARCH 19, 2024 Agent for ITERIS, INC. c/o NCS P. O. Box 24101 Cleveland, OH 44124 Fax: 440-461-6202 Email: noticeoremCa)ncscredit.com Our Ref# N775190 NCSICA(N775190OW]BO USPS CERTIFIED MAILTM 729 Miner Road Cleveland, OH 44143 9414 8091 0971 2006 5316 55 City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 ATTENTION Why are you receiving this notice? Please visit http://www.ncscredit.com/notice for more information. If you have any additional questions, please email Tara Todd noticeprem@ncscredit.com Distribution List Track Number: 9414809109712006631655 City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 Track Number: 9414809109712006534403 TEK SERVICES, LLC PO Box 2096 Yorba Linda, CA 92885 Track Number: 9414809109712006534427 SELECT ELECTRIC, INC. 1700 E. VIA BURTON VISTA, CA 92081 Track Number: 9414809109712006534397 SELECT ELECTRIC, INC. 2790 Business Park Dr. Vista, CA 92081 Track Number: 9414809109712006534410 Fidelity Deposit Co. of Maryland 1299 Zurich Way 5th Floor Schaumburg, IL 60196 a3g©9ol, CALIFORNIA PRELIMINARY NOTICE *****PLEASE ISSUE JOINT CHECKS***** NOTICE IS HEREBY GIVEN that: ROBERTSON'S 200 S MAIN ST CORONA CA 92882 (951)685-2200 Has or will Furnish labor, services, equipment, or materials, generally described as: READY MIX CONCRETE, ROCK & SAND To be furnished or furnished for the building, structure or the work of improvement described as follows: 14 INTERSECTIONS - CITYWI PALM SPRINGS J.C.N. # 3590 Tract No. Lot No.TRAFFIC SIGNAL Cert Num: 21222132 IMPROVE (14 INTERSEC Name of Person or Firm who contracted for purchase of the labor, services, equipment, or materials is: ONE CALL CONSTR SERVICES 9550 FIRESTONE BLVD STE #105 DOWNEY CA 90241 An estimate of the total prim of said labor, services, equipment or materials is: 43,780.00 NOTICE TO PROPERTY OWNER EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if the person or firm that has given you this notice is not paid in full for labor, service, equipment, or material provided or to be provided to your construction project, a lien may be placed on your property. Foreclosure of the lien may lead to loss of all or part of your property. You may wish to protect yourself against this by (1) requiring your contractor to provide a signed release by the person or firm that has given you this notice before making payment to your contractor, or (2) any other method that is appropriate under the circumstances, This notice is required by law to be served by the undersigned as a statement of your legal rights. This notice is not intended to reflect upon the financial condition of the contractor or the person employed by you on the construction project. H you record a notice of cessation or completion of your constriction project, you must within 10 days after recording, send a copy of the notice of completion to your contractor and the person or firm that has given you this notice. The notice must be sent by registered or certified mail. Failure to send the notice will extend the deadline to record a claim of lien. You are not required to send the notice If you are a residential homeowner of a dwelling containing four or fewer units. CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 SELECT ELECTRIC INC 1700 E VIA BURTON ANAHEIM CA 92806 RECEIVED MAR 18 2024 OFFICE OF THE CITY CLERK TRUST FUNDS TO WHICH SUPPLEMENTAL FRINGE BENEFITS ARE PAYABLE Prrmf of Service This undersigned declares as follows: I am over the age of 18, and employed by RobertsonY, whose business address is 200 South Main Street, Suite 200, Comma, California 92882. I am employed in the County of Riverside, where this mailing occurs, and not a party tothis action. On the dare shown below, in the City of Corona, I served the within California Preliminary Notice, sealed a� deposited in the mail in the mummer prescribed by law, by first class registered or certified mail, postage fully prepaid, to the person(s) at the addresses shown thereon. Tr Date: 03/12/2024 Name: ROBERTSON'S �'► US POSTAGE--w 8o*es P.O. BOX 3600 CORONA, CA 92878-3600 :; .:.... 02 1VV $ 005.040 " 0001399944 MAR 12 2024 7108 1176 8852 1222 1325 IMPORTANT: CALIFORNIA PRELIMINARY NOTICE CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 20241 3590 File: 13910676 (CA PV) Customer: DCS PLASTERING INC Notice Requested by: Customer #: 11231 / Thompson Building Malls Inc, Orange Job Name: MRG-PALM SPRINGS AIRPORT 80-24-017 Po Box 5406 Job# / PO#: 24015 / Orange, CA 92863-5406 714-637-7373 Cert #: 9314 8898 8030 0073 1475 68 APN #: PRELIMINARY NOTICE This is not a lien. This is not a reflection on the integrity of any contractor or subcontractor, but the notice prescribed in California Civil Code Sections 8102, 8200, et seq., 9300, et seq. TO OWNER OR REPUTED OWNER(S)/PUBLIC ENTITY PALM SPRINGS INTERNATIONAL AIRPORT 3400 EAST TAHQUITZ CANYON WAY PALM SPRINGS, CA 92262 TO DIRECT CONTRACTOR JRM CONSTRUCTION WEST, LLC —� 959 SCPUTH-COAS i DR-#300 COSTA MESA, CA 92626 TO LENDER/SURETY Advised No Lender i Bond/Loan # See Exhibit B jor Additional Legal Parties The following is a general description of the labor, service, equipment or materials furnished or to be furnished: Masonry, Lath, Plaster Or Drywall & Related Materials Estimated Price: $7,000.00 The name of the person who furnished that labor, service, equipment or materials is: Thompson Building Malls Inc, Orange Po Box 5406 Orange, CA 92863-5406 714-637-7373 The name of the person who contracted for purchase of that labor. service, equipment or material is: DCS PLASTERING INC 2851 E VIA MARTENS, ANAHEIM, CA 92806 The description of thejobsite is: MRG-PALM SPRINGS AIRPORT 80-24-017 #24015 3400 E TAHQUITZ CANYON WAY, PALM SPRINGS, CA 92262 NOTICE TO PROPERTY OWNER EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if the person or firm that has given you this notice is not paid in full for labor, service, equipment, or material provided or to be provided to your construction project, a lien may be placed on your property. Foreclosure of the lien may lead to loss of all or part of your property. You may wish to protect yourself against this by (1) requiring your contractor to provide a signed release by the person or firm that has given you this notice before making Payment to your contractor, or (2) any other method that is appropriate under the circumstances. This notice is required by law to be served by the undersigned as if statement of your legal rights. This notice is not intended to reflect upon the financial condition of the contractor or the person employed by you on the construction project. If you record a notice of cessation or completion of your construction project, you must within 10 days after recording, send a copy of the notice of completion to your contractor and the person or firm that has given you this notice. The notice must be sent by registered or certified mail. Failure to send the notice will extend the deadline to record a claim of lien. You are not required to send the notice if you are a residential homeowner of a dwellin- ccnfaining four cr fewer units. -_ Dated: 3/12/2024 By: Laura Pavey / CRF Solutions Authorized Agent For: Thompson Building Mails Inc, Orange PROOF OF NOTICE DECLARATION I declare that I served a copy of the above Preliminary Notice, and any related documents, by (as required by law) first-class, certified or registered mail, postage prepaid, addressed to the above named parties, at the addresses listed above, on 3/12/2024. 1 declare under penalty of perjury that the foregoing is true and correct. Executed at Simi Valley, CA on 3/12/2024. - By: Laum Pavey / Lien Administrator Construction Notice Department P.O. Box 1389 Simi Valley, CA 93062 Address Service Requested 3/12/2024 City Of Palm Springs PO BOX 2743 PALM SPRINGS, CA 92263 II{ill�l'�!'��II�IIIIIII''��III� BCA668 13910676 IMPORTANT NOTICE PLEASE READ CAREFULLY Enclosed you will find a notice that is being sent to you on behalf of Thompson Building Malls Inc, Orange in regards to the construction project known as MRG-PALM SPRINGS AIRPORT 80-24-017 24015 and located at 3400 E TAHQUITZ CANYON WAY, PALM SPRINGS, CA 92262. It is important to note that this notice is not a lien nor a claim on a bond. This is a routine procedure to comply with certain state requirements that may exist and should not reflect in any way on the integrity or credit standing of any of the known interested parties associated with this job. Our records indicate the following parties are associated with this job: OWNER: PALM SPRINGS INTERNATIONAL AIRPORT PALM SPRINGS, CA GENERAUDIRECT/ORIGINAL CONTRACTOR: JRM CONSTRUCTION WEST, LLC COSTA MESA, CA LENDER/SURETY: Please advise if Lender applicable If any of this information is incorrect, or you are not associated.with this job, please contact us immediately at myjobinfo@.crfsolutions.com Please use this number, 13910676 in your email subject line. Thank you, CRF Solutions RECEIVED MAR 18 2024 OFFICE OF THE CITY CLERK EXHIBIT B - OTHER LEGAL PARTIES PROJECT: MRG-PALM SPRINGS AIRPORT80-24-017 FILE #: 13910676 Tenant --MARSHALL--RETPdL-GROUP- -- - -- -- — - - -- �- 3755 W SUNSET ROAD, SUITE A LAS VEGAS NV 89118 Other Owner City Of Palm Springs PO BOX 2743 PALM SPRINGS CA 92263 071 f) O� Martin Marietta is on your job! TRAFFIC SIGNAL IMPROVEMENTS JOB# 3590 Various Locations Palm Springs, California 92262 Contact Info Monica Lekas Martin Marietta Agent Phone: (858) 944-6715 Email: monica.lekas@martinmarietta.com AMP i ,r EVELSET � Martin Marietta is proud to be providing services or materials on yourjob. We are using Levelset to set this job up for payment success. We would like to share with you the information we have about your project. ' • - Byrdoy AGGREGATES and/or CEMENT and/or READY MIX and/or ASPHALT and/or MAGNESIA PRODUCTS Work Starts / Material First Furnished 5/3/2024 Work Finishes / Material Last Furnished 5/9/2024 Martin Marietta 4123 Parklake Avenue Raleigh, North Carolina 27612 levelset.com/talk Reference PPQX2DLYFCVK There you will be able to: • Send and receive messages about this document • Fix or provide additional details Project i ! Our Vendors (If applicable) Subcontractor SELECT ELECTRIC INC 2790 BUSINESS PARK DR VISTA, California 92081 Property Owner / Public Entity City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs, California 92262 General Contractor Select Electric 1700 E. Via Burton Anaheim, California 92806 N Want more information on this project? Visit levelset.com/talk and enter L E V E L S E T PPQX2DLYFCVK Estimate of the total price of the labor, services, equipment or material Additional Info furnished or to be furnished: About the Job $15,O00.00 The following is text required to be provided by California law: IN ACCORDANCE WITH SECTIONS 8100 et seq., and 9300 et seq., CALIFORNIA CIVIL CODE, THIS IS NOT A REFLECTION OF THE INTEGRITY OF ANY CONTRACTOR OR SUBCONTRACTOR. NOTICE TO PROPERTY OWNER EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if the person or firm that has given you this notice is not paid in full for labor, service, equipment, or material provided or to be provided to your construction project, a lien may be placed on your property. Foreclosure of the lien may lead to loss of all or part of your property. You may wish to protect yourself against this by (1) requiring your contractor to provide a signed release by the person or firm that has given you this notice before making payment to your contractor, or (2) any other method that is appropriate under the circumstances. This notice is required by law to be served by the undersigned as a statement of your legal rights. This notice is not intended to reflect upon the financial condition of the contractor or the person employed by you on the construction project. If you record a notice of cessation or completion of your construction project, you must within 10 days after recording, send a copy of the notice of completion to your contractor and the person or firm that has given you this notice. The notice must be sent by registered or certified mail. Failure to send the notice will extend the deadline to record a claim of lien. You are not required to send the notice if you are a residential homeowner of a dwelling containing four or fewer units. Martin Marietta Signed by Monica Lekas Signed on May 16, 2024 INFORMATION REQUEST PURSUANT TO §8208 If the property owner and/or construction lender and/or general contractor are not identified in enclosed notice, or if either are incorrectly identified, please accept this notice as a formal request to the direct contractor pursuant to §8208, and all other recipients, to deliver (i) The name and address of the owner; and / or (ii) The name and address of the general contractor, and / or(iii) The name and address of the construction lender, if any; as the case may be, to the Notifying Party at the address provided in this notice. Employee Trust Funds (and Laborers) If applicable, and pursuant to §8208 (b) of the California Civil Code, the following is a list of the Employee Trust Funds (described in subdivision (b) of Section 8024) and/or laborers to which payments are due: 6 Want more information on this project? Visit levelset.com/talk and enter _ E V E L S E T PPQX2DLYFCVK Mail Center PRESORT PO Box 9023 First -Class Mail Temecula, CA 92589-9023 U.S. Postage and Fees Paid W SO 9307 1100 1170 1167 9699 75 R 20240517-214 �II��III"I'1'11It1111111111II'I1.11'I�'I�I"�I�I�III�I�II11��� 1 City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 CM CM AK CALIFORNIA PRELIMINARY NOTICE -PUBLIC WORKS (THIS NOTICE IS GIVEN PURSUANT TO CALIFORNIA CIVIL CODE §§ 8034(b), 8102, 8106-8118, 9300 et seq.) TO: PUBLIC ENTITY DIRECT CONTRACTOR 1ST TIER SUBCONTRACTOR (CA Civ. Code § 8036, 9302) (CA Civ. Code § 8018) (IF APPLICABLE) (CA Civ. Code § 8046) NAME: ADDRESS: City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs, CA. 92262 YOU ARE HEREBY NOTIFIED THAT: Name: Address: Landmark Surveying Solutions, Inc Select Electtric, Inc. 1700 E. Via Burton Anaheim, CA. 92806 7231 Boulder Ave., #538, Highland, CA 92346 Relationship to the parties of the one giving this notice (subcontractor, supplier, describe if otherwise): Subcontractor HAS FURNISHED OR WILL FURNISH WORK, LABOR, SERVICES, EQUIPMENT OR MATERIAL OF THE FOLLOWING GENERAL DESCRIPTION: Surveying, mapping and drafting FOR THE BUILDING, STRUCTURE OR OTHER WORK OF IMPROVEMENT LOCATED AT THE FOLLOWING ADDRESS OR SITE OTHERWISE DESCRIBED SUFFICIENTLY FOR IDENTIFICATION: Address: Various Locations in Palm Springs Palm Springs, CA. or Description: Traffic Signal Improvement (14 Intersections) Job #3590 THE PERSON OR FIRM TO WHOM SUCH WORK, LABOR, SERVICES, EQUIPMENT OR MATERIAL IS PROVIDED: Name: Select Electtric, Inc Address: 1700 E. Via Burton, Anaheim, CA. 92806 AN ESTIMATE OF THE TOTAL PRICE OF THE WORK, LABOR, SERVICES, EQUIPMENT OR MATERIAL PROVIDED OR TO BE PROVIDED IS: Amount:$ 34,950.00 THE LABOR, SERVICES, EQUIPMENT OR MATERIAL WAS PROVIDED OR WILL BE PROVIDED BEGINNING ON Feb 19 20b (date). PROOF OF SERVICE DECLARATION Alexa Talavera declare that I served copies of the above CALIFORNIA PRELIMINARY NOTICE - PUBLIC WORKS, (check appropriate box): a. ❑ By personally delivering copies to (name(s) and title(s) of person served) at (address), on (date), at .m. (time) b, 0 By Registered or Certified Mail, Express Mail or Overnight Delivery by an express service carrier, addressed to each of the parties at the address shown above on February 21 2024 (date). C. ❑ By leaving the notice and mailing a copy in the manner provided in § 415.20 of the California Code of Civil Procedure for service of Summons and Complaint in a Civil Action. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Signed at 301 N. 9th Street, Redlands , California, on February 1 2024 (date). RECEIVED nature of Person Making Service) FEB 2 6 2024 (Sig © Porter Law Group, Inc. 2012 City Hall Reception Desk PRELIMINARY NOTICE CALIFORNIA USE PROOF OF SERVICE AFFIDAVIT OF CALIFORNIA 20-DAY PRELIMINARY NOTICE (PRIVATE AND PUBLIC WORK) IN ACCORDANCE WITH SECTIONS 8102, 8200-8202 and 9300-9303, CALIFORNIA CIVIL CODE CONSTRUCTION LENDER (Or Reputed Construction Lender, If Any) Construction loan no. (if known) OWNER or PUBLIC AGENCY (Or Reputed Owner) AND DISBURSING OFFICER (On Private Work) (On Public Work) CITY OF PALM SPRINGS 3200 TAHQUITZ CANYON WY PALM SPRINGS, CA 92262 DIRECT CONTRACTOR (Or Reputed Direct Contractor) SELECT ELECTRIC INC 1700 E VIA BURTON ANAHEIM, CA 92806 SUBCONTRACTOR (Or Reputed Subcontractor) SUB -SUBCONTRACTOR (Or Reputed Sub -Subcontractor) BOND COMPANY FIDELITY AND DEPOSIT CO OF MARYLAND 1299 ZURICH WY 5TH FL SCHAUMBURG, IL 60196 An estimate of the total price of the labor, services, equipment or materials furnished or to be furnished is: $20,000.00 Statement or estimate of the Claimant's demand for sums currently due after deducting all just credits and offsets: $20,000.00 RECEIVED JUN 0 4 2024 OFFICE OF THE CITY CLERK YOU ARE HEREBY NOTIFIED THAT... WALTERS WHOLESALE ELECTRIC CO. 200 N BERRY ST. BREA, CA 92821 (MS. KIM GRIFFITHS at (760) 658 - 6300 - KIM.GRIFFITHS@WALTERSWHOLESALE.COM) (name and address of person or firm — sender) has furnished or will furnish MATERIALS of the following general description: ELECTRICAL SUPPLIES for the building, structure or other work of improvement located at: 3590 TS IMPROVEMENT 14 INTERSECTIONS PALM SPRINGS, CA 92262 The name of the person or firm who contracted for the purchase of such labor, services, equipment or materials: SELECT ELECTRIC INC NOTICE TO PROPERTY OWNER EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if the person or firm that has given you this notice is not paid in full for labor, service, equipment, or material provided or to be provided to your construction project, a lien may be placed on your property. Foreclosure of the lien may lead to loss of all or part of your property. You may wish to protect yourself against this by (1) requiring your contractor to provide a signed release by the person or firm that has given you this notice before making payment to your contractor, or (2) any other method that is appropriate under the circumstances. This notice is required by law to be served by the undersigned as a statement of your legal rights. This notice is not intended to reflect upon the financial condition of the contractor or the person employed by you on the construction project. If you record a notice of cessation or completion of your construction project, you must within 10 days after recording, send a copy of the notice of completion to your contractor and the person or firm that has given you this notice. The notice must be sent by registered or certified mail. Failure to send the notice will extend the deadline to record a claim of lien. You are not required to send the notice if you are a residential homeowner of a dwelling containing four or fewer units. Claimant's Notice of unpaid compensation & employer payments owing to laborers & entities (described in Civil Code §8202(b)): The names and addresses of the laborer(s) and the Trust Fund to whom compensation and employer payments is/are due and payable are: (Names) (Addresses) Mailed this date: MAY 28, 202024 Agent (Signature) Our Reference: (N822289) 462143 H REQUEST FOR INFORMATION Pursuant to California Civil Code §8208 and §8210 CITY OF PALM SPRINGS 3200 TAHQUITZ CANYON WY PALM SPRINGS, CA 92262 SELECT ELECTRIC INC 1700 E VIA BURTON ANAHEIM, CA 92806 Re: 3590 TS IMPROVEMENT 14 INTERSECTIONS PALM SPRINGS, CA V. WALTERS WHOLESALE ELECTRIC CO., 200 N BERRY ST. , BREA, CA 92821 is furnishing materials and/or labor in connection with the above project. It is our understanding that you are the owner, part owner, or lessee and/or the direct contractor on that project. In accordance with §8208 and §8210 of the California Civil Code, please provide the following information if not already correctly identified within the attached notice: Owner Name: _ Owner Address: Owner City For privately owned projects: Lender Name: Lender Address: Lender City Direct Contractor Name: _ Direct Contractor Address: Direct Contractor City: State State State Zip Zip Zip If a Construction Loan has not been obtained for this project at the time of the receipt of this request, please consider this an ongoing request and provide the name and address of the construction lender once the loan has been obtained. Please return this information to the undersigned, including a copy of this Request for Information to permit us to reference the proper file. Please also provide a copy of any payment bonds, not already provided to WALTERS WHOLESALE ELECTRIC CO., for this project. Dated: MAY 28, 2024 Agent for WALTERS WHOLESALE ELECTRIC CO. c/o NCS P. 0. Box 24101 Cleveland, OH 44124 Fax: 440-461-6202 Email: noticeprem@ncscredit.com Our Ref# N822289 462143 NCS[CA(N8222890W)BO USPS CERTIFIED MAIL TM 729 Miner Road Cleveland, OH 44143 9414 8091 0971 2007 7281 60 CITY OF PALM SPRINGS 3200 TAHQUITZ CANYON WY PALM SPRINGS, CA 92262 ATTENTION Why are you receiving this notice? Please visit http://www.ncscredit.com/notice for more information. If you have any additional questions, please email Selena Rodriguez noticeprem@ncscredit.com Distribution List Track Number: 9414809109712007728160 CITY OF PALM SPRINGS 3200 TAHQUITZ CANYON WY PALM SPRINGS, CA 92262 Track Number: 9414809109712007729976 SELECT ELECTRIC INC 1700 E VIA BURTON ANAHEIM. CA 92806 File: 17658 (CA PV) CO: I Customer: 2100V Notre Requested by and Return t St: I Ref. Num: Hi -Grade Materials Co. I Job Name: 17671 Bear Valley Road I Job No. RECEIVED Hesperia, CA 92345 Hesperia, CA 9234 1 Cert No. 760-244-9325 III 1 o) on m California Preliminary Notice OFFICE OF THE CITY CLERK ( Public and Private Work) See Civil Code Sections 8200 et sea., 9300, et se4. This is not a Lien; This is not a reflection on the Integrity of anv contractor or subcontractor TO THE OWNER or PUBLIC ENTITY 1. 1 he following is a general description of the labor, service, or reputed owner(private work) (public work) City of Palm Springs equipment or materials furnished or to be furnished by the 3200 East Tahquitz Canyon Way undersigned: Palm Springs, CA 92262 Ready Mix Concrete, Rock and Sand Miscellaneous Construction & Equipment Rentals 2. Estimated Price: $ $2,500.00 TO THE DIRECT CONTRACTOR 3. The name of the person, who furnished that labor, service, Select Electric Inc. equipment, or materials is: 2790 Business Park Dr Vista, CA 92081 Hi -Grade Materials Co. 17671 Bear Valley Road Hesperia, CA 92345 LENDER (IF ANY) 4. The name of the person who contracted for purchase of that Reputed Lender, ifany labor, service, equipment or material is: None Provided IE General Engineering, Inc 103 Ivy Street Jones Creek, TX 77451 5. The description of the jobsite is: Traffic Signal Improvments 14 Intersections Project #465263 NOTICE TO PROPERI EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if the person or firm that has given you this notice is not paid in full for labor, service, equipment, or material provided or to be provided to your construction project, a lien may be placed on your property. Foreclosure of the lien may lead to loss of all or part of your property. You may wish to protect yourself against this by (1) requiring your contractor to provide signed release by the person or firm that has given you this notice before making payment to your contractor, or (2) any other method that is appropriate under the circumstances. This notice is required by law to be served by the undersigned as a statement of your legal rights. This notice is not intended to reflect upon the financial condition of the contractor or the person employed by you on the construction project. If you record a notice of cessation or completion of your construction project, you must within 10 days after recording, send a copy of the notice of completion to your contractor and the person or firm that has given you this notice. The notice must be sent by registered or certified mail. Failure to send the notice will extend the deadline to record a claim of Iien.You are not required to send the notice if you are a residential homeowner of a dwelling containing four or fewer units. true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct. Executed at Hesperia, CA. On 06105/2024 for Hi -Grade Materials Co. By. Carlos Ramirez, Credit Assistant PROOF OF SERVICE BY MAIL AFFIDAVIT I declare that I served a copy of the above document, and any related documents, by (as required by law) first-class, certified or registered mail, postage prepaid, addressed to the above named parties, at the addresses listed above, on 06105/2024 1 declare under penalty that the foregoing is true and correct. Executed at Hesperia, Cali mia on 06105/2024 By. Carlos Ramirez, Credit Assistant HI-,GAmm 17671 Bear Valley Rd Hesperia, CA 92345 Postage: $7.3600 USPS CERTIFIED MAIL 9214 8901 9403 8364 6026 90 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262-6959 File #: 1331 [CA][PUBLIC][COPY:EST] I Customer: Recording Requested by and Return to: I P.O. #: Matich Corporation I Project: Rec ID: P.O. Box 10 I Job #: Hiqhland, CA 92346-1010 I Cert No.: IE General Engineering, Inc. 9'02;�,� Job# 16-18 Contract# 23BO92 404B8A90-E7A1-4A81-B882-171293763535 57752R 9589 0710 5270 0951 8416 43 CALIFORNIA PRELIMINARY NOTICE - PUBLIC WORKS (THIS NOTICE IS GIVEN PURSUANT TO CALMPNIA CIVIL Corr $S 8034 (B), 8102, 8106-8118, 8200 st seq., 8612, 9300 et Seq.) >> TO THE PUBLIC ENTITY OR REPUTED City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 USA >> TO DIRECT OR REPUTED CONTRACTOR select Electric 2790 Business Park Dr. Vista, CA 92081 USA >> TO LENDER, SURETY OR BONDING CO. >> REPUTED LENDER, SURETY, BONDING Zurich Surety Claims Zurich Customer Care Center P.O. Box 968017 Schaumburg, IL 60196 USA Acct/Bond# 9423048 1. The following is a general description of the labor, service, equipment or materials furnished or to be furnished by the undersigned: Asphalt Materials 6 Delivery 2. The estimated amount of the work provided or to be provided is $13,608.00 3. The name of the person or entity who furnished that labor, service, equipment or materials is: Matich Corporation P.O. Box 10 JOINT CHECK REQUESTED Highland, CA 92346-1010 Relationship to Parties: Material Supplier OR 4. The name of the person or entity who contracted for CO. purchase of that labor, service, equipment or material is: IE General Engineering, Inc. 1440 Beaumont Ave., Ste. A2-130 Beaumont, CA 92223 USA The description of the jobsite is: Job# 16-18 Contract# 23BO92 Traffic Signal Improvements 14 Intersections various Locations Palm Springs, CA USA County of Riverside REQUEST FOR COPY OF PAYMENT BOND AND NAME OF SURETY CCMPANY TO CONTRACTING BODY: City of Palm Springs or State Comptroller The undersigned Claimant hereby declares that he has supplied or will supply labor or materials as described above, that payment has not yet been made therefore; and that he hereby requests that the contracting body furnish a certified copy of the Payment Bond, if any, to the Claimant, at the address listed above, and the current address of the contracting public entity. NOTICE TO PROPERTY OWNER OR PUBLIC ENTITY I declare that I am authorized to file this claim on behalf of the Claimant. I have read the foregoing document and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct. Executed at Highland, California on 06/13/202 for ICH CORPORATION. Prepared by:dkA, Teri Wiley, Credit nager Phone: (909) 382-7400 Fax: (909) 382-0191 PROOF OF SERVICE BY MAIL AFFIDAVIT I declare that I served the Preliminary Notice, and any related documents, by certified or registered mail, postage prepaid, J ther certified delivery, addressed to the above named parties, at the addresses listed abon 06/13/2024. I declare under penalty of perjury that the foregoing is trruu and c ect. Exeat Highland, California on 06/13/2024. Prepared by: AA / 1 '' Peggy Brunswic , d t Assistant RECEIVED v JUN 17 2024 OFFICE OF THE CITY CLERK CALIFORNIA PRELIMINARY NOTICE a3.6v1Q *****PLEASE ISSUE JOINT CHECKS***** NOTICE IS HEREBY GIVEN that: ROBERTSON'S 200 S MAIN ST CORONA CA 92882 (951)685-2200 Has or will Furnish labor, services, equipment, or materials, generally described as: READY MIX CONCRETE, ROCK & SAND To be furnished or furnished for the building, structure or the work of improvement described as follows: CLUB HOUSE VIEW DR & E VI PALM SPRINGS J.C.N. # 240522 Tract No. J:3590 Lot No.PALM SPRINGS TRAFFIC SIGNAL Cert Num: 21234040 Name of Person or Firm who contracted for purchase of the labor, services, equipment, or materials is: IE GENERAL ENGINEERING IN 1440 BEAUMONT AV STE A2-130 BEAUMONT CA 92223 An estimate of the total price of said labor, services, equipment or materials is: 39,329.68 NOTICE TO PROPERTY OWNER EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if the person or firm that has given you this notice is not paid in full for labor, service, equipment, or material provided or to be provided to your construction project, a lien may be placed on your property. Foreclosure of the lien may lead to loss of all or part of your property. You may wish to protect yourself against this by (1) requiring your contractor to provide a signed release by the person or firm that has given you this notice before making payment to your contractor, or (2) any other method that is appropriate under the circumstances. This notice is required by law to be served by the undersigned as a statement of your legal rights. This notice is not intended to reflect upon the financial condition of the contractor or the person employed by you on the construction project. If you record a notice of cessation or completion of your construction project, you must within 10 days after recording, send a copy of the notice of completion to your contractor and the person or firm that has given you this notice. The notice must be sent by registered or certified mail. Failure to send the notice will extend the deadline to record a claim of lien. You are not required to send the notice if you are a residential homeowner of a dwelling containing four or fewer units. OWNER OR REPUTED OWNER OR PUBLIC AGENCY CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 LENDER OR REPUTED LENDER DIRECT OR REPUTED DIRECT CONTRACTOR SELECT ELECTRIC 2790 BUSINESS PARK DR VISTA CA 92081 SUBCONTRACTOR with whom claimant has contracted ALSO NOTIFIED TENANT OR BONDING AGENT RECEIVED JUN 17 2024 OFFICE OF THE CITY CLERK TRUST FUNDS TO WHICH SUPPLEMENTAL FRINGE BENEFITS ARE PAYABLE Proof of Service This undersigned declares as follows: I am over the age of 18, and employed by Robertson's, whose business address is 200 South Main Street, Suite 200, Corona, California 92882. I am employed in the County of Riverside, where this mailing occurs, and not a party to this action. On the date shown below, in the City of Corona, I served the within California Preliminary Notice, sealed and deposited in the mail in the manner prescribed by law, by first class registered or certified mail, postage fully prepaid, to the person(s) at the addresses shown thereon. IC Name: Date: 06/10/2024 CERTIFIED MAIL ROBERTSON'S CA 9205 : US POSTAGE-FrNEYBOWES P.O. BOX 3800 CORONA, CA 92878-3600 -• i• ('%� ai�r� � ZIP 1VV $ 008.690 rr 02 1YV ti 0001399944JUN 10 2024 7108 1176 8852 1234 0408 IMPORTANT: CALIFORNIA PRELIMINARY NOTICE CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 f2:2G2_ t-:l39 13'11lll'IIlPldilill,il�i'Id, Id11ll'illil,i, 52223 240522