Loading...
HomeMy WebLinkAbout24B133 - West Coast Arborists, Inc.CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 06/2612025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CE RTIFICATE 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 CO NSTITUTE 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 provision s or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Insurance services west, Los Angeles CA office 707 Wilshire Boulevard suite 2600 LOS Angeles CA 90017-0460 USA INSURED west Coast Arborists, Inc. 2200 Evia Burton Anaheim CA 92806 USA Inc. RECEIVED JUL O 8 2025 CONTACT NAME: AIC. No. Ext): (866) 283-7122 FC:_. No. : (800) 363-0lOS E-MAIL ADDRESS: INSURER A: INSURER B: INSURER C: INSURER($) AFFORDING COVERAGE Property & casualty Ins co of Hartford Hartford Fire Insurance Co. NAIC# 34690 19682 OFFICE OF THE CITY CLE ,._.fltl-1.u_RE_R_D, ____________ +---~ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER· 570113701221 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. Limits shown are as requested ''i:fW TYPE OF INSURANCE 'f~6 I~~ POLICY NUMBER I IMM/00/Y~'v'vi IMM/DDIY'f,yv LIMITS B X COMMERCIAL GE NERAL LIABILITY [72ECSSo\JjUl I U/ /Ul/2025 I 07 /Ul/ LULt EACH OCCURRENCE S2,000,000 ........ D CL.AIMS-MADE 0occuR SIR applies per policy ter tns & condi ions LJJ'\MM.UC l0MCl'llt:U Sl,000,000 PREMISES /Ea occurrence' MED EXP (Any one person) PERSONAL & ADI/ INJURY S2,000,000 I--S4,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE R 0 PRO-0LOC PRODUCTS • COMP/OP AGG S4,000,000 POLICY X JECT OTHER: B AUTOMOBILE LIABILITY 72 CSE S89302 07/01/2025 07/01/2026 COMBINED SINGLE LIMIT S2,000,000 •r!-----i -t-ntl ,-.... X ANY AUTO BODILY l~URY ( Per person) --SCHEDULED BODILY l~URY (Per ac¢idenl) OWNED I--AUTOS ONLY 1--AUTOS PROPERTY DAMAGE HIRED AUTOS NON-OWNED I Per accident\ -ONLY 1--AUTOS ONLY UMBRELLA LIAB lli OCCUR EACH OCCURRENCE -AGGREGATE EXCESS LIAB CLA IMS-MADE DEDI I RETENTION A WORKERS COMPENSATION AND 172WNS8930U 107/01/2025 07/01/LUlf X I PER STATUTE I ll?J;H· EMPLOYERS' LIABILITY Y /N workers comp AZ CA,TX ANY PROPRIETOR I PARTNER I EXECUTIVE ~ E.L. EACH ACCIDENT S2,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L. DISEASE-EA EMPLOYEE $2,000,000 ;lfc~rtf~ t~PERATIONS below E.L DISEASE-POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additiona l Remarks Schedule, may be attached if more space is required) The city of Palm Springs, its officials, emplo~ees, and a9ents are included as Additional Insured in accordance with the policy provisions of the General Liability and Automo ile Liabil ity ~olicies. General Liability policy evidenced herein is Primary and Non-Contributory to other insurance available to an Additiona Insured, but only in accordance with the policy's provisions. A waiver of subro9ation is granted in favor of the Ci ty of Pal m Spri ngs, its officials, employees, and agents in accordance with the pol icy provisions of the General Liability and workers compensation policies. CERTIFICATE HOLDER city of Palm Springs 3200 E. Tahquitz canyon way Palm Springs CA 92262 USA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ... Q) !E c Q) ~ t "Cl 0 ::c 0 z .!! ~ ;.: 'f Q) 0 -~ ~ ....... ~ ~ ~ ~ 8t =--= ~ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD n. ~ 0 (') 0 § ,._ 0 8 i 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) Vegetation Management Services West Coast Arborists, Inc. Isaac Garza igarza@wcainc.com Provide vegetation management services $183,000 + $183,000 = $366,000 July 1, 2024 to June 30, 2026 Yes Patrick Mahoney, pmahoney@wcainc.com Richard Mahoney, rmahoney@wcainc.com Fire Department Paul Alvarado 06/27/2024 24B133 1 Yes Yes Yes Department N/A No IFB24-14 CONTRACT EXTENTION LETTER FY2025-26 05/29/2025 Lois Casman Docusign Envelope ID: 02D91958-EAF1-40D0-8F74-F677E854CAEF 55575.18100\42913029.1 Page 1 of 5 (BB&K 2024) AMENDMENT NO. 1 TO THE VEGETATION MANAGEMENT SERVICES AGREEMENT 24B133 BETWEEN THE CITY PALM SPRINGS AND WEST COAST ARBORISTS, INC. 1. Parties and Date. This Amendment No. 1 to the Vegetation Management Services is made and entered into as of this 29TH day of May, 2025, by and between the City of Palm Springs, a California charter city and municipal corporation (“City”), and West Coast Arborists, Inc., a California Corporation (“Contractor”). City and Contractor are sometimes individually referred to as “Party” and collectively as “Parties.” 2. Recitals. 2.1 Agreement. City and Contractor entered into an agreement titled Vegetation Management Services” dated July 1, 2024, Agreement for the purpose of retaining the services of Contractor to provide vegetation management services in an amount of $183,000 and a term of one year ending on June 30, 2025. 2.2 Amendment Purpose. City and Contractor now desire to amend the Agreement to exercise the one-year extension option and add additional compensation. 2.4 Amendment Authority. This Amendment No. 1 is authorized pursuant to Section 3.3 of the Agreement. 3. Terms. 3.1 Compensation of Contractor. Section 3.1 of the Agreement is hereby amended in its entirety to read as follows: “Contractor shall be compensated and reimbursed for the services rendered under this Agreement in accordance with the schedule of fees set forth in Exhibit “A”. The total amount of Compensation shall not exceed $366,000.” 3.2 Term. Section 4.4 of the Agreement is hereby amended in its entirety to read as follows: “Unless earlier terminated in accordance with Section 4.5 of this Agreement, this Agreement shall continue in full force and effect for a period of two years, commencing on July 1, 2024, and ending on Juny 30, 2026, unless extended by mutual written agreement of the Parties.” In addition, the term may be extended at the sole discretion of the City upon written notice to the Contractor, for one (1) additional one (1) year term. 3.2 Continuing Effect of Agreement. Except as amended by this Amendment No. 1, all other provisions of the Agreement remain in full force and effect and shall govern the actions of the parties under this Amendment No. 1. From and after the date of this Amendment No. 1, whenever the term “Agreement” or “Contract” appears in the Agreement, it shall mean the Agreement as amended by this Amendment No. 1. Docusign Envelope ID: 02D91958-EAF1-40D0-8F74-F677E854CAEF 55575.18100\42913029.1 Page 2 of 5 (BB&K 2024) 3.3 Adequate Consideration. The Parties hereto irrevocably stipulate and agree that they have each received adequate and independent consideration for the performance of the obligations they have undertaken pursuant to this Amendment No. 1 3.4 Severability. If any portion of this Amendment No. 1 is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. 3.5 Counterparts. This Amendment No. 1 may be executed in duplicate originals, each of which is deemed to be an original, but when taken together shall constitute but one and the same instrument. [SIGNATURES ON FOLLOWING PAGE] Docusign Envelope ID: 02D91958-EAF1-40D0-8F74-F677E854CAEF 55575.18100\42913029.1 Page 3 of 5 (BB&K 2024) SIGNATURE PAGE FOR AMENDMENT NO. 1 TO VEGETATION MANAGEMENT SERVICES BETWEEN THE CITY PALM SPRINGS AND WEST COAST ARBORISTS, INC. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the dates stated below. CONTRACTOR: By: ____________________________ By: ______________________________ Signature Signature (2nd signature required for Corporations) Date: Date: CITY OF PALM SPRINGS: APPROVED BY CITY COUNCIL: Date: ___ ____ Item No. APPROVED AS TO FORM: ATTEST: By: ___________________________ By: _______________________________ City Attorney City Clerk APPROVED: By: Date: Fire Chief By: _______________________________ Date: City Manager – up to $150,000 Deputy/Assistant City Manager – up to $50,000 Director – up to $25,000 Manager – up to $5,000 Docusign Envelope ID: 02D91958-EAF1-40D0-8F74-F677E854CAEF 5/29/2025 5/29/2025 5/29/2025 5/29/2025 55575.18100\42913029.1 Page 4 of 5 (BB&K 2024) EXHIBIT “A” PALM SPRINGS VEGETATION MANAGEMENT SERVICES CONTRACT EXTENSION LETTER FY2025-26 Docusign Envelope ID: 02D91958-EAF1-40D0-8F74-F677E854CAEF 55575.18100\42913029.1 Page 5 of 5 (BB&K 2024) Docusign Envelope ID: 02D91958-EAF1-40D0-8F74-F677E854CAEF 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) Vegetation Management Services West Coast Arborists, Inc. Isaac Garza igarza@wcainc.com provide vegetation management services $183,000 July 1, 2024 to June 30, 2025 Yes Patrick Mahoney, pmahoney@wcainc.com Richard Mahoney, rmahoney@wcainc.com Fire Department Paul Alvarado / Taylor Teeple 24B133 N/A Yes Yes Yes Procurement N/A No IFB 24-14 N/A N/A N/A 6/13/2024 Brian Sotak-Rossman DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 06/27/2024 Page 1 of 27 CONTRACT SERVICES AGREEMENT 24B133 VEGETATION MANAGEMENT SERVICES THIS AGREEMENT FOR CONTRACT SERVICES (“Agreement”) is made and entered into on July 1, 2024, by and between the City of Palm Springs, a California charter city and municipal corporation (“City”), and West Coast Arborists, Inc., a California Corporation, (“Contractor”). City and Contractor are individually referred to as “Party” and are collectively referred to as the “Parties”. RECITALS A. City requires the services of a licensed and qualified vendor to provide vegetation management services for the Palm Springs Fire Department, (“Project”). B. Contractor has submitted to City a Bid to provide vegetation management services, under the terms of this Agreement. C. Based on its experience, education, training, and reputation, Contractor is qualified and desires to provide the necessary services to City for the Project. D. City desires to retain the services of Contractor for the Project. NOW, THEREFORE, in consideration of the promises and mutual obligations, covenants, and conditions contained herein, and other valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows: AGREEMENT 1. CONTRACTOR SERVICES 1.1 Scope of Services. In compliance with all terms and conditions of this Agreement, Contractor shall provide services to City as described in the Scope of Services/Work attached to this Agreement as Exhibit “A” and incorporated herein by reference (the “Services” or “Work”). Exhibit "A" includes the agreed upon schedule of performance and the schedule of fees. Contractor warrants that the Services shall be performed in a competent, professional, and satisfactory manner consistent with the level of care and skill ordinarily exercised by high quality, experienced, and well qualified members of the profession currently practicing under similar conditions. In the event of any inconsistency between the terms contained in the Scope of Services/Work and the terms set forth in this Agreement, the terms set forth in this Agreement shall govern. 1.2 Compliance with Law. Contractor shall comply with all applicable federal, state, and local laws, statutes and ordinances and all lawful orders, rules, and regulations when performing the Services. Contractor shall be liable for all violations of such laws and regulations in connection with the Services and this Agreement. 1.3 Licenses and Permits. Contractor shall obtain at its sole cost and expense such licenses, permits, and approvals as may be required by law for the performance of the Services required by this Agreement. 1.4 Familiarity with Work. By executing this Agreement, Contractor warrants that it has carefully considered how the Work should be performed and fully understands the facilities, difficulties, and restrictions attending performance of the Work under this Agreement. 2. TIME FOR COMPLETION DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 2 of 27 The time for completion of the Services to be performed by Contractor is an essential condition of this Agreement. Contractor shall prosecute regularly and diligently the work of this Agreement according to the agreed upon schedule of performance set forth in Exhibit “A.” Neither Party shall be accountable for delays in performance caused by any condition beyond the reasonable control and without the fault or negligence of the non-performing Party. Delays shall not entitle Contractor to any additional compensation regardless of the Party responsible for the delay. 3. COMPENSATION OF CONTRACTOR 3.1 Compensation of Contractor. Contractor shall be compensated and reimbursed for the services rendered under this Agreement in accordance with the schedule of fees set forth in Exhibit “A”. The total amount of Compensation shall not exceed $183,000. 3.2 Method of Payment. In any month in which Contractor wishes to receive payment, Contractor shall submit to City an invoice for Services rendered prior to the date of the invoice, no later than the first working day of such month, in the form approved by City’s finance director. Payments shall be based on the hourly rates set forth in Exhibit “A” for authorized services performed. City shall pay Contractor for all expenses stated in the invoice that are approved by City and consistent with this Agreement, within thirty (30) days of receipt of Contractor’s invoice. 3.3 Changes. In the event any change or changes in the Services is requested by City, Parties shall execute a written amendment to this Agreement, specifying all proposed amendments, including, but not limited to, any additional fees. An amendment may be entered into: A. To provide for revisions or modifications to documents, work product, or Work, when required by the enactment or revision of any subsequent law; or B. To provide for additional services not included in this Agreement or not customarily furnished in accordance with generally accepted practice in Contractor’s profession. 3.4 Appropriations. This Agreement is subject to, and contingent upon, funds being appropriated by the City Council of City for each fiscal year. If such appropriations are not made, this Agreement shall automatically terminate without penalty to City. 4. PERFORMANCE SCHEDULE 4.1 Time of Essence. Time is of the essence in the performance of this Agreement. 4.2 Schedule of Performance. All Services rendered under this Agreement shall be performed under the agreed upon schedule of performance set forth in Exhibit “A.” Any time period extension must be approved in writing by the Contract Officer. 4.3 Force Majeure. The time for performance of Services to be rendered under this Agreement may be extended because of any delays due to a Force Majeure Event if Contractor notifies the Contract Officer within ten (10) days of the commencement of the Force Majeure Event. A Force Majeure Event shall mean an event that materially affects the Contractor’s performance and is one or more of the following: (1) Acts of God or other natural disasters occurring at the project site; (2) terrorism or other acts of a public enemy; (3) orders of governmental authorities (including, without limitation, unreasonable and unforeseeable delay in the issuance of permits or approvals by governmental authorities that are required for the Work); and (4) pandemics, epidemics or quarantine restrictions. For purposes of this section, “orders of governmental authorities,” includes ordinances, emergency proclamations and orders, rules to protect the public health, welfare and safety, and other actions of the City in its capacity as a municipal authority. After Contractor notification, the Contract Officer shall investigate the facts and the extent of any necessary delay, and extend the time for performing the Services for the period of the enforced delay when and if, in the Contract Officer’s judgment, such delay is justified. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 3 of 27 The Contract Officer’s determination shall be final and conclusive upon the Parties to this Agreement. The Contractor will not receive an adjustment to the contract price or any other compensation. Notwithstanding the foregoing, the City may still terminate this Agreement in accordance with the termination provisions of this Agreement. 4.4 Term. Unless earlier terminated in accordance with Section 4.5 of this Agreement, this Agreement shall continue in full force and effect for a period of one year, commencing on July 1, 2024, and ending on June 30, 2025, unless extended by mutual written agreement of the Parties. In addition, the term may be extended at the sole discretion of the City upon written notice to the Contractor, for two (2) additional one (1) year terms. 4.5 Termination Prior to Expiration of Term. City may terminate this Agreement at any time, with or without cause, upon thirty (30) days written notice to Contractor. Where termination is due to the fault of Contractor and constitutes an immediate danger to health, safety, and general welfare, the period of notice shall be such shorter time as may be determined by the City. Upon receipt of the notice of termination, Contractor shall immediately cease all Services except such as may be specifically approved by the Contract Officer. Contractor shall be entitled to compensation for all Services rendered prior to receipt of the notice of termination and for any Services authorized by the Contract Officer after such notice. City shall not be liable for any costs other than the charges or portions thereof which are specified herein. Contractor shall not be entitled to payment for unperformed Services and shall not be entitled to damages or compensation for termination of Work. If the termination is for cause, the City shall have the right to take whatever steps it deems necessary to correct Contractor's deficiencies and charge the cost thereof to Contractor, who shall be liable for the full cost of the City's corrective action. Contractor may not terminate this Agreement except for cause, upon thirty (30) days written notice to City. 5. COORDINATION OF WORK 5.1 Representative of Contractor. The following principal of Contractor is designated as being the principal and representative of Contractor authorized to act and make all decisions in its behalf with respect to the specified Services: Patrick Mahoney, President. It is expressly understood that the experience, knowledge, education, capability, and reputation of the foregoing principal is a substantial inducement for City to enter into this Agreement. Therefore, the foregoing principal shall be responsible during the term of this Agreement for directing all activities of Contractor and devoting sufficient time to personally supervise the Services under this Agreement. The foregoing principal may not be changed by Contractor without prior written approval of the Contract Officer. 5.2 Contract Officer. The Contract Officer shall be the City Manager or his/her designee ("Contract Officer"). Contractor shall be responsible for keeping the Contract Officer fully informed of the progress of the performance of the Services. Contractor shall refer any decisions that must be made by City to the Contract Officer. Unless otherwise specified, any approval of City shall mean the approval of the Contract Officer. 5.3 Prohibition Against Subcontracting or Assignment. The experience, knowledge, education, capability, and reputation of Contractor, its principals, and employees, were a substantial inducement for City to enter into this Agreement. Contractor shall not contract with any other individual or entity to perform any Services required under this Agreement without the City's express written approval. In addition, neither this Agreement nor any interest may be assigned or transferred, voluntarily or by operation of law, without the prior written approval of City. Subcontracts, if any, shall contain a provisions making them subject to all provisions stipulated in this Agreement including without limitation the insurance and indemnification requirements. If Contractor is permitted to subcontract any part of this Agreement by City, Contractor shall be responsible to City for the acts and omissions of its subcontractor(s) in the DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 4 of 27 same manner as it is for persons directly employed. Nothing contained in this Agreement shall create any contractual relationships between any subcontractor and City. 5.4 Independent Contractor. Neither City nor any of its employees shall have any control over the manner, mode, or means by which Contractor, its agents, or employees, perform the Services required, except as otherwise specified. Contractor shall perform all required Services as an independent contractor of City and shall not be an employee of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role; however, City shall have the right to review Contractor’s work product, result, and advice. Contractor shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of City. Contractor shall pay all wages, salaries, and other amounts due personnel in connection with their performance under this Agreement and as required by law. Contractor shall be responsible for all reports and obligations respecting such personnel, including, but not limited to: social security taxes, income tax withholding, unemployment insurance, and workers’ compensation insurance. Contractor shall not have any authority to bind City in any manner. 5.5 Personnel. Contractor agrees to assign the following individuals to perform the services in this Agreement. Contractor shall not alter the assignment of the following personnel without the prior written approval of the Contract Officer. Acting through the City Manager, the City shall have the unrestricted right to order the removal of any personnel assigned by Contractor by providing written notice to Contractor. Name: Title: (to be determined) 5.6 California Labor Code Requirements. A. Contractor is aware of the requirements of California Labor Code Sections 1720 et seq. and 1770 et seq., which require the payment of prevailing wage rates and the performance of other requirements on certain “public works” and “maintenance” projects (“Prevailing Wage Laws”). If the Services are being performed as part of an applicable “public works” or “maintenance” project, as defined by the Prevailing Wage Laws, and if the total compensation is $15,000 or more for maintenance or $25,000 or more for construction, alteration, demolition, installation, or repair, Contractor agrees to fully comply with such Prevailing Wage Laws. Contractor shall defend, indemnify, and hold the City, its officials, officers, employees, and agents free and harmless from any claims, liabilities, costs, penalties, or interest arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. It shall be mandatory upon the Contractor and all subcontractors to comply with all California Labor Code provisions, which include but are not limited to prevailing wages (Labor Code Sections 1771, 1774 and 1775), employment of apprentices (Labor Code Section 1777.5), certified payroll records (Labor Code Sections 1771.4 and 1776), hours of labor (Labor Code Sections 1813 and 1815) and debarment of contractors and subcontractors (Labor Code Section 1777.1). B. If the Services are being performed as part of an applicable “public works” or “maintenance” project and if the total compensation is $15,000 or more for maintenance or $25,000 or more for construction, alteration, demolition, installation, or repair, then pursuant to Labor Code Sections 1725.5 and 1771.1, the Contractor and all subcontractors performing such Services must be registered with the Department of Industrial Relations. Contractor shall maintain registration for the duration of the Project and require the same of any subcontractors, as applicable. This Agreement may also be subject to compliance monitoring and enforcement by the Department of Industrial Relations. It shall be Contractor’s sole responsibility to comply with all applicable registration and labor compliance requirements. 6. INSURANCE DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 5 of 27 Contractor shall procure and maintain, at its sole cost and expense, policies of insurance as set forth in the attached Exhibit "B", incorporated herein by reference. 7. INDEMNIFICATION. 7.1 Indemnification. To the fullest extent permitted by law, Contractor shall defend (at Contractor’s sole cost and expense), indemnify, protect, and hold harmless City, its elected officials, officers, employees, agents, and volunteers (collectively the “Indemnified Parties”), from and against any and all liabilities, actions, suits, claims, demands, losses, costs, judgments, arbitration awards, settlements, damages, demands, orders, penalties, and expenses including legal costs and attorney fees (collectively “Claims”), including but not limited to Claims arising from injuries to or death of persons (Contractor’s employees included), for damage to property, including property owned by City, for any violation of any federal, state, or local law or ordinance or in any manner arising out of, pertaining to, or incident to any acts, errors or omissions, or willful misconduct committed by Contractor, its officers, employees, representatives, and agents, that arise out of or relate to Contractor’s performance of Services or this Agreement. This indemnification clause excludes Claims arising from the sole negligence or willful misconduct of the Indemnified Parties. Under no circumstances shall the insurance requirements and limits set forth in this Agreement be construed to limit Contractor’s indemnification obligation or other liability under this Agreement. Contractor’s indemnification obligation shall survive the expiration or earlier termination of this Agreement until all actions against the Indemnified Parties for such matters indemnified are fully and finally barred by the applicable statute of limitations or, if an action is timely filed, until such action is final. 7.2 Design Professional Services Indemnification and Reimbursement. If Contractor’s obligation to defend, indemnify, and/or hold harmless arises out of Contractor’s performance as a “design professional” (as that term is defined under Civil Code section 2782.8), then, and only to the extent required by Civil Code section 2782.8, which is fully incorporated herein, Contractor’s indemnification obligation shall be limited to the extent which the Claims arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor in the performance of the Services or this Agreement, and, upon Contractor obtaining a final adjudication by a court of competent jurisdiction, Contractor’s liability for such claim, including the cost to defend, shall not exceed the Contractor’s proportionate percentage of fault. 8. RECORDS AND REPORTS 8.1 Reports. Contractor shall periodically prepare and submit to the Contract Officer reports concerning the performance of the Services required by this Agreement, or as the Contract Officer shall require. 8.2 Records. Contractor shall keep complete, accurate, and detailed accounts of all time, costs, expenses, and expenditures pertaining in any way to this Agreement. Contractor shall keep such books and records as shall be necessary to properly perform the Services required by this Agreement and enable the Contract Officer to evaluate the performance of such Services. The Contract Officer shall have full and free access to such books and records at all reasonable times, including the right to inspect, copy, audit, and make records and transcripts from such records. 8.3 Ownership of Documents. All drawings, specifications, reports, records, documents, and other materials prepared by Contractor in the performance of this Agreement shall be the property of City. Contractor shall deliver all above-referenced documents to City upon request of the Contract Officer or upon the termination of this Agreement. Contractor shall have no claim for further employment or additional compensation as a result of the exercise by City of its full rights or ownership of the documents and materials. Contractor may retain copies of such documents for Contractor's own use. Contractor shall have an unrestricted right to use the concepts embodied in such documents. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 6 of 27 8.4 Release of Documents. All drawings, specifications, reports, records, documents, and other materials prepared by Contractor in the performance of Services under this Agreement shall not be released publicly without the prior written approval of the Contract Officer. 8.5 Audit and Inspection of Records. After receipt of reasonable notice and during the regular business hours of City, Contractor shall provide City, or other agents of City, such access to Contractor’s books, records, payroll documents, and facilities as City deems necessary to examine, copy, audit, and inspect all accounting books, records, work data, documents, and activities directly related to Contractor’s performance under this Agreement. Contractor shall maintain such books, records, data, and documents in accordance with generally accepted accounting principles and shall clearly identify and make such items readily accessible to such parties during the term of this Agreement and for a period of three (3) years from the date of final payment by City hereunder. 9. ENFORCEMENT OF AGREEMENT 9.1 California Law. This Agreement shall be construed and interpreted both as to validity and to performance of the parties in accordance with the laws of the State of California. Legal actions concerning any dispute, claim, or matter arising out of or in relation to this Agreement shall be instituted in the Superior Court of the County of Riverside, State of California, or any other appropriate court in such county, and Contractor covenants and agrees to submit to the personal jurisdiction of such court in the event of such action. 9.2 Interpretation. This Agreement shall be construed as a whole according to its fair language and common meaning to achieve the objectives and purposes of the Parties. The terms of this Agreement are contractual and the result of negotiation between the Parties. Accordingly, any rule of construction of contracts (including, without limitation, California Civil Code Section 1654) that ambiguities are to be construed against the drafting party, shall not be employed in the interpretation of this Agreement. The caption headings of the various sections and paragraphs of this Agreement are for convenience and identification purposes only and shall not be deemed to limit, expand, or define the contents of the respective sections or paragraphs. 9.3 Waiver. No delay or omission in the exercise of any right or remedy of a non- defaulting Party on any default shall impair such right or remedy or be construed as a waiver. No consent or approval of City shall be deemed to waive or render unnecessary City’s consent to or approval of any subsequent act of Contractor. Any waiver by either Party of any default must be in writing. No such waiver shall be a waiver of any other default concerning the same or any other provision of this Agreement. 9.4 Rights and Remedies are Cumulative. Except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative. The exercise by either Party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other Party. 9.5 Legal Action. In addition to any other rights or remedies, either Party may take legal action, in law or in equity, to cure, correct, or remedy any default, to recover damages for any default, to compel specific performance of this Agreement, to obtain injunctive relief, a declaratory judgment, or any other remedy consistent with the purposes of this Agreement. 9.6 Attorney Fees. In the event any dispute between the Parties with respect to this Agreement results in litigation or any non-judicial proceeding, the prevailing Party shall be entitled, in addition to such other relief as may be granted, to recover from the non-prevailing Party all reasonable costs and expenses. These include but are not limited to reasonable attorney fees, expert contractor fees, court costs and all fees, costs, and expenses incurred in any appeal or in collection of any judgment entered in such proceeding. 10. CITY OFFICERS AND EMPLOYEES: NON-DISCRIMINATION DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 7 of 27 10.1 Non-Liability of City Officers and Employees. No officer or employee of City shall be personally liable to the Contractor, or any successor-in-interest, in the event of any default or breach by City or for any amount which may become due to the Contractor or its successor, or for breach of any obligation of the terms of this Agreement. 10.2 Conflict of Interest. Contractor acknowledges that no officer or employee of the City has or shall have any direct or indirect financial interest in this Agreement, nor shall Contractor enter into any agreement of any kind with any such officer or employee during the term of this Agreement and for one (1) year thereafter. Contractor warrants that Contractor has not paid or given, and will not pay or give, any third party any money or other consideration in exchange for obtaining this Agreement. 10.3 Covenant Against Discrimination. In connection with its performance under this Agreement, Contractor shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin ( i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition (each a “prohibited basis”). Contractor shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City’s lawful capacity to enter this Agreement, and in executing this Agreement, Contractor certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Contractor activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Contractor is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. 11. MISCELLANEOUS PROVISIONS 11.1 Notice. Any notice, demand, request, consent, approval, or communication that either Party desires, or is required to give to the other Party or any other person shall be in writing and either served personally or sent by pre-paid, first-class mail to the address set forth below. Notice shall be deemed communicated seventy-two (72) hours from the time of mailing if mailed as provided in this Section. Either Party may change its address by notifying the other Party of the change of address in writing. To City: City of Palm Springs Attention: City Manager/ City Clerk 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 To Contractor: West Coast Arborists, Inc. Attention: Patrick Mahoney 43712 Jackson Street Indio, CA 92201 11.2 Integrated Agreement. This Agreement constitutes the entire understanding between the Parties and supersedes and cancels all prior negotiations, arrangements, agreements, representations, and understandings, if any, made by or among the Parties with respect to the subject matter in this Agreement. 11.3 Amendment. No amendments or other modifications of this Agreement shall be binding unless through written agreement signed by all Parties. 11.4 Severability. Whenever possible, each provision of this Agreement shall be interpreted in such a manner as to be effective and valid under applicable law. In the event that DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 8 of 27 any one or more of the phrases, sentences, clauses, paragraphs, or sections contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs, or sections of this Agreement, which shall be interpreted to carry out the intent of the Parties. 11.5 Successors in Interest. This Agreement shall be binding upon and inure to the benefit of the Parties’ successors and assignees. 11.6 Third Party Beneficiary. Except as may be expressly provided for in this Agreement, nothing contained in this Agreement is intended to confer, nor shall this Agreement be construed as conferring, any rights, including, without limitation, any rights as a third-party beneficiary or otherwise, upon any entity or person not a party to this Agreement. 11.7 Recitals. The above-referenced Recitals are hereby incorporated into the Agreement as though fully set forth in this Agreement and each Party acknowledges and agrees that such Party is bound, for purposes of this Agreement, by the same. 11.8 Authority. The persons executing this Agreement on behalf of the Parties warrant that they are duly authorized to execute this Agreement on behalf of Parties and that by so executing this Agreement the Parties are formally bound to the provisions of this Agreement. 11.9 Counterparts. This Agreement may be signed in counterparts, each of which shall constitute an original. 11.10 Compliance with Economic Sanctions in Response to Russia's Actions in Ukraine. When funding for the services is provided, in whole or in part, by an agency controlled of the State of California, Consultant shall fully and adequately comply with California Executive Order N-6-22 (“Russian Sanctions Program”). As part of this compliance process, Consultant shall also certify compliance with the Russian Sanctions Program by completing the form located in Exhibit “C” (Russian Sanctions Certification), attached hereto and incorporated herein by reference. Consultant shall also require any subconsultants to comply with the Russian Sanctions Program and certify compliance pursuant to this Section. [SIGNATURES ON NEXT PAGE] DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 9 of 27 SIGNATURE PAGE TO CONTRACT SERVICES AGREEMENT BY AND BETWEEN THE CITY OF PALM SPRINGS AND WEST COAST ARBORISTS, INC. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the dates stated below. CONTRACTOR: By: _____________________________ By: _____________________________ Signature Signature (2nd signature required for Corporation) Date: ___________________________ Date: ___________________________ CITY OF PALM SPRINGS: APPROVED BY CITY COUNCIL: Date: _______________ Item No. _______________ APPROVED AS TO FORM: ATTEST: By: _____________________________ By: _____________________________ City Attorney City Clerk APPROVED: By: _____________________________ Date: ____________________________ City Manager – over $50,000 Deputy/Assistant City Manager – up to $50,000 Director – up to $25,000 Manager – up to $5,000 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 6/24/2024 6/24/2024 6/28/2024 1-B6/27/2024 Page 10 of 27 EXHIBIT “A” SCOPE OF SERVICES/WORK Including, Schedule of Fees And Schedule of Performance DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 11 of 27 1.1 Background: The City of Palm Springs Fire Department is in need of a vendor to provide vegetation management services. Vegetation management has proven to be a major factor in reducing the chances of buildings igniting from wildfires and from wildland areas being ignited from burning buildings. The city-owned vacant lots within the very high fire severity zone pose a significant fire risk due to the accumulation of dry vegetation and combustible materials. With the increasing frequency and severity of wildfires in recent years, proactive measures are essential to minimize the risk of fire ignition and spread within these areas. Vegetation management is crucial for reducing fuel loads, creating defensible space, and enhancing overall fire resilience. 1.2 Scope: A. Contractor shall furnish all labor, materials, and equipment necessary to provide vegetation management services (Work) for the Palm Springs Fire Department. B. Contractor shall provide (3) 3-man crews and (1) supervisor. C. Contractor shall adhere vegetation management requirements detailed below and in the ‘VEGETATION MANAGEMENT IN VERY HIGH FIRE HAZARD SEVERITY ZONES’, as detailed in Appendix “A”. 1. Areas within 200 feet of structures and/or 10 feet of roadside surfaces or combustible fence: Grass shall be cut to three inches in height. Native brush shall be reduced in quantity to three inches in height. This does not apply to individual native shrubs spaced a minimum of 18 feet apart, provided such shrubs are trimmed up from the ground to 1/3 of their height with all dead material being removed (see diagram below). 2. For trees taller than 18 feet, trim lower branches so no foliage is within six feet of the ground, and remove all dead material. For trees and shrubs less than 18 feet, remove lower branches to 1/3 of their height, and remove all dead material (see diagram below). 3. Trees shall be trimmed up so the foliage is no closer than 10 feet from the outlet of a chimney. 4. All cut vegetation and debris shall be removed in a legal manner. Cut vegetation may be machine processed (i.e. chipped) and spread back onto the property at a depth not to exceed three inches within 30 feet of structures and six inches beyond 30 feet of structures. In addition, spread material shall not be placed within 10 feet of any usable roadside. 5. Use of metal cutting blades for grass or brush clearance shall be limited to those which are non-ferrous/non-sparking. 6. Brush clearance cannot be done on red flag days, when fire weather conditions are at their peak. 7. Individuals engaged in brush clearance operations shall not engage in any other activities during their actual clearance of grass or brush. 8. An approved 2-A two (2) gallon water fire extinguisher, or a pressurized garden hose with attached nozzle shall be within 10 feet of any grass or brush clearance operation, to quickly extinguish a small fire before it burns out of control. 9. Where a gasoline container is present at the site of the grass or brush clearance operation, a minimum 4A 60BC dry chemical fire extinguisher shall be within 10 feet of the brush clearance operation. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 12 of 27 10. A mobile phone capable of dialing 9-1-1 shall be charged and readily accessible to the grass or brush clearance operation. D. Contractor will perform vegetation management on city lots located with our city’s Very High Fire Severity Zone (VHFSZ), see Appendix “B”. E. Contractor shall manage all vegetation 10 feet from roadways and 200 feet from structures. F. Contractor shall limb up all dead or dying limbs. G. Contractor will regularly meet with Fire Marshal or designee. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 13 of 27 H. Contractor will perform extra work as needed when requested by the Fire Marshal or designee. I. The City will establish a schedule for conducting vegetation management. J. The Contractor shall submit a weekly detailed job schedule, time sheet, names and titles of all persons working on the project within ten (10) days after issuance of the notice to proceed. K. Contractor shall begin work and shall proceed with all reasonable dispatch to completion. The Contractor will be required to maintain all areas in accordance with the contract documents. Work must be completed in consecutive days. Inclement weather may result in the cancellation of certain vegetation management services only if the Contract Administrator or designee determines that there was insufficient time available for the services described to be performed. L. The Contractor shall accomplish all normal vegetation management services required under this contract between the hours of 7:00 AM and 3:30 PM, 5-days a week (or as otherwise required), for the Fall/Spring months (November through April), and between the hours of 6:00 AM and 2:30 PM, 5-days a week (or as otherwise required), for the Summer/Fall months (May through October). Exceptions may be made to normal working hours, where incidences of use may be too great during the hours specified to allow for proper maintenance. The City may grant, on an individual basis, permission to perform contract maintenance at other hours. No management functions that generate excess noise which would cause annoyance to residents of any area shall be commenced before 8:00 AM. The Contractor shall establish a schedule of routine work to be followed in the performance of this contract. M. Contractor shall make Lead Workers available for a weekly meeting with Contract Administrator or their designee. Supervisor and/or Area Manager for Contractor shall be available for quarterly meetings with Contractor Administrator or their designee. N. Except in the case of an emergency call-out, there will be no work scheduled on days that the City is closed for holidays: New Year's Day, Martin Luther King Jr. Day, Presidents Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving Day, Day after Thanksgiving, Christmas Eve, and Christmas Day. O. City properties to be included in these services shall include the following APNs: 504150058 504150046 504150055 504150019 504150018 504150017 504150011 504150012 504150013 513070009 513060021 510210017 P. Minimum Equipment Needed: Contractor is expected to own and include in pricing all hand tools, hand trucks, boom trucks, bobcats, trucks, and any other equipment necessary to provide the services required by this scope of work. The City will not pay additional equipment fees or rentals. 1. All vehicles must be Heavy Duty four-wheel drive vehicles equipped with flashing arrow signs (FAS), and caution beacons. A hauling bed or pull trailer with a capacity no less than 14 feet long, six feet wide, with side boards at least five feet high is required. 2. Small hand tools including but not limited to: loppers, clippers, hand saws, chainsaws, rakes, brooms, shovels, pitch forks, weed-eaters, hoes, wheelbarrows and all employee safety and personal protective equipment, are to be provided by Contractor at all times. Leaf blowers must be battery powered. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 14 of 27 3. Contractor is responsible for all traffic control and must meet CalTrans standards and practices. Each truck shall carry adequate traffic control devices such as cones, roadwork signs on barricades and delineators to perform assigned tasks. A minimum of 25 cones with reflective sleeves, 2 Road Work Ahead signs (36” x 36”) on barricades and 2 Lane Closed Ahead (36” x 36”) signs on barricades are required for each truck. Reflective roll up signs that are 48” x 48” with stands are acceptable. 4. Minimal required Personal Protective Equipment needed, but not limited to: Class 2 Safety Vests, puncture proof disposable gloves, leather work gloves, reinforced work boots, safety glasses/goggles, face shields, dust masks, face coverings, headwear for sun protection, rain gear and appropriate hearing protection. Contractor shall provide documentation for all employee attended safety meetings and bi-annual IMSA CAL-TRANS standard ‘Work Zone Temporary Traffic Control’ certifications for Lead Workers and Supervisors. Q. Green Waste Disposal: Green waste shall be defined as tree and shrubbery trimmings, grass, weeds, leaves, woodchips and other garden organic materials. 1. Contractor shall be responsible for recycling all green waste generated from their contract performance. 2. Contractor shall have the duty to keep all green waste from being contaminated to an extent it no longer can be recycled. 3. Contractor shall deliver all green waste to a city approved reclamation site, for the purposes of recycling. Approved reclamation sites are: i. California Valley Compost Facility – 87011 Landfill Road, Coachella ii. So Cal Recycling – 29250 Rio Del Sol, Thousand Palms 4. Contractor shall submit a monthly report identifying the weight and/or volume of green waste recycled during the preceding month. Payment of maintenance invoice will not be made until green waste monthly report is completed and received by the City. 5. All debris resulting from any of the Contractor’s operations shall be removed and disposed of legally at the Contractor’s expense. No debris will be allowed to remain at the end of the workday. (Failure to remove and dispose of debris shall result in a liquidated damages charge of $100 per site, per occurrence to be deducted from the Contractor’s payment.) 6. All debris must be separated into green waste, recyclables, and other waste to minimize contamination and be disposed of in the appropriate locations. (Failure to separate and dispose of debris appropriately shall result in a liquidated damages charge of $100 per site, per occurrence to be deducted from the Contractor’s payment.) R. Storage Facilities: The City shall not provide any storage facilities for the Contractor. The City’s Corporate Yard located at 425 N. Civic Drive is a secure facility and shall not be used by the Contractor. The Contractor shall be responsible for obtaining an appropriate administrative office, storage yard, and secure parking lot for its equipment and vehicles. The location of its facility shall be within the City of Palm Springs, or subject to the approval of the City. S. Parking: 1. During the Contractor’s daily operations and completion of the Work, the Contractor shall park their vehicles and equipment within designated public parking DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 15 of 27 areas or work zones, in accordance with local and state laws, maintaining clear travel lanes for vehicular traffic. Overnight parking of the Contractor’s vehicles and equipment shall be located within the Contractor’s own secured storage facility, and not within any City facilities or public parking lots. 2. The Contractor’s vehicles and equipment shall not be parked or set in such a manner that they block pedestrian access or vehicular right-of-way except as required to comply with all safety standards of OSHA or CAL-OSHA. T. Vehicles: The Contractor’s vehicles used in performance of the services required hereunder shall be maintained in first class condition. Upon commencement of the services, the Contractor shall furnish and apply an appropriate logo on all vehicles to be used within the City identifying the Contractor’s company name. The logo shall be prepared by the Contractor and submitted to the City for approval prior to use. 1.3 Schedule: Work will commence upon issuance of notice to proceed, and all work shall be completed by the end of contract term. 1.4 Compensation: Work will be compensated on an hourly basis at the rates detailed on the bid form. Contract pricing includes all labor, expenses, and incidentals to complete the work outlined in the contract scope. The Contractor may request monthly payments based on the percentage of work completed for the previous month as long as a detailed progress report is provided to support the amount requested. No additional compensation will be due by the City unless the contract is modified for additional work requested by the City. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 16 of 27 Appendix “A” VEGETATION MANAGEMENT IN VERY HIGH FIRE HAZARD SEVERITY ZONES DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 17 of 27 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 18 of 27 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 19 of 27 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 20 of 27 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 21 of 27 Appendix “B” VERY HIGH FIRE HAZARD SEVERITY ZONES DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 22 of 27 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 23 of 27 EXHIBIT “B” INSURANCE PROVISIONS Including Verification of Coverage, Sufficiency of Insurers, Errors and Omissions Coverage, Minimum Scope of Insurance, Deductibles and Self-Insured Retentions, and Severability of Interests (Separation of Insureds) DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 24 of 27 INSURANCE 1. Procurement and Maintenance of Insurance. Contractor shall procure and maintain public liability and property damage insurance against all claims for injuries against persons or damages to property resulting from Contractor’s performance under this Agreement. Contractor shall procure and maintain all insurance at its sole cost and expense, in a form and content satisfactory to the City, and submit concurrently with its execution of this Agreement. Contractor shall also carry workers’ compensation insurance in accordance with California workers’ compensation laws. Such insurance shall be kept in full force and effect during the term of this Agreement, including any extensions. Such insurance shall not be cancelable without thirty (30) days advance written notice to City of any proposed cancellation. Certificates of insurance evidencing the foregoing and designating the City, its elected officials, officers, employees, agents, and volunteers as additional named insureds by original endorsement shall be delivered to and approved by City prior to commencement of services. The procuring of such insurance and the delivery of policies, certificates, and endorsements evidencing the same shall not be construed as a limitation of Contractor’s obligation to indemnify City, its elected officials, officers, agents, employees, and volunteers. 2. Minimum Scope of Insurance. The minimum amount of insurance required under this Agreement shall be as follows: 1. Comprehensive general liability and personal injury with limits of at least one million dollars ($1,000,000.00) combined single limit coverage per occurrence and two million dollars ($2,000,000) general aggregate; 2. Automobile liability insurance with limits of at least one million dollars ($1,000,000.00) per occurrence; 3. Professional liability (errors and omissions) insurance with limits of at least one million dollars ($1,000,000.00) per occurrence and two million dollars ($2,000,000) annual aggregate is: _________ required ___x_____ is not required; 4. Workers’ Compensation insurance in the statutory amount as required by the State of California and Employer’s Liability Insurance with limits of at least one million dollars $1 million per occurrence. If Contractor has no employees, Contractor shall complete the City’s Invitation for Waiver of Workers’ Compensation Insurance Requirement form. 3. Primary Insurance. For any claims related to this Agreement, Contractor’s insurance coverage shall be primary with respect to the City and its respective elected officials, officers, employees, agents, and volunteers. Any insurance or self-insurance maintained by City and its respective elected officials, officers, employees, agents, and volunteers shall be in excess of Contractor’s insurance and shall not contribute with it. For Workers’ Compensation and Employer’s Liability Insurance only, the insurer shall waive all rights of subrogation and contribution it may have against City, its elected officials, officers, employees, agents, and volunteers. 4. Errors and Omissions Coverage. If Errors & Omissions Insurance is required, and if Contractor provides claims made professional liability insurance, Contractor shall also agree in writing either (1) to purchase tail insurance in the amount required by this Agreement to cover claims made within three years of the completion of Contractor’s services under this Agreement, or (2) to maintain professional liability insurance coverage with the same carrier in the amount required by this Agreement for at least three years after completion of Contractor’s services under this Agreement. Contractor shall also be required to provide evidence to City of the purchase of the required tail insurance or continuation of the professional liability policy. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 25 of 27 5. Sufficiency of Insurers. Insurance required in this Agreement shall be provided by authorized insurers in good standing with the State of California. Coverage shall be provided by insurers admitted in the State of California with an A.M. Best’s Key Rating of B++, Class VII, or better, unless otherwise acceptable to the City. 6. Verification of Coverage. Contractor shall furnish City with both certificates of insurance and endorsements, including additional insured endorsements, effecting all of the coverages required by this Agreement. The certificates and endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All proof of insurance is to be received and approved by the City before work commences. City reserves the right to require Contractor’s insurers to provide complete, certified copies of all required insurance policies at any time. Additional insured endorsements are not required for Errors and Omissions and Workers’ Compensation policies. Verification of Insurance coverage may be provided by: (1) an approved General and/or Auto Liability Endorsement Form for the City of Palm Springs or (2) an acceptable Certificate of Liability Insurance Coverage with an approved Additional Insured Endorsement with the following endorsements stated on the certificate: A. "The City of Palm Springs, its officials, employees, and agents are named as an additional insured…” ("as respects City of Palm Springs Contract No.___" or "for any and all work performed with the City" may be included in this statement). B. "This insurance is primary and non-contributory over any insurance or self- insurance the City may have..." ("as respects City of Palm Springs Contract No.___" or "for any and all work performed with the City" may be included in this statement). C. "Should any of the above described policies be canceled before the expiration date thereof, the issuing company will mail 30 days written notice to the Certificate Holder named." Language such as, “endeavor to” mail and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representative" is not acceptable and must be crossed out. D. Both the Workers’ Compensation and Employers' Liability policies shall contain the insurer's waiver of subrogation in favor of City, its elected officials, officers, employees, agents, and volunteers. In addition to the endorsements listed above, the City of Palm Springs shall be named the certificate holder on the policies. All certificates of insurance and endorsements are to be received and approved by the City before work commences. All certificates of insurance must be authorized by a person with authority to bind coverage, whether that is the authorized agent/broker or insurance underwriter. Failure to obtain the required documents prior to the commencement of work shall not waive the Contractor’s obligation to provide them. 7. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions must be declared to and approved by the City prior to commencing any work or services under this Agreement. At the option of the City, either (1) the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect to the City, its elected officials, officers, employees, agents, and volunteers; or (2) Contractor shall procure a bond guaranteeing payment of losses and related investigations, claim administration, and defense expenses. Certificates of Insurance must include evidence of the amount of any deductible or self-insured retention under the policy. Contractor guarantees payment of all deductibles and self-insured retentions. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 26 of 27 8. Severability of Interests (Separation of Insureds). This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the limits of the insurer’s liability. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 27 of 27 EXHIBIT “C” EXECUTIVE ORDER N-6-22 CERTIFICATION DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY, PALM SPRINGS, CA 92262 (760) 322-8328 BUSINESS LICENSE CERTIFICATE Fees Paid:$193.00 ISSUANCE OF THIS LICENSE DOES NOT ENTITLE THE LICENSEE TO OPERATE OR MAINTAIN A BUSINESS IN VIOLATION OF ANY OTHER LAW OR ORDINANCE. THIS IS NOT AN ENDORSEMENT OF THE ACTIVITY NOR OF THE APPLICANT'S QUALIFICATIONS. Business Name:WEST COAST ARBORISTS, INC DBA: Owner:PATRICK MAHONEY Mailing Address:2200 E VIA BURTON ANAHEIM, CA 92806 License Number:CBL-000387-2023 Expiration Date:05/31/2025 PLEASE NOTE THAT IT IS YOUR RESPONSIBILITY TO RENEW AND UPDATE THIS LICENSE ANNUALLY. Business Location:2200 E VIA BURTON, ANAHEIM, CA 92806 Business Description:TREE MAINT. & LANDSCAPING SERVICES TO BE POSTED IN A CONSPICUOUS PLACE DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 ABHDEOHolder Identifier : 7777777707070700077761616045571110766716117215557207442027772507300073741577156221030772415557067454207173011776321557074377225221322600705333207006223007344015752274130076727242035772000777777707000707007 7777777707070700073525677115456000723111406037013007022236342173100071233362420721110702232634317300007132327253173100070223363420731000703333734207310107132236353172001077756163351765540777777707000707007Certificate No :570106216183CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/06/2024 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. PRODUCER Aon Risk Insurance Services West, Inc. Los Angeles CA Office 707 Wilshire Boulevard Suite 2600 Los Angeles CA 90017-0460 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED 19682Hartford Fire Insurance Co.INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.):(800) 363-0105 CONTACT NAME: West Coast Arborists, Inc. 2200 E Via Burton Anaheim CA 92806 USA COVERAGES CERTIFICATE NUMBER:570106216183 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.Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X X GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 $1,000,000 $2,000,000 $4,000,000 $4,000,000 A 07/01/2024 07/01/2025 SIR applies per policy terms & conditions 72ECSS89301 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X BODILY INJURY (Per accident) $2,000,000A07/01/2024 07/01/2025 COMBINED SINGLE LIMIT (Ea accident) 72 CSE S89302 EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED UMBRELLA LIAB RETENTION E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER PER STATUTEA07/01/2024 07/01/2025 Workers Comp AZ CA $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N / AN WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 72WNS89300 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Palm Springs, its officials, employees, and agents are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability policy evidenced herein is Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of the City of Palm Springs, its officials, employees, and agents in accordance with the policy provisions of the General Liability and Workers Compensation policies. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECity of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs CA 92262 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 Page 1 of 2 POLICY NUMBER: 72 ECS S89301 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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 WHERE REQUIRED BY WRITTEN CONTRACT WHERE 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. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill - 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. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 POLICY NUMBER: 72 ECS S 8 9 3 01 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 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(sJ Location And Description Of Completed Operations WHERE REQUIRED BY WRITTEN CONTRACT WHERE 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" 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 Ill - 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. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Named Insured: WEST COAST ARBORISTS, INC. Endorsement Effective Date: 07/01/2024 Name Of Person(s) Or Organization(s): WHERE REQUIRED BY WRITTEN CONTRACT POLICY NUMBER: 72 CSE S89302 COMMERCIAL AUTO CA20481013 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. SCHEDULE 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.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 Page 1 of 1 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 POLICY NUMBER: ABCDEFGHIJ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION - PRIMARY OR PRIMARY AND NON-CONTRIBUTORY WHEN REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART (EXCESS) PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART (EXCESS – BROAD FORM) With respect to other insurance available to any person or organization who is an additional insured under this Coverage Part, the following replaces Paragraph 4., Other Insurance of Section IV – PRODUCTS/COMPLETED OPERATIONS LIABILITY CONDITIONS: 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance be primary, then subject to the "self- insured retention", this insurance is primary . If other insurance is also primary, we will share with all that other insurance by the method described in Paragraph c. below. b. Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement, or permit that this insurance is primary and non-contributory with the additional insured's own insurance, then subject to the "self-insured retention", this insurance is primary, and we will not seek contribution from that other insurance. Paragraphs a. and b. do not apply to other insurance to which the additional insured has been added as an additional insured. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer’s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Form EH 24 08 03 14 Page 1 of 1 © 2014, The Hartford (Includes copyrighted material of Insurance Services Office, Inc., with its permission.) DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. State Or Governmental Agency Or Subdivision Or Political Subdivision: WHERE REQUIRED BY WRITTEN CONTRACT POLICY NUMBER: 72 ECS S89301 COMMERCIAL GENERAL LIABILITY CG 20 12 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE A. Section II - Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products-completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill - 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. CG 20 12 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number: 72 WN S89300 Endorsement Number: Effective Date:07 / 01/2024 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: WEST COAST ARBORISTS' INC. 220 E. VIA BURTON ANAHEIM, CA 92806 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 shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. Countersigned by Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date: Policy Expiration Date: DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: Endorsement Number: Effective Date: Effective hour is the same as stated on the Declarations of the policy. Named Insured and Address: We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be otherwise due on such remuneration. % of the California workers’ compensation premium SCHEDULE Person or Organization Job Description Countersigned by Authorized Representative Form WC 04 03 06 Printed in U.S.A. DocuSign Envelope ID: 01365361-8009-4734-9861-A4BCF20227A4