Loading...
HomeMy WebLinkAbout23B100 - SOUTHERN CONTRACTING CO.23BIW Recording Requested By: City of Palm Springs When Recorded Mail To Name Brenda Pree, City Clerk street Address 3200 E. Tahquitz Canyon Way City & State Palm Springs, CA 92262 NOTICE IS HEREBY GIVEN THAT: 2025-0102346 04/07/2025 11:04 AM Fee: $ 0.00 Page 1 of 2 Recorded in Official Records County of Riverside Peter Aldana Assessor -County Clerk -Recorder V Ih1lrYli'IT Yi ��I'� �� if l�r rill ll � SPACE ABOVE THIS LINE FOR RECORDERS USE NOTICE OF COMPLETION (CA Civil Code §§ 81808190, 8100-8118, 9200-9208) 1. The undersigned is an owner of an interest of estate in the hereinafter described real property, the nature of which interest or estate is: Fee V 1v - (e.g. fee, leasehold, joint tenancy, etc.) 2. The full name and address of the undersigned owner or reputed owner and of all co -owners or reputed co -owners are: Name Street and No. City State City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Spdngs CA 92262 3. The name and address of the direct contractor for the work of improvement as a whole is: Southern Contracting Company 559 N Twin Oaks Valley Rd. San Marcos, Ca 92069 4. This notice is given for (check one): 0 Completion of the work of improvement as a whole. ❑ Completion of a contract for a particular portion of the work of improvement (per CA Civ. Code § 8186). 5. If this notice is given only of completion of a contract for a particular portion of the work of improvement (as provided in CA Civ. Code § 8186), the name and address of the direct contractor under that contract is: Not Applicable 6. The name and address of the construction lender, if any, is: Not Applicable 7. On the 27 day of Maw , 2025 , there was completed upon the herein described property a work of improvement as a whole (or a particular portion of the work of improvement as provided in CA Civ. Code § 8186) a general description of the work provided: LED Lighting at 9 recreational baseball fields complete. Note, the electrical switchgear is still pending install. 8. The real property herein referred to is situated in the City of Palm Songs County of Riverside ' State of California, and is described as follows: 9. The street address of said property is: Demuth Park baseball fields 1 -8 and Palm Spdngs Stadium baseball field. 10. If this Notice of Completion is signed by the owners successor in interest, the name and address of the successor's transferor is: Not applicable I``cer ify (or declare) under penalty of perjury under the laws of the Stat f Calil'Iff to that the for ' . a a correct. Date: 1` o\ t^ � M c C c � By: /'Y Signature of Owner or Owner's Authorized Agent Joel Montalvo/City Engineer City of Palm Springs Page 1 of 2 VERIFICATION 1, Joel Montalvo , state: I am the City Engineer _ ('Owned, "President", "Authorized Agent", "Partner", etc.) of the Owner identified in the foregoing Notice of Completion. I have read said Notice of Completion and know the contents thereof, the same is true of my own knowledge. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on Imo' l A iZ C k - l " ), at Palm Springs Joel Montalvo/City Engineer City of Palm Springs (city), CA (State). A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. ANITA L, FIELDS Nogry Public - California Riverside Couray Canmissim/2354350 My Comm. Expires Apr 13, 2025 r STATE OF CALIFORNIA COUNTY OF l On(date), before me, Notary Public (name and title of officer) personally appeared c)V V L ho proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/herftheir authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PURJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Page 2 of 2 ignature ACOR1 a `� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI 9n2/2024 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 endorsement(s). PROWCER SullivanCurtisMonroe Insurance Services (COR) 2010 Main Street Suite 700 CONTACT "ME: Tien Le E FAx 951 493-3314 No: 949-852-9762 E-MAIL ADDRESS tle sAlicurt.com INSURE $ AFFORDING COVERAGE NAIC0 Irvine, CA 92614 INSURERA: Hartford Fire Insurance Coma A+ 19682 www.SullivanCurtisMonroe.corrl Licenses OE83670 INSURED RECEIVED Southern Contracting Company P.O. Box 445 INSURER e: Hartford Casualty Insurance Company A+) 29424 INSURERC: Sentinel Insurance Company, Ltd. A+ 11000 INSURER o: AGCS Marine Insurance Coma A+ X 22837 San Marcos CA 92079 SEP 17 2024 INSURER E : WAMBER F: COVERAGES dtM1MeKA01WUA1§LFR:4i 96462fY"'T"m 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. ILTR TYPE OF INSURANCE FOUCYNUMBER PMAXNYYM YEFF M �YYY LIMITS A ✓ COMMERCIAL GENERAL LN&LITY �/ ✓ 72UEABG9UG8 10/112024 10/112025 EACH OCCURRENCE $1000000 CLAIMS -MADE OCCUR PREMISES E. orcunerv:e $300000 ✓ MED EXP (Any sore person) $1 O 000 XCU Included ✓ 1$5,000 PD Deductible PERSONAL a AM INJURY $1 OOO O0O AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 GENL POLICY [V] J'ERT ElDOC PRODUCTS - COMPIOP AGG $2000000 $ OTHER'. A AUTOMOBILEUASIUTY ✓ 72UEAPT0696 10/1/2024 10/l/2025 CEOMBBIINNEEDISINGLE LIMIT $1000000 BODILY INJURY (Per person) $ ✓ ANY AUTO CNRJEO SOHEDIILED AUTOS ONLY AUrpS BODILY INJURY (Per aa'+accident)$ ✓ HIRED AUTOS ONLY ✓ AUTOS ONLY Comp Ded$lk/$2k/$5k DAMAGE (per saiderno $ $ Coll Ded tk/ 2k/ 5k B ✓ UMBRELU DAB ✓ OCCUR 72RHABG9UCT 10/1/2024 10/1/2025 EACH OCCURRENCE $10OD0000 AGGREGATE $10000 000 EXCESS SUNS CLAIMS -MADE DEO I ✓ I RETENTION$ 10,000 $ C WORXERSCOMPENSATION AND EMPLOYERS' LIABILITY Y I N OF CEANYPRRNEMBEREXCLUDED'I CUTNE ❑N NIA ✓ 72VIEAZR3341 10I1I2024 10/1/2025 ✓ PEART OTH- EL EACH ACCIDENT fi DOD OOO E.L DISEASE- EA EMPLOYE $ (MarMatory in NH) If yes descdhe under DESCRIPTION OF OPERATIONS Eelav EL. DISEASE - POLICY LIMIT $1.000.000 D Installation Floater MZ193091424 10/1/2024 10/1/2025 $2,500,000 Limit ($2,500 Deductible) D -Property in Transit /Temp Locations MZI93091424 10/1I2024 10/1/2025 $750,000 Limit ($2,500 Deductible) D Leased & Rented Equipment W193091424 10/1/2024 10/1/2025 $2.MIT ,000 Limit ($1 k/5k Deductible) DESCRIPTION OF OPERATONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks SCMduM, may IM M1acMtl if more apace ie repuiredl RE: SCC Job No 107171 —Project No. 19-28 Recreation Fields LED Lighting Upgrades The City of Palm Springs, its official, employees and agents are additional insured per attached endorsement. Primary and Non -Contributory and Waiver of Subrogation are included per attached endorsement. 30 day notice of cancellation except for 10 days notice for nonpayment of premium applies. RE: SCC Job NO: 107171 —Project No. 19-28 Recreation Fields LED Lighting Upgrades City of Palm Springs Attn: Vonda Teed, Engineering Services Department 3200 E Tahquitz Can on 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. Tien All rights ranamad. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 81814I-- SOGTHCOn1 12'J24 GL CAC IMC WC IM I ::en Lo I 5.:.-.12024 La2:13 AM (PDT) I Page I of 18 This certificate cancels and supersedes ALL previously issued certificates. CONTRACT ABSTRACT 1 Original: Agreement, Performance & Payment Bond, and Insurance Contract Company Name: Company Contact: Summary of Services: Contract Price: Funding Source: Contract Term: Southern Contracting Company Timothy R. McBride, CEO Recreational Fields LED Lighting Upgrades City Project 19-28 $4,974,788.05 Measure J funds To be determined by the Notice to Proceed Contract Administration Lead Department: Contract Administrator: Engineering Services Joel Montalvo / Andrew Crider Contract Approvals Council Approval Date: Agreement Number: April 10, 2023, Item 1.N. 23B100 Contract Compliance Exhibits: Signatures: Insurance: Bonds: Attached Attached Attached Attached Contract prepared by: Engineering Services Submitted on: 05/02/2023 By: Anil Cholakkara DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE southern Contracting Company 9/12/2024 72UEABG91JG8 SECTION II -WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Employees And Volunteer Workers Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (f you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for. (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or that 'volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (1)(b) above; or (d)Arising out of his or her providing or failing to provide professional health care services. If you are not in the business of providing professional health care services: (a) Subparagraphs (1)(a), (1)(b) and (1)(c) above do not apply to any "employee" or "volunteer worker" providing first aid services; and (b)Subparagraph (1)(d) above does not apply to any nurse, emergency medical technician or paramedic employed by you to provide such services. (2) "Property damage" to property: (a) Owned, occupied or used by, (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (f you are a limited liability company). b. Real Estate Manager Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. c. Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) VVith respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties underthis Coverage Part. e. Unnamed Subsidiary Any subsidiary, and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of the Coverage Part. HIS 00 01 0916 Page 11 of 21 81864627 1 SOUTNCON1 1 2024 GL CAU We WC IM I Tien to 1 9/12/2024 11:12:13 AM (POT) I Page 2 of 18 This certificate cancels and supersedes ALL previously issued Certificates. The insurance afforded herein for any A person or organization is an additional insured subsidiary not named in this Coverage Part under this provision only for that period of time as a named insured does not apply to injury required by the contract or agreement. or damage with respect to which such insured However, no such person or organization is an is also a named insured under another policy insured under this provision if such person or or would be a named insured under such organization is included as an insured by an policy but for its termination or the exhaustion endorsement issued by us and made a part of of its limits of insurance. this Coverage Part. 3. Newly Acquired Or Formed Organization a. Vendors Any organization you newly acquire or form, Any person(s) or organization(s) (referred to other than a partnership, joint venture or limited below as vendor), but only with respect to liability company, and over which you maintain "bodily injury" or "property damage" arising financial interest of more than 50% of the voting out of "your products" which are distributed or stock, will qualify as a Named Insured if there is sold in the regular course of the vendor's no other similar insurance available to that business and only if this Coverage Part organization. However: provides coverage for "bodily injury" or a. Coverage under this provision is afforded only "property damage" included within the until the 180th day after you acquire or form "products -completed operations hazard". the organization or the end of the policy (1) The insurance afforded the vendor is period, whichever is earlier, subject to the following additional b. Coverage A does not apply to "bodily injury" exclusions: or "property damage" that occurred before This insurance does not apply to: you acquired or formed the organization; and (a) "Bodily injury' or "property damage" for c. Coverage B does not apply to "personal and which the vendor is obligated to pay advertising injury" arising out of an offense damages by reason of the assumption committed before you acquired or formed the of liability in a contract or agreement. organization. This exclusion does not apply to 4. Nonowned Watercraft liability for damages that the vendor With respect to watercraft you do not own that is would have in the absence of the less than 51 feet long and is not being used to contract or agreement; carry persons for a charge, any person is an (b)Any express warranty unauthorized by insured while operating such watercraft with your you; permission. Any other person or organization (c) Any physical or chemical change in the responsible for the conduct of such person is product made intentionally by the also an insured, but only with respect to liability vendor, arising out of the operation of the watercraft, and (d) Repackaging, except when unpacked only if no other insurance of any kind is available solely for the purpose of inspection, to that person or organization for this liability. demonstration, testing, or the However, no person or organization is an insured substitution of parts under instructions with respect to: from the manufacturer, and then a. "Bodily injury" to a co -"employee" of the repackaged in the original container, person operating the watercraft; or (e) Any failure to make such inspections, b. "Property damage" to property owned by, adjustments, tests or servicing as the rented to, in the charge of or occupied by you vendor has agreed to make or normally or the employer of any person who is an undertakes to make in the usual insured under this provision. course of business, in connection with S. Additional Insureds When Required By the distribution or sale of the products; Written Contract, Written Agreement Or (f) Demonstration, installation, servicing Permit or repair operations, except such The following persons) or organization(s) are an operations performed at the vendor's additional insured when you have agreed, in a premises in connection with the sale of written contract, written agreement or because of the product; a permit issued by a state or political subdivision, (g) Products which, after distribution or that such person or organization be added as an sale by you, have been labeled or additional insured on your policy, provided the relabeled or used as a container, part injury or damage occurs subsequent to the or ingredient of any other thing or execution of the contract or agreement. substance by or for the vendor, or Page 12 of 21 HG 00 01 0916 81864627 1 SDUTHCONI 1 2024 UL CAU UMC HC 1M I Tien Le 1 9/12/2024 11:12:13 AM (PDT) I Page 3 of 18 This certificate cancels and supersedes ALL previously issued certificates. (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own ads or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Sub- paragraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessors Of Equipment (1) Any person(s) or organization(s) from whom you lease equipmerit; but only with respect to their liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). (2) With respect to the insurance afforded to these additional insureds this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. c. Lessors Of Land Or Premises Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. With respect to the insurance afforded these additional insureds the following additional exclusions apply: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to lease that land; or 2. Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with your premises; or (2) In the performance of your ongoing operations performed by you or on your behalf. With respect to the insurance afforded these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury' arising out of the rendering of or the failure to render any professional services by or for you, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by.that insured, if the "occurrence" which caused the "bodily injury' or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services by or for you. e. Permits Issued By State Or Political Subdivisions Any state or political subdivision, but only with respect to operations perforated by you or on your behalf for which the state or political subdivision has issued a permit. With respect to the insurance afforded these additional insureds, this insurance does not apply to: (1) "Bodily injury', "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) "Bodily injury' or "property damage" included within the "products -completed operations hazard". f. Any Other Party Any other person or organization who is not an additional insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations; HG 00 01 0916 81864627 1 SOUTHCON1 1 2024 GL CAU WC WC I4 1 Tien Le 1 9/12,2024 11:12:13 AM (PUT) I Page 4 of 18 This certificate cancels and supersedes ALL previously issued certificates. Page 13 of 21 (2) In connection with your premises owned by or rented to you; or (3) In connection with "your work" and included within the "products -completed operations hazard", but only if (a) The written contract or agreement requires you to provide such coverage to such additional insured; and (b) This Coverage Part provides coverage for "bodily injury" or "property damage" included within 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. With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services by or for you. The limits of insurance that apply to additional insureds is described in Section III - Limits Of Insurance. How this insurance applies when other insurance is available to the additional insured is described in the Other Insurance Condition in Section IV - Commercial General Liability Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III - LIMITS OF INSURANCE 1. The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. General Aggregate Limit The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard'; and c. Damages under Coverage B. 3. Products -Completed Operations Aggregate Limit The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury' and "property damage" included in the "products - completed operations hazard". 4. Personal And Advertising Injury Limit Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 5. Each Occurrence Limit Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence". 6. Damage To Premises Rented To You Limit Subject to 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. Page 14 of 21 HG 00 0109 16 81864627 1 SOUTNCON1 1 2024 GL CAU UMC KC IM I Tien Le 1 9/12/2024 11:12:13 AM (POT) I Page 5 of le This certificate cancels and supersedes ALL previously issued certificates. Southern Contracting Company 9/12/2024 72UEABG9UG8 CONTRACTORS BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX 1. Alienated Premises Coverage........................................................................................................................1 2. Damage To Your Work...................................................................................................................................1 3. That Particular Part .........................................................................................................................................1 4. Contractors Limited Professional Liability....................................................................................................... 2 5. Per Project and Per Location General Aggregate Limits Of Insurance.......................................................... 2 6. Medical Payments Coverage - Including Products - Completed Operations .................................................. 3 7. Injury To Employee's Reputation With Respect To Incidental Medical Malpractice ...................................... 3 8. Bodily Injury Employee Suits...........................................................................................................................4 9. Consolidated Insurance (Wrap -Up) Programs................................................................................................4 10. Access Or Disclosure Of Confidential Or Personal Information And Data -Related Liability ......................... 5 11. Supplementary Payments...............................................................................................................................5 12. Two Or More Coverage Parts Or Policies Issued By Us................................................................................ 6 13. Notice of Cancellation to Certificate Holders.................................................................................................. 6 14. Contractual Liability Coverage For Personal And Advertising Injury............................................................... 6 15. Insured Contract Definition.............................................................................................................................. 6 1. ALIENATED PREMISES COVERAGE Exclusion j. Damage To Property of Section 1 - Coverage A is amended as follows: a. The following exception to the exclusion is deleted: Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. b. This exception is replaced by the following: _Paragraph (2) of this exclusion does not apply if the premises are "your work". 2. DAMAGE TO YOUR WORK A. Section I - Coverage A - Bodily Injury And Property Damage Liability, Paragraph 1. Insuring Agreement is amended to add the following: f. Damages because of "property damage" include damages the insured becomes legally obligated to pay because of "property damage" to "your work" or caused by "your work", and such "property damage" shall be deemed to be caused by an "occurrence", if not intended or expected from the standpoint of the insured, regardless of whether the "property damage" arises from breach of contract. B. Exclusion 1. Damage To Your Work of Section I - Coverage A is replaced by the following: I. Damage to Your Work "Property damage" to that particular part of "your work" that must be restored, repaired or replaced because "your work" was incorrectly performed and included in the "products -completed operations hazard". This exclusion does not apply if the damaged work or the work performed incorrectly was performed on your behalf by a subcontractor. This Paragraph 2.B. does not apply if Exclusion I. Damage To Your Work has been otherwise modified by endorsement. 3. THAT PARTICULAR PART This Paragraph 3. applies to Exclusion j. Damage to Property, subparagraphs (5), and (6), Exclusion k. Damage to Your Product, and Exclusion I. Damage to Your Work. Form HS 24 50 12 20 © 2020, The Hartford Pagel of 7 81864627 1 SOOTHCON1 1 2124 GL CAD WC PIC IM ITien Le 1 9/12/2024 11:12:13 AM (PDT) I Page 6 Of le This certificate cancels and supersedes ALL previously issued certificates. When performing operations as a "general contractor", the term that particular part shall not mean the entire construction, improvement or renovation project. For purposes of this provision, the term "general contractor" means the contractor signing the prime construction contract for a construction, erection, improvement or renovation project and that has main responsibility for such project including hiring all of the subcontractors and suppliers. 4. CONTRACTORS LIMITED PROFESSIONAL LIABILITY The following exclusion is added to Paragraph 2., Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, and to Paragraph 2., Exclusions of Section I - Coverage B - Personal And Advertising Injury Liability: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. Professional services include: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (2) Supervisory or inspection activities performed as a part of any related architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. This exclusion does not apply to your operations in connection with construction work performed by you or on your behalf. However, this exception to the exclusion will not apply if you are in the business or profession of providing the professional services described above independent from the construction work performed by you or on your behalf. In the event this insurance applies to any injury, damage, loss, cost or expense covered by Professional Liability insurance issued by a company unaffiliated with us, then the insurance afforded under this Coverage Part is excess over such other valid and collectible Professional Liability insurance (including any deductible or self - insured retention portion thereof), and any other valid and collectible insurance available to the insured whether primary, excess, contingent or on any other basis. 5. PER PROJECT AND PER LOCATION GENERAL AGGREGATE LIMITS OF INSURANCE 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 "project" or a single "location"; 1. A separate Per Project General Aggregate Limit or a separate Per Location General Aggregate Limit applies to each "project" or "location", whichever is applicable. The Per Project General Aggregate Limit and Per Location Aggregate Limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Per Project General Aggregate Limit or the Per Location General Aggregate Limit, whichever applies, 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 Per Project General Aggregate Limit for that "project" or the Per Location General Aggregate for that "location", whichever applies. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, the Per Project General Aggregate Limit for any other "project", or the Per Location General Aggregate Limit for any other "location". 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of Page 2 of 7 Form HS 24 50 12 20 81864627 1 SOUTHCON1 1 2024 GL CAU UMC wC IM I Tien Le 1 9/12/2024 11:12:13 AM (POTI I Page 1 of 18 This certificate cancels and supersedes ALL previously issued Certificates. being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Project General Aggregate Limit if attributable only to ongoing operations at a single "project" or the Per Location General Aggregate if attributable only to ongoing operations at a single "location". B. 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 cannot be attributed only to ongoing operations at a single "project" or a single "location"; 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Per Project General Aggregate Limit or any Per Location General Aggregate Limit. C. When coverage for liability arising out of the 'Products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit; and not reduce the General Aggregate Limit,or any Per Project General Aggregate Limit or any Per Location General Aggregate Limit. D. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. E. For the purposes of Paragraph 5., the following definitions apply: "Project" means a premises an insured does not own or rent and where such insured performs construction -related operations. Each "project" involving the same or connecting lots, or premises whose connection is separated by a street, roadway, waterway, railroad or right-of-way shall be considered a single "project". 1. If a "project" has been abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the "project" shall be considered a single "project". "Project" does not include a premises that is a "location". 2. "Location" means a premises an insured owns or rents and where such insured performs business operations other than construction -related operations. Each "location" involving the same or connecting lots, or premises whose connection is separated by a street, roadway, waterway or right-of-way railroad shall be considered a single "location." "Location" does not include a premises that is a "project". This provision does not apply if the Per Project and the Per Location General Aggregate Limit has been otherwise modified by endorsement. 6. MEDICAL PAYMENTS COVERAGE - INCLUDING PRODUCTS -COMPLETED OPERATIONS Paragraph 1.a. of the Insuring Agreement - Coverage C is replaced by the following: 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; (3) Because of your operations; or (4) Included within the definition of the "products -completed operations hazard;" provided that: (1) The accident takes place in the "coverage territory" and during the policy period; (2) The expenses are incurred and reported to us within three years of the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. 7. INJURY TO EMPLOYEE'S REPUTATION WITH RESPECT TO INCIDENTAL MEDICAL MALPRACTICE A. The following is added to Paragraph 1.e. of the Insuring Agreement - Coverage A: (3) With respect to incidental medical malpractice, "bodily injury" includes damages claimed for injury to emotions or reputation of an "employee" arising out of the rendering or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic services. Form HS 24 5012 20 $1864627 1 SOUTHCON1 1 2024 GL Can DP.0 WC I% I Tien is 1 9/12/2024 11:12:13 AM (PDT) I Page 0 of 18 This certificate cancels and supersedes ALL previously issued Certificates. Page 3 of 7 B. The following exclusion is added to Coverage B - Personal and Advertising Injury: "Personal and advertising injury arising out of the rendering or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic. 8. BODILY INJURY EMPLOYEE SUITS A. "Bodily injury" as listed in Paragraph 2.a.(1) of Section II - Who Is An Insured, does not apply to 2.a.(1)(a) through 2.a.(1)(c). B. Part a. of Paragraph 4. Nonowned Watercraft in Section II Who Is An Insured does not apply. 9. CONSOLIDATED INSURANCE (WRAP-UP) PROGRAMS The following exclusion is added to Section I Coverage A: This insurance does not apply to any "bodily injury" or "property damage" arising out of any "wrap project or premises" where an insured under this policy is or was also an insured under one or more commercial general liability (CGL) policies (including any umbrella or excess policies that include the commercial general liability policy(ies) as underlying insurance) included within a "consolidated insurance (wrap-up) program." This exclusion applies even if the limits of insurance for such "consolidated insurance (wrap-up) program" are exhausted or not collected for any reason, including bankruptcy or insolvency of the insurer providing coverage for the "consolidated insurance (wrap-up) program". This exclusion also applies if the CGL coverage afforded under the "consolidated insurance (wrap-up) program" is narrower in scope than the coverage provided by this policy. This exclusion does not apply to: A. Products -Completed Operations Hazard Exception "Bodily injury" or "property damage" arising out of an "insured's operations" at or in connection with a "wrap project or premises" when such "bodily injury" or "property damage" commences after the "products -completed operations hazard" coverage or any completed operations extension coverage provided by the applicable "consolidated insurance (wrap-up) program" has ended or is no longer in effect. B. Off -Site Location Exception "Bodily injury" or "property damage" resulting from an "insured's operations" at or in connection with a "wrap project or premises" at a location to which the applicable "consolidated insurance (wrap-up) program" does not apply. C. Repair Work And Punch List Work Exception "Bodily injury" or "property damage" resulting from "repair work" or "punch list work" at a "wrap project or premises" but only when the applicable "consolidated insurance (wrap-up) program" does not apply or no longer applies to such "repair work" or "punch list work". This exception does not apply to the cost of performing such "repair work" or "punch list work", or to the "repair work" or "punch list work" itself. D. Additional Insured Extension "Bodily injury" or "property damage" for which you are solely an additional insured under the "consolidated insurance (wrap-up) program". The coverage provided under Paragraphs 9.A through 9.D. above is subject to all terms, conditions and exclusions of this policy. For purposes of Paragraph 9, the following definitions apply: "Consolidated insurance (wrap-up) program" means any agreement or arrangement, including any contractor -controlled, owner -controlled, project -specific or similar insurance program under which one or more contractor(s) working on a specified project are insured under one or more commercial general liability (CGL) policies (including any umbrella or excess policies that include the commercial general liability policy(ies) as underlying insurance) issued by a specified carrier for injury or damage arising out of operations conducted in connection with or necessary or incidental to the project. 'Insured's operations" means all operations performed by a named insured (and not sub- contracted or performed by others on the insured's behalf). "Punch list work" means the "insured's operations" at or in connection with a "wrap project or premises" in order to complete the work called for in an insured's contract for the "wrap project or premises". "Repair work" means the "insured's operations" that are service, maintenance, correction, repair, replacement work, or periodic inspection performed by an insured at or in connection with a "wrap project or premises", in order to replace or repair an insured's completed work. "Wrap project or premises" means any premises or construction, erection, improvement or renovation project subject to a "consolidated insurance (wrap-up) program". 10. ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA - RELATED LIABILITY Page 4 of 7 Form HS 24 60 12 20 81864627 1 SDOSxCONI 1 2024 GL CAD Me NC 1N I Tien is 1 9/12/2024 11:12:13 AM (PDT) I Page 9 of 18 This certificate Cancels and supersedes ALL previously issued Certificates. A. Exclusion p. of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: p. Access Or Disclosure Of Confidential Or Personal Information And Data - Related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. However, unless Paragraph (1) above applies, this exclusion does not apply to liability for damages because of "bodily injury". B. Exclusion w. of Section 1 - Coverage B - Personal and Advetising Injury is replaced by the following: : w. Access Or Disclosure Of Confidential Or Personal Information "Personal and advertising injury" arising out of any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information. ' This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of any access to or disclosure of any person's or organization's confidential or personal information. C. The following Paragraph is added to Section III - Limits Of Insurance: Subject to Paragraph 5. Each Occurrence Limit, the most we will pay under Coverage A for "property damage" because of all loss of "electronic data" arising out of any one "occurrence" is $100,000, unless modified by endorsement. D. The following definition is added to Section V - Definitions: "Electronic data" means information, facts or programs: a. Stored as or on; b. Created or used on; or c. Transmitted to or from; computer software, (including systems and applications software) hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. E. For the purposes of the coverage provided by this provision, the definition of "property damage" in Section V - Definitions is replaced by the following: "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. 11. SUPPLEMENTARY PAYMENTS In the Supplementary Payments - Coverages A and B provision: The limit for the cost of bail bonds is increased to $2,500. Form HS 24 50 12 20 81864627 1 SODTHC0e1 1 2024 GL CAD WC wC IN I Tien Le 1 9/12/2024 11:12:13 M (PDT) I Page 10 of 18 This certificate cancels and supersedes ALL previously issued certificates. Page 5 of 7 12. TWO OR MORE COVERAGE PARTS OR POLICIES ISSUED BY US If this policy and any other policy issued to an insured by us or any affiliated company provides coverage that applies to the same claim or damages, the maximum applicable limit(s) of liability or limit of insurance under all the policies will not exceed the highest applicable limit of liability or limit of insurance under any one policy. This condition does not apply to any policy issued by us or an affiliated company specifically written to apply as excess insurance over this policy. 13. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extendlthe date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. 14. CONTRACTUAL LIABILITY COVERAGE FOR PERSONAL AND ADVERTISING INJURY Exclusion e. of SECTION I - COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is replaced by the following: This insurance does not apply to: e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "personal and advertising injury" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. ' 15. INSURED CONTRACT DEFINITION a. INSURED CONTRACT -CONSTRUCTION OPERATIONS AND MUNICIPAL WORK Paragraph d. of the definition of "insured contract" in Section V - Definitions is deleted and replaced by the following: An obligation, as required by ordinance, to indemnify a municipality. b. CONTRACTUAL LIABILITY Paragraph f. of the definition of "insured contract" is deleted and replaced by the following: That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury", "property damage", or "personal and advertising injury" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. includes that part of any contract or agreement that indemnifies a railroad for "bodily injury", "property damage", or "personal and advertising injury" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing. However, Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: Page 6 of 7 Form HS 24 50 12 20 81864627 1 SOnTHCONI 1 2024 GL CAC OMC WC IM I Tien Le 1 9/12/2024 11:12:13 AM (PDT) I Page 11 of le This certificate cancels and supersedes ALL previously issued Certificates. (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. All other terms and conditions in the policy remain unchanged. Form HS 24 50 12 20 Page 7 of 7 $1864627 1 SOUTHCONI 1 2024 GL DAD WC WC IM I Tien Le 1 9/12/2024 11:12:13 AM (POT) I Page 12 of 18 This certificate cancels and supersedes ALL previously .issued certificates. Southem Contracting Company COMMERCIAL AUTOMOBILE HA 99 1612 21 72UEAPT0696 - 10/01/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions; of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED e. Employees as Insureds Paragraph .1. - WHO IS AN INSURED - of (1). Any "employee" of yours while using a Section II - Liability Coverage is amended to covered "auto" you don't own, hire or add the following: borrow in your business or your d. Subsidiaries and Newly Acquired or personal affairs. Formed Organizations f. Lessors as Insureds The Named Insured shown in the (1). The lessor of a covered "auto" while the Declarations is amended to include: "auto" is leased to you under a written (1) Any legal business entity other than a agreement if: partnership or joint venture, formed as a (a) The agreement requires you to subsidiary in which you have an provide direct primary insurance for ownership interest of more than 50% on the lessor and the effective date of the Coverage Form. (b) The "auto" is leased without a However, the Named Insured does not driver. include any subsidiary that is an "insured" under any other automobile Such a leased "auto" will be considered a policy or would be an "insured" under covered "auto" you own and not a covered such a policy but for its termination or "auto" you hire. the exhaustion of its Limit of Insurance. g. Additional Insured if Required by Contract (2) Any organization that is acquired or (1) When you have agreed, in a written formed by you and over which you contract or written agreement, that a maintain majority ownership. However, person or organization be added as an the Named Insured does not include any additional insured on your business auto newly formed or acquired organization: policy, such person or organization is an (a) That is a partnership or joint "insured", but only to the extent such venture, person or organization is liable for "bodily injury" or "property damage" (b) That is an "insured" under any other caused by the conduct of an "insured" policy, under paragraphs a. or b.'of Who Is An (c) That has exhausted its Limit of Insured with regard to the ownership, Insurance under any other policy, or maintenance or use of a covered "auto." (d) 180 days or more after its The insurance, afforded to any such acquisition or formation by you, additional insured applies only if the unless you have given us notice of "bodily injury" or "property damage" the acquisition or formation. occurs: Coverage does not apply to "bodily (a) During the policy period, and injury" or "property damage" that results (b) Subsequent to the execution of such from an "accident" that occurred before written contract, and you formed or acquired the organization. Form HA 99 16 12 21 Pagel of 5 © 2021, The Hartford (Includes copyrighted material of Insurance Services Office, Inc. with its permission.) 81864627 1 SOUTNCON1 ) 2024 GL CAD UMC wC IM I Tien Le 19/12/2024 11:12:13 AM (PDT) I Page 13 of 18 This certificate cancels and supersedes ALL previously issued certificates. (c) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured. (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non- contributory with the additional insured's own insurance. (4) Duties in The Event Of Accident, Claim, Suit or Loss If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the additional insured shall be required to comply with the provisions in LOSS CONDITIONS 2. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM , SUIT OR LOSS — OF SECTION IV — BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. 2. Primary and Non -Contributory if Required by Contract Only with respect to insurance provided to an additional insured in A.1.g. - Additional Insured If Required by Contract, the following provisions apply: (1) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance 5.d. (2) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self - insured amounts under all that other insurance. We will share the remaining loss, if any, by the method described in SECTION IV - Business Auto Conditions, B. General Conditions, Other Insurance 5.d. 3. AUTOS RENTED BY EMPLOYEES Any "auto" hired or rented by your "employee" on your behalf and at yobr direction will be considered an "auto" you hire. The SECTION IV- Business Auto Conditions, B. General Conditions, 5. OTHER INSURANCE Condition is amended by adding the following: e. If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. Page 2 of 5 Form HA 99 16 12 21 81864627 1 501THCONI 1 2024 GL CAD I C HC IM I Tien Le ) 9/12/2024 11:12:13 M (PDT) I Page 14 of 16 This certificate cancels and supersedes ALL previously issued Certificates. 4. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5. - FELLOW EMPLOYEE - of SECTION II - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "employees". Coverage is excess over any other collectible insurance. 5. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $100,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident". This extension of coverage does not apply to any "auto" you hire or borrow from any of your ,.employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 6. PHYSICAL DAMAGE - ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph AA.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1,000. 7. LOAN/LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, in the event of a total "loss" to a covered "auto",, we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the loan/lease. "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees; security deposits not returned by the lessor; costs for extended warranties, credit life Insurance, health, accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. 8. AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 9. ELECTRONIC EQUIPMENT - BROADENED COVERAGE a. They exceptions to Paragraphs B.4 - EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto'; (2) Removable from a housing unit which is permanently installed in or upon the covered "auto'; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. b. Section III, Physical Damage Coverage, Limit of Insurance, Paragraph C.2. is amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is: Form HA 99 16 12 21 81864627 1 SOUTHCON1 1 2024 OL CAU UMC K IM I Tien to ) 9/12/2024 11:12:13 AM (PDT) I Page 15 of la This Certificate cancels and supersedes ALL previously issued Certificates. Page 3 of 5 (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 10.EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A. - COVERAGE - of SECTION III - PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 11. GLASS REPAIR -WAIVER OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 12. TWO OR MORE DEDUCTIBLES Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 13. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS - of SECTION IV - BUSINESS AUTO CONDITIONS'that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 14. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 15. HIRED AUTO -COVERAGE TERRITORY SECTION IV, BUSINESS AUTO CONDITIONS, PARAGRAPH B. GENERAL CONDITIONS, 7. - POLICY PERIOD, COVERAGE TERRITORY - is added to include the following: (6) For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 16. WAIVER OF SUBROGATION Paragraph 5. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - of SECTION IV - BUSINESS AUTO CONDITIONS A. Loss Conditions is amended by adding the following:. We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages underthis Coverage Form. 17. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS, C. is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person including mental anguish or death resulting from any of these. 18. EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. Page 4 of 5 Form HA 99 16 12 21 81864627 1 SOUTHCONI ) 2024 GL CAD UMC VIC IM I Tien Le ) 9/12/2024 11:12:13 AM (POT) I Page 16 of 18 This certificate cancels and supersedes ALL previously issued certificates. 19. HYBRID, ELECTRIC, OR NATURAL GAS b. A "hybrid" auto is defined as an auto with an VEHICLE PAYMENT COVERAGE internal combustion engine and one or more In the event of a total loss to a "non -hybrid" auto electric motors; and that uses the internal for which Comprehensive, Specified Causes of combustion engine and one or more electric Loss, or Collision coverages are provided under motors to move the auto, or the internal this Coverage Form, then such Physical combustion engine to charge one or more Damage Coverages are amended as follows: electric motors, which move the auto. a. If the auto is replaced with a "hybrid" auto or 20. VEHICLE WRAP COVERAGE an auto powered solely by electricity or In the event of a total loss to an "auto" for which natural gas, we will pay an additional 10%, Comprehensive, Specified Causes of Loss, or to a maximum of $2,500, of the "non -hybrid" Collision coverages are provided under this auto's actual cash value or replacement Coverage Form, then such Physical Damage cost, whichever is less, Coverages are amended to add the following: b. The auto must be replaced and a copy of a In addition to the actual cash value of the "auto", bill of sale or new lease agreement received we will pay up to $1,000 for vinyl vehicle wraps by us within 60 calendar days of the date of which are displayed on the covered "auto" at the "loss;' time of total loss. Regardless of the number of c. Regardless of the number of autos deemed autos deemed a total loss, the most we will pay a total loss, the most we will pay under this under this Vehicle Wrap Coverage provision for Hybrid, Electric, or Natural Gas Vehicle any one "loss" is $5,000. For purposes of this Payment Coverage provision for any one coverage provision, signs or other graphics "loss" is $10,000. painted or magnetically affixed to the vehicle are For the purposes of the coverage provision, not considered vehicle wraps. a. A "non -hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas. Form HA 99 16 12 21 81664627 1 SOUTHCONI 1 2024 GL CAD UMC 91C IM I Tien Le 1 9/42/2024 11:12:13 AM (POT) I Page 17 of 18 This certificate cancels and supersedes ALL previously issued Certificates. Page 5 of 5 l 9/122024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 72WEAZR3341 Endorsement Number Effective Date: 10/01/2024 Effective hour is the same as staled on the Information Page of the policy. Named Insured and Address: Southern Contracting Company P.O. Box 445 San Marcos CA 92079 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 premium otherwise due on such remuneration. Person or Organization ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US. SCHEDULE 2 % of the California workers' compensation Job Description AS REQUIRED BY WRITTEN CONTRACT. ALL CALIFORNIA LOCATIONS. Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: Policy Expiration Date: 10/012025 81864627 1 SWTHCONI t 2024 GL MUMCWe IM Tien Le 19/12/2029 11:12:13 AM (POT) Page 18 Of 18 This cc rtific ate cancels and supersedes ALL previously issued certificates. AGREEMENT 23B100 (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 Southern Contracting Company, 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: RECREATION FIELDS LED LIGHTING UPGRADES CITY PROJECT N0.19-28 The Work comprises of all materials, labor, tools, equipment, apparatus, facilities, transportation, and incidentals necessary to furnish all implied requirements and all appurtenant work as required to deliver and install the Recreation Fields LED Lighting Upgrades City Project No. 19-28, including, but not limited to, new light poles with new LED lighting, removal of the existing light poles, landscape, wrought iron fence, concrete sidewalk, chain link, asphalt restoration, and irrigation replacement. The Work also includes electrical work associated with the new LED lighting upgrades, modifications to existing system and installation of new conduit wiring and pull-boxes as detailed within the contract documents. The locations of the work will be in the vicinity of 1901 E. Baristo Road and 3965 E. Mesquite Avenue, Palm Springs, CA 92264. ARTICLE 2 -COMMENCEMENT AND COMPLETION The Work to be performed under this Contract shall commence on the date specified in the Notice to Proceed by the City, and the Work shall be fully completed within the time specified in the Notice to Proceed. The City and the Contractor recognize that time is of the essence of this Agreement, and that the City will suffer financial loss if the Work is not completed within the time specified in Article 2, herein, plus any extensions thereof allowed in accordance with applicable provisions of the Standard Specifications, as modified herein. The parties also recognize the delays, expense, and difficulties involved in proving in a legal proceeding the actual loss suffered by the City if the Work is not completed on time. Accordingly, instead of requiring any such proof, the City and the Contractor agree that as liquidated damages or delay (but not as a penalty), the Contractor shall pay the City the sum specified in Section 6-9 of the Special Provisions for each calendar day that expires RECREATION FIELDS LED LIGHTING UP GRADES CITY PROJECT NO. 19-28 MARCH 2023 AGREEMENT FORM AGREEMENT AND BONDS -PAGE 1 DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE5/2/2023 DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE 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 4/24/2023 SullivanCurtisMonroe Insurance Services (COR) 1920 Main Street Suite 600 Irvine, CA 92614 949-250-7172 949-852-9762 www.SullivanCurtisMonroe.com License # 0E83670 Hartford Fire Insurance Company (A+, XV)19682 Hartford Casualty Insurance Company (A+, XV)29424 A 1,000,00072UEAPT057410/1/2022 10/1/2023 300,000 3 10,000 3 1,000,000 3 XCU Included 2,000,000 2,000,0003 A 72UEAPT0696 10/1/2022 10/1/2023 1,000,000 3 3 Comp Ded $1k/$2k/$5k Coll Ded $1k/$2k/$5k 3 B 72RHAPT0617 10/1/2022 10/1/2023 10,000,00033 10,000,000 3 10,000 A 72WEAZR3341 10/1/2022 10/1/2023 3 1,000,000N 1,000,000 1,000,000 Tien Le Southern Contracting Company P.O. Box 445 San Marcos CA 92079 74026777 3 3 3 3 The City of Palm Springs, its official, employees and agents are additional insured per attached endorsement. Primary and Non-Contributory and Waiver RE: SCC Job No.: 107171 –Project No. 19-28 Recreation Fields LED Lighting Upgrades City of Palm Springs Attn: Vonda Teed, Engineering Services Department 3200 E Tahquitz Canyon Way Palm Springs CA 92262 RE: SCC Job No.: 107171 –Project No. 19-28 Recreation Fields LED Lighting Upgrades of Subrogation are included per attached endorsement. 30 day notice of cancellation except for 10 days notice for nonpayment of premium applies. 3 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 1 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: POLICY TYPE: PACKAGE Carrier: Hartford Fire Insurance Company (NAIC #19682) A.M. Best: A+, XV (Admitted) Policy #: 72UUMPT0797 Effective: 10/01/2022 - 10/01/2023 CONTRACTOR'S EQUIPMENT: Leased/Rented Equipment Limit - $2,000,000 (Max. $750,000 Per Item) Scheduled Equipment Limit - $2,887,901 Deductible - $1,000 (All other perils) Deductible - $5,000 (Theft) Deductible - Greater of 2% or $5,000 Minimum (Cranes) Deductible - 5 Day Wait Period (Rental Expense) INSTALLATION: Maximum Limit - $2,500,000 Property in Transit Limit - $750,000 Property at Temporary Storage Limit - $750,000 Deductible - $2,500 ****************************************************************************** POLICY TYPE: BUILDERS RISK Carrier: Hartford Fire Insurance Company (NAIC #19682) A.M. Best: A+, XV (Admitted) Policy #: 72MSPT1923 Effective: 10/01/2022 - 10/01/2023 Hard Costs Maximum Limit - $1,500,000 Soft Costs Maximum Limit - $150,000 Property at Temporary Storage - $100,000 Property in Transit - $100,000 Flood - $1,000,000 (Flood Zone X/C Only) Deductible – $2,500 (Hard Costs) Deductible – 120 Hour Wait (Soft Costs) Deductible – $25,000 (Flood) ***************************************************************************** Commercial Automobile Deductibles: Light/PPTs - $1,000 Comprehensive / $1,000 Collision Medium/Heavy - $2,000 Comprehensive / $2,000 Collision Extra Heavy - $5,000 Comprehensive / $5,000 Collision Trailers - $500 Comprehensive / $500 Collision ***************************************************************************** A.M. BEST RATING: Hartford Fire Insurance Company: A+, XV (Admitted) Hartford Casualty Insurance Company: A+, XV (Admitted) Pacific Insurance Company, Ltd.: A+, XV (Non-Admitted) SOUTHCON1 SullivanCurtisMonroe Insurance Services (COR)Southern Contracting Company P.O. Box 445 San Marcos CA 92079 25 Certificate of Liability (03/16) ATTACHMENT HOLDER: ADDRESS: City of Palm Springs Attn: Vonda Teed, Engineering Services Department 3200 E Tahquitz Canyon Way Palm Springs CA 92262 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 2 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE 4/24/2023Southern Contracting Company 72UEAPT0574 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 3 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 4 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 5 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 6 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Form HS 24 50 12 20 © 2020, The Hartford Page 1 of 7 CONTRACTORS BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX 1. Alienated Premises Coverage ........................................................................................................................ 1 2. Damage To Your Work ................................................................................................................................... 1 3. That Particular Part ......................................................................................................................................... 1 4. Contractors Limited Professional Liability ....................................................................................................... 2 5. Per Project and Per Location General Aggregate Limits Of Insurance .......................................................... 2 6. Medical Payments Coverage - Including Products - Completed Operations .................................................. 3 7. Injury To Employee's Reputation With Respect To Incidental Medical Malpractice ...................................... 3 8. Bodily Injury Employee Suits........................................................................................................................... 4 9. Consolidated Insurance (Wrap-Up) Programs. ............................................................................................... 4 10. Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability ......................... 5 11. Supplementary Payments ............................................................................................................................... 5 12. Two Or More Coverage Parts Or Policies Issued By Us ................................................................................ 6 13. Notice of Cancellation to Certificate Holders .................................................................................................. 6 14. Contractual Liability Coverage For Personal And Advertising Injury .............................................................. 6 15. Insured Contract Definition.............................................................................................................................. 6 1. ALIENATED PREMISES COVERAGE Exclusion j. Damage To Property of Section I - Coverage A is amended as follows: a. The following exception to the exclusion is deleted: Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. b. This exception is replaced by the following: Paragraph (2) of this exclusion does not apply if the premises are "your work". 2. DAMAGE TO YOUR WORK A. Section I - Coverage A - Bodily Injury And Property Damage Liability, Paragraph 1. Insuring Agreement is amended to add the following: f. Damages because of "property damage" include damages the insured becomes legally obligated to pay because of "property damage" to "your work" or caused by "your work", and such "property damage" shall be deemed to be caused by an "occurrence", if not intended or expected from the standpoint of the insured, regardless of whether the "property damage" arises from breach of contract. B.Exclusion l. Damage To Your Work of Section I - Coverage A is replaced by the following: l. Damage to Your Work "Property damage" to that particular part of "your work" that must be restored, repaired or replaced because "your work" was incorrectly performed and included in the "products-completed operations hazard". This exclusion does not apply if the damaged work or the work performed incorrectly was performed on your behalf by a subcontractor. This Paragraph 2.B. does not apply if Exclusion l. Damage To Your Work has been otherwise modified by endorsement. 3. THAT PARTICULAR PART This Paragraph 3. applies to Exclusion j. Damage to Property, subparagraphs (5), and (6), Exclusion k. Damage to Your Product, and Exclusion l. Damage to Your Work. 4/24/2023Southern Contracting Company 72UEAPT0574 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 7 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Page 2 of 7 Form HS 24 50 12 20 When performing operations as a "general contractor", the term that particular part shall not mean the entire construction, improvement or renovation project. For purposes of this provision, the term "general contractor" means the contractor signing the prime construction contract for a construction, erection, improvement or renovation project and that has main responsibility for such project including hiring all of the subcontractors and suppliers. 4. CONTRACTORS LIMITED PROFESSIONAL LIABILITY The following exclusion is added to Paragraph 2., Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability,and to Paragraph 2.,Exclusions of Section I - Coverage B - Personal And Advertising Injury Liability: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. Professional services include: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (2) Supervisory or inspection activities performed as a part of any related architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. This exclusion does not apply to your operations in connection with construction work performed by you or on your behalf. However, this exception to the exclusion will not apply if you are in the business or profession of providing the professional services described above independent from the construction work performed by you or on your behalf. In the event this insurance applies to any injury, damage, loss, cost or expense covered by Professional Liability insurance issued by a company unaffiliated with us, then the insurance afforded under this Coverage Part is excess over such other valid and collectible Professional Liability insurance (including any deductible or self- insured retention portion thereof), and any other valid and collectible insurance available to the insured whether primary, excess, contingent or on any other basis. 5. PER PROJECT AND PER LOCATION GENERAL AGGREGATE LIMITS OF INSURANCE 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 "project" or a single "location"; 1. A separate Per Project General Aggregate Limit or a separate Per Location General Aggregate Limit applies to each "project" or "location", whichever is applicable. The Per Project General Aggregate Limit and Per Location Aggregate Limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Per Project General Aggregate Limit or the Per Location General Aggregate Limit, whichever applies, 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 Per Project General Aggregate Limit for that "project" or the Per Location General Aggregate for that "location", whichever applies. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, the Per Project General Aggregate Limit for any other "project", or the Per Location General Aggregate Limit for any other "location". 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 8 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Form HS 24 50 12 20 Page 3 of 7 being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Project General Aggregate Limit if attributable only to ongoing operations at a single "project" or the Per Location General Aggregate if attributable only to ongoing operations at a single "location". B. 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 cannot be attributed only to ongoing operations at a single "project" or a single "location"; 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Per Project General Aggregate Limit or any Per Location General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit,or any Per Project General Aggregate Limit or any Per Location General Aggregate Limit. D. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. E. For the purposes of Paragraph 5., the following definitions apply: "Project" means a premises an insured does not own or rent and where such insured performs construction-related operations. Each "project" involving the same or connecting lots, or premises whose connection is separated by a street, roadway, waterway, railroad or right-of-way shall be considered a single "project". 1. If a "project" has been abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the "project" shall be considered a single "project". "Project" does not include a premises that is a "location". 2. "Location" means a premises an insured owns or rents and where such insured performs business operations other than construction-related operations. Each "location" involving the same or connecting lots, or premises whose connection is separated by a street, roadway, waterway or right-of-way railroad shall be considered a single "location." "Location" does not include a premises that is a "project". This provision does not apply if the Per Project and the Per Location General Aggregate Limit has been otherwise modified by endorsement. 6. MEDICAL PAYMENTS COVERAGE - INCLUDING PRODUCTS-COMPLETED OPERATIONS Paragraph 1.a. of the Insuring Agreement - Coverage C is replaced by the following: 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; (3) Because of your operations; or (4) Included within the definition of the "products-completed operations hazard;" provided that: (1) The accident takes place in the "coverage territory" and during the policy period; (2) The expenses are incurred and reported to us within three years of the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. 7. INJURY TO EMPLOYEE'S REPUTATION WITH RESPECT TO INCIDENTAL MEDICAL MALPRACTICE A. The following is added to Paragraph 1.e. of the Insuring Agreement - Coverage A: (3) With respect to incidental medical malpractice, "bodily injury" includes damages claimed for injury to emotions or reputation of an "employee" arising out of the rendering or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic services. 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 9 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Page 4 of 7 Form HS 24 50 12 20 B. The following exclusion is added to Coverage B - Personal and Advertising Injury: "Personal and advertising injury arising out of the rendering or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic. 8. BODILY INJURY EMPLOYEE SUITS A. "Bodily injury" as listed in Paragraph 2.a.(1) of Section II -Who Is An Insured, does not apply to 2.a.(1)(a) through 2.a.(1)(c). B. Part a. of Paragraph 4. Nonowned Watercraft in Section II - Who Is An Insured does not apply. 9. CONSOLIDATED INSURANCE (WRAP-UP) PROGRAMS The following exclusion is added to Section I Coverage A: This insurance does not apply to any "bodily injury" or "property damage" arising out of any "wrap project or premises" where an insured under this policy is or was also an insured under one or more commercial general liability (CGL) policies (including any umbrella or excess policies that include the commercial general liability policy(ies) as underlying insurance) included within a "consolidated insurance (wrap-up) program." This exclusion applies even if the limits of insurance for such "consolidated insurance (wrap-up) program" are exhausted or not collected for any reason, including bankruptcy or insolvency of the insurer providing coverage for the "consolidated insurance (wrap-up) program". This exclusion also applies if the CGL coverage afforded under the "consolidated insurance (wrap-up) program" is narrower in scope than the coverage provided by this policy. This exclusion does not apply to: A. Products-Completed Operations Hazard Exception "Bodily injury" or "property damage" arising out of an “insured's operations” at or in connection with a "wrap project or premises" when such "bodily injury" or "property damage" commences after the "products-completed operations hazard" coverage or any completed operations extension coverage provided by the applicable "consolidated insurance (wrap-up) program" has ended or is no longer in effect. B. Off-Site Location Exception "Bodily injury" or "property damage" resulting from an “insured's operations” at or in connection with a "wrap project or premises" at a location to which the applicable "consolidated insurance (wrap-up) program" does not apply. C. Repair Work And Punch List Work Exception "Bodily injury" or "property damage" resulting from "repair work" or "punch list work" at a "wrap project or premises" but only when the applicable "consolidated insurance (wrap-up) program" does not apply or no longer applies to such "repair work" or "punch list work". This exception does not apply to the cost of performing such "repair work" or "punch list work", or to the "repair work" or "punch list work" itself. D. Additional Insured Extension "Bodily injury" or "property damage" for which you are solely an additional insured under the "consolidated insurance (wrap-up) program". The coverage provided under Paragraphs 9.A through 9.D. above is subject to all terms, conditions and exclusions of this policy. For purposes of Paragraph 9, the following definitions apply: "Consolidated insurance (wrap-up) program" means any agreement or arrangement, including any contractor-controlled, owner-controlled, project-specific or similar insurance program under which one or more contractor(s) working on a specified project are insured under one or more commercial general liability (CGL) policies (including any umbrella or excess policies that include the commercial general liability policy(ies) as underlying insurance) issued by a specified carrier for injury or damage arising out of operations conducted in connection with or necessary or incidental to the project. “Insured’s operations” means all operations performed by a named insured (and not sub- contracted or performed by others on the insured’s behalf). "Punch list work" means the “insured’s operations” at or in connection with a "wrap project or premises" in order to complete the work called for in an insured's contract for the "wrap project or premises". "Repair work" means the “insured’s operations” that are service, maintenance, correction, repair, replacement work, or periodic inspection performed by an insured at or in connection with a "wrap project or premises", in order to replace or repair an insured's completed work. ."Wrap project or premises" means any premises or construction, erection, improvement or renovation project subject to a "consolidated insurance (wrap-up) program". 10. ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA- RELATED LIABILITY 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 10 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Form HS 24 50 12 20 Page 5 of 7 A.Exclusion p. of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: p. Access Or Disclosure Of Confidential Or Personal Information And Data- Related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. However, unless Paragraph (1) above applies, this exclusion does not apply to liability for damages because of "bodily injury". B.Exclusion w. of Section 1 - Coverage B - Personal and Advetising Injury is replaced by the following: : w.Access Or Disclosure Of Confidential Or Personal Information "Personal and advertising injury" arising out of any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of any access to or disclosure of any person's or organization's confidential or personal information. C. The following Paragraph is added to Section III - Limits Of Insurance: Subject to Paragraph 5.Each Occurrence Limit, the most we will pay under Coverage A for "property damage" because of all loss of "electronic data" arising out of any one "occurrence" is $100,000, unless modified by endorsement. D. The following definition is added to Section V - Definitions: "Electronic data" means information, facts or programs: a. Stored as or on; b. Created or used on; or c. Transmitted to or from; computer software, (including systems and applications software) hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. E. For the purposes of the coverage provided by this provision, the definition of "property damage" in Section V - Definitions is replaced by the following: "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. 11. SUPPLEMENTARY PAYMENTS In the Supplementary Payments - Coverages A and B provision: The limit for the cost of bail bonds is increased to $2,500. 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 11 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Page 6 of 7 Form HS 24 50 12 20 12. TWO OR MORE COVERAGE PARTS OR POLICIES ISSUED BY US If this policy and any other policy issued to an insured by us or any affiliated company provides coverage that applies to the same claim or damages, the maximum applicable limit(s) of liability or limit of insurance under all the policies will not exceed the highest applicable limit of liability or limit of insurance under any one policy. This condition does not apply to any policy issued by us or an affiliated company specifically written to apply as excess insurance over this policy. 13. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. 14. CONTRACTUAL LIABILITY COVERAGE FOR PERSONAL AND ADVERTISING INJURY Exclusion e. of SECTION I - COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is replaced by the following: This insurance does not apply to: e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "personal and advertising injury" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 15. INSURED CONTRACT DEFINITION a. INSURED CONTRACT-CONSTRUCTION OPERATIONS AND MUNICIPAL WORK Paragraph d. of the definition of ''insured contract'' in Section V - Definitions is deleted and replaced by the following: An obligation, as required by ordinance, to indemnify a municipality. b. CONTRACTUAL LIABILITY Paragraph f. of the definition of "insured contract" is deleted and replaced by the following: That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury", "property damage", or "personal and advertising injury" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. includes that part of any contract or agreement that indemnifies a railroad for "bodily injury", "property damage", or "personal and advertising injury" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing. However, Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 12 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Form HS 24 50 12 20 Page 7 of 7 (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. All other terms and conditions in the policy remain unchanged. 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 13 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE COMMERCIAL AUTOMOBILE HA 99 16 03 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured"than other provisions of the Coverage Form,the provisions of this endorsement apply. 1.BROAD FORM INSURED d.Any "employee"of yours while using a covered "auto"you don't own,hire or A.Subsidiaries and Newly Acquired or borrow in your business or yourFormed Organizations personal affairs.The Named Insured shown in the C.Lessors as InsuredsDeclarations is amended to include: Paragraph A.1.-WHO IS AN INSURED -of(1)Any legal business entity other than a Section II -Liability Coverage is amended topartnershiporjointventure,formed as a add:subsidiary in which you have an ownership interest of more than 50%on e.The lessor of a covered "auto"while the the effective date of the Coverage Form."auto"is leased to you under a written However,the Named Insured does not agreement if: include any subsidiary that is an (1)The agreement requires you to"insured"under any other automobile provide direct primary insurance for policy or would be an "insured"under the lessor andsuchapolicybutforitsterminationor (2)The "auto"is leased without a driver.the exhaustion of its Limit of Insurance. Such a leased "auto"will be considered a (2)Any organization that is acquired or covered "auto"you own and not a covered formed by you and over which you "auto"you hire.maintain majority ownership.However, the Named Insured does not include any D.Additional Insured if Required by Contract newly formed or acquired organization:(1)Paragraph A.1.-WHO IS AN INSURED (a)That is a partnership or joint -of Section II -Liability Coverage is venture,amended to add: (b)That is an "insured"under any other f.When you have agreed,in a writtenpolicy,contract or written agreement,that a (c)That has exhausted its Limit of person or organization be added as Insurance under any other policy,or an additional insured on your business auto policy, such person or (d)180 days or more after its organization is an "insured",but only acquisition or formation by you, to the extent such person orunlessyouhavegivenusnoticeof organization is liable for "bodilythe acquisition or formation. injury"or "property damage"causedCoveragedoesnotapplyto"bodily by the conduct of an "insured" under injury"or "property damage"that results paragraphs a.or b.of Who Is Anfroman"accident"that occurred before Insured with regard to theyouformed or acquired the organization. ownership,maintenance or use of a B.Employees as Insureds covered "auto." Paragraph A.1.-WHO IS AN INSURED -of SECTION II -LIABILITY COVERAGE is amended to add: ©2011,The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 1 of 5ofISOProperties,Inc.,with its permission.) 4/24/2023Southern Contracting Company 72UEAPT0696 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 14 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE E.Primary and Non-Contributory ifTheinsuranceaffordedtoanysuch Required by Contractadditionalinsuredappliesonlyifthe "bodily injury"or "property damage"Only with respect to insurance provided to occurs:an additional insured in 1.D.-Additional (1)During the policy period, and Insured If Required by Contract,the following provisions apply:(2)Subsequent to the execution of such written contract, and (3)Primary Insurance When Required By Contract(3)Prior to the expiration of the period of time that the written contract This insurance is primary if you have requires such insurance be provided agreed in a written contract or written to the additional insured.agreement that this insurance be primary.If other insurance is also (2)How Limits Apply primary,we will share with all that otherIfyouhaveagreedinawrittencontractinsurancebythemethoddescribedinorwrittenagreementthatanother Other Insurance 5.d.person or organization be added as an (4)Primary And Non-Contributory To Otheradditionalinsuredonyourpolicy,the Insurance When Required By Contractmostwewillpayonbehalfofsuch additional insured is the lesser of:If you have agreed in a written contract or written agreement that this insurance(a)The limits of insurance specified in is primary and non-contributory with the the written contract or written additional insured's own insurance,this agreement;or insurance is primary and we will not(b)The Limits of Insurance shown in seek contribution from that otherthe Declarations.insurance. Such amount shall be a part of and not (3)(4)Paragraphs and do not apply to other in addition to Limits of Insurance shown insurance to which the additional insuredintheDeclarationsanddescribedinthishasbeen added as an additional insured.Section. When this insurance is excess,we will have no (3)Additional Insureds Other Insurance duty to defend the insured against any "suit"if If we cover a claim or "suit"under this any other insurer has a duty to defend the Coverage Part that may also be covered insured against that "suit".If no other insurer by other insurance available to an defends,we will undertake to do so,but we will additional insured,such additional be entitled to the insured's rights against all insured must submit such claim or "suit"those other insurers. to the other insurer for defense and When this insurance is excess over otherindemnity. insurance,we will pay only our share of the However,this provision does not apply amount of the loss,if any,that exceeds the sum to the extent that you have agreed in a of: written contract or written agreement (1)The total amount that all such otherthatthisinsuranceisprimaryandnon-insurance would pay for the loss in thecontributorywiththeadditionalinsured's absence of this insurance;andowninsurance. (2)The total of all deductible and self-insured (4)Duties in The Event Of Accident,Claim,amounts under all that other insurance.Suit or Loss We will share the remaining loss,if any,by the If you have agreed in a written contract method described in Other Insurance 5.d.or written agreement that another 2.AUTOS RENTED BY EMPLOYEESpersonororganizationbeaddedasan additional insured on your policy,the Any "auto"hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an "auto"you hire. CONDITIONS 2.-DUTIES IN THE The OTHER INSURANCE Condition is amended EVENT OF ACCIDENT,CLAIM ,SUIT by adding the following: OR LOSS –OF SECTION IV – BUSINESS AUTO CONDITIONS,in the same manner as the Named Insured. ©2011,The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 2 of 5ofISOProperties,Inc.,with its permission.) 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 15 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE 5 PHYSICAL DAMAGE -ADDITIONALIfan"employee’s"personal insurance also . TEMPORARY TRANSPORTATION EXPENSE applies on an excess basis to a covered "auto" COVERAGEhiredorrentedbyyour"employee"on your behalf and at your direction,this insurance will Paragraph A.4.a.of SECTION III -PHYSICAL be primary to the "employee’s"personal DAMAGE COVERAGE is amended to provide a insurance.limit of $50 per day and a maximum limit of 3.AMENDED FELLOW EMPLOYEE EXCLUSION $1,000. 6.LOAN/LEASE GAP COVERAGEEXCLUSION5.-FELLOW EMPLOYEE -of SECTION II -LIABILITY COVERAGE does not Under SECTION III -PHYSICAL DAMAGE apply if you have workers'compensation COVERAGE,in the event of a total "loss"to a insurance in-force covering all of your covered "auto",we will pay your additional legal "employees".obligation for any difference between the actual Coverage is excess over any other collectible cash value of the "auto"at the time of the "loss" insurance.and the "outstanding balance"of the loan/lease. 4.HIRED AUTO PHYSICAL DAMAGE COVERAGE "Outstanding balance"means the amount you owe on the loan/lease at the time of "loss"less If hired "autos"are covered "autos"for Liability any amounts representing taxes;overdueCoverageandifComprehensive,Specified payments;penalties,interest or chargesCausesofLoss,or Collision coverages are resulting from overdue payments;additionalprovidedunderthisCoverageFormforany mileage charges;excess wear and tear charges;"auto"you own,then the Physical Damage lease termination fees;security deposits notCoveragesprovidedareextendedto"autos" you returned by the lessor;costs for extendedhire or borrow,subject to the following limit. warranties,credit life Insurance,health,accidentThemostwewillpayfor"loss"to any hired or disability insurance purchased with the loan or "auto"is:lease;and carry-over balances from previous (1)$100,000;loans or leases. (2)The actual cash value of the damaged or 7.AIRBAG COVERAGE stolen property at the time of the "loss"; or Under Paragraph B.EXCLUSIONS -of (3)The cost of repairing or replacing the SECTION III -PHYSICAL DAMAGE damaged or stolen property,COVERAGE,the following is added: whichever is smallest,minus a deductible.The The exclusion relating to mechanical breakdown deductible will be equal to the largest deductible does not apply to the accidental discharge of an applicable to any owned "auto"for that airbag. coverage.No deductible applies to "loss"caused 8.ELECTRONIC EQUIPMENT -BROADENEDby fire or lightning. Hired Auto Physical Damage COVERAGEcoverageisexcessoveranyothercollectible a.The exceptions to Paragraphs B.4 -insurance.Subject to the above limit,deductible EXCLUSIONS -of SECTION III -PHYSICAL and excess provisions,we will provide coverage DAMAGE COVERAGE are replaced by the equal to the broadest coverage applicable to any following:covered "auto"you own. 4.c.4.d.Exclusions and do not apply to We will also cover loss of use of the hired "auto" equipment designed to be operated solelyifitresultsfroman"accident",you are legally by use of the power from the "auto's"liable and the lessor incurs an actual financial electrical system that,at the time of "loss", loss,subject to a maximum of $1000 per is:"accident". (1)Permanently installed in or upon This extension of coverage does not apply to the covered "auto";any "auto"you hire or borrow from any of your "employees",partners (if you are a partnership),(2)Removable from a housing unit members (if you are a limited liability company),which is permanently installed in or members of their households.or upon the covered "auto"; (3)An integral part of the same unit housing any electronic equipment described in Paragraphs (1)and (2)above;or ©2011,The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 3 of 5ofISOProperties,Inc.,with its permission.) 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 16 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE (4)Necessary for the normal If another Hartford Financial Services Group, operation of the covered "auto"or Inc.company policy or coverage form that is not the monitoring of the covered an automobile policy or coverage form applies to "auto's"operating system.the same "accident",the following applies: b.Section III –Version CA 00 01 03 10 of the (1)If the deductible under this Business Auto Business Auto Coverage Form,Physical Coverage Form is the smaller (or smallest) Damage Coverage,Limit of Insurance,deductible,it will be waived; Paragraph C.2 and Version CA 00 01 10 01 of (2)If the deductible under this Business Auto the Business Auto Coverage Form,Physical Coverage Form is not the smaller (or Damage Coverage,Limit of Insurance,smallest)deductible,it will be reduced by Paragraph C are each amended to add the the amount of the smaller (or smallest) following:deductible. $1,500 is the most we will pay for "loss"in 12.AMENDED DUTIES IN THE EVENT OF any one "accident"to all electronic ACCIDENT,CLAIM,SUIT OR LOSS equipment (other than equipment designed The requirement in LOSS CONDITIONS 2.a.-solely for the reproduction of sound,and DUTIES IN THE EVENT O F ACCIDENT,CLAIM,accessories used with such equipment)SUIT OR LOSS -of SECTION IV -BUSINESSthatreproduces,receives or transmits AUTO CONDITIONS that you must notify us ofaudio,visual or data signals which,at the an "accident"applies only when the "accident" istime of "loss", is:known to: (1)Permanently installed in or upon (1)You,if you are an individual;the covered "auto"in a housing, (2)A partner,if you are a partnership;opening or other location that is not normally used by the "auto"(3)A member,if you are a limited liability manufacturer for the installation of company;or such equipment;(4)An executive officer or insurance manager,if (2)Removable from a permanently you are a corporation. installed housing unit as described 13.UNINTENTIONAL FAILURE TO DISCLOSE in Paragraph 2.a.above or is an HAZARDSintegral part of that equipment;or If you unintentionally fail to disclose any hazards(3)An integral part of such equipment.existing at the inception date of your policy,we c.For each covered "auto",should loss be limited will not deny coverage under this Coverage to electronic equipment only,our obligation to Form because of such failure. pay for,repair,return or replace damaged or 14.HIRED AUTO -COVERAGE TERRITORYstolenelectronicequipmentwillbereducedby Paragraph e.of GENERAL CONDITIONS 7.-the applicable deductible shown in the POLICY PERIOD,COVERAGE TERRITORY -Declarations,or $250,whichever deductible is of SECTION IV -BUSINESS AUTO less. CONDITIONS is replaced by the following:9.EXTRA EXPENSE -BROADENED e.For short-term hired "autos",the coverageCOVERAGE territory with respect to Liability Coverage isUnderParagraphA.-COVERAGE -of SECTION anywhere in the world provided that if theIII-PHYSICAL DAMAGE COVERAGE,we will "insured's"responsibility to pay damages for pay for the expense of returning a stolen covered "bodily injury"or "property damage"is "auto"to you.determined in a "suit," the "suit" is brought in 10.GLASS REPAIR -WAIVER OF DEDUCTIBLE the United States of America,the territories and possessions of the United States ofUnderParagraphD.-DEDUCTIBLE -of SECTION America,Puerto Rico or Canada or in a III -PHYSICAL DAMAGE COVERAGE,the settlement we agree to.following is added: 15.WAIVER OF SUBROGATIONNodeductibleappliestoglassdamageifthe glass is repaired rather than replaced.TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -of SECTION IV -11.TWO OR MORE DEDUCTIBLES BUSINESS AUTO CONDITIONS is amended byUnderParagraphD.-DEDUCTIBLE -of SECTION adding the following:III -PHYSICAL DAMAGE COVERAGE,the following is added: ©2011,The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 4 of 5ofISOProperties,Inc.,with its permission.) 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 17 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE We waive any right of recovery we may have c.Regardless of the number of autos deemed a against any person or organization with whom total loss,the most we will pay under this you have a written contract that requires such Hybrid,Electric,or Natural Gas Vehicle waiver because of payments we make for Payment Coverage provision for any one damages under this Coverage Form."loss"is $10,000. 16.RESULTANT MENTAL ANGUISH COVERAGE For the purposes of the coverage provision, The definition of "bodily injury"in SECTION V-a.A "non-hybrid"auto is defined as an auto that DEFINITIONS is replaced by the following:uses only an internal combustion engine to move the auto but does not include autos"Bodily injury"means bodily injury,sickness or powered solely by electricity or natural gas.disease sustained by any person,including mental anguish or death resulting from any of b.A "hybrid"auto is defined as an auto with an these.internal combustion engine and one or more electric motors;and that uses the internal17.EXTENDED CANCELLATION CONDITION combustion engine and one or more electric Paragraph 2.of the COMMON POLICY motors to move the auto,or the internal CONDITIONS -CANCELLATION -applies combustion engine to charge one or more except as follows:electric motors,which move the auto. If we cancel for any reason other than 19.VEHICLE WRAP COVERAGEnonpaymentofpremium,we will mail or deliver In the event of a total loss to an "auto"for whichtothefirstNamedInsuredwrittennoticeof Comprehensive,Specified Causes of Loss,orcancellationatleast60daysbeforetheeffective Collision coverages are provided under thisdate of cancellation. Coverage Form,then such Physical Damage18.HYBRID,ELECTRIC,OR NATURAL GAS Coverages are amended to add the following:VEHICLE PAYMENT COVERAGE In addition to the actual cash value of the "auto",In the event of a total loss to a "non-hybrid"auto we will pay up to $1,000 for vinyl vehicle wraps for which Comprehensive,Specified Causes of which are displayed on the covered "auto"at theLoss,or Collision coverages are provided under time of total loss.Regardless of the number ofthisCoverageForm,then such Physical autos deemed a total loss,the most we will pay Damage Coverages are amended as follows:under this Vehicle Wrap Coverage provision for a.If the auto is replaced with a "hybrid"auto or any one "loss"is $5,000.For purposes of this an auto powered solely by electricity or natural coverage provision,signs or other graphics gas,we will pay an additional 10%,to a painted or magnetically affixed to the vehicle are maximum of $2,500,of the "non-hybrid"auto’s not considered vehicle wraps. actual cash value or replacement cost, whichever is less, b.The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," ©2011,The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 5 of 5ofISOProperties,Inc.,with its permission.) 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 18 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE PolicyNumber: EffectiveDate: EndorsementNumber: EffectivehouristhesameasstatedontheInformationPageofthepolicy. NamedInsuredandAddress: 2 ANYPERSONORORGANIZATION FROMWHOMYOUAREREQUIRED BYWRITTENCONTRACTOR AGREEMENTTOOBTAINTHIS WAIVEROFRIGHTSFROMUS. ASREQUIREDBYWRITTEN CONTRACT. ALLCALIFORNIALOCATIONS. THISENDORSEMENTCHANGESTHEPOLICY.PLEASEREADITCAREFULLY. Countersignedby AuthorizedRepresentative FormWC040306(1)PrintedinU.S.A. ProcessDate:PolicyExpirationDate: WAIVEROFOURRIGHTTORECOVERFROM OTHERSENDORSEMENT-CALIFORNIA Wehavetherighttorecoverourpaymentsfromanyoneliableforaninjurycoveredbythispolicy.Wewillnot enforceourrightagainstthepersonororganizationnamedintheSchedule.(Thisagreementappliesonlytothe extentthatyouperformworkunderawrittencontractthatrequiresyoutoobtainthisagreementfromus.) Youmustmaintainpayrollrecordsaccuratelysegregatingtheremunerationofyouremployeeswhileengagedin theworkdescribedintheSchedule. Theadditionalpremiumforthisendorsementshallbe%oftheCaliforniaworkers’compensation premiumotherwisedueonsuchremuneration. SCHEDULE PersonorOrganizationJobDescription 4/24/2023 72WEAZR3341 10/01/2022 10/01/2023 Southern Contracting Company P.O. Box 445 San Marcos CA 92079 74026777 | SOUTHCON1 | 2022 GL CAU UMC WCO IM | Kiara Maldonado | 4/24/2023 10:45:30 AM (PST) | Page 19 of 19 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: CD07FB8E-8B60-442F-B98F-835A903AA6BE Alla.aae�iRiD® CERTIFICATE OF LIABILITY INSURANCE100 F manszoz/a I 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(les) must have ADDITIONAL INSURED provisions or be endorsed. N 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 . PRODU ER SullivanCurtisMonroe Insurance Services (COR) 1920 Main Street Suite600 CONTACT NAME, Tien Le PHONE FAz 951 493-3314 xo: 949-852-9762 ADDRESS, tee sullicurt.cam _ INSURER(S) AFFORDING COVERAGE NAIC0 Irvine, CA 92614 INSURERA: Hartford Fire Insurance Can A+ 19682 WWW.SullivanCurtisMonroeCom License Y OES3670 INSURED Southern Contracting Company P.O. Box 445 INSURER B: Hartford Casualty Insurance Company A+ 7 29424 INSURERC: Sentinel Insurance Company, Ltd. A+ X 11000 INSURERD: AGCS Marine Insurance Coma A+ X 22837 San Marcos CA 92079 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 763B17og 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. INSLTR TYPEOFINSURANCE AOCL PCLICYNUMBER POl1CYEFF MPOLICY EMP fYY OMITS A V COMMERCIAL GENERAL LIABILITY V 72UEAPT0574 10/1/2023 1011/2024 EACHOCCURRENCE s1000000 CLAIMSMADE OCCUR $300000 PREMI E Eaentummos if MED UP (Any are Person) f 10 000 XCU Included J 1$5.ODO PD Deductible PERSONAL N ADV INJURY $1 000 OGO GENL AGGREGATE OMIT APPLIES PER: POLICY JET � LOC GENERALAGGREGATE s2,000,000 PRODUCTS-COMPIOPAGG _ f2 00O 000 s OTHER: A AUTOMOSILEUABIUTY 72UEAPT0696 10/1/2023 1011/2024 COMBINED SINGLE UNIT i1000000 BODILY INJURY LPar Pram) ANY AUTO f OWNED SCHEDULED AUTO! AUTOS MIRED AUTOS NLY AUTOS ONLY AUTOS ONLYBooesinel Comp Ded$lk/$2k/$5k f _ BODILY INJURY IPr aoodrx) APE GE Coll Ded tk/ 2k/ 5k s B �/ UMBRELLA WB pOCUR 72RHAPT0617 10/1/2023 10/1/2024 EACHOCCURRENCE 510000000 AGGREGATE EXCESS UM CWMSMADE i 10 000 000 DELI I V I RETENTION s 10,000 1 1$ C WORHERSCOMPFINSATION AND EMPLOYERS' LIABILITY FVE YIN OFF CER EMBFJICLUD D'IC� ® N/A 72WEAZR3341 10/1/2023 10/112024 PERT OTM ER EL. EACH ACCIDENT - ft 000000 _ EL DISEASE- EA EMPLOYE (Mandatory in NH) If yea, disrobe under i _ DESCRIPTION OF OPERATIONS beb EL DISEASE POLICY OMIT IS 1,000,D00 D Installation MZ193091424 10/1/2023 10/1/2024 $2,500,000 Limit ($2,500 Deductible) D -Properly in Transit / Temp Locations MZ193091424 10/112023 10/1/2024 $750,000 Limit ($2,500 Deductible) D Leased 8 Rented Equipment MZ193091424 1011/2023 10/l/2024 $2,DDO,000 Limit ($1k/5k Deductible) DESCRIPTION OF OPERAnONS / LOCATIONS I VEHICLES (ACORD tit, Additional Remarks ScIvadule, may W anacMd N mom space Is rpulnd) RE: SCC Job No.: 107171 -Pro ect No. 19-28 Recreation Fields LED Lighting Upgrades The City of Palm Springs, its Acial, employees and agents are additional insured per attached endorsement. Primary and Non -Contributory and Waiver of Subrogation are included per attached endorsement. 30 day notice of cancellation except for 10 days notice for nonpayment of premium applies. Job No.: 107171 -Project No. 1 Services Department Lighting 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 Tien Le C All riahts reserved. ACCIRD 25 (2016103) The ACORD name and logo are registered marks of ACORD I SW)THCONI 1 2023 GL CAU UMC WO TM I Ticn Le 9/19i W3 4:31:57 PM (PST') I Page 1 of 19 This certificate cancels and supersedes ALL prev ously issued certificates. Southern Contracting Company 9/19/2023 72UEAPT0574 SECTION II - WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization otherthan a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Employees And Volunteer Workers Your 'volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, chili, parent, brother or sister of that co -"employee" or that "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (1)(b) above; or (d)Adsing out of his or her providing or failing to provide professional health care services. If you are not in the business of providing professional health care services: (a) Subparagraphs (1)(a), (1)(b) and (1)(c) above do not apply to any "employee" or "volunteer worker" providing first aid services; and (b)Subparagraph (1)(d) above does not apply to any nurse, emergency medical technician or paramedic employed by you to provide such services. (2) "Property damage" to property: (a) Owned, occupied or used by, (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Real Estate Manager Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. c. Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. e. Unnamed Subsidiary Any subsidiary, and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of the Coverage Part. HG 00 01 09 16 76381709 1 SOUlil,arvl i .: oJ3 IL CAU UMC MCO IM I Tien Le 19/19/2023 4:31:57 PM (PST) I Page 2 of 1S This certificate cancels and supersedes ALL previously issued certificates. Page 11 of 21 The insurance afforded herein for any subsidiary not named in this Coverage Part as a named insured does not apply to injury or damage with respect to which such insured is also a named insured under another policy or would be a named insured under such policy but for its termination or the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or forth the organization or the end of the policy period, whichever is earlier, b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury' arising out of an offense committed before you acquired or formed the organization. 4. Nonowned Watercraft With respect to watercraft you do not own that is less than 51 feet long and is not being used to tarty persons for a charge, any person is an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co -"employee" of the person operating the watercraft; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. S. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The following person(s) or organization(s) are an additional insured when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement. A person or organization is an additional insured under this provision only for that period of time required by the contract or agreement. However, no such person or organization is an insured under this provision if such person or organization is included as an insured by an endorsement issued by us and made a part of this Coverage Part. a. Vendors Any person(s) or organization(s) (referred to below as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". (1) The insurance afforded the vendor is subject to the following additional exclusions: This insurance does not apply to: (a) "Bodily injury' or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b)Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor, (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or Page 12 of 21 HG 00 01 09 16 76301709 1 SWTNCONl 1 1121 11 "1 "1 MO fM I Tien Le j 9/19/2023 4:31:57 PM (PST) I Page 3 of 18 This certificate cancels and supersedes ALL previously issued certificates. (h) "Bodily injury' or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Sub- paragraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. b. Lessors Of Equipment (1) Any person(s) or organization(s) from whom you lease equipment; but only with respect to their liability for "bodily injury', "Property damage" or "personal and advertising injury' caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). (2) With respect to the insurance afforded to these additional insureds this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. c. Lessors Of Land Or Premises Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. With respect to the insurance afforded these additional insureds the following additional exclusions apply: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to lease that land; or 2. Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. d. Architects, Engineers Or Surveyors Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with your premises; or (2) In the performance of your ongoing operations performed by you or on your behalf. With respect to the insurance afforded these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury' arising out of the rendering of or the failure to render any professional services by or for you, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury', involved the rendering of or the failure to render any professional services by or for you. e. Permits Issued By State Or Political Subdivisions Any state or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. With respect to the insurance afforded these additional insureds, this insurance does not apply to: (1) "Bodily injury', "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) "Bodily injury' or "property damage" included within the "products -completed operations hazard". Any Other Party Any other person or organization who is not an additional insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the ads or omissions of those acting on your behalf: (1) In the performance of your ongoing operations; HG 00 01 0916 36301109 i SWTHCOHI 1 2023 GL CM ONC NCO 1M I Tien Le 19t1912023 4:31:51 PM (PM I Page 9 of 18 9Tis reai ELcare cancels and supersedes ALL previously issued certificates. Page 13 of 21 Southern Contracting Company 9/19/2023 72UEAPT0574 CONTRACTORS BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX 1. Alienated Premises Coverage........................................................................................................................1 2. Damage To Your Work...................................................................................................................................1 3. That Particular Part .........................................................................................................................................1 4. Contractors Limited Professional Liability .......................................................................................................2 S. Per Project and Per Location General Aggregate Limits Of Insurance.......................................................... 2 6. Medical Payments Coverage - Including Products - Completed Operations .................................................. 3 7. Injury To Employee's Reputation With Respect To Incidental Medical Malpractice ...................................... 3 8. Bodily Injury Employee Suits...........................................................................................................................4 9. Consolidated Insurance (Wrap -Up) Programs................................................................................................4 10. Access Or Disclosure Of Confidential Or Personal Information And Data -Related Liability ......................... 5 11. Supplementary Payments............................................................................................................................... 5 12. Two Or More Coverage Parts Or Policies Issued By Us................................................................................ 6 13. Notice of Cancellation to Certificate Holders.................................................................................................. 6 14. Contractual Liability Coverage For Personal And Advertising Injury .............................................................. 6 15. Insured Contract Definition.............................................................................................................................. 6 1. ALIENATED PREMISES COVERAGE Exclusion j. Damage To Property of Section I - Coverage A is amended as follows: a. The following exception to the exclusion is deleted: Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. b. This exception is replaced by the following: Paragraph (2) of this exclusion does not apply if the premises are "your work". 2. DAMAGE TO YOUR WORK A. Section I - Coverage A - Bodily Injury And Property Damage Liability, Paragraph 1. Insuring Agreement is amended to add the following: I. Damages because of "property damage" include damages the insured becomes legally obligated to pay because of "property damage" to "your work" or caused by "your work", and such "property damage" shall be deemed to be caused by an "occurrence", if not intended or expected from the standpoint of the insured, regardless of whether the "property damage" arises from breach of contract. B. Exclusion I. Damage To Your Work of Section I - Coverage A is replaced by the following: I. Damage to Your Work "Property damage" to that particular part of "your work" that must be restored, repaired or replaced because "your work" was incorrectly performed and included in the "products -completed operations hazard". This exclusion does not apply if the damaged work or the work performed incorrectly was performed on your behalf by a subcontractor. This Paragraph 2.B. does not apply if Exclusion I. Damage To Your Work has been otherwise modified by endorsement. 3. THAT PARTICULAR PART This Paragraph 3. applies to Exclusion j. Damage to Property, subparagraphs (5), and (6), Exclusion k. Damage to Your Product, and Exclusion I. Damage to Your Work. Form HS 24 6012 20 02020, The Hartford Page 1 of 7 76381709 1 Sg HCMI 1 2023 GL CM WIC WO IM I Tien Le 1 9/19/2023 4:31:57 PM iPSTI I Page 6 0[ 18 9Tis certificate cancels and supersedes ALL previously issued certificates. When performing operations as a "general contractor", the term that particular part shall not mean the entire construction, improvement or renovation project. For purposes of this provision, the term "general contractor" means the contractor signing the prime construction contract for a construction, erection, improvement or renovation project and that has main responsibility for such project including hiring all of the subcontractors and suppliers. 4. CONTRACTORS LIMITED PROFESSIONAL LIABILITY The following exclusion is added to Paragraph 2., Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, and to Paragraph 2., Exclusions of Section I -Coverage B - Personal And Advertising Injury Liability: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. Professional services include: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (2) Supervisory or inspection activities performed as a part of any related architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury', involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. This exclusion does not apply to your operations in connection with construction work performed by you or on your behalf. However, this exception to the exclusion will not apply if you are in the business or profession of providing the professional services described above independent from the construction work performed by you or on your behalf. In the event this insurance applies to any injury, damage, loss, cost or expense covered by Professional Liability insurance issued by a company unaffiliated with us, then the insurance afforded under this Coverage Part is excess over such other valid and collectible Professional Liability insurance (including any deductible or self - insured retention portion thereof), and any other valid and collectible insurance available to the insured whether primary, excess, contingent or on any other basis. S. PER PROJECT AND PER LOCATION GENERAL AGGREGATE LIMITS OF INSURANCE 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 "project" or a single "location"; 1. A separate Per Project General Aggregate Limit or a separate Per Location General Aggregate Limit applies to each "project" or "location", whichever is applicable. The Per Project General Aggregate Limit and Per Location Aggregate Limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Per Project General Aggregate Limit or the Per Location General Aggregate Limit, whichever applies, 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 "suds" 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 Per Project General Aggregate Limit for that "project" or the Per Location General Aggregate for that "location", whichever applies. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, the Per Project General Aggregate Limit for any other "project", or the Per Location General Aggregate Limit for any other "location". 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of Page 2 of 7 Form HS 24 50 12 20 16381709 1 SOOTNCONI 1 2023 OL C201 UNC NCO IN I Tien Le 1 9/19/2023 9:31:57 IN PST) I Page 7 of 18 This certificate cancels and supersedes ALL previously issued certificates. being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Project General Aggregate Limit if attributable only to ongoing operations at a single "project" or the Per Location General Aggregate if attributable only to ongoing operations at a single "location". B. 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 cannot be attributed only to ongoing operations at a single "project" or a single "location"; 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable, and 2. Such payments shall not reduce any Per Project General Aggregate Limit or any Per Location General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit,or any Per Project General Aggregate Limit or any Per Location General Aggregate Limit. D. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. E. For the purposes of Paragraph 5., the following definitions apply: "Project" means a premises an insured does not own or rent and where such insured performs construction -related operations. Each "project" involving the same or connecting lots, or premises whose connection is separated by a street, roadway, waterway, railroad or right-of-way shall be considered a single "project". 1. If a "project" has been abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the "project" shall be considered a single "project". "Project" does not include a premises that is a "location". 2. "Location" means a premises an insured owns or rents and where such insured performs business operations other than construction -related operations. Each "location" involving the same or connecting lots, or premises whose connection is separated by a street, roadway, waterway or right-of-way railroad shall be considered a single "location." "Location" does not include a premises that is a "project". This provision does not apply if the Per Project and the Per Location General Aggregate Limit has been otherwise modified by endorsement. 6. MEDICAL PAYMENTS COVERAGE - INCLUDING PRODUCTS -COMPLETED OPERATIONS Paragraph 1.e. of the Insuring Agreement - Coverage C is replaced by the following: 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; (3) Because of your operations; or (4) Included within the definition of the "products -completed operations hazard;" provided that: (1) The accident takes place in the "coverage territory" and during the policy period; (2) The expenses are incurred and reported to us within three years of the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. 7. INJURY TO EMPLOYEE'S REPUTATION WITH RESPECT TO INCIDENTAL MEDICAL MALPRACTICE A. The following is added to Paragraph 1.e. of the Insuring Agreement - Coverage A: (3) With respect to incidental medical malpractice, "bodily injury" includes damages claimed for injury to emotions or reputation of an "employee" arising out of the rendering or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic services. Form HS 24 50 12 20 76381709 1 SWTFmnt I _ _J C.L 'AU OMC MCa tM I Tien Le ( 9/19/2023 4:31:51 PM (PST) I Page B of 18 This certificate cancels and supersedes ALL previously issued certificates. Page 3 of 7 B. The following exclusion is added to Coverage B - Personal and Advertising Injury: "Personal and advertising injury arising out of the rendering or failure to render professional health care services as a physician, dentist, nurse, emergency medical technician or paramedic. 8. BODILY INJURY EMPLOYEE SUITS A. "Bodily injury" as listed in Paragraph 2.a.(1) of Section II - Who Is An Insured, does not apply to 2.a.(1)(a) through 2.a.(1)(c). B. Part a. of Paragraph 4. Nonowned Watercraft in Section II - Who Is An Insured does not apply. 9. CONSOLIDATED INSURANCE (WRAP-UP) PROGRAMS The following exclusion is added to Section I Coverage A: This insurance does not apply to any "bodily injury' or "property damage" arising out of any "wrap project or premises" where an insured under this policy is or was also an insured under one or more commercial general liability (CGL) policies (including any umbrella or excess policies that include the commercial general liability policy(ies) as underlying insurance) included within a "consolidated insurance (wrap-up) program" This exclusion applies even if the limits of insurance for such "consolidated insurance (wrap-up) program" are exhausted or not collected for any reason, including bankruptcy or insolvency of the insurer providing coverage for the "consolidated insurance (wrap-up) program". This exclusion also applies if the CGL coverage afforded under the"consolidated insurance (wrap-up) program" is narrower in scope than the coverage provided by this policy. This exclusion does not apply to: A. Products -Completed Operations Hazard Exception "Bodily injury" or "property damage" arising out of an "insured's operations" at or in connection with a "wrap project or premises" when such "bodily injury" or "property damage" commences after the "products -completed operations hazard" coverage or any completed operations extension coverage provided by the applicable "consolidated insurance (wrap-up) program" has ended or is no longer in effect. B. Off -Site Location Exception "Bodily injury" or "property damage" resulting from an "insured's operations" at or in connection with a "wrap projector premises" at a location to which the applicable "consolidated insurance (wrap-up) program" does not apply. C. Repair Work And Punch List Work Exception "Bodily injury" or "property damage" resulting from "repair work" or "punch list work" at a 'Wrap project or premises" but only when the applicable "consolidated insurance (wrap-up) program" does not apply or no longer applies to such "repair work" or "punch list work". This exception does not apply to the cost of performing such "repair work" or "punch list work", or to the "repair work" or "punch list work" itself. D. Additional Insured Extension "Bodily injury" or "property damage" for which you are solely an additional insured under the "consolidated insurance (wrap-up) program". The coverage provided under Paragraphs 9.A through 9.D. above is subject to all terms, conditions and exclusions of this policy. For purposes of Paragraph 9, the following definitions apply: "Consolidated insurance (wrap-up) program" means any agreement or arrangement, including any contractor -controlled, owner -controlled, project -specific or similar insurance program under which one or more contractor(s) working on a specified project are insured under one or more commercial general liability (CGL) policies (including any umbrella or excess policies that include the commercial general liability policy(ies) as underlying insurance) issued by a specified carrier for injury or damage arising out of operations conducted in connection with or necessary or incidental to the project. "Insured's operations" means all operations performed by a named insured (and not sub- contracted or performed by others on the insured's behalf). "Punch list work" means the "insured's operations" at or in connection with a "wrap project or premises" in order to complete the work called for in an insured's contract for the "wrap project or premises". "Repair work" means the "insured's operations" that are service, maintenance, correction, repair, replacement work, or periodic inspection performed by an insured at or in connection with a "wrap project or premises", in order to replace or repair an insured's completed work. .'Wrap project or premises" means any premises or construction, erection, improvement or renovation project subject to a "consolidated insurance (wrap-up) program". 10. ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA - RELATED LIABILITY Page 4 of 7 Form HS 24 50 12 20 18381709 � SeGTHCONl 1 2023 GL CAU MC WO IN I Tien Le [ 9/19/2023 4:31:57 IN (PST) I Page 9 of 19 This certificate cancels and supersedes ALL previously issued certificates. A. Exclusion p. of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following. p. Access Or Disclosure Of Confidential Or Personal Information And Data - Related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. However, unless Paragraph (1) above applies, this exclusion does not apply to liability for damages because of "bodily injury". B. Exclusion w. of Section 1 - Coverage B - Personal and Advertising Injury is replaced by the following: : w. Access Or Disclosure Of Confidential Or Personal Information "Personal and advertising injury" arising out of any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of any access to or disclosure of any person's or organization's confidential or personal information. C. The following Paragraph is added to Section III - Limits Of Insurance: Subject to Paragraph 5. Each Occurrence Limit, the most we will pay under Coverage A for "property damage" because of all loss of "electronic data" arising out of any one "occurrence" is $100,000, unless modified by endorsement. D. The following definition is added to Section V - Definitions: "Electronic data" means information, facts or programs: a. Stored as or on; b. Created or used on, or c. Transmitted to or from; computer software, (including systems and applications software) hard or floppy disks, CO-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. E. For the purposes of the coverage provided by this provision, the definition of "property damage" in Section V - Definitions is replaced by the following: "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused R. For the purposes of this insurance, "electronic data" is not tangible property. 11. SUPPLEMENTARY PAYMENTS In the Supplementary Payments - Coverages A and B provision: The limit for the cost of bail bonds is increased to $2,500. Form HS 24 50 12 20 76361709 15OUI ON I -0:. i. 'AU IINC NCO IN I Tien Le 1 9/19/2023 4: 31:57 PM (PST) I Page 10 of 10 This certi ificate cancels and supersedes ALL previously issued certificates. Page 5 of 7 12. TWO OR MORE COVERAGE PARTS OR POLICIES ISSUED BY US If this policy and any other policy issued to an insured by us or any affiliated company provides coverage that applies to the same claim or damages, the maximum applicable limit(s) of liability or limit of insurance under all the policies will not exceed the highest applicable limit of liability or limit of insurance under any one policy. This condition does not apply to any policy issued by us or an affiliated company specifically written to apply as excess insurance over this policy. 13. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. 14. CONTRACTUAL LIABILITY COVERAGE FOR PERSONAL AND ADVERTISING INJURY Exclusion e. of SECTION I - COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is replaced by the following: This insurance does not apply to: e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "personal and advertising injury" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 15. INSURED CONTRACT DEFINITION a. INSURED CONTRACT -CONSTRUCTION OPERATIONS AND MUNICIPAL WORK Paragraph d. of the definition of "insured contract" in Section V - Definitions is deleted and replaced by the following: An obligation, as required by ordinance, to indemnify a municipality. Iimpiel Ll CA Paragraph f. of the definition of "insured contract" is deleted and replaced by the following: That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury", "property damage", or "personal and advertising injury" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. includes that part of any contract or agreement that indemnifies a railroad for "bodily injury', "property damage", or "personal and advertising injury" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing. However, Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: Page 6 of 7 Form HS 24 50 12 20 76381709 1 6WTHCON3 1 2023 GL CAU OMC WO IM I Tien Le 1 9/19/2023 4:31:57 PM (PST) I Page 11 of 19 This certificate cancels and supersedes ALL previously issued certificates. (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. All other terms and conditions in the policy remain unchanged. Form HS 24 50 12 20 Tfi➢a iTO9 1 3aaar.u; _,�_ !. ,Ac OW WO IN I Tien Le 1 9/19/2023 4:31:57 PH (PST) I Page 12 of 18 This certificate cancels and supersedes ALL previously issued certificates. Page 7 of 7 Soulhum Contracting Company COMMERCIAL AUTOMOBILE HA 99 16 12 21 72UEAPT0696 10101 /2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. BROAD FORM INSURED e. Employees as Insureds Paragraph .1. - WHO IS AN INSURED - of (1). Any "employee" of yours while using a Section II - Liability Coverage is amended to covered "auto" you don't own, hire or add the following: borrow in your business or your d. Subsidiaries and Newly Acquired or personal affairs. Formed Organizations f. Lessors as Insureds The Named Insured shown in the (1). The lessor of a covered "auto" while the Declarations is amended to include: "auto" is leased to you under a written (1) Any legal business entity other than a agreement if: partnership or joint venture, formed as a (a) The agreement requires you to subsidiary in which you have an provide direct primary insurance for ownership interest of more than 50% on the lessor and the effective date of the Coverage Form. (b) The "auto" is leased without a However, the Named Insured does not driver. include any subsidiary that is an "insured" under any other automobile Such a leased "auto" will be considered a policy or would be an "insured" under covered "auto" you own and not a covered such a policy but for its termination or 'auto" you hire. the exhaustion of its Limit of Insurance. g. Additional Insured if Required by Contract (2) Any organization that is acquired or (1) When you have agreed, in a written formed by you and over which you contract or written agreement, that a maintain majority ownership. However, person or organization be added as an the Named Insured does not include any additional insured on your business auto newly formed or acquired organization: policy, such person or organization is an (a) That is a partnership or joint "insured", but only to the extent such venture, person or organization is liable for "bodily injury" or "property damage" (b) That is an "insured" under any other caused by the conduct of an "insured" policy, under paragraphs a. or b. of Who Is An (c) That has exhausted its Limit of Insured with regard to the ownership, Insurance under any other policy, or maintenance or use of a covered "auto." (d) 180 days or more after its The insurance afforded to any such acquisition or formation by you, additional insured applies only if the unless you have given us notice of "bodily injury" or "property damage" the acquisition or formation. occurs: Coverage does not apply to "bodily (a) During the policy period, and injury" or "property damage" that results (b) Subsequent to the execution of such from an "accident" that occurred before written contract, and you formed or acquired the organization. Form HA 99 16 12 21 Page 1 of 5 ©2021, The Hartford (Includes copyrighted material of Insurance Services Office, Inc. with its permission.) 76381709 1 p9yTNCOMI 1 2023 GL CAU UMC Wo 1M I Tien Le I e/19/2023 4:31:51 PM (PST) I Page 13 of 10 This certificate cancels and supersedes ALL previously issued certificates. (c) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured. (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non- contributory with the additional insured's own insurance. (4) Duties in The Event Of Accident, Claim, Suit or Loss If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the additional insured shall be required to comply with the provisions in LOSS CONDITIONS 2. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM , SUIT OR LOSS — OF SECTION IV — BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. 2. Primary and Non -Contributory if Required by Contract Only with respect to insurance provided to an additional insured in A.1.g. - Additional Insured If Required by Contract, the following provisions apply: (1) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance 5.d. (2) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of. (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self - insured amounts under all that other insurance. We will share the remaining loss, if any, by the method described in SECTION IV - Business Auto Conditions, B. General Conditions, Other Insurance 5.d. 3. AUTOS RENTED BY EMPLOYEES Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire. The SECTION IV- Business Auto Conditions, B. General Conditions, 5. OTHER INSURANCE Condition is amended by adding the following: e. If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. Page 2 of 5 Form HA 99 16 12 21 78381709 1 SCUTHCM 1 2023 GL CAU UNC NCO IN I 'Tien to 1 9/19/2023 4:31:57 PM IPSTI I Page 11 of 18 This certificate cancels and supersedes ALL previously issued certificates. 4. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5. - FELLOW EMPLOYEE - of SECTION II - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "employees". Coverage is excess over any other collectible insurance. S. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $100,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident". This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 6. PHYSICAL DAMAGE - ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1,000. 7. LOAN/LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, in the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the loan/lease. "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees; security deposits not returned by the lessor; costs for extended warranties, credit life Insurance, health, accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. 8. AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 9. ELECTRONIC EQUIPMENT - BROADENED COVERAGE a. The exceptions to Paragraphs BA - EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto", (2) Removable from a housing unit which is permanently installed in or upon the covered "auto", (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. b. Section III, Physical Damage Coverage, Limit of Insurance, Paragraph C.2. is amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident' to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss". is: Form HA 99 16 12 21 Page 3 of 5 76381709 1 SWTHCOHI I - .1 IL 'AU OHC NCO IM I Ti.. Le 19/19/2023 4:31:57 PM (PST) I Page 15 of 10 This certificate cancels and supersedes ALL previously issued certificates. (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 10.EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A. - COVERAGE - of SECTION III - PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 11. GLASS REPAIR -WAIVER OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage 9 the glass is repaired rather than replaced. 12. TWO OR MORE DEDUCTIBLES Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 13. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS - of SECTION IV - BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident' is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 14. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Forth because of such failure. 15. HIRED AUTO - COVERAGE TERRITORY SECTION IV, BUSINESS AUTO CONDITIONS, PARAGRAPH B. GENERAL CONDITIONS, 7. - POLICY PERIOD, COVERAGE TERRITORY - is added to include the following: (6) For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit,' the "suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 16. WAIVER OF SUBROGATION Paragraph 5. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - of SECTION IV - BUSINESS AUTO CONDITIONS A. Loss Conditions is amended by adding the following: We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. 17. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS, C. is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death resulting from any of these. 18. EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. Page 4 of 5 Form HA 99 16 12 21 76381709 1 a' u.u<ou: a..3 sL <A0 0MO WO IM I lien Le 1 9/19/2023 4:31:57 PMPM I Page 16 of 10 This certificate cancels and supersedes ALL piev3ously issued certificates. 19. HYBRID, ELECTRIC, OR NATURAL GAS VEHICLE PAYMENT COVERAGE In the event of a total loss to a "non -hybrid" auto for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended as follows: a. If the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natural gas, we will pay an additional 10%, to a maximum of $2,500, of the "non -hybrid" auto's actual cash value or replacement cost, whichever is less, b. The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," c. Regardless of the number of autos deemed a total loss, the most we will pay under this Hybrid, Electric, or Natural Gas Vehicle Payment Coverage provision for any one "loss" is $10,000. For the purposes of the coverage provision, a. A "non -hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas. b. A "hybrid" auto is defined as an auto with an internal combustion engine and one or more electric motors; and that uses the internal combustion engine and one or more electric motors to move the auto, or the internal combustion engine to charge one or more electric motors, which move the auto. 20. VEHICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended to add the following: In addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage provision for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. Form HA 9916 12 21 76381709 1 SWTHCON1 1 2023 GL CAO UM WO IM I Tien Le 19/19/2023 4:31:57 PM (PST) I Page 11 of le This certificate cancels and supersedes ALL previously issued certificates. Page 5 of 5 9/192023 P1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 72WEAZR3341 Endorsement Number Effective Date: 10/012023 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: Southern Contracting Company FO. Box 445 San Marcos CA 92079 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 premium otherwise due on such remuneration. Penton or Organization ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US. SCHEDULE Countersigned by Form WC 0403 06 (1) Printed in U.S.A. Process Date: 2 % of the California workers' compensation Job Description AS REQUIRED BY WRITTEN CONTRACT. ALL CALIFORNIA LOCATIONS. Authorized Representative Policy Expiration Date: 10/012024 76381709 I SWTHCW1 1 2023 GL CAU UNC NCO IN I Tien Le 1 9/19/2023 4:31:57 IN MV I Page Is of Is This certificate cancels and supersedes ALL previously issued certificates. 0?3131,00 Bragg Crane Service is on your jobs . Demuth Park 4365 E Mesquite Avenue; Palm Springs, California 9� Bond Number (if known): 20- DAY P RFL.!MiNARYN TiCL Cai. C<iv, Code 3§ 8200-8216 Bragg Crane Service is proud to be providing services 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. Our Project Contribution Operated Crane Rental Work Starts / Material First Furnished 3/12/2024 Work Finishes / Material Last Furnished 3/28/2024 About Us Bragg Crane Service 13188 Dahlia Street Fontana, California 92337 RECEIVED Bragg has been in operation since 1946, providing the highest quality work and expertise with locations in APR 0 1 2024 Arizona, California, Florida, Idaho, Nevada, Texas, Utah and Washington. OFFICE OF THE CITY CLERK Bragg provides it operated and maintained crane service, steel erection, and heavy hauling services across several industries. From setting backyard spas, to building NFL stadiums, to major petrochemical plants, Bragg has the experience and know-how to get the job done. We appreciate your confidence in our abilities and thank you for allowing Bragg to be of service. THIS IS NOT A LIEN. This communication is a required document in many states to maintain mechanics liens rights, and is not a reflection on the credit worthiness of any party, nor does it indicate expected problems regarding payment. This is a legal requirement on Bragg's part. If you have any questions regarding preliminary notices or other documents received by Bragg Crane Service, please visit our website at www.BraggCompanies.com or call our main office at (562) 984-2400. Contact Info More details can be found at Robert Theisen Bragg Crane Service Business Manager levelset.com/talk Phone: (562) 244-0015 Email: Robert.Theisen@braggcrane.com Reference 5922VSYFHWX5 9307110011701162900089 There you will be able to: • Send and receive messages about this document • Fix or provide additional details 0-i LEVELSET i .t We were hired by Project Stakeholders Our Vendors (If applicable) _EVELSET General Contractor Southern Contracting Company PO Box 445 San Marcos, California 92079-0000 Property Owner/ Public Entity CITY OF PALM SPRINGS PO BOX 2743 Palm Springs, California 92263-2743 Want more information on this project? Visit'levelset.com/talk and enter 5922VSYFHWX5 Additional Info Property Description About the Job Estimate of the total price of the labor, services, equipment or material furnished or to be furnished $34,626.50 NOTICE TO PROPERTY OWNER / PUBLIC ENTITY 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, alien 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 bylaw to be served by the undersigned as a statement of your legal rights. This notice is not intended to reflect upon the financial condition ofthe-contractor orthe person employed byyou onthe 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 area residential homeowner of a dwelling containing four or fewer units. IMPORTANT: INFORMATION REQUEST PURSUANTTO§9550etseq. If the public entity commissioning work and/or the surety are not identified in this notice, or if either are incorrectly identified, please accept this notice as a formal request to the direct contractor pursuant to §9550 et seq to deliver (i) The name and address of the public entity commissioning the work; and/or (1i) The name and address of the surety, if any; as the case maybe; Further, if the direct contractor is not identified or is misidentified, please consider this a formal request to provide that information to Bragg Crane Service. Any information provided to Bragg Crane Service maybe provided by visiting levelsetcom/talk and entering 5922VSYFHWX5or by sending to the following address: Bragg Crane Service 13188 Dahlia Street Fontana, California 92337 lbe ! 466,16 f p ts�wreao: �azerao Bragg Crane Service Signed by Robert Theisen Its duly authorized and disclosed agent , Signed on March 22, 2024 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. _ Want more information on this project? Visit leveiset.com/talk and enter i L E V E L S E T 5922VSYFHWX5 SUPERIOR READY MIX 1764 W MISSION RD FSCONDIDO CA 92029 RECEIVED FEB 2 0 2024 City Hall Reception Desk CITY OF PALM SPRINGS 3200 E. TAHQUITZ CANYON WAY PALM SPRINGS CA 92262- OWNER or Reputed Owner (on private work) 02 or PUBLIC AGENCY (on public work) CITY OF PALM SPRINGS 3200 E, TAHQUITZ CANYON WAY PALM SPRINGS CA, 92262- CONSTRUCTION LENDER/Surety or Reputed Construction Lender/Surety. If any. NATIONWIDE MUTUAL INSURANCE COMPANY 500 N BRAND BLVD #2000 GENDALE CA, 91203- DIRECT CONTRACTOR or Reputed Contractor. if any 03 SOUTHERN CONTRACTING COMPANY 559 N TWIN OAKS VALLEY RD SAN MARCOS CA, 92069- SUB CONTRACTOR/person or firm who contracted for the purchase of such labor, services, equipment or materials is SOUTHERN CONTRACTING COMPANY P.O. BOX 445 SAN MARCOS CA. 92069 OTHER INFORMATION, if any. Owner Copy 3 B I") CALIFORNIA PRELIMINARY NOTICE THIS IS NOT A LIEN. THIS NOTICE IS GIVEN PURSUANT TO SECTIONS 8034(a), 8102, 8200 et seq, CALIFORNIA CIVIL CODE. THIS IS NOT A REFLECTION ON THE INTEGRITY OF ANY CONTRACTOR OR SUBCONTRACTOR. YOU ARE HEREBY NOTIFIED THAT.... SUPERIOR READY MIX CONCRETE L.P. 1564 W MISSION RD ESCONDIDO CA 92029 has furnished or will furnish labor, services, equipment or materials of the following general description: READY MIX CONCRETE. SAND AND/OR ROCK for the building, structure or other work of Improvement located at DEMUTH PARK RECREATION FIELDS LED 4200 E. MESQUITE AVENUE PALM SPRINGS An estimate of the total price of labor, services. equipment or materials furnished or to be furnished is: $30,000.00 By wk- Prelim Manager Dated: 02/13/2024 (Signature) (Title) 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. PROOF OF SERVICE BY MAIL AFFIDAVIT 1, Jesie Walker, declare that I served copies of the above PRELIMINARY NOTICE by First Class Certified, postage prepaid, addressed to each of the parties at the addresses shown above on 02/13/2024. 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. gyp-��-54.L llx� BY: Jesie Walker, Agent Executed at ESCONDIDO, California on 02/13/2024 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 C2 Vfo 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 TAHOUITZ CANYON WY PALM SPRINGS. CA 92262 CITY OF PALM SPRINGS PO BOX 2743 PALM SPRINGS, CA 92263 PALM SPRINGS POWER 1901 E BARISTO RD, PALM SPRINGS, CA 92262 DIRECT CONTRACTOR (Or Reputed Direct Contractor) SOUTHERN CONTRACTING CO 559 N TWIN OAKS VALLEY RD SAN MARCOS, CA 92069 SUBCONTRACTOR (Or Reputed Subcontractor) SUB -SUBCONTRACTOR (Or Reputed Sub -Subcontractor) BOND COMPANY NATIONWIDE MUTUAL INSURANCE CO 500 N BRAND BLVD STE 2000 GLENDALE, CA 91203 An estimate of the total price of the labor, services, equipment or materials furnished or to be furnished is: $100.000.00 Statement or estimate of the Claimant's demand for sums currently due after deducting all just credits and offsets: YOU ARE HEREBY NOTIFIED THAT... 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: 107171 PALM SPRINGS PWR BASEBAL REC FIELDS LED LTG UPGRADES 1901 E BARISTO RD PALM SPRINGS, CA 92262 The name of the person or firm who contracted for the purchase of such labor, services, equipment or materials: SOUTHERN CONTRACTING CO 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. $100,000.00 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 Mailed this date: MAY 23, 2024 Agent MAY 2 8 2024 ( Signature) Our Reference: (N820800) 461939 OFFICE OF THE CITY CLERK -.. �; ,i _ _ , . [�� s. ... >e � ... REQUEST FOR INFORMATION Pursuant to California Civil Code §8208 and §8210 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WY PALM SPRINGS, CA 92262 CITY OF PALM SPRINGS PO BOX 2743 PALM SPRINGS, CA 92263 PALM SPRINGS POWER 1901 E BARISTO RD, PALM SPRINGS, CA 92262 SOUTHERN CONTRACTING CO 559 N TWIN OAKS VALLEY RD SAN MARCOS, CA 92069 Re: 107171 PALM SPRINGS PWR BASEBAL REC FIELDS LED LTG UPGRADES 1901 E BARISTO RD PALM SPRINGS, CA 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 M 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 23, 2024 Agent for WALTERS WHOLESALE ELECTRIC CO c/o NCS P. O. Box 24101 Cleveland, OH 44124 Fax: 440-461-6202 Email: noticer)rem ncscredit.com Our Ref# N820800 461939 NCS[CA(N8208000W]BO USPS CERTIFIED MAILT"' 729 Miner Road Cleveland, OH 44143 9414 8091 0971 2007 6824 24 CITY OF PALM SPRINGS 3200 E 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. 9414809109712007682424 Track Number: 9414809109712007685043 CITY OF PALM SPRINGS SOUTHERN CONTRACTING CO 3200 E TAHQUITZ CANYON WY 559 N TWIN OAKS VALLEY RD PALM SPRINGS.. CA 92262 SAN MARCOS, CA 92069 Track Number: 9414809109712007685050 Track Number: 9414809109712007685067 CITY OF PALM SPRINGS PALM SPRINGS POWER PO BOX 2743 1901 E BARISTO RD, Palm Springs, CA 92263 Palm Springs, CA 92262 J 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 E TAHOUITZ CANYON WY PALM SPRINGS, CA 92262 CITY OF PALM SPRINGS PO BOX 2743 PALM SPRINGS, CA 92263 PALM SPRINGS POWER 1901 E BARISTO RD, PALM SPRINGS, CA 92262 DIRECT CONTRACTOR (Or Reputed Direct Contractor) SOUTHERN CONTRACTING CO 559 N TWIN OAKS VALLEY RD SAN MARCOS, CA 92069 SUBCONTRACTOR (Or Reputed Subcontractor) SUB -SUBCONTRACTOR (Or Reputed Sub -Subcontractor) BOND COMPANY NATIONWIDE MUTUAL INSURANCE CO 500 N BRAND BLVD STE 2000 GLENDALE, CA 91203 An estimate of the total price of the labor, services, equipment or materials furnished or to be furnished is: $100,000.00 Statement or estimate of the Claimant's demand for sums currently due after deducting all just credits and offsets: $100,000.00 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: 107171 PALM SPRINGS PWR BASEBAL REC FIELDS LED LTG UPGRADES 1901 E BARISTO RD PALM SPRINGS, CA 92262 The name of the person or firm who contracted for the purchase of such labor, services, equipment or materials: SOUTHERN CONTRACTING CO 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) RECEIVED Mailed this date: MAY 23, 2024 JUN 12 2024 eAgent (Signature) Our Reference: (N820800) 461939 OFFICE OF THE CITY CLERK y�- D u� �' � '"� �, :� i � ., a REQUEST FOR INFORMATION Pursuant to California Civil Code §8208 and §8210 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WY PALM SPRINGS, CA 92262 CITY OF PALM SPRINGS PO BOX 2743 PALM SPRINGS, CA 92263 PALM SPRINGS POWER LM 1901 E BARISTO RD, PALM SPRINGS, CA 92262 SOUTHERN CONTRACTING CO 559 N TWIN OAKS VALLEY RD SAN MARCOS, CA 92069 Re: 107171 PALM SPRINGS PWR BASEBAL REC FIELDS LED LTG UPGRADES 1901 E BARISTO RD PALM SPRINGS, CA 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 2M 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 23, 2024 Agent for WALTERS WHOLESALE ELECTRIC CO. c/o NCS P. O. Box 24101 Cleveland, OH 44124 Fax: 440-461-6202 Email: noticeprem ncscredit.com i Our Ref# N820800 461939 -. -. - . , . -. A USPS CERTIFIED MAIL T NCS[CA(N820800A11BO "' 729 Miner Road Cleveland, OH 44143 9414 8091 0971 2007 6850 50 CITY OF PALM SPRINGS PO BOX 2743 Palm Springs, CA 92263 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: 9414809109712007685050 CITY OF PALM SPRINGS PO BOX 2743 Palm Springs. CA 92263 Track Number: 9414809109712007685043 SOUTHERN CONTRACTING CO 559 N TWIN OAKS VALLEY RD SAN MARCOS, CA 92069 Track Number: 9414809109712007682424 CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WY PALM SPRINGS, CA 92262 Track Number: 9414809109712007685067 PALM SPRINGS POWER 1901 E BARISTO RD, Palm Springs, CA 92262