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A7154 - D W JOHNSTON CONSTRUCTION INC - CORNELIA WHITE HOUSE EXT REPAIRS CP 15-16
,acoRv® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/10/2025 06 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. T CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIC BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR12 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). PRODUCER CONTACT Heffernan Insurance Brokers NAME: Heffernan Insurance Brokers 18004 Sky Park Circle, Suite 210 ac°NN EXt :9Z5-934-8500 Fvc No): 925-9348278 Irvine CA 92614 RECEIVED AnRtF' hibcertreauestla'�heffins_com CL uu r LL719 'cense#: 0564249 INSURERS AFFORDING COVERAGE NAIC # INSURERA: Hartford Accident & Indemnity Company 22357 INSURED DWJOHNS-01 DW Johnston Construction, ,k1F 71650 Sahara Rd. Suite #2 FICE OF THE CITY CLERK Rancho Mirage CA 92270 COVFRAGFS rFRTIGIf'ATF Kit 1109211=0• 47An904 Ann INSURER Hartford Fire Insurance Company 19682 INsuRERc: Hartford Casual Insurance Com an 29424 INSURERD: Sentinel Insurance Company, Limited 11000 INSURER E: Westchester Surplus Lines Insurance Com an 10172 INSURER F : 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. F INSURANCEINSD ADDL SUBRPo WVQPOLICY NUMBER MM DDY/YYYY MM/DDY/YYYY LIMITS GENERAL LIABILITY Y 72UEABA7Y17 2/5/2025 2/5/2026 EACH OCCURRENCE $1,000,000 MADE OCCUR DAMAGE TO rGEN'LAGGREGATE PREMISES Ea occurrence) nce $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2.000,000 LIMIT APPLIES PER: POLICY II PECOT- LOC HOTHER PRODUCTS -COMP/OP AGG $ 2,000,000 $ A I AUTOMOBILE LIABILITY - 72UEACG2896 2/5/2025 2/5/2026 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANY AUTO $ BODILY INJURY (Per person) OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY ROPERTY DAMAGE Zero $ Per accident C X UMBRELLA LIAR X OCCUR 72HHABA8CTE 2/5/2025 2/5/2026 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 10,000,000 DED X RETENTION $ $ D WORKERS COMPENSATION 72WEAAPOT05 1/1/2025 1/1/2026 X PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 Mandatory in NH) I (f yes, describe under E.L. DISEASE - POLICY LIMIT —__ $ 1,000,000 DESCRIPTION OF OPERATIONS below E Pollution Liability G71671604 001 10/3/2024 10/3/2025 Aggregate Limit $2,000,000 Per Poll. Condition: $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: As Per Contract or Agreement on File with Insured. City of Palm Springs is included as an additional insured on General Liability policy per the attached endorsement, if required. City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 USA V /11\VGLLM 1 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 (0 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THE HARTFORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - OPTION I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Designated Project(s) Or Location(s) Or Or anization s : Of Covered Operations: All, except Additional Insureds that are insured under a separate additional insured endorsement on this policy mtormation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. With respect to those person(s) or organization(s) shown in the Schedule above when you have agreed in a written contract or written agreement to provide insurance such as is afforded under this policy to them, Subparagraph f., Any Other Party, under the Additional Insureds When Required By Written Contract, Written Agreement Or Permit Paragraph of Section II — Who Is An Insured is replaced with the following: f. Any Other Party Any other person or organization who is not an 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 for such additional insured at the project(s) or location(s) designated in the Schedule; (2) In connection with your premises owned by or rented to you and shown in the Schedule; or (3) In connection with "your work" for the additional insured at the project(s) or location(s) designated in the Schedule and included within the "products -completed operations hazard", but only if: (a) The written contract or written agreement requires you to provide such coverage to such additional insured at the project(s) or location(s) designated in the Schedule; and (b) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". The insurance afforded to the additional insured shown in the Schedule applies: (1) Only if the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed: (a) During the policy period; and (b) Subsequent to the execution of such written contract or written agreement; and (c) Prior to the expiration of the period of time that the written contract or written agreement requires such insurance be provided to the additional insured. (2) Only to the extent permitted by law; and Form HS 24 80 07 13 Page 1 of 2 © 2013, The Hartford (Includes copyrighted material of Insurance Services Office, Inc., with its permission.) (3) Will not be broader than that which you are required by the written contract or written agreement to provide ft :h such additional insured. With respect to the insurance afforded to the person(s) or organization(s) that are additional insureds under thi endorsement, 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 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, designs or specifications; or (2) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to the additional insured shown in the Schedule are described in the Limits Of Insurance section. 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, except as otherwise amended below. B. With respect to insurance provided to the person(s) or organization(s) that are additional insureds under this endorsement, the When You Add Others As An Additional Insured To This Insurance subparagraph, under the Other Insurance Condition of Section IV — Commercial General Liability Conditions is replaced with the following: When You Add Others As An Additional Insured To This Insurance (a) 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 Paragraph (c) below. This insurance does not apply to other insurance to which the additional insured in the Schedule has been added as an additional insured. (b) Primary And Non -Contributory To Other Insurance When Required By Contract This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (i) The additional insured in the Schedule is a Named Insured under such other insurance; and (ii) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured in the Schedule. (c) Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. All other terms and conditions in the policy remain unchanged. Page 2 of 2 Form HS 24 80 07 13 , QaLMs,, CITY OF PALM SPRINGS CONTRACT CHANGE ORDER '�q<rxoaN`P To: D.W. Johnston Construction, Inc. Date: December 5, 2019 1445 N. Sunrise Way, Suite 203 Project No: CP 15-16 Palm Springs, CA 92262 Project: Cornelia White House Recon. Change Order Four(4) Final Purchase Order 19-0718 CHANGES IN WORK/COST: New Items: C04A Additional Landscaping and Irrigation $5,000.00 C04B Moving and Storage of Interior Furnishings $2,750.00 Total Net Change Order Amount: $7,760.00 4 I REASON FOR CHANGES C04A At,the request of City Council, the Landscaping and irrigation that was installed at Cornelia White House (CWH), was expanded to include additional plantings and modifications to the irrigation system. This work is being performed and the Lump Sum/Agreed Price of$5,000.00. C04B Prior to beginning construction, the interior furnishings of CWH were carefully packed and moved to climate controlled storage facility. Due to the extended timeline of the project, the furnishings remained in storage for a longer than expected period. This item compensates the contractor for costs incurred for the extended storage of CWH furnishings. This is a Final Contract Change Order and no additional compensation will be made on this project. SOURCE OF FUNDS: 260-4500-59494 SUMMARY OF COSTS: Original Contract Amount: $ 332,319.00 This Change Order: $ 7,760.00 Previous Change Order(s): $ 65,347.89 Revised Contract Amount: $ 405,416.89 [SIGNATURES ON NEXT PAGE] CP 15-16, Cornelia White House Reconstruction Contract Change Order No. 4 Final DATE: December 5, 2019 Page 2 I have received a copy of this Change Order and the above AGREED PRICES are acceptable to D.W. Johnson Construction, Inc. 2�S / Signature Date Printed Name and Title Citv of Palm Springs Recommended Bv: / io t5 Marcus Fuller, Asst. City Manager Date p � L Approved Bv: David H. R i Manager Date Attest Bv: thony Mejia, City Date Distribution: Original Conformed Copy: Conformed - File Copy: APPROVED BY MY COUNCIL Contractor (1) Engineering Pay File (1) f4f, tz 75 .00 'i City Clerk (1) Project City File (1) Purchasing (1) Finance (1) ppLM'sp.., -� CITY OF PALM SPRINGS CONTRACT CHANGE ORDER c�SixoRN`P To: D.W. Johnston Construction, Inc. Date: May 7, 2019 1445 N. Sunrise Way, Suite 203 Project No: CP 15-16 Palm Springs, CA 92262 Project: Cornelia White House Recon. Change Order Three (3) Purchase Order 19-0718 CHANGES IN WORK/COST: New Items: CO3A Drill and Epoxy Anchor Bolts $ 260.00 CO3B Framing for Revised Structural Details (Dining Room) $23,750.00 CO3C Framing for Revised Structural Details (Kitchen) $10,100.00 CO3D Geotechnical Testing for C.I.P. Footings $ 580.00 CO3E Contractors Fee and Insurance $ 2,448.28 Credits for Deleted Items: Bid Item 16 Deleted structural details and Framing (Dining Room) (-$ 3,560.00) Total Net Change Order Amount: $33,578.28 REASON FOR CHANGES All additional costs and credits directly applicable to structural drawing revision #3. SOURCE OF FUNDS: 260-4500-59494 SUMMARY OF COSTS: Original Contract Amount: $ 332,319.00 This Change Order: $ 33,578.28 Previous Change Order(s): $ 31,769.61 Revised Contract Amount: $ 397,666.89 [SIGNATURES ON NEXT PAGE] e :.. .., :a-:, CP 15-16, Cornelia White House Reconstruction Contract Change Order No. 3 DATE: May 7, 2019 Page 2 I have received a copy of this Change Order and the above AGREED PRICES are acceptable to D.W. Johnson Construction, Inc. 6 �" Signature Date aeC-1 0" Printed Name and Title 5 Citv of Palm Sorinas Recommended Bv: Marcus Fuller, Asst. City Manager Date Approved Bv: ISO ' David H. a ity Manager Date Attest Bv: % "7 An ny Mejia, t C rk . Date Distribution: Original Conformed Copy: Conformed - File Copy: gppROVED BY CITY COUNCIL Contractor (1) Engineering Pay File (1) n kt 37,2� A7154 City Clerk (1) Project City File (1) Purchasing (1) Finance (1) pA`M sb- CITY OF PALM SPRINGS ' CONTRACT CHANGE ORDER ,CQS"I F.O RN�P' To: D.W. Johnston Construction, Inc. Date: May 7, 2019 1445 N. Sunrise Way, Suite 203 Project No: CP 15-16 Palm Springs, CA 92262 Project: Cornelia White House Recon. Change Order Two (2) Purchase Order 19-0718 CHANGES IN WORK/COST: New Items: CO2A Drill and Epoxy Anchor Bolts $ 400.00 CO2B Remove and Replace Stone Foundation Cladding $ 1,160.00 CO2C Fabricate %" Steel Straps $ 1,600.00 CO2D Framing for Revised Structural Details $13,060.00 CO2E Remove and Replace All Wood Floors as necessary $24,220.55 CO2F Contractors Fee and Insurance $ 1,957.06 Credits for Deleted Items: Bid Item 16 Deleted structural details and Framing (-$9,420.00) Bid Item 28 Credit for Unused Flooring Allowance (-$6,600.00) Total Net Change Order Amount: $26,377.61 REASON FOR CHANGES All additional costs and credits directly applicable to structural drawing revisions #1 and #2. SOURCE OF FUNDS: 260-4500-59494 SUMMARY OF COSTS: Original Contract Amount: $ 332,319.00 This Change Order: $ 26,377.61 Previous Change Order(s): $ 5,392.00 Revised Contract Amount: $ 364,088.61 [SIGNATURES ON NEXT PAGE] CP 15-16, Cornelia White House Reconstruction Contract Change Order No. 2 DATE: May 7, 2019 Page 2 I have received a copy of this Change Order and the above AGREED PRICES are acceptable to D.W. Johnson Construction, Inc. • Signature Date Printed Name and Title Citv of Palm Springs Recommended Bv: hvL 6.7_ M Marcus Fuller, Asst. City Manager Date Approved Bv: -7 1 74rt ` David 26aidy, City Manager Date Attest Bv: -7 1 A ny Mejia, jtybi-,-� Date Distribution: Original Conformed Copy: Conformed - File Copy: APPROVED BY CITY COh"'s :,` Contractor (1) Engineering Pay File (1) City Clerk (1) Project City File (1) In 6U4 7- WL Purchasing (1) Finance (1) {�PtM s� .. CITY OF PALM SPRINGS . ." CONTRACT CHANGE ORDER cq<rroaN'P To: D.W. Johnston Construction, Inc. Date: October 12, 2018 1445 N. Sunrise Way, Suite 203 Project No: CP 15-16 Palm Springs, CA 92262 Project: Cornelia White House Recon. Change Order One (1) Purchase Order 18-03E3fX CHANGES IN WORKICOST: New Items: A. Temporary Construction Fencing: The original bid did not include the installation of temporary security fencing. This additional item includes the rental of approximately 228 LF of 6 ft high fence panels, 1 double gate and 6 support posts. Also included is the purchase and installation of tan fence fabric. Rental period is four(4) Months. The fence is being rented and installed at the lump sum/agreed price of$1,290.00. B. Furniture Moving and Storage: Prior to construction it was necessary to move and store various furniture items that remained in the house. This item is for the packing, moving and climate controlled storage of the existing furnishings. This work will be completed at the lump sum/agreed price of$2,354.00. C. Builders Risk Insurance Policy: Insurance required by the City in order to execute a contract with the Contractor was not included in the original bid. The contractor has obtained the required insurance and will be reimbursed the lump sum amount of$1,748.00. Total Net Change Order Amount: $5,392.00 SOURCE OF FUNDS: To Be Determined SUMMARY OF COSTS: Original Contract Amount: $332,319.00 This Change Order: $ 5,392.00 Previous Change Order(s): $ 0.00 Revised Contract Amount: $ 337,711.00 [SIGNATURES ON NEXT PAGE] CP 15-16, Cornelia White House Reconstruction Contract Change Order No. 1 DATE: 10/12/18 Page 2 1 have received a copy of this Change Order �and dtthe above AGREED PRICES are acceptable to D.W. Johnson Construction, Inc. Signature Date Printed Name and Title Citv of Palm Springs Recommended Bv: Marcus Fuller, Assk C anager Date Approved Bv: A 2Y I I tqll� Da ' dy, City Manager Date Attest Bv: 11 d" ),b thony M Date Distribution: Original Conformed Copy: Conformed - File Copy: Cpy APPROVED BYr,7v"'!VIACER Contractor (1) Engineering Pay File (1) r_ r �a t Or, . 5N City Clerk (1) Project City File (1) --: Purchasing (1) Finance (1) AGREEMENT (CONSTRUCTION CONTRACT) THIS AGREEMENT made this at day of PkWVAV , 201, by and between the City of Palm,Springs, a charter city, organize 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 D.W. Johnston Construction, Inc., a California corporation hereinafter designated as the Contractor. The City and the Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: ARTICLE 1 --THE WORK For and in consideration of the payments and agreements to be made and performed by City, Contractor agrees to furnish all materials and perform all work required to complete the Work as specified in the Contract Documents, and as generally indicated under the Bid Schedule(s) for the Project entitled: ' CORNELIA WHITE HOUSE EXTERIOR REPAIRS CITY PROJECT NO. 15-16 The Work comprises selective demolition, removals, and performance of structural repairs, exterior repairs, historic preservation, landscaping, and miscellaneous work as outlined in the Contractor's Proposal and Scope of Services included as Attachment "A", excluding the optional fireplace repairs. 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 in accordance with the schedule of performance and frequency of services specified in the Contract Documents. They 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 failure to complete or perform the frequency of services specified in the Contract Documents. In executing the Agreement, the Contractor acknowledges it has reviewed the provisions of the Standard Specifications, as modified herein, related to liquidated damages, and has made itself aware of the actual loss incurred by the City due to the inability to complete the Work within the time specified in the Notice to Proceed. CORNELIA WHITE HOUSE ��{t�������D CITY PROJECT NO.15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGE 1 AN1� � � . MFNT Termination Prior to Expiration of Term. City may terminate this Agreement for its convenience at any time, without cause, in whole or in part, upon giving Contractor thirty (30) days written notice. Where termination is due to the fault of Contractor and constitutes an immediate danger to health, safety, and general welfare, the period of notice shall be such shorter time as may be determined by the City. Upon such notice, City shall pay Contractor for Services performed through the date of termination in accordance with the Contract Documents. Upon receipt of such notice, Contractor shall immediately cease all work under this Agreement, unless stated otherwise in the notice or by written authorization of the Contract Officer. After such notice, Contractor shall have no further claims against the City under this Agreement. Upon termination of the Agreement under this section, Contractor shall submit to the City an invoice for work and services performed prior to the.date of termination. ARTICLE 3 -- CONTRACT PRICE The City.shall pay the Contractor for the completion of the Work, in accordance with the Contract Documents, in current funds the Contract Price(s) named in the Contractor's Bid Proposal and Bid Schedule(s), and any duly authorized Construction Contract Change Orders approved by the City. The amount of the initial contract award in accordance with the Contractor's Bid Proposal is Three Hundred Thirty Two Thousand Three Hundred Nineteen Dollars ($332,319). It is acknowledged and understood that this price is a maximum not to exceed price, to deliver all of the services identified by Contractor as outlined in Attachment "A". Contractor agrees to receive and accept the prices set forth herein, as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Said compensation shall cover all expenses, losses, damages, and consequences arising out of the nature of the Work during its progress or prior to its acceptance including those for well and faithfully completing the Work and the whole thereof in the manner and time specified in the Contract Documents; and, also including those arising from actions of the elements, unforeseen difficulties or obstructions encountered in the prosecution of the Work, suspension of discontinuance of the Work, and all other unknowns or risks of any description connected with the Work. ARTICLE 4 --THE CONTRACT DOCUMENTS The Contract Documents consist of the prevailing rate of per diem wages as determined by the Director of the California Department of Industrial Relations, the accepted Proposal, this Agreement, Worker's Compensation Certificate, Payment Bond, Standard Specifications, Special Provisions, the Drawings, and all Construction Contract Change Orders and Work Change Directives which may be delivered or issued after the Effective Date of the Agreement and are not attached hereto. CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGE 2 ARTICLE 5 -- MUTUAL OBLIGATIONS For and in consideration of the payments and agreements to be made and performed by the City, the Contractor agrees to furnish all materials and perform all work required for the above stated project, and to fulfill all other obligations as set forth in the aforesaid Contract Documents. City hereby agrees to employ, and does hereby employ, Contractor to provide the materials, complete the Work, and fulfill the obligations according to the terms and conditions herein contained and referred to, for the Contract Price herein identified, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the Contract Documents. Contractor specifically acknowledges and agrees to be bound by the Wage Rates and Labor Code requirements specified in the Contract Documents, including the requirement to furnish electronic certified payroll records directly to the Labor Commissioner (via the Division of Labor Standards Enforcement), and shall pay the general prevailing rate of per diem wages as determined by the Director of the Department of Industrial Relations of the State of California. ARTICLE 6 -- PAYMENT PROCEDURES The Contractor shall submit Applications for Payment in accordance with the Standard Specifications as amended by the Special Provisions. Applications for Payment will be processed by the City Engineer as provided in the Contract Documents. ARTICLE 7 -- NOTICES Whenever any provision of the Contract Documents requires the giving of a written Notice between the parties, it shall be deemed to have been validly given if delivered in person to the individual or to a member of the firm or to an officer of the corporation for whom it is intended, or if delivered at or sent by registered or certified mail, postage prepaid, to the last business address known to the giver of the Notice. ARTICLE 8 -- INDEMNIFICATION The Contractor agrees to indemnify and hold harmless the City, and all of its officers and agents from any claims, demands, or causes of action, including related expenses, attorney's fees, and costs, based on, arising out of, or in any way related to the Work undertaken by the Contractor hereunder. This Article 8 incorporates the provisions of Section 7-15 "Indemnification," of the Special Provisions, which are hereby referenced and made a part hereof. Prevailing Wages. Contractor agrees to fully comply with all applicable federal and state labor laws including, without limitation California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGE 3 16000, et seq. ("Prevailing Wage Laws"). Contractor shall bear all risks of payment or non-payment of prevailing wages under California law, and Contractor hereby agrees to defend, indemnify, and hold the City, its officials, officers, employees, agents and volunteers, free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. ARTICLE 9 — CONFLICT OF INTEREST & NON-DISCRIMINATION 9.1 Non-liability of City Officers and Employees. No officer or employee of the City shall be personally liable to the Contractor, or any successor-in-interest, in the event of any default or breach by the City or for any amount which may become due to the Contractor or to its successor, or for breach of any obligation of the terms of this Agreement. 9.2 Conflict of Interest. Contractor acknowledges that no officer or employee of the City has or shall have any direct or indirect financial interest in this Agreement nor shall Contractor enter into any agreement of any kind with-any such officer or employee during the term of this Agreement and for one year thereafter. Contractor warrants that Contractor has not paid or given, and will not pay or give, any third party any money or other consideration in exchange for obtaining this Agreement. 9.3 Covenant Against Discrimination. In connection with its performance under this Agreement, Contractor shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin (i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition (each a "prohibited basis"). Contractor shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City's lawful capacity to enter this Agreement, and in executing this Agreement, Contractor certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any-Contractor activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Contractor is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. ARTICLE 10 -- MISCELLANEOUS Terms used in this Agreement which are defined in the Standard Specifications and the Special Provisions will have the meanings indicated in said Standard Specifications and the Special Provisions. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically, but without limitation, monies CORNELIA WHITE HOUSE CITY PROJECT NO. 15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGE 4 that may become due and monies that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment, no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. The City and the Contractor each binds itself, its partners, successors, assigns, and legal representatives, to the other party hereto, its partners, successors, assigns, and legal representatives, in respect of all covenants, agreements, and obligations contained in the Contract Documents. SIGNATURES ON NEXT PAGE CORNELIA WHITE HOUSE CITY PROJECT NO. 15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGE 5 IN WITNESS WHEREOF, the City and the Contractor have caused this Agreement to be executed the day and year first above written. CITY OF PALM SPRINGS, APPROVED BY THE CITY COUNCIL: CA IFORNIA Date lv I� 5.d- y David H. Ready AI(5q City Manager Agreement No. ATTEST: By Anthon J. , MMC ?ity Clerk APPROVED AS TO FORM: Edward Z. Kotkin City Attorney RECOMMENDED: dl Marcus L. Fuller, MPA, PE, PLS Assistant City Manager CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGEP(p CONTRACTOR By: D.W. Johnston Construction, Inc., a California corporation Firm/Company Name By: By:.- Signatu notarized) Signature(notarized) Name: T'12c.t� Name: Title: Title: 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. (This Agreement must be signed in the above (This Agreement must be signed in the above space by one having authority to bind the space by one having authority to bind the Contractor to the terms of the Agreement.) Contractor to the terms of the Agreement.) n State of h ' State of ) County of K84 `t ss County of )ss On � On before me, - before me, personally appeared _,��t�Y personally appeared who, proved to me on the basis of satisfactory who proved to me on the basis of satisfactory evidence to be the person(,s'f whose name(s) evidence to be the person(s) whose- name(s) is/ayesubscribed: to the within instrument and is/are subscribed to the within instrument and acknowledged to me that 44she/toey executed. acknowledged to me that he/she/they executed the same in hK/her/tl?fir authorized capacity, the same in his/her/their authorized capacity(ies), and that by t d/her/their signatures(sf on the and that by his/her/their signatures(s) on the instrument the personal, or the entity upon behalf instrument the person(s), or the entity upon behalf of which the person(61 acted, executed the of which the person(s) acted, executed the instrument. instrument. I certify under PENALTY OF PERJURY under the I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing laws of the State of California that the foregoing paragraph is true and correct. paragraph is true and correct. WITNESS my ha d -fficial seal. WITNESS my hand and official seal. Notary Signature: ""�"' Notary Signature: Notary Seal: Notary Seal: odb Y.GARCIA CABRERA Notary Public.California Riverside County is Commission k 2237245 emy Comm.Expires Apr 25,2022 CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGE7 ATTACHMENT "A" FOLLOWS THIS PAGE CORNELIA WHITE HOUSE CITY PROJECT NO. 15-16 AGREEMENT FORM APRIL 30,2018 AGREEMENT AND BONDS-PAGEYC r �UCI� 1445 N.Sunrise Way,Suite 203,Palm Springs,California 92262 Ca.State Contractors License#B699640 P:760-416-1144 F:760-416-1 124 DWJohnston.com May 22,2018 Over the past 4.5 years we have put together multiple cost estimates for the renovation of The Cornelia White House. Our approach has philosophically always been the same. We have been working with subcontractors and vendors,in an effort to build a team who understands the historical significances for the residents& visitors of Palm Springs. Many of our subcontractors who have gotten involved with this project realize the importance of contributing to this community effort and have reduced cost by furnishing material at a reduced cost or simply not charging for them,and or, have reduced their profit margins accordingly. D.W.Johnston Construction Contributions: Furnish all necessary labor and material to remove existing landscaping material and install per new plans prepared by Desert Modern Landscaping. Including but not limited to removal of existing irrigation piping and heads,valves. Furnish all clean fill necessary for all landscape berms. Installation of drought tolerant plant material and rose garden as requested. Savings estimated at$29,000.00 Reduce contractors fee from original established fee of 10%of cost to a fee of 6%of cost for structure. A savings of approximately$12,280.00. Reduced supervision and project management costs by$7,040.00. Offered not to exceed allowances for the following general condition line items. Any dollars that remain in the following allowances will be awarded back to The City of Palm Springs. 1. Temporary utilities 2. Barricades and protection 3. Shoring 4. Air quality scrubbers S. Construction materials Sub-contractors and vendors contributions: 2-010 Demolition—Universal General and Engineering has reduced their fee for this work from 15%of cost to 10%of cost,savings of approximately$800.00. 2-120 Finish grade/drainage swales 2-120-1 Irrigation Mark Logan Landscape has waived all profit for these scopes of services. Logan Landscape will charge only for cost of burdened labor and cost of all materials purchased to perform respective scopes of services. 3-010 Foundation footings and piers. Summit Framing has reduced profit from 15%to 10%for this respective scope of work. Summit is to provide all labor and materials necessary to prepare the forming of the foundation system. United Brothers Concrete has offered to place all necessary concrete for direct cost of labor and materials waiving their profit for this scope of work. 6-030 Structural repairs carpentry damaged floor beams. Summit Framing has reduced their fee from 15%to 10%, a savings of approximately$2,200.00. 6-030-1Siding Allowance. Summit framing in collaboration with D.W.Johnston Construction will make best efforts to recondition and reinstall wood siding. All siding that cannot be.reused or repurposed will be repaired with the material and distressed according to retain the same aesthetic of what is currently installed. Summit Framing has reduced their fee from 15%to 10%. 6-030-2 Railroad Tie Repair. D.W.Johnston Construction is furnishing labor in an effort to self-perform this scope of services to save subcontractor mark up. 6-040-1 Doors and Trim Interior Paneling. D W.Johnston will perform this work at cost in an effort to save sub-contractor mark up. 7-010 Waterproofing&Sealants. R.Sanchez Painting is performing this work at cost plus 8`Yo,this is a reduction in his fee structure by 7%. 7-020 Roofing-Al Miller Roofing has agreed to perform this work at cost. Waiving their profit for this scope of work. 7-030 Copper Flashing—Uselman Heating and Air Conditioning is performing this scope of works at a cost plus and have reduced their profit margin by 5%. 8-040 Windows—D.W.Johnston Construction will remove,and shop repair all windows and doors to original specification,estimates for this scope of work provided to D.W.Johnston by sub-contractors exceeded$35,000.00 in value. Proposed saving of approximately$6,725.00 9-010 Plaster and Sound Board Patch—Universal Construction has reduced their fee from 15%of cost to 10%of work cost. 9-030 Exterior Painting 9-035 Interior Painting R.Sanchez Painting has proposed to repaint the entire outside of this structure and perform interior paint to match for cost plus and 8%fee. Which is a savings of 7%of their average fee. 9-060 Wood Floor Allowance—The Works Floor and Wallis performing all work necessary to patch and.or repair all wood flooring removed for the purpose of performing structural repairs.This work will be performed on a basis of cost of material and cost of labor. The Works is waiving their traditional overhead and profit for this project. 15-030 HVAC Revised—All work performed by Uselman Heating and Air Conditioning will be performed at cost plus 7%. 16-010 Electrical 16-020 Electrical Fixture Removal and Reinstallation LaSalle Electric is donating the necessary material and will be preforming labor at a cost plus 8% fee. Outline Scope of Services Cornelia White House 1. Demolition/Prep Work a. Exterior 1. Remove screen wall at HVAC unit.Prepare for new fencing and equipment enclosures. ii. Remove and salvage existing building board and batten siding. Boards will be evaluated for Integrity and material compatibility. The intent will be to reuse the boards which should allow a more consistent level of finish for the exterior of the building. ill. Remove existing grass and plant material to allow for new drought tolerant palate. iv. Prepare windows and doors that are in need of modification due to dry rot and/or severe weathering. v. Regrade drain swales and prep for new drought tolerant landscape DW Johnston will engage the services of Desert Modern Landscape to assist in preparing a landscape and irrigation plan. b. Interior i. Removal of interior plaster and soundboard products at areas required to allow for the installation of the structural floor to wall to roof connections as designed by RA Engineering 2-100 Construct new air conditioning enclosure and mechanical screen at West Side of building. Materials will be 1 x 6 cedar boards with cedar wood lath battens. 2-120 Install landscape material and irrigation material to provide for efficient maintenance and water use. Plan to be prepared by Desert Modern in collaboration with DW Johnston and Desert Water Agency compliancy. 3-010 Provide material and labor to install concrete piers and footing per structural drawings prepared by RA Engineering. 4-010 Masonry: specified work in this division to remove and reconstruct the fireplace is not included in this scope of services. 5-010 Provide all necessary rough hardware as specified in the structural drawings prepared by RA Engineering. This does not include hardware necessary to dismantle and reassemble the stone fireplace. No work is to be performed in this area. 6-030 Structural repairs will be performed as noted on RA Engineering structural plans. Including: wood floor repair, stem wall repair, installation of plywood shear panels, and installation of all structural hardware. Beam repair and replacement as specified. 6-030-1Repair and replace exterior wood siding material as required due to existing conditions. All replacement materials will be like in form and installation practice. Based upon the condition some boards may need to be enhanced and treated with a wood epoxy based system as recommended. Fasteners will be installed with methods and means to meet recommended requirements. The reconditioned or new siding products will be installed over the plywood shear panels that are attached to the wood framed walls. A single ply adhering vapor barrier will be installed over the plywood shear walls. The self-adhered membrane will receive an additional layer of double 60 minute building paper. 6-030-2 Floor sills and cross tie — repairs will be made as noted in the plans and specifications prepared by RA Engineering. 6040-1 Doors and trim and interior paneling—reinstallation of doors and trim to allow for all structural work that is necessary to perform. Best efforts will be put forth to reuse existing materials that were removed during the demolition phase of the work. In the event that the existing material cannot be reinstalled,contractor will install"like for like"materials where and when possible. 7-010 Sealants—apply necessary sealants at sill plates and wood to masonry/concrete transitions. 7-030 . install a copper flashing break metal at masonry to wood framed walls that receive the exterior siding application. This metal is designed to break approximately N beyond the exterior siding. The metal will be bent as to allow water.to flow away from the wood surfaces. This flashing will be placed in a bed of sealant vertically and horizontally and attached with specified fasteners. 7030-1. Install new galvanized sheet metal flashing at fireplace to roof transition. 8-040 Windows—Remove windows as noted in demolition to enable contractor to repair and/or replace all parts as necessary. This scope of work may require the use of the recommended wood epoxy system in conjunction with the restoration process. All hardware that was removed during the restoration process will be reinstalled accordingly. 9-010 Patch interior wall and ceiling finishes with sound board and interior plaster as necessary using like materials at areas affected by structural repairs per RA Engineering plans and specifications 9-030 Exterior painting—color match exterior paint and/or stain colors. Prepare all exterior surfaces by removing existing paint scale,flaking,and chipping due to weathering. Prime all walls with products as specified to meet restoration guidelines. All caulking and sealants will meet state VOC regulations and will be conducive with the paint specifications. 9-035 Interior paint—prep interior surfaces at areas affected by structural repairs to receive one(1)coat of primer and two finish coats of paint with comparable sheen and finish to what currently exists. 9-060 Wood floor—replace floor at areas where required do to structural repairs with salvaged or new "like" materials due to crawl space accessibility. Floor will be sanded and refinished as necessary. 15-010 Remove and reinstall plumbing fixtures due to shear panel installation. 15-030 HVAC—Installation and stabilization of new HVAC duct work in the crawl space. Replace existing HVAC unit with new equipment per submittal. 16-010 Electrical—rewiring of unsound wiring conditions in crawl space, including but not limited to, new wire, conduit,junction and distribution boxes. Removal of conduit and wiring mounted to the exterior surfaces of the building. All efforts will be made to place conduits in wall connectors. 16020 Remove and reinstall all fixtures required to be removed during the restoration process. EXCWSIONS • Repairs or reconstruction of front porch railing no design available j • Termite,rodent or other pest control measures • Mold removal or remediation • Replacement of any plumbing fixtures • Signage • Perimeter Fencing • Relocation of HVAC Equipment OPINION OF PROBABLE COST CORNELIA WHITE HOUSE 512212016 CODE DESCRIPTION OF WORK COST 1-000. GENERAL CONDITIONS 1-190 Untingency 1-010 Plana&architect 4,056 1.020 Engmeer stalting By Owner i-030 Soils testing allowance Owner 1-030-1 Structural Eng.Inspectmns By Owner 1-040 Permits By Oyer 1-050 Fees&assessments 13Y Owner 14XD Temp.utilities 1,935 1-070 Bamcades Protection 2,360 1-070.1 Short 9000 1-070.2 Alr Control/Air Scrubbem 1,050 1.090 R h clean-Up W Owner 1.095 Final clean-up Owner 1-110 Sup=sm 15 000 1-130 General labor 3853 1-135 Debris ramoval By Owner 1.170 Conminxtion materials 1,250 2-000 SITE WORN 2.010 Oemotitian 16 326 2-040 Drainage 1050 2-050 Utility trenchi 0 2-100 Fences and Gates E uI eni Area 7,240 2.110 Finch Grade I Drainage Swales 1,500 2-120 Larxiscape 0 2.120.1 Irogation 7,053 2.130 Landscape lighting 0 3-M CONCRETE . 3-010 Foundation Footings,Bets 19.8m 3-035 Chemical SaI Treatment 0 4tb fkkSONRY : . 4-010 Mason Stone Walls 0 4-010-1 Remwe aril R face Chim Stone 0 5-000 METALS. 5-010 Rouqh Hardware fi 500 6-OW , WOOD&PLASTIC 6-030 Structural Repairs I Carpentry I Danuged Floor Beam 4B 569 6-030.1 Siding Allowance 26.J46 M30-2 Railroad The Re Per HSPB 2113118 it 6 T 9 15 x4n r.,narsF t 1 1128 6-040-1 Deors Trim and Interior Paneli 8,7001 7-000 RM' THE .&MOIS'T.t°1Rti 01 7-010 Waterproofi2q&Sealants 7 151 7-020 Roos -Remove and Replace at Chimney 6,405 7-M ICGpw FilashIng at Wood Wall to Stone Wall 135 lineal feet 0,923 7.030-1 Galvanizect Flashina at ChimneV and Root Transitions 2104 7-040 Insulation 0 8-000 DOORS&YANDOWS - 8-040 Windows 28.275 8 07p Finish Hardware D 94100 FINISHES 9710 Piaster/Sound Board Patch 17.565 9-020 Drywall 0 9.030 Exterior PaintEi 16.400 9.035 Interior Paint 4,986 94360 Wadi Flooring Allowance t? l 10.000 SPECIALTIES, 10-030 Silinage By Owner 15-000 MECHANICAL 15-010 Plumbi WA 15-030 HVAC REVISED 13,750 16-LU ELECTRW.AL 16-010 Electrical/Ciean u Win Conduct on extenor arrd in Crawl Space 8,302 16�020 Surface Mounted Fixtures 1 Remove and Replace 888 1-001 Overhead&Fee 18.460 i.100 Liabitilyinsurance 6196 TOTAL 332,319 phool-ace Repair Otscion 35530 includes demo h Ca rebui;dirm stone fits rc d removal and rrergir at fit t interiortinish re and birth touch uo in IMN roam' Overhead and Fee 2.132 Liabil' Insurance 716 TOTAL 38,377 WORKER'S COMPENSATION CERTIFICATE' (AS REQUIRED BY SECTION 1861 OF THE CALIFORNIA LABOR CODE) I am aware of the provisions of Section 3700 of the California Labor Code, which require every employer to be insured against liability for worker's compensation,. or to undertake self-insurance in accordance with the provisions of said Code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Contractor '� � By Title Cm CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 WORKER'S COMPENSATION CERTIFICATE JANUARY 11,2018 AGREEMENT AND BONDS-PAGE 1 Contractor Spec Description Sample from Urrutia IDC/David Volz Notes Person 1st Draft? 02060 Demo .02060-building demolition 024113-outside? Donn y 2100 Air conditioning Screens-wood panels Wood slats-quick spec with sealant Bill y 2120 Landscaping 32 90 00;32 90 10 Minor work-grass r&R Donn y 3000 Concrete piers and footings 03000-Concrete,General Use structural plans Donn y 5010 structural hardware Use structural plans Reza y 6030 Structural repairs Use structural plans Reza y 6030-1 Repair and replace exterior wood siding Use report to B&S Bill 6030-2 Floor sills and cross tie Use structural plans Reza 6040-1 Doors and trim and interior paneling 08210-Wood Doors and Frames 7010 Sealants 79000 Joint Protection IDC-pdf only 7030 Copper flashing break metal at masonry to wood framed walls 076200 Sheet metal flashing and trim IDC-pdf only 8000 Windows 08166-Sliding Glass Doors and Windows 9030 Exterior painting 09900 Painting 9035 Interior paint 09900 Painting 9060 Wood floor—replace floor with salvaged or new"like"materials due to demolition for crawl space accessibility.Floor will be sanded and refinished to blend with existing floor finish. 09645 Hardwood Flooring 15010 Remove and reinstall plumbing fixtures due to shear panel installation. 224000 Plumbing Fixtures IDC-pdf only 15030 HVAC—installation and stabilization of new HVAC duct work in the crawl space. This work includes all necessary transition housings for in floor registers. 15655 HVAC 16010 Electrical—rewiring of unsound wiring conditions in crawl space,including but not limited to,new wire,conduit,junction and distribution boxes.Removal of conduit and wiring mounted to the exterior surfaces of the building.All efforts will be made to place conduits in wall connectors. 16123 Building Wire and Cables 16020 Remove and reinstall all fixtures required to be removed during the restoration process. EXHIBIT "A" CONDITIONS OF APPROVAL Certificate of Approval - City of Palm Springs Cornelia White Residence Stabilization and Restoration 219 South Palm Canyon Drive (Village Green Park) Case HSPB #4 February 13, 2018 The applicant shall incorporate the following conditions of approval into the scope of the project. 1. Require a "control sample" be produced showing repair/patching/replacement of key components such as the railroad ties and board and batten siding for approval by 1he','City prior to proceeding with the work. This should include examples of railroad tie "Dutchman" patches, end-to-end angled cut at vertical butt joints between wood members, application of sealants, proper wood species, dimensions, surface finish, etc. 2. Replace the existing air conditioning condensing unit and system with a higher SEER-rated system and relocate the new unit away from the front of the house, perhaps behind the house where it is less conspicuous. 3. Omit the proposed installation of sealants at the transition between the wood sill plates and the masonry foundation wall to avoid trapping moisture within the wall assembly and to allow moisture that does accumulate to weep out. Provide sealant at all vertical joints in wood members as proposed. At batten strips, sealants and adhesives should be applied at the back side of the strips where possible to.retain the historic appearance of this detail. 4. Cut in a minimum % inch vertical gap "drip edge" on the bottom edge of any wood member that is in contact with the top of the masonry foundation wall to prevent water that collects on the top of the masonry foundation wall or that runs down the surface of the wood from seeping up into the wood. Provide flashing at that interface that is properly attached to the vapor barrier such that moisture is not trapped in the joint. Provide properly detailed flashing at window heads, and at ductwork penetrations of the exterior wall surface. 5. Via scraping, confirm the original exterior paint color and use that color in repainting,the structure. (Note green paint on window muntin on west elevation shown in ARG report page 21.) Apply borate preservative treatment and water repellant treatments as outlined in ARG report page 29. 6. Properly implement treatment recommendations (epoxy, Dutchman and other wood repairs, flashing, sealants, etc. as outlined in the ARG report and appendices. Assure all replacement wood is properly seasoned and dried to reduce shrinkage, warping, splitting, etc. 7. Salvage and re-install railroad spikes, notches or other "distressed" conditions that exist in wood members to be replaced to assure the historic appearance is retained. Where it is necessary to remove original railroad ties, any solid portions of such ties should be salvaged and re-used for Dutchman repair to enable these patches to match the surface texture and appearance of other original ties to be retained as closely as possible. 8. Where plumbing fixtures must be removed, replace with water efficient fixtures. 9. Cut in a drip edge"kerf' at the underside of the belt course railroad ties to minimize water running down the surface of the wood railroad ties below. 10.Treat any evidence of mold within the structure and repair any water damaged interior finishes. 11.Interior replacement surfaces and materials should be detailed as much as possible to be consistent with a "lath and plaster" assembly commonly used during the historic period of the home. 12.Consult with a landscape historian to revise'the landscape plan approved in 2012 (Cioffi Architects sheet L-1) with alternative plant choices to more closely reflect the natural desert setting that was in the area at the. time of the home's construction. 13.Treat the structure for termites, rodents, and other pests. 14.Review ARG report page 19 regarding porch railings. It appears these do not reflect the original character and detailing and should be removed. If new safety barriers are required, they should be detailed separately from the historic structure and visually differentiated per the Secretary of the Interior Standards. 15.As recommended in the RA report page 7, replace wood members that show two inches or more of decay depth. 16.Replace-flush door on the south side of the structure with a solid panel type wood door appropriate for the period of the structure. 17.In lieu of re-installing the large wood sign on the northeast corner of the house, install the City's standard cast bronze historic marker with relevant text relating to the house provided by the Department of Planning Services. (end of conditions) EXCERPTS OF MINUTES At the Historic Site Preservation Board meeting of the City of Palm Springs, held February 13, 2018, the Historic Site Preservation Board took the following action: 3.A. A CERTIFICATE OF APPROVAL REQUEST BY THE CITY OF PALM SPRINGS FOR STABILIZATION AND REHABILITATION OF THE CORNELIA WHITE RESIDENCE, A CLASS 1 HISTORIC SITE LOCATED AT THE VILLAGE GREEN PARK (221 SOUTH PALM CANYON DRIVE), HSPB #4, (ZONE CBD) AND A CATEGORICAL EXEMPTION PURSUANT TO CEQA. (KL) Staff member Lyon summarized the staff report and introduced Councilmember J.R. Roberts who further summarized the scope of work. Member Dixon inquired how long the project might take (Councilmember Roberts suggested around 6 months). Member Dixon asked about proper construction fencing and signage to explain the project and Councilmember Roberts advised that was possible and there was thought about also placing a "donation box" at the site for citizens and visitors to contribute. Assistant City Manager Marcus Fuller joined the meeting and explained it was their desire to take the project to City Council for approval in March and construction could potentially start in the next few months. Member La Voie suggested the process be fully documented of existing, in process and final product photo/video documentation. He also asked about how new work would be differentiated from original materials. Staff member Lyon further clarified the expectations of the new work blending with the original is the goal, even though exact replication of new materials to appear as old will be difficult and thus a control sample should be established to set a standard for the degree of match between the new and existing materials. Councilmember Roberts pointed out that the new technology materials such as vapor barriers, seismic shear -panels, etc. would be concealed within the reconstructed exterior walls and would not generally be seen. Member Marsh asked about photo-documentation through the process. Councilmember Roberts noted it would be important to produce a record for the future. Chair Johns asked Palm Springs Historical Society's Jeri Vogelsang about also helping videograph the project process. Member Burkett inquired of Mr. Fuller about the chimney reconstruction. Mr. Fuller noted the reconstruction of the chimney was deemed to be too destructive and thus was not part of the current proposed project. The chimney will be structurally tied to the structure of the house. Member Burkett suggested the video record may-be a good piece of information for next year's National Preservation Month Symposium M/S/C (Dixon/La Voie) to approve the certificate of approval subject to conditions (attached to this minute excerpt) and that the project have a video/photographic record of the process. (7-0.to approve.) I, JOANNE BRUGGEMANS, Administrative Secretary for the City of Palm Springs, hereby certify that the above action was taken by Historic Site Preservation Board of the City of Palm Springs on the 13th day of February, 2018, by the following vote: AYES: Johns, Burkett, Hays, La Voie, Dixon, Kiser, Marsh NOES: None ABSENT: None Joanne Bruggemans Administrative Secretary 7-3 LIAMLITY INSURANCE. DELETE in its entirety and SUBSTITUTE the following: The insurance provisions herein shall not be construed to.limit the Contractor's indemnity obligations contained in this contract. ADD: 7-3.1 Policies and Procedures. The Contractor shall procure the insurance described below, at its sole-cost-and-expense, to provide coverage against claims for loss including injuries to persons or damage to .property, which may. arise out of or in connection with the performance of the Work,by the Contractor, the Contractor's agents,, representatives, officers, employees or subcontractors. At a minimum, on all contracts, Commercial General Liability, Commercial.Automobile Liability, and Worker's Compensation insurance shall be provided. Depending upon the type of construction, nature and location of the Work, the Engineer,reserves the right to require the additional policies of insurance related to: Builders Risk (REQUIRED) If the Contractor determines these insurance policies are not applicable to the Work,the Contractor shall request the Engineer's waiver of a requirement to submit these insurance policies within 5 working ,days receipt of,.City's Notice of Award. All required insurance policies must be returned with the Contractor's executed Agreement. The Contractor shall maintain this insurance for the -duration of this contract and at all times thereafter when the -Contractor. is. correcting, ..removing, or replacing Work in accordance -with this contract. The Contractor's liabilities under this contract, e.g.,, the Contractor's indemnity obligations, shall not be deemed limited to the insurance coverage required by.this contract. Payment for. insurance shall be included ;in the various items of Work as bid by the Contractor, and except as specifically agreed to by the City.in writing, the Contractor shall not be entitled to any additional payment. The Contractor shall not begin any work under this contract until. it has provided and the City has approved all required insurance. Policies of insurance shall-provide that.the City is entitled to 30 days (ten days for cancellation due. to non-payment of .premium) prior written notice of cancellation or.non-renewal of the policy. Maintenance of specified.insurance coverage is a material element of this contract and. the'_Contractor's.failure to maintain or renew coverage or to provide evidence of renewal during the term of this contract may be treated by the City as a material breach of contract. -ADD: 7-3.2 Types of Insurance. 7-3.2.1 Commercial General Liability Insurance. Commercial General Liability Insurance written on the current version .of, the ISO Occurrence.form CG 0001 or an equivalent form providing coverage at least as broad.The policy shall cover liability arising from premises and operations, XCU (explosions, underground, and collapse), independent o o contractors, products/completed operations, personal injury and advertising injury, bodily injury, property damage, and liability assumed under an insured's contract (including the tort liability of another assumed in a business contract).There shall be no endorsement or modification limiting the scope of-coverage for either. "insured vs. insured" claims or contractual liability. All.costs of defense shall be outside the policy limits: Policy coverage shall be in liability limits of not less than the following: (a) $1,000,000 for each,occurrence (combined single limit for bodily injury and property damage) (b) $2,000,000 aggregate for products=completed operations. (c) $1,000,000 umbrella or excess liability. (d) Umbrella or excess policy shall follow form over the Contractor's General Liability coverage and shall provide a separate aggregate limit for products and completed operations coverage. The,umbrella or excess policy shall contain a clause stating that it takes effect(drops down) in the event the primary limits are impaired or exhausted. . 7-3.2.2 Commercial Automobile Liability Insurance. The Contractor shall provide a Policy or policies of Commercial Automobile Liability Insurance written on the current version of the ISO form CA 00 01 12 90 or later version or equivalent form providing coverage providing coverage at least as broad in the amount of $1,000,000 combined single limit per accident, covering bodily injury and property damage for owned, non- owned and hired automobiles ("Any Auto"). All costs of defense shall be outside the limits of the policy. . 7-3.2.3.Contractors Builders Risk Property Insurance. The Contractor shall provide at its expense, and maintain until Final Completion and Acceptance_of the Work, a Special Form Builders Risk Policy or Policies. This insurance shall be in an:amount equal to the. replacement cost of the completed Work (without deduction for depreciation) including the cost of excavations, grading, and filling. The policy or policies limits shall be 10.0% of this contract value of the"Work plus 15% to cover administrative costs, design costs, and the , costs of inspections and construction management. Insured property shall include material or portions of the'Work located away from the Site but intended for use at the Site, and shall cover material or portions of the Work in transit. -The policy or policies_ shall include as insured property scaffolding,. falsework, and temporary buildings located at the Site. The policy or policies -shall cover the cost of. removing debris, including demolition. The policy or policies shall provide that all proceeds thereunder shall be payable to the City as Trustee for the insureds, and shall name-the City, the Contractor, Subcontractors, and suppliers of all tiers as named insureds. The City asTrustee shall collect, adjust, and receive all monies which may become due and payable under the policy or policies, may compromise any and all claims thereunder, and .shall apply the proceeds of such insurance to the repair, reconstruction, or replacement of the Work. . o 0 Any deductible applicable to the insurance;shall be identified in the policy or, policies documents and responsibility for paying the'part of any loss not covered because of the application of such deductibles shall be apportioned among the.parties except.for the City as follows: if there is more than one claimant for a.single occurrence,, then each claimant shall pay a pro-rata share of the per occurrence deductible based upon the percentage of their paid.claim to the total paid for all insureds. The City shall be entitled to 100% of its loss. Any portion of that loss not covered because of a deductible shall be paid to the City by the Contractor at the same time the proceeds of the insurance are paid to the City as trustee. Any insured,other than the City, making claim to which a deductible.applies shall be- responsible,, for 100% of the loss not insured because of the deductible. Except as provided,for under California law, the. policy or policies shall provide that the City is entitled to 30 days prior written notice (10 days for cancellation due to non-payment of premium) of cancellation or non-renewal of the policy or policies. ADD: 7-3.3 Rating Requirements. Except for the State.Compensation Insurance Fund, all ,insurance required by this contract as described herein shall be carried only by responsible,insurance companies with a rating of, or equivalent to, at least "B++, VII" by A.M. Best Company, that are authorized by the California Insurance Commissioner to do business in the State, and that have been approved by the City. 7-3.3.1 Non-Admitted Carriers. The City will accept insurance provided by non=admitted, "surplus lines" carriers only if the carrier is authorized to do business in the State and is included on the List ofEligible Surplus Lines Insurers (LESLI list). All policies of insurance carried by non-admitted carriers shall be subject to all of the requirements for policies of insurance provided by admitted carriers described herein. . ADD: 7-3A Verification of Coverage. Contractor shall furnish City with both certificates of insurance and endorsements, including additional insured endorsements, affecting all of the coverages required by the contract, The certificates and endorsements are to be . signed by a person authorized by that insurer to bind coverage on its behalf. All proof of insurance As to;be received and approved. by the City before work commences. City reserves the right to require Contractor's insurers to provide.complete, certified copies of all required insurance policies at any time. Additional insured endorsements are not required for Errors and Omissions and Workers' Compensation policies. Verification of Insurance coverage may be provided by: (1) an.approved General and/or Auto Liability. Endorsement Form-for the City of Palm_ Springs or (2) an acceptable Certificate of Liability Insurance .Coverage with an ' approved Additional Insured Endorsement with the following endorsements stated on the certificate: 1.- "The. City of Palm Springs, its officials, employees, and agents are named as an additional insured..." (`as respects City of Palm Springs City Project No. " or "for any and all work performed with the City',may be included in this statement). o 0 2. "This insurance is primary and non-contributory over any insurance or self-insurance the City may have..." Cas respects City of Palm Springs City Project No. " or `for any and all work performed with the City' may be included in this statement). 3. "Should any of the above described policies be canceled before the expiration date thereof, the issuing company will mai1.30 days written notice to the Certificate..Holder named." Language 'such as; "endeavor to" mail and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its-agents or representative" is not acceptable and must be crossed out. 4. Both the Workers' Compensation .and Employers' Liability policies shall contain the insurer's waiver of subrogation in favor of City, its elected officials, officers, employees, agents, and volunteers. In addition to the endorsements listed above, the City of Palm Springs shall be named the certificate holder on the policies. .All certificates of insurance and endorsements are to be received and approved by the City before work commences. All .certificates of insurance must be authorized by a person with authority:to bind _.coverage,. whether that is .the authorized agent/broker or insurance underwriter. Failure . to obtain the.. required documents prior to.the commencement of work shall not waive the Contractor's obligation to provide#hem. ADD: 74A Other Insurance Requirements. The following provisions shall apply to the, insurance policies required of Contractor under the contract: a) For any, claims related to the .contract, Contractor's coverage_ shall be .primary insurance with respect to the City and its officers, council members, officials, . employees, agents, and volunteers. Any insurance or self-insurance maintained by the City and its officers, council members, .officials, employees, agents, and volunteers shall be in excess of Contractor's insurance and shall not contribute to it. b) Any failure to comply with. reporting or other provisions of the policies, including breaches of warranties, shall not affect coverage provided to City and its officers, council members,.officials; employees, agents; and volunteers. c) All insurance coverage.and limits provided by Contractor.and available or applicable to the contract are intended to apply to each insured, including additional insureds, against whom a claim .is made or suit is brought.to the full extent of the policies. Nothing contained in the contract or any other agreement relating to the City.or its operations shall limit the application of such insurance coverage. d) No required insurance, coverages may include. any limiting endorsement which substantially impairs the coverages set forth in 'the contract. (e.g., elimination of contractual liability or reduction of discovery period), unless the endorsement has first been submitted to the Engineer and approved in writing. o 0 e) :Contractor agrees to require its insurer to modify insurance endorsements to delete any exculpatory wording stating that failure-of the insurer to mail`written.notice of cancellation imposes no obligation, or that any party will "endeavor" (as opposed to being required) to comply with the requirements of the endorsements. Certificates of insurance, will not be accepted in lieu of required endorsements, and .submittal of. certificates without required endorsements may delay commencement of the Work. It is Contractor's obligation to, ensure timely compliance with all insurance submittal requirements as provided in the contract. f) Contractor agrees to ensure that subcontractors; and any other parties involved with the Project who are brought onto or involved in the Project by Contractor, provide the same minimum insurance coverage required of Contractor. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that -such coverage is provided in conformity. with the. requirements of this section. Contractor agrees that upon request, .all agreements with subcontractors and others engaged in the Project will be submitted to the City for review. g) Contractor acknowledges and agrees that any actual or alleged failure on the part of the City to inform Contractor of non-compliance with any insurance requirement in no way imposes any additional obligations on the City nor does it waive any rights in this or any other regard. h) Contractor shall provide proof that policies of insurance required in the contract, expiring during the term of the contract, have been renewed or replaced with other policies._providing at least the same coverage. - Proof that,such coverage has been. ordered shall -be submitted ,prior to expiration. Endorsements as required in the contract applicable to the renewing or new coverage shall be provided to City no later than ten (10)days prior to expiration of the lapsing coverage. i) Requirements of specific insurance coverage features or limits contained in this section are not intended as limitations on coverage, limits, or other requirements, or as a waiver of any .coverage normally provided by any given policy. Specific reference to a- given coverage feature is for purposes of ,clarification only as it pertains to a given issue, and is not intended by any party or insured to be limiting or all-inclusive. j) The'requirements in this section supersede all other- sections and provisions of the contract to the extent that any other section or provision conflicts with or impair the provisions of this section. k) Contractor agrees to provide immediate notice-to City of any claim or loss against Contractor arising out of the Work performed under the contract and for any other claim or loss which may reduce the insurance available to pay claims arising out of the contract. City assumes no obligation or liability by such notice, but has the right (but not the.duty) to monitor the.handling of any such claim or claims if they are likely to involve City, or to reduce or dilute insurance available for payment of potential claims.. 1) Contractor agrees that the provisions of this section shall not be construed as limiting in. any way the extent to which the Contractor may be held_ responsible for the payment of damages'resulting from the Contractors activities or the activities of any.person or person for which the Contractor is otherwise responsible. ADD: 7-3:6 Policy Endorsements. 7-3.6.1 Commercial General Liability Insurance 7-3.6.1.1' Additional Insured. To the- fullest extent allowed by law e.g., California Insurance Code § 11580.04, the.policy shall be endorsed to include the City and its respective elected officials, officers, employees, agents, and representatives as additional insureds. The additional insured coverage for Projects for which the Engineers Estimate is $1,000,000 or more shall include liability arising out of. (a) Ongoing operations performed by the Contractor or on the Contractors behalf, (b) Your products; '(c)Your work, e.g., the Contractors completed operations performed by the' Contractor'or,on the Contractors, behalf, or (d) premises owned, leased, controlled, or used by the Contractor; the coverage for Projects for which the Engineers Estimate is less than $1,000,000 shall include'-liability arising out of:.(a) Ongoing operations performed by the Contractor or on the Contractors behalf, (b) Your products, or (c) premises: owned, leased, controlled, or .used by the .Contractor. 7-3.6.1.2 Primary and Non-Contributory Coverage. The policy shall be endorsed to provide that the coverage with respect to operations, including the completed operations, if appropriate, of the;Named Insured is primary to any insurance or self-insurance of the City .. and its elected officials, officers, employees, agents and representatives. Further, it shall provide .that any insurance maintained by the City and its elected officials, officers, employees, agents and representatives.shall be in excess of the Contractors insurance and shall not contribute to it. 7-3.6.1.3 Project General Aggregate Limit. The policy or policies shall be endorsed to provide a Designated Construction Project General Aggregate Limit that will apply only to the Work..Only claims payments which-arise from the Work shall reduce the: Designated Construction Project General Aggregate Limit. The Designated Construction Project General Aggregate Limit shall, be .in addition to'the aggregate limit provided for the products-completed operations hazard. 7-3.6.2.Commercial Automobile Liability Insurance. 7-3.6.2.1.Additional Insured.--Unless the policy or policies of Commercial Auto- Liability Insurance are written on an.ISO form CA 00 01 12 .90 or a later version of this form or equivalent form providing coverage at least as broad, the policy shall be endorsed to include the City and its respective elected officials, officers, employees, agents, and representatives as additional insureds, with respect to liability arising out of automobiles owned, leased, hired or borrowed by or on behalf of the Contractor. This endorsement is limited to the obligations permitted by California insurance.Code § 11580.04.. 7-3.6.3 Builders Risk Endorsements. 7-3.6.3.1 Waiver of Subrogation. The policy or policies shall be endorsed to provide that the insurer will waive all rights of subrogation against the City,and its respective elected officials, officers,employees, agents, and representatives for losses paid under the terms of the policy or policies and which arise from work performed by the Named Insured for the City. 7-3.6.3.2 .Builders Risk — Partial Utilization. If the City desires to occupy.or use a portion or portions of the Work prior to Final Completion in accordance with this contract; the City shall notify the Contractor and the Contractor shall immediately notify its Builder's Risk insurer and obtain an endorsement that the policy.or policies shall not be cancelled or lapse on account of any such.partial use or occupancy. The Contractor shall obtain the endorsement prior to the City's:occupation and use. ADD: 7-3.6 Deductibles/Self-Insured Retentions.. The Contractor shall be responsible . for the payment of all deductibles and self-insured retentions. Deductibles and self-insured retentions shall be disclosed to the City at the time,the evidence of insurance is provided. ADD: 7-3.7 Reservation of Rights. The City reserves the right, from.time to time, to review Contractor's insurance coverage, limits, deductibles and self-insured retentions to determine if they are acceptable to the City. The City will reimburse Contractor, without overhead, profit, or any other markup, for the cost of,additional premium for any coverage requested by the City but not required by this contract. ADD: 7-3.8 Notice of Changes to Insurance. The Contractor shall notify the City 30 days prior to any material change to the policies of insurance provided under this contract: ADD: 7-3.9 Excess Insurance. Policies providing excess coverage shall follow the form of the primary policy or policies e.g., all endorsements. 7-4. WORKERS' COMPENSATION INSURANCE. DELETE in its entirety and SUBSTITUTE the following: 7-4.1 Workers' Compensation Insurance and Employers Liability Insurance. In accordance with the provisions of§3700 of the California Labor Code, the Contractor shall provide at its expense Workers' Compensation Insurance and Employers Liability Insurance-to protect the ,Contractor against all,claims under applicable state workers, compensation laws. The City, its elected officials,and employees will not be responsible for any claims in law or equity occasioned`by the failure of the Contractor to comply with the requirements of this section. Limits for this insurance shall be not less than the following: . Workers' Compensation Statutory Employers Liability Bodily Injury by Accident $1,000,000 each accident Bodily Injury by Disease $1,000,000 each employee Bodily Injury by Disease $1,000,000 policy limit By signing and returning this contract the Contractor certifies that the Contractor is aware of the provisions of§3700 of the,Labor Code which require every employer to be insured. against liability for worker's compensation or to undertake self-insurance_.in accordance with the provisions of that code and the Contractor will comply with such provisions before commencing the performance of the work of this contract as required by-Section 1861 of the California Labor Code. 7-4.2.1 Waiver of Subrogation. The policy or policies shall be endorsed to provide that the insurer will waive all rights of subrogation against the City, and its respective elected officials; ofricers, employees, agents, and representatives for losses paid-under the terms of the policy or policies and which arise from work performed by the Named Insured for the City. Bond Number:CAC714904 PAYMENT BOND—PUBLIC WORKS Premium lis for contract term and subject to adjustment based on final contract price KNOW ALL MEN BY THESE PRESENTS, WHEREAS, the City of Palm Springs, a charter city, organized and existing in the County of Riverside, Califomia, as Obligee, (hereinafter referred to as the "City"), has awarded to the undersigned Contractor, (hereinafter referred to as the"Contractor"), an agreement for the work described as follows: CORNELIA WHITE HOUSE EXTERIOR REPAIRS CITY PROJECT NO.15-16 (hereinafter referred to as the"Public Work");and WHEREAS, the work to be performed by the Contractor is more particularly. set forth in that certain Agreement(Construction Contract)for the said Public Work awarded to the Contractor and approved by the City for the Project hereinabove named, (hereinafter referred to as the"Contract"),which Contract is incorporated herein by this reference;and WHEREAS, said Contractor is required to furnish a bond in connection with said Contract and pursuant to Section 9550 of the California Civil Code. NOW,THEREFORE,we, the undersigned Contractor,as Principal,and: . Merchants Bonding Company(Mutual) , a corporation organized and existing under the laws of the State of Iowa , and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the City, and to any and all persons, companies, or corporations entitled to file stop payment notices under Section . 9100 of the California Civil Code, in the sum of Three Hundred Thirty Two Thousand Three Hundred Nineteen and 00/100 Dollars ($ 332,319.00 ), said sum being not less than 100 percent of the total amount payable by the City under the terms to the said Contract, for which amount well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if said Contractor, his or its heirs, executors, administrators, successors, or assigns, or Subcontractors, shall fail to pay for any materials, provisions or other supplies, implements, machinery, or power used in, upon, for, or about the performance of the Public Work contracted to be done, or to pay any person for any work.or labor of any kind, or for bestowing skills or other necessary services thereon, or for amounts due under the Unemployment Insurance Code with respect to such work or labor, or for any amounts required to be deducted, . withheld, and paid,over to the Employment Development Department from the wages of employees of paid Contractor and his Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor as required by the provisions of Sections 9550 through 9560 of the Civil Code, the Surety or Sureties hereon will pay for the same in an amount not exceeding the sum specified in this bond, otherwise the above obligation shall be void. In addition to the provisions herein above, it is agreed that this bond will inure to the benefit of any and all persons, companies, and corporations entitled to serve stop payment notices under Section 9100 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond. CORNELIAwHiTE HOUSE CITY PROJECT NO.15-16 PAYMENT BOND JANUARY 11,2018 AGREEMENT AND BONDS-PAGE 2 PAYMENT BOND--PUBLIC WORKS (CONTINUED) The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration,or additions to the terms of the said Contract or to the work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration, or addition to the terms of the Contract or to the work or to the Specifications. No final settlement between the City and the Contractor hereunder shall abridge the right of any beneficiary hereunder,whose claim may be unsatisfied. Contractor and Surety, an admitted surety insurer, further agree that if the City or any entity or person entitled to file stop payment notices is required to engage the services of an attorney in connection with the enforcement of this bond, each shall be liable for the reasonable attorney's fees incurred, with or Without suit, in addition to the above sum. SIGNED AND SEALED,this 25th day of June , 2018, CONTRACTOR: D.W.Johnston Construction, Inc., a California Corporation Check one: individual,_partnership, x corporation (This Payment Bond must be signed by representatives and/or officers having appropriate authority to bind the Contractor and Surety to the terms of the Payment Bond,) EXECUTED FO E CONTRACTOR: EXECUTED FOR THE SURETY: By: D.W.Johnst onstr ction, Inc.,a California Corporation By Merchants Bonding Company(Mutual) ature signature (NO IZED) (NOTARIZED) t ' Print Name and Title: Print Name and Title: = - CFO Elba McCullough,Attorney-In-Fact By: signature (NOTARIZED) Print Name and Title: CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 PAYMENT BOND JANUARY 11,2018 AGREEMENT AND BONDS-PAGE 3 PAYMENT BOND—PUBLIC WORKS . (CONTINUED) The rate of premium on this bond is$ ** per thousand. ** $9.75 first$100,000 $7.50 next$232,319 The total amount of premium charged:$ 2,717.00 (The above must be filled in by corporate surety). IMPORTANT: Surety companies executing bonds must possess a certificate of authority from the California Insurance Commissioner authorizing them to write surety insurance defined in Section 105 of the California Insurance Code, and If the work or project is financed, in whole or in part, with Federal, grant, or loan funds, it must also appear on the Treasury Department's most current list(Circular 570 as amended).THIS IS A REQUIRED FORM. Any claims under this bond may be addressed to: (Name and Address of Surety) Merchants Bonding Company(Mutual) 6700 Westown Parkway West Des Moines, IA 50266 (Name and Address of Agent or KPS Insurance Services, Inc./Michael R.Strahan Representative for service of process in California if 1620 5th Ave,Suite 340 different from above) San Diego,CA 92101 (Telephone Number of Surety and Surety 515-558-8709/agent 858-538-8822 Agent or Representative for service of process in California) CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 PAYMENT BOND JANUARY 11,2018 AGREEMENT AND BONDS-PAGE 4 PAYMENT BOND—PUBLIC WORKS (CONTINUED) ALL-PURPOSE ACKNOWLEDGMENT 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. State of h Gl. County of 3\-I�t'iA' &Z' On— 1 1 a5 M before me,�/ C% & . Vet Date Na Titl of 0 car, � personally appeared NAME(S)OF SI NER(S) who proved to me on the basis of satisfactgry evidence to be the persons f whose nameg is/ap(subscribed to the within ins ment and acknowledged to me that /she/t*executed the same in iaits/herltheif authorized capacity(iyj,and that by them signatures on the instrument the persong,, or the entity upon behalf of which the persono#acted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State identified herein,that the foregoing paragraph is true and correct. 7 ss i y hand and official se (gn to of Rotary .� ., Y.GARCIA CABRERA Notary Public•California Z " _•+ Riverside County s: t Commission k 2237245 "°'"�� My Comm.Expires Apr 25,2022 ATTENTION NOTARY; Although the infom ffon requested below is OPTIONAL,it could prevent fraudulent attachment of this certificate to unauthorized document. THIS CERTIFICATE Title or Type of Document MUST BE ATTACHED TO THE DOCUMENT Number of Pages DATE of DOCUMENT DESCRIBED AT RIGHT: Signer(s)Other Than Named Above CORNELIA WHITE HOUSE CITY PROJECT NO.15-16 PAYMENT BOND JANUARY 11,2018 AGREEMENT AND BONDS-PAGE 5 3:4 4685 STATE OF CALLCORNIA. DEPARTMENT OF INSURANCE SAN MA.NCISCO AMENDED Certificate of Authority Tins Is To Cr; wiy,That,pursuant to the Insurance Code of the State of California,, MERCHANTS BONDING COMPANY (MUTUAL) Of DES MOINES , IOWA ,organized under the laws of IOWA ,subject to its Articles of Incorporation or other fundamental organizational documents, is hereby authorized to transact within this State, subject to all provisions of this Certificate,the fallowing classes of insurance: SURETY, LIABILITY AND MISCELLANEOUS as such classes are now or may hereafter be defined in the Insurance Laws of the State of California. Tins Cm- TirieATE is expressly conditioned upon the holder hereof flow and hereafter being in full compliance with all,and not in violation of any,of the applicable laws and lawful requirements mute under authority of the laws of the State of California.-as long as such laws or requirements are in effect and applicable,and as such laws and requirements now are,or may hereafter be chaiigod or amended. IN Wrrrirss FVrrmuor,effective as of the .._.?�h._•--_.. day I have hereunto set my hand and caused iffy official seal to be axed this day BR f IS B NOTiUL: a -- -- - Qualification with the Secretary of State must be accomplished as required by the California Corporation Ccuc:_' piomptly after issuance of this Certificate of Authority.Failure to do so will be a violation of Ins.Code Sec.-7O1 and will be grounds for revolting this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein. FORM CS-3 vcZ-Ds em 6W urr"^'' fin, �. ;:�, ;, ;; y=;. i - _. _ � •, :. .t { n stat i f o r mb OFFICE OF THE SECRETARY OF STATE SACRAMENTO Ct'APORATIQN :alxao.r CERTIFICATE OF QUALIFICATION 1, MARCH FONG EU, Secretary of State of the State of California, hereby certify: That on the __..._ 3RD day of DECEMBER MPIZCHliNzs--aaiNDIaG COraPAUY—C�LQT.UA.) , a corporation organ'i.<;ed and existing under the laws of _..__.—. -W&— ,complied with the requirements of California. lazy in, effect on that slate for the purpose of qualifying to transact intrastate business in the State of California and that as of said date said corporation became and now is fully qualified an-d authorized to transact intrastate; business in the State of California, subject, however, to any licens'in.g requirements otherwise iniposed by the laws of this State. I y IN WITNESS V'WHEBEO , I execute this certificate and of fix the:Great Seal of the State of California this 3RD (hlv of DECEMBER, 1981 • (�-r 1FL�-�T i"a'.w`�4\ yr`�. •(` yacu�T�' (,,, � � r'�...^" �r_�./ 1�... �.�I� (1 I F{ � � �p�*�i�3,{L••'•"iv� �~ �{ 7^1' P 1�f� �t�-'��i�l � �'f �"0�. �r � n .�,.•� " .1�i L�i�'�'� 4.'CGi��� �� ���u��C�V� ,�;,, �'�'s. �!�r�s CF �'1ii S'L�v�q• kr5=. b Y IE I'll i����%f1Z ,eLr'•tfGGG ��f( C/,�11,�z'���(.�,��Gc��G�',scz:� rcr•�`�'�ta*c`�ct%G�i:C,G/,�£�(✓�G�GI'C/✓c�GCs ���c�r-vr'��iL:G�it'.L1/�G�Uf�i F/��,�G`�2E��ji���c�i�zF'�c�i:��f'•rE/ 'c -GGC����'> °C'�f•/�z�.iti!FCC•.cF��^/i�f:F'�£IGCt���r?•��",iri�'� cc,��rz aaG, z ' 'G = 'cPcc��� zcc� c� � cx � � 6 i�r��z MERCHANTS BONDING COMPANY (MUTUAL) , DES MOINES� TOWA .��;c�-� DcCCCU,I '��CGJ�,!�c%?7IG/19`� L�Zf'/Gc��ffl� F't%�c';�cG?ZC /��cGG+�C,�ZGaGCf � < <_Liability other than auto, Fide lit Surety, Burglary & theft :f??, r;C, cC/f2•�r' f���G2/. l?/U�I.G(/fl�-i�.,l�!s G'�/rig`L��C/�GfI�2�f>G/LF.-C�'Cl•%?�.G�:'r1f°�/ • �?�/�/Y- 14 r✓, �zf�.ta c�c4-1u;elei�i 1STDECEMBER '/,(g- (1 .. 00 Cn u+au rsscoaae�'o!'Trr.r+orrnee. Dt,va^lv<�rnnaissranc�ru±Irrsarrtixc'e CP-32576 M.ERCHANi7'� BONDING COMPANY, POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC., both being corporations of the State of Iowa(herein collectively called the"Companies")do hereby make,constitute and appoint,individually, Elba McCullough;Michael R Strahan their true and lawful Attorneys)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding,Inc.,on October 16,2015. "The President, Secretary,Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 6th day of April 2017 lO•��.....u•a.•• ••. •• MERCHANTS BONDING COMPANY. o N •�.•�P�.......q<�.,. ;�p�NG,COMA•. P�R :•@�v0�P0R9.,�'A MERCHANTS NATIONAL BONDING,INC. (MUTUAL) 2003 ;��i :y 1933 c: By :mod.' • j'. :C, • .,•. ••. ,..�'��, •6�i .. `1 . President STATE OF IOWA COUNTY OF DALLAS ss. On this this 6th day of April 2017 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. �V9 IA4 s ALICIA K.GRAM . p Commission Number 767430 �17.777. My Commission Expires ` 41 April 1,2020 Notary Public (Expiration of notary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.,do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 25th=day of June 2018 .••'Z10Nq•..•• .••LNG CO••• = ze _ 2003 imi �� 1933 ;c• r Seci- " POA 0018 (3/17) ACKNOWLEDGMENT 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. State of Califomia County of San Diego ) On June 25th, 2018 before me, E.B.Strahan, Notary Public (insert name and title of the officer) personally appeared Elba McCullough who proved to me on the basis of satisfactory evidence to be the personA whose name is re subsc ' ed to the within instrument and acknowledged to me that heQjj3hey executed the same in hi er -Aheir authorized capacity>s),and that by hi e&ihheir signature(Won the instrument the person , or the entity upon behalf of which the persorr'acted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph Is true and correct, E. B. STRAHAN WITNESS my hand and off&aal Commission#20.69654 z Notary Public-California D z San Diego County My Comm.Ex Tres Jun 25,.2018 Signature (Seal) CDWJOHNS-01 EXEC ACOR>D OIYYYY) E(MMID �� CERTIFICATE OF LIABILITY INSURANCE 0 DATE 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). PRODUCER License#0566836 CONTACT NAME: Mahan Insurance Brokers,Inc. PHONE FAX 2503 Eastbluff Dr.,#203 (AIC,No,E.t):(714)389-9450 (A/C,No):, Newport Beach,CA 92660 ADOREss:certs@mahanins.com . I INSURERS AFFORDING COVERAGE NAIC# INSURER A:Travelers Indemnity Company 25658 INSURED - INSURER B:Travelers Property Casualty Company of America 25674 D.W.Johnston Construction,Inc. INSURER C: 1445 N.Sunrise Way,#203 INSURER D: Palm Springs,CA 92262 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP I LIMITS LTR I D WVD MMIDD MMIDOfYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I S 2,000,000 CLAIMS-MADE OCCUR DT22-CO-6G624923-TCT-18 02/0512018 02/05/2019 DAMAGE TO RENTED 300,000 Pa E I ES Ea occurrence S MED EXP(Any oneperson) S 5,000 PERSONAL&ADV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 4,000,000 POLICY I X]Too FI LOC PRODUCTS-COMP/OPAGG S 4,000,000 OTHER: $ A COMBINED SINGLE LIMIT 2,000,00 AUTOMOBILE LIABILITY (Ea accident $ X ANY AUTO BA-6GG24923-18-CNS 02/0512018 02/05/2019 BODILY INJURY Per person I s OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUR7'OS ONLY ASTO ED PROPERTY DAMAGE S ONLY (Per accident S 5 B X UMBRELLA LIAB M OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE CUP-5K968074-18-26 02/05/2018 02105120.19 AGGREGATE g 5,000,000 DED I RETENTION S S B AND KERSEMPL COMPENSA TIOITNY Y/N X. PER OERH 1-7 UB-9J554624-18-26-G 01/01/2018 01/01/2019 1,000,000 ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S 1,000,000 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Re:221 North Palm Canyon Dr.,Palm Springs,�A 92262. The City of Palm Springs,its officials,employees,and agents are additional insureds per the attached CGD246 and CA T4 45 04 09 endorsements.Primary a butory wording applies per the attached CGD246 endorsement.Per Project General Aggregate Limit applies per the attached CGD211 endorsement.GL, uto,and WC Waivers of Subrogation appy per the attached CGD316,CA T4 45 04 09,and WC990376 endorsements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City f Palm Springs THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y oACCORDANCE WITH THE POLICY PROVISIONS. 3200 E Tahquitz Canyon Way Palm Springs,CA 92262 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 13A-6G6249? 3-CNS COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However,coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage.Part, and these coverage broadening provisions do not apply to the extent that coverage is.excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this.en- dorsement and the rest of your policy carefully to determine rights,duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED,AUTO PHYSICAL DAMAGE—LOSS_OF B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT C. 'EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS -INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE—INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED -this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies as an "insured" An Insured, of SECTION 11-COVERED AUTOS under the Who Is An Insured provision contained LIABILITY COVERAGE: in Section 11. Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The,following is added to Paragraph A.1., 50% or more ownership interest and that is not Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission, while performing duties related to the conduct of your busi- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1., 2. The following replaces Paragraph b. in B.5:, Who Is An Insured, of SECTION 11—COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that is signed and ered"autos"you own: . - executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire-, "property damage" occurs and that is in effect rent or borrow;and during the policy period, to be named.as an addi- (2) Any covered"auto"hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name,.-with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. POLICY NUMBER: BA-6G624923(D-CNS COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit". related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any'auto'that is leased, hired, of the United States of America, Puerto Rico and Canada: rented or borrowed with a driver is not a covered"auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured"against,and investigate or set- tle any such claim or"suit"-and keep The following is added to Paragraph A.1.,Who Is us advised of all proceedings and ac- An Insured, of SECTION II=COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any"employee'of yours is an "insured"while us- "insured" will make any settlement ing a covered"auto"you don't own, hire or borrow without our consent. in your business or your personal affairs. (III)We may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED in defending the "insured" against, or LIMITS in the settlement of, any claim or . 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION 11-COVERED AUTOS LIABIL- (iv)We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for'cost of bail bonds (in-_ pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or"property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sured" .pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, .of of SECTION 11—COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day- be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense F. HIRED AUTO — LIMITED WORLDWIDE COV. of the "insured" against any such ERAGE—INDEMNITY BASIS '.suit", but, only up to and included within the limit described in Para- The following-replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation.imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the`•`"transaction of business with or (b) This insurance is excess over any valid within such country-or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. POLICY NUMBER: BA-6G624923010NS . � COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to,the minimum limits required by theft of your covered"auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will coverage. not invalidate the coverage afforded by this.policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to "loss" to one or ted or authorized insurer outside the more airbags in a covered "auto"you own that in- United States of America, its territories flate due to a cause other than a cause of "loss" and possessions, Puerto Rico and Can- set forth_ in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that"auto" is a covered "auto"for Compre- for compliance in any way with the laws. hensive Coverage under this policy; of other countries relating to insurance. b. The airbags.are not covered under any war- G. WAIVER OF DEDUCTIBLE—GLASS rarity;and The following is added to Paragraph D., Deduct!- c. The airbags were not intentionally inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any .COVERAGE: one"loss". No deductible, for a covered "auto" will.apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather_ than LOSS , replaced. The following is added to Paragraph A.2.a., of H. HIRED AUTO PHYSICAL DAMAGE—LOSS OF SECTION IV—BUSINESS AUTO CONDITIONS: USE—INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or "loss" ap- graph AA.b., Loss Of Use.Expenses, of SEC- plies only when the "accident" or "loss" is known TION III—.PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership); $750 for any one"accident". (c) A member (if you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager(if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization);or . . SECTION III — PHYSICAL DAMAGE COVER- (e) Any"employee"authorized by you to give no- AGE: tice of the"accident"or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.5., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered"auto"of the private passenger type. of. SECTION IV — BUSINESS AUTO CON.DI- J. PERSONAL PROPERTY TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age.Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap= signed and executed prior to any "accident" parel and other personal property which is: or"loss",provided that the"accident"or"loss" (1) Owned by an"insured%and arises out of operations contemplated by CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. POLICY NUMBER: BA-6G624923-1g-CNS COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. SECTION IV—BUSINESS AUTO CONDITIONS: Page 4 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. POLICY NUMBER: DT22-CO-6G624923-TCT-18 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) .This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED— (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you "property damage"or"personal injury";and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the,injury or the additional insured .applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring Insurance applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the.Declarations available to the additional'insured,for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires, that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and. non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that b) The insurance provided to the additional in- the insurance". But the insurance provided to sured does not apply to "bodily Injury", the additional insured by this endorsement.still is pp y y ' ry , "prop- excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance of the rendering of, or failure to render, any , whether primary, excess, contingent or professional architectural, engineering or sun= on any other basis, that is available to the addi- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- i. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap a) The additional insured must give us written prove,drawings and specifications;and notice as soon as practicable of an "occur- li., Supervisory, inspection, architectural or rence" or an offense which may result in a claim. To the extent possible, such,notice engineering activities. should include: CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 POLICY NUMBER: DT22-CO-6G624923-TCT-18 COMMERCIAL GENERAL LIABILITY i. How, when and where the 'occurrence" any provider of'other insurance"which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses;and condition does not affect whether the insur- ance provided to. the additional insured by Ili. The nature and location of any injury or this endorsement is primary to 'other insur- e Y damage arising out of the'occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or"suit' is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. I. Immediately record the specifics of the —DEFINITIONS: claim or"suit'and the date received;and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement The additional insured must see to it that we under which you are required to include a receive written notice of the claim or"suit' as persursoned oortorhis Coverage as an art, provided s l in- that soon as practicable. the "bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or"suit', cooperate a. After the signing and execution of the with us in the investigation or settlement of the claim or defense against the "suit', and contract or agreement by you; otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender.the de- agreement is in effect;and fense and indemnity of any claim or "suit' to c. Before the end of the policy period. Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: DT22-CO-6G624923-TCT-18 ISSUE DATE: 02-08-18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project Designated Project(s): General Aggregate(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, GENERAL AGGREGATE IN A WRITTEN CONTRACT WHICH IS IN EFFECT LIMIT SHOWN ON THE DURING THIS POLICY PERIOD, TO PROVIDE A DECLARATIONS SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE.CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes legally 3. Any payments made under COVERAGE A. obligated to pay as damages caused by "occur- for damages or under COVERAGE C. for rences" under COVERAGE A. (SECTION 1), and medical expenses shall reduce the Desig- for all medical expenses caused by accidents un- nated Project General Aggregate Limit for der COVERAGE C (SECTION I), which can be that designated "project". Such payments attributed only to operations at a single desig- shall not reduce the General Aggregate Limit nated"project"shown in the Schedule above: shown in the Declarations nor shall they re-. 1. A separate Designated Project General Ag- duce any other Designated Project General gregate Limit applies to each designated"pro- Aggregate Limit for any other designated ject", and that limit is equal to the amount of project shown in the Schedule above. the General Aggregate Limit shown in the 4. The limits shown in the Declarations for Each Declarations, unless separate Designated Occurrence, Damage To Premises Rented Project General Aggregate(s) are sched- To You and Medical Expense continue to uled above. apply. However,-instead of being subject to 2. The Designated Project General Aggregate the .General Aggregate Limit shown in the Limit is the most we will pay for the sum of all Declarations, such limits will be subject to the damages under COVERAGE A., except applicable Designated Project General Ag- damages'because of "bodily injury" or"prop- gregate Limit. erty damage" included in the "products- B. For all sums which the insured becomes legally completed operations hazard", and for medi- obligated to pay as damages caused by "occur- cal expenses under COVERAGE C, regard- rences" under COVERAGE A. (SECTION 1), and less of the number of: for all medical expenses caused by accidents un- a. Insureds; der COVERAGE C. (SECTION 1), which cannot be attributed only to operations at a single desig- nated"project"shown in the Schedule above: c. Persons or organizations making claims or bringing"suits". CG D2 11 01 04 Copyright,The Travelers Indemnity Company,2004 Page 1 of 2 �J COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. vided, any payments for damages because of for damages or under COVERAGE C. for `'bodily injury" or "property damage" included in medical expenses shall reduce the amount the "products-completed operations hazard" will available under the General Aggregate Limit reduce the Products-Completed Operations Ag- or the Products-Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gregate Limit,whichever is applicable;and gate Limit nor the Designated Project General 2. Such payments shall not reduce any Desig- Aggregate Limit. nated Project General Aggregate Limit. E. For the purposes of this endorsement the.Defini- C. Part 2.of SECTION III—LIMITS OF INSURANCE tions Section is amended by the addition of the is deleted and replaced by the following: following definition: 2. The General Aggregate Limit is the most we "Project" means an area .away from premises will pay for the sum of: owned by or rented to you at which you are per- forming operations pursuant to a contract or a. Damages under Coverage B;and agreement. For the purposes of determining the b. Damages from "occurrences" under applicable aggregate limit of insurance, each COVERAGE A (SECTION 1) and for all "project" that includes premises involving the medical expenses caused by accidents same_or connecting lots, or premises whose con- under COVERAGE C(SECTION 1)which nection is interrupted only by a street, roadway, cannot be attributed only to operations at waterway or right-of-way of a railroad shall be a single designated"project"shown in the considered a single"project". SCHEDULE above. F. The provisions of SECTION III — LIMITS OF D. When coverage for liability arising out of the INSURANCE not otherwise modified by this en- "products-completed operations hazard" is pro- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright,The Travelers Indemnity Company,2004 CG D211 01 04 POLICY NUMBER: DT22-CO-6G624923-TCT-18 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include (ji) A manager of any limited liability as an additional insured on this Coverage Part is company;or an insured, but only with respect to liability for '(III)An executive officer or director of "bodily injury", "property damage", "personal in- any other organization; jury" or"advertising injury" arising out of such op- erations. that is your partner, joint venture member or manager;or The insurance provided to such state or political (b) Any "employee" authorized by such subdivision does not apply to: partnership, joint venture, limited li- a. Any "bodily injury," "property damage," "per- ability company or other organization sonal injury"or"advertising injury"arising out to give notice of an "occurrence" or of operations performed for that state or po- offense. litical subdivision;or (3) Notice to us of such"occurrence"or of an b. Any "bodily injury" or "property damage" in- offense will be deemed to be given as eluded in the "products-completed operations soon as practicable if it is given in .good hazard". faith as soon as practicable to your work- J. KNOWLEDGE AND NOTICE OF OCCUR- ers' compensation insurer. This applies RENC.E OR OFFENSE only if you subsequently give notice to us The following is added to Paragraph 2., Duties In of the"occurrence"or offense as soon as The Event of Occurrence, Offense, Claim or practicable after any of the persons de- Suit, of SECTION IV — COMMERCIAL GEN- scribed in Paragraphs e. (1) or(2) above ERAL LIABILITY CONDITIONS: discovers that the"occurrence"or offense may result in sums to which the insurance e. The following provisions apply to Paragraph . provided under this Coverage Part may a. above, but only for the purposes of the in- apply. surance provided under this Coverage Part to you or any insured listed in Paragraph 1.or 2. However, if this Coverage Part includes an en- of Section II—Who Is An Insured: dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution (1) Notice to us of such "occurrence" or of- costs arising out of a discharge, release or es- fense must be given as soon as practica- cape of "pollutants"which contains a requirement ble only after the "occurrence" or offense that the discharge, release or escape of "pollut- is known by you (if you are an individual), ants" must be reported to us within a specific any of your partners or members who is . number of days after its abrupt commencement, an individual (if you are a partnership or this Paragraph e. does not affect that require- joint venture), any of your managers who ment. is an individual (if you are a limited liability K. UNINTENTIONAL OMISSION company), any of your "executive offi- cers"or directors (if you are an organiza- The following is added to Paragraph 6., Repre- tion other than a partnership,joint venture sentations, of SECTION IV — COMMERCIAL or limited liability company) or any "em- GENERAL LIABILITY CONDITIONS:. ployee" authorized by you to give notice The unintentional omission of, or unintentional of an"occurrence"or offense. error in, any information provided by you which (2) If you are a partnership, joint venture or we relied upon in issuing this policy.will not preju- limited liability company, and none of your dice your rights under this insurance. However, partners, joint venture members or man- this provision does not affect our right to collect agers are individuals, notice to us of such additional premium or to exercise our rights of "occurrence" or offense must be given as cancellation or nonrenewal in accordance with soon as practicable only after the "occur- applicable insurance laws or regulations. rence"or offense is known by: L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8.,Transfer (1) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV— COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 ©2011 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 POLICY NUMBER: DT22-CO-6G624923-TCT-18 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- 3. ."Bodily injury" means bodily injury, mental ment to waive that insured's right of recovery anguish, mental injury, shock,fright,disability, against any person or organization, we waive our humiliation, sickness or disease sustained by right of recovery against such person or organiza- a person, including death resulting from any tion, but only for payments we make because of: of these at any time. a. "Bodily injury" or "property damage" that oc- N. CONTRACTUAL LIABILITY—RAILROADS curs;or 1. The following replaces Paragraph c. of the b. "Personal injury" or "advertising injury" definition of "insured contract" in the DEFINI- caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract or c. Any easement or license agreement; agreement. 2. Paragraph f.(1) of the definition, of "insured M. AMENDED BODILY INJURY DEFINITION contract" in the DEFINITIONS Section is de- The following replaces the definition of "bodily leted. injury"in the DEFINITIONS Section: Page 6 of 6 ©2011 The Travelers Indemnity Company.All rights reserved. -CG D3 16 11 11 Certificate of -R-T Specialty Insurance Services, LLC (hereinafter called "Correspondent") Evidencing Placement of Insurance with certain UNDERWRITERS AT LLOYD'S, LONDON Correspondent hereby certifies that insurance as described herein has been effected with certain Underwriters at Lloyd's, London, NOTICE: 1. THE INSURANCE POLICY THAT YOU HAVE PURCHASED IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED-BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED "NONADMITTED" OR "SURPLUS LINE" INSURERS. 2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT THAT APPLY TO CALIFORNIA LICENSED INSURERS. 3. THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED. 4. THE INSURER SHOULD BE LICENSED EITHER AS A FOREIGN INSURER IN ANOTHER STATE IN THE UNITED STATES OR AS A NON-UNITED STATES (ALIEN)'INSURER. YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE" BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL-FREE TELEPHONE NUMBER 1-800-927-4357. ASK WHETHER OR NOT THE INSURER IS LICENSED AS A FOREIGN OR NON-UNITED STATES (ALIEN) INSURER AND FOR ADDITIONAL INFORMATION ABOUT THE INSURER. YOU MAY ALSO CONTACT THE NAIC'S INTERNET WEB SITE AT WWW.NAIC.ORG . 5. FOREIGN INSURERS SHOULD BE LICENSED BY A STATE IN THE UNITED STATES AND YOU MAY CONTACT THAT STATE'S DEPARTMENT OF INSURANCE TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 6. FOR NON-UNITED STATES (ALIEN) INSURERS, THE INSURER SHOULD BE LICENSED BY A COUNTRY OUTSIDE OF THE UNITED STATES AND SHOULD BE ON THE NAIC'S INTERNATIONAL INSURERS DEPARTMENT (IID) LISTING OF APPROVED NONADMITTED NON- UNITED STATES INSURERS. ASK YOUR AGENT, BROKER, OR «SURPLUS LINE" BROKER TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 7. CALIFORNIA MAINTAINS A LIST OF APPROVED SURPLUS LINE INSURERS. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST, OR VIEW THAT LIST AT THE INTERNET WEB SITE OF THE CALIFORNIA DEPARTMENT OF INSURANCE. WWW.INSURANCE.CA.GOV . 8. IF YOU, AS THE APPLICANT, REQUIRED THAT THE INSURANCE POLICY YOU HAVE PURCHASED BE BOUND IMMEDIATELY, EITHER BECAUSE EXISTING COVERAGE WAS GOING TO LAPSE WITHIN TWO BUSINESS DAYS OR BECAUSE YOU WERE REQUIRED TO HAVE COVERAGE WITHIN TWO BUSINESS DAYS, AND YOU DID NOT RECEIVE THIS DISCLOSURE FORM AND A REQUEST FOR YOUR SIGNATURE UNTIL AFTER COVERAGE BECAME EFFECTIVE, YOU . HAVE THE RIGHT TO CANCEL THIS POLICY WITHIN FIVE DAYS OF RECEIVING THIS DISCLOSURE. IF YOU CANCEL COVERAGE, THE PREMIUM WILL BE PRORATED AND ANY BROKER'S FEE CHARGED FOR THIS INSURANCE WILL BE RETURNED TO YOU. Such insurance has been placed in accordance with the limited authorization granted to the Correspondent by certain Underwriters at Lloyd's, London, whose syndicate numbers and the proportions underwritten by them can be ascertained from the office of the said Correspondent. (such, Underwriters being hereinafter called "Underwriters") and in consideration of the premium specified herein, Underwriters have agreed to bind themselves severally and not jointly each for his own part and not one for another, their Executors and Administrators. The Insured is requested to read this Certificate and if it is not correct, return it immediately to the Correspondent for appropriate alteration. 2 CERTIFICATE PROVISIONS 1. Signature Required. This Certificate shall not be valid unless signed by the Correspondent on the attached Declaration Page. 2. Correspondent Not Insurer. The Correspondent is not an Insurer of the insurance described herein and neither is nor shall be liable for any loss or claim whatsoever. The Insurers of such insurance are those Underwriters at Lloyd's, London, whose names can be ascertained as hereinbefore set forth. As used in this Certificate "Underwriters" shall be deemed to include incorporated as well as unincorporated persons or entities that are Underwriters at Lloyd's, London. 3. Cancellation. If the insurance described herein provides for cancellation and if said insurance is cancelled after the inception date, earned premium must be paid for the time the insurance has been in force. 4. Service of Suit Clause. In the event of the failure of Underwriters to pay any amount claimed to be due under the insurance described herein, Underwriters have agreed that, at the request of the Insured, they will submit to the jurisdiction of a Court of competent jurisdiction within the United States. Nothing in this Clause constitutes or should be understood to constitute a waiver of Underwriters' rights to commence an action in any Court of competent jurisdiction in the United States, to remove an action to a United States District Court, or to seek a transfer of a case to another Court as permitted by the laws of the United States or of any State in the United States. In any suit instituted against any one of them upon the insurance described herein, Underwriters have agreed to abide by the final decision of such Court or of any Appellate Court in the event of an appeal. Underwriters have further agreed that service of process in such suit may be made upon the firm or person named in item 6 on the attached Declaration Page. Underwriters have agreed that such firm or person is authorized and directed to accept service of process on behalf of Underwriters in any such suit and/or upon the request of the Insured to give a written undertaking to the Insured that they will enter a general appearance upon Underwriters' behalf in the event that such a suit shall be instituted. Further, pursuant to any statute of any state, territory or district of the United States which makes provision therefor, Underwriters have designated the Superintendent, Commissioner or Director of Insurance or other officer specified for that purpose in the statute, or his successors in office, as their true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by or on behalf of the Insured or any beneficiary arising out of the insurance described herein, and have designated the above-mentioned as the person to whom the said officer is authorized to mail such process or true copy thereof. 5. Assignment. The insurance described herein shall not be assigned either in whole or in part without the written consent of the Correspondent endorsed hereon. 6. Attached Conditions Incorporated. The insurance described in this Certificate is subject to all provisions, conditions and warranties set forth herein, attached, or endorsed, all of which are to be considered incorporated herein as further descriptive of the insurance the placement of which is evidenced by this Certificate. 7. Short Rate Cancellation. If the attached provisions provide for cancellation, the table below will be used to calculate the short rate proportion of the premium when applicable under the terms of cancellation. Premiums for cancellations pursuant to Paragraph 8 of the Notice on page 2 of this Certificate will be prorated. 3 Short Rate Cancellation Table For Term of One Year. Days Per Cent Days Per Cent Days Per Cent Days Per Cent Insurance in of one year Insurance in of one year Insurance in of one year Insurance in of one year Force Premium Force Premium Force Premium Force Premium 1...................... 5% 66- 69......................29% 154-156......................53% 256-260......................77% 2...................... 6 70- 73......................30 157-160......................54 261 -264......................78 3- 4...................... 7 74- 76......................31 161 -164......................55 265-269......................79 5- 6...................... 8 77- 80......................32 165-167......................56 270-273(9 mos)......80 7- 8...................... 9 81 - 83......................33 168-171......................57 274-278......................81 9- 10......................10 84- 87......................34 172-175......................58 279-282......................82 11 - 12......................11 88- 91 (3 mos)......35 176-178......................59 283-287......................83 13- 14......................12 92- 94......................36 179-.182(6 mos)......60 288-291......................84 15- 16......................13 95- 98......................37 183-187......................61 292-296......................85 17- 18......................14 99-102......................38 188-191......................62 297-301......................86 19- 20......................15 103-105......................39 192-196......................63 302-305(10 mos).....87 21 - 22......................16 106-109......................40 197-200......................64 306-310......................88 23- 25......................17 110-113.......................41 201 -205......................65 311 -314......................89 26- 29......................18 114-116......................42 206-209......................66 315-319......................90 30- 32(1 mos)......19 117-120......................43 210-214.(7 mos)......67 320-323......................91 33- 36......................20 121 -124(4 mos)......44 215-218......................68 324-328......................92 37- 40......................21 125-127......................45 219-223......................69 329-332......................93 41 - 43......................22 128-131 ......................46 224-228......................70 333-337(11 mos).....94 44- 47......................23 132-135......................47 229-232......................71 338-342......................95 48- 51......................24 136-138......................48 233-237......................72 343-346......................96 52- 54......................25 139-142......................49 238-241..._.:.................73 347-351......................97 55- 58......................26 143-146......................50 242-246(8 mos)......74 352-355......................98 59- 62(2 mos)......27 147-149......................51 247-250......................75 356-360......................99 63- 65......................28 150-153(5 mos)......52 251 -255......................76 361 -365(12 mos).....100 Rules applicable to insurance with terms less than or more than one year: A. If insurance has been in force for one year or less, apply the short rate table for annual insurance to the full annual premium determined as for insurance written for a term of one year. B. If insurance has been in force for more than one year: 1. Determine full annual premium as for insurance written for a term of one year. 2. Deduct such premium from the full insurance premium, and on the remainder calculate the pro rata earned premium on the basis of the ratio of the length of time beyond one year the insurance has been in force to the length of time beyond one year for which the policy was written. 3. Add premium produced in accordance with items (1) and (2)to obtain earned premium during full period insurance has been in force. 8. The Certificate is intended for use as evidence of the placement of the insurance described herein, in accordance with Section 1764 of the California Insurance Code. 4 This Declaration Page is attached to and forms part of Certificate provisions (Form SLC- 3 (COR) California LMA3102) Previous No. Not applicable Authority Ref. No. B0507N18NA01030 Certificate No. JAS0653-18 1. Name and address of the First Named Insured: D.W.JOHNSTON CONSTRUCTION, INC. 1445 NORTH SUNRISE WAY, SUITE 203 PALM SPRINGS,CA 92262 USA 2. Effective from JULY 17,2018 to NOVEMBER 17, 2018 both days at 12:01 a.m. local standard time at the location of the risk. 3. This evidences that insurance has been placed with certain UNDERWRITERS AT LLOYD'S, LONDON. Percentage: 100% 4. Coverage including specification of property insured and risks insured against: Hard Costs as per the project(s) bound at inception and on file with Underwriters or as may be more fully-defined in the policy wordings attached Amount Rate Premium USD 332,000 Agreed USD 1,500.00 Term Minimum and Deposit USD 45.00 CA S/L Tax(3%) USD 3.00 CA Stamp. Fee(.2%) USD 17,028.00 TOTAL 5. Forms attached hereto and special conditions: Form -Completed Value Builder's Risk/Installation Floater Form 664THB00124(Amended)and Schedule of Participating Syndicates. The clauses as attached hereto shall form a part of this Certificate 6. Service of Suit may be made upon: FLWA SERVICE CORP. 7. In the event of a claim under the insurance described in this Certificate, please noting the following: R-T Specialty Insurance Services, LLC 2601 Main St., Suite 450 Irvine, CA 92614 USA Telephone: 949.477.5400 Facsimile: 949.477.5411 Dated: July 18, 2018 By: Correspondent 5 Q Q SURPLUS LINE AGENT/BROKER: R-T Specialty, LLC; in CA: R-T Specialty Insurance Services, LLC, 2601 Main St., Suite 450, Irvine, CA 92614; CA Surplus Line License No.: OG97516 PRODUCING AGENT: Mahan Insurance Brokers Inc., 2503 Eastbluff Dr., Suite 203, Newport Beach, CA 92660; CA License No.: 0566836 ADDITIONAL CERTIFICATE PROVISIONS 1. If the Insured shall make any claim knowing the same to be false or fraudulent, as regards amount or otherwise, this certificate shall become void, and all claims hereunder shall be forfeited. 2. The Insured shall immediately report to the said Insurer's representative, any occurrence likely to result in a claim under this certificate, and shall also file with the said Insurer's representative a detailed sworn proof of loss within sixty days from the date of loss. Failure by the Insured either to report the said loss or damage to file such written proof of loss as above provided, shall-invalidate any claim under this certificate. 3. All adjusted claims shall be paid or made good to the Insured within thirty days after presentation and acceptance of satisfactory proofs of interest and loss at the office of the said Insurer's representative. 4. Loss, if any, to be payable in United States Currency. 5. Any provisions or conditions appearing in any forms attached hereto and made a part hereof, which conflict with or alter the certificate provisions stated above, shall supersede the provisions appearing in this certificate, insofar as the latter are inconsistent with the provisions appearing in such attached forms. LLOYD.'S One Lime Street London EC3M 7HA s G COMPLETED VALUE BUILDER'S RISK/INSTALLATION FLOATER WORDING DECLARATION 1. NAME AND ADDRESS OF FIRST NAMED INSURED: D.W. Johnston Construction Inc. 1445 North Sunrise Way, Suite 203 Palm Springs, CA 92262 USA 2. ADDITIONAL INSURED(S): None . To the extent required by any written contract or subcontract, and then only as their respective. interests may appear, any individual(s) or entity(ies) specified 'in such contract or subcontract are recognized as Additional Insured(s). In no event shall this provide any Additional Insured with cover in excess of that available to the First Named Insured under this Certificate. 3. PROJECT LOCATION INSURED: A. Project Description: Historical dwelling (Miss Cornelia White's"Little House") in the course of renovation;work includes repairing and replacing exterior siding; installation of new shear panel; reinforce foundation piers, repair and replace windows; repainting exterior; originally constructed in 1893; constructed of railroad ties; single-story; 890 square feet. B. Project Name and/or Contract Number: None applicable C. Project Location:.221 North Palm Canyon Drive, Palm Springs, Riverside County, CA 92262 USA D. Estimated Total Project Value at Inception: (1) Estimated Construction Contract Price: USD 332,000 Hard Costs only(existing structure is excluded). (2) Value of Property not declared in (1)whether supplied by the project owner(s) or other(s)for installation under the contract which is to be insured hereunder: USD INCLUDED 4. TERM OF INSURANCE: In consideration of the deposit premium as stated in item number 8A, this Certificate shall be effective from the date and time shown on the declarations page and expire at the date and time shown on the declarations page at the Project Location insured. Notwithstanding the foregoing effective and expiration dates or subsequent endorsements affecting such dates, the liability under this Certificate will apply only for such periods commencing directly with work at the project locations and the Underwriters liability will cease for any insured portions of the project for which the work has been taken over by the owner or placed in service or when the contractor's interest ceases but in no event beyond the expiration date as herein provided. 5. LIMIT OF LIABILITY: A. USD 332,000 any one occurrence at the project site (subject to Sub-limits as shown below or as endorsed hereon) B. SUB-LIMITS OF LIABILITY Transit: USD 50,000 any one conveyance Page 1 of 33 Off Site Storage: USD 50,000-any one occurrence Landscaping: USD.15,000 any one occurrence, any one project, subject to a USD 2,500 maximum anyone item Valuable Papers and Records: USD 50,000 any one occurrence Scaffolding, Form and False-work: USD 5,000 any one occurrence Cold Testing: USD 50,000 any one occurrence Electronic Data Processing including Data and Media:'USD 50,000 any one occurrence Back-up of Sewers and Drains: USD 50,000 any one occurrence Pollution and Contamination(Listed Perils Only): USD 5,000 in the aggregate for the term of insurance Fungus: USD 5,000 in the aggregate for term of insurance In no event shall these Sub-limits of Liability increase the Limit of Liability as provided herein as a result of loss or losses from any one occurrence and in the aggregate where shown. 6. DEDUCTIBLE: The Underwriters will adjust all claims for loss, damage or expense arising out of any one occurrence as one claim and from the amount of such adjusted claim or the applicable limit(s)of liability or sub-limit(s) of liability,whichever is less,there shall be deducted the amount(s)specified herein. If two or more deductibles apply to the same loss the larger deductible shall apply: USD 2,500 any one occurrence however any one conveyance as respects Property in Transit. USD 5,000 any one occurrence as respects Water Damage USD 5,000 any one occurrence as respects Frost, Falling Ice and/or Freezing It is noted that in the event that work ceases at a location insured hereunder for a period of 60 days,the deductible in respect of such location shall be increased to two(2) hundred % of the figure shown above,any one occurrence. .7. TERRITORY: Coverage applies to property within the fifty(50) states comprising the United States of America and within the District of Columbia, and Canada. 8. DEPOSIT PREMIUM/RATES/ADJUSTMENT/CERTIFICATE EXTENSION A. Deposit Premium The deposit premium for the Certificate term is.USD 1,500 and shall be subject to a minimum and earned premium of USD 1,500. The deposit premium shall be adjusted in accordance with provisions as outlined in B and C of this Item 8. B. Reporting Provisions At time of expiration, cancellation, or at time of requested certificate extension,the Insured shall report to the Underwriters, the Total Project Value of all property as had been reported to develop the Deposit Premium including but not limited to all wages, expenses, materials, supplies, equipment and such other charges,whether provided by the owner, contractor(s) or other(s), which became a part or was expended in the project. C. Premium Adjustment The final earned premium for this Certificate.shall be computed by applying the rates used for the purpose of computing the Deposit Premium to the Total Project Values as developed at the completion.of the construction project insured hereunder, subject to any minimum and Page 2 of 33 �J earned premium requirement. There shall be no return premium if the construction project insured hereunder is completed prior to the Certificate expiration or if the Total Project Value at completion is less than declared at Certificate inception. D. Term Rates The rates used for the purpose of computing the deposit premium and final earned premiums are: Term Term Developed Term Rate Premium 4 months Agreed USD 1,500 9. LAW This Insurance shall be governed by and construed in accordance with the law of the State of California. 10. INSURING CLAUSE This Certificate, subject to the terms, exclusions, limitations and conditions contained herein or endorsed hereon, insures against risks of direct physical loss of or damage to insured property while at the project location, while in offsite storage or while in transit all within the territorial limits specified in the Certificate and during the term of this insurance contract. Provided also that the liability of the Underwriters in respect to any one occurrence shall not exceed the applicable Limit of Liability, Sub-Limits of Liability or Aggregate Sub-Limits of Liability specified in this Certificate. 11. INSURED PROPERTY A. At Project Location Insured This Certificate insures all material, supplies, machinery, equipment, fixtures, temporary structures, hoardings, excavations-, site preparation and other property of a similar nature owned by the Insured (scaffolding, falsework or forms is insured by this Certificate if a Sub-limit of Liability for scaffolding, falsework or forms for is specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability), all of which is to be used in or incidental to the fabrication, erection, or completion of the Project while situated at the Project Location defined in the Certificate, whether the property of the Insured or property of others for which the Insured shall be legally liable, subject to the exclusions, limitations, terms and conditions of this Certificate and to the extent such values are reported for premium purposes. B. Extensions of Coverage Subject to the terms, exclusions, limitations and conditions contained herein or endorsed hereon, this Certificate also insures: (1) Offsite Storage: Property which is in Offsite Storage is insured by this Certificate where a sub-limit is specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability. If Offsite Storage coverage is provided, then this Certificate insures all property described in paragraph A. above while in storage anywhere in the United States of America, Canada or Puerto Rico, but excluding such property while in transit or in the care, custody or control of any manufacturer or supplier unless otherwise provided. (2) Transit: Property which is in Transit is insured by this Certificate where, a sub-limit is specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability. If transit coverage is provided, then this Certificate insures all property described in paragraph A. above, from the commencement of loading at the original point of Page 3 of 33 C� shipment anywhere in the United States of America, Canada, and Puerto Rico, until the completion of the unloading at the project location (excluding while waterborne, except on a ferry, railway car or transfer barge, all in connection with land transportation). (3) Expediting Expenses This certificate shall pay for the reasonable extra costs to make temporary repairs and to expedite the permanent repair or replacement of the Insured Property damaged by a peril insured against by this Certificate, including additional wages for overtime, night work and work on public holiday and the extra cost of express freight and other rapid means of transportation. Expediting Expense is insured by this Certificate where a sub-limit is specifically . provided for under 5. Limit of Liability, B. Sub-limits of Liability. (4) Extra Expense The recoverable Extra Expense loss-will be the reasonable and necessary extra costs incurred by the Insured of the following during the Term of Insurance a) Extra expenses to temporarily continue as nearly normal as practicable the conduct of the Insured's business; and b) Extra costs of temporarily using property or facilities of the Insured or others, Extra Expense is insured by this Certificate where a sub-limit is specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability. (6) Cold Testing: This Certificate is extended to insure loss or damage directly caused by or resulting from Cold Testing including but not limited to electrical, mechanical, hydraulic, hydrostatic and pneumatic. Start up and testing of building systems shall be considered as Cold Testing. Cold Testing is insured by this Certificate where a sub-limit is specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability. The Insured warrants that supervisory or safety systems shall not be deliberately circumvented during such periods, but the Underwriters shall not withhold coverage where it can be reasonably shown that the management or supervisory staff was not aware of such situations. (6) Fire Brigade Charge and Extinguishing Expenses: Fire Brigade Charges and Extinguishing Expenses are insured by this Certificate if a Sub-limit of Liability is stated in the Certificate under 5. Limit of Liability, B. Sub- limits of Liability. If property insured is destroyed or damaged by a peril hereby insured against, this Certificate shall cover (a) fire brigade and other extinguishing expense for which the Insured may be assessed; (b) loss of fire extinguishing materials expended in fighting fire including the loss of similar material which may be brought to the project location for the purpose of extinguishing a fire already in progress at the time such materials are ordered and delivered, but liability shall not exceed the combined value of such extinguishing materials which are on the premises, or on adjacent premises if such materials are jointly owned at the time of loss. (7) Debris Removal: Debris Removal coverage is insured by this Certificate if a Sub-limit of Liability is stated in the Certificate under 5. Limit of Liability, B. Sub-limits of Liability. Page 4 of 33 In the event of direct physical loss, damage or.expense insured against and occurring during the term of this Certificate, the Underwriters will pay: (a) necessary.and reasonable costs to remove debris being an insured part of the property from the Project Location of the Insured; and/or (b) cost of clean-up, at the Project Location of the Insured, made necessary as a result of such direct physical loss, damage or expense. The Underwriters will not pay any expense or cost to extract pollutants or contaminants from land, water, debris, or to remove, restore, or replace contaminated or polluted land or water. Nor will.the Underwriters pay any expense or cost to remove or transport any property or debris to a site for storage or decontamination required because the property or debris is affected by pollutants or.contaminants, whether or not such removal, transport or decontamination is required by law, ordinance or regulation. It is a condition precedent to recovery under this extension that the Underwriters shall have paid or agreed to pay for direct physical loss, damage or expense to the property insured hereunder unless such. payment is precluded solely by the operation of any deductible and that the Insured shall give written notice to the Underwriters of intent to claim for cost of debris removal or cost to clean up not later than twelve(12) months after the date of such physical loss, damage or expense. (8) Permission to Occupy Permission is granted to the Insured to occupy any property, excluding single-family dwellings, insured hereunder for up to sixty(60)days whilst.it is in the course of construction, reconstruction or repair. It is understood and agreed that coverage under these Extensions of Coverage is part of and not in addition to the Limits of Liability of this Certificate 12. PROPERTIES EXCLUDED This Certificate does not insure: A. Accounts, bills, currency, deeds, securities, plans, blueprints, specifications, books, manuscripts, or other similar property or data processing media. Also Valuable papers and records unless specifically provided for under 5. Limit of Liability, B. Sub-limits-of Liability; B. Landscaping, Land and Land Values unless specifically provided for under 5. Limit of Liability, B.Sub-limits of Liability. C. Contractor's tools, machinery, plant and equipment not destined to become a permanent part of the completed project unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; D. Vehicles and equipment licensed for highway use, rolling stock, aircraft, and watercraft; E. Property while covered by Ocean Marine Insurance or while water-borne in the course of ocean shipment or while aboard any aircraft; F. Existing buildings or structures or any existing properties located at or adjacent to the project location; G. Used machinery and equipment but only as to damage while undergoing any form of testing, commissioning or start up; H. Contraband or property in the course of illegal transportation or trade. Page 5 of 33 I. Grading, backfilling or earthwork incorporated in the project unless a statement of value has been reported for coverage and premium purposes and a sub-limit is specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; J. Transmission and distribution lines beyond one thousand (1,000)feet of the project location. K. Rigging unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; L. Fine Arts unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; M. Trade in/Buy Back Homes unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability. 13. PERILS EXCLUDED This Certificate does not insure loss or damage caused by or resulting from, contributed to or aggravated by any of the following perils or general exclusions whether or not any other insured event contributes to the loss except as provided in (E), (J), (K), (L), (M(1)) (0), (R), (T), (U), and M. -Such loss or damage is not covered. regardless of any.other cause or event that contributed concurrently or iri any sequence to the loss or damage. A. Any dishonest act or omission of the Insured or of any associate,agent, or employee of the Insured whether acting alone or in collusion with others; B. Unexplained disappearance, shortage or other loss discovered upon taking inventory; C. Wear and tear, deterioration, corrosion, oxidation, inherent vice, latent defect, gradual deterioration, erosion, moth, vermin,termites or other insects; D. Dampness or dryness of atmosphere,, extremes or changes of temperature, shrinkage, evaporation, loss of weight, leakage of contents, marring, scratching, exposure to light, change in flavor or color or texture or finish or rust; E. Consequential loss or damage of any kind including but not limited to loss of market, liquidated damages, performance penalties, penalties for non-completion of or delay in completion of the Project or non-compliance with contract conditions nor any loss of use of occupancy however caused unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; F. Normal settling, cracking, expansion or shrinkage of walls, floors, ceilings, buildings, pavements or foundations; G. Under any-written or implied guarantee or warranty by any contractor, manufacturer or supplier whether or not such are insured under this Certificate; H. War, hostile or warlike action in time of peace or war, including action in hindering combating, or defending against an actual, impending, or expected attack by (1) any government or sovereign power (de jure or de facto), or by any authority maintaining or using military, naval, air forces, or (2) military, naval or air forces, or.(3) an agent of any such government, power, authority, or forces, it being understood that any discharge, explosion, or use of any weapon of war employing nuclear fusion or fission shall be conclusively presumed to be such a hostile or warlike action by such a government, power, authority, or force; I. Insurrection, rebellion, revolution, civil war, usurped power or action taken by governmental authority in hindering, combating, or defending against such occurrence; J. Seizure or destruction of property by order of governmental authority. However, if fire is :covered under this Certificate, the Underwriters will pay for acts of destruction ordered by governmental authority and taken at the time of a fire to prevent its spread; Page 6 of 33 . K. Nuclear reaction or nuclear radiation or radioactive contamination, all whether controlled or uncontrolled, or due to any act or.condition incident to any of the foregoing, whether such loss be director indirect; proximate or remote, or be in whole or in part caused by, contributed to or aggravated by a cause not otherwise excluded ; however, subject to the foregoing and all provisions of this Certificate, direct loss by fire as .insured against hereunder, resulting from nuclear reaction, or nuclear radiation, or radioactive contamination is insured against by this Certificate; L. Resulting from, contributed to or made worse by actual, alleged or threatened release, discharge, escape or dispersal of CONTAMINANTS or POLLUTANTS, all whether direct or indirect, proximate or remote or in whole or in-part caused by, contributed to or aggravated by any direct physical damage insured by this Certificate; Nevertheless, if fire.or explosion is not excluded from this Certificate and a fire or explosion arises directly or indirectly from seepage or contamination or pollution, any loss or damage insured under this Certificate arising directly from that fire or explosion is insured, subject to the.provisions of this Certificate; CONTAMINANTS or POLLUTANTS means any material which after it is released can cause or threaten damage, deterioration, loss of value, marketability or loss of use to property insured hereunder, including but not limited to bacteria,fungi, virus, or hazardous substances as listed in fhe Federal Water Pollution Control Act, Clean Air Act, Resources Conservation and Recovery Act of 1976, and. Toxic Substances Control Act, or as designated by.the U.S. Environmental Protection Agency; This exclusion shall not apply when (i) loss or damage is directly caused by fire, lightning, aircraft impact, explosion, riot, civil commotion, smoke, vehicle impact, wind, hail, ! vandalism or malicious mischief. (ii) loss or damage is directly caused by leakage or accidental discharge from automatic fire protective systems; M. (1) asbestos material removal unless the asbestos is itself damaged by fire, lightning, aircraft impact, explosion, riot, civil commotion, smoke, vehicle impact, wind or hail, vandalism, malicious mischief, leakage or accidental discharge from automatic fire protective systems; (2) demolition or increased cost of reconstruction, repair, debris removal or loss of use necessitated by the enforcement of. any law or ordinance regulating asbestos material; The Insured shall give notice to the Underwriters of intent to make a claim no later than twelve(12) months after the date the,original physical loss or physical-damage occurred; N. Costs, fines, penalties or expenses, incurred or sustained by the Insured or imposed on the Insured at the order of any Government Agency, Court, Arbitration Panel or Authority or similar tribunal in connection with any kind or description of environmental impairment including.seepage or pollution or contamination from any cause; O. The cost of making-good faulty, inadequate or defective planning, zoning, development, surveying, siting, design, specifications, renovation, workmanship, repair, reconstruction or remodeling, materials used in.repair, construction or remodeling, labor or maintenance unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; P. From cessation of the work for any period beyond the first ninety(90) days;Q. Enforcement of any ordinance or law regulating the construction, use, repair or demolition of any property insured.hereunder, except as specifically stated herein or added by endorsement; R. Earthquake unless loss by fire or explosion ensues and then Underwriters shall be liable for only such ensuing loss; S. Hot Testing, commissioning; shakedown. or following the introduction of feedstock or similar media into the facility and continuously thereafter including during operational or performance tests whether for sporadic or sustained periods. T. Flood (other than flood as defined in 15 B below associated with Wind), unless loss by fire or explosion ensues and then Underwriters shall be liable for only such ensuing loss; Page 7 of 33 CI U. Back up of sewers or drains unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; V. Earthquake Sprinkler Leakage unless specifically provided for under 5. Limit of Liability, B. Sub-limits of Liability; W. Loss or damage caused by exposure to weather conditions where any property insured is left in the open or not contained in buildings which are capable of secure storage. 14. VALUATION At the time of loss,the basis of adjustment, unless otherwise endorsed herein, shall be as follows: A. Property Under Construction — Cost to repair or replace the property lost or damaged at the time and place of loss with material of like kind and quality; if not so replaced the Actual Cash Value with proper deduction for depreciation. 15. DEFINITIONS A. Occurrence Occurrence shall have the meaning as herein defined except where more specifically stated in this Certificate including but not limited to Earthquake, Wind or Flood. Occurrence means an accident, incident, or a series of accidents or incidents, arising immediately out of a single event or originating cause and includes all resultant or concomitant losses wherever located. B. Wind Wind (including resulting flood or wave action from wind) means an atmospheric disturbance marked by high winds, with or without precipitation, including such events as hurricane, typhoon, rainstorm, hailstorm, tornado and/or a combination of events. C. Fire Protective Equipment Fire protective equipment means tanks, water mains, hydrants, or valves, and any other equipment whether used solely for fire protection or jointly for fire protection and for other purposes but does not include: (1) branch piping from a joint system where such branches are used entirely for purposes other than fire protection; (2) any underground water mains or appurtenances located outside of the described premises and forming part of the public water distributing system; (3) any pond or reservoir in which the water is impounded by a dam. D. Flood Flood means; surface waters; rising waters; waves; tide or tidal water; the release of water, the rising, overflowing or breaking of boundaries of natural or manmade bodies of water; or the spray therefrom, excluding back up from sewers or drains. E. Back up of sewers or drains Back up of sewers or drains means; loss or damage resulting from back up arising out of . accidental damage as insured by this Certificate to sewers, drains or watercourses causing fouling or clogging. F. Time Element Time Element loss as provided by this Certificate shall mean, the interruption of activities as insured by this Certificate directly resulting from physical loss or damage of the type insured by this Certificate. G. Earthquake Any natural or man-made earth movement, including but not limited to earthquake, volcanic eruption, landslide or mudslide regardless of any other cause or event contributing concurrently or in any other sequence of loss. Page 8 of 33 �j H. Buildings Buildings means; Structure of buildings in the course of construction and completed buildings including conveyers, wires, service pipes and other equipment that is associated with the building, being property of the insured or for which they are legally liable to insure. I. Service Work Service work means; Telephones, gas, water pipes and cabling which are outside the Building but within the contract site. J. Contractual Penalties Contractual Penalties means; penalties that the insured is legally liable to pay, however, such penalties shall only arise out of physical loss or damage to property insured by this Certificate, by a peril not excluded by this Certificate. K. Rigging Property of Others in the Insured's care, custody and control that the Insured has agreed to move, lift, hoist or lower 16. CONTRIBUTING INSURANCE Permission is granted for other insurances written upon the same plans, terms, conditions, and provisions as those contained in this Certificate. This Certificate shall contribute to the total of each loss otherwise payable herein to the extent of the participation of this Certificate in the total limit of liability as provided by all insurances written upon the same plan, terms, conditions, and provisions as those contained in this Certificate. 17. EXCESS INSURANCE Permission is granted for the Insured to have insurance over the limit of liability in this Certificate and the existence of such insurance, if any, shall not reduce any liability under this Certificate. 18. UNDERLYING INSURANCE Permission is granted to the Insured to purchase insurance on all or any part of the deductible and against all or any of the perils covered by this Certificate. The existence of such underlying insurance shall not prejudice or affect any recovery otherwise payable under this Certificate. 19. OTHERINSURANCE Except as referred to in Articles 16 and 17, if there is other collectible insurance, this Certificate will cover as excess insurance and will not contribute with such other insurance. 20. SUBROGATION A. In the event of any payment made hereunder, the Underwriters shall be subrogated to all the Insured's rights of recovery therefore against any person or organization and the Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured shall do nothing after the loss to prejudice such rights. B. The Underwriters shall have no rights of subrogation against any person or entity, which is a Named Insured or Additional Insured. C. The Underwriters hereby waive all rights which they may have acquired by payment of a claim under this Certificate to recover the amount so paid from any person or organization with whom the Insured, prior to the occurrence of the loss or damage, shall have agreed in writing to waive their.rights to recovery in respect of any loss or damage which may be caused by said person or organization to the property described in this Certificate. However, the Underwriters shall be subrogated, to the extent of payment, to all the Page 9 of 33 Insured's rights of recovery against any manufacturer or supplier of machinery, equipment or other property whether a Named Insured or not, for the cost of making good any loss or damage which said party has agreed to make good under a guarantee or warranty, whether expressed or implied, or any consulting engineer, architect, or designer, whether a Named Insured or not, for any loss or damage which arises out of the performance of their respective professional activities. D. If any amount is recovered as a result of such proceedings, the net amount recovered after deducting the costs of recovery will accrue first to the Underwriters involved in proportion to their respective interests. Any excess of this amount will be remitted to the Insured. If there is no recovery, the interests instituting the proceedings will bear the expense of the proceedings proportionately. E. It is warranted and a condition precedent to the Liability of Underwriters that no rights of subrogation are.waived against contractors, and/or sub-contractors of any tier, unless they are named specifically under contractor's OCIP (Owner Controlled Insurance Programs). F. It is warranted that and a condition precedent to the Liability of Underwriters that contractors and/or sub-contractors carry minimum of USD 1,000,000 Contractors General Liability Insurance throughout the Certificate Period. 21. APPRAISAL If the Insured and Underwriters fail to agree on the amount of loss, each upon the written demand either made within sixty (60) days after receipt of proof of loss by the Underwriters, shall select a competent and disinterested appraiser. The appraisers shall.then select a competent and disinterested umpire. If they should fail for fifteen (15) days to agree upon such umpire, then upon the request of the Insured, or of Underwriters, such umpire shall be selected by a judge of a court of record in the country and state in which such appraisal is pending. Then at a reasonable time and place, the appraisers shall appraise the loss, stating separately the value at the time of loss and the amount of loss. If the appraisers fail to agree, they shall submit their differences to the umpire. An award in writing of any two (2) shall determine the amount of loss. The Insured and Underwriters shall each pay his, her or its chosen appraiser and shall bear equally the other expenses of the appraisal and of the umpire. 22. PRESERVATION OF PROPERTY CLAUSE: In case of actual or imminent physical loss or damage of the type insured against by this Certificate, the expenses incurred by the insured in taking reasonable and necessary actions for the temporary protections and preservation of property insured hereunder shall be added to the total physical loss or damage, if any, otherwise recoverable under the Certificate and be subject to the applicable deductible and without increase in the limit provisions contained in this Certificate. 23. IN CASE OF LOSS A. Notice of Loss The Insured shall, as soon as reasonably practicable, notify the Underwriters of every loss occurrence which may give rise to a claim under this Certificate, except as provided in Item 11.13.7. Debris Removal. B. Protection of Property The Insured shall protect the property from further loss or damage. C. Proof of Loss At the request of the Underwriters the Insured shall report within sixty (60) days, unless such time is extended in writing by the Underwriters, a signed and sworn detailed proof of loss by the Insured stating the knowledge and belief of the Insured as to the time and cause of loss or damage and the interest of the Insured and all others in the property. Page 10 of 33 D. Exhibit The Insured shall exhibit to any person designated by the Underwriters all that remains of any property herein described as often as may reasonably be required. E. Examination Under Oath The Insured shall produce for examination all books of account, bills, invoices and vouchers and any and all documents pertaining to the interest of the Insured hereunder or a certified copy thereof if originals be lost, at such reasonable place as may be designated by the Underwriters or their representative, and permit extracts and copies thereof to be made. The Underwriters may examine any Insured under oath, while not in the presence of any other Insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an Insured's books and records. In the event of an examination, an Insured's answers must be signed. F. Assistance and Cooperation of the Insured The Insured shall cooperate with Underwriters and, at Underwriters' request and expense, shall attend hearings and trials and shall assist in effecting settlements, in securing and giving evidence, in obtaining the attendance of witnesses and in conducting suits. G. Inspection and Audits The Underwriters shall be permitted at all reasonable times to inspect the property covered, and to examine the Insured's books and records at any time during the currency hereof, and within three (3) years after final settlement of all claims so far as the books and records relate to any payments made because of occurrences during the term of this Certificate, but the Underwriters waive no rights and undertake no responsibility by reason of such inspection or examination or the omission thereof. H. Payment of Loss All adjusted claims are due and payable no later than sixty (60) days after presentation and acceptance of proof of loss by the Underwriters or their appointed representative. 24. LOSS PAYABLE Loss, if any, shall be adjusted with and payable to the First Named Insured and designated Loss Payees and Mortgagees or as per the order of the First Named Insured, whose receipt shall constitute a release of full liability under this Certificate with respect to such loss. 25. PERMISSION TO CARRY OUT REPAIRS The Underwriters hereby grant permission to the Insured to carry out necessary and reasonable repairs which can be undertaken by them in respect of partial damage insured herein, up to a maximum of USD 2,500 subject to the applicable deductible and the limit of liability. If insurance in respect of such repairs is provided by this Certificate and subject to the deductible and any limit of- liability stated in the Certificate, the Underwriters will reimburse the Insured for their proportion of the actual cost of such repairs. Nothing in the clause shall be deemed to have waived the requirement that notice of loss be given forthwith to the Underwriters as provided in this Certificate. 26. SUIT AGAINST THE UNDERWRITERS No suit, action or proceeding against the Underwriters for the recovery of any claim under this Certificate, shall be sustainable in any court of law or equity, unless the same be commenced within twelve (12) months of discovery by the Insured of the loss or damage which gives rise to the claim, provided however, that if by the laws of the state within which this Certificate is issued such limitation is invalid, then any such claim shall be void unless such action, suit or proceeding be commenced within the shortest period of time permitted by the laws of such state. Page 11 of 33 27. REINSTATEMENT With the exception of loss caused by perils, which are subject to aggregate limits, no loss hereunder shall reduce the amount of this Certificate. 28. UNINTENTIONAL ERRORS AND OMISSIONS The Insured hereunder is not to be prejudiced by an unintentional or inadvertent omission or error, as relates to this insurance, provided immediate notice is given to the Underwriters on discovery of any such error or omission and the Underwriters may at their option undertake any action within reason which it deems necessary to continue coverage under this Certificate. 29. PAIR AND SET A. In the event of loss or damage to any article or articles which are part of a pair or set, the measure of loss of or damage to such article or articles shall be a reasonable and fair proportion of the total value of the pair or set, giving consideration to the importance of said article or articles, but in no event shall such loss or damage be construed to mean total loss of the pair or set, or B. In the event of loss or damage to any part of property covered consisting, when complete for use, of several parts, the Underwriters shall only be liable for the value of the part lost or damaged. 30. SALVAGE AND RECOVERIES All salvages, recoveries, and payments excluding proceeds from subrogation and underlying insurance recovered or received subsequent to a loss settlement under this Certificate shall be applied as if recovered or received prior to the said settlement and all necessary adjustments shall be made to the parties involved. 31. BENEFIT TO BAILEE The Certificate will not inure, directly or indirectly, to the benefit of any carrier or bailee. 32. CANCELLATION A. This Certificate may.be cancelled by the Insured by mailing to the Underwriters written notice stating when thereafter such cancellation shall be effective. This Certificate may be cancelled by the Underwriters by mailing to the Insured, at the address shown in this Certificate or last known address, written notice stating when not less than sixty (60) days thereafter such cancellation shall be effective. The mailing of notice as aforementioned shall be sufficient.proof of notice and the effective date of cancellation stated in the notice shall become the end of the Certificate Period. Delivery of such written notice either by the Insured or by the Underwriters shall be equivalent to mailing. In the event of non-payment of premium when due, cancellation shall be ten (10) days in lieu thereof. B. If the Insured cancels this Certificate, premium adjustment may be made at the time cancellation is effected and, if not then made, shall be made as soon as practicable after cancellation becomes effective. The Underwriters' check or the check of their representative mailed or delivered as aforesaid shall be a sufficient tender of any refund of premium due to the Insured. C. If conditions beyond the control of the Insured, not arising out of circumstances giving rise to a claim hereunder, necessitate abandonment of the Project this Certificate may be cancelled by the Insured upon written notice to the Underwriters. 33. STATUTES If anything herein stated conflicts with the laws or statutes of any jurisdictions in which this Certificate applies, the same is amended to conform to such laws or statutes. Page 12 of 33 34. ABANDONMENT There can be no abandonment to Underwriters of the property insured. 35. ASSIGNMENT No assignment of interest under this Certificate shall bind the Underwriters until their consent is endorsed hereon. However, should the Insured die or be adjudged bankrupt or insolvent, the Underwriters shall consent to the assignment of this Certificate to the Insured's legal representative provided that written notice is given to the Underwriters within thirty (30) days after the date of such death, bankruptcy or insolvency. . 36. DUE DILIGENCE The Insured shall, at their own expense, take all reasonable precautions and comply with all reasonable recommendations of the Underwriters to prevent loss or damage to the property insured. 37. INSPECTION The Underwriters shall be permitted but not obligated to inspect, at all reasonable times, the property of the Insured. Neither the Underwriters' right to make inspections nor the making thereof nor any report thereon shall constitute any undertaking, on behalf of or for the benefit of the Named Insured or others, to determine or warrant that such property is safe or healthful. 38. TITLES OF PARAGRAPHS The several titles of the various paragraphs of this form and endorsements attached to this Certificate are inserted for reference and shall not be deemed in any way to affect the provisions to which they relate. 39. MISREPRESENTATION AND FRAUD This entire Certificate shall be void if, whether before or after a loss, the Named Insured has concealed or misrepresented any material fact or circumstance concerning this insurance or the subject thereof, or the interest of the Named Insured therein, or in case of any fraud or false swearing by the Named Insured relating thereto. 40. CONFLICT OF WORDING The conditions contained in this form shall supersede those of the basic Certificate to which this form is attached wherever the same may conflict. Where there is a conflict between the specific sections and general conditions of this Certificate, the conditions of the specific section shall prevail. 664THB00121A(Amended) Page 13 of 33 SOFT COSTS COVERAGE EXTENSION In consideration.of the premium paid and.subject to the terms, conditions, exclusions and limitations of the Certificate to which this Extension is attached,this Certificate is extended to cover the following due to physical loss or damage to Property as covered by this Certificate, such coverage shall only apply where a sub-limit is shown. ARCHITECTS AND ENGINEERS: 1)Architectural costs to include, but not be limited to: master planning, landscaping, printing and architectural costs. 2) Engineering costs to include but not be limited to: civil, structural, survey, soils and geology costs. USD NIL BOND INTEREST: Bond interest payments,which become due and must be paid whether the project.is habitable or not. USD NIL CONSTRUCTION LOAN FEES:Additional commissions or loan fees incurred in rearranging financing necessary for completion of the project. USD NIL DEBT SERVICE PAYMENTS: Interest payments and/or principal payments,which become due and must be paid whether the project is operational or not. USD NIL FINANCE &TAXES, including but not limited to: 1. Commissions, Points and Fees 2. All Interest Expenses/Internal Financing Arrangements 3. Real Estate/Property Taxes:Additional realty taxes and other assessments actually incurred for the period of time that construction has been extended beyond the scheduled completion date. 4. The additional costs expended by the Insured solely to obtain new financing for the project, should the financing expire or fail to be renewed. USD NIL FIXED OPERATIONAL AND MAINTENANCE EXPENSES: Those costs incurred,whether or not the project is operating, less any income derived from the project operations. Such items include salaries, wages,taxes, maintenance, and other ongoing expenses,which cannot be reasonably avoided during such delay. USD NIL FOUNDER'S FEE REFUNDS: Founder's fee refunds are defined as deposits made by prospective occupants. A refund of said deposits might become necessary if the project is delayed. If payment by the insurers is necessary for founder's fee refunds, any new founder's fees later collected by the Insured on the same property will be applied to reduce the loss payment made under this certificate. USD NIL GENERAL OVERHEAD/MISCELLANEOUS OPERATING EXPENSES: General overhead, administration and miscellaneous expenses incurred, including but not limited to additional clerical personnel, consultant's fees, temporary office space, additional.security, advertising, taxes, and other similar expenses incurred as a result of the delay in completion. USD NIL GROUND.RENTS: Rent paid for land to be used chiefly for building. USD.NIL LEASING EXPENSES:Additional costs renegotiating and pre-leasing of the project as a result of delay in the scheduled opening date. USD NIL Page 14 of 33 LEGAL/PROFESSIONAL FEES: Additional accounting work incurred in renewing or restructuring the financing, other professional fees as a result of additional costs and expenses of the project and additional legal work incurred in renegotiating and preparing revised contracts and other documents. USD NIL MISCELLANEOUS BONDS AND PERMITS USD NIL MARKETING AND LEASING COMMISSIONS (expended prior to loss) USD NIL MARKETING EXPENSES:.Additional advertising, promotion and such additional expenses as are incurred as a result of delay in scheduled completion of the project. USD Nil TITLE AND ESCROW COSTS USD NIL VALUATION:Actual Loss Sustained Underwriters'total liability under this Extension shall not exceed USD NIL included in the Limit of Liability shown in the Certificate to which this Extension is attached. 664THB00124(Amended) Page 15 of 33 GENERAL ENDORSEMENTS FIRST NAMED INSURED Wherever the words"Insured" or"Named Insured"shall appear this shall be deemed to read and mean "First Named Insured". LAW AND BUILDING ORDINANCE If: 1. Any building suffers direct physical damage of more than 5b% (fifty percent)of its area and such damage is insured by this Certificate, and 2. There existed prior to that damage a law or ordinance which regulates the use of, and/or the, building materials permitted to be used at, the site of such damage, and 3. The implementation of that law or ordinance becomes enforceable, and is enforced, as a result of the insured direct physical damage, Then this Certificate,within its limits and subject to its exclusions, conditions and limitations insures costs actually and necessarily incurred in (a)the demolition and clearing of the site of the undamaged portion of the insured building and (b).reconstructing the building to conform with the law or ordinance. Sub-limited to USD NIL any one occurrence and in the aggregate for the term of insurance. PROTECTION WARRANTY In consideration of the premium charged, it is agreed that any protection, as advised by the Assured. and/or the Assured's Representative, provided for the safety of the insured property shall be maintained in good order throughout the currency of this certificate and shall be in use at all relevant time and that such protection shall not be withdrawn or varied to the detriment of the interests of the underwriters without their consent. Failure to comply shall suspend all insurance coverage provided by this Certificate. Protection details advised Underwriters include but may not be limited to: 1) Project site is fenced (the peril of Theft, if not elsewhere excluded in the Certificate, shall be excluded as respects materials and supplies that are not fully secured behind a locked fence) during all non-working hours. 2) Risk is situated in an ISO Public Protection 3 Page 16 of 33 BIOLOGICAL OR CHEMICAL MATERIALS EXCLUSION It is agreed that this Insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with the actual or threatened malicious use of pathogenic or poisonous biological or chemical materials regardless of any other cause or event contributing concurrently or in any other sequence thereto. N MA2962 06/02/03 Form approved by Lloyd's Market Association [Non-Marine] AVERAGE CLAUSE This Policy is subject to the condition of average, that is to say, if the property covered by-this Insurance shall at the time of any loss be of greater value than the Value Declared by the Assured, prior to the loss, then the Assured shall only be entitled to recover hereunder such proportion of the.said loss as the Value Declared by this Policy bears to the total value of the said property. 22/10/17 NMA348(Amended) BRUSH CLEAR SPACE CONDITION It is a condition precedent to the liability of the Underwriters hereon that the minimum exposure distance from native brush or other natural vegetative growth to any portion of the building(s) containing insured property is two hundred and fifty(250)feet measured in accordance with the instructions below. Cultivated planting (other than native growth) is permitted in this space provided such planting will not readily transmit fire from the native growth to the building(s). If the Insured fails to comply with this condition,the Underwriters will not have to pay any related claim. EXPOSURE DISTANCE: The distance measured parallel to the general ground surface shall be considered the exposure distance, except when a down slope below the b.uilding(s) exceeds 30 degrees, in which case only one-half the measured distance on such slope shall be used. Page 17 of 33 WEH ASBESTOS ENDORSEMENT A. .This Certificate only insures asbestos physically incorporated in an insured building or structure, and then only that part of the asbestos which has been physically damaged during the certificate period by one of these Listed Perils: FIRE; EXPLOSION; LIGHTNING; WINDSTORM; HAIL; DIRECT IMPACT OF VEHICLE, AIRCRAFT OR VESSEL; RIOT OR CIVIL COMMOTION;VANDALISM OR MALICIOUS MISCHIEF;ACCIDENTAL DISCHARGE OF FIRE PROTECTIVE EQUIPMENT This coverage is subject to all limitations in the certificate.to which this endorsement is attached and, in addition, to each of the following specific limitations: 1) The said building or structure must be insured under this certificate for damage by that Listed Peril 2) The Listed Peril must be the immediate, sole cause of the damage to the asbestos 3) The Insured must report to Underwriters the existence and cost of the damage as soon as practicable after the Listed Peril first damaged the asbestos. -However this certificate does not insure any such damage first reported to Underwriters more than 12 (twelve) months after the expiration, or termination, of the certificate period. 4) Insurance under this certificate in respect of asbestos shall not include any sum relating to: - i) any faults in-the design, manufacture or installation of the asbestos. ii) asbestos not-physically damaged by the Listed Peril including any governmental or regulatory authority direction or request of whatsoever nature relating to undamaged asbestos. B Except as set forth in the foregoing Section A,this Certificate does not insure asbestos or any sum relating thereto. Page 18 of 33 ACCOUNTS RECEIVABLE This Certificate covers any shortage in the collection of accounts receivable, resulting .from insured physical loss or damage to.accounts receivable records, including accounts receivable records stored'as electronic data, while anywhere within this Certificate's TERRITORY, including while in transit. .The Underwriters will be liable.for the interest charges on any loan to offset impaired collections pending repayment of such sum uncollectible as the result of such loss or damage. Unearned interest and service charges on deferred payment accounts and normal credit losses on bad debts will be deducted in determining the recovery. 1) In the event of loss to accounts receivable records, the Insured will- use all reasonable efforts, including legal action, if necessary,to effect collection of outstanding accounts receivable. 2) The Insured agrees to use any suitable property or service: a) owned or controlled by the Insured; or b) obtainable from other sources, in reducing the loss under.this Additional Coverage. 3) This Certificate covers any other necessary and reasonable costs incurred to reduce the loss, to the extent the losses are reduced. 4) If it is possible to reconstruct accounts receivable records so that no shortage is sustained, the Underwriters will be liable only for the reasonable and necessary cost incurred for material and time required to re-establish or reconstruct such records, and not for any costs covered by any other insurance. 5) ACCOUNTS RECEIVABLE Exclusions: The following exclusions are in addition to the Properties Excluded section of this Certificate: This Additional.Coverage does not insure against shortage resulting from: . aj bookkeeping, accounting or billing errors or omissions; or b) (i) alteration, falsification, manipulation; or (ii) concealment, destruction or disposal, of accounts receivable records committed to conceal the wrongful giving, taking, obtaining or withholding of money, securities or other property; but only to the extent of such wrongful giving, taking, obtaining or withholding. 6) The settlement of loss_will be made within 90 days from the date of physical loss or damage. All amounts recovered by the Insured on outstanding accounts receivable on the date of loss will belong and be paid to the Underwriters up to the amount of loss paid by the Underwriters. All recoveries exceeding the amount paid will belong to the Insured. 7) The amount of loss occasioned by the operation of this Endorsement shall.not exceed USD 100,00b per occurrence. Page 19 of 33 - "` TERRORISM EXCLUSION ENDORSEMENT Notwithstanding any provision to the contrary within this insurance or any endorsement thereto it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss. For the purpose of this endorsement an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. This endorsement also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of terrorism. If the Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the Assured. In the event any portion of this endorsement is found to be invalid or unenforceable,the remainder shall remain in full force and effect. NMA2920 08/10/2001 U.S.Terrorism Risk Insurance Act of 2002 as amended Not Purchased Clause This Clause is issued in accordance with the terms and conditions of the "U.S. Terrorism Risk Insurance Act of 2002"as amended as summarized in the disclosure notice. It is hereby noted that the Underwriters have made available coverage for"insured losses"directly resulting from an "act of terrorism"as defined in the"U.S. Terrorism Risk Insurance Act of 2002", as amended ("TRIA") and the Insured has declined or not confirmed to purchase this coverage. This Insurance therefore affords no coverage for Losses directly resulting from any"act of terrorism" as defined in TRIA except to the extent, if any, otherwise provided by this policy. All other terms, conditions, insured coverage and exclusions of this Insurance including applicable limits and deductibles remain unchanged and apply in full force and effect to the coverage provided by this Insurance. LMA521912 January 2015 Page 20 of 33 ELECTRONIC DATA ENDORSEMENT 1. Electronic Data Exclusion Notwithstanding any provision to the contrary within the Certificate or any endorsement thereto, it is understood and agreed as follows:- A. This certificate does not insure loss,damage, destruction, distortion, erasure, corruption oi�alteration of ELECTRONIC DATA from any cause whatsoever(including, but not limited to COMPUTER VIRUS)or loss of use, reduction in functionality, cost, expense of whatsoever nature resulting therefrom, regardless of any other cause or event contributing or in any other sequence to the loss. ELECTRONIC DATA means facts, concepts and information converted to a form useable for communications, interpretation or processing by electronic and electromechanical data processing or. electronically controlled equipment and includes programs, software and other coded instructions for the processing and manipulation of data or the direction and manipulation of such equipment. COMPUTER VIRUS means a set of corrupting, harmful or otherwise unauthorized instructions or code including a set of maliciously introduced unauthorized instructions or code, programmatic or otherwise, that propagate themselves through a computer system or network of whatsoever nature. COMPUTER VIRUS includes but is not limited to"Trojan Horses", "worms" and"time or logic bombs". However, in the event that a peril below results from any of the matters described in paragraph A. above, this Certificate, subject to all its terms, conditions and exclusions, will cover physical damage occurring during the certificate period to property insured by this certificate directly caused by such listed peril. Listed Perils: Fire, Explosion. 2. Electronic Data Processing Media Valuation Notwithstanding any provision to the contrary within the Certificate or any endorsement thereto, it is understood and agreed as follows:- Should electronic data processing media insured by this certificate suffer physical loss or damage insured by this certificate, then the basis of valuation shall be the cost of the blank media plus the costs of copying the ELECTRONIC DATA from backup or from originals of a previous generation. These costs will not include research and engineering nor any costs of recreating, gathering, or assembling such ELECTRONIC DATA. If the media is not repaired, replaced or restored the basis of valuation shall be the cost of blank media. However, this certificate does not ensure any amount pertaining to the value of such ELECTRONIC DATA to the Assured or any other party, even if such ELECTRONIC DATA cannot be recreated, gathered or assembled. N MA2915 Page 21 of 33 ELECTRONIC DATE RECOGNITION EXCLUSION (EDRE) This Insurance does not cover any loss, damage, cost, claim or expense,whether preventative, remedial or otherwise, directly or indirectly arising out of or relating to: 1. the calculation, comparison, differentiation, sequencing or processing of data involving the date change to the year 2000, or any other date change, including leap year calculations, by any computer system, hardware, programme or software and/or any microchip, integrated circuit or similar device in computer equipment or non-computer equipment, whether the property of the Insured or not; or 2. any change, alteration, or modification involving the date change to the year 2000, or any other date change, including leap year calculations, to any such computer system, hardware, programme or software and/or any microchip, integrated circuit or similar device in computer equipment or non-computer equipment,whether the property of the Insured or not. This clause applies regardless of any other cause or event.that contributes concurrently or in any sequence to the loss, damage, cost, claim or expense. 17/12/97 NMA2802 Page 22 of 33 This Endorsement Changes The Certificate Please.Read It Carefully EXCLUSION AND LIMITED ADDITIONAL COVERAGE FOR FUNGUS ALL COVERAGE PARTS 1. The following Exclusion is added: EXCLUSION—"Fungus",Wet Rot, Dry Rot And Bacteria We will not pay for loss or damage caused directly or indirectly by the presence, growth, proliferation. spread or any activity of fungus", wet or dry rot or bacteria. Such loss or damage is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss. But if"fungus", wet or dry rot or bacteria results in a "covered cause of loss", we will pay for the loss or damage caused by that"covered cause of loss". This exclusion does not apply: A. When"fungus",wet or dry rot or bacteria results from fire or lightning; or B. To the extent that coverage is provided in the Additional Coverage - Limited Coverage For "Fungus", Wet Rot, Dry Rot And Bacteria with respect to loss or damage by a cause of loss other than fire or lightning. 2. The following Additional Coverage is added: ADDITIONAL COVERAGE - Limited Coverage For "Fungus", Wet Rot, Dry Rot And Bacteria A. This limited coverage applies only when the"fungus", wet or dry rot or bacteria is the result of one or more of the following causes that occurs during the certificate period and only if all reasonable means were used to save and preserve the property from further damage at the time of and after that occurrence, and only if any loss resulting from the following is reported to us within 60 days of the occurrence. (1) A"covered cause of loss'other than fire or lightning; or (2) Flood, if the Flood Coverage Endorsement applies to the affected.premises. B. Under conditions described in item 2.A. above, we will pay for loss or damage by "fungus" wet or dry rot or bacteria.As used in this Limited Coverage,the term loss or damage means (1) Direct physical loss or damage to Covered Property caused by"fungus', wet or dry rot or bacteria, including the cost of removal of the"fungus", wet or dry rot or bacteria; (2) The cost to tear out and replace any part of the building or other property as needed to gain access to the"fungus",wet or dry rot or bacteria; and (3) The cost of testing performed after removal, repair, replacement or restoration of the damaged property is completed, provided there is a reason to believe that "fungus', wet or dry rot or bacteria are present. C. The coverage provided_ under this Limited Coverage is limited to USD 5,000. Regardless of the number of claims, this limit is the most we will pay for the total of all loss or damage arising out of all occurrences which take place in a 4-month period (starting with the beginning of the present term certificate period). With respect to a particular occurrence of Page 23 of 33 loss which results in "fungus", wet or dry rot or bacteria, we will not pay more than a total of USD 5,000 even if.the"fungus",wet or dry rot or bacteria continues to be present or active, or recurs, in a later certificate period. D. The coverage provided under this Limited Coverage does not increase the applicable Limit of Insurance on any Covered Property. If a particular occurrence results in loss or damage by "fungus", wet or dry rot or bacteria, and other loss or damage, we will not pay more, for the total of all loss or damage, than the applicable Limit of Insurance on the affected Covered Property. If there is covered loss or damage to Covered Property, not caused by'fungus', wet or dry rot or bacteria, loss payment will not be limited by the terms of this Limited Coverage, except to the extent that"fungus",wet or dry rot or bacteria causes an increase in the loss. Any such increase in the loss will be subject to the terms of this Limited Coverage. �. The following Definition is added: . "Fungus"means any type or form of fungus, including mold or mildew, and any mycotoxins, spores, scents or by-products produced or released by fungi. PSG01FUNGUS Page 24 of 33 WAR AND CIVIL WAR EXCLUSION (Approved by Lloyd's Underwriters' Non-Marine Association) Notwithstanding anything to the contrary contained herein this Certificate does not cover Loss or Damage directly or indirectly occasioned by, happening through or in consequence of war, invasion, acts of foreign enemies,.hostilities (whether war be declared or not), civil war, rebellion, revolution; insurrection, military or usurped power or confiscation or nationalisation or requisition or destruction of or damage to property by or under the order of any government or public or local authority. 1/1/38 N.M.A. 464 U.S.A. SEVERAL LIABILITY NOTICE The subscribing insurers' obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual sGbscriptions. The subscribing insurers are not responsible for the subscription of any co-subscribing insurer who for any reason does not satisfy all or part of its obligations. 08/94 LSW1001 (Insurance) Page 25 of 33 ADDITIONAL LIMITATIONS AND CONDITIONS ENDORSEMENT (STANDARD) THIS ENDORSEMENT CONTAINS PROVISIONS IN CLAUSES 11, V AND VI THAT MAY LIMIT OR PREVENT RECOVERY UNDER THIS POLICY FOR DEBRIS REMOVAL (AS PROVIDED IN CLAUSE 11) AND/OR RESULTING LOSS (AS PROVIDED IN CLAUSE V). 1. LAND, WATER AND AIR EXCLUSION CLAUSE Notwithstanding any provision to the contrary within the Policy of which'this Endorsement forms part (or within any other Endorsement which forms part of this Policy), this Policy does not insure land (including but not limited to land on which the insured property is located), water or air, howsoever and wherever occurring, or any interest or right therein. The foregoing exclusion shall not apply to water which is contained in plumbing or firefighting installations in the Assured's buildings at the time of any damage insured by this Policy. 11. DEBRIS REMOVAL CLAUSE Nothing contained in this Clause shall override any seepage and/or pollution and/or contamination exclusion or any radioactive contamination exclusion or any other exclusion applicable to this Policy. The inclusion of this Clause shall in no event increase the limit of liability of Underwriters under this Policy or any other endorsement applicable to this Policy. Any provision within this Policy(or within any other Endorsement which forms part of this Policy)which insures debris removal is cancelled and replaced by the following: 1. In the event of direct physical damage to property, for which Underwriters agree to pay hereunder, or which but for the application of a deductible or underlying amount they would agree to pay (hereinafter in this Clause referred to as"Damage"), this Policy also insures, subject to the limitations below and method of calculation in Clause VI of this Endorsement and to all the other terms and conditions of the Policy, expense: (a) which is reasonably and necessarily incurred by the Assured in the removal,from the premises of the Assured at which the Damage occurred, of debris which results from the Damage; and (b) of which the Assured becomes aware and advises the amount to Underwriters hereon within one year of the commencement of the Damage; provided, however, that nothing in this Clause shall insure any expense provided under Clause V of this Endorsement. 2. The maximum amount of expense for removal of debris (subject to the limitations of paragraph 1 above)that can be included in the method of calculation in Clause VI of this Endorsement, shall be USD NIL any one occurrence. 111. SEEPAGE AND/OR POLLUTION AND/OR CONTAMINATION EXCLUSION CLAUSE Notwithstanding any provision to the contrary within the Policy of which this Endorsement forms part (or within any other Endorsement which forms part of this Policy), this Policy does not insure: 1. any loss, damage, cost or expense; or 2. any increase in insured loss, damage, cost or expense; or Page 26 of 33 3. any loss, damage, cost, expense, fine, penalty or other sum which is incurred, sustained or imposed by, or by the threat of, any judgment, order, direction, instruction or request of, or any agreement with, any court, government agency, any public, civil or military authority or any other person (and whether or not as a result of public or private litigation); which arises from any kind of seepage or any.kind of pollution and/or contamination, or threat thereof, whether or not caused by or resulting from a peril insured, or from steps or measures taken in . connection with the avoidance, prevention, abatement, mitigation, remediation, clean-up or removal of such seepage or pollution and/or contamination, or threat thereof. The term"any kind of seepage or any kind of pollution and/or contamination"as used in this Endorsement includes (but is not limited to): 1. seepage of, or pollution and/or contamination,by, anything, including but not limited to, any material designated as a"hazardous substance"by the United States Environmental Protection Agency or as a"hazardous material'by the United States Department of Transportation, or defined as a"toxic substance"by the Canadian Environmental Protection Act for the purposes of part II of that Act, or any substance designated or defined as toxic, dangerous, hazardous or deleterious to persons or the environment under any other law, ordinance or regulation; and 2. the presence, existence, or release of anything which endangers or threatens to endanger the health, safety or welfare of persons or the environment. IV. LISTED PERILS RESULTING FROM SEEPAGE AND/OR POLLUTION AND/OR CONTAMINATION CLAUSE This Policy is amended as set forth below. All other terms and conditions of this Policy remain unchanged and continue to apply with full-force and effect. Nothing contained in this Clause shall override any radioactive contamination exclusion applicable to this Policy. If any of the perils listed below results from seepage and/or pollution and/or contamination, then such resultant perils shall not be excluded solely by the foregoing Seepage and/or Pollution and/or Contamination Exclusion Clause. Listed perils Fire, Explosion. Nothing in this Clause, however, shall extend this Policy to insure: 1. loss, damage, cost, expense, fine or penalty, or other sum arising from any kind of seepage or any-kind of pollution and/or contamination that causes or results from a listed peril; or 2. loss or damage at any premises other than the premises where the listed peril took place; or 3. property and/or interests other than those insured by this Policy against the listed perils. V. LIMITED SEEPAGE AND/OR POLLUTION AND/OR CONTAMINATION RESULTING FROM PHYSICAL DAMAGE CAUSED BY LISTED PERILS CLAUSE THIS CLAUSE IS VOID AND OF NO FORCE OR EFFECT UNLESS AN AMOUNT IS SPECIFIED IN PARAGRAPH 2 BELOW. Page 27 of 33 This Policy is amended as set forth below. All other terms and conditions of this Policy remain unchanged and continue to apply with full force and effect. Nothing contained in this Clause shall override any radioactive contamination exclusion or, except as set forth herein, the foregoing Seepage and/or Pollution and/or Contamination Exclusion Clause. The inclusion of this Clause shall in no event increase the limit of liability of Underwriters under this Policy or any other endorsement applicable to this Policy. 1. If, (a) any of the perils listed below is the sole, immediate and direct cause of physical damage to property insured by this Policy against such listed peril (hereinafter in this Clause referred to as "Original Damage"); and (b) the Original Damage is the sole, immediate and direct cause of seepage onto, and/or pollution and/or contamination of property which is: (i) at the same premises as the Original Damage; and (ii) insured by this Policy against the listed peril causing the Original Damage; and (c) said property is damaged thereby(hereinafter in this Clause referred to as"Resulting Damage"); then this Policy, subject to the following additional terms and limitations and the method of calculation in Clause VI of this Endorsement, also insures: (d) the Resulting Damage; and (e) the reasonable and necessary expense incurred by the Assured for debris removal and/or clean-up which is: (i) limited to the same premises as the Original Damage; and (ii) made necessary solely by the Resulting Damage; but which shall in no event include any expense of clean-up or removal of land,water or air, (which Resulting Damage and expense of debris removal and/or clean-up, hereinafter in this Clause are referred to as"Resulting Loss"); provided, however, that this Policy only insures the Resulting Loss where: (f) Underwriters have agreed to pay for the Original Damage or, but for the operation of a deductible or underlying amount, would have agreed to pay for the Original Damage; and (g) within one year of the commencement of the listed peril which caused the Original Damage, the Assured became aware and advised Underwriters of the amount of: (i) the Resulting Loss; and (ii) any other interest to be claimed under this Policy as a result of the Resulting Damage, whether physical damage, business interruption, extra expense or otherwise. Listed Perils Fire, Lightning, Explosion. Page 28 of 33 Nothing in this Clause, however, shall extend this Policy to cover any condition that existed prior to the Original Damage nor to insure any loss, damage, cost, expense, fine, penalty, or other sum which is incurred, sustained or imposed by,or by the threat of, any judgment, order, direction, instruction or request of, or any agreement with, any court, government agency, any public, civil or military authority or any other person (and whether or not as a result of public or private litigation) in connection with any kind of seepage or any kind of pollution and/or contamination from any cause. 2. The maximum amount for any Resulting Loss and any other interest claimed under this Policy as a result of the Resulting Damage,whether physical damage, business interruption, extra expense or otherwise,that can be included in the method of calculation in Clause VI of this Endorsement is USD 5,000 in the aggregate for the term of insurance. VI. METHOD OF CALCULATION In calculating the amount, if any, payable under this Policy for a claim including expense of debris removal(as provided for and limited in Clause II of this Endorsement) and/or Resulting Loss (as provided for and limited in Clause V of this Endorsement),the amount of such expense of debris removal and/or such Resulting Loss shall be added to: (a) the amount of the Damage(as defined in Clause II) or the amount of the Original Damage(as defined in Clause V); and - (b) all other amounts, if any, insured under this Policy as a result of the same occurrence that Underwriters hereon agree to pay or, but for the application of a deductible or underlying amount, they would agree to pay; then the resulting sum shall be the amount to which first all deductibles and then any underlying amounts to which this Policy is subject shall be applied and the balance, if any, shall be the amount payable, subject to all other provisions of this Policy and to the applicable limit(s), sub-limit(s) and aggregate limit(s). 21/2/91 NMA2415 (Amended) Page 29 of 33 SERVICE OF SUIT It is agreed that in the event of the failure of the Underwriters hereon to pay any amount claimed to be due hereunder, the Underwriters hereon, at the request of the Insured (or Reinsured), will submit to the jurisdiction of a Court of competent jurisdiction within the United States. Nothing in this Clause constitutes or should be understood to constitute a waiver of Underwriters' rights to commence an action in any Court of competent jurisdiction in the United States, to remove an action to a United States District Court, or to seek a transfer of a case to another Court as permitted by the laws of the United States or of any State in the United States. z It is further agreed that service of process in such suit may be made upon FLWA Service Corp., c/o Foley& Lardner LLP, 555 California Street,Suite 1700, San Francisco, CA 94104- 1520, USA and that in any suit instituted against any one of them upon this contract, Underwriters will abide by the final decision of such Court or of any Appellate Court in the event of an appeal. The above-named are authorized and directed to accept service of process on behalf of Underwriters in any such suit and/or upon the request of the Insured (or Reinsured)to give a written undertaking to the Insured (or Reinsured)that they will enter a general appearance upon Underwriters'behalf in the event such a suit shall be instituted. Further, pursuant to any statute of any state, territory or district of the United States which makes provision therefor, Underwriters hereon hereby designate the Superintendent, Commissioner or Director of Insurance or other officer specified for that purpose in the statute, or his successor or successors in office, as their true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by or on behalf of the Insured (or Reinsured) or any beneficiary hereunder arising out of this contract of insurance(or reinsurance), and hereby designate the above-named as the person to whom the said officer is authorized to mail such process or a true copy thereof. 2414/86 NMA1998 Page 30 of 33 SANCTION LIMITATION AND EXCLUSION CLAUSE (Approved by Lloyd's Underwriters' Non-Marine Association) No (re) insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment or such claim or provision of such benefit would expose that (re)insurer to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanction, laws or regulations of the European Union, United Kingdom or United States of America. LMA3100 Page 31 of 33 U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to.replace any provisions of your policy. You should read your policy.and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presidential declarations of"national emergency". OFAC has identified and listed numerous: . Foreign agents; • Front organizations; • Terrorists; • Terrorist organizations; and •, Narcotics traffickers; as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's web site— http//www.treas..qov/ofac. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. IL P 001 01 04 Page 32 of 33 SCHEDULE-OF PARTICIPATING SYNDICATES , 25.00% HISCOX SYNDICATES LIMITED (HIS) #33 50.00% TOKIO MARINE KILN SYNDICATES LIMITED (KLN) #510 25.00% ARGENTA SYNDICATE MANAGEMENT LIMITED (ARG)#2121 100.00% TOTAL Page 33 of 33 NOTICE: 1. THE INSURANCE POLICY THAT YOU HAVE PURCHASED IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY THE STATE OF CALIFORNIA. . THESE COMPANIES ARE CALLED "NONADNITTED" OR "SURPLUS LINE" INSURERS. 2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT THAT APPLY TO CALIFORNIA LICENSED INSURERS. 3. THE INSURER. DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED. 4. THE INSURER SHOULD BE LICENSED .EITHER AS A FOREIGN INSURER IN ANOTHER STATE IN THE UNITED STATES OR AS A NON-UNITED STATES (ALIEN) .INSURER. YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL-FREE TELEPHONE NUMBER: 1-800-927-4357 OR INTERNET WEB SITE WWW.INSURANCE.CA.GOV. ASK WHETHER OR NOT THE INSURER IS LICENSED AS A FOREIGN OR NON-UNITED STATES (ALIEN) INSURER AND FOR ADDITIONAL INFORMATION ABOUT THE INSURER. YOU MAY ALSO CONTACT THE NAIL'S INTERNET WEB SITE AT WWW.NAIC.ORG. 5. FOREIGN INSURERS SHOULD BE LICENSED BY A STATE IN THE UNITED STATES AND YOU MAY CONTACT THAT STATE'S DEPARTMENT OF INSURANCE TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 6. FOR NON-UNITED STATES (ALIEN) INSURERS, THE INSURER SHOULD ° BE LICENSED BY A COUNTRY OUTSIDE OF THE UNITED. STATES AND SHOULD BE ON ' THE -NAIL'S INTERNATIONAL INSURERS DEPARTMENT (Im) LISTING OF APPROVED NONADM[TTED NON-UNITED STATES INSURERS. ASK YOUR AGENT, BROKER, OR "SURPLUS LINE" BROKE_ R TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 7. CALIFORNIA MAINTAINS A LIST OF APPROVED SURPLUS LINE INSURERS. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST, OR VIEW THAT LIST AT THE . INTERNET WEB SITE OF THE CALIFORNIA DEPARTMENT OF INSURANCE: WWW.INSURANCE.CA.GOV. 8. IF YOU, AS THE APPLICANT, REQUIRED THAT THE INSURANCE POLICY YOU HAVE PURCHASED BE BOUND IMMEDIATELY, EITHER BECAUSE EXISTING COVERAGE WAS GOING TO LAPSE WITHIN TWO BUSINESS DAYS OR BECAUSE YOU WERE REQUIRED TO HAVE COVERAGE WITHIN TWO BUSINESS DAYS, AND YOU DID NOT RECEIVE THIS DISCLOSURE FORM AND A REQUEST FOR YOUR SIGNATURE UNTIL AFTER COVERAGE BECAME EFFECTIVE, YOU HAVE ,THE. RIGHT TO CANCEL THIS POLICY WITHIN, FIVE DAYS OF RECEIVING THIS DISCLOSURE. IF YOU CANCEL COVERAGE, THE PREMIUM WILL BE PRORATED AND ANY BROKER'S FEE CHARGED FOR THIS INSURANCE WILL BE RETURNED TO YOU. D-2 (Effective January 1, 2017) UNITBRO-01 JLOF ACORo' CERTIFICATE OF LIABILITY INSURANCE DATE(Mgnn419111 YYY) `.� nn11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO MONTS UPON THE CERTIFICATE MOLDER. 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). _ PRODUCER CONTACT Jessica Lopez Commercial The Brokerage PHONE FAR The Brokerage, an Were Group Company (Ac, No, Eat): (949) 287-5677 (VC, me): 20281 SW Acacia St, Suite 20 E-MAILADDRESS: jiopez@ thebrokerageins.com INSURED Universal General & Engineering, Inc. 41-905 Boardwalk, Suite K Palm Desert, CA 92211 INSURERS) AFFORDING COVERAGE NAIL d INSURER A:Capitol Specialty Ins Corp 10328 INSURER B: Clear Spring Property and Casualty Company 15563 INSURER C INSURER 0: INSURER E: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOOL lIBR PoLICY EFF POLICY UP LIR TYPE OF INSURANCE POLICY NUMBIR / LIMIT! IA A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE s CLAIMS -MADE X OCCUR CT20220363-01 10/26/2022 10126/2023 DDRA GETISES RENTED 100,000 X ! MED EXP(Any one person) S 5,000 _._ PERSONAL&ADV INJURY_ S 1,000,000 GEN-L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X %,0i I LOC PRODUCTS -COMP/OPAGG S 2,000,000 OTHER' AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) OWNED OWNS lEO SCHEDULED .1 AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ AUTOS AUTO q (Parr ecadentDAMAGE ONLY ONLY S - umeRELL o OCCUR EACH OCCURRENCE S _ EXCESS LIAR CLAIMS -MADE AGGREGATE S DIED RETENTIONS $ B me YER! NLIpBIT�I X EMPLORKERS A RIETORIPARTNERIE%ECUTIVE YAM' CS-WC-001027-02 211512022 2JI512023 STATUTE EORH- EL. EACH ACCIDENT $ 1rO110�000 FFICERryTA BER EXCLUDEDi NIA IFFICE NMI I tloecdEe u,Mar EL DISEASE - EA EMPLOYEE, 3 -- gyeeee OESCRIPTIONOFOPERATIONStroba EL DISEASE - POLICY LIMB 1A00r000 DUCRIMON OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addi lonal Remarks Schedule, may Im attached d mom spew is required) RE: All operations performed by the Named Insured during the current policy period. glai City of Palm Springs is included as Additional Insured as respects General Liability per attached endorsement. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Palm Springs QE EXPIRATION DATE THEREOF, NOTI CT 2 I rY ZQ�2 ACCORDANCE WITH THE POLICY PROVISIONSCE WILL BE DELIVERED IN 3200 E. Tahquitz Canyon Way Palm Springs. CA 92262 Office of the City Clerk V — AMVKM AO tLUIWU4) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD items end logo are ragbtared marks of ACORD ACORO" :ommercial The Brokerage PO:ICY NUMBER WE PAGE 1 CARRIER IIEE PAGE 1 ADDITIONAL REMARKS AGENCY CUSTOMER 10: UNIT11RO-01 LOC fF: 1 ADDITIONAL REMARKS SCHEDULE NAMED INSURED Universal General & Engineering, Inc. 41-905 Boardwalk, Suite K Palm Desert, CA 92211 NAIC CODE SEE P 1 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Llablliy Insurance JLOPEZ Page 1 of 1 Cancellation: 'Should this policy be cancelled before the expiration date, The Brokerage. an Alera Group Company will mail 30 (thirty) days written notice to those Certificate Holders which require such action per contract or agreement.' 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CT20220363-01 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) OrOrganization(s) Locations Of Covered Operations Any person or organization for whom you are performing All locations where "your work' is performed as "your work" when you and such person or organization specified in thecontract or written agreement between have agreed in writing in a contract or agreement that you and the Additional Insured(s such person or organization be added as an Additional Insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — VWko Is An Insured is amended to B. include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 110 12 19 C Insurance Services Office, Inc., 2018 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III — Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable limits of insurance. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 C Insurance Services Office, Inc., 2018 CG 20 10 12 19 POLICY NUMBER: CT20220363-01 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization for whom you are All locations where "your work" is performed as performing "your work", when you and such person specified in the contract or written agreement or organization have agreed in writing in a contract between you and the Additional Insured(s) oragreement that such person or organization be added as an Additional Insured for Completed Operations Coverage on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ili -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1