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15-208 Coastwide Enviromental Technologies, Inc., Hazardous Material Abatement at the Simms House, Project No. 2016-064¥C(5q..z_ y? o it ')t> 1 b -4o l Project No. 2016-06 AGREEMENT BETWEEN THE CITY OF CUPERTINO AND COASTWIDE ENVIRONMENT AL TECHNOLOGIES, INC. FOR HAZARDOUS MATERIAL ABATEMENT AT THE SIMMS HOUSE THIS AGREEMENT, for reference dated September 10, 2015, is by and between CITY OF CUPERTINO (hereinafter referred to as "City"), a municipal corporation, and COASTWIDE ENVIRONMENTAL TECHNOLOGIES, INC. (hereinafter referred to as "Contractor"), a California corporation whose address is 201 Walker St., Watsonville, CA 95706 and is made with reference to the following: RECITALS: A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the Constitution and the statutes of the State of California and the Cupertino Municipal Code. B. City and Contractor desire to enter into an agreement for hazardous material abatement, in accordance with the adopted Specifications, Special Provisions and Plans. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. TERM: The Contractor shall begin work within ten (10) working days after receiving notice from City to commence the work, and shall diligently prosecute the work to completion before the expiration of ten (10) consecutive working days from the date of receipt of notice to begin work. 2. SERVICES TO BE PERFORMED: Contractor agrees, at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all work strictly in accordance with Specifications, Special Provisions and Plans, which are hereby referred to and expressly made a part hereof with the same force and effect as if the same were fully incorporated herein. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 1 of24 Project No. 2016-06 3. COMPENSATION TO CONTRACTOR: Contractor shall be compensated for services performed pursuant to this Agreement in the amount and manner set forth in Contractor's bid, which is attached hereto as Exhibit "A" and incorporated herein by this reference. Payment will be made in the same manner that claims of a like character are paid by City, with checks drawn on the treasury of City, to be taken from the 420-99-020-900-905-MRP 003-03-02 fund. Payment will be made by City in the following manner: On the first day of each month, Contractor shall submit a written estimate of the total amow1t of work done the previous month. Payment shall be made up to 95% of the value of the work. City shall retain 5% of the value of the work as partial security for the completion of the work by Contractor. Retained amounts will be paid to Contractor 35 days after the acceptance by City and the recording of the Notice of Completion with the Santa Clara County Recorder's office. Payment shall not be construed as acceptance of defective work. No interest will be paid to Contractor on retained funds. 4. TIME IS OF THE ESSENCE: Contractor and City agree that time is of the essence regarding the performance of this Agreement. It is agreed by the parties to the Agreement that in case all the work called for under the Agreement is not completed before or upon the expiration of the time limit as set forth in paragraph 1 above, damage will be sustained by City, and that it is and will be impracticable to determine the actual damage which City will sustain in the event of and by reason of such delay. It is therefore agreed that the Contractor will pay to City the sum of Two Thousand Dollars ($ 2,000) per day for each and every day's delay beyond the time prescribed to complete the work; and the Contractor agrees to pay such liquidated damages as herein provided, and in case the same are not paid, agrees that City may deduct the amount thereof from any money due or that may become due the Contractor under the Agreement. It is further agreed that in case the work called for under the Agreement is not finished and completed in all parts and requirements within the time specified, City shall have the right to extend the time for completion or not, as may seem best to serve the interest of City; and if it decides to extend the time limit for the completion of the Agreement, it shall further have the right to charge the Contractor, his or her heirs, Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 2 of 24 Project No. 2016-06 assigns, or sureties, and to deduct from the final payment for the work, all or any part, as it may deem proper, of the adual costs and overhead expenses which are directly chargeable to the Agreement, and which accrue during the period of such extensions. The Contractor shall not be assessed with liquidated damages during any delay in the completion of the work caused by an act of God or of the public enemy, acts of City, fire, flood, epidemic, quarantine restriction, strikes, freight embargoes, and unusually severe weather or delays of subcontractors due to such causes; provided that the Contractor shall, within one (1) day from the beginning of such delay, notify City in writing of the causes of delay. City shall ascertain the facts and the extent of the delay, and its findings of the facts thereon shall be final and conclusive. 5. STANDARD OF CARE: Contractor agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by City nor have any contractual relationship with City. 6. INDEPENDENT PARTIES: City and Contractor intend that the relationship between them created by this Agreement is that of employer-independent contractor. The mam1er and means of conducting the work are under the control of Contractor, except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Contractor's services. None of the benefits provided by City to its employees, including but not limited to unemployment insurance, workers' compensation plans, vacation and sick leave are available from City to Contractor, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer-employee relationship from any fees due Contractor. Payments of the above items, if required, are the responsibility of Contractor. 7. IMMIGRATION REFORM AND CONTROL ACT (IRCA): Contractor assumes any and all resp01isibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 3 of 24 Project No. 2016-06 Contractor shall indemnify and hold City harmless from and against any loss1 damage1 liability, costs or expenses arising from any noncompliance of this provision by Contractor. 8. NON-DISCRIMINATION: Consistent with City's policy that harassment and discrimination are unacceptable employer/employee conduct, Contractor agrees that harassment or discrimination directed toward a job applicant, a City employee, or a citizen by Contractor or Contractor's employee on the basis of race, religious creed1 color, national origin, ancestry, handicap, disability, marital status, pregnancy, sex, age, or sexual orientation will not be tolerated. Contractor agrees that any and all violations of this provision shall constitute a material breach of this Agreement. 9. HOLD HARMLESS: Contractor shall, to the fullest extent allowed by law, indemnify, defend, and hold harmless City and its officers, officials, agents, employees and volunteers against any and all liability, claims, stop notices, actions, causes of action or demands whatsoever from and against any of them, including any injury to or death of any person or damage to property or other liability of any nature1 arising out of, pertaining to, or related to the performance of this Agreement by Contractor or Contractor's employees, officers, officials, agents or independent contractors. Contractor shall not be obligated under this Agreement to indemnify City to the extent that the damage is caused by the sole or active negligence or willful misconduct of City, its agents or employees. Such costs and expenses shall include reasonable attorneys' fees of counsel of City's choice, expert fees and all other costs and fees of litigation. Contractor agrees to obtain executed indemnity agreements with prov1s10ns identical to those set forth here in these sections from each and every subcontractor or any other person or entity involved by, for, with, or on behalf of Contractor in the performance of this agreement. If Contractor fails to obtain such indemnity obligations from others as required here, Contractor agrees to be fully responsible according to the terms of this section. 10. INSURANCE: On or before the commencement of the terms of this Agreement, Contractor shall furnish City with certificates showing the type, amount, class of operations covered, Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 4 of 24 Project No. 2016-06 effective dates and dates of expiration of insurance coverage in compliance with paragraph lOA, B, C and D. Such certificates, which do not limit Contractor's indemnification, shall also contain substantially the following statement: "Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty (30) days' advance written notice to City by certified mail, "Attention: City Manager." It is agreed that Contractor shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company that is acceptable to City and licensed to do insurance business in the State of California. Endorsements naming City as additional insured shall be submitted with the insurance certificates. Contractor shall complete the attached Document 00530 Insurance Forms. A. COVERAGE: Contractor shall maintain the following insurance coverage: Contractor Agreement McClellan Ranch West (1) Workers' Compensation: Statutory coverage as required by the State of California; Employers' Liability $1,000,000 per occurrence (2) General Liability: Commercial general liability coverage in the following minimum limits: Bodily Injury: Property Damage: $2,000,000 each occurrence $4,000,000 aggregate -all other $2,000,000 each occurrence $4,000,000 aggregate If submitted, combined single limit of $2,000,000 per occurrence; $4,000,000 in the aggregate will be considered equivalent to the required minimum limits shown above. (3) Automotive: Comprehensive automobile liability coverage in the following minimum limits: Bodily injury: $1,000,000 each occurrence Property Damage: $1,000,000 each occurrence Page 5 of 24 Simms House Hazmat Abatement Project No. 2016-06 or Combined Single Limit: $1,000,000 each occurrence B. SUBROGATION WAIVER: Contractor agrees that in the event of loss due to any of the perils for which it has agreed to provide comprehensive general and automotive liability insurance, Contractor shall look solely to its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Contractor or City with respect to the services of Contractor herein, a waiver of any right to subrogation which any such insurer of said Contractor may acquire against City by virtue of the payment of any loss under such insurance. C. FAILURE TO SECURE: If Contractor at any time during the term hereof should fail to secure or maintain the foregoing insurance, City shall be permitted to obtain such insurance in the Contractor's name or as an agent of the Contractor and shall be compensated by the Contractor for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid. D. ADDITIONAL INSURED: City, its City Council, boards and commissions, officers, employees, and volunteers shall be named as an additional insured under all insurance coverages, except worker's compensation insurance. The naming of an additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 6 of 24 Project No. 2016-06 E. SUFFICIENCY OF INSURANCE: The insurance limits required by City are not represented as being sufficient to protect Contractor. Contractor is advised to consult Contractor's insurance broker to determine adequate coverage for Contractor. 11. BONDS: Contractor shall furnish the following bonds from a bonding company acceptable to the City Attorney: A. Faithful Performance: A bond in the amount of 100% of the total contract price guaranteeing the faithful performance of this contract, and B. Labor and Materials: A bond for labor and materials in the amount of 100% of the total contract price. 12. PROHIBITION AGAINST TRANSFERS: Contractor shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do so without said consent shall be null and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money by Contractor from City under this Agreement may be assigned to a bank, trust company or other financial institution without prior written consent. Written notice of such assignment shall be promptly furnished to City by Contractor. The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate member or cotenant, if Contractor is a partnership or joint venture or syndicate or cotenancy, which shall result in changing the control of Contractor, shall be construed as an assignment of this Agreement. Control means fifty percent (50%) or more of the voting power of the corporation. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 7 of 24 Project No. 2016-06 13. SUBCONTRACTOR APPROVAL: Unless prior written consent from City is obtained, only those people and subcontractors whose names are listed in Contractor's bid shall be used in the performance of this Agreement. Requests for additional subcontracting shall be submitted in writing1 describing the scope of work to be subcontracted and the name of the proposed subcontractor. Such request shall set forth the total price or hourly rates used in preparing estimated costs for the subcontractor's services. Approval of the subcontractor may, at the option of City1 be issued in the form of a Work Order. In the event that Contractor employs subcontractors, such subcontractors shall be required to furnish proof of workers' compensation insurance and shall also be required to carry general and automobile liability insurance in reasonable conformity to the insurance carried by Contractor. In addition1 any work or services subcontracted hereunder shall be subject to each provision of this Agreement. 14. PERMITS AND LICENSES: Contractor, at its sole expense1 shall obtain and maintain during the term of this Agreement all appropriate permits, certificates and licenses1 including a City Business License1 that may be required in connection with the performance of services hereunder. 15. REPORTS: Each and every report, draft1 work product1 map1 record and other document reproduced1 prepared or caused to be prepared by Contractor pursuant to or in connection with this Agreement shall be the exclusive property of City. Consultant may retain a copy of any report furnished to City pursuant to this Agreement. No report, information or other data given to or prepared or assembled by Contractor pursuant to this Agreement shall be made available to any individual or organization by Contractor without prior approval by City. Contractor shalt at such time and in such form as City may require, furnish reports concerning the status of services required under this Agreement. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 8 of 24 Project No. 2016-06 16. RECORDS: Contractor shall maintain complete and accurate records with respect to sales, costs, expenses, receipts and other such information required by City that relate to the performance of services under this Agreement. Contractor shall maintain adequate records of services provided in sufficient detail to permit an evaluation of services. All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Contractor shall provide free access to such books and records to the representatives of City or its designees at all proper times, and gives City the right to examine and audit same, and to make transcripts therefrom as necessary, and to allow inspection of all work, data, documents, proceedings and activities related to this Agreement. Such records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained for a period of three (3) years after receipt of final payment. If supplemental examination or audit of the records is necessary due to concerns raised by City's preliminary examination or audit of records, and City's supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of contract or failure to act in good faith, then Contractor shall reimburse City for all reasonable costs and expenses associated with the supplemental examination or audit. 17. NOTICES: All notices, demands, requests or approvals to be given under this Agreement shall be given in writing and conclusively shall be deemed served when delivered personally or on the second business day after the deposit thereof in the United States Mail, postage prepaid, registered or certified, addressed as hereinafter provided. All notices, demands, requests, or approvals from Contractor to City shall be addressed to City at: City of Cupertino Attn: Alex Acenas, Public Works Project Manager 10300 Torre A venue Cupertino CA 95014 Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 9 of 24 Project No. 2016-06 All notices1 demands, requests1 or approvals from City to Contractor shall be addressed to Contractor at: Coastwide Environmental Technologies, Inc. Attn: Rodrigo Gutierrez 201 Walker St. Watsonville1 CA 95076 18. URBAN RUNOFF MANAGEMENT: The Contractor shall avoid creating excess dust as the work is being prosecuted. If water is used for dust control, contractor shall use as little as necessary. Contractor shall take all steps necessary to keep wash water out of the streets, gutters1 storm drains and streams. The Contractor shall develop and implement erosion and sediment control to prevent pollution of storm drains and streams. Such control includes but is not limited to: A. Use storm drain inlet protection devices such as sand bag barriers, filter fabric fences1 block and gravel filters. (Block storm drain inlets prior to the start of the rainy season (October 15), in site de-watering activities and saw- cutting activities; shovel or vacuum saw-cut slurry and remove from the site). B. Cover exposed piles of soil or construction material with plastic sheeting. All construction materials must be stored in containers. C. Sweep and remove all materials from paved surfaces that drain to streets, gutters and storm drains prior to rain as well as at the end of the each work day. At the completion of the project the street shall be washed and the · wash water shall be collected and disposed of offsite in an appropriate location. D. After breaking old pavement, Contractor shall remove all debris to avoid contact with rainfall or runoff. E. Contractor shall maintain a clean work area by removing trash, litter, and debris at the end of each work day. Contractor shall also clean up any leaks, drips, and other spills as they occur. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 10 of 24 Project No. 2016-06 The objective is to ensure that the City and County of Santa Clara County-Wide Clean Water Program is adequately enforced. These controls should be implemented prior to the start of construction, up-graded as required, maintained during construction phases to provide adequate protection, and removed at the end of construction. These recommendations are intended to be used in conjunction with the State of California's Best Management Practices Municipal and Construction Handbooks, local program guidance materials from municipalities, Section 7.1.01 of the Standard Specifications and any other appropriate documents on storm water quality controls for construction. Failure to comply with this program will result in the issuance of noncompliance notices, citations, project stop orders or fines. The fine for noncompliance of the above program is two hundred and fifty dollars ($250.00) per occurrence per day. The State under the Federal Clean Water Act can also impose a fine on the contractor, pursuant to Cal. Water Code '13385. 19. TERMINATION: In the event Contractor fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Contractor shall be deemed in default in the performance of this Agreement. If such default is not cured within a period of two (2) days after receipt by Contractor from City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, City may terminate the Agreement forthwith by giving to the Contractor written notice thereof. City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days' prior written notice to Contractor as provided herein. Upon termination of this Agreement, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. 20. COMPLIANCES: Contractor shall comply with all state or federal laws and all ordinances, rules and regulations enacted or issued by City. Specifically, and without limitation, Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 11of24 Project No. 2016-06 Contractor shall comply with all state, federat or local regulation regarding the removal and disposal of hazardous waste. A. PREY AILING WAGES: To the extent applicable, Contractor shall comply with the City's Labor Compliance Program and all other requirements set forth in Labor Code section 1770 et seq. Contractor shall pay prevailing wages. Contractor will submit monthly certified payroll records to City for all employees and subcontractors in a preapproved format or a City provided form. Any delay in remitting certified payroll reports to City upon request from City will result in either delay and/or forfeit of outstanding payment to Contractor. B. WORKING DAY: To the extent applicable, Contractor shall comply with California Labor Code Section 1810, et seq. which provides that work performed by employees of contractors in excess of 8 hours per day, and 40 hours during any one week, must be compensated as overtime, at not less than 1 112 times the basic rate of pay. C. PAYROLL RECORDS: To the extent applicable, Contractor shall comply with California Labor Code Section 1776 which requires certified payroll records be maintained with the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed by him or her in connection with this Agreement. The Payroll Records shall be made available for inspection as provided in California Labor Code Section 1776. D. APPRENTICES: To the extent applicable, Contractor shall comply with California Labor Code Section 1777.5 regarding apprentices. 21. CONFLICT OF LAW: This Agreement shall be interpreted under, and enforced by the laws of the State of California excepting any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought pursuant to Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 12 of 24 Project No. 2016-06 this Agreement shall be filed with the courts of the County of Santa Clara, State of California. 12. ADVERTISEMENT: Contractor shall not post, exhibit, display or allow to be posted, exhibited, displayed any signs, advertising, show bills, lithographs, posters or cards of any kind pertaining to the services performed under this Agreement unless prior written approval has been secured from City to do otherwise. 23. WAIVER: A waiver by City of any breach of any term, covenant, or condition contained herein, shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character. 24. INTEGRATED CONTRACT: This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both City and Contractor. 25. INSERTED PROVISIONS: Each provision and clause required by law to be inserted into the Agreement shall be deemed to be enacted herein, and the Agreement shall be read and enforced as though each were included herein. If through mistake or otherwise, any such provision is not inserted or is not correctly inserted, the Agreement shall be amended to make such insertion on application by either party. 26. CAPTIONS: The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 13 of 24 Project No. 2016-06 P.O. No.: 0-o l lo -~ l.l,c:> l IN WITNESS WHEREOF, the parties have· caused the Agreement to be executed on the day and year first above written. CONTRACTOR CITY OF CUPERTINO Coastwide Environmental A Municipal Corporation Technologies, Inc. By~~'tfl ~ By ~~L ~Timm Boni!l(Diredo~blic Works Name Rodrigo Gutierrez / J /.- Date /..Z~ Title Estimator 7 Date September 10, 2015 Address: 201 Walker St. RECOMMENDED FOR APPROVAL: By~ f JfJ.KX· A-Cc:A!A:f 12/21 /1< Watsonville, CA 95076 Printed Name · Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Title fr W, f(toJt;ur MA-1\J~~ APnOVEO AS TO FORM: ByL~CLQ?:,- ~e, City Attorney A~g ~:>1 ~1\4! ~t4-~t~2P Grace Schmidt, City Clerk {2---2 ?,,.-/ J Contract Amount: $24,700 WI Account No. : 420-99-020-900-905-MRV 001-03-02 Page 14of 24 Project No. 2016-06 DOCUMENT 00530 INSURANCE FORMS INSURANCE FORMS INSTRUCTIONS FOR ITEMS 3, 4 AND 5, THE FORMS PROVIDED BY THE CITY OF CUPERTINO MUST BE USED. FORMS OTHER THAN THESE WILL NOT BE ACCEPTED. ALL DOCUMENTS MUST BE ORIGINALS -SUBMIT IN TRIPLICATE l. Insurance Agreement -Must be signed by Contractor. 2. Certificate of Insurance to the City of Cupertino -must be completed by the insurance agent or must provide a certificate on the company's form. They must contain the same information. 3. Endorsement of Additional Insured and Primary Insurance and Notice of Cancellation - must be signed by the insurance agent for general liability and automobile liability only. 4. . Comprehensive general liability/commercial general liability endorsement of aggregate limits of insurance per project -must be signed by the insurance agent for general liability only. 5. Waiver of subrogation endorsement worker's compensation insurance -must be signed by the insurance agent for worker's compensation only. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 15 of 24 CITY Or Project No. 2016-06 CUPERTINO INSURANCE AGREEMENT A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker's compensation or undertake self- insurance in accordance with the provisions of that Code, and will comply with such provisions before commencing the performance of the work of this Contract. B. Contractor and all subcontractors will carry worker's compensation insurance for the protection of its employees during the progress of the work. The insurer shall waive its rights of subrogation against the City, the City's officers, agents and employees and shall issue an endorsement to the policy evidencing same. C. Contractor shall carry at all times, on all operations hereunder, commercial general liability insurance, automobile liability insurance and builder's all risk insurance. All insurance coverage shall be in amounts required by the City and shall be evidenced by the issuance of a certificate in a form prescribed by the City and shall be underwritten by insurance companies satisfactory to the City for all operations, sub-contract work, contractual obligations, product or completed operations, all owned vehicles and non-owned vehicles. Said insurance coverage obtained by the Contractor, excepting worker's compensation coverage, shall name Gilbane Building Company and the City, its engineer, and each of its directors, officers, agents and employees, as determined by the City, as additional insureds on said policies. Insurers must be licensed to do business in the State of California. The Insurers must also have an "A" policyholder's rating and a financial rating of at least Class VII in accordance with the current Best's Guide Rating or that is otherwise acceptable to the City. D. Before Contractor performs any work at, or prepares or delivers materials to, the site of construction, Contractor shall furnish certificates of insurance evidencing the foregoing insurance coverages and such certificates shall provide the name and policy number of each carrier and policy and that the insurance is in force and will not be canceled or modified without thirty (30) days w1itten notice to the City. Contractor shall maintain all of the foregoing insurance coverages in force until the work under this Contract is fully completed. The requirement for carrying the foregoing insurance shall not derogate from the provisions for indemnification of the City by Contractor under this Contract and for the duration of the warranty period. Notwithstanding nor diminishing the obligations of Contractor with respect to the foregoing, Contractor shall maintain in full force and effect during the life of this Contract, the following insurance in amounts not less than the amounts specified and having a Best's Guide Rating of A, Class VII or better or that is otherwise acceptable to the City. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 16 of 24 Project No. 2016-06 LIMITS Worker's Compensation and Employers' Liability General Liability -commercial general liability; including provisions for contractual liability, personal injury, independent contractors and products -completed operations hazard. Automobile Liability -comprehensive covering owned, non-owned and hired automobiles. In accordance with the Worker's Compensation Act of the State of California -Worker's Comp "statutory" per CA Law; Employers' Liability $1,000,000 per occurrence Combined single limit of $2.0 million per occurrence; $4.0 million in the aggregate Combined single limit of $1.0 million per occurrence. By: _____________ _ (Contractor's Name) Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Dated: __________ 20_ Page 17 of 24 Project No. 2016-06 CUPERTINO CERTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO This certifies to the City of Cupertino that the following described policies have been issued to the insured named below and are in force at this time. Insured: ________________ _ Address:----------------- Description of operations/locations/products insured (show contract name and/or number, if any): _______________________________ _ ==================================================================================== WORKER'S COMPENSATION (name of insurer) * Statutory Min. * Employer's Liability $ ____ _ $ _____ _ $ ___ _ Insurance Company's State License No.-------------------- =====================================================~========================= Check Policy Type: COMPREHENSIVE GENERAL LIABILITY [ ] Premises/Operations [ ] Owners & Contractors Protective [ ] Contractual for Specific Contract $. ______ _ [ ] Products Liability [ ] XCU Hazards [ ] Broad Form P.O. [ ] Severability of Interest Clause [ ] Personal Injury with Employee Exclusion Removed or Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Each Occurrence General Aggregate (if applicable) Aggregate Personal Injury Fire Damage (any one fire) Medical Expense (any one person) Self-Insured Page 18 of 24 $ ______ _ $ _______ _ $ _______ _ $ _______ _ $ ______ _ Project No. 2016-06 COMMERCIAL GENERAL LIABILITYRetention $ ______ _ (name of insurer) Policy No.---------Expiration Date ______ _ ===================================================================================== AUTOMOTIVE/VEHICLE LIABILITY Commercial Form BODILY INJURY Each Person PROPERTY DAMAGE Each Accident Liability Coverage $ _______ $ ______ _ Each Accident (name of insurer) $ _______ or Combined Single Limit $ ______ _ Policy No. _______ _ Expiration Date ______ _ ====================================================================================== BUILDER'S RISK "ALL RISK" This is to certify that the following policy has been issued by the below-stated company in conformance with the requirements of the project documents and is in force at this time. NIA (Name of insurer) Policy No. ________ _ Expiration Date ______ _ Limits of Liability: _______ _ Deductible: ________ _ (agent's initial) A copy of all Endorsements to the policy(ies) which in any way limit the above-listed types of coverage are attached to this Certificate of Insurance. This Certificate of Insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or any other document with respect to which this Certificate of Insurance 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. IT IS HEREBY CERTIFIED that the above policy(ies) provide liability insurance as required by the Agreement between the City and the insured. By: __________ _ Dated: __________ 20 __ Attach Certificate of Insurance and Additional Insured Endorsement on company forms. Contractor Agreement McClella11 Ranch West Simms House Hazmat Abatement Page 19 of 24 CITY Of' CUPERTINO ADDITIONAL INSURED ENDORSEMENT and ENDORSEMENT OF PRIMARY INSURANCE and NOTICE OF POLICY CANCELLATION ENDORSEMENT Project No. 2016-06 Project Title and Number:------------------------ In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows: The City of Cupertino ("City") and its directors, officers, engineers, agents and employees, and all public agencies from whom permits will be obtained and their directors, officers, engineers, agents and employees, and the State of California, and its officers, agents and employees, are hereby declared to be additional insureds under the terms of this policy, but only with respect to the operations of the Contractor at or upon any of the premises of the City in connection with the Contract with the City, or acts or omissions of the additional insureds in connection with, but limited to its general supervision or inspection of said operations. The insurance afforded by this policy is primary insurance, and no additional insurance held or owned by the designated additional insured(s) shall be called upon to cover a loss under said additional policy. Cancellation Notice. The insurance afforded by this policy shall not be suspended, voided, canceled, reduced in coverage or in limits, or materially altered, except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to the City of Cupertino ("City"). Such notice shall be addressed to the City as indicated below. Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 20 of 24 Project No. 2016-06 POLICY INFORMATION 1. Insurance Company: _________________________ _ 2. Insurance Policy Number: _____________________ _ 3. Effective Date of this Endorsement: _________________ .20 __ 4. Insured: _____________________________ _ All notices herein provided to be given by the Insurance Company to the City in connection with this policy and these Endorsements, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. I, (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative: ___________________ _ (Original signature required on all Endorsements furnished to the District) Names of Agent/Agency: _____________ _ Address: _______________ _ Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 21of24 Title: _________ _ Telephone: _______ _ Facsimile: -------- CUPERTINO COMPREHENSIVE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ENDORSEMENT OF AGGREGATE LIMITS OF INSURANCE PER PROJECT Project No. 2016-06 Project Title and Number: _______________________ _ In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is as follows: This Endorsement modifies the insurance provided under the General Liability Coverage part of the below-referenced policy of insurance. The general aggregate limit under LIMITS OF INSURANCE applies separately to the project described as POLICY INFORMATION 1. Insurance Company: ________________________ _ 2. Insurance Policy Number: _______________________ _ 3. Effective Date of this Endorsement: _________________ 20 __ 4. Insured: _____________________________ _ 5. Additional Insured: City of Cupertino, its directors, officers, agents and employees. All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. I, (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative: __________________ _ (Original signature required on all Endorsements furnished to the District) Names of Agent/Agency: ____________ _ Title: _________ _ Address: _______________ _ Telephone: _______ _ _________________ Facsimile: -------- Contractm Agreement McClellan Ranch West Simms House Hazmat Abatement Page 22 of 24 Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Project No. 2016-06 Page 23 of 24 CITY OF CUPERTINO WAIVER OF SUBROGATION ENDORSEMENT WORKER'S COMPENSATION INSURANCE Project No. 2016-06 Project Title and Number: _______________________ _ In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows: It is agreed that with respect to such insurance as is afforded by the policy, the Insurance Company waives any right of subrogation against the City of Cupertino, and each of its directors, officers, agents, consultants and employees by reason of any payment made on account of injury, including death resulting therefrom, sustained by any employee of the insured, arising out of tl1e performance of the above-referenced Contract. POLICY INFORMATION 1. Insurance Company: ________________________ _ 2. Insurance Policy Number: ______________________ _ 3. Effective Date of this Endorsement: _________________ 20 __ 4. Insured: _____________________________ _ All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014. I, (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signah1re hereon do so bind this Company. Signature of Authorized Representative: __________________ _ (Original signahlre required on all Endorsements furnished to the District) Names of Agent/Agency: ____________ _ Title: __________ _ Address: _______________ _ Telephone: _______ _ Facsimile: _______ _ END OF DOCUMENT Contractor Agreement McClellan Ranch West Simms House Hazmat Abatement Page 24 of 24 Expert service since 1988 December 18, 2015 . City of Cupertino Public Works Dept. 22241 McClellan Rd. Cupertino, CA 95014 Simms House Project. Dear Mr. Acenas. EXHIBIT A This Letter is to confirm that Coastwide Environmental wiU perform all the work listed on proposal number 11958, dated Sep. 8, 2015 for the dollar amount of $24, 700.00 specified in proposal. Coastwide proposal (see attached). Feel free to contact me if you should need any forther information. Best Regards ~'9P~ Rodrigo Gutierrez Coastwide Environmental Technologies, Inc. • 201 Walker Street, Watsonville, CA 95076 • 1.131.761.5511 • FAX 831.761SS13 • UC# 523560 • www.coastwide.net EXHIBIT A Coastwide Environmental Technologies, Inc. City of Cupeiiino Public Works Dept. 10300 Torre Ave. Cupertino, CA 95014 Phone: 408-777-3232 Fax: Attn: 408-777-3333 AlexAcenas Job Simms Residence. BID 15 -11958 September 8, 2015 Location: 22241 McClellan Rd., Cupertino, CA 95014 Class of Work: Asbestos Lead SCOPE OF WORK Asbestos Abatement: Per Haz Mat portion of the contract and ENVIROCOM specifications, project No 15-013.02 and revised 1000 Point count analysis . Remove and properly dispose <0.1 % ACM GWB from first and second floor of (E) property but not limited to walls and ceilings throughout of interior, remove and properly dispose 6" in diameter transite pipe . Includes notification and one mobilization for each phase. Lead: Remove and dispose of exterior loose and peeling lead containing paint, spot prime scab areas. Exclusions: Feathering, removal of intact paint, repair of damaged substrate. Clarifications: there will be a thickness transition between previously painted and scab areas. Work performed by Cal DPH certified Lead Workers with Cal DPH certified Lead Supervision. EPA RRP certified. Clarifications/Qualifications: Work area shall be free of obstructions. Concrete demolition, structural demolition excluded. Price includes Insurance, performance, labor and materials bonds. General Exclusions Clearance air monitoring/sampling; connect or disconnect temporary power, HV AC, electrical, plmnbing or gas cut, cap, disconnect or lockout, layout of cut lines, utilities relocation or reinstallation, shoring or supporting, rigid barriers, board up, pedestrian walkways, baTI"icades, toilets or temporary fencing, power washing, weather protection or site security, protection of items to be salvaged, saved, re-used unless noted. Asbestos Abatement Total Price. Lead Base Paint Stabilization Total Price. Taxes included -No other exclusions or qualificatious. Prices are good 60 days from bid date. $18,900.00 $5,800.00 ~Y'~-Rodrigo Gutien~ :Estimator Ov•mcr/Gcncral Contractor to provide water a11d power to site, and ensure that the jobs site is accessible and free from obstrnctions, Price includes one mobilization per building to complete job unless stated otherwise. Any delays after crew arrives will be charged@ $95.00/hr. CET assumes no responsibility for, nor liability to inspect, locate, or remove hazardous materials beyond that identified in the bid or on any inspectio11 report, plans and/or specifications provided for the bid. Additionally, CET will not be responsible for incidental tape, staple or safety procedure damage. There will be additional charges for insurance for the following: increased general liability limits in excess of 5mil/5mil; workers comp increased limits in excess of l mil; additional insured endorsements; strike endeavor to; per project aggregate and named insured, are all an additional charge. A 1 y, % interest charge will be applied monthly to any unpaid balance past 30 days from original invoice. Attorney's fees -in any action or proceeding involving the issues of this contract between patiies hereto, whether for tort or breach of contract, the prevailing party shall be entitled to an award of it's reasonable attorney's fees and costs. Job cancellation/postponement is required by 5 :00 p.111. of previous scheduled wod,day. If crew has repotied for work, and job is cancelled or postponed, the responsible paity will be invoiced for a show-up time at our regular aforementioned rate for a minimum of two (2) hours for each person. License# 523560 B, ASB, C-21, C-22 DOSH Registration# 058 SBE # 3174 Laborers Local 67 DIR Reg # 1000001357 201 WALKER ST. WATSONVILLE, CA 95076 (831) 761-5511 FAX (831) 761-5513 WORK PLAN FOR ABATEMENT OF ASBESTOS-CONTAINING MATERIAL (ACM} AND DE'TERfORATED LEAD .. CONTAINfNG.,PAINT STABALIZATlON Residential Structure 22241 McClellan Roadt Cupertim>i California Prepared Ft:Jr: Mr, Alex Acen.a1S City m C11pertino 10000 'rDrrtl Avenue Cupertino, ·Cui. 95014 Pr!i!PtH'ed By: 1£nvirocom 1;!(10 Charc:ot Ave., Suite H 4 San CA 951~1 Jufy .20Hi PrtljBct 15"'013.02 Prepared b:,r: Mitch HajiaghalM ... -.. , .•. ~ .. " •... ~,L .... :_ .. ,;~.L Cat·OSHA Certified AOO~$:l0$ Consult.ant tl'l-2200 'EPA·CerltflGd Sul!d!ng Inspector COPH Certified le.ad lrl$Jj•1!1Clor/Aa:£U!!SSQ£1'<1oriitor 1.,7266 TABLE OF CONTENT PAGE BACKGROUND INFORMATION .................................................................... 1 2 SCOPE OF WORK..................................................................................... 4 3 ACM ABATEMENT WORK PROCEDURES AND ENGINEERING CONTROL ......... 6 4 PAINT STABILIZATION PROCEDURES......................................................... 8 5 SUBMITTALS............... ............... ... ...... ... ... ......... ...... ......... ... ... ............... 8 Attachments: Figure 1 Table 1 Table 2 Floor Plan Test Results For Asbestos Lead In Paint 1.0 BACKGROUND INFORMATION Envirocom surveyed the property located at 22241 McClellan Road, Cupertino, California (Site) on June 18, 2015, for asbestos-containing-material (ACM) and lead content in and condition of the painted surfaces. 1.1 Description of the Surveyed Areas The surveyed area consisted of one two-story wood frame residential structure/building on concrete footing/walls. The first floor of the building was divided into several areas including garages, and storage rooms on concrete slab. The second floor of the building was the main living area, which was divided into a laundry room, 3 bathrooms, a living room, a kitchen, and 6 bedrooms. Figure 1 shows the floor plan. The exterior walls were covered with wood planks and concrete. The interior walls were covered with painted/textured drywall (sheetrock), wood, and plaster. The roof was covered with mineral roll, and composition shingles. The floors were covered with sheet vinyl, carpet, hard wood, concrete, and 12" X 12" vinyl floor tiles. An air heater was located in the lower level. Air ducts and air registers were covered with fiberglass. 1.2 Survey Results For Asbestos And Lead In Paint Table I summarizes the survey results for suspect ACMs. Table II presents lead concentrations in painted surfaces, and paint conditions at the time of surveying at the Site. July 2, 2015 Pagel Work Plan For ACM Abatement And Lead-Containing-Paint Stabilization 22241 McClellan Road, Cupertino, California A1 Aia* A2 A3 A4 A5 A6 Al A8 A9 AID A11 A12 A13 A14 A15 A16 July 2, 2015 Page 2 Drywall, Paint & Tape Mud Concrete Footin Chimney Brick Sheetrock, Tape & Mud Sheetrock, Tape & Mud Sheetrock, Tape & Mud Mineral Roof Roofing Material Roofing Shingles Chimney Flue Chimney Mortar Chimney Mastic 6" Diameter Cemantmous Cream Sheet Vin I 411-Wide Cream Cove Base and Mastic Drywall, Tape & Mud White Sheet Vinyl Table I Test Results For Asbestos Back Garages Interior Wall, First Floor From Above Sam:ile Garage Interior Wall Chimney Gara e Air Heater Room 1st Floor Storage Room 1st Floor Storage Room With Chairs 1st Floor Roof Roof Roof Roof Roof West Sltla trf Root Laundry Room 2nd Floor Same As Above Same As Above Bathroom Next To Laundry Room 2nd Floor None Detected 2°/o >20001r !! None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected ·is% r"' 'JOO ft N !! 4% Crocldolit® None Detected None Detected None Detected None Detected Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California A18 Drywall, Paint Northeastern None & Tape Bedroom 2nd Detected Floor AHh1* Mud Frorn Above 2% >200011 a A19 Cream Sheet Bathroom 2n None Vin I Floor Detected A20 Plaster Fire Place None Wall Livin~ Detected Room 2n Floor A21 Insulation Around Floor None Material Air Registers 2nd Floor Detected A22 Cream Sheet Bathroom 2n None Vin I Floor Detected F = Friable N Non Friable * = Mud/joint compound-containing asbestos is assumed to be throughout the first and second floor interior walls. NOTES: (1) The quantities of ACMs presented in the above table are rough estimates. Contractors shall base their bids on their own estimates of the ACM quantities. (2) Envirocom did not perform intrusive and destructive sampling by breaking walls and floors. During the course of demolition, if suspect ACM are exposed, contractor shall notify Envirocom for material testing. July 2, 2015 Page 3 Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California s~m~I~ u:{' Paint .q~scripUon White Paint Pb3 Gray Paint Pb5 Gray Paint Pb7 Blue Paint Pb8 White Paint Pb10 White Paint END OF SECTION 2.0 SCOPE OF WORK Tal:)le II Lead In Paint Paint Lo.cation Exterior Walls Exterior Trims Interior Walls Of Interior Walls Of Air Heater Room 181 Floor Cor;cn:ite Floor F!onr Interior Walls Of Storage Room 1st Floor Interior Wall of Bathroom 2nd Floor Interior Walls 2nd Floor Results (ppm Lead) 67 <50.3 <45.2 <45.5 <46.2 <47.3 Paint Lead- Condition . Based,, Paint (ppm). Poor Poor 5,000 Good 5,000 Good 5,000 Good 5,000 Good 5,000 Cal-0$HA non~trigger task$ threshold . (ppm) 600 600 600 600 600 Scope of work consists of providing all labor, equipment, material, superv1s1on and subcontracting for removal and disposal of all ACMs including all asbestos-containing debris, dust, over spray from the buildings at the Site. July 2, 2015 Page 4 Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California Additionally, it includes stabilization of deteriorated/chipping painted surfaces containing any detectable lead. The work outlined below shall be performed by a licensed asbestos abatement contractor (Contractor) following Cal-OSHA work procedures outlined in 8 CCR 1529 and 8 CCR 1532.1 . The work procedures specified in the work plan shall not be construed as an abatement specification. It serves only as a guideline for the Contractor to perform removal of identified asbestos-containing-materials (ACMs), and stabilization of deteriorated painted surfaces, before demolition of structures the Site. Scope of work includes the following tasks: 1. Create regulated areas for asbestos abatement and stabilization of deteriorated painted surfaces to prevent unauthorized access. 2. Place warning signs to designate regulated areas in compliance with 8 CCR 1529-Asbestos and 8 CCR 1532.1-Lead. 3. Clean and HEPA vacuum all objects and remove them out of the buildings at the Site. 4. Construct full negative pressure containment within the asbestos abatement and paint stabilization areas inside the buildings at the Site, and cover all critical barriers with two layer of plastic sheeting; DOP test negative air machines, before starting the asbestos abatement work. Place 2 layers of 6-mil plastic sheet on the ground extending 10 feet from paint stabilization areas outside of the structures at the Site within regulated areas. 5. Properly remove, package, label, and dispose of all identified ACMs; properly categorize, package, label, and dispose of lead wastes. 6. After completion of asbestos abatement, and paint stabilization work, properly clean inside of containments using HEPA vacuum and wipes for visual inspections. 7. Perform post abatement asbestos clearance testing prior to release of regulated areas. 2.1 Abatement Notification The Bay Area Air Quality Management District (BAAQMD) requires a 1 O days notification for abatement of friable ACM greater than 100 square feet. Table I presents the list of the materials requiring the notification. California Department of Public Health (CDPH) requires 5 days notification for LBP stabilization work. July 2, 2015 Page 5 Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California · -The abatement contractor shall notify the above agencies, before disturbing materials requiring notifications. END OF SECTION 3.0 ACM ABATEMENT WORK PROCEDURES AND ENGINEERING CONTROL A California licensed contractor shall perform the work outlined below and in accordance with Cal-OSHA proper work procedures as outlined in 8 CCR 1529. Regulated work area and signs posting shall be in place at the entry to each work area. The procedures shall be in place for removal of ACMs identified in Table I of this work plan. Removal of all ACMs shall be conducted under full negative pressure containment with viewing window. To layers of 6-mil fire-retardant plastic sheeting shall be used to secure on all entries, windows, vents, and other critical barriers. A negative pressure enclosure with a minimum pressure differential of -0.02 inches of water shall be maintained throughout the abatement work including final visual inspections. Ventilation of the regulated areas must be in place prior to starting the abatement work. Ventilation shall be designed to move contaminated air away from worker's breathing zone (BZ) toward HEPA filtration or collection devices. The contractor shall construct a three stage decontamination unit consisting of equipment room, (dirty room) connected to a shower and a clean room for employee decontamination. Wet method shall be used throughout the abatement procedures, and shall be maintained throughout the subsequent waste handling and disposal procedures. Vacuum cleaners equipped with HEPA filters shall be used to collect dust and debris containing ACM. The contractor shall remove all wastes generated from the abatement activities as asbestos containing waste and in accordance with all applicable Local, State, and Federal regulations. Upon achieving visual clearance from the Consultant, encapsulating material shall be applied to all surfaces prior to final air clearance sampling. 3.1 Personal Protective Equipment Personal protective equipment (PPE) shall consist of full body disposable protective suit, steel-toed boots, gloves, safety glass or goggles, hard hat (as required), and respirator. Respirators shall offer at least the protection of 1 /2-face negative pressure respirators equipped with HEPA filters. Unless fiber concentrations require greater protection. The contractor is responsible for appropriate respirator selection. July 2, 2015 Page 6 Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California 3.2 Consultant Monitoring, Reporting, and Clearance Criteria The Consultant will be the Consultant representing the owner at the Site. It will provide the abatement monitoring, work area inspection, and final visual inspection of the asbestos abatement and paint stabilization areas. Envirocom will collect air clearance samples for laboratory testing. 3.3 Consultant's Daily Oversight Duties During the asbestos abatement and paint stabilization work, the Consultant will provide daily oversight and monitoring of the contractor's work. The Consultant's on-Site representative will be a CAC or Certified Site Surveillance Technician (CSST). The project will be supervised by a CAC and CDPH certified Lead Project Monitor. Prior to starting the abatement work, the Consultant will verify that the abatement contractor has completed all pre-work submittals and workers possess valid training and medical certifications for the project. The Consultant will also perform regular examination of the containments, engineering controls and work practices of the abatement contractor to ensure that the containments will remain intact , and controls are effective, and the work practices are minimizing creation of visible dust. The Consultant will maintain a daily log of Site activities including sketches of the work areas and air sample locations. 3.4 Visual Clearance Criteria As part of clearance process for all asbestos abatement and paint stabilization work, the Consultant will perform final visual inspection. The inspection will include a complete walkthrough of the work areas prior to application of sealing or bridging encapsulants. Visual clearance of the work areas are achieved when removal of all identified ACMs and debris are complete, and all deteriorated/pilling painted surfaces are stabilized. 3.5 Asbestos Air Clearance Criteria Final clearance phase contrast microscopy (PCM) sampling shall be conducted, after the visual inspections by Envirocom. A minimum of 1,250 liters to a maximum of 3,850 liters of air shall be collected from each containment One clearance air sample will be collected from each containment area. The results of the PCM analysis for each sample shall be below 0.01 flee for the clearance. The air sample shall be analyzed in accordance with the LDEQ-required NIOSH 7400 analytical method "A" rules for asbestos and 0th.er fibers by PCM by a proficiency analytical testing/asbestos analytical registry (PAT/AAA) certified and LDEQ licensed laboratory. Collecting and analyzing samples as well as inspecting the abatement work July 2, 2015 Page? Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California will be the responsibility of the Consultant. The laboratory results will be available within 24 hours, after completion of the sampling. END OF SECTION 4.0 PAINT STABILIZATION PROCEDURES Lead-based paint (LBP) and lead-containing paint (LCP) have been identified at the Site. Abatement of LBP and LCP is not required for demolition projects. However, to minimize worker's exposure, proper hazardous waste management, and preventing soil contamination, stabilization of deteriorated painted surfaces are required prior to demolition work. · Precautions should be taken to minimize lead dust generation and exposure and to avoid accumulation of large quantities of lead-containing wastes. 4.2 Visual Clearance Criteria After completion of paint stabilization and removal of waste, the contractor shall clean the regulated area, and notify the Consultant for final visual inspection. 4.2 Waste Disposal Packing, labeling, transporting, and disposing of hazardous waste shall comply with applicable Cal/EPA regulations under 22 CCR, and California Health and Safety Code. A "Waste Manifest" shall be completed for disposal of hazardous waste. The transported waste shall posses a valid EPA generator ID number. The Contractor shall notify the owner at least 24 hours prior to the time that the manifest is required to be signed by the owner. The contractor shall be responsible for conducting an appropriate hazardous waste determination for the wastes containing lead. Profiling lead in wastes requires both California as well as Federal hazardous waste characterization. California has two regulatory threshold for wastes contaminated with lead, Total Threshold Limit Concentration (TTLC) and Soluble Threshold Limit Concentration (STLC). The regulatory limits for lead are 1000 mg/kg and 5.0 mg/L, respectively. Lead wastes consider hazardous under Federal regulations when concentration of lead is equal or exceed 5.0 mg/L using Toxicity Characteristic Leaching Procedure (TCLP) procedure. The contractor shall use a State-certified analytical laboratory for the above analytical procedures. END OF SECTION 5.0 SUBMITTALS 5.1 Submittals Prior To The Abatement Work July 2, 2015 Page 8 Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California Prior to starting the abatement work, the Contractor shall submit the following docume-ritations to the Consultant: BAAQMD notification for asbestos work. Cal/OSHA notification (if required) CDPH notification for lead stabilization EPA/AHERA and CDPH training certificates for supervisor who will be designated as the on-site competent person/supervisor. All workers shall be EPA/AHERA and CDPH certified workers Copies of workers' annual respirator fit test Copies of workers' medical certificates and doctor's approval for the use of respirators as outlined in 8 CCR 1529 (h) Respiratory Protection Negative Exposure Assessment (NEA), if applicable Material Safety Data Sheet (MSDS) for any chemicals (if used) Emergency phone and pager listing llPP and Lead Compliance Plan 5.2 Submittals After The Abatement Work After completion of the abatement work, the Contractor shall submit the following documentations to the Consultant: Certificate of the abatement work completion Copies of completed waste manifests END OF SECTION July 2, 2015 Page 9 Work Plan For ACM Abatement And Lead-Containing Paint Stabilization 22241 McClellan Road, Cupertino, California LEGEND o A 1 Asbestos Bulk Sample Location and Designation D Pb1 Paint Sample Location and Designation BR= Bedroom pA1 Garage Garage A2 pPb3 "3 0 Storage Air Heater Room loA4 a Pb6 P.P5 Room With ft5 Chairs Storage I P Pb8 Pb1 Garage AR• First Floor EiVJ/77\_0COM 800 Charcot Avenue· Suite 114 San Jose • California • 95131 Phone [408] 894-9062 • Fax [408] 894-9063 a Pb1 Pb2 Pb4 t i;;- BR I ""l"" I c "' 0. -< A18 Bath Room f0J FP A19 o 0 I 6. OJ A21 () f!l. ::r CD ::r ::::> a Pb9 0 3 Pb10 I 0 A12 d A17 Living Area "] BR oA16 OJ a ::r 0 0 3 A131 A14 0 A15 I Front Door I BR Second Floor Drawing Not To Scale Floor Plans Work Plan For Abatement Of ACM And Deteriorated Lead-Containing-Paint Stabilization 22241 McClellan Road · Cupertino • California FIGURE 1 July15,2015 Project 15-013.02 August 261 2015 Project 15-013.02 Mr., Alex A.cenas City of Cupertino 10300 Tone Avenue Cupertino, CA 95014 £1\IVIJ{QC)(J/Vl Subject: Addendum to Work Plan for Abatement of Asbestos~containing Material (ACM) And Deteriorated Lead .. contaJning-pafnt Sta.billzation, 22241 McClellan Road, Cupertino, California On August 24, 2015, Envlrooom ~lected sample Ai and A18 at the subJoot f.oooiloo (Sita) for !aborat\>ry testing. Th~ $ampfes were submitted 10 EML.<$b P&K o~ San Bruno, OaU~oril'llt\ 11'.'> oo tl'J$ted for asoos1os using 1000 pok1t count meit'NJ<l. Tue $amplt;s wera ooliacted from wall units al the garage, anid a oodroom at the Site, The sarr1pte Identifications and ior:ations were k!afit!ool ~o t~ ool!ected lilt fut) Site on Jtme 18, 2015, Resuns for ~ha June 2015, Stirvey w~ presented in Jtme 23, 20t5, .rePQrt Orlginally, the j<>lnt oorn~nd (mud) ltt t11ampte A1 and A18 <:ontmned 2"k a:Soostos. CompoSJte tes~ results for the kJentical $amples uslng tOOO PQint cotmt showed as00l:Jt{}$ for drywall and: J¢lnt compound. The l~ooratory test r~G'u.!ts me ericiosoo with th.ls letter. Therefore,. the bui!d!ng at ttie Site could oo demolished using a :DOSHMregistered oontractor amp!emerlting Cia$S II OSHA worf< practices !ricil!Jdfflg wet :rm~thod. The contrac11'.'>r i$OOll l"lotlfy Bay Ate$'! Air Quality Manage·ment Olsmct (BAAQMD). Pleas~ note !hat d~t0rromterj ~ined s1.1riac.es ha.vet to oo slabtnzod, before the d~rt'IOfltion work. AddltlonaHy, asb$$~·containlng piping i~entffielifion. Sincerely~ Envirocom soo Chmrcot AWL Suite r14 SanJose. CA9S131 Pr10rte (408) 8'9Hi002 Fl!Vt \400) S94-'!Kt63 La Report for: Mr. Mitch Hajiaghai Envirocom 800 Charcot Avenue Suite 114 San Jose, CA 95131 Regarding: Approved by: Project: 15-013.02; Residential EML ID: 1413786 Approved Signatory Dr. Kamashwaran Ramanathan Dates of Analysis: Asbestos-EPA 1000 point count: 08-26·2015 Service SOPs: Asbestos-EPA 1000 point count (EPA Methods 600/R-93/116 & 600/M4-82-020, SOP EM·AS-S-1262) All samples were received in acceptable condition unless noted in the Report Comments portion in the body of the report. Due to the nature of the analyses performed, field blank correction of results is not applied. The results relate only to the items tested. EMLab P&K ("the Company") shall have no liability to the client or the client's customer with respect to decisions or recommendations made, actions taken or courses of conduct implemented by either the client or the client's customer as a result of or based upon the Test Results. In no event shall the Company be liable to the client with respect to the Test Results except for the Company's own willful misconduct or gross negligence nor shall the Company be liable for incidental or consequential damages or lost profits or revenues to the fullest extent such liability may be disclaimed by law, even if the Company has been advised of the possibility of such damages, lost profits or lost revenues. In no event shall the Company's liability with respect to the Test Results exceed the amount paid to the Company by the client therefor. EM Lab P&K, LLC EMLablD: 1413786, Page 1 of2 EMLabP&K 1150 Bayhill Drive, Suite 100, San Bruno, CA 94066 (866) 888-6653 Fax (650) 829-5852 www.emlab.com Client: Envirocom Date of Sampling: 08-24-2015 C/O: Mr. Mitch Hajiaghai Date of Receipt: 08-25-2015 Re: 15-013.02; Residential Date ofRep01i: 08-26-2015 ASBESTOS POINT COUNT REPORT: EPA METHOD 600/R-93-116 Location: Al Sheetrock/Tape/Mud and Paint-garages interior wall Total Points Counted: 1000 Lab ID-Versiont: 6511483-1 Sample Layers Asbestos Type Asbestos Points Asbestos Counted Concentration (%) Blue Paint --ND Layer Totals: -- Tape --ND Layer Totals: -- White Dtywall /Joint Compound Chrysotile 0 < 0.1 Layer Totals: 0 NA Comments: Location: A18 Sheetrock/Tave/Mud and Paint-bedroom Total Points Counted: 1000 Lab ID-Versiont: 6511484-1 Sample Layers Asbestos Type Asbestos Points Asbestos Counted Concentration (%) Tape --ND Layer Totals: -- White Compo1md with Paint Chrysotile 0 < 0.1 Layer Totals: 0 NA White D1ywall /Joint Compound Chrysotile 0 < 0.1 Laver Totals: 0 NA Comments: The analytical sensitivity is 1 asbestos point. The limit of detection is 1 asbestos point divided by the total number of asbestos points counted and multiplied by 100. The results relate only to the items tested. Interpretation is left to the company and/or persons who conducted lhe field work. The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government. · All samples were received in acceptable condition unless otherwise noted. EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. t A "Version" indicated by-"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". EMLab P&K, LLC EMLab ID: 1413786, Page 2 of2 l•m •Haln~ !l:>w tlir>1ctlyl<.>Qll•k>cJ:1lCru"1<1<,an<1on lvSl:I» l'u1nc1,,i;o Say, wful •~O tri>atment. Stormwatcirpl>U1:1•<1Ril>il>'OHl<>llSj>•Ol>!olnfOI wl11J1ifu<l"J>"n<l<tn!cnn11r ..... 111u-w:tys1J"tll<>• lh1>T!<l'<ll>~""Bofi.,,tt<11<3rpOH>tl•~"t<o.>cmo:1,>r Myla"d~. Ptnp~• m.,,n,.e11mt>11t <:>I <lf>nHntr.'llmt ~ll>'l'll r<r<l'u~""" pl)!f.,ttOr'i '><iln!f1ca<tt!y, Tt«S"Sl'o'.<'<!l$1,1ln•"a•fa<!"~1h"wat>t.1M;ill>ag<:"'"nt p.,,,,11,.,..,i::~ {BMJ>«~ liH "'rnrm W:t!"• rinUul"lnn 11~<:.,<:utinn ORDINANCE OF THE CITY OF CUPERTINO FOR STORM WATER POLLtJTION PREVENTION & WAIERCOURSE PROTECTION; ChapterS.18 9.1a040 Dlscharga into the storm drain prohibited l! shaJI te uo.!awfU b dis<:."!al'Qe, er cause, a:iow, er per mt to be dischatged into any storrnoran cr mt·,m;;l n;.tlet or chan~ all waste. ixaiding bJl i-:et i~ictcd to, SG1."<rfi indt:str~ wasl1"s. p<:irdru:n pn:xioct.<;, coal lat .er any refuse substance a:ising lromtr':e marufacl;ze of gai1 from coal i:r petroleum. chemii:a!s, OO:ergenls. sd'<e'l'!lS, 1:aim. ci:mtamitla!ed ord"f.etinateds·MinmnYJ pod 'ovater. pes1icicie.. herbicides an:i fortiiaers. 9.18.010 Acckfontal Ol$charge Al< pcnocms 1;hlli nd1fy th:! O'.tB":ta of Public Works bi' klopht:ru:; irnn'ledlatffy IJ~K'f'I m::cid1:t"1t<tlly cfis.":ha:q)!V wasi~s to am:tJ!eeoi.rni;,m~a~t~s lo tie t~m by the Qty !O minirnw dmnage-lo stO!m 't;om;$ aril!tne reca'ving W<l1t~rs n1~1 n0Wicat1cn Sha~ te fu"l!°""<v.!, wdhh ten ifO)dll"fSol ll"teda1e- of-occurreN:i?. by a detailed wltt~n stat1=1r.enf ooscobtrg thi;. causes e;f tne ~iderta; diseharge and th&-rneasvres bell:I taken lo prevent further 6Cetrrr~. Such notffica11on'!l. wiU ml ra!iew! f'({OOns of liability for vic!a!ior.s of t:Ss cha!.Xer i:r for any fines rmpo1;ixf en !he rity on account tteroof undtr Section 13:350 of !heCa!f.orria Water Code. m for violat:ons a! Section 55:0 ofcaiifomia t-&: aoow•ld!ira Code, er any d:t!er ap~JCabie provisions cf State or Fee-era! ~.;ws. 9.1a220 Viol.a.lion'" Any person vi.ho V.O!a!es. any provision d this Chapter shaft be 91ilty of amisdemeam:r and upon o:;n·1ictlon l'.""aeo~ shal bep.mis'16'.! as pro\~ded i!'ChaJ;ter 1.12 oft!1e Ci!'( of C:,per!lno Municipal Cocie C!1apter 1.12· Gereml Pem!ty, Section 1.12:,010, paragraph 0, sta!<>is· Un~$ 0L"'iarw1se speohed by this coce. an frlfracfa.'ln is punrs.'"'laC!<: by i A fll'!eno: ~ot~xco~d "SlCOfor af.~ victat.cn 2 A lkie no! toe)((:ee:I S2:00for ,is1:c<:nci violaiim 3 .:.. fl:1e not to exc1:<:d S500 fClr a tl"iit d viol;~lion of the s-<irre chspler wimin aie 'tWT !:1.18.2.40 Ctvil penalty for IUkff &scharges• .J:.r;y person ld!o dsdiarges. polkJtants, ~' "'IO!ahon of this Crapteor. by the use r::i1:lic1t connoct!OOSst'la1! be C-Jlll'i t1abl& tc the Oty in a~~ notto ex~od twooty.:flw thousand dollars per day par violation frx eactt clay in >'.tlich str.;h VIO!a:~Of'l <ltr.Ur.i. •bcetpls-for co-np!ele CODE languaje re!er !n the City of C!..p<:!rtroMunioi:elCar<-i!'. APW'l9'1(E:~._, C<.tJ>e<tino ~t! .. ;~:;~~1~:i"' ::a:~i;;~~~~~ G<tl>t: Sani"" Cl3<a Co\>rHy :~,.<1".l"j;~~~ .~"'mn..-: i£tf!s1t£!~11:~r~;r~rd<>u~ w~~1 .. ; .t~ll·::!U·?ii~ c.ur~e,•~:i ,!:~.ibr}' S:>t-wt1r Dist~ $a11tl:f C!.H., V<il!11;-tlrb*" a.,,,.,11 ;eol>!!;;~~x~;;re""ntiott Ptnm Sfat<> otn.::~ of Em<>r91>i1i:)' S<t>11rc«~ •·1tel>-l$$Z·!S$l>!Utin; $<<':pf)tf«l>ill.!< fo ~11 General Construction and Site Supervision Sktrm0ri>inP<>ikttl1>rrtrnn C<'lllOltroctk>nAr.:11\0ilfo~ ¢«•'11':<t•l'I "'"~<llt'ix'> .... >Kl'>A~(o":<o<l~l<'r<m ...-'>ff>'if,."!i> l,ll;t,<l<l·~1'1w.,bl"'~"""'!AA"U .,,...,~, r,fJ.>,Hl<>I<• <1°:"' ,,.~ .... '" <t-11"""" ~ <><>!<" "':">"~"' ,.,,,,~;J·~"'"""'1lt•1f\.>v W.~•»!llei•:lelf,ll<Wl~""P ....... >1,°""'"' .. 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'~ '"''" <•:l.,mc wtwo1144~<~ll!<> OT>:inyva<••"Pl<r\O<"""""d""h<:'""'ot:r"" 'l'>o>t<tf::«1l•«•••lol••o;!o..,.~>n1~•~...,...,.l«1t»w<0:lth1<10l~·N.>*w.<:<>'><O ~~~f~(~.~~~-:;:~:~~";~~.; ~"*lx'>•"•'"ltY..U••·!b,.,,.;,~ko;~tlc<." R> .,,.,,,,,~<.l"J'"""''"'"~""""'i~m• ;,=il••«<«\>l:•<•:f;Mfl\>l;~cgt><.f <CV:I« Landscaping, Gardening, and Pool Maintenance L;,nd11c11pi1•11.'GweN»M;i/11t1•mm~., :.J So;!1~4•~o ~•Y•f,-.~O'"'"'''"'"'"'• !....,..,,t> ,;~~"'>"'> _, • .,..,,. ..l \!>~ "1~,~~'~'1' "h<~~ """"' 6'" Ni•<:l>U <1: .,,.,,, .... &. ..... ,,.,~~"'""y""~'"'"• :J f!\ll..:!"'°ni•<h111~-.jlt>-•<ll>tH,l-.O"'''<I' ':~~~"·"'~"""ti'••."'<•!:« >o:l<:o<·»; :.:t ~.:.:~:'J,~!:.n ,!; "'"'-""""-t-.ffl"'h"'""'' 0 ~I:i~~~;:;:i~~- -:4 rm""M~\<>w»><><•~,...,.~•;Mu Storm Crain Pollut!on fr.om Landscapinlf' $!1tS Swiinmlng Pool Mainbl-n,;mco ~,~!..;:~'::::.~.'.~:;,;~~:~:.:!~"~ '""""''"""" "''"J" ~t .,~ ~~ .... .,,. ,)"'""'· ~-=""• <""t'~"' oc Wl"".~'0"~ ~wi<o0>,..<JM~!W>l>i> ;n;c':<"'·'~ "'~"•M• _,,,.; '""'""•O••••l •llJ<l<'<l•k<< >t·C'-M:,,_.~, ;\o> ~'.;.~"t'~~;,~~'~" ~,._,,~ y.,,,,,r.,.'"''"""~"" Pt1.,l'f1>w•t.2in.iti(lifM<l;trm11an~~ r>rai1~111Jf1<>0l1t<lr!WA~ '.J Nno:<l!•"".,~"PO..t,,."I!~""·,..,.,~• =~:;•::.~..:.~~~"'<J+'n~ " ~r.3Iff.gf~;:::::~:~;:~ a !:~~,~::~~~~~:~~:~· Flftbl'Cloanifl9 "-·""'''·"'"'"'''""~"'"'"'' Earth-Moving Activities PYac1ioos During Consiructian U l<'o»nwt> <"'1'1""; "<>;l<ot:w.l~ "'"'Y W!'f!n ~*'~7 "'1¢<r~~•11r Pbn~ 1""'P.,,.-V wg<tt.¥1l<:1nfa<<>«:1•loneam'n:>1>)1>iie~o/ 'l>tl,,.. ="'i~d~ i• 11\'ll imr..(l.,,"i:<l.~;'rlafl:".l.t\! ::J Proto~: .t-n1!0;><1 <f"'i<>•liJe l:<IUf~~ stfuin-¥,.;cndstc>rmlto-""'4mi: .. 11<i:e:o.& ~"';K0'"4f'Y<.l<:.i<w~o: •"«*-'· ~ .. d>c<:~ d"'M"' '1::< ..... R1:>0:rc<tr .... aff;orounil.w~s<r.1ti'o»s ~"~"' ~ m .. ~,,,..l <;,';<n., Ca;.~~v <'.'.<><W.:.I $o!.«r~ '""'"""' -..,, s.r,J,,wmr c.,r.:•<.::"F,.;14 M..->/;:al! bJ°l>fl}OO'#~l(o> ~!OJlf c:>~ot ~ CWw ~too',.µin ,,,.,1 >;>>~,;.nultc" ""~ -~ ""°""""""~",,,-;iia~t<,;r;'><'tw.!; Dewatering Operations [ ----··- Storm Drain Polfuticn From Oewatering Activities 8.. 'il'Uru to,...,,!! yo .. 1 elty'o: i.tonn w.a.t"r insp"""ta~ a.t 4Cll··"1~-ll1HI"'" h11fore dlll'l'>h'lr!)mg Wal.UC "I " <!il«'N !JU~<!< Ji( l!lim:r:m a llA'-"' ''>'llJ""'<l l'l:ri<m• ano!hN <Hl<1k< ;)Q$$1bl> nn--.n~• oh n n n---nnnnn _.__.. __ n_ Che<:>k for Sediment ar Tair.h; PQllutants: 0 Cll•;:r;lr!wQd<m>. <J111r.otor>Ji>Qn.w"«n l;<ly !11'1100 llQ;JrCW;i<Jll<"&llH. Q i\$k y1>1ir city in~p111;1;,>1 whfl~'W'" ~ ;irvundwater must~ tesl~omtory 0 010pr:o111,1"11111 "'" tt'" tel<t :~su!Cs. y:..s may t:e imowed l<t <lis<:r.a>'ge po.1mpeci 9•0•11111W2t•., ;1' Illa st1>rrn cr"'r. OR i"!>.S rna~ tru-'~":rod :» r)j11r,t>2r;ic In th.> ••mit11ry ~<'llil" <:f(.\"ll":ld. 3'1~ 1111,;! !Ole ...-:uer <'!t!·'><~ fer t>f::>tm<lnt mid 11•¥1>C>n1at:in<1;>!1?<:11l•ia1~trt111tM;:,m111~•iit; Q WMn d1w::;'1ll~ing !Q-:. ~1orm drnc'l\ ;i.>lllee! Oh<': •'Ilk! li~;ng a ~rrler ~ l:!1>ti:ip ~A'~ l>iier.f'>.mt>d.,rrd<it!hi':!'.l'"'ltt, i.:J C.:mtm~t Ctio~r:in<'! $ilnilllf;' O!it!.'>:'.I at 253-?M.1 pnnrt<:> di~•"u1·y1r19 ·~ t:.<i -.~11itJ•"!' AA"W<!I'. The property owner and the contractor share ultimate responsibility for the activities that occur on a construction site. You may be held responsible for any environmental damage caused by your subcontractors or employees. Painting and Application of Solvents and Adhesives r Storm Drai~-~:iutlon f:n Pai11f5,1 !SI;'\ ~/- P«/nfRamo~;if 0 :~·~;;:;:;:<.::;:.:;~;;::~":::,:;~ ~ Cl-i"°"f1-1><1'1P--"1v,., .. >i,,'1''> ... ,, ~;!\: ,,,... -~~~ .... ~<ts, ... !loi>« <11'11'>1~°'1!1o<rd ""'«l'""YQ"11b11t>1~n>=<11:1t t<l'lll>:'~"'-~""~·~-..,,,...!<~a<'<><: j~ ~.~:.nl '"""'"'~~>'<;~,; m•'·O(<l"""1 Roadwork and Paving GeneTl!!l IJusi11e:;$ Practice.: Ii :'(.~ ;,J :/~ ... 1>:<,p "''"I trnr1te."'-~-~.t fff..,~k>nl~<>\lim,.,,t <';(rnt<<ll !)!:11>• ''" •V.'«<l"'>l~ l""U~J\~m<:"h. U $~1'<:~~''<' ~».:<'•~~"" ~::<) !<r<>Um!< Wll'1l. \!"t:o>~ dr~-..-..,u""" Storm Drain Ponution from Roadwork Durin11Cr;m.'ftm~tiQ'f> Fresh Concrete 0"ri"'0""""""0" iJ ~~~-~.7:,i::p .. ~~"= :-::.~ ;.;;;;;::,~~; ~·1">•~' and :vioi:tar ;~ ";;:;:;;:,:;".:'.:~~~;:;""'""' .. "'"" Application _..:> " ~::.;~:::·~::.:;;;::";'.:i;~~:;::;::,, Storm Drain PoJlution from Fresh Concrete and Mortar AppHcattons l'rn~t> <~r>~w.I~ ~ml ';""""n'""~'mri mnn~,.,. (i:,i1 w:,i:m "'"" 111~~~. ~Wrnm~ "' 1'~!11;11~•'> J<1':ll>•!<':l<;.f<';l<:JM<"«<1<1tlSli< ;:;i <'.'.i':<>:-:> r,,, ~~,, ~"f'"l• ><1"111<1t>11 eQ,,11'"' .. "' ":.J ?•·!!(>:~:, "~"':\M <'<i1<'P'"<">I fop~\,.,; I ~~1~~~~~~~;~ I t::·::~~:~:~~".;,:.:~=:.· 0 -.,.,Y.,, ~"" ~""' ""'"" "o""' """ "'~"""''"" I ~~~:~i~~:~~;f :~!::~·;:::if~:·':, I HMdh'flg Paint Products 0 Ko•~a~ 1tq1licl1»'Hpn><IU..:t~a<o1"'">1 ... ~:;..fr<>mth~ij»<loo",~ ......... ;u'l<f., .... N PiilitilingCJu;mup ONo.,..,.ctr.,,brl!Sl•""•"'JN""p;li"-•=oio•o"'i"ll>"~"'ol.gutl,,..,~l<>fm<l,.Ot FtOl>d><iQlfl,Dr<:<-.... q """"'~·~""''""''""'"'' "s§:~~.§i~§;;_ (:\)ir1tD#!rp-0.<ii11..Rc"llrK"<JrDWwt:°ion :.J O<o"rl<-"""'"».::;oc<l<<a"':!W.~z-,i::1~"'-"W..) ::.J :::,~~~,:::.:•,M-:.\l .':~ >~~·;-~"y,"'.:__'~":.:.:·":~ •::~:,_ :J 0(> 1rnt «H <IHi&HI ant~ l<<l><!C .. I" "q•W~'""''" ;m;\.O\ "' c,"'=2~ .,,,,,rn><>~1 ;:J Aspha/l/Cancmta Rc:m ovaJ :.J ;,~~~~:~~~~<<:;! <!.<<':<:~~ <IU$f v.n~tl ll><><lk;l'>il '1~1>h:\i' w a :.:.:i ~·'"-·'' ''"'·"-~ <A>< ...... > ., '", ~-•·•' ..... ~-°'' " 0 ::'.'.'.:'":~~-:~'".:::~ .• '""."!:':.~\~~ .',~..!~~:':".: .. w < "'"'"''"'>""-"0~>'""'<'••¥ y•X'"'""• •0<">'"' ~~ ;,,,,,,,..,,.,,,~<'ht: "}l" ;;'"~~ +.~%1" 3<':~ l>*:O.:» 0 ;~:;,,:: •. :':"::~::'.':'.''" " U '.:'.::'::: ~~'.~~~".:!','.:.~·>;'~;'~~;;::~% ~:•f•cw {<1 a G<:1n1>r.if8us1n~sl>'~"etic":. ..1 -~:;:;,'!;~,~!':,~~~."o~'~ ~·rt~,..~• :tt•t'*> '-<d " ::::;·; :::~: .~~:,::~ ::~ 7;;,:;::~~·::,.,, .:i :~~~~~~·;:,~~~~~·.-~;·,~~~ .. ~~b"' .... "~ ::i ~:,i;:.;::~~~ .. ~.:::;~u:;·;• ;~,~~:~;~ Heavy Equipment Operation !;~~ .. ~;'!." .. ~·;,; ~"" "'""~"''"" v~~ir.;.o ,:. "::;·;~:·,..:: :;~:;~ 6 :: ; ';4'.;.'. .;~::· ',. ::. ,.~~-~::: ·;~ ~·i! ;;:··,:.~t!:~;.~';:~;· ~~,~· ~»'..'., :J ~.~, >6: ~~t:::: ,·::~, ~ ~:;: .~:~:;.: ;;; .. ::··~ ..:. "~~ .. ::;.~;:,/::'. ~.-:~::·::.;" • .'."".;'.'.!:~· . .1,,.,. ~I '~~:~ ::~~~~: :7'.;< ;:,~;':'~;_'.',",~·':: ·.~', , .. ·' <l '~'.'.,:".,,~," ,~:,~::,;'; .~.~·. :": ~.-.• ~.-,:;",., Small BUSiness Hazardous Waste Disposal Prgm Businesses that generate less than Zl galfoos or 220 pot>1ds of hazardous waste per month are eligible to use this program.. Call 408-299-7300 fora quote. ~ ·~: C!JPfRJ!NO ilWMii ~:~::;::~.~ ... p,¥~···· l '!'(•s;; =:> •.\">JCA1;;r ~11,1 ~ TIM:~~JJ~~111·2·· .... !1~~1~:,,p-I CONSTRUCTION BEST MANAGEMENT PRACTICES Clf!ili!IY. ~\· CTf'IPPB~!.J!.Bf#A.. ~=5 ~-=.. ~=.l Y' U =i E:!JS1i::r =: ::i=i!I Y/ DEPARTMENT OF PUBLIC WORKS OlRECTOR Ol" POSUC. WORKS 314779 D AE!?flD® CERTIFICATE OF LIABILITY INSURANCE I DA TE (MMIDDNYYY) 09/21/2015 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 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 2~~i~cT Cheri Greco John 0. Bronson Co. A Division of HUB International I #0757776 f1J~NJn ~--'" 916-480-4153 I FAX 3636 American River Drive, Suite 200 IA/C Nol: 916-993-7253 Sacramento, CA 95864 ~DMDA~~ss: Cheri.Greco@lhubinternational.com 916-974-7800 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Starr Indemnity & Liability Company 38318 INSURED Coastwide Environmental Technologies, Inc INSURERS: State Compensation Insurance Fund of California INSURER C: 201 Walker Street INSURERD: Watsonville, CA 95076 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:21410 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMM/DDIYYYYl IMM/DDNYYYl LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -7/01/16 DAMAGE TO RENTED x COMMERCIAL GENERAL LIABILITY EIL70111015 7/01/15 PREMISES IEa occurrence\ $ 300,000 -~ CLAIMS-MADE 0 OCCUR MED EXP (Any one person) $ 5,000 A x Contractors Pollution Liability x x Per project aggregate applies as PERSONAL & ADV INJURY $ 1,000,000 -required by written contract with x $5,000 Deductible GENERAL AGGREGATE $ 2,000,000 -a $5M Cap GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,000,000 n POLICY IXl ~rP..,: nLOC $ AUTOMOBILE LIABILITY fE~~~b~~~tf INGLE LIMIT $ I 000 000 f--PCA08237215 7101115 7/01/16 x ANY AUTO BODILY INJURY (Per person) $ f--ALL OWNED ~ SCHEDULED A x x BODILY INJURY (Per accident) $ f--AUTOS f--AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS IPer accident\ -f--x MCS90 $ UMBRELLA LIAB ~OCCUR XNV71050015 7/01/15 7/01116 EACH OCCURRENCE $ 10,000,000 - A x EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 OED I I RETENTION$ $ WORKERS COMPENSATION I WCSTATU-I IOJ~-AND EMPLOYERS' LIABILITY 9062218 7101115 7101116 X TORY LIMITS YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 5CJ NIA X E.L. EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Project No. 2016-06 Simms Residence, 22241 McClellan Road, Cupertino, CA 95014 Add'! The City of Cupertino ("City") and its directors, officers, engineers, agents and employees and all public agencies from who pennits will be obtained and their Interests: directors, officers, engineers, agents and employees, and the State of California, and its officers, agents and employees are additional insured where required by •vritten contract. 30 day notice of cancellation except I 0 day for 11011 payment of premiwn D J<'m·ms: 10217 0112; CAOOOI 0310; CA0444 0310; SICA1016 0212; CG2010 0413; CG2037 0413; SL023 0611; SL739 0711; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino Public Works Dept. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Ave AUTHORIZED REPRESENTATIVE !j~· Cupertino, CA 95014 I © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PCA08237215 COMMERCIAL AUTO CA 04 440310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Coastwide Environmental Technologies, Inc Endorsement Effective Date: 7/01/15 Name(s) Of Person{s) Or Organization(s): SCHEDULE The City of Cupertino ("City") and its directors, officers, engineers, agents and employees and all public agencies from who pennits will be obtained and their directors, officers, engineers, agents and employees, and the State of California, and its officers, agents and employees are additional insured where required by written contract. Information required to complete this Schedule, if not shown above, wm be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is walved prior to the "accident" or the "loss" under a contract with that person or organization. © Insurance Services Office, Inc. Policy Number: PCA08237215 Named Insured: Coastwide Environmental Technologies, Inc BUSINESS AUTO COVERAGE FORM COMMERCIAL. AUTO CA 00 O'i OS 10 Various provisions in this pollcy restnct coverage. Read the entire poHoy carefully to determine light$, duties and what is and ls not covered, SECTION I -COVERED AU'fOS Ttarn Two of the Oeclarat1ons shows the "autos" that are covered "autos" for each of your cover· ages. The following> numerical symbols describe the "autos'* that may he covered "autos". The symbols entered next to a coverage on the Oectarat1ons designate the only "autos" that are covered 1tautos ", Throughout this policy the words "you" and "your" refer to the Named Insured shown m the Declara- tions. TI1a words "we", "us" and "our" refer to the company providing this Insurance. Other words and phrases that appear In quotation marks have spacial meaning. Refer to Section V - Oaflnit1ons:. A. Description Of Covered Auto Oesignatir.m Symbols Symbol. 1 ~2- Desorlption Of Covered Auto Designatftm Symbols 7\11Y"A~---""-~-~-~---~· -~~ ...... ~---· Owned "Autos" Only those "aL!tos" you own (anITor-llabi""Ut-y---:=C-ov_e_r._a_9_e_a_n_y.....,.,."t_ra_,,i"""lt11-rs_,",,--y-o--1u OrHy don't own while attached to power units you own). Thia includes those Owned Private Passenger "Autos" Only "autos" you acquire ownership of after the policy begins. · Only the private passMger "autos" you own. This includes those private passsenger "autos" you acquire ownership -of after the policy begins~ 1--~---f~~----'-~~~~~-~----~~~~~--~~~~~~~~~~~~~~-, Owned "Autos" Only those ''autos" you own that are not •of the private passenger type {and Other Than Pri-'fOt L!abiHty Coverage any ntra!!ers" you don't own while attached to power • vata Passenger units you own). This includes those "autos" not of the private passenger type "Autos" Only you ac:qufre ownership of after the policy begms. 1---5-· --1-0-w_n_e_d_"_AU_•t_o_s-11-0"""n-fv-_ -th-;;e "auto-s11 you-own .. thai.ara"raquiredto have no-fault bana1its fn the To state where they are licensed or princip This includes those tilt *'autos" you acquire ownership of i:rfter the eglns provided they are required to hava no·fault benefits in tho stata where they are hoensed or prlnorpally garaged. Owned "Autos" On!y those •autos" you own that because 01' tfn: !aw m the state where they Subject To A are hcensed or princ!pal!y garaged are required to have and carmot reject Compulsory Un!nsunid Motorists Coverage. Thier includes those "autos" you acquire Uninsured ownership of after the polmy begfns provided they are subject to the sa.ma Motorists Law state uninsured motorists requirement, r-~7~-..-t-s-p_e_c_it~ic-a~lly~~-o-1"""11y_t.,...h-o .. -.,e~,,~au ___ t'-O$TciascnbedTn1t·-e~in~. ~i"""h_re_e_o._,..f-t-he~D-e~c-la_r_a.t-10_n_s_fo~r-w---h-lc_h_a-i· Described premium charge is shown (and for Liability Coverage any "trailers-rt you don't "Autos'1 own while attached to any power unit described !n Item Three), ----ic----------~---~----~··~ Only those "autos" you lease, hire, rent or borrow. Thm does not include any Hired "Autos" Only Non-owned "Autos" Only "auto" you lease, hlre, rent or borrow from any of your '1employees", partnen> (if you are a partnership). members {if you are a hmited liability company) or members of their households. Only thosi;; "autos" yuu do not own, lease, hire, rent or borrow that are used m connection with your busmess, This includes "autos'1 owned by your '1employee:s"1 partners {Jf you am a partnership>, members (H you are a limited llabillty company) or members of their households but only while used in yqur '--·-~__.. ________ p~~iness or your personal affairs. ~-~~------' CA 00 01OJ10 ~ l•nsurance Services Office, lno,, 2009 Paga 1 of 11 0 19 Mobile Eqmp· ment Subject To Compulsory Or Financial Responsibility Or Other Motor Vehicle Insur· ance Law Ordv Only those "autos11 that are land vehicles and that would qualify under the definition of t1mob1le oqulpmentu under this pol!cy if they were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where they are licensed or principally garaged. B. Owned Autos You Ac:qufre After The Polley Begins 1. If Symbols 1, 21 3, 4, 5, 6 or 19 are entered next to a coverage in Item Two of the Decla- rations, than you have coverage for "autos~ that you acquire of the type ·described for the remainder of the policy period. .i. But, 1f Symbol 1 Is entered next to a coverage in Item Two of the Declaratlons, an "auto" you acqu!r;;1 wm be a covered 11 auto" for that coverage only if; a. We already cover all "autos" that you own for that coverage or it replaces an "auto" you previously owned that had that coverage; and b, You tell us within 30 days after you acquire 1t that you want us to cover it for that coverage, C. Certain Trailers, Mobile Equipment And Temporary Substitute Aut.os If LJability Coverage is provided by this coverage form1 the following types of vehicles are also covered "autos" for L1ab1Uty Coverage: 'L "Trailers" with a load <;ftpac1ty of 2,000 pounds or less designed primarily for travel on public roads. 2. "Mobile equipment" whl!e befng carried or towed by a covered "auto". 3. Any "auto" you do not own while used with the permisslon of its owner as a temporary substitute for a covered "auto" you own that is out of service because of its: a. Breakdown; b. Repain c, Servicing; d. "loss"; or a, Destruction. SECTION Jr -LIABlLITY COVERAGE A. Coverage We will pay aU sums an "insured" legarly must pay as damages because of "bodily injury" or "propartv damage" to which this insurance applies, caused by an "accident" and resulting from the ownership, ma1nternmca or use of a covered "auto", We will arso pay ail sums an "insured" legally must pay as a "covered pollution c:ost or expense" to which this insurance applies, caused by an "accident" and resultmg from the ownership, mamtenanoe or use of covered ''autos", However, we will only pay for the "covered pollution cost or expense" if there is erther "bodily iniury" or "property damage" to which this Jnsuranoe applies that is caused by the same "accident", We have the right and duty to defend any "insured" against u "suit" asking for such damages or a "covered pollutlon cost or expense". However, we have no duty to defend any "Insured" against a 11suit» seeking damages for 11bod!ly Injury" or ''property damage" or a "covered poUtrtlon CO$t or expefl!il~" to which this insurance does not apply. We may investigate and settle any claim or "suit" as we consider approprmte. Our duty to defend or settle ends when the l.iab!lity Coverage, Limit of tnsuranca has been exhausted by payment of judgments or settlements. 1, Who !s An Insured The following are "insured$": a, You for any covered "auto", b. Anyone else while using with your permission a covered "auto" you own, hire or borrow ex.capt: (1 t The owner or anyone .else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a. "traf!ar" connected to a covered "auto" you own. (2} Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3} Someone using a covered 11 auto" while he or she is working in a bus!· ness of seHing, servicing, repairing, parking or storing "autos" unless that business Is yours. (4} Anyone other than your "employ- ees", partners (if you are a partner+ ship), members (H you are a ltm1ted llab!lity company) or a lessee or borrower or any of their "employees••, while moving property to or from a covered "auto", (5} A partner {if you are a partnership) or a member (If you ara a limited liability company) for a covered "auto" owned by h1m or her or a memb£tr of his or her household. Page 2 of 11 ~ Insurance Services Office, Inc., 2.009 CA 00 01OJ10 r:t c. Anyone liable for the conduct of an ''insuretr described above but only to the extent of that liability. 2, Ccnreraga Extanslcms a. Supplementary Payments We wH! pay tor the "insured": (1.) All expenses we incur~ (2) Up to $2,000 for cost of ball bonds (inoludlng bonds for ralated traffic law violatrons} required because of en "accident" we cover. We do not have to furnish these bonds. (3) The cost O·f bonds to release attach· ments In any '1sult" agarnst the "msuredri we defend, but only for bond amounts w1tt·un our Lnnit of lru::urttnca. (4) All reasonable expenses 1rmurred by the "insuredu at our request, m~ olud ing actual loss of earnings. up to $250 a day because of time off from work. (5} All court costs taxed agamst the "instued" In any 1osu1t10 against the *'Insured'' we defend. However, thesa payments do not include attomeys' fees or attorneys' expenses taxed against the "insured". {6) All interest on the full amount of any judgment that accrues after entry of the judgment in any Jjsuit11 agalnst the "inuumd" we defend, but our duty to pay interest ends when we have paid1 offered to pay or depos· ited in court the part of the judgment that is within our ,t.1mlt of lnsura11Ca. These payments will not reduce the Limit of Insurance, b. Out~of~state Coverage Extensions While a covE!red "auto" rs away from the state where it ts ficensed we will: i1) Increase the Limit of Insurance for Lisbillty Coverage to meet the limits specified bY a compulsory or firwmcial rasponslbillty law of the jur1sd1ctlon where the covered "auto" is being used, This extension does not apply ta the limit or limits specified by any law governing motor carriers o'f passengers er property. (2} Provide the tnmimum amounts and types of oth<~r coverages, such as no~fault, required of out~of·state vehi· ctes by the jurisdJCt1on where the covered nautu'* is bamg used. We will not pay anyone more than once for the same elements of loss because of these extensions, ·· B. Exclusfons This insurance does not apply to any of the following: 1 . Expected Or Intended injury "Sod1!y injury" or "prdperty damage" ex- pected or Intended from the standpomt of the "insured". 2, Contractual Liability assurned under any contract or agreement. But this excluskm does not apply to llablllty for d?mages! a. Assumed ln a contract or agrearnent that Is an "Insured contract" provided the "bodily injury" 'or "property. damage" occurs subsequent to the execution of the contract or agreement: or b. That the "losured11 would have in the absenoe of the contract or agreement, 3. Workers' Compemmtion Any obUgation for which the ~insured". or the "lnuured1s0 insurer may be held liable under any workers' compensation, dmabi!lty benefits or unemployment oompansatkm law or any similar law. 4. Employee Indemnification And Employer's liability ...Bod1!y in;ury" to; a. An "employee" of the "insured" arising out of and in the course of: l1l Employment by the "insured"; or f Zl Performing the duties related to the conduct of the ''lnsu~d's" business~ or b. The spouse, child, parent1 brother qr sister of that "employee" as a conse- quence of Paragraph a. above. This exclusion applies: (1) Whether the "insured" may ba liable as an employer or In any other capacity; and {2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. But this exclusion does not apply to "bodily injury'' to domestic "employees" m:it entitled to workers' compensation benefits or to liability assumed by tl1e "insured" under an "msured contract", For the purposes of the coverage form, a domestic "employee" is a person engaged m household or domestic work performed prim::ipally 1n connection with a residence premises, 5, fallow Employee "Bodily injury" to: CAOO 01 0310 @ Insurance Services Office, Inc., 2009 Page 3of11 !J a. Any fallow "employee" of the "insured" arising out of and 111 the course of the fellow "ernployaa's'1 employment or while performing duties related to the conduct of your busmess; or I:!. The, spouse, child, parent, brother or sis~ ter of that fellow "employee'1 as a conse- quence of Paragraph a. above. 6. Cars. Custody Or Control "Property damage" to or "covered po!lut1on oost nr £ixpense" involving property owned or trans~orted by the "insured" or m the "Insured s" care, custody or control, But this exclusion does not apply to liability assumed under a sidetrack agreement, 7, Handllng Of Property "Bodily injury" ur "property damage" re· suiting from the handling of property: a. Before It Is moved from the place where lt is accepted by the "insured" for movement into or onto the covered "auto"; or b. After it is moved from the covered "auto" to the place where rt is finally delivered by thee "insured", 8, Movement Of Property By Mechanical DeYic!l 11sod:l!y in;ury" or "property damage'' re~ suiting from the movement of property by a mechanical device {other than a hand truck/ unless the device is attached to the covered "auto". 9, Operations ~Bodily in1ury" or uproperty damage" arising out of the operation of: a. Ar.y equipment listed 111 Paragraphs 6.b. and ti.c. of the deilmtion of "mobile equipment"; or b. Machinery or equtpmant that is on, attached to or part of a land vehicle that would qllalify under tha definition of "rnobile equipment" if 1t were not sub1ect to a compulsory or financial responsibility law or other motor vehicle insurance !aw where it is Ucansad or principally ga" raged. 10. Completed Opatations "Bodily Injury" or "property ctnmaga" arising out of your work after that work has bean completed or abandoned. In this exclus1on1 your work means: a. Work or operations performed by you or on your behalf; and b. Materials, parts or equipment furrnshed n; connection with such work or operations, Your work includes warranties or represen~ tat1011s made at any time with respect to the fitness, quality, durability or performance of any of the ltems Included ln Paragraph a. or b. above. Your work will be deemed completed at the earliest of the following times: (1)When all of the work called for In your contract has been completed, (2,l When all of the work to be done at the site has been completed if your contr<'lct calls for work at more than one site. (3l When that part of the work dona at a job site has been put to its Intended use by any person or organization other than another contractor or sub- contractor working on the same proiect. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, wm be treated as completed. 11 • Pollution "Bodily injury" or "property damage'' arising out of. the actual, alleged or threatened discharge, d!sj:larsal, seepage, migration, re· lease or escape of "pol!utanbt": a, That are, or that are conta.ined in any property that is: (1) Be trahsported or towed by, ha or handled for movement lnto1 onto or from the covered "au- to"; {2) Otherwise m the course of transit by or on behalf of the "insured"; or 131 Selt'll'J stored, disposed of, treated or processed in or upon the covered "auto"; b. Before the "pollutants" or any property in wl'uch the "pollutants" are contained ara moved from the place where they are accepted by the "insured" for movement into or onto the covered uauto"; or o. After the •rpollutants" or any property in which the "pollutants" are contamed are moved from the covered 11auto11 to the place where they are finally delivered, disposed of or abandoned by the "in· sured", Paragraph a. above does not apply to fuels, lubnc1mts, fluids, exhaust gases or other similar "pci,l!utants" that are needed for or result from the normal electrical, lwdnml1c or machal)lcal functioning of the r;overed "au- to" or its parts, if: (1 l The "pollutant'>" escape, siaep, mi- grate or are discharged, dispersed or released directly from an "auto" part designed by its manufacturer to hold, Page4of11 @ Insurance Services Office, !nc., 2009 CA 00 01 03 10 0 store, receive or dispose of such "pollutants"; and (.2) The "bodily injury", " party dam- age n or ucovered pol cost or expense" does not arise out of the oparat1on of any equipment fisted in Paragraphs 6.b. and 6'.o, of the deflnltio11 of "moblte equrpment*'. Paragraphs b. and c. above of this exclusion do not apply to "accidents" that occur away from promises owned by or rented to an "insured" with respect to '1p0Jlutants" not in or upon a covered "auto11 If: (a) The 1'pollutants« or any prop in whmh the "pollutants" are ed are upset, overturned or damaged as a result of the mamtenanoe or use of a covered "auto"; and (b) The discharge, dispersal, seepage, migration, r~lease or escape of the "pollutants" is caused directly by such upset, overturn or damage. 'l:.t. War "Bodily injury" or "property damage" 1.msing directly or 111d1rectly out of: a. War, incluclfng undeclared or oM! war; b. Warlike action by a military force, including action Jn hindering or cl.efendmg against an actual or expected attack, by any government, sovereign or other au- thority using military personnel or other agents; or c, insurrection, rebefl!on, i:avolutu:ai, usurped powe( or action taken by gov· emmental authority in hindering or de· fonding against any of these. 13 .• Racing Covered "autos" while used In any profas~ sional or organized racing or demolition con· test or stunting act!vlty1 or whlle practicing for such contest or activity. This insurance also does not apply while that covered •au· to11 is betng prepared for such a contest or activity. C. Umit Of Jnsi.mmce Regardless of the number of covered "autos" "if'lSl,Jrl~dS" I Pft1miUITI$ paid, OlaJmS made Of vehicles Involved fn the "aucidant", the most we will pay for the total of an darnag!tis and "covered pollution cost or expense" combined resulting from any one "accident'' Is the Limit of Insurance for Liabl!ity Coverage shown in the Declarations. Al! "bodily !nJury" '· "property damage'1 end "covered pollution cost or axpense" resulting from continuous or repeated exposure to sub~ stant1aUy the same conditions will be consid- ered as resulting from one "accident". No one wm be entitled to receive duplicate J:layments fut the imme elements of llJosa" ut1der this coverage form and any Medical Paymants Coverage endorsement, Uninsured Motorists Coverage endorsement or· Under· insured Motorists Coverage endorsement at- tached to thls Coverage Part. SEC'flON IU -PHYSICAL DAMAGE COVERAGE! A. Coverage 1. We will pay for "loss" to a covered "auto" or its eqwpment under: a. Comprehensive Coverage From any cause except: f1 > The covered ''auto's'* collision with another object: or {2) The cave;red "auto's" overturn. b. Specified Causes Of loss :Govera9e Caused by: f 11 Fire, lightnmg or explosh.J11; {2} Theft; {31 Windstorm, hail or earthquake; (4) Flood; (6) Mischief or vandalism; or (CS) The sinking, burning, coll!sfon or derailment of any oo.nveyance transpmtlng tha covered ''auto". c. Col!Islon Coverase Caused by: (1 J The, covered "auto's" collision with another obiect; or {.2:~ The covered "auto's" overturn. 2. Towing We wlll pay up to the limit shown in tha Declarations for towmg and labor costs 111~ curred each tfme a covered "auto" of the private pas:senganypa is disabled, However, tha labor must be performed at the place of dlsab!ement. 3. Glass Breakage -Hitting A Bird Or Animal ~ falling Objects Or Missiles If you carry Comprehensive Coverage for the damaged covered "auto", we will pay for the foHow111g under Comprehensive Coverage: a. Gla!>s brealrn9e; b. "Loss" caused by hitting a blrd or animal; and a. "L_oss" caused by falling objects or m1s:sd\\ls, However, you have the opt1011 of having glass b~eakage caused by a covered "au· to's" collision or overturn considered a "loss 11 under Colliswn Coverage, 4. Coverage Exte11sfons CA.00 01 0310 4> Insurance Services Oifica, I.no., 2009 Page S of 11 11. Transportation Expenses We wl!I pay up to $20 per day to . a maximum of $600 for temporary trans· portation expense incurred by you because of the total theft of a covered ''autou of the private passenger type. We will pay only for those covered "autos" far which you carry either Compre- hensive or Specified Causes Of loss Coverage. We will pay for temporary transportation expenses Incurred during the. period beginning 48 hours after the theft and endlng, regardless of the policy's expiration, when ttie covered ·~~u.1to11 Is ratumed to use or we pay for its "loss\ b. loss Of Usa Expeni;es For Hired Auto Physical Oamage, we w!ll pay expenses tor whmh an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver 1.mder a wnttan rental contract or agreement. We will pay for 'loss o:f us.e expenses 1t caused by; {1) Other than oollision only if the Dao· larations indicate that Compre- hensive Coverage is provided for any covered "auto"; {23 Specified Causes Of Loss only if the DecJsratlons indicate that Specified Causes Of Loss Coverage ls provided for any covered "auto"; or (3) Collision only . if the Declaratioos indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use ia $20 per day, to a maximum of $600. B. Exclusions 1. We wi!I not pay. for "loss" caused by or resulting from any of the following, Such "loss" ts excluded regardless of any other cause or event that contril:mtes concummtly or In any sequence· to the ''loss'". a. Nuclear Hazard (1) The explosion of any weapon employing atomic fissmn or fusion; or (2) Nuclear reaction or radiation, or radi· oactive contamination, however caused. b. Wat Or Milita:ty Action t1 l War, including undeclared or civil war; fl} Warlike action by a military force, including action !n hindering or de- fending against an actual or expected attack, by any government, .sovereign or other authority using military per- sonnel or other agents; or (3) Insurrection, rebelllon, revolution, usurped power ur action taken by governmental authority in hindering or defending agamst any of these. 2. We will not pay 'for "loss" to any covered "auto" while used In any professional or organ1zad racing or demolition contest or stunting activity, or wh cticing for such contest or actlvtty, We also not pay for uloss" to any covered "auto" Whlla that covered "auto" ts being prepared for such a contest or activity. 3, We will not pay for "h:iss" due and confined to: a. Wear and tear, freezing, mechanical or electrical breakdown. b. Blowouts, punctures or other road dam· age to tires. This exclusion does not apply to such "loss" resulting from the total theft of a covered "auto", 4. We will not pay for "loss" to any of the following:: a, Tapes, records, discs or other similar audio, visual or data electronic: devices designed fol' use with audio, visual or data aleatronio aqwpment. b. Any device designed or used to detect speed-measuring equipment such as radar or laser detectors and any jamrnmg apparatus intended to elude or disrupt speed-measurement equipment, c. Any eJactronic eqwpment, without regard to whether this equipment is permanently installed,. that reproduces, race1ves: or transmits audio, visual or data signals. d. Any aocesiwnea usod with the electronlc equipment described in Paragraph c. above. 5. Exclusions 4.c, and 4,d. do not apply tll equipment designed to be operated solely by use of the pov•l'er from the 1•auto's" electrical system that, at the time of "loss", 1s: a. Permanently installed in or upon the covered ''auto''; b. Removable from a housing unit which 1s permanently tnstal!ed In or upon the covered "auto"; e. An Integral part of the same unit housing any electronic equipment described in Paragraphs a. and b. above; or d, Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. 6. We w1H not pay for "loss" to a covered »auto" due to "diminution in value". Page 6 of 1'1 ce> Insurance Services Office, fnc,, 2009 CA0001 0310 0 C. Umit Of Jnsuram::e 1. The most we wi!I pay for "loss" in any one "acC"ldentn is the lesser of: a. The actual cash valua of the damaged or stolen property as of the time of the "loss"; or b. The cost of repairlni;J or replacing the damaged or stolen p.roperty with other property of !Ike kind and quallty, 2. $1 1000 ls the most we will pay for nlosa" in any one "accident" to all electron lo equrp· ment that reproduces, receives or transmits audio, vlaual or data sign;ifs w!'m:h, at the time of "loss" 1 is: a. Permanenrly Installed In or upon the covered "auto" !n a ho.us:mg, opening or other location that is not normally used by the "auto" manufacturer for the instal- lation of such equipment; b. Removable from a permanently installed housing unit as described In· Paragraph 2.a. above or is an Integral part of that equipment; or c •. An integral part of such equipment. 3. An adiustment for depreciation and physical condition w1U be made In determ1nmg actual cash va!ua in the event of a total "!oss1'. 4. It a repair or replacement results m better than like kind or quality, we will not pay for the amount of the betterment. o, Deductibra For each covered "auto", owr oblfgatlon to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable daductlf:lle shown in the Declarations. Any Comprehensive Coverage deductible shown in the Daolarations does not apply to "loss" caused by fire or !lghtnln9. SECTION IV -BUSINESS AUTO GONOITtoNS The following conditions apply m 1i1dd1t1on to the Common Polley Com:litions: A, loss Conditions f. Appraisal For Phys.il:ml Darrmge Loss Jf you and wa ee on the amount of "loss", either may and an appraisal of the ''loss". In this event, each party will select a competent appraiser. Tha two .ap~ praisers wm sefeot a competent and impartial umpire. The appraisers will state separately the actual cash value and amount ot "los$". If they foll to agree, they will submit their differences to the umpire. A decision :agreeq to by any two will be binding. Each party will: a. Pay fts chosen appraiser; and b. Bear the other expenses of the appraisal and umpire equally. If we submit to an apprnleal, we w1!1 still retaln our· right to deny the claim. 2. Duties In The Ev'Elnt Of Accident, Claim, Suit Or l.Qsa We have no duty to provide coverage under thi$ policy unless there has been full com- pliance with the followlng duties: U• ln the event of "aoolctent", claim, "sult" or "!os$", you must give us or our au· thorized reprasantatlve prompt noiica of the "aco!dent0 o.r "loss". Include: 111 How, when and where the "accident" or 01l:rns" occurred; (2J The "irisured's 11 name and address:; and {3) To the extent possible, the names and addresses o'f any injured parsons and witnesses. b. Additionally, you and any other Involved "Insured" must: {11 Assume no obligation, make no payment or incur no expense without our consent, except at the ''In~ sured's" own cost. (2:) Immediately send us copies of any requas;t, demand, order, notma, sum- mons or legal paper received con· oernlng the claim or ''suit". (3> Cooperate with us in the Investigation or settlement of the claim or defense against the "suit". (4) Authorize us to obtain medical records or other pertinent informa· ti on. {$) Submit to examination, at our expense, by physicians of our choice, as often us we raaso11ably reql!ire. c. If there la "loss" to a covered nauto11 or its equipment you must also do the following: (1) Promptly notify the police fr the COV· ered "auto" or any of Its aquipment is stolen, · {21 Take all reasonable steps to protect the covered "auto" from further damage. Also keep a record of your expenses for comndarat!on in the settlement of the claim. !31 Permit us to inspect tha covered "auto" and records provmg the "loss" before its repair or disposition. (4} Agree to examinations under oath at our request and give us a signed statement of your answers. 3. l.egal Action Against Us No one may bring a legal action agamst us CA 00 01 0310 © Insurance Services Office, !no., 2009 Paga 1 of 11 D under this coverage form until: a. ihere has been furl oompltance with all the terms of this coverage form; and b, Under Ltabillty Coverage, we . agree ln writing: that tho ''insur<lld" has art obliga· tion to r>ay or until the amount of that obligation has finally been datem1lned by judgment after trial. No one hae the right under this policy to bring us into an ac~ tkmto determine the "lnsured's" liab11ity. 4. Loss Payment ~ Physical Damage Coverages At our option we may: a. Pay for, repair or replace damaged or stolen property; b. Return the stolen property, at our ex- pense. We will p.ay for any damage that results ta the "auto" from the thoft; or c. Take all or any part of the damaged or stolen property at an agreed· or appramed value; If we pay for thil "loss", our paym.ent will include the applicable sales tax for the damaged or stolen property, 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this coverage form has rights to recover damages from another, thosa rights are transferred to us. That person or organization must do everything oeoess1;1,ry to secure OU( rights and must do nothing after "accident'' or "loss" to impair them. B. General Ct:mditlon$ 1. Saok"ur>tcy Bankruptcy or insolvency of the "insured" or the "!nsured's11 estate will not relieve us of any obllgatkins under this oovernge form. 2. Concealment, Misrepresentation Or Fraud This coverage form Is void In any case of fraud by you at any time as tt relates ta this c:overage form. lt is also void if you or any other "insured", at any time, mtent1onally com:aal or misrepresent a rnaterfal fact concerning: a. This coverage form; b. The covered "auto"; c. Your interest in the covered "auto"; or d. A claim under this coverage form. 3. Liberalization !f we revise this coverage form to provide more coverage without additional premium charge, your policy will automatmally pro- vide the additional coverage as of the day the revision is e.ffective m your state. 4. No Benefit To Bailee -Physical Damage Coverages We will not reoogntze any assignment or grant any coverage for the bene11t of any parson or organization holdh19, storing or transporting property for a fee regardless of any other provision of this coverage form, 15. Other Insurance a. For any ooverad "auto" y-0u own, this coverage form provides pnmary insur- ance. For any covered "auto" you don't own, the insurance provided by this cov• eraga forrn is excess over any other collect1ble insurance. However, while a covered "auto" which Is a "trailer" is connected to another vehicle, the Liability Coverage this coverage form provides for the "trailer'* ia: (1j Excess while it is connected to a motor vehicle you do not own. (2.) Primary while lt is connected to a covered "auto'' you own. b. For Hired Auto Physical Damage Coverage, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own, Howaver1 any "auto" that Is. !eased, hired, rented or borrowed with a driver m not a covered "auto". · · c. Regardless of the provisions of Paragraph a. above, thi.s coverage form;e Liability Coverage is prtmar·t for any liability assumed under an "msured contractu. d. When this coveratie form and any other coverage form or po!lcy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit Of Insurance of our coverage form bears to tho total of the limits of all the coverage forma and policies covering: on the same basis. 6. Premium Audit a. The estfrnated premium for thfa coverage form is based on the exposures you to!d us you would have when this pollcy began. We will compute the final pre- mium due when we determine your actual exposures. The estimated total premium will be credited against the ftnal premium due and the first Named lnsured will be billed for the ba!anoe, if any. The due date for the final premium or retrospective premium Is .the date shown as the due date on the bill. If the estimate<! total premium exceeds the final premium due, the first Named Insured will get a refund. b. If his policy !s issued for more than one year, the premium for this coverage form wrll be computed annually based on our Page B of 11 (> Insurance Services Office, Inc., 2009 CAOO 01 0310 0 mtaa or premiums in effect at the begin- ning of each year of the policy. 7. Policy Period, Coverage Territory Undar this oovaraga form, we cover "accidents" and "!m1:sea11 occurring: a. During the policy period shown In the Declarat!ons; and b. Within the coverage territory. The coverage territory rs: {1)The United States of America; (2) The territories and possessions of the United States of America; t3) Puerto Rico; (4) Canada; and (5} Anywhere 1n the world if: (a) A covered. "auto" of the. private passenger type is leased, hired, ranted or borrowed without a driver for a period of 30 days or less; and lb> The "fnsurnd's ... responslb11it¥ to pay damages Is determined in a ' suit" on the merits, in the United States of America, the territories and pos· sessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to, We also cover "loss" to, or "accidents" involving, a covered li auto" while being transportti>d between any of these places, 8. Two Or Mofe Coverage Forms O·r Pol!oles Issued By Us If this coverage form and any other coverage form or policy issued to you by us or any company affiliated with us applies to the same "accident", the aggregate maximum Umit of Insurance under all· the . coverage forms or policies shall not exceed the highest applicable Limrl: of lmmrance under any one :coverage form or policy. This condition does not apply to any coverage form or pollcy issued by us or an affl11ated company specifically to apply as excest> insurance over this coverage form. SECitON V -OEFINtTfONS A. "Accident" includes continuous or repeated exposure to the same conditions resulting In "bodily injury" or "proparty damage". B, "Auto" means: 1. A land motor vehfcJe, "trailer" or sem!tra!ler desigru;,d for travel on puhllc roads; ot 2. Any other hmd vehicle that is subject tel a compulsory or financial respons1bl!ity law or other motor vetiicle insurance !aw where it 1a licensed or principally garaged. However, "auto" does not Include "mob1fe equipment". C. "Bodily injury" means bodily in1ury, sickness or disease sustained by a person including death ra1m!tlr1g from any of these. ll. °Covered pollution oost or expense'* means any cost or expense arlsmg out of: 1. Arw raquest1 demand, order or statutory or regulatory requirement that any "insured" or others t&st fort mo111tor1 clean up, remove1 contain, treat, detoxify or neutralize, or In any way respond to, or assess the affects of, 11pollutanta11i or · 2. Any claim or "s1,1it11 by or on bahaff of a governmental authority for damages beos1.me of testing for, monltor.ing, cleaning LIP1 removing, containing, treating, detox!fy1ng or neutra!lzlng, or In any way r111spond1ng to, or assesslng the effects of, "pollutants". °Covared pol!utmn cost or expense" does not include any coat or expense arising out of the actual, alleged or threatened discharge, dispsr· sal, seepage, migration, release or escape of "pof!utants": a. Th.at are, or that are contained in any property that llH (1) Se transported or towed by, han or handled for movement into, onto or from the covered "au~ to"; (2) Otherwise !n the course ol transit by or on behalf of the "insured"; or (3} Being stored, disposed of, treated or processed m or upon the covered "auto'*; b, Sefore the "pollutants'' or any property 01 which the "pollutants" are contained are moved from the place where they are accepted by the "msured" for movement into or onto the covered "auto"< or e. After the "pollutants'' or any property 1n whrch the 11pollutarrts11 are oontalned am moved from tJ)e covered "auto" to the place where they are finally delivered1 dh~posed of or abandoned by the "insured". Paragraph a. above does not apply to fuels, IUbricants, fluids, exhaust gases or other simHar "pnllutantsi• that are mleded for or result from the normal e!ectncal, hydraulic ot mechanical functioning of the covered "au- to" or its parts1 If; 11 l The "pollutants" escape, seep, migrate or are discharged, dispersed or released directly from an "auto" part designed by its manufacture. T to hold, store, receive or dfapose of such "pollutants"; and {21 The "bodily injury", "property darn.· age" or ncovered pollution cost or expense" does not arlse out of the CA 00 01 03 10 ~ Insurance Servkms Office, Inc., 2009 Page 9 of 11 operation of any equipment listed in Paragraph 6.b. or 6.c:. of the deflnl~ tion of "mobile equipment". Panigraphs b. and e. above do not apply to "acoictents" that occur away from pramises owned by or rented to an "insured11 with respect to 1'pollutantan not in or upon a covered "auto" if: ta} Tho "pollutants" or any property in wf'Ucl'l the "pollutants" are contained are upset, overturned or damaged as a result of the maintemmca or use of a covered "auto"; and (b} The discharge, di.spersal, seepage, migratkm, release or escape of the "pollutants11 is caused dir,actly by such upset, overturn or damage. E. ~oimlnution in valua" meana tha actual or perceived loss In market value or resale value which results from a direct and Mcidental "loss .... F. "Employee" includes a "leased worker", "Em- ployee" does not include a "temporary worker", G. "Insured" moans any per.son or organization qualifying as an Insured in the Who Is An In" sured provision of the app.llcable coverage. Except with respect to the Limit Of Insurance, the coverage affon::led applies separately to aac:h Insured who ls seeking coverage or against whom a claim or "suit'' is brought. H. "Insured contract" means: 1. A !ease of premises~ 2. A sldetrack agreement: 3. Any easement or lloense agreement, except in connection with construction or deill· olit1on operations on or within 50 feet of a ral!road; 4. An obligation, as required by ordinance, to indemnify a municipality, except in connec" tion with work for a municipality; 6. That part of any other contract or agreement pertair\l11g to your business. (Including an indammfication ·of a municlpaJlty m oonnect1on with work perfom1ed for a rm.mimpahty} under which you assume the tort liability of another to pay for "bodily injury'' or ''property damage" to a third party or organization. Tort liability means a liability that would be imposed by law in the abmince of any contract or agreement; a. That part of any contract or agreement entered into, as part of your business, pertam1ng to tho rental or lease, by you or any of your "employees", of any "auto". However, such contract e>r agreement shall not be considered an "insured contract" to the extent that it obligates you or any of vour 01employees" to pay for "property damage" to any ''auto" rented or leased by you or any of your "employees". An "insured contract" does not include that part of any contract or agreement: a. That indemnifies a radroad for "bodily injury" or "property damage" arising out of construction or demolition operations, wlthtn 60 f.eet of any railroad property and affectmg any railroad hndge or tn.:rstle~ trach, roadbeds, tunnel, underpass or crossing; b, That pertains to the loan, lease or rental of an "auto" to you or any of your "em· p!oyees", if the "auto" is loaned, !eased or ranted with a driven or a. T!1at holds a person or organization engaged in the business of transporting property by "auto" for hire harmless for vour use of a covered nauto" over a route or territory that person or organ- izatkm is authoirlzed to serve by public authority. f. "l<'Jased workeru means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. "leased worker" does not include a "temporary worker". J. ''Loss" means direct and accidental loss or damage. K •. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment! 1. Bulldozers, farm machinery, forkll'fts and other vehmles designed for usa princ!paOy off public n:iadsf 2. Vehicles maintained for use solely on or next to premises you own or rent; 3. Vehicles that travel on crawler treads; 4. Vehlcles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: a. Power cranes, shovels, loaders, diggers or drills; or b. Road construction or resurfacing equip- ment such as graders, scrapers or rollers; 5. Vehicles not described in Paragraph 1 .. 2 •• 3. or 4. above that are not salf"propel!ed and are malntainatj pr!mar!ly to provide mobility to permanently attached equipment of the following types: · a. Air compressors, pumps and generators, Including spraying/ welding, building cleaning, geophysmal exploration, lighting and well-servicing equipment; or b. Cherry pickers and similar devices used to raise or lower workers; or 6. Vehicles not described in Paragraph 1,, 2., 3, or 4. above maintained prlmarl!y for pur~ poses other than the transportation of par· sons or cargo, However, self·propeUed vehi· Paga 10of11 ri7 Insurance Services OffiC(l, Inc., 2009 CA 00 01 03 'IQ 0 etas with the following types of permanently attached equipment are not "moblfe equip· mant" but will be considered "autos": a. Equipment designed primarily fur: (1!Snow removal: (2) Road maintenance., but not construe~ tion or resurfacing; or €3) Street cleaning; b. C11erry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and c. Air compressors, pumps ertd generators, including spraying, welding, building cleaning, geophyslcai exploration, lighting or well-servicing equipment. Howevar1 '1mobi!e equipment" does not lnolude land vehicles that are subject to a compulsory or financial respooslb1llty law or other motor ve.hlcle insurance: Jaw whore It 1s Hcensed or principally garaged. l~and vel1icles subject to a compulsory or flmmc!al responsib1bty !aw or other motor vehicle insurance law are consid- ered "autos". 1... "Pollutants" meMs any solid, liquid, gaseous or thermal irritant or oontammant, mcluding $moke, vapor, soot, fumes, acu:lsr atkalis, chem· !cals and waste. Waste Includes materials to be racycled1 racondit!onecl or reclairned, M. 1'Property damage" meane damage to or loss of use of tangible property. l\I. "$ult'1 maami a cMI proceeding in which: 1. Damages because of "bodrly injury" or "property damage''; or 2. A "covered pollution cost or expense"; to which this msurance applies, are alleged. ''Sult'' includes: a. An arbitration proceeding in whmh such damages or 0covered pollution costs or expenses'' are clalmed and to which the "insured" must submit or does submit wlth our consent; or b., Any other alternative dispute resolution proceeding In which such damages or "covered pollution costs or expenses" are clain1ed and to which the insured submits with our consent. 0. "Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meat seasonal or short-term workload oom:l1tlons. P. "Tr~ilar" incfudes semitrailer. GA 00 010310 ~ Insurance Services Office, Inc., 2009 Paga 11i:tf11 CJ Named Insured: Coastwide Environmental Technologies, Inc POLtCY NUMBER: EJL701I1015 COMMERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED .. OWNERS, LESSEES OR CONTRACTORS ... SCHEDULED PERSON OR ORGANIZATION This endorsement modlfles insurance provided under the. following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizatlon(s) Location(s) Of Covered Operations The City of Cupertino ("City") and its directors, officers, Project No. 2016-06 :::>imms Kes1dence, LLL41 Mcueuan engineers, agents and employees and all public agencies from Road, Cupertino, CA 95014 who pennits will be obtained and their directors, officers, engineers, agents and employees, and the State of California, and its officers, agents and employees where required by Bl 10300 ToITe Ave Cupertino, CA 95014 ~ lnforrnationrequired to complete this Schedufe, if not shown above, will be shown In the Declarations. A. Section lJ • Who Is An Insured is amended to in cf ude 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 "persona! and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s} designated above. However. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additiona[ 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, ma[ntenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project C. Wlth respect to the insurance afforded to these additional insureds, the folrowing is added to Section !!! ~ Umits Of Insurance: If coverage provided to the addit1onal insured Is required by a contract or agreement, the most we wrn pay on behalf of the additional insured is the amount of insurance: 1. Required by the contt·act or agreement; or 2. Avaifable under H1e appl!cable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the appllcab!e Limits of lnsurance shown rn the Declaration~. © !nsL1rance Services Office, Inc. ©Insurance Services Office, Inc. Named Insured: Coastwide Environmental Technologies, Inc POLICY NUMBER: EIL70111015 COMMERCIAL GENERAL LlA13!Lln' CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLlCY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED .. OWNERS1 LESSEES OR CONTRACTORS· COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL UABIUTY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS UABIUTY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s} Or Organiz.at!on(s) Location And Description Of Completed Operations The City of Cupe1iino ("City") and its directors, Project No. 2016-06 Simms Residence, 22241 officers, engineers, agents and employees and all McClellan Road, Cupertino, CA 95014 public agencies from who permits will be obtained and their directors, officers, engineers, agents and emnlovees. and the State of California. and its officer~ Address: 10300 Torre AveCupertino, CA 95014 Information required lo.complete this Schedule, ff not shown above, wll! be shown In the Declaratlons. A Section II -VI/ho Is An Insured is amended to include as an addmonaf Insured the person{s) or organization (s) shown in the Schedule, but only with respect to fiabiHty 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. !f 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. \Mth respect to the insurance afforded to these additional insureds, the following is added to Section !II - Umits Of Insurance; If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance; 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Decfarations; whichever is less. This endorsement shall not increase the applicable Umits of Insurance shown in the Declarations. ©Insurance Services Office, Inc. ©Insurance Services Office, Inc. S"TATE COMPJ1lNSATION !NS\JRANCS El....JNC> HOME OFFICE SAN FRANCISCO ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS Policy#: 9062218 ALL EFFECTlVE DATES ARE Ai 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME Policy Eff Date: 07/01/15 Policy Exp Date: 07/01/16 Endorsement Date: 09/21/15 Named Insured: Coastwide Environmental Technologies, Inc Address: 201 Walker StreetWatsonville, CA 95076 WE HAVE TB'E RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE POR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. nrn ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE £.00% OF THE TOTAL POLICY PREMIUM. SCE:EDULE PERSON OR Q!~p~IZAT!O~ ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB D~SCBIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THJS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDJTIONS, AGREEMENTS, OR UMfTATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POUCY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~~ PRESIDENT AND CEO SCIF FORM 10217 {F!EV, 1·2012) OLD OP 217 Starr Indemnity & liability Company Dallas, TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy Number: SISIPCA08237215 Effective Date: 7/1/2015 at 12:01 AM Named Insured: Coastwide Environmental Technologies, Inc ADDITIONAL INSURED -WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This policy is amended as follows: ADDITIONAL INSURED BUSINESS AUTO COVERAGE FORM SCHEDULE ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF THE USE OF A COVERED "AUTO" I. SECTION II -LIABILITY COVERAGE A. Coverage, 1. Who is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to 'liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. SICA 1016 (02/12) Page 1 of 2 Copyright© C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Starr Indemnity & Liabi.lity Company Dallas, TX 1-866-519-2522 Signed for STARR INDEMNITY & LIABILITY COMPANY SICA 1016 (02/12) Page 2 of 2 Copyright ©C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Starr Surplus Lines Insurance Company Chicago, IL 1-646-227-6300 Primary and Non .. contributory, Additional Insured and Waiver of Subrogation Polley Number: EIL7011101s Effective Data: 7/01/15 Named rnsured: Coastwide Enviromnental Technologies, Inc This endorsement modifies 1he lnsuranoe coverage form(s) l!ste<l below that have been purohased by you and evidenced as such on the Declarations page, Please rnad the endorsement and respective pollcy(ies} carefully. SCHEDULE Commerofal General L!al:dll!y Coverage Form Owners and Contractors Protectlve liability Coverage form PrOducts/Compteted OperaUons liability Coverage Form Contractors Pollution Llabllity Coverage Form Professional Uablllty C-0verage Form Site Pollution Liability Coverage Form All as requlred by written, signed or executed contract. A. Sl:CTION II~ WHO IS AN IN SORED is amended t:o Include as !iln insured fue parson or organization shown Jn tho schedule of thts endorsement, but only with respect to lia'billty arising out of "your work" for that lneured by or for you. 13. As. respects additional insureds as defined above, thls Insurance also applies to "bodily Injury" or ·property damage" arising out of your negligence when the following written contract requlrements are applicable; i. Coverage available under this coverage part sht\!l apply as pt'!mary insurlilnce. Any other insurance available to these additional insured'c& shall apply !Ml excess Md not contribute f!IS primary to the insure.nee afforded by this endorsement 2. We waive any right of recovery we may have against these addltlonal lnsured's because of payments we make for lnjury or damage at1slng out of •your work" done Lmder a wrlttem contract with the additional ltisured. 3. The term Insured i$ used separately and not colleoUve!y, but the lncluslon of more than one Insured shall not lncrease the limlts or coverage provided by this insurance. · Insureds and Agents are advised that oertlflcates of Insurance should be used only to pmvlde evklence of Insurance In lieu of an actual copy of the apptlcable insurance pollcy. Certificates should not be used to amend, expand or otherwise alter the terms of the actual po!lcy. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. Slgnod for Si ARR SURPLUS UNES INSURANCE COMPANY SL· 023 (06/11) Page 'f of 1 Copyright© c. V. Starr & C{)mpany lln<l Starr Sm1>lm; Lines lnsuranco Company, AU rluhta roaorvad. lm:ludos copyrlghtnd mafodul of ISO Pro1Jortloa, Inc., u11ed with lta pwmlselon. Starr Surplus Lines Insurance Company Chloago, lL 1-646·227·6300 Amendment of lirnits of Insurance (Per Project or Per Location Aggregate Limit) Polley Number: EIL 70111015 Effective Date: 07101115 Named Insured: Coastwide Enviromnental Technologies, Inc This endorsement modlfles Insurance provided under the following:: COMMERCIAL GSNERAL LIABILITY COVERAGE FORM !. Your po!lcy ls amended to inollJtle eith(jr a Per Project G\jinsral Aggregate Umft, ~Par Location Gene:rai Aggregate llmlt or a Por Project and Per locatlon General Aggrs,gate Umlt Please &'elect only one of the fol!o\liflng: 1. [x J Per Project General Aggre9ate llmlt [ 1 Par Location General Aggregate khnlt [ ] Per Project and Peil!' Location GeMral AggragatrJ Limit 2. [ J Overall Policy Aggre!'.j!ite Limit $ 1,000,000 $ $ $ 2,000,000 !F NEITHER OF THESE BOXES ARE CHEC!\ED, THIS ENDORSEMENT !$VOID. IF MORE THAN ONE OF THE THESE BOXES ARE CHECl'\E.D, THIS ENDORSEMENT IS VOID. I. SECTION lft-LIMffS Or INSURANCE!, Is amended to lno1ude the following: 1. The Llmlm of Insurance and the mies below fix the most we w1l! pay regardless crf the number of: a, Insureds; b. Claims made or "suit's" brought; or c. Persons or organlzatlons making: claims or bringing "suits", 2. The Gen®ral Aggregate Limit ls the most we wllJ pay for the sum of: a, Medical e:q:ierises um:ler Coverage C: a. Damages under Cowraga A, excapt damages bees use of "bodlly injury" or "property damage~ lncludod !n the prooocts~oomp!etad operations hazard"; and b. Damages under Coverage 6. 3. Persons or organizations making claims or brlflglng ''suits", 4. The Proow::ts"Comp!ated Operations Aggregate Lrmlt !s lhe most wa will pay um:!er Coverage A for damages because of ttbod!ly 1nJury'' and "property damage" lnclt1doo In the ''products-completed oparattcms hazard". SL 139 {OM1} Page 1 of 3 C1;1pyrlght@C, v, Starr & Company ;ind Sl!lrr Surplus Um111 l111>ui'llncll Co1111nmy. AU rlghti1 r1'a.urviid.. hwludo11 copyrlghiod mntorlnt of iso Pmportllls, Inc., umHI wl!h 11s purmlsalm1, Starr Surplus lines Insurance Cownpany Chicago, IL 1--048-227-6300 5. Subject to 2 above, the Persona! and Adverti!!1ing Injury Limit is the most we will pay under Coverage a for the sum of all clarrm.gea because or all "personal and advertising injuril sustained by any one person or organization. t'L Subject to 2 or 3 above, wl'llchever applies, the Eaoh Occurrence Limit is the most we w!ll pay for the .sum of: a, Damages under Coverage A: and b. Medical expenses under Coverage C because of all "bodily injury" an<;! "property damage" arising out of a:iiy 011\!i •occurremoo", 7. Subject to l.i above, the Damage to Premises Rented to You Umit !s the most we wlll p;iy under Cov/ilrage A because of "property damage" to any one pre1nlses, while rented to you, or In the case of damage by fire, while rented to you or temporarily oocuploo by you wllh permlssloo by the owner. B, Subjecl ro 5 a bow, the Med!ca! Expense Llmlt Is the most we wm ~ay under Coverage C for all medical expenses: because of "bodily Injury" sustained by any one person. 9. Subject to 21 4, 5, 6, and/or 7 above, the Per Project Aggregate Limit ls the most we will pay under Coverages At a, and C combined for the sum of: a. Damages under Coverage A; b. Damages under Coverage B; and c. Medlcal expenses under Coverage C arisi.ng out of ~he any s1ngle L<1catlon ooscrlbe.d above. 10, Subject to 2, 4, 5, 6, and/or 7 above, 1he Per Location Aggregate Umlt Is the most we wlll pay under Coverages A, 13, and C combim:id for the sum of: ct Damages under Coverage A; e. Damages under Coverage B; and f. Medical expenses under Coverage C arising out of the any single Location descrlbed above, '11. The Overall Policy Aggregate Is the most we will pay In any po!!cy period regardless of number of projects or locat!ons. The Limits of Insurance of th!s Coverage Part apply separately to eech consecutive annual period and to any remaJnlng period of less than 12 months, starting w1th lhe beginning of the policy period shown in the Declarations, un!e:ss the policy period 1$ extended after Issuance for an addl!lonal period of less than 12 months. in that case, the addlllonal period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. 11. The Limits of Insurance shown kt the Declarations are deleted ln their entirely and replaced by the Limits of Insurance set forth below. General Aggregale Uml! Each Occurrence Limit Umlts of lnsuranc11 $ 2,000,000 $ 1,000,000 SL 739 (OM1) P:age 2 of 3 Copytll.lh! ® c. \I, Stnrr & C1;1mp1my and Starr Surp!ua Llnn!i lmn1rnm.:n Company. All rliJhro r11sorvll:d. lmilmfoe oopyrigfltod matorlnl .of 180 PrcpQrtla1t, Inc,, uaod wlth lls parrnlirn!on. Starr· Surplus tines Insurance Company Chicago, ft 1-646-227-6300 Products~Completed Operatlons Aggregate l.lmit Personal & Advert!slng Injury Umtt Damage to Premlses Rented to You Medlcal Expense Llml1 Overall Po!lcy Aggregate Limlt Capped At Iii. SECTION V -DEFINITIONS: is: amended to include the folh:iwlng: $ 2,000,000 $ 1,000,000 $ 50,000 $ 5,000 $ 2.000.000 23. ''Locatlon'1 rneans premises lnvolvlngc U1e same or connecting lots, or premises whose ci::umeotion !s lnlarruptecl onty by a street, roadway, waterway, or rJ.ght-of·W'aY raHromd. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGEO. Signed for STARR SURPLUS LINES INSURANCE COMPANY SL 739 {OM1} . . Page 3 of 3 Copyright <GI c •. v, Starr~ Cornpnny 11nd Starr Surplus Lt11-0s lmn1mno;, Compnny. AU rights t!lllllltwd, !ncll1des copyrtghtud m;;1tnrlal of tao f'rcp~·rtlrni, Inc,, usoct with Us p;,rmlualon.