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16-005 Metal Building Company, Improvements to Mechanic ShopAGREEMENT BETWEEN THE CITY OF CUPERTINO AND METAL BUILDING COMPANY FOR IMPROVEMENTS TO MECHANIC SHOP [' iott THIS AGREEMENT, for reference dated ,...20f5, is by and between CITY OF CUPERTINO (hereinafter referred to as "City"), municipal corporation, and Metal Building Company. (hereinafter referred to as "Contractor"), a California corporation whose address is 9957 Medford Ave., Bldg. 14A, Oakland, CA. 94603 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 construction work, 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 thirty (30) working days after receiving notice from City to commence the work, and shall diligently prosecute the work to completion before the expiration of thirty (30) 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. 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 100-87-829-900-990 fund. Payment will be made by City in the following mam1er: On the first day of each month, Contractor shall submit a written estimate of the total amount 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 Page1 of20 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 above1 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 Conh·actor 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, assigns, or sureties, and to deduct from the final payment for the work, all or any part, as it may deem proper, of the actual 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 fhe 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 manner and means· of conducting th.e 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 Page2of20 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 responsibility 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 shall indemnify and hold City harmless from and against any loss, damage, 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 creed, 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 nature, 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 indenmity agreements with provisions 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 accol'ding to the terms of this section. 10. INSURANCE: On or before the commencement of the terms of this Agreement, Contractol' shall furnish City with certificates showing the type, amount, dass of operations covered, 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 Page3of20 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: (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: $2,000,000 each occurrence $4,000,000 aggregate -all other Property Damage: $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 followmg minimum limits: Bodily injury: $1,000,000 each occurrence Property Damage: $1,000,000 each occurrence or Combined Single Limit: $1,000,000 each occurrence B. SUBROGATION WAIVER: Contractor agrees thatin 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 msurance 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 foil to secure or Page4of 20 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. 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 deterrnine adequate coverage for Contractor. 11. BONDS: Bonds are not required for this agreement. 12. PROHIBITION AGAINST TRANSFERS: Contractor shaJl 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 instih1tion 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 1nterest 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. 13. SUBCONTRACTOR APPROVAL: Unless prior written consent from City is obtained, only those people and subcontractors Page 5 of 20 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 writing, 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 City, 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 addition, any work or services subcontracted hereunder shall be subject to each provision of this Agreement. 14. PERMITS AND LICENSES: Contractor, at its sole expense, shall obtain and maintain dusing the term of this Agreement, all appropriate permits, certificates and licenses, :including a City Business License that may be required in connection with the performance of services hereunder. 15. REPORTS: Each and every report, draft, work product, map, record and other document reproduced, 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 shaU be made available to any individual or organization by Contractor without prior approval by City. Contractor shall, at such time and in such form as City may require, furnish reports concerning the status of services required under this Agreement. 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 pr:inciples and shall be dearly identified and readily accessible. Contractor shall provide free access to such books and records to the xeprese:ntatives of Ciiy 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 docwnents and records and shall be maintained for a period of three (3) years after receipt of final payment. Page 6 of20 If supplemental examination or audit of the records is necessary due to concerns raised by City's preliminary examination or audit of records1 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: Chris Orr 10555 Mary Ave. Cupertino CA 95014 All notices1 demands, requests, or approvals from City to Contractor shall be addressed to Contractor at: Metal Building Company Attn: Bryan Morrish 9957 Medford Ave., Bldg. 14A, Oakland, CA. 94603 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, gutters, storm drains and streams. TI1e 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 fences, 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 vamum 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. Page7of 20 D. After breaking old pavement, Contractor shall remove all debris to avoid contact with rainfall or runoff. E. Contractor shall maintain a dean 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. 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 lime 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 o.r issued by City. Specifically, and without limitation, Contractor shall comply with all state, federal, or local regulation regarding the removal and disposal of hazardous waste. A. PREVAILING WAGES: To the extentapplicable, Contractor shall comply with the City's Labor Compliance Program and all other requ:irernents set forth in Labor Code section 1770 et seq. Contractor shall pay prevailing wages. Contractor will submit Page 8 of 20 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 1/z 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 maintaiJ.1ed 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 authorili.es having jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought pursuant to this Agreement shaII 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 nahire 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. Page9of20 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. Page 10of20 P.O. No.: )DIV>· ~°1'2.. IN WITNESS WHEREOF, the parties have caused the Agreement to be executed on the day and year first above written. CONTRACTOR Metal Bui Name __ ~'-'--' _M_<>AA_' s_~;........,...._- Title ___ f_,..,,.,_/ V_,_v ·- Date _ ____..l l_\l-1--"I {~6 __ CITY OF CUPERTINO By . ,--"'-rimm Borde , Director of Public Works Date ________ _ RECOMMENDED FOR APPROVAL: By~~ Address: 9957 Medford Ave., Bldg. 14A C HR 4.s OR.It. Oakland, CA. 94603 Printed Name Title ~ .Su ftilrllt $r1r- APPROVED AS TO FORM: By ODll jJJ---/ Colleen Winchester, ~City Attorney ATTEST: ~ ~f!c"-~tt f-13 ~1 &, Grace Schmidt, City Clerk v' Contract Amount: $14,883.00 Account No.: 100-87-829-900-990 DOCUMENT 00530 Page11of20 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 fonn. 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 Ii.ability 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 liabillty only. 5. Waiver of subrogation endorsement worker's compensation insurance -must be signed by the insurance agent for worker's compensation only. Page 12of20 CITY OF 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. T11e 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 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 11 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 written 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 dimJnisfong 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. LIMITS Page 1.3 of 20 Worker's Compensation and Employers1 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. (Contractor's Name) By;-----t-.,ffE~--=----' Dated: __ t...,..._/l_l ___ 201i Page 14 of 20 CITY Of CUPERTJNO 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 * Statutory Mjn. * Employer's Liability (Name of insurer) $ $ $ Insurance Company's State License No. Check Policy Type: Each Occurrence $ COMPREHENSIVE GENERAL LIABILITY [ ] Premises/Operations General Aggregate $ (if applicable) [ J Owners & Contractors Protective Aggregate $ [ ] Contractual for Specific Contract Personal Injury $ I ] Products Liability [ ] XCUHazards [ ] Broad Form P.D. Fire Damage (any one fire) $ [ ] Severability of Interest Clause [ J Personal Injury with Medical Expense $ Employee Exclusion Removed (any one person) or Self-Insured COMMERCIAL GENERAL LIABILITY Retention $ (Name of insurer) Policy No. Expiration Date AUTOMOTIVE/VEHICLE LIABILITY BODILY INJURY PROPERTY DAMAGE Commercial Form Each Person Each Accident Page15 of20 Liability Coverage Each Accident (Name of insurer) Co.mbined Single Limit $ ______ _ Policy No.~------Expiration Date _____ _ BUILDER'S RISK II 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. Page16 of20 CITY OP CUPERTINO ADDITIONAL INSURED ENDORSEMENT and ENDORSEMENT OF PRIMARY INSURANCE and NOTICE OF POLICY CANCELLATION ENDORSEMENT 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 ~o 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 shalI 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. Page 17 of20 POLICY INFORMATION 1. Insurance Company:----------------------- 2. Insurance Policy Number:------------------- 3. Effective Date of this Endorsement: ________________ 20 __ All notices herein provided to be given by the Insurance Company to the City in connection with this policy and these Endorsements1 shall be mailed to or delivered to the City at 10300 Torre A venue; Cupertino, California 95014. I, (print/type name) warrant that I have authority to bi11d 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:------------ Page 18 of 20 Title:---------- Telephone: __ ------ Facsimile: ------- C!TYOI' CUPERTINO COMPREHENSIVE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ENDORSEMENT OF AGGREGATE LIMITS OF INSURANCE PER PROJECT Project Title and Number:----~---------------- In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which f:his 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:------------------~-- 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 th.e 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:-------------Address: ______________ _ Page 19 of 20 Title: ---------~ Telephone:-------- Facsimile: -------- CUPERTINO WAIVER OF SUBROGATION ENDORSEMENT WORKER'S COMPENSATION INSURANCE 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 the 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 A venue; Cupertino, California 95014. I, (print/type name) warrant that I have authority to bind the below listed Insurance Company and by my signature hexeon do so bind this Company. Signature of Authorized Representative:------------------ (Original signature required on all Endorsements furnished to the District) Names of Agent/Agency:------------- Address: ______________ _ Title: _________ _ Telephone:-------- Facsimile:-------- END OF DOCUMENT .Page 20 of 20 \ \ I 1 A y (510) 635-0111 • FAX (510) 635-0626 • 9957 Medford Ave., Bldg. i 4A, Oakland, CA 94603 December 9, 2015 City of Cupertino 10555 Mary Ave. Cupertino, CA 95014 Attention: Mr. Chris Orr Subject: various repairs, Rev. 1 Chris, Thank you for giving us this opportunity to provide you with a quote for the following scope of work in Cupertino: A. Extend existing canopy gutter Supply and install approx. 20LF of additional canopy eave trim/gutter in same profile and similar color as existing material. No nevv downspouts included. Our price for Item A. only is: $594.00 ~ B. Replace skylights Remove and replace ( 10) brittle skylights with new white fiberglass units. Material to be high-strength, UV-resistant. Includes 16ga. welded wire safety screening. Our price for Item B. only is: / $5,204.00 C. New rollup door Remove Yz of existing slide door. Track will be removed, only if needed. Frame for and install (1) 12'w x 1 O'h manually-operated Porvene rollup door with prime- painted continuous 26ga. steel curtain. Includes new off-white rough opening trim. Any plumbing or electrical in the way to be removed by others first. Framing will be cold-form galvanized and anchored as needed to concrete slab. Our price for Item C. only is: $5,970.00 ,_, For slat-curtain R&S door, along with steel angle guides and footpiece, add: $1,790.00 I""' For installation of (1) 1/2HP, 120V, single phase motor operator w/ 3-button station (assumes City will bring dedicated power in a junction box to the door motor location), add: $1,325.00 t/" New Buildings and Complete Turnkey Proiects Repairs, Alterations, and Additions to all types of Metal Buildings Operating a Merit Shop since 1977 Cal. Cont. Uc,# 421040 www.metalbuildingcompany.com A DIVISION OF ZIVKO CORPORATION Page 1 of3 BC Qualifications: 1. Buyer shall provide temporary power, water and sanitary facilities within 1 OOft. of the work area. 2. Access to pe1fonn roof repair work requfres foot traffic to and from the repair area. On older roofs, this can break old sealants, repairs, or cause other such problems. Metal Building Company is not Liable for repairs caused by foot traffic. 3. Payment of wages at prevailing wage rates is included. 4. This work is quoted on the basis of straight time working hours, which are Monday through Friday between 7a.m. and 4p.m .. 5. The quoted price includes all applicable sales tax and freight. 6. Architectural or site plans, pennits, fees, tests or inspections are not included. Work or materials not specifically noted as included are excluded. 7. Any engineering analysis of existing structures is not included. 8. Electrical work, plumbing, painting, insulation, underlayment beneath roof or wall sheeting, temporary security or weather protection, field welding or supply of related materials, sitework, dissimilar metals isolation methods, caulking or glazing, concrete work or grouting, building engineering, foundation engineering or shop drawings are excluded. Standard Terms: 1. Quotations are valid for 30 days and must be reconfinned thereafter. 2. This quote is based upon receipt of payments without retention being withheld unless stated and agreed to otherwise. 3. Invoices are due upon receipt. Payments received after 30 days :from the invoice date will incur an interest charge of 1 Yz% per month or potiion thereafter. 4. Metal Building Company shaII be entitled to compensation for all expenses including, but not limited to, materials and services expended, equipment usage, unreturnable and special order materials, fees, overhead and profit in the event that this contract is canceled or work is suspended. 5. Any collection costs, including legal, management, and clerical fees in any way associated with the collection, will be paid by the customer. 6. Terms of our guarantee require that an identifying nameplate be attached to each structure. 7. We typically schedule jobs on a 'first-in' basis following receipt of a properly executed contract, Preliminary Notice information sheet and down payment when required. Page2 of3 BC Thank you for your consideration of our proposal. Please feel free to call me directly should you have any questions or additional requirements. cerely, 0 (}. /fA_Al1~ Morrish Authorized Signature for A., *note price is valid in conjunction wl other work on site. Authorized Signature for B. Authorized Signature for C. C HRtS Name (please print): Svrervzc..,.r Title: Add for slat curtain constmction Add for motor operator Metal Building Company is a division of Zivko Corporation, Inc., licensed in CA, contractor's state license number 421040. Contractors are required by law to be licensed and regulated by the Contractors' State License Board which has jurisdiction to investigate complaints against contractors if a complaint regarding a patent act or omission is filed within four years of the date of the alleged violation. A complaint regarding a latent act or omission pertaining to structural defects must be filed within I 0 years of the date of the alleged violation. Any questions concerning a contractor may be referred to the Registrar. Contractors' State License Board, P.O. Box 26000, Sacramento, CA 95826. Page 3of3 ZIVK0-1 OP ID: DA ACORD* CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) ~ 12/28/2015 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 ccH1ificato holdor In liou of such ondorsomcmt(s). PRODUCER l:iA'r;;F:~'"'' Paul coupin Crist, Frttschl & Paterson Inc WBi~ Ext): 510-451-6000 I FAX 266 Grand Avenue, Suite 230 (AIC, No): 510-451-4203 Oakland, CA 9461 o ~~,(\Ji,.,.,. oaul®-cfoinsurance.com Pau1coup1n INSURER(SJ AFFORDING COVERAGE NAIC# 1NsuRERA: Kinsale Insurance Company INSURED Zivko Corporation, Inc. 1NsuRERB: State Compensation Ins.Fund OBA: Metal Building Company INSURER c: Liberty Mutual Insurance Co. 012076 Attn: Kristi Linn 9957 Medford Ave., Bldg 14A INSURER.D: Oakland, CA 94603 INSURERE: INSURER. F . COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIClES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ''L"TR' TYPE OF INSURANCE '"'"" ~· WVD POLICY NUMBER cM~r~~lvWYi cM~r~~ LIMITS A x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 f--D CLAIMS-MADE [!] OCCUR 0100008329-3 10/31/2015 10/01/2016 DAMAGE TO RENTED x x PREMISES (Ea occurrence) $ 100,000 x Owner/Cont Prot. MED EXP (Any one person) $ Excluded x Ded:$5000 PERSONAL & ADV INJURY $ 1,000,00C -GEN"L AGGREGATE LIMIT APPLIES PER: GEl~ERAL AGGREGATE $ 2,000;00C =l CK] PRO-DLoc PRODUCTS -COMP/OP AGG $ 2,000,00C . POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00ll CEa aooidont) c X ANYAUTO x x BAW56196545 10/31/2015 10/31/2016 BODILY INJURY (Per person) $ f--ALL OWNED -SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS 1f HIRED AUTOS x NON-OWNED f te9~~§~n?f MAGE $ AUTOS ..____ -$ UMBRELLA LIAB M OCCUR EACH OCCURRENCE $ 4,000,000 f-- 4,000,00C A x EXCESSLIAB CLAIMS-MADE 100008327-3 10/3112015 10/01/2016 AGGREGATE $ OED I x I RETENTION $ 10000 $ WORKERS COMPENSATION x I PER I I OTH-AND EMPLOYERS' LIABILITY STATUTE ER B ANY PROPRIETORIPARTNERIEXECUTIVE Y/N x 9113811-15 10/01/2015 10/01/2016 1,000,00C IT] E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.1-· Dl8EA8E E,n, EMf'LOYEE ~ 1,000.,00( If yes. describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 1,000,00ll DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Job Project: City of Cupertino Mechanical Shop See Holder Notes for Additional Insured Wording and Endorsements CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino and the THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. State of California Attn: Chris Orr AUTHORIZED REPRESENTATIVE 10555 Mary Ave. J.dtu...t tl/MIH-/ Cupertino, CA 95014 l ® 1900-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NOTEPAD: HOLDER CODE IN:!;UK1=u·:!; NAMt: Zivko Corporation, Inc. ZIVK0-1 OP ID: DA The City of Cupertino ("City") and its directors, officers, engineers, agents and employees 1 and all public agencies from whom permits will be ootained and their directors, officers~ engineers, agents and employees, and the State of California, and its orfioers, 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 Named Insured at or upon p.ny of the premises of the City in connection with the Contract with the City per written contract, agreement or permit; See attached general lial;:>i:).ity b:j.anket endorsement forms CG2010.07Q4.and CG2037 0704 for additional insured. See attached general liability blanket endorsement form CAS5003 0110 for primary and noncontributory wording. See attached general liability blanket enaorsement form CAS4002 0110 for waiver of subrogation. See attached general liability endorsement form CAS2007 0110 for cancellation wording. See attached business auto blanket endorsement form CA.8810 0113 for adaitional insured and waiver of subrogati01•. See attached workers compensation SCIF form 10217 for blanket waiver of subrogation. PAGE 2 uate 12/28/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100008329-3 10/31/2015 12:01AM at the Named Insured Zivko Corporation Inc address shown on the Declarations Additional Premium: I Return Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): I Location(s) of Covered Operations Blanket, as required by written contract. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project {other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CG 201007 04 © ISO Properties, Inc., 2004 Page 1of1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100008329-3 10/31/2015 12:01AM atthe Named Insured Zivko Corporation Inc address shown on the Declarations Additional Premium: I Return Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s) Location and Description of Completed Operations Blanket, as required by written contract. EXCLUDES ALL NEW RESIDENTIAL CONSTRUCTION "Your work" does not include "new residential construction", which means any building or structure not previously occupied, and designed or intended for occupancy In whole or In part as a residence by any person or persons. "New residential construction" does not include apartments or apartment buildings or assisted living facilities. Information required to complete this Schedule, if not shown above, will be shown in the Declaration.s. Section H -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability rur "!Judily injury" UI "f.HUfJ~rly UC:lrrlag~" t:C:IU!;~d, in whole or in part, by "your work" at the location desig- nated and described in the schedule of this endorse- ment performed for that additional insured and in- cluded in the "products-completed operations hazard". ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CG 2037 07 04 © ISO Properties, Inc., 2004 Page 1of1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMON CONDITIONS -CASUALTY Attached To and Forming Part of Policy Effective Date of Endorsement 0100008329-3 10/31/2015 12:01AM at the Named Insured address shown on the Declarations Addtttondf Premtum: I Return Premtum: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS llABILllY COVERAGE LIQUOR LIABILITY COVERAGE OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE This insurance is amended by adding the following provisions: CANCEUATION Named Insured Zivko Corporation Inc a. The first named insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellotiori. b. We may cancel this policy by mailing or delivering to the first named insured written notice of cancellation at least: 1) Ten (10) days before the effective date of cancellation if we cancel for non-payment of premium; or 2) Thirty (30) days before the effective date of cancellation if we cancel for anv other reason. c. We will mail or deliver our notice to the first named insured's .lastmailingaddress.known to us. d. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. e. If this policy is cancelled, we will send the first named insured any refund due subject to the minimum earned premium prov'isions of the policy. If we cancel for reasons other than non-payment of premium, the refund will be pro rata. If we cancel due to hon-payment of premium or if the first named insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. f. If notice is mailed, proof of mailing will be sufficient proof of notice. NON-RENEWAL-the When We Do Not Renew Condition of the policy is deleted and replaced with the following: a. if we elect not to renew this policy we shall mail written notice to the first named Insured at the address shown ih the declarations. Such written notice of non-renewal shall be mailed at least thirty (30) cl;:iys prior to the end of the policy period. b. If notice is mailed1 proof of mailing will be sufficient proof of notice. CHANGES This polity contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. TERMS, CONDITIONS AND PREMIUMS The first Named Insured shown ih the Declarations is responsible for the payment of ail premiums and will be the payee for any return premiums we pay. On each renewa I, continuation or anniversary of the effective date of the policy or on an annual basis, the Company will determine the rate and premium and may amend the terms and conditions of the polfcy in accordance with the rates and rules then in effect. CAS2007 0110 Page 1 of3 EXAMINATION OF YOUR BOOKS AND RECORDS We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS POLICY Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative rs appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respectto that property, SERVICE OF SUIT In the event of the failure of the Company to pay ariy amount claimed to be due under this Policy, the Company will submit to the jurisdiction of any court of competent jurisdiction within the United States of America or Canada. All matters arising under this Policy shall be determined in accordance with the choice of law rules of such court. Nothing in this clause constitutes or should be understood to constitute a waiver of the Company's rights to commence an CIC Lion ill Cl r1y Cuur L of t;UrTlfJl:!Ll:!ll l jur isdil;Liu11 ill Lltl:! U11iL1:!d SLCI Ll:!S, lu r l:!lllUVI:! Clll ClliLiUll Lu Cl u 11il1:!U SLCILl:!S Dis Lr ic.;L Cuur L, or to seek a transfer of a case to another Court as permitted by the laws of the United States or of any State in the United States. Service of process in any such suit may be made upon the President and Chief Executive Officer of the Company or his designee at the address shown on the Declarations of this Policy. In any suit instituted upon this contract and against the President and Chief Executive Officer of the Company or his designee, the Company will abide by the final decision of such Court or of any Appellate Court in the event of an appeal. The President and Chief Executive Officer of the Company or his deslgnee are authorized and directed ta accept service of process. Pursuant to any statute of any state, territory or district of the United States of America, the Company designates the Superintendent, Commissioner or Director of Insurance or other officer specified for the purpose in the statute, or his successors in office, as its true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding Instituted by or on behalf of the Insured or any beneficiary under this Polley arising out ofthls contract of insurance. The Company designates the above-named as the person to whom said officer is authorized to mail such precess or a true copy of such process. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US-the Transfer Of Rights Of Recovery Against Others To Us Condition of the policy is deleted and replaced with the following: If any person or organization to or for whom we make payment under this Policy has rights to recover damages from another, those rights are transferred to us. That person or organization must do nothing after loss to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. LEGAL ACTION AGAINST US-the Legal Action AgainstUs Condition of the policy is deleted and replaced with the following: Nu 0111:! rnciy l.Hill{'l Cl ll:!{'ICll Clt:Lio11 cigcii11sl us UllUl:!I Lllis Pulit:y u11l1:!SS Lltl:!ll:! licis bl:!l:!ll rulJ c.;umplicirit:I:! wi.Ll1 cill ur Lill:! Ll:!llTIS of this Policy. No suit, action or proceeding for the recovery of any claim under this policy shall be sustainable in any court of law or equity unless it is commenced within twelve (12) months next after discovery by the insured of the occurrence which gives rise to the claim, provided however, that if by the laws of the state within which this Policy is issued, such limitation is invalid then any such claims shall be void unless such action, suit or proceeding is commenced within the shortest limit of time permitted by the laws of such state. We will not be liable for damages that are not pava ble under the terms of this policy or that are in excess of the applicable Limit of Insurance. CAS2007 0110 Page 2of3 BINDING ARBITRATION All disputes over coverage or any rights afforded under this policy, including whether an entity or person is a named Insured, an Insured, an additional Insured, or entitled to coverage under the supplementary Payments provisions of this policy or the effect of any applicable statutes or common law upon the contractual obligations owed, shall be submitted to binding arbitration, which shall be the sole and exclusive means to resolve the dispute. Either party may initiate the binding arbitration. The arbitration forum and process shall be agreed to by the parties. In the event the parties cannot agree on an arbitration torum and process, the matter shall be submitted to the American Arbitration Association. The Arbitration shall be before a panel of three arbitrators, unless the parties agree to one arbitrator, all of whom shall have experience in insurance coverage of the type afforded bythis policy. If the parties select a panel of three arbitrators, each party shall select an arbitrator and the chosen arbitrators shall select a third arbitrator. The American Arbitration Association shall decide any disputes concerning the selection of the Arbitrators. The potential arbitrators from which the arbitrators shall be selected shall not be confined to those provided by the American Arbitration Association. Each party shall bear the costs of its arbitrator and shall share equally the costs of the third arbitrator and arbitration process. In the event of a single arbitrator, the cost shall be shared equally by the parties. The decision of the arbitration is final and binding on the parties. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS2007 0110 Page 3 of3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT Attached To and Forming Part of Policy Effective Date of Endorsement 0100008329-3 10/31/2015 12:01AM at the Named Insured address shown on the Declarations Addlrlonal Premium: I Rerurn Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABllllV COVERAGE Named Insured Zivko Corporation Inc ENVIRONMENTAL CONTRACTING AND PROFESSIONAL SERVICES LIABILITY COVERAGE The insurance provided to Additional Insureds shall be primary and non-contributory with respect to any other valid and collectible insurance available to the Additional Insured, provided that the written contract specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS5003 0110 Page 1of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHER TO US-BLANKET Attached To and Forming Part of Policy Effective Date of Endorsement 0100008329-3 10/31/2015 12:01AM at the Named Insured address shown on the Declarations Addlrlonal Premium: I Rerurn Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILllV COVERAGE Named Insured Zivko Corporation Inc SECTION IV-CONDITIONS, 8. Transfer of Rights of Recovery against Others to Us is amended by the addition of the followini;r We warve any right of recovery we may have against persons or organizations because of payments we make for injury or damage arising out of "your work" done under a written contract with that person or organization wherein you have agreed to provide this waiver. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS4002 0110 Page 1of 1 0 "' COMMERCIAL AUTO CA 88 10 01 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGE INDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 19 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DAT/\ ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 22 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 23 EXTRA EXPENSE -BROADENED COVERAGE 10 GLASS REPAIR-WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN I LEASE GAP 14 PARKCD AUTO COLLISION COVCRAGC (WAIVCR or DCDUCTIOLC) 16 PERSONAL EFFECTSCOVERAGE 11 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 TWO OR MORE DEDUCTIBLES 17 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 18 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 20 SECTION II -LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED SECTION II -LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does hot include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. {2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; tel 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 0 <D (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the nrg:'lni7;:ifinn. 2. EMPLOYEES AS INSUREDS SECTION II -LIABILITY COVERAGE, paragraph A.1. ·WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow, but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II -LIABILITY COVERAGE, paragraph A.1. ·WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use bf a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II -LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to $500 a day because of time off from work. 5. AMENl'lED FELLOW EMPLOYEE EXCLUSION· In those jurisdictions where, by law, fe!Jow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar proteCtion, the following provision is added: SECTION II -LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION Ill • PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION Ill -PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision cqverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or t&> 2013 Liberty Mutual Insurance CA8810 0113 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 7 0 "' b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This covorago oxtonsion doos not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V-DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION Ill -PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following:. We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light t.ruck" or "medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For "medium trucks" , we wlll pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 -20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE ·ADDITIONAL TRANSPORTATION EXP.ENSE COVERAG.E Paragraph A,4,a.1 Coverage Extension of SECTION Ill -PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of $50 per day and a maximum limit of $1,500 $ 2013 Lipel'l:y Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 0 "' 9. RENTAL REIMBURSEMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able for your use and operation cannot fill. e. If "loss" results from the total theft of ·a covered "auto" of the· private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Covorago Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "p!')rsonal effects" as defined in provision 11. 10. EXTRA EXPENSE -BROADENED COVERAGE Under SECTION 111 -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SCCTION Ill -Pl IYSICAL DAMAGC COVCRAGC, A. COVCRAGC, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for a:n "auto" you own and that "auto" is stolen, we will pay, Without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V-DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION Ill -PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does hot apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION Ill -PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. 1s deleted and replaced with the following: 1'l 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7 0 "' Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not ciAsignArl snlAly for fhA rArirnrl11r.tinn nf snimrl, if fhA Afllli[lmAnt is [lArm::inP.ntly insfallArl in thA covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. 14. LOAN I LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" Is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", I. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the Joss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V -DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment * 2013 Liberty Mutual Insurance CA8810 0113 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 15. GLASS REPAIR· WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by the Addition of thA followino: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended by the addition of the following~ The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked; and c. Unocc;upied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amounLof the 9amage to the cov~red ".auto" must exceed the deductiblli! shown in the Decl<;irations: · · This provision doos not apply to any "loss" if tho covorod "auto" is in tho chargo of any parson or organization engaged in the automobile business. 17. TWO OR MORE DEDUCTIBLES Under SECTION Ill PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group. SECTION IV ·BUSINESS AUTO CONDITIONS Is amended as follows: 16. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph 8.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the. coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 19. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV -BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice. if you are a corporation. 1'l 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7 To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV -BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECTION IV -BUSINESS AUTO CONDITIONS, paragraph 8.7., Polley Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. I his extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V • DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V-DEFINTIONS, ·definition C. is replaced by the following: "Bodily injury'' means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. -CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. @ 2013 Liberty Mutual Insurance CA8810 0113 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 STATE COMPENS1'-TION /r-JSU~ANCG: FUNC ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS REP 31 9113811-15 RENEWAL HOME OFFICE SAN FRANC,SCO EFFECTIVE OCTOBER 1, 2015 AT 12. 01 A.M. NA 0-77-72-82 PAGE 1 OF 1 ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME AND EXPIRING OCTOBER 1, 2016 AT 12.01 A.M. METAL BUILDING COMPANY 9957 MEDFORD AVE BLDG 14A cmKIAND, CA 94603 WE HAVE TI-IE RIGITT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY IBIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN TI-IE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO lHE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN IBIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR 'WHOM THE NAMED INSURED HAS AGREED BY WRITIEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVt:: OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN . THIS POLICY SHALL SE HELO TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~!:~ OCTOBER 1, 2015 ti~,,,~ ,d/L~:~ PRESIDENT AND CEO SCIF FORM 10217 (REV.7·l!014) 2572 OLD DP 217 CUPERTINO ~ City of Cupertino -c;· Service Center -f 10555 Mary Avenue o CUPERTINO, CA 95014 www. Cupertino.erg VENDOR 435 -METAL BUILDING COMPANY &> METAL BUILDING COMPANY ::1 9957 MEDFORD AVE ii BLDG 14A S. OAKLAND, CA 94603 REFERENCE# QUANTITY Hfol;& DESCRIPTION 1.0000 Each City of Cupertino Service Center 10555 Mary Avenue CUPERTINO, CA 95014 www.Cupertino.org Purchase Order No. 2016-00000392 DATE 12/21/2015 PURCHASE ORDER NUMBER MUST APPEAR ON ALL INVOICES, SHIPPERS, BILL OF LADING AND CORRESPONDENCE DELIVER BY SHIP VIA FREIGHT TERMS PAGE 1 of1 ORIGINATOR: Chylene Osborne DESCRIPTION: Building improvements to mechanic she UNIT COST TOTAL COST 14,883.0000 $14,883.00 100-87-829 900-990-Capital Outlay Special Projects -PW 14,883.00 ,. TOTAL DUE $14,883.00 • DATE 12/21/2015 Authorized Signature Special Instructions