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16-102 Partition Specialties, Inc., to Recover Existing PartitionsAGREEMENT BETWEEN THE CITY OF CUPERTINO AND PARTITION SPECIALTIES, INC. TO RECOVER EXISTING PARTITIONS THIS AGREEMENT, for refe rence dated July 9.. °l 2016, is by and between CITY OF CUPERTINO (hereinafter r e ferred to as "City"), a municipal corporation, and Partition Specialties, Inc. (hereinafter referred to as "Contractor"), a California corporation whose address is 505 San Marin, Suit AJ20 Novcito , CA. 94945 and is made vvith 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 th e 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 Contr<:ictor 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 aJJ labor, tools, equipment, materials, except as otherwise specified, and to do all work strictly in accordance with the Proposal dated February 11 '11, 2016, attached hereto as Exhibit "A", and 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 srnne were fully incorporated herein. 3. COMPENSATION TO CONTRACTOR: Contractor shall be compensated for services performed pursu ant 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 t11e 100-87-831-900-990 fund, which compensation is not to exceed forty nine thousand six hundred and fifty nine dollars ($49,659.00) Payment will be made by City in the following manner: On the first day of each month, Contractor s hall submit a written estimate of the total amount of work done the previous month. Payment shall be made up to 95% of the value of the work City shall retain 5% of the value of the work as partial security for the completion of the work by Contractor. Retained amounts wiJJ Page 1of20 be paid to Contractor 35 days after the acceptance by City and the recording of the Notice of Completion with the Santa Clar<1 County Re corder's office . Payment shall not be construed as acceptance of defective work. No interest will be paid to Contractor on retained funds. 4. TIME IS OF THE ESSENCE: Contractor and City agree that time is of the essence regarding the performance of this Agreement. Jt is agreed by the parties to the Agre ement th a t in case all the work called for under the Agreement is not completed before or upon the expiration of the time limit as set forth in paragraph 1 above, dam<lge will be sustained by City, <lnd that it is and wilJ be impracticable to determine the actual dam<lge which City will sustain in the event of and by reason of such delay . It is therefore agreed that the Contractor will pay to City the sum of Two Thousand Dollars ($ 2,000) per day for each and every day's delay beyond the time prescribed to complete the work; and the Contractor agre es to pay such bguidated damages as herein provided, and in case the same are not paid, agrees that City may deduct tl1 e amount thereof from any money due or that may become due the Contractor under the Agre em e nt. It is further agreed that in case the work call e d for under the Agreement is not finished <1nd completed in <lll parts and requirements within the time specified, City s hall have the right to extend the time for completion or not, as may see m best to serve the inte rest 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 h e irs, ;:issign s, 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 e xpenses 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 h e reunder 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 e xperienced personnel who are not employed by City nor have any contractual relationship with City . 6 . JNDEPENDENT PARTIES: City and Contractor intend that the relationship between them crea ted by this Agreement is that of employer-independent contractor. The manner rn1d means of conducting the work are Page 2 of 20 under the control of Contractor, except to the extent they Me limited by s tatute, 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 se rvices . None of th e benefits provided by City to its employees, including but not limited to unemployment insurance, workers' compensation plans, vacation and s ick leave are available from City to Contrnctor, its employees or agents . Deductions shall not be made for ;my state or federal ta xes, 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 reguired, are the responsibility of Contrnctor. 7. IMMIGRATION REFORM AND CONTROL ACT ORCA): Contractor assumes any and all responsibility for verifying the identity and employment authoriz ation 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 Joss, damage, liability, costs or expenses arising from any noncompliance of this provision b y Contractor. 8. NON-DISCRIMINATION: Consistent with City's policy that harassment and discrimination are unacceptable employer/employee conduct, Contractor agrees that harass ment or discrimination direc ted toward a job applicant, a City employee, or a citi zen by Contractor or Contractor's employee on the basis of nice, religious creed, color, national origin, ances try, handicap, disability, marital status, pregnancy, sex, age, or sexw:il orientation will not be tolerated. Contractor Clgrees that any and all violations of this provision sl1a11 constitute a materia l breach of this Agreement. 9. HOLD HARMLESS : Contractor shall, to the fullest extent allowed by law, indemnify, defend, and h o ld harmless City and its officers, officials, agents, employees and volunteers against any and all li a bility, claims, stop notices, actions, causes of action or demands whatsoeve r fr o m 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 th e sole or active negligence or willful mi sconduct 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 obtClin executed indemnity agreements with prov is ions identicC1! to those set forth here in these sections from eC1ch and every subcontractor or any other person or entity involved by, for, with, or on be half 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 accordin g to the terms of this section . 10 . INSURANCE: On or before the commencement of th e terms of thi s Agreement, Contractor shall furnish City with certifirntes showin g the type, amount, c las s of operations covered, effective dates and dates of expiration of insurance coverage in compliance with paragraph 10A , B, C and D. Such Page 3 of 20 ... certificates, which do not limit Contractor's indemnific;1tion, shall a]so contain substantially the following statement: "Should any of the above insurance covered by thi s certificate be CClnceled or coverage reduced before the expir<ltion date thereof, the in s urer affording coverage shall provide thirty (30) days' advance written notice to City by certified mail , "Attention: City Manager." It is agreed that Contractor shall m ai ntain in force Clt all times during the perform<lnce of this Agreement all appropriate coverage of insurClnce required by this Agreement with <ln insurance company that is acceptable to City and licensed to do insurance busin ess in the State of California. Endorsements naming City ClS Cldditional insured shall be submitted with the insurnnce certificates. Contractor slwll complete the Clttached Document 00530 Insurance Forms. A. COVERAGE: Contractor shall maintain the foLlowing insurance covernge: (J) 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 eguivC1Jent 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 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 Contrnctor 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. Page 4 of 20 C. FAILURE TO SECURE: If Contrnctor <lt any time during the term hereof s hould foil to secure or m<lint<lin the foregoing insurance, City shall be permitted to obt<lin such insurance in the Contrnctor'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 l<lw and computed from the date written notice is rece ived that the premiums have not b een 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 <1dditional insured named herein s hall not be held li<tble 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 b e required to contribute anything toward <my 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. Contnictor is advised to consult Contractor's insurance broker to determine adequate coverage for Contractor. 11 . BONDS: Bonds are not required for this agreement. 12. PROHIBITION AGAINST TRANSFERS: Contractor shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of Jaw 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, hypotheca tion or transfer. However, claims for money by Contractor from City under this Agreement m ay 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. Pnge 5 of 20 13. SUBCONTRACTOR APPROVAL: Unless prior written consent from City is obtained, only those people and subcontractors whose names are listed in Conh·actor's bid shall be u sed in the performance of this Agreement. Requests for udditiomil subcontracting shall be submitted in vvriting, 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. Jn addition, any work or services s ubcontracted hereunder shall be subject to each provision of this Agreement. 14. PERMITS AND LICENSES: Contractor, at its sole expense, shall obtC1in and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City Business Lic ense that may be required in connection with the performance of services hereunder. 15. REPORTS: Each and every report, draft, work product, mC1p, record and other document reproduced, prepared or caused to be prep<1red 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 prepMed 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 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 accurc:ite records with respect to SC11es, 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 exC1mine and audit same, C1nd to make transcripts th erefrom as necessary, and to allow inspection of all work, data, documents, proceedings and activities related to this Agreement. Such records, together with s upporting P<ige 6 of 20 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. lf supplemental examination or audit of the records is necessary due to concerns raised by City's preliminc1ry examination or audit of records, and City's supplemental examiniltion 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 ;:i]J 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 notices, demands, requests, or approvals from City to Contractor shall be addressed to Contractor at: Partition Specialties Inc. Attn: Barbara Parkman 505 San Marin Drive, Suite A120 Novato, CA. 94945-2419 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. Contr'1ctor shall take all steps necessary to keep wC1sh water out of the streets, gutters, storm drC1ins and stre<ims. The Contractor shC1ll develop C1nd implement erosion C1nd sediment control to prevent pollution of s torm drC1ins and streC1ms. Such control includes but is not limited to: A. Use storm drnin inlet protection devices s uch as S'1nd 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-vvatering 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. Svveep and remove all materiC1ls from paved surfaces that drnin to streets, gutters and storm drC1ins prior to rain as well as at the end of the each work day. At the P<1ge 7 of 20 completion of th e project, the street s h a ll b e washed and th e wa s h W<ll e r s h a ll be collected and disposed o f offsite in an appropriate loca tion . D. After breaking o ld pavement, Contrnctor shill ! r e mov e illl debris to <lvoid contact wi th rai nfa ll or runoff. E. Co ntractor shalJ maintain a clean work area by removing trash, litt e r, and d e bri s at the e nd of each work da y. Contractor s h a ll also clean up any leak s, drips, a nd other spi ll s as th ey occur. l11 e objective is to en s ure that th e City and County of Santa Claril County-Wide Clean Water Program is adeguate ly e nforced. These controls s hould be impl e m ented prior to the start of construction, up-gra ded as required, maintaine d during construction phases to provid e adequate protec ti o n, a nd removed a t the end of cons truction. These r ecommend a tions are int e nd e d to be u sed in co njun c ti o n with the State of California's Best Management Prilctices Municipal a nd Construction Handbooks, loc a l program g uidan ce materia ls from municipalities, Sect ion 7 .1.01 of the Standard Speci ficati ons and any other appropria le documents o n s torm WC1ter guC1lity co ntrol s for con s truction. Failure to comply with this progrC1m will r es ult in the issuance of noncompliance notices, citations, proj ec t s to p ord e r s or fines. The fin e for noncompliance of th e a b ove program is tw o hundred and fifty dollars ($250.00) per occurrence p er day. l11e State und er th e Federal Clean Water Act can a lso impose a fine on the contrac tor, pursuC1nt to Cal. Water Cod e '13385. 19 . TERMINATlON : In the event Con tractor fails or refuses to perform any of th e provi s ions h e reof a t the time a nd in the mann e r regu ired here under, Contractor shalJ be deemed in default in the performance of this Agreement. If s uch default is not cured within a period of two (2) d ays afte r receipt by Contractor from C ity of written notice of d efa ult, s pecifying the nature of such default and th e steps necessa ry to cure such default, City may te rminate the Agreement forthwith by giving to the Contractor written n o tice thereof. City shall h ave th e option, at its sole discretion and vvithout ca u se, of terminating thi s Agreement by givin g seven (7) da ys' prior written notice to Contractor as provided herein. Upon te rminat io n of thi s Agreement, each party s hnll pay to the other pa rt y that portion o f compensa tion speci fied in thi s Agreement that is ea rn ed and unpaid prior to the e ff e ctive date o f termination . 20. COMPLIANCES: Contractor shCl ll co mply with all s tate or federal laws and all o rdin nnces, rul es and regulations e n acted o r issu ed by City. SpecifirnJJ y, and without limita tio n , Cont rac to r sha ll comply with a ll s tate, federa l, or local r egul a tio n r egarding the re moval a nd disposal of ha za rd ous waste. A. PREVAILING WAGES: To th e ex te nt applicable, Contractor s hall comply !'age 8 o f 20 with the City's Labor Compliance Program and all other requirements se t forth in Labor Code section 1770 et seq. Contractor s hall pay prevailing wages. Contractor will submit monthly certified payroll records to City for all employees a nd s ubcon tractors in a preapproved format or a City provided form. Any delay in remitting certified payroll reports to City upon request from City vvill resu lt in either delny nnd/or forfeit of outstanding pa yment to Contrnctor. B. WORKING DAY: To th e extent applicable, Contractor s hnll comply with Cnlifornin Labor Code Section 1810, et seq . which provides that work performed by employees of contrzictors in excess of 8 hours per day, and 40 hours during <my one week, mu st be compen sa ted as overtime, lit not less thiln 1 1/2 times the bn sic rilte of pny . C. PAYROLL RECORDS: To the extent applicable, Contractor shall comply with California Labor Code Section l 776 which requires certified payroll records be maintained with th e name, address, social security number, work classification, straight time and overtime hours worked each dfly llnd week, and the actufll per diem wilges p<1id to eilch journeyman, apprentice, ,,vorkcr, or other employee employed by him or her in connection vvith this Agreement. The Pziyrol l Records shall be made avC1ilable for in spec ti o n ilS provided in Ca lifornill Labor Code Section 1776. D. APPRENTJCES: To the ex te nt applicnbl e, Contrilctor s hall comply with California Labor Code Section 1777.5 revrding i1pprentices . 21. CONFLICT OF LAW: This Agreement shall be interpreted und er, ilnd enforced by the laws of the State of California excepting any c hoi ce of law rules which may direct the application of l aws of another jurisdiction. The Agreement and obligations of the pilrties are subject to all valid laws, orders, rules, ilnd regulations of th e authorities having jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought pursuant to this Agreement shC1ll be filed with the courts of th e Cotmty of Santa Clara, State of Californiil. 12 . ADVERTISEMENT: Contractor sh illl not post, exhibit, display or allow to be posted, exhibited, displayed any signs, advertising, show bills, lithographs, posters or cards of any kind pertilining to the services performed under thi s Agreement unless prior written approval has been secured from City to do o th erwise. 23. WAIVER: A wiliver by City of llny breach of any term, covenant, or condition contained herein, shall not be deemed to be a waiver of any subsequent breach of the Silme or any other term, covenant, or condition contllined herein, whether of tl1 e same or il different charncter. 24. INTEGRATED CONTRACT: This Agreement represents the full ilnd complete understilnding of every kind or nahire whatsoever between the parties hereto, and a ll preliminary negotiC1ti ons ilnd zigreernents of whatsoever kind or nature are merged herein . No verbal agreement or implied covenilnt shC11l be P<1ge 9 of 20 held to vary the provisions hereof. Any modification of this Agreement will be effec tiv e only by written execution signed by both City and Contractor. 25. lNSERTED PROVJSIONS: Each provision and clause require d by law to be inserted into th e Agreement shull be deemed to be enacted herein, and the Agreement s hall be read and enforced as though e<lch were included herein. If through mistake or otherwise, c:my such provision is not inserted or is not correctly inserted, the Agreement shnll be amended to make such insertion on npplication by either p<1rty. 26. CAPTIONS: The captions in this Agreement are for convenience only, <lre not <l p<1rt of the Agreement and in no way affect, limit or <lmplify the terms or provisions of this Agreement. Page 10 of 20 Zol-=t-I IY P.O. No .:~~ IN WITNESS WH EREOF , the parti es have caused the Agreement to be exec uted on the day and year first above written . CONTRACTOR CITY OF C UPERTINO ::~!~ AYMunicipo l Cmpo'.'.'tion _,/ 2- Nome r imm Bocde ~ 6 , ,;?~of Public Wocks l3mbara Parkman Date o~/ Lt, Tit le Assistant Cor porate Secre tary ---;--___,.~-=----- Date_~B-+-f,_,_/1~<,.. ___ _ r I Address: 505 San Ma 0 rin Dr., Suite A120 Novato, CA. 94945 RECOMMENDED FOR APPROVAL: By ~~~ Chris Orr, Public Works Supervisor APPROVED AS TO FORM : By ~~ City Attorney ATTEST: 1it Grace Schmidt, City Clerk J-Z.--fb Contract Amou nt: $49,659.00 Accoun I No . : 100-87-831-900-990 Page 11nf20 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 JN TRIPLICATE ] . Insurance Agreement -Must be signed by Contractor. 2. Certificate of lnsurance 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 s igned by the insurance agent for general linbility and nutomobile liability o nly . 4. Comprehensive general liability/commercial general liability endorsement of aggregate limits of insurance per project -must be s igned by the ins ur<ince <igent for general liability only . 5. W<iiver of s ubroga tion e ndorsement worker's compcns<ition insurance -must b e s igned by the insurance agent for worker's compensation only. Page 12 of 20 CUPERTINO INSURANCE AGREEMENT A. Contrnctor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against li ability for worker's compensation or undertake self- insurance in accordance with the provisions of that Code, and will comply with s uch provis ions 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 s hall waive its rights of subrogation against the City, the City's officers, agents and employees and shall iss ue an endorsement to the policy evidencing same . C. Contractor sha ll carry at all times, on all operations hereunder, commercia l general liability insurance, automobile liability insurance and builder's all risk insurance. All insurance covernge shall be in amounts required by the City and shall be evidenced by the issuance of a certificate in a form presc ribed by th~. City and shaJI be underwritten by insurance companies satisfactory to the City for all operation.s, s ub-contract work, contractual obligations, product or completed operations, a ll owned vehicles <md non-owned vehicles . Said insurance coverage obtained by the Contractor, excepting worker's compensation coverage, shall name the City, its eng in eer, and each of its directors, officers, agents and employees, as determined by the City, as additional insureds on s C1id policies. Insurers must be licensed to do business in the State of California. The Insurers must also h ave 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 pre pares or delivers materials to, the site of construction, Contractor sha ll furnish certificates of insurance evidencing the foregoing insurance coverages and such certificates sha ll provide th e 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 ins urance 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 Con t ractor under this Contract and for the duration of the warranty period . Notwithstanding nor dim ini shing the obligations of Contractor with respect to the foregoing, Contractor shall mC1intain in full force and effect during th e life of this Contract, the following insurance in amoun ts not less than the amounts specified and having a Best's Guide Ratin g of A, Class VlI or better or that is otherwise acceptable to the City. LIMITS Pi!ge 13 of 20 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. In accordance with the Worker's Compensation Act of the State of California -Work er'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 Automobile Liability -comprehensive Combined single limit of $1.0 million covering owned, non-owned and hired per occurrence . automobiles . • 0 jj,J, INC. dbaPART ITION SPECIALTIE.S, INC. /) r----:-J , By (_\tM~~ (Contractor's Name) P~ge 14 of 20 CUPERTINO CEHTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO This certjfies 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 . Ins u red : --PP'SSIB<3S&,-tllt~~C7-. Tildbiil"'"'fi'14Ae"RT'1'tfT'1'tl'"'0Nkt-<.'SrnpE'°'C"'IAL...,.Tl""'E"""S,"IN"'C..--. -- Address: ----------------- Description of operations/locations/products insured (show contract name and/or number, if any):--------------------------------- WORKER'S COMPENSATJON (Name of insurer) * StCltutory Min. *Employer's Liability $ _____ _ $ _____ _ $ ____ _ Insurance Company's State License No . __________________ _ Check Policy Type: COMPREHENSIVE GENERAL LIABILITY ( J Premises/Operations Ovvncrs & Contractors Protective [ ] Contractua l for Specific Contract $ _______ _ ( ] Products Liability [ J XCU Hazards [ ] Broad Form P.D . [ ] Severab ility of Interest Clause [ J Persona l Injury with Employee Exclusion Removed or Self-Ins ured COMMERCIAL GENERAL LIABILITY Each Occurrence General Aggregate (if <1pplicable) Aggregate Personal Injury $ ______ _ $ _______ _ $ _______ _ Fire Damage (any one fire) $ _______ _ Medical Expense (any one person) Ret enti on $ _______ _ $ ______ _ (Name of insurer) Policy No . _______ _ AUTOMOTIVE/VEHICLE LIABILITY Commercial Form Expira ti on Date ______ _ BODILY INJURY Each Person Page 15 of 20 PI\OPERTY DAMAGE Each Accident LiC1bility Cove rC1 ge Ei1ch Accident (NC1me o f in s ure r ) $ ________ or Com bined Si n gle Limit $ _______ _ Policy No. _______ _ Ex pirC1tion Date ______ _ -===------------------------=========~== BUJLDER'S RISK "ALL RISK " Thi s is to certify that the following policy h;i s been issu e d by the below-stilted company in co nformance with th e requirements of th e projec t documents a n d is in force a t thi s ti me. NIA (Name o f insure r) Policy No. ________ _ Expiration Da te _______ _ Limits o f Liabil it y: _______ _ Deductible: ________ _ (Agent's ini ti a l) A copy of a ll Endorse ments to the policy(ies) which in any way limit th e above-li sted types of coverage are attached to this Certifi cate of In sura n ce . Thi s Certificate of lnsurance is not an insurance poli cy and does not mnend, extend or <ilter the coverage afforded by the policies listed herein. Notwi th standing <iny requirement, term , or condi t io n o f a n y co ntract or any oth e r document with respect to which this Cer tific;ite o f lns uran ce may be iss u e d or may pertain, th e insurance ;if forded b y the polici es descri bed herein is subject to all the te rms, exclusions and cond ition s of s uch policies. IT JS HEJ\EBY CERTJFJ ED th a t th e above policy(ies) provide li ab ilit y in s ur<ince as r equired by the Ag~;$Jll-ef t between the C By ~-=....:~===~--=---=--"-'---Dated: ___ 8_/_1 ____ 20_1 t.P At tach Certifi ca te of lnsur<ince and Ad diti onal In sured Endorsemen t on company forms. CITY OF II 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 <'lnd notwithstanding any inconsistent st<1tement in the policy to which thi s Endorsement is attached or any other Endorsement attciched 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 additionill insureds in connection with, but limited to its general supervision or inspection of said operations. The insuran ce afforded by this p o licy is primary insurance, and no additional insurance held or owned by the designated Cldditional 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 rnilil, return receipt requested, hils been given to the City of Cupertino ("City"). Such notice shall be addressed to the City ClS indicC1ted below. Page 17 of 20 POLICY INFORMATION 1 . Insu ranee Company: -------------------------- 2. Insurance Policy Number: ____________________ _ 3. Effective Date of this Endo rsement: __________________ 20 4. Insured: _____________________________ _ All notices herein prov ided to be given by the Insurance Company to the City in connection with this policy and thes e Endorsements, shaJJ be mail ed to or delivered to the City at 10300 Torre Avenue; C11pertino, Califomi<1 95014. I,-------------------------(print/type name) warrant th<lt I have Cluthority to bind th e below listed lnsurnnce CompC1ny C1nd by my signature hereon do so bind this CompC1ny. Sign<i tu re of A uthorized RepresentCI tive: ___________________ _ (Original s ignature required on <111 Endorsements furnished to th e District) NC1m e s of Agent/Agency: _____________ _ Title: __________ _ Address: ________________ _ Telephone: _______ _ FC1csimile: -------- Page 18 of 20 CITY Of CUPERTINO COMPREHENSIVE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ENDORSEMENT OF AGGREGATE LIMITS OF INSURANCE PER PROJECT Project Title ilnd Number: ______________________ _ In consideration of th e policy pre mium a nd n otwi th s tanding any in cons is tent s tat e m e nt in th e p o li cy to which thi s Endorsement is a tt ached or a ny o th e r Endorsement attached thereto, it is as foll ows: This Endorsement modifi es the insuran ce provided under the GenerJl Liability Covern ge part of the below-refe renced policy of insurance. The general aggrega te limit under UMITS OF INSURANCE applies separa te ly to th e project described as POLICY INFORMATION 1 . In surance Co mpany:------------------------- 2. Jn s urance Policy N umber:----------------------- 3. Effecti ve Date of thi s End orsement: _________________ 20 __ 4. Jn s urc d: ----------------------------- 5 . Additional Jn s ured: Ci ty o f Cupertino, it s directors, offic ers, agents a nd em pl oyees . All noti ces h ere in provided to be given by th e Insurance Company to th e City in connection w ith thi s policy and t11i s End orsement, s h all be mailed to or delivered to th e C ity a t 10300 Torre A venue; Cupertino, Ccdiforni a 950 14 . 1, -------------------------(print/typ e nc11ne) warrant that 1 have authority to bind th e b elovv li s ted In s urance Compa ny and by my signature hereo n do so bind this Co mpany . Signature of Authorized Representative: __________________ _ (Or ig inal s ig nature required on all Endorsements furn ished to the District) Na m es of Agent/Agency: _____________ _ Title: ----------- Address: _______________ _ Te 1 e phon e: -------- Facsimile: -------- Pa ge ]9 of 20 CITY OF a CUPERTINO WAIVER OF SUBROGATION ENDORSEMENT WORKER'S COMPENSATION INSURANCE Project Title and Number: _______________________ _ In consideration of the policy premium and notwithstanding any inconsistent statem ent in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows: Jt 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 Avenue; Cupertino, California 95014 . I, (print/type name) warrant that I have authority to bind the be low listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative: ___________________ _ (Original signature required on Jll Endorsements furnished to the District) Names of Agent/Agency: _____________ _ Title : __________ _ Address: ________________ _ Telephone: _______ _ Facsimile : -------- END OF DOCUMENT P~gc 20 o f 20 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD!YYYY) ~ 7/19/2016 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 endorsementfs). PRODUCER CONTACT Certificate Department NAME ; Arthur J. Gallagher & Co. !'.~~N~n c-" 925-299-1112 I ~!'.~ •. _ .. 925-953-6210 Insurance Brokers of CA. Inc. LIC #0726293 3697 Mt. Diablo Blvd, Suite 300 ~;.,Mn~~ ••. CertRequests@ajg.com Lafayette CA 94549 INSURERISl AFFORDING COVERAGE NAIC # 1NsuRERA:Travelers Prooertv Casualty Co of A 25674 INSURED PS131NC-01 INSURER B: Travelers Indemnity Co of America 25666 PSl3G, Inc. dba Partition Specialties, Inc. INSURER c ,Nationa l Union Fire Insurance Campa 19445 7428 Redwood Blvd., Suite 101 INSURER D : Novato, CA 94945 INSURER E : -·-----------------------·-----------------~ >--·----- INSURER F: COVERAGES CERTIFICATE NUMBER· 1634629759 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 CONDITION S OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR l 1NSD POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE WVD POLICY NUMBER IMMIDD!YYYYl IMMIDD!YYYYl A x COMMERCIAL GENERAL LIABILITY i y y DTE-C0-366K2526-TIL-15 10/1/2015 10/1/2016 EACH OCCURRENCE S1 .000 ,000 -~ CLA IMS -MADE : X ! OCCUR I DAMAGE TO RENTED I PREMISES CEa occurrence) S300,000 x $10K PO OEO/OCC I MED EXP (Any one person) $5,00 0 I ! PERSONAL & ADV INJURY S1 ,000 ,000 -GEN'L AGGREGATE LIMIT APPLIES PER : I GENERAL AGGREGATE S2,000 ,000 i =i 0 PRO-D LOC I PRODUCTS -COMP /OP AGG $2,000,000 POLICY JECT I OTHER: ! I s B AUTOMOBILE LIABILITY y y BA-366K2526-15-CNS 10/1/2015 10 /1/2 016 COMBINclJ SINGLc LIMIT S1 ,OD O.ODO : (Ea accident) ------- x ANY AUTO BODILY INJURY (Per person) s -~ ; ALL OWNED SCHEDULED ! BODILY INJURY (Per accident) s AUTOS AUTOS --NON-OWNED PROPERTY DAMAGE x HIRED AUTOS x AUTOS ; !Per accidenl) s -- x Comp/Coll x $500 Oed . s c x UMBRELLA LIAB X [ OCCUR BE068023778 10/1 /20 15 10/1/2 016 EACH OCCURRENCE $5,000 ,000 -~ i EXCESS LIAB ; I CLAIMS-MADE i AGGREGATE s5.ooo .ooo OED Ix I RETENTION$ 10,000 I s A WORKERS COMPENSATION Y/J y OT J-UB-366K400-9-15 10/1 /2 015 10 /1/2016 x 1 mTUTE 1 I OTH - ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE D /N/A E.L. EACH ACCIDENT s 1,000.000 OFFICER/MEMBER EXCLUDED ? (Mandatory in NH) E.L DISEASE -EA EMPLOYEE $1 ,000,000 It yes, describe under E.L DISEASE -POLICY LIMIT $1 ,000 ,000 DESCRIPTION OF OPERAT IONS below (See attached Suppl. Page ... ) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) PSl3G Job#: 3008216 I RE: Cupertino Senior Center ADDITIONAL INSURED(S): City of Cupertino, its City Council, boards and commissions, officers, employees and volunteers. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10300 Torre Avenue ACCORDANCE WITH THE POLICY PROVISIONS . Cupertino CA 95014 I ~:z;RE~IV~t? © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMNBER:DTE-C0-3 66K252 6-TIL-15 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY . BLANKET ADDITIONAL INSURED -AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II -WHO IS AN INSURED : Any person or organization that: a . You agree in a "written contract requiring in - surance" to include as an additional insured on this Coverage Part ; and b. Has not been added as an additional insured for the same project by attachment of an en - dorsement under this Coverage Part which includes such person or organization in the endorsement's schedule ; is an insured , but : a. Only with respect to liability for "bodily injury'', "property damage" or "personal injury"; and b. Only as described in Paragraph (1 ), (2) or (3) below, whichever applies : (1) If the ''written contract requiring insur- ance" specifically requires you to provide addit ional insured coverage to that per- son or organization by the use of: (a) The Additional Insured -Owners , Lessees or Contractors -(Form B) endorsement CG 20 10 11 85 ; or (b) Either or both of the following : the Additional Insured -Owners, Les- sees or Contractors -Scheduled Person Or Organization endorsement CG 20 10 10 01, or the Additional In- sured -Owners , Lessees or Contrac- tors -Completed Operations en- dorsement CG 20 37 10 01; the person or organizat ion is an additional insured only if the injury or damage arises out of "your work" to which the "w ritten contract requiring insurance" applies; (2) If the ''written contract requiring insur- ance" specifically requires you to provide additional insured coverage to that per- son or organization by the use of: (a) The Additional Insured -Owners, Lessees or Contractors -Scheduled Person or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13, the Additional Insured -Owners , Lessees or Contractors -Completed Operations endorsement CG 20 37 07 04 or CG 20 37 04 13, or both of such endorsements with either of those edition dates ; or (b) Either or both of the following : the Additional Insured -Owners, Les- sees or Contractors -Scheduled Person Or Organization endorsement CG 20 10, or the Additional Insured - Owners, Lessees or Contractors - Completed Operations endorsement CG 20 37, without an edition date of such endorsement specified; the person or organization is an additional insured only if the injury or damage is caused, in whole or in part, by acts or omiss ions of you or your subcontra ctor in the performance of "your work" to which the "written contract requiring insurance" applies ; or (3) If neither Paragraph (1) nor (2) above ap- plies : (a) The person or organization is an ad- ditional insured only if, and to the ex- tent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the perform- ance of "your work" to which the "writ- ten contract requiring insurance" ap- plies; and (b) The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organi- zation . CG 06 04 0813 © 2013 The Travelers Ind emnity Company . All rights reserved . Page 1of3 COMMERCIAL GENERAL LIABILITY 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured will be limited to such minimum required limits of liability . For the purposes of determining whether this limitation applies, the minimum limits of liability required by the "written con- tract requiring insurance" will be considered to include the minimum limits of liability of any Umbrella or Excess liability coverage required for the additional insured by that "written con - tract requiring insurance". This endorsement will not increase the limits of insurance de- scribed in Section Ill -Limits Of Insurance . b. The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arisin9 out of the rendering of, or failure to render, any professional architectural , engineering or sur- veying services, including: (1) The preparing, approving, or failing to prepare or approve , maps, shop draw- ings , opinions, reports , surveys, field or- ders or change orders. or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications ; and (2) Supervisory, inspection, architectural or engineering activities . c. The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products-completed opera- tions hazard" unless the "written contract re- quiring insurance" specifically requires you to provide such coverage for that additional in- sured during the policy period . 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible other insurance, whether primary, ex- cess, contingent or on any other basis , that is available to the additional insured . However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured under which that person or organization qualifies as a named insured, and we will not share with that other insurance . But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible other insurance , whether primary, excess , contingent or on any other basis, that is available to the additional insured when that per- son or organization is an additional insured, or is any other insured that does not qualify as a named insured, under such other insurance. 4 . As a condition of coverage provided to the addi- tional insured by this endorsement : a . The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim . To the extent possible, such notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense . · b. If a claim is made or "suit" is brought against the additional insured, the additional insured must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Not ify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable . c. The additional insured must immediately send us copies of all legal papers received in con- nection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and oth- erwise comply with all policy conditions . d. The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of other insurance which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to other insurance available to the additional insured which cov- ers that person or organization as a named insured as described in Paragraph 3. above. 5. The following is added to the DEFINITIONS Sec - tion : "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or or- Page 2 of 3 © 2013 The Travelers Indemnity Company . All rights reserved . CG 06 04 0813 ganization as an additional insured on this Cover- age Part , provided that the "bodily injury" and "property damage" occurs, and the "personal in- jury" is caused by an offense committed, during the pol icy period and: COMMERCIAL GENERAL LIABILITY a. After the signing and execution of the contract or agreement by you ; and b. While that part of the contract or agreement is in effect . CG 06 04 0813 © 2013 The Travelers Ind emnity Company . All rights reserved . Page 3 of 3 POLICY NUMBER : DTE-C0-366K2526-TIL-15 NAMED INSURED : PSI3G, INC DBA: Partition Specialties, Inc . COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE -Provisions A.-H. and J.-N. of this endorsement broaden coverage, and provision I. of this endorsement may limit coverage. The following listing is a general coverage description only. Limitations and exduslons may apply to these coverages. Read all the PROVISIONS of this endorsement carefully to determine rights. duties. and what is and is not covered. A. Broadened Named Insured B. Extension of Coverage -Damage To Premises Rented To You • Perils of fire, explosion, lightning, smoke, water • Limit increased to $300,000 C. Blanket Waiver of Subrogation D. Blanket Additional Insured -Managers or Lessors of Premises E. Incidental Medical Malpractice F . Extension of Coverage -Bodily Injury G. Contractual Liability -Railroads PROVISIONS A. BROADENED NAMED INSURED 1. The Named Insured in Item 1. of the Declara- tions is as follows: The person or organization named in Item 1. of the Dedarations and any organization . other than a partnership, joint venture or lim- ited liability company, of which you maintain ownership or in which you maintain the major- ity interest on the effective date of the policy . However, coverage for any such .additional organization will cease as of the date , if any, during the policy period, that you no longer maintain ownership of, or the majority Interest in, such organization. 2. WHO IS AN INSURED {Section II) Item 4.a. is deleted and replaced by the following: a. Coverage under this provision is afforded only until the 18oth day after you acquire or form the organization or the end of the policy period, whichever Is earlier. H. Additional Insured -State or Political Subdivisions I. Other Insurance Condition J. Increased Supplementary Payments • Cost of bail bonds increased to $2 ,500 • Loss of earnings increased to $500 per day K. Knowledge and Notice of Occurrence or Offense L. Unintentional Omission M. Personal Injury -Assumed by Contract N. Blanket Additional Insured -Lessor of Leased Equipment 3. This Provision A. does not apply to any per- son or organization for which coverage is ex- cluded by endorsement. B. EXTENSION OF COVERAGE -DAMAGE TO PREMISES RENTED TO YOU 1. The last paragraph of COVERAGE A. BOD- ILY INJURY AND PROPERTY DAMAGE LI- ABILITY (Section I -Coverages) is deleted and replaced by the following : Exclusions c. through n. do not apply to dam- age to premises while rented to you , or tem- porarily occupied by you with permission of the owner, caused by : a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water. A separate limit of insurance applies to this coverage as described in Section Ill Limits Of Insurance. CG 0316 07 04 Copyright, The Travelers Indemnity Company, 2004 Page 1of6 COMMERCIAL GENERAL LIABILITY 2. This insurance does not apply to damage to premises while rented to you , or temporarily occupied by you with permission of the owner, caused by : a. Rupture, bursting, or operation of pres- sure relief devices ; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from wa- ter; c . Explosion of steam boilers , steam pipes , steam engines, or steam turbines. 3. Paragraph 6. of LIMITS OF INSURANCE (Section Ill) is deleted and replaced by the following : Subject to 5. above , the Damage To Prem - ises Rented To You Limit is the most we will pay under COVERAGE A. for the sum of all damages because of "property damage" to any one premises whil e rented to you , or temporarily occupied by you with permission of the owner, caused by: fire; explosion; light- ning; smoke resulting from such fire , explo- sion , or lightning; or water. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occurrence". whether such damage results from : fire ; explosion; lightning ; smoke resulting from such fire, explosion, or light- ning; or water; or any combinat ion of any of these causes. The Damage To Premises Rented To You Limit will be the higher of: a. $300,000 ; or b. The amount shown on the Declarations for Damage To Premises Rented To You Limit. 4. Paragraph a. of the definition of "insured con- tract" (DEFINITIONS -Section V) is deleted and replaced by the following: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that Indemnifies any person or organization for damage to premises while rented to you , or tempo- rarily occupied by you with permission of the owner , caused by: fire ; explosion ; lightning ; smoke resulting from such fire, explosion, or lightning; or water, is not an "Insured contract"; 5. This Provision B. does not apply if coverage for Damage To Premises Rented To You of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I - Coverages) is excluded by endorsement. C. BLANKET WAIVER OF SUBROGATION We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of : premises owned or occupied by or rented or loaned to you ; ongoing operations performed by you or on your behalf, done under a contract with that person or organization; "your work "; or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily Injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense ls committed. D. BLANKET ADDITIONAL INSURED -MANAG- E RS OR L ES SORS OF PREMIS ES WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization (referred to below as "additional insured") with whom you have agreed in a written contract , exe- cuted before the "bodily injury" or "property dam- age" occurs or the "personal injury" or "advertis- ing injury" offense is committed , to name as an additional insured , but only with respect to liability arising out of the ownership, maintenance or use of that part of any prem ises leased to you , subject to the following provisions : 1. Limits of Insurance. The limits of insurance afforded to the additional insured shall be the limits which you agreed to provide in the writ- ten contract, or the limits shown on the Decla- rations, whichever are less. 2. The insurance afforded to the additional in- sured does not apply to : a. Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense which is committed, after you cease to be a ten- ant in that premises ; b. Any premises for which coverage is ex- cluded by endorsement ; or c. Structural alterations , new construction or demolition operations performed by or on behalf of such additional insured . 3. The insurance afforded to the additional in- sured is excess over any valid and collectible Page 2 of 6 Copyright, The Travelers Ind emnity Company , 2004 CG D3 16 07 04 "other insurance" available to such add itional insured , unless you have agreed in th e writ- ten contract that this Insurance must be pri - mary to, or non-contributory with , such "other insurance". E. INCIDENT Al MEDICAL MALPRACTICE 1. The following is added to paragraph 1. Insur- ing Agreement of COVERAGE A -BODILY INJURY AND PROPERTY DAMAGE LIABIL- ITY (Section I -Coverages): "Bodily injury" arising out of the rendering of, or failure to render , the following will be deemed to be caused by an "occurrence": a. Medical , surgical, dental, laboratory , x-ray or nursing service , advice or instruction, or the related furnishing of food or bever- ages ; b. The furnishing or dispensing of drugs or medical, dental , or surgical suppl ies or appliances ; c. First aid; or d. "Good Samaritan services." As used in this Provision E., "Good Samaritan ser- vices " are those medical servi ces ren- dered or provided In an emergency and for which no remuneration is demanded or received. 2. Pa ragraph 2.a.(1)(d) of WHO IS AN IN - SURED (Section II) does not apply to any registered nurse , licensed practical nurse , emergency medical technician or paramedic employed by you , but only while performing the services described in paragraph 1. above and while acting within the scope of their em - ployment by you. Any "employees· rendering "Good Samaritan services " will be deemed to be acting within the scope of their employ- ment by you. 3. The following exclusion is added to paragraph 2. Exdusions of COVERAGE A. -BODILY INJURY AND PROPERTY DAMAGE LIABIL- ITY (Section 1-Coverages): (This insurance does not apply to:) "Bodily In - jury• or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals com - mitted by or with the knowledge or consent of the insured. 4. For the purposes of determining the applica - ble limits of insurance , any act or omission COMMERCIAL GENERAL LIABILITY together with all related acts or omis sions in the furnishing of the services described in paragraph 1. above to any one person will be deemed one "occurrence•. 5. This Provision E. does not apply if you are in the business or occupation of providing any of the services described In paragraph 1. above. 6. The insurance provided by this Provision E. shall be excess over any valid and collectible "other insurance " available to the insured, whether primary, excess , contingent or on any other basis , except for insurance that you bought specifically to apply in excess of the Limits of Insurance shown on the Declara- tions of this Coverage Part F. EXTENSION OF COVERAGE -BODILY IN - JURY The definition of "bodily injury" (DEFINITIONS - Section V) is deleted and repla ced by the follow- in g : "Bodily injury " means bodily injury, mental an- guish , mental injury, shock , frigh~ disab~ity , hu- miliation, sickness or disease sustained by a per- son, including death resulting from any of these at any time . G. CONTRACTUAL LIABILITY -RAILROADS 1. Paragraph c. of the definition of "insured con- tracr (DEFINITIONS -Section V) is deleted and replaced by the following : c. Any easement or license agreement ; 2. Paragraph f.(1) of the definition of "Insured contract" (DEFINITIONS -Section V) is de- leted. H. ADDITIONAL INSURED -STATE OR POLITI· CAL SUBDIVISIONS -PERMITS WHO IS AN INSURED (Section II) is amended to include as an insured any state or political subdi- vision , subject to the following provisions : 1. This insurance applies only when required to be provided by you by an ordinance, law or building code and only with respect to opera - tions performed by you or on your behalf for which the state or political subdivision has is- sued a permit. 2. This insurance does not apply to : a. "Bodiy injury," "property damage," "per- sonal injury• or "advertising injury • arising out of operations performed for the state or political subdivision; or CG D316 07 04 Copyright , The Travelers Indemnity Company , 2004 Page 3 of 6 COMMERCIAL GENERAL LIABILITY b. "Bodily injury" or "property damage" in- cluded in the "products-completed opera- tions hazard". I. OTHER INSURANCE CONDmON A.. COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV), paragraph 4. (Other Insurance) is deleted and replaced by the fol- lowing : 4. Other Insurance If valid and collectible "other insurance" is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insur- ance is primary, our obligations are not affected unless any of the "other insurance" is also primary. Then, we will share with all that "other insur- ance" by the method described in c. below. b. Excess Insurance This insurance is excess over any of the "other insurance", whether pri- mary, excess, contingent or on any other basis: (1) That is Fire, Extended Coverage, Builder's Risk. Installation Risk, or similar coverage for "your work"; (2) Thal is Fire insurance for prem- ises rented to you or temporarily occupied by you with permission of the owner; (3) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or tempo- rarily occupied by you with per- mission of the owner; or (4) If the loss arises out of the main- tenance or use of aircraft, "autos", or watercraft to the ex- tent not subject lo Exclusion g. of Section I -Coverage A -Bodily Injury And Property Damage Li- ability; or (5) That is available to the insured when the insured ls an additional insured under any other policy, Including any umbrella or excess policy. When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any provider of "other in- surance" has a duty to defend the in- sured against that "suit". If no pro- vider of "other insurance" defends, we will undertake to do so, but we will be entiUed to the insured's rights against all those providers of "other insurance". When this insurance is excess over "other insurance", we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such "other insurance" would pay for the loss in the absence of this in- surance; and (2) The total of all deductible and self-insured amounts under that "other insurance". We will share the remaining loss, if any, with any "other insurance" that is not described in this Excess Insur- ance provision. c. Method Of Sharing If all of the "other insurance" permits contribution by equal shares, we will follow this method also. Under this approach each provider of insurance contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, which- ever comes first. If any of the "other insurance" does not permit contribution by equal shares, we will contribute by limits. Under this method, the share of each provider of insurance is based on the ratio of its applicable limit of insur- ance to the total applicable limits of insurance of all providers of insur- ance. B. The following definition is added to DEFINITIONS (Section V): "Other insurance": a. Means insurance, or the funding of losses, that is provided by, through or on behalf of : Page 4 of 6 Copyright, The Travelers Indemnity Company, 2004 CG 0316 07 04 (1) Another insurance company; (2) Us or any of our affiliated insurance com- panies, except when the Non cumulation of Each Occurrence Limit section of Paragraph 5 of LIMITS OF INSURANCE (Section 111) or the Non cumulation of Per- sonal and Advertising Injury limit sections of Paragraph 4 of LIMITS OF INSUR- ANCE (Section 111) applies; (3) Any risk retention group; (4) Any self-insurance method or program, other than any funded by you and over which this Coverage Part applies ; or (5) Any similar risk transfer or risk manage- ment method . b. Does not include umbrella insurance, or ex- cess insurance, that you bought specifically to apply in excess of the Limits of Insurance shown on the Declarations of this Coverage Part. J. INCREASED SUPPLEMENTARY PAYMENTS Paragraphs 1.b. and 1.d. of SUPPLEMENTARY PAYMENTS -COVERAGES A AND B (Section I -Coverages) are amended as follows : 1. In paragraph 1.b., the amount we will pay for the cost of bail bonds is increased to $2500. 2. In paragraph 1.d., the amount we will pay for loss of earnings is increased to $500 a day. K. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE 1. The following is added lo COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV). paragraph 2. (Duties In The Event of Oc- currence, Offense, Claim or Suit): Notice of an "occurrence" or of an offense which may result in a claim must be given as soon as practicable after knowledge of the ''occurrence" or offense has been reported to you, one of your "executive officers" (if you are a corporation), one of your partners who is an individual (if you are a partnership), one of your managers (if you are a limited liability company), or an "employee" (such as an in- surance, loss control or risk manager or ad- ministrator) designated by you to give such notice. Knowledge by any other "employee" of an "occurrence" or offense does not imply that you also have such knowledge. COMMERCIAL GENERAL LIABILITY 2. Notice of an "occurrence" or of an offense which may result in a claim will be deemed to be given as soon as practicable lo us 11 it is given in good faith as soon as practicable to your workers' compensation insurer. This ap- plies only if you subsequently give notice of the "occurrence" or offense to us as soon as practicable after you, one of your "executive officers" (if you are a corporation), one of your partners who is an individual (if you are a partnership), one of your managers (if you are a limited liability company), or an "employee" (such as an insurance , loss control or risk manager or administrator) designated by you to give such notice discovers that the "occur- rence" or offense may involve this policy. 3. This Provision K. does not apply as respects the specific number of days within which you are required to notify us in writing of the abrupt commencement of a discharge, re- lease or escape of "pollutants" that causes "bodily injury" or "property damage" which may otherwise be covered under this policy . L. UNINTENTIONAL OMISSION The following is added lo COMMERCIAL GEN- ERAL LIABILITY CONDITIONS (Section IV). paragraph 6. (Representations): The unintentional omission of, or unintentional error in, any information provided by you which we relied upon In Issuing this policy shall not prejudice your rights under this insurance . How- ever, this Provision L. does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable state insurance laws, codes or regula- tions. M. PERSONAL INJURY -ASSUMED BY CON- TRACT 1. The following Is added to Exdusion e. (1) of Paragraph 2., Exclusions of Coverage B. Personal Injury, Advertising Injury, and Web Site Injury Llablllty of the Web XTEND Liability endorsement: Solely for the purposes of liability assumed in an "insured contract", reasonable attorney fees and necessary litigation expenses in- curred by or for a party other than an insured are deemed to be damages because of "per- sonal injury" provided : (a) Liability to such party for, or for the cost of, that party's defense has also been as- CG 0316 07 04 Copyright, The Travelers Indemnity Company, 2004 Page 5 of 6 COMMERCIAL GENERAL LIABILITY sumed in the same "insured contract "; and (b) Such attorney fees and litigation ex- penses are for defense of that party against a civil or alternative dispute reso- lution proceeding in whi ch damages to which this Insurance applies are all eged. 2. Paragraph 2.d. of SUPPLEMENTARY PAY- MENTS -COVERAGES A AND B (Section I -Coverages) is deleted and replaced by the following : d. The allegations in the "suit" and the in- formation we know about the "occur- rence " or offense are such that no conflict appears to exist between the interests of the insured and the interests ol the in- demnitee; 3. The third sentence of Paragraph 2 of SUP- PLEM ENTARY PAYMENTS -COVERAGES A AND 8 (Section I -Coverages) is deleted and replaced by the following : Notwithstanding the provisions of Paragraph 2.b.(2) of Section I -Coverage A -Bodily In- jury And Property Damage Liability , or th e provisions of Paragraph 2.e .(1) of Section I - Coverage B -Personal Injury, Advertis ing In - jury And Web Site Injury Liabiily, such pay- ments will not be deemed to be damages for "bodily injury" and "property damage ", or damages for "personal injury", and will not re- duce the limits of insurance . 4. This provision M. does not apply If coverage for "personal injury " liability is excluded by endorsement. N. BLANKET ADDITIONAL INSURED -LESSOR OF LEASED EQUIPMENT WHO IS AN INSURED (Section II) is amended to Include as an Insured any person or organization (referred to below as "additional insured") with whom you have agreed in a written contract , exe- cuted before the "bodily injury" or "property dam- age " occurs or the "personal injury" or "advertis- ing injury " offense is committed, to name as an additional insured, but only with respect to their li - ability for "bodily injury", "property damage", "per- sonal injury" or "advertising injury" caused , in whole or in part , by your acts or omissions in the maintenance, operation or use of equipment leased to you by such additional insured , subject to the following provisions: 1. Limits of Insuran ce. The limits of insuran ce afforded to the additional insured shall be the limits which you agreed to provide in the wr it- ten contract. or the limits shown on the Decla- rations , whichever are less . 2. The insurance afforded to the additional in - sured does not apply to any "bodily injury " or "property damage " that occurs, or "personal injury" or "advertising Injury• caused by an of- fense which is committed , after the equ ipment lease expires. 3. The insurance afforded to the additional in- sured is excess over any valid and collectible "other insurance " available to such additional insured, unless you have agreed in the writ- ten contract that th is insurance must be pri - mary to , or non-contributory with, such "other insurance". Page 6 of 6 Copyright, The Travelers Ind emnity Company , 2004 CG DJ 16 07 04 Policy No : BA-366K2526-15-CNS Named lns med : PSBG. INC. DBA P;;i11i1i o n Specialties, Jue . COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS F. HIRED AUTO LIMITED WORLDWIDE COVERAGE -INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE -GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -LIABILITY COV- ERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage . Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. 8. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II -LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II . C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1 ., Who Is An Insured, of SECTION II -LI - ABILITY COVERAGE : An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness . CA TJ 53 0310 © 2010 The Travelers Ind emnity Company . Page 1of4 lndudes copyrighted materi al of In surance Services Office , Inc . with its permi ss ion. COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.5 •. Other Insurance, of SECTION IV -BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease. hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -LIABILITY COV- ERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or.borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2). of SECTION II -LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II-LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO -LIMITED WORLDWIDE COV- ERAGE -INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV -BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their house- holds. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada : (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (Ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent. but only up to the limit described in Para- graph C., Limit Of Insurance, of SEC- TION II -LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limit Of Insurance, of SECTION II -LIABILITY COVER- AGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the ap- plicable limit of insurance in pay- ments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available Page 2 of 4 © 2010 The Travelers Indemnity Company. CA T3 53 0310 Includes copyrighted material of Insurance Services Office, Inc. with its permission. to the "insured" whether primary, excess contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law . Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance , or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE -GLASS The following is added to Paragraph D., Deducti- ble, of SECTION Ill -PHYSICAL DAMAGE COVERAGE : No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced . H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION Ill -PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION Ill -PHYSICAL DAMAGE COVER· AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. COMMERCIAL AUTO J. PERSONALEFFE CTS The following is added to Paragraph A.4., Cover- age Extensions, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss" to wearing ap - parel and other personal effects which are : (1) Owned by an "insured": and (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Effects coverage. K. AIRBAGS The following is added to Paragraph 8.3., Exclu· slons, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of '1oss" set forth in Paragraphs A.1 .b. and A .1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV -BUSINESS AUTO CONDITIONS : Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". CA Tl 53 0310 © 2010 The Tr avelers Indemnity Company . Page 3 of 4 Includes copyrighted material of Insurance Services Office , Inc. with its permission. COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV -BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex - tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organi zation designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV -BUSINESS AUTO CONDITIONS : The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non-renewal. Page 4 of 4 © 2010 The Travelers Indemnity Company. CA T3 53 0310 Includes copyrighted material of In surance Services Office , Inc. with its permission . TRAVELER S'f' ON! TOWER SQUARE HARTFORD, CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH TH E INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated . (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Policy No. DTJ-UB-366K400-9-15 Endorsement No. 001 ST ASSIGN: Page 1 of 1 ~ TRAVELERS] WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00)- POLICY NUMBER: DTJ-UB-366K400-9-15 11\SLR ED: P IJ(j 11\C OBJ\ Pnrti1i on pccinlli~s In c WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us .) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. THE PREMIUM CHARGE FOR THIS ENDORSEMENT IN HI IS 2% OF THE HI STATE PREMIUM SUBJECT TO A $250 MINIMUM POLICY PREMIUM . DESIGNATED ORGANIZATION: ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED POLICY NUMBER CARRIER I NAIC CODE EFFECTIVE DATE : ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM , FORM NUMBER: FORM TITLE : GENERAL LIABILITY: •Additional Insured if required by written contract per attached form CGD6040813 •Coverage is Primary/Non-Contributory if required by written contract per attached form CGD3160704 •Waiver of Subrogation if required by written contract per attached form CGD3160704 AUTOMOBILE LIABILITY : •Additional Insured if required by w ritten contract per attached form CAT3530310 •Waiver of Subrogation ii required by written con _tract per attached form CAT3530310 WORKER'S COMPENSATION : •Waiver of Subrogation if required by written contract per attached form WC990376A (California) •Waiver of Subrogation if required by written contract per attached form WC00031300 (Other States) UMBRELLA LIABILITY : • Underlying Policies : General Liability, Automobile Liability and Employer's Liability Page of ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD February 11 , 2016 City of Cupertino Attention : Rudy Lomas 10300 Torre Ave Cupertino, CA 95014 RE : Cupertino Senior Center-recover 21251 Stevens Creek Blvd Cupertino, CA 95014 Dear Rudy : Partition Specialties, Inc . (PSI) proposes to furnish labor and materials for the above referenced project according to the scop e of work as outlined below . This scope of work is based on our site m ee ting, addenda n a included . Scope of Work (2 walls) Demo existing st anda r d M odernfold fabric and r einstall new fab ric on ex isti ng op erab le w all pa nels o n stra ight time . All work w ill be d one on site In b allroom. We propose to furnish quantities listed for the sum of (including applicable ta xes): $49,6 59.00 Clarif ication s: • Price is based upon a 2 phase installation, Phase 1 -installation of trac k and field dimensions . Phas e 2 -installa t ion of panel s. • PSl 's ability t o install material according to project schedule is based on approved submittals being return ed to PSI within 30 days of being submitted • Please allow :_na_ weeks from PSl 's receipt of approved submittals, for in stallation of the track and field dimen sion s. u Please allow _3-4_ weeks after field dimensions and color selec tion for panel installat ion . • Unless otherwise noted, price is based on installation during normal wo r kin g hou rs. • Price is based on PSI having clear acces s to work. • Track attachment to steel or wood beam (supplied by others) is based on Modernfold standard details with a 12 " ma ximum rod length . • Stocking to work area is based on adequate freight elevator availability without eleva t or downtime. • Bid Is based upon standard product construction and finishes unless otherwise noted. • COM finishes are factory applied and must be factory approved prior to application. • Required Pocket Dimensions may vary from construction drawing set and should only be built AFTER operable wall submittals are approved so required dimensions can be verified . • Operable wall being provided will meet STC requirements defined In product specification . However, surrounding construction may cause unwanted sound transmission from one side of a barrier to the other. • Preparation of the opening (by others) shall conform to the criteria set forth per ASTM E557 "Standard Guide for Architectural Design and Installation Practices for Sound Isolation between Spa ces Separ ated by Operable Partitions", including the installation of a sound baffle and acoustical floor break, as required . • PSI will furnish shop drawings and header details in accordance with Modernfold specifications showing all track bracket placements and seismic bracing . • PSI requires written Notification of Owner Controlled Insurance Requirements and liquidated Damages . Participation in OCIP or CCIP Is subject to policy review and PSI acceptance . • All applicable taxes will be adjusted accordingly should Partition Specialties, Inc . responsibilities change for the above referenced project at a later date. Exclusions: Unless specifically noted above exclusions include : Structural support, structural engineering, lateral bracing, punching or drilling of header to receive threaded rods, backing at jambs, ceiling work and sound baffling, repair to monocoat (fire proofing) and drywall, if required, pocket doors, pass doors concrete drilling/cutting if required, final cl eaning,NEW PANELS, testing, field sound testing, wood trim at header or jambs, plan check, permits, February 11, 20 16 Cit y of Cupertino Cupertino Se nio r Center-recover Page I o/2 (.-:-) SPACE DIVISION ,(i .. ;i ACOUSTIC PRIVACY WORKSPACE FLEXIBILITY (h. SUSTAINABILITY ·..-' DESIGN + AESTHETICS www.PS 13G.com overtime, building load analysis, special inspections, seismic qualification certificates (Project Specifi c), setting drawings, custom painting of tra ck and/or panels, manufacturers' attendance during installation, keying of cylinders. A change in the price of an item of material, labor, equipment, fuel or any other component of this bid proposal of more than 5% between the date of bid proposal and the date of installation shall warrant an equitable adjustment in the subcontract price . CON TRACTO RS ARE REQUI RED BY LAW TO BE LICE NSED AND REGULATED BY THE CONTRACTORS STATE LI CENSE BOARD, WHICH HAS JURISDICTION TO INVESTI GATE COMPLAINTS AGAINST CONTRACTORS IF A COMPLAINT REGARDING APATENT ACT OR OMISSION IS FILED WI THIN FOUR YEA RS OF THE DATE OF THE ALLEGED VI OLATION. A COMPLAINT REGARDING A LATENT ACT OR OMISSION PERTA INING TO STR UCTU RAL DEFECTS MUST BE FILED W ITHIN 10 YE ARS OF THE DATE OF THE ALLEGED VI OLATION. ANY QUESTIONS CONCERNING A CONTRACTOR MAY BE REFERRED TO THE REGISTRAR, CONTRACTORS STATE LI CENSE BOARD, P.O. BOX 26000, SACRA MEN TO, CA 95826. This proposal is based exclusively on our interpretation of project requirements. If plans or written specifications are found to conflict with our product as quoted or our interpretation, the right to change our proposed price Is reserved . This proposal is expressly conditioned upon review , acceptance and execution of acceptable contract documents, including but not limited to, an achievable schedule for delivery and continuous uninterrupted work flow during regular business hours. This proposal remains in effect for 30 days unless otherwise noted and is subject to our terms and conditions. Our terms are net 30 days and subject to credit approval. Following credit review, PSI may request a cash deposit prior to material procurement or installation. If you do not have a copy of the terms and conditions, please contact us and a copy will be sent to you . All of the terms in this proposal shall be deemed acce pted by Partition Specialties, Inc. commencing work, the issuance of a letter of intent, or any instructions to Partition Specialties, Inc. to proceed with work by the Purchaser. The above is our quotation of prices. If this meets with your approval, pleas e indicate your acceptance by signing below. Thank you for t he opportunity to quote this project. If we can be of any further assistance please contact us. Sincerely, 20996 Cabot Blvd Hayward, CA 94545 Phone: (510) 266-8257 Fax : (510) 293-9947 Email: efreesto&ne@~~.c om ~ 0..11/VF .. Ct Ty o'f'Cvfe.1·fJrt__,0 t. 7-./j ~/.6 Accepted by: . ..._.-.. _________ . lfm. . a e .. _____ _ Authorized Signer Accep ted by PSI : _____________________ . Date:. _____ _ Authorized Signer February I I, 2016 Cit y of Cupertino Cupertino Senior Cent er-recover (B SPACE DIVISION :(1 .. '1• ACOUSTIC PRIVACY WORKSPACE FLEXIBILITY ...... {!J .. SUSTAINABILITY w ww .P S l3G .com /'agelof l DESIGN +AESTHETICS CUPERTINO CJ) =::J' "C -i 0 City of Cupertino Service Center 10555 Mary Avenue CUPERTINO, CA 95014 www.Cupertino.org VENDOR 2686 -PARTITION SPECIALTIES, INC. Q PARTITION SPECIALTIES, INC . 3. 7 428 Redwood Blvd., Ste 101 a NOVATO, CA 94945 REFERENCE# QUANTITY llJSll& DESCRIPTION 1 .0000 Each m -i 0 City of Cupertino Service Center 10555 Mary Avenue CUPERTINO, CA 95014 www. Cupertino. org Purchase Order No. 2017-00000114 DATE 07/12/2016 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: New fabric on partitions-senior center UNIT COST TOTAL COST 49,659.0000 $49,659 .00 100-87-831 900-990 -Capital Outlay Special Projects -PW 49,659 .00 • TOTAL DUE $49,659 .00 • DATE 07/12/2016 Authorized Signature Special Instructions