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16-161 Roto-Rooter Inc., Storm Drain Cleaning CCTV Inspection ServiceAGREEl\tlENT BETWEEN THE CITY OF CUPERTINO AND ROTO-ROOTER INC. FOR STORM DRAIN CLEANING/ CCTV INSPECTION SERVICE THIS AGREEMENT, for reference dated November _J_Q_, 2016, is by and between CITY OF CUPERTINO, a municipal corporation (hereinafter refen-ed to as "City"), and ROTO-ROOTER, a California corporation whose address 1s 195 MASON CIRCLE, CONCORD CA 94520, hereinafter called the Contractor, and is made with reference to the following : RECITALS: A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to can-yon its business as it is now being conducted under the Constitution and the statutes of the State of California and the Cupertino Municipal Code . B . City and Contractor desire to enter into an agreement for Storm Drain Cleaning / CCTV Inspection Services, in accordance with the adopted Storm Drain Cleaning / CCTV Inspection Services-Scope of Work & Requirements dated October 20, 2016 and as revised November 2 , 2016 . NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows : 1. TER.tVI: The Contractor shall begin work within five (5) calendar days after receiving notice from the Engineer to commence the work, and shall diligently prosecute the work to completion before January 31, 2017. 2 . SERVICES TO BE PERFORMED: Contractor agrees, at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all work strictly in accordance with Storm Drain Cleaning / CCTV Inspection Services -Scope of Work & Requirements dated October 20, 2016 , revised November 2, 2016 , hereby refen-ed to and expressly made a part hereof with the same force and effect as if the same were fully incorporated herein. 3. COMPENSATION TO CONTRACTOR: Contractor shall be compensated for services performed pursuant to this Agreement in the amount and manner set forth in Contractor's bid , which is attached hereto as Exhibit "A" and incorporated herein by this reference. Payment will be made in the same manner that claims of a like character are paid by the City, with checks drawn on the treasury of the City, to be taken from Storm Drain Cleaning I CCTV Inspection Services -Standard Agreement October 20 , 2016 the stonn drain maintenance fund. 4. TIME IS OF THE ESSENCE: Contractor and City agree that time is of the essence regarding the perfonnance of this Agreement. It is agreed by the parties to the Agreement that in case all the work called for under the Agreement is not completed before or upon the expiration of the time limit as set forth in paragraph 1 above, damage will be sustained by the City, and that it is and will be impracticable to detennine the actual damage which the City will sustain in the event of and by reason of such delay. It is therefore agreed that the Contractor will pay to the City the sum of Five Hundred Dollars ($500) per day for each and every day's delay beyond the time prescribed to complete the work; and the Contractor agrees to pay such liquidated damages as herein provided, and in case the same are not paid, agrees that the City may deduct the amount thereof from any money due or that may become due the Contractor under the Agreement. It is fu1iher agreed that in case the work called for under the Agreement is not finished and completed in all parts and requirements within the time specified, the City shall have the right to extend the time for completion or not, as may seem best to serve the interest of the City; and if it decides to extend the time limit for the completion of the Agreement, it shall fu1iher have the right to charge the Contractor, his or her heirs , assigns, or sureties, and to deduct from the final payment for the work, all or any part, as it may deem proper, of the actual costs and overhead expenses which are directly chargeable to the Agreement, and which accrue during the period of such extensions. The Contractor shall not be assessed with liquidated damages during any delay in the completion of the work caused by an act of God or of the public enemy, acts of the 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 begirming of such delay, notify the City in writing of the causes of delay. The City shall ascertain the facts and the extent of the delay, and its findings of the facts thereon shall be final and conclusive. 5. ST AND ARD OF CARE: Contractor agrees to perfonn all services hereunder in a manner commensurate with the prevailing standards oflike professionals in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced persormel who are not employed by the City nor have any contractual relationship with City. 6. INDEPENDENT PARTIES: City and Contractor intend that the relationship between them created by this Agreement is that of independent contractor. The manner and means of conducting the work are under the control of Contractor, except to the extent they are limited by statute, rule or regulation and the express tem1s of this Agreement. No civil service status or other right of employment will Stom1 Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20, 2016 be acquired by virtue of Contractor's services . None of the benefits provided by City to its employees , including but not limited to unemployment insurance , workers' compensation plans , v acation and sick leave are available from City to Contractor, its employees or agents . Deductions shall not be made for an y state or federal taxes , FICA payments, PERS payments, or other purposes normall y associated with an employer-employee relationship from any fees due Contractor. Payments of the above items, if required, are the responsibility of Contractor. 7. IMMIGRi\ TION REFORM AND CONTROL ACT {IRCA): Contractor assumes any and all responsibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal , or state rules and regulations . Contractor shall indemnify and hold City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Contractor. 8. NON-DISCRIMINATION: Consistent with City's policy that harassment and discrimination are unacceptable employer/employee conduct, Contractor agrees that harassment or discrimination directed toward a job applicant, a City employee, or a citizen b y Contractor or Contractor's employee on the basis of race , religious cre ed, color, national origin, ancestry , handicap , disability, marital status , pregnanc y, sex, age , o r sexual orientation will not be tolerated . Contrac tor agrees that an y and all v iolations of this provision shall constitute a mate rial breach of this Agreement. 9 . HOLD HARMLESS : Contrac tor shall, to the fullest extent allo w ed by la w, indemnify, defend, and hold harml ess the City and its officers, officials , agents , employees and volunteers against an y and all liability, claims, stop notices , actions , causes of action or demands whatsoever from and against any of them, including any injury to or death of any person or damage to property or other liability of an y nature, arising out of, pertaining to, or related to the performance of this Agreement by Contractor or Contractor's employees, officers, officials, agents or independent contractors . Contractor shall not be obligated under this Agreement to indemnify City to the extent that the damage is caused by the sole or active negligence or willful misconduct of City, its agents or employees. Such costs and expenses shall include reasonable attorneys' fees of counsel of City 's choice, expert fees and all other costs and fees of litigation . Contractor agrees to obtain executed indemnity agreements with provisions identical to those set forth here in these sections from each and every subcontractor or any other person or entity involved by, for, with, or on behalf of Contractor in the performance of this agreement. If Contractor fails to obtain such indemnity obligations from others as required here, Contractor agrees to be fully responsible according to the terms of this section. 10 . INSURANCE : Storm Drain Cleaning / CCTV Inspe ction Serv ic e s -Standard Agree m e nt October 20, 2016 On or before the commencement of the terms of this Agreement, Contractor shall furnish City with ce11ificates showing the type , amount, class of operations covered, effective dates and dates of expiration of insurance coverage in compliance with paragraphs I OA, B , C and D . Such certificates , which do not limit Contractor's indemnification, shall also contain substantially the following statement: "Should any of the abo ve insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty (30) days' advance written notice to the City of Cupertino by certified mail, "Attention: City Manager." It is agreed that Contractor shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company that is acceptable to City and licensed to do insurance business in the State of California. Endorsements naming the City as additional insured shall be submitted with the insurance certificates. A. COVERAGE : Contractor shall maintain the following insurance coverage : (1) \Yorkers' Compensation : Statutory coverage as required by the State of California . (2) Liabilitv: Commercial general liability cov erage in th e follo w in g minimum limits : Bodil y Injury: $1 ,000 ,000 each occurTence $2 ,000,000 aggregate -all other Property Damage: $500,000 each occurrence $1 ,000 ,000 aggregate If submitted, combined single limit policy w ith aggregate limits in the amounts of $2,000,000 will be considered equivalent to the required minimum limits shown above. (3) Automotive: Comprehensive automobile liability coverage in the following minimum limits: Bodily injury: $500 ,000 each occurrence Property Damage: $500 ,000 each occurrence or Combined Single Limit: $1,000 ,000 each occurrence B . SUBROGATION \VAIVER: Contractor agrees that in the event of loss due to any of the perils for which it has agreed to provide comprehensive general and automotive liability insurance, Contractor shall look solely to its insurance for recovery . Contractor hereby grants to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Contractor or City with respect to the services of Contractor herein, a waiver of any right to subrogation which any such insurer of said Contractor may acquire against City by virtue of the payment of any loss under such msurance. Storm Drain Cleaning / CCTV Inspection Se rv ices -Standard Agreement October 20 , 2016 C. FAIL URE TO SECURE: If Contractor at any time during the tenn hereof should fail to secure or maintain the foregoing insurance, City shall be permitted to obtain such insurance in the Contractor's name or as an agent of the Contractor and shall be compensated by the Contractor for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid . D. ADDITIONAL INSURED: City, its City Council , boards and commissions, officers, employees, and volunteers shall be named as an additional insured under all insurance coverages, except worker's compensation insurance. The naming of an additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured . An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy. E . SUFFICIENCY OF INSURANCE: The insurance limits required by City are not represented as being sufficient to protect Contractor. Contractor is ad v ised to consult Contractor's insurance broker to determine adequate cov erage for Contractor. 11 . BONDS : N o bonds are required . 12 . PROHIBITION AGAINST TR.\NSFERS : Contractor shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein , directly or indirectly, b y operation of law or otherwise, without prior written consent of City. Any attempt to do so without said consent shall be null and void, and any assignee , sub lessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer . However, claims for money by Contractor from City under this Agreement may be assigned to a bank, trust company or other financial institution without prior written consent. Written notice of such assignment shall be promptly furnished to City by Contractor. The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate member or cotenant, if Contractor is a partnership or joint venture or syndicate or co tenancy, which shall result in changing the control of Contractor, shall be construed as an assignment of this Agreement. Control means fifty percent (50%) or more of the voting power of the corporation. 13. SUBCONTRACTOR APPROVAL : Unless prior written consent from City is obtained, only those people and subcontractors whose names are listed in Contractor's bid shall be used in the performance of this Agreement. Requests for additional subcontracting shall be submitted in writing, describing the scope of work to be subcontracted and the name of the proposed subcontractor. Such request shall set Storm Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20, 2016 forth the total price or hourly rates used in preparing estimated costs for the subcontractor's services . Approval of the subcontractor may, at the option of City, be issued in the form of a Work Order. In the event that Contractor employs subcontractors, such subcontractors shall be required to furnish proof of workers' compensation insurance and shall also be required to carry general and automobile liability insurance in reasonable conformity to the insurance carried by Contractor. In addition, any work or services subcontracted hereunder shall be subject to each pro v ision of this Agreement. 14. PER.iVIITS AND LICENSES : Contractor, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits , certificates and licenses , including a City Business License , that may be required in connection with the performance of services hereunder. 15. REPORTS : Each and every report, draft, work product, map , record and other document reproduced, prepared or caused to be prepared by Contractor pursuant to or in connection with this Agreement shall be the exclusive property of City. Consultant may retain a copy of any report furnished to the City pursuant to this Agreement. No report, information nor other data gi v en to or prepared or assembled by Contractor pursuant to this Agreement shall be made available to any individual or organization b y Contractor without prior approval by City. Contractor shall, at such time and in such form as City may require, furnish reports concerning the status of services required under this Agreement. 16. RECORDS : Contractor shall maintain complete and accurate records with respect to sales, costs , expenses, receipts and other such information required by City that relate to the performance of services under this Agreement. Contractor shall maintain adequate records of services provided in sufficient detail to permit an evaluation of services . All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Contractor shall provide free access to such books and records to the representatives of City or its designees at all proper times, and gives City the right to examine and audit same, and to make transcripts therefrom as necessary, and to allow inspection of all work, data, documents, proceedings and activities related to this Agreement. Such records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained for a period of three (3) years after receipt of final payment. If supplemental examination or audit of the records is necessary due to concerns raised by City's preliminary examination or audit of records, and the City's supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of contract or failure to act in good faith , then Contractor shall reimburse City for all reasonable costs and expenses associated with the supplemental examination or audit. Storm Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20 , 2016 17 . NOTICES : All notices , demands , requests or appro v als to be given under this Agreement shall be given in writing and conclusively shall be deemed served when delivered personall y or on the second business day after the deposit thereof in the United States Mail , postage prepaid, registered or certified, addressed as hereinafter provided . City at: All notices , demands , requests , or approvals from Contractor to City shall be addressed to City of Cupertino 10300 Torre Avenue Cupertino CA 95014 Attention : Roger Lee, Assistant Director of Public Works All notices, demands , requests , or approvals from City to Contractor shall be addressed to Contractor at: Ro+o -K.oo+er 5c:,......,+¼, c..Jo.rCA., cA o/0050 A,-+ ,v : BC ; (.\....., i3 r; s to I I V p 18 . URBAN RUNOFF MANAGEMENT: The Contractor shall avoid creating excess dust when breaking asp halt or concrete and during excav ation and grading . If water is used for dust control , contractor shall use as little as necessary. Contractor shall take all steps necessary to keep wash water out of the streets , gutters and storm drains . The Contractor shall develop and implement erosion and sediment control to prevent pollution of storm drains . Such control includes but is not limited to : A. Use storm drain inlet protection devices such as sand bag barriers , filter fabric fences , block and ·gravel filters. (Block storm drain inlets prior to the start of the rainy season (October 15), in site de-watering activities and saw-cutting activities; shovel or vacuum saw-cut slurry and remove from the site). B. Cover exposed piles of soil or construction material with plastic sheeting . All construction materials must be stored in containers . C. Sweep and remove all materials from paved surfaces that drain to streets , gutters and storm drains prior to rain as well as at the end of the each work day. At the completion of the project, the street shall be washed and the wash water shall be collected and disposed of offsite in an appropriate location . D. After breaking old pavement, Contractor shall remove all debris to avoid contact with rainfall or runoff. E . Contractor shall maintain a clean work area by removing trash, litter, and debris at the end of each work day . Contractor shall also clean up any leaks , drips , and other spills as they occur. The objecti ve is to ensure that the City and County of Santa Clara County-Wide Clean Storm Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20, 2016 Water Program is adequately enforced. These controls should be implemented p1ior to the sta1t of construction, up-graded as required , maintained during construction phases to provide adequate protection, and removed at the end of construction . These recommendations are intended to be used in conjunction with the States Best Management Practices Municipal and Construction Handbooks , local program guidance materials from municipalities , Section 7.1.01 of the Standard Specifications and any other appropriate documents on storm water quality controls for construction. Failure to comply with this program will result in the issuance of noncompliance notices , citations, project stop orders or fines. The fine for noncompliance of the above program is two hundred and fifty dollars ($250.00) per occurrence per day. The State under the Federal Clean Water Act can also impose a fine on the contractor, pursuant to Cal. Water Code '13385 . 19. TERMINATION: In the event Contractor fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Contractor shall be deemed in default in the performance of this Agreement. If such default is not cured within a period of two (2) days after receipt by Contractor from City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, City may terminate the Agreement forthwith b y giving to the Contractor written notice th e reof. City shall have th e option, at its sole di sc r etion and without cause, of te1minating thi s Agreement by giving se v en (7) days' prior written notice to Contractor as pro vided herein . Upon termination of this Agreement, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination . 1. COMPLIANCES : Contractor shall compl y with all laws , state or federal and all ordinances, rules and regulations enacted or issued b y City . Consultant shall comply with all state or federal laws and all ordinances, rules and regulations enacted or issued by City . A. PREVAILING WAGES: To the extent applicable, Contractor shall comply with the City's Labor Compliance Program and all other requirements set forth in Labor Code section 1770 et seq. Contractor shall pay prevailing wages. Contractor will submit monthly certified payroll records to the City for all employees and subcontractors in a preapproved format or a City provided form . Any delay in remitting certified payroll reports to the City upon request from the City will result in either delay and/or forfeit of outstanding payment to Contractor. B. WORKING DAY: To the extent applicable, Contractor shall comply with California Labor Code Section 1810, et seq. which provides that work performed by employees of contractors in excess of 8 hours per day, and 40 hours during any one week, must be compensated as overtime, at not less than 1 ½ times the basic rate of pay. Storm Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20 , 2016 C. PAYROLL RECORDS : To the extent applicable, Contractor shall comply with California Labor Code Section 1776 which requires certified payroll records be maintained with the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed by him or her in connection with this Agreement. The Payroll Records shall be made available for inspection as provided in California Labor Code Section 1776 . D. APPRENTICES: To the extent applicable, Contractor shall comply with California Labor Code Section 1777 .5 regarding apprentices. 21. CONFLICT OF LAW: This Agreement shall be interpreted under, and enforced by the laws of the State of California excepting any choice of law rules which may direct the application of laws of another juris diction . The Agreement and obligations of the patties ar e subject to all v alid laws , orders , rules , and regulations of the authorities ha ving jurisdiction over this Agreement ( or the successors of those authorities .) Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Santa Clara, State of California . 22. ADVERTISEMENT: Contractor shall not post, exhibit, display or allow to be posted, exhibited , displa ye d any signs , advertising, show bills , lithographs , posters or cards of any kind pertaining to the services performed under this Agreement unless prior written appro val has been secured from City to do otherwise . 23 . \V AIYER: A waiver by City of any breach of any term , covenant, or condition contained herein, shall not be deemed to be a waiver of any subsequent breach of the same or any other term , covenant, or condition contained herein, whether of the same or a different character. 34 . INTEGRI\. TED CONTRACT : This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both City and Contractor. 25. INSERTED PROVISIONS: Each provision and clause required by law to be inserted into the Agreement shall be deemed to be enacted herein, and the Agreement shall be read and enforced as though each were Storm Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20 , 2016 included herein. If through mistake or otherwise, any .su ch pro v ision is not inserted or is not correctly inserted , the Agreement shall be amended to make such inse11ion on app lication by either par1y. 46 . CAPTIONS: The captions in this Agreement are for conv enience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or pro v isions of this Agreement. Storm Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20, 2016 P.O. No.: 'U>l '"1", ~ ?;-J,-, fN WITNESS WHEREOF, th e parties ha ve caused the Agreement to be executed on the da y and year first above written. CONTRACTOR ROTO-ROOTER By g_:_, //i:Y ~ Title ti,' c.. e... Pr et}~ J e. ,.J+ Date /' -/ O -c2 o , Cc CITY OF CUPERTINO A Municipal Corporation RECOMMENDED FOR APPROVAL: B ~ 9"" Q ~ ,, S\s>:<:>-s:-..o ,--yy---......, T1tle_s_,. eJr:\.b\ o@c "'~ "'1:c c\r\ APPROVED AS TO FORM: By .hJ :.;;.:::-. City Attorney City Clerk ~ Contract Amount: Lf' !}1-/-D. /JD AccountNo .: /dV·Z6,21~ 1ZflJ.17J;r ye #-U L1--;;~:}- Storm Drain Cleaning / CCTV Inspection Services -Standard Agreement October 20 , 2016 OFF ICE 195 Mason Circle, Concord , California 94520 • FAX (925) 798 -1852 OFFICE 356 Mathew Street. Santa Clara , CA 95050 • FAX (408) 987 -0474 0.!!!~7N C LE AN IN G ELE CTRICALLY Walnut Creek, Lafayette , Orinda , Danville , San Ramon (92 5) 939 -3100 Los Gatos (408 ) 354-2324 Co nco rd , Pleasant Hill , Ma rt inez (9 25 ) 798 -2122 San Jose, Santa Cla ra (408 ) 727 -9850 • SEPTIC TAN K S PUMPED, A LSO IN STA LLED Pittsburg, West Pittsburg (9 25 ) 439 -9100 Milpitas (408 ) 263 -7411 • SEW ERS, STOR M & YA RD DRAI NS IN STA LLED Pinole, Hercules , Rodeo , Crockett (510 ) 758-8100 Gilroy, Morg an Hill (408 ) 842 -9744 • RADI O DI SPAT C HE D SERVI C E Antioch, Oak ley, Brentwood , Discovery Bay (9 25) 754-8866 Hollister / San Juan Bau tista (831) 636 -0655 Proposal Schedule City of Cupertino Storm Drain Cleaning/ CCTV Inspection Services Contractor to provide a proposal that details a schedule of hourly costs for ALL personnel and ALL equipment likely to be used to meet the intent of the scope of services. City to pay only for personnel and equipment actually used to the nearest hour of use (no minimums). For City to determine lowest cost, City will evaluate the proposal of hourly costs for personnel and equipment for the following typical crew: PERSONNEL EQUIPMENT $/HOUR # of HOURS TOTAL (AxB) (A) (B) (1) Operator $110.00 8 $880.00 (2) Laborers $90.00 8 $72 0 .00 Flusher Truck $110.00 8 $880.00 Vacu u m Truck $110 .00 8 $88 0.00 Video Inspection $110.00 8 $88 0.00 Vehicle GRAND TOTAL: $_$4,240.00_ This schedule and Contractor proposal will be an exhibit t o the agreement to the selected Contractor. iJ ~ / ~-~-_/ Lc· l -f 7' ., ;z 5 2 ~-6.3 7 7 1-800-GET-ROTO November 8, 2016 RESIDENTI A L -MUNICIPAL -INDUSTRIAL -PLUMBING OR DR A IN CLEAN I NG OVERM-1 OP ID : SP ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM /DD NYYY) ~ 11/10/2016 THIS CERTIFICATE IS ISSUED AS A MATIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW . THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ~~~?CT Certificate Department Legacy Risk & Insurance Svcs r.:JfNNE,, Ext I · 925-482-1000 !FAX 925-482-1001 CA License #OH66758 fA/C Nol : 1850 Mt. Diablo Blvd, Ste #400 !o~~~ss certificates@llegacyrisk.net Walnut Creek, CA 94596 Chris Lang, CPCU, ARM INSURE RISI AFFORDING COVERAGE NAIC # INSURER A : Navigators Specialty Ins Co 36056 INSURED Overmiller lnc.Dba:Roto Rooter INSURER B : Depositors Insurance Company 42587 Sewer Service, Fast Flow Inc. INSURER C : Starr Indemnity & Liabiillty 38318 OBA Roto Rooter Sewer Service 195 Mason Circle INSURER D : Cypress Insurance Company 10855 Concord, CA 94520 INSURER E : Nationwide Mutual ins Co 23787 INSURER F : COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED . NOTWITHSTANDING ANY REQUIREMENT , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MA Y HA VE BEEN REDUCED BY PAID CLAIMS . INSR "' " ,i2lilE~i POLIC Y EXP LTR TYPE OF INSURANCE •••~M '"'V D POLIC Y NUMBER (MM IDDNYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -CJ CLAIMS -MADE 0 OCCU R U"M"'-'" \ Y1 """, c:u X X SF16CG L145 489 1C 10/01/2016 10/01/2017 PREMISES Ea occurrence ) $ 50,000 $10,000 Bl/PD 1-- MED EX P (An y one perso n) $ excludec Deductible/Occ PE RSONAL & ADV INJUR Y $ 1,000,00C 1-- GEN'L AGGR EGATE LIMIT APPLI ES PER : GENE RA L AGGREGATE $ 2,000,00C =l 0 PR O· D LOC PRODUCTS -COMP/OP AGG $ 2,000 ,000 POLICY JEC T OTHER: $ AUTOMOBILE LIABILITY /"'"'"'"" COMBINED SINGLE LI MIT $ 1,000,000 fEa accidentl B x ANY AUTO 10/01/2016 10/01/2017 BODILY INJURY (Per person ) $ 1--ALL OWNED -SCH EDULED AUTOS AUTOS BODILY INJU RY (Per accident ) $ x x NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS fs~6~1'ooo f Pe r accidentl x Comp/Coll x $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ 2,000,00C 1-- 2,000,000 C X EXCESS LIAB CLA IMS-M AD E 1000023105 10/01/2016 10/01/2017 AGGREGATE $ X DED I I RETENTION $ NIL $ WORKERS COMPENSATION X I ~ffTUTE I I UTH, AND EMPLOYERS ' LIABILITY ER D Y/N OVWC702528 10/01/2016 10/01/2017 1,000,000 ANY PR OPRIETO R/PARTNE R/EXECUTI VE D E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED ? N/A (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,00C If yes . describe und er E.L. DISEASE -POLIC Y LIMIT $ 1,000,00C DESCRIPT IO N OF OPER AT ION S bel ow E Equipment Floater ACP3007930862 10/01/2016 10/01/2017 Rented Eq 125,00C E Crime ACP30079J0862 10/01/2016 10/01/2017 Limit 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedu le, may be attached if mor e space Is required) RE: Work performed b~ written contract. ADDITIONAL INSURED(s) as respects to General Liability (ongo and Auto: City of Cupertino, its City Council, boards commissions, officers, emplo;ees, and volunteers. Primary endorsement applies to General Liability. Waiver o subrogation applies to General, Auto and Workers Comp. CERTIFICATE HOLDER CANCELLATION CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS . Public Works Department AUTHORIZED REPRESEN TAT IVE 10300 Torre Ave ~ Cupertino, CA 95014-3255 ~i+-I © 1988-2014 ACORD CORPORATION . All rights reserved . NOTEPAD 1NSUREo·s NAME Overmiller lnc.Dba:Roto Rooter OVERM-1 OP ID : SP **THE FOLLOWING ENDORSEMENTS APPLY ONLY AS INDICATED IN THE DESCRIPTION OF OPERATIONS .** GENERAL LIABILITY *Additional insured if required by written contract form CG20380413 (ONGO) *Additional insured if required by written contract form CG20370413 (COOP) *Waiver of Subrogation if required by written contract form CG24040509 *Coverage is Primary if required by written contract form CG20010413 !AUTOMOBILE LIABILITY *Additional Insured if required by written contract form AC01020310 *Waiver of Subrogation if required by written contract form AC0101A0310 WORKERS COMPENSATION *Waiver of Subrogation if required by written contract form WC990410B-0914 *10 days notice for nonpayment of premium PAGE 2 Date 11/10/2016 Insured: Overmille :-Inc. dba Rota Rooter Sewe!"" Service Policy No .: SF16CGL145489 I C COMMERCIAL GENERAL LIABILITY CG 20 38 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY . ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured : 1 . Any person or organization for whom you are performing operations when yo u and such person or organization ha ve agreed in wr iting in a contract or agreement that such person or organization be added as an additional ins ure d on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1 . above . Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part , by : a . Your acts or omissions ; or b . The acts or omissions of those acting o n your behalf; in the performance of your ongoing operations for the additional insured . However, the insurance afforded to such additional insured described above: a . Only applies to the extent permitted by law ; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured . A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed . rr:. .,n 'lQ n.t 1 'l B. With respe ct to the insurance afforded to the se additional insureds , the following additional exclusions apply : This insu ran ce does not apply to : 1 . "Bodily injury", "property damage" or "personal and advertisi ng injury" arising out of th e rendering of, or the failure to render , any professional architectural, engineering or surveying services , including : a . The preparing , approving , or failing to prepare or approve , maps , shop drawings , opinions , reports , surveys , field orders , change orders or drawings and specifications ; or b. Supervisory , inspection , architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision , hiring , employment, training or monitoring of others by that insured , if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render , any professional architectural , engineering or surveying services . 2 . "Bodily injury" or "property damage" occurring after: a . All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service , maintenance or repairs ) to be performed by or on behalf of the additional insured(s ) at the location of the covered operations has been completed; or b . That portion of "your work" out of wh ich the injury or damage arises has been put to its intended use by any person or organization other than anothe r contractor or s ubco ntrac tor engaged in perfo rming operations for a principal as a part of the same project. C . With respect to the insurance afforded to these additional insureds , the following is added to Section Ill -Limits Of Insurance : The most we will pay on behalf of the additio nal insured is the amount of insurance : 1. Required by the contract or agreement described in Paragraph A.1 .; or 2 . Available under the applicable Limits of Insurance shown in the Dec la ra tio n s; whichever is le ss . This end ors ement shall no t inc rease the applicable Limits of Insurance shown in the Declara tions . IP\ 1....,,,.., ,,..,.,..,,...,... c ........ ,;,...,...,.. nu; .... ,.. 1 ..... ,... ,..,n 1 ,; Insured: Overmiller Inc . dba R~to Roo ter Sewer Service Policy No.: Sfl5CSL1454S9IC COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY . PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCT S/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured . (1) The additional insured is a Named Insured under such other insurance ; and rr.. ?n n1n,11'\ If.\ ln c:rrr,:,nrQ C::.,.n,i rQc: (')ff,,...,. lnr ?()1? p,.,,., 1 nf 1 Insured: Cvermiller Inc. dba Rote Rooter Sewer Servi~e Pclicy No SF16CGL145433IC COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization : ANY PERSON OR ORGANIZATION WHEN YOU AND SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR AGREEMENT THAT YOU WILL WAIVE ANY RIGHT OF RECOVERY AGAINST SUCH PERSON OR ORGANIZATION . Informatio n required to complete this Schedule , if not shown above , wil l be shown in the Declarations . The followin g is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recove ry we may ha ve against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. r, Icsu re d: Overmiller Inc. dba Rote Rooter Sewer Serv1=e ?olicy No.: J\CPJ007930.962 COMMERCIAL AUTO AC 70 05 03 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO PROTECTION -GOLD This endorsement modifies insurance provided under the following : BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A. Effect of This Endorsement B. Newly Acquired or Formed Entities C . Employees as Insureds -Nonowned Autos D . f\c{dTtional In su re~ by Contract, Permit or Agreement E . Supplementary Payments -Bail Bonds F. Supplementary Payments -Loss of Earnings G . Personal Effects and Property of Others Extension H . Prejudgment Interest Coverage I. Fellow Employee -Officer, Managers and Supervisors J . Hired Auto Physical Damage K . Temporary Substitute Autos -Physical Damage Coverage L. Expanded Towing Coverage M . Auto Loan or Lease Coverage N. Original Equipment Manufacturer Parts -Leased Private Passenger Types 0 . Deductible Amendments P. Rental Reimbursement Coverage 0 . Expanded Transportation Expense R. Extra Expense -Stolen Autos S . Physical Damage Limit of Insurance T . New Vehicle Replacement Cost U . Physical Damage Coverage Extension V. t r~~'sJe'r <;>f Rig'ht_s <5{FfE3cqy~ry Agai~si Others To Us W . Section IV -Business Auto Conditions -Notice of and Knowledge of Occurrence X . Hired Car Coverage Territory Y. Emergency Lock Out Z . Cancellation Condition AC70050316 Includes copyrighted material of Insuran ce Services Office , Inc . with its permission Page 1 of 7 COMMERCIAL AUTO AC 70 05 03 16 A . EFFECT OF THIS ENDORSEMENT Co vera ge pro v ided unde r this poli cy is modified by the provisions of this endorsement. If there is any conflict between the provis ions of this endorsement and the provision(s) of any state - specific endorsement also attached to this poli - cy , then the provision(s) of the state-specific endorsement shall apply instead of the provi - sions of this endorsement that are in conflict , but only to the extent of the conflict, and only to the extent necessary to bring such provisions into conformance with the state requirement(s) contained in the provision(s) of the state-specific endorsement. B . NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include any organization you newly acquire or form, other than a partnership , joint venture , or limited liability company , an d ov er which yo u maintain ownership or majority (more than 50 %) interest ; if there is no other simila r in- surance available to that organi zation . Coverag e under thi s provis ion is afforded un ti l the 180 th day after you acquire or form the organization or the end of the policy period , whiche ver is later. C. EMPLOYEES AS INSUREDS -NONOWNED AUTOS The following is added to paragraph A.1. Who Is An Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE : d. Any "employee" of yours is an "insured " while using a covered "auto" you don't own , hire or borrow in your business or your per- sonal affairs . l>,.f;A.i5oft1 6.NA9.J ~~·Q:~$J>. ,~y {~2~TM ~t!· !PERMIT;OR)\GREEMENT, "i:,.J;; . ..;,:~,.,..,.,.,~.nJl:""Nw.-.ll4'»,:>/4:S...,1.d~k1,.:....,, .• ,.,.;,:,;;.u,1,..:,, The following is added to A.1 . Who Is An In - sured of SECTION II -COVERED AUTOS LIABILITY COVERAGE : Any person or organization that you are re - quired to name as an additional insured in a written contract or agreement that is executed or signed by you prior to a "bodily injury" or "property damage " occurrence is an "insured " for Covered Auto L iability coverage . How- ever , with respect to covered "autos ", such person or organization is an insured only to the extent that person or organi zation qualifie s as an "insured " under A.1 . Who is an Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE : If specifically required by the written contract or agreement referenced in the paragraph abo ve , any coverage provided by this endorsement to an add itional insured shall be pr imary and any other val id and collectible insurance avail - able to the additional insured shall be non- contributory with this insurance . If the written contract does not require this coverage to be primary and the additional insured 's coverage to be non -contributory , then this insurance will be excess over any other valid and collectible insur- ance available to the additional insured . E. SUPPLEMENTARY PAYMENTS BAIL BONDS Supplementary Payments of SECTION 11 - COVERED AUTOS LIABILITY COVERAGE is revised as follows : (2) Up to $2 ,500 fo r co st of bail bond s (inclu din g bonds for relat ed traffi c law violations ) required be cause of an "acciden t" we cove r. We do not ha ve to furnish these bonds . F. S UP PLEMEN TAR Y PAY M ENTS -LO SS OF EARNINGS Supplementary Payments of the SECTION 11 - COVERED AUTOS LIABILITY COVERAG E is revised as follo ws: ( 4) All reasonable expenses incurred by the "in - sured " at our request , including actual loss of earnings up to $500 a day because of time off from work . G. PERSONAL EFFECTS AND PROPERTY OF OTHERS EXTENSION 1. The . Care, Custody or Control Exclusion of SECTION II COVERED AUTOS LIABILITY COVERAGE , does not apply to "property damage" to property , other than your property, up to an amount not exceed - ing $250 in any one "accident". Coverage is excess over any other valid and collectible insurance. 2. The following paragraph is added to A.4 . Coverage Extensions of SECTION 111 - PHYSICAL DAMAGE COVERAGE : c. We will pay up to $500 for your property that is lost or damaged as a result of a covered "loss", without applying a de - ductible . Coverage is excess over an y other valid and collectible insurance . Pag e 2 of 7 Incl udes co pyrig ht ed materi al of Ins urance Serv ices Offi ce , Inc . with its permi ss io n A C 7 0 05 03 16 COMMERCIAL AUTO AC 70 05 03 16 ously title d and which you purc hased le ss than 365 days before the date of the "los s". U . PHYSICAL EXTENSIONS DAMAGE COVERAGE Under SECTION Ill -PHYSICAL DAMAGE COVERAGE , A. Coverage , Coverage Exten - sions , b. Loss of Use Ex penses is replaced by the following : b. Loss of Use Expenses For Hired Auto Phys ical Damage , we will pay expenses for which an "insured " be - comes legally responsible to pay for loss of use of a vehicle rented or hired without a driver , under a written rental contract or agreement. We will pay for loss of use ex - penses if caused by : ( 1) Othe r than collision if the Declarations indicate that Comprehensive Coverage is provide d for any co vered "auto "; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Co verage is provided for any covered "auto "; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto ." However , the most we will pa y for any expenses for loss of use is $50 per day , to a maximum of $1 ,500 . The insurance provided by this provision is excess over any other collectible insurance . V . TRANSFE'r{ OF 'RIGHTS OF RECOVERY AGAIN.ST OTHE!!S !O ~S The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition : We waive any right of recovery we may have against any person or organization to the extent required of you by a written con - tract executed prior to any "accident" be - cause of payments we make for damages under this coverage form . W . NOTICE OF AND KNOWLEDGE OF OCCURRENCE SECTION IV -BUSINESS AUTO CONDITIONS , Paragraph A is amended as follows : 6 . NOTICE OF AND KNOWLEDGE OF OCCURRENCE a. Your obligati o n in the Duties in the Event of Accident , Claim, Suit or Loss Condi - tion relative to not ific ation requirements applies only when the "accident" or "loss" is known to : (1) You , if you are an individual ; (2) A partner, if you are a partnership ; (3) A member, if you are a limited liability company ; or ( 4 ) An executive officer or insurance manager, if you are a corporation . b. Your obligation in the . Duties in the Event of Accident , Claim , Suit or Loss Condition relative to providing us with documents concerning a claim or "suit" will not be considered breached unless the breach occurs after suc h claim or "su it" is know n to: (1) You, if you are an indi vidual; (2) A partner , if you are a partnership ; (3 ) A member, if you are a limited liability company ; or ( 4) An execu ti ve officer or insurance manager, if you are a corpo ration . X . HIRED CAR -COVERAGE TERRITORY Item (5) of the Policy Period , Coverage Te rritory General Conditions is replaced by the following : (5) Anywhere in the ¼Orld if a covered "auto" is leased , hired , rented or borrowed without a driver for a period of 30 days or less ; and Y. EMERGENCY LOCKOUT We will reimburse you up to $100 for reasonable expense incurred for the services of a locksmith to gain entry into your covered "auto " subject to these provisions : 1. Your door key , electronic key or key entry pad has been lost, stolen or locked in your covered "auto " and you are unable to enter such "auto " , or 2. Your keyless entry device battery dies and you are unable to enter such "auto" as a re - sult , 3. Your key , electronic key or key entry pad has been lost or stolen and you have changed the lock to prevent an unauthorized entry ; and Page 6 of 7 Includes copyrighted material of In surance Services Offic e , Inc with its permission. AC 70 05 0 316 In sured : Overmiller Inc . dba Roto Rooter Sewer Service t'~)l:cy ,'o . · ACPJJ079J0862 COMMERCIAL AUTO CAOO 011013 BUSINESS AUTO COVERAGE FORM Various prov1s1ons in this policy restrict coverage . Read the entire policy carefully to determine rights , duties and what is and is not covered. SECTION I -COVERED AUTOS Item Two of the Declarations shows the "autos" that are covered "autos" for each of your coverages . The following numerical symbols describe the "autos" that may be covered "autos". The symbols entered next to a coverage on the Declarations designate the only "autos" that are covered "autos". Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations . The words "we", "us" and "our" refer to the company providing this insurance . Other words and phrases that appear in quotation marks have special meaning . Refer to Section V - Definitions . A . Description Of Covered Auto Designation Symbols Svmbol Description Of Covered Auto DesiQnation Svmbols 1 Any "Auto" 2 Owned "Autos" Only those "autos" you own (and for Covered Autos Liability Coverage any Only "trailers" you don't own while attached to power units you own ). This includes those "autos" you acquire ownership of after the policy beqins . 3 Owned Private Only the private passenger "autos" you own. Th is inc ludes those private Passenger passenger "autos" you acquire ownership of after the policy begins . "Autos" Only 4 Owned Only those "autos" you own that are not of the private passenger type (and for "Autos" Other Covered Autos Liability Coverage any "trailers" you don't own while attached to Than Pri vate power units you own). This includes those "autos" not of the private passenger Passenger type you acqu ire ownership of after the policy begins . "Autos" Only 5 Owned "Autos" Only those "autos" you own that are required to have no-fault benefits in the state Subject To where they are licensed or principally garaged . This includes those "autos" you No-fault acquire ownership of after the policy begins provided they are required to have no - fault benefits in the state where they are licensed or principally garaged . 6 Owned "Autos" Only those "autos" you own that because of the law in the state where they are Subject To A licensed or principally garaged are required to have and cannot reject Uninsured Compulsory Motorists Coverage . This includes those "autos" you acquire ownership of after the Uninsured policy begins provided they are subject to the same state uninsured motorists Motorists Law requirement. 7 Specifically Only those "autos" described in Item Three of the Declarations for which a Described premium charge is shown (and for Covered Autos Liability Coverage any "trailers" "Autos" you don't own while attached to any power unit described in Item Three). 8 Hired "Autos" Only those "autos" you lease, hire , rent or borrow. This does not include any "auto" Only 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 households . 9 Non -own ed Only those "autos" you do not own , lease , hire, rent or borrow that are used in "Autos" Only connection with your business . This includes "autos" owned by your "employees", partners (if you are a partnership ), members (if you are a limited liability company) or members of their households but only while used in your business or your personal affa irs . CAOO 0110 13 © Insurance Services Office , In c ., 2011 Page 1 of 12 4 . Loss Payment -Physical Damage Coverages At our option , we ma y: a . Pay for , repair or replace damaged or stolen property ; b . Return the stolen property , at our expense . We will pay for any damage that results to the "auto" from the theft; or c . Take all or any part of the damaged or stolen property at an agreed or appraised value . If we pay for the "loss", our payment will include the applicable sales ta x for the damaged or stolen property . 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another , those rights are transferred to us . That person or organi za tion must do everything necessary to secure ou r rights and must do nothing after "accident" or "loss" to impair them. B . Ge neral Condition s 1 . Bankruptcy Bankruptcy or insolvency of the "insured " or the "insured's" estate will not relieve us of an y obligations under this Coverage Form . 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured", at any time, intentionally conceals or misrepresents a material fact concerning : a. This Coverage Form; b . The covered "auto"; c . Your interest in the covered "auto"; or d . A claim under this Coverage Form . 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. 4. No Benefit To Bailee -Physical Damage Coverages We will not recognize any assignment or gran t any coverage for the benefit of any person or organization holding , storing or transporting property for a fee regardless of any other provision of this Coverage Form . 5. Other Insurance a . For any covered "auto" you own , this Coverage Form provides primary insurance . For any covered "auto" you don't own, the insurance provided by this Coverage Form is excess over any other collectible insurance. However , while a covered "auto" which is a "trailer" is connected to another vehicle , the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is : (1) Excess while it is connected to a motor vehicle you do not own ; or (2) Primary while it is connected to a covered "auto" you own . b . For Hired Auto Physical Damage Coverage , any covered "auto" you lease , hire , rent or borrow is deemed to be a covered "auto" you own . However, any "auto" that is leased , hired , rented or borrowed with a driver is not a covered "auto". c. Regardless of the provisions of Paragraph a. above , thi s Coverage Form's Covered Autos Liability Coverage is primary for any liability assumed unde r an "insured contract". d . When this Coverage Form and any other Coverage Form or policy covers on the same bas is , either excess or pri mary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis . 6 . Premium Audit a . The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began . We will compute the final premium due when we determine your actual exposures . The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance , if any. The due date for the final premium or retrospective premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due , the first Named Insured will get a refund . b . If this policy is issued for more than one year , the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of ea c h year of the policy. CA OO 011013 © Insuran ce Services Office , In c ., 2011 Page 9 of 12 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04108 (Ed . 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the rig ht to recove r our payments from anyone liable for an injury covered by th i s policy . We will n ot enforce our right against the person or organ ization named in the Schedule . (This agreement appl i es only to the e xtent th at you perform work under a written con tra c t that requires you to obtain this agreement from us .) The additional premium for this endorsement shall be 2 % of the total manual p remium otherwise d ue on su ch remunera ti on . The minimum premium for this endorsement is $350 . This agreement sha ll not operate d i rectly or indirectly to benefit anyone no t named in the Schedule BLANKET WAIVER Perso n /0 rga n izatio n Job Description All CA Operations SCHEDULE B l anket Waive r -Any pe rson or organizati on for whom the Named In sured has agreed by written co ntract to furnish this waive r . Waiver Premium This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated . (The information below is required only when this endorsement is issued subsequent to preparation of the policy .) Endorsement Effective l O / O l / 2 O 16 Policy No . OVWC702 .528 Insured Overmiller Inc. dba Reta Rooter 8-e 1.v'=:-Service Endorsement No . Premium$ Insurance Company Cypress Insu rance Company WC 99 04 108 (Ed . 9-14) Countersigned by _______________ _