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19-139 AIMS Companies, Storm Drain Cleaing CCTV Inspection Services Project RECORDING REQUESTED BY: City of Cupertino 24424910 Regina Alcomendras Santa Clara County - Clerk-Recorder WHEN RECORDED,MAIL TO: 03/09/2020 12:29 PM Titles: 1 Pages: 2 City Clerk's Office Fees: 0.00 Taxes: 0 City of Cupertino Total: 10.00 10300 Torre Avenue ®ill FAS JI'XXVaJA SKIWI'44 Cupertino, CA 95014-3255 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NO FEE IN ACCORDANCE WITH GOV. CODE 27383 NOTICE OF COMPLETION CITY PROJECT NAME: Storm Drain Cleaning and CCTV Inspection Project No. 2019-107 Original 0 Conformed Copy Recording Requested By: The City of Cupertino When Recorded Mail To: <name, title> Cupertino City Hall 10300 Torre Avenue Cupertino, CA 95014 EXEMPT FROM RECORDING FEES PER GOVERNMENT CODE §§6103, 27383 SPACE ABOVE THIS LINE IS FOR RECORDER'S USE NOTICE OF COMPLETION Civil Code§§ 8182, 8184, 9204, and 9208 NOTICE IS HEREBY GIVEN THAT: 1. The undersigned is the agent of the owner of the Project described below. 2. Owner's full name is the City of Cupertino ("City") 3. City's address is 10300 Torre Avenue, Cupertino, CA 95014. 4. The nature of City's interest in the Project is: _Fee Ownership _Lessee X Other: Right-of-Way 5. Construction work on the Project performed on City's behalf is generally described as follows: Storm Drain Cleaning and CCTV Inspection 6. The name of the original Contractor for the Project is: AIMS Companies 7. The Project was accepted as completed on: 2/20/2020 8. The Project is located at: City of Cupertino, Various Locaitons Verification: In signing this document, 1, the undersigned, declare under penalty of perjury under the laws of the State of California that I have read this notice, and I know and understand the contents of this notice, an hat the facts stated in this notice and correct. 2 J U Date nd Place - Si nat�ure /J Ile Name and Title Storm Drain Cleaning/CCTV Inspection Services Project NOTICE OF COMPLETION Project Number 2019-107 Page 111 Contract This public works contract ("Contract") is entered into by and between the City of Cupertino ("City"), a municipal corporation, and AIMS Companies ("Contractor'), for work on the Storm Drain Cleaning/CCTV Inspection Services Project ("Project"). The parties agree as follows: 1. Award of Contract. In response to the Notice Inviting Bids, Contractor has submitted a Bid Proposal and accompanying Bid Schedule, a copy of which is attached for convenience as Exhibit A, to perform the Work to construct the Project. On August 6, 2019, City authorized award of this Contract to Contractor for the amount set forth in Section 4 below. 2. Contract Documents. The Contract Documents incorporated into this Contract include and are comprised of all of the documents listed below. The definitions provided in Article 1 of the General Conditions apply to all of the Contract Documents, including this Contract: 2.1 Notice Inviting Bids; 2.2 Instructions to Bidders; 2.3 Addenda, if any; 2.4 Bid Proposal and attachments thereto; 2.5 Contract; 2.6 Payment Bond, and Performance Bond; 2.7 General Conditions; 2.8 Special Conditions; 2.9 Project Plans and Specifications; 2.10 Change Orders, if any; 2.11 Notice of Award; 2.12 Notice to Proceed; 2.13 City of Cupertino Standard Details; and 2.14 The following: No Other Documents 3. Contractor's Obligations. Contractor will perform all of the Work required for the Project, as specified in the Contract Documents. Contractor must provide, furnish, and supply all things necessary and incidental for the timely performance and completion of the Work, including all necessary labor, materials, supplies, tools, equipment, transportation, onsite facilities and utilities, unless otherwise specified in the Contract Documents. Contractor must use its best efforts to diligently prosecute and complete the Work in a professional and expeditious manner and to meet or exceed the performance standards required by the Contract Documents. 4. Payment. As full and complete compensation for Contractor's timely performance and completion of the Work in strict accordance with the terms and conditions of the Contract Documents, City will pay Contractor and amount not to exceed $160,000.00 ("Contract Price")for all of Contractor's direct and indirect costs to perform the Work, including all labor, materials, supplies, equipment, taxes, insurance, bonds and all overhead costs, in accordance with the payment provisions in the General Conditions. 5. Time for Completion. Contractor will fully complete the Work for the Project within 45 calendar days from the commencement date given in the Notice to Proceed ("Contract Time"). By signing below, Contractor expressly waives any claim for delayed early completion. Storm Drain Cleaning /CCTV Inspection Services Project CONTRACT Project Number 2019-107 Page 21 6. Liquidated Damages. If Contractor fails to complete the Work within the Contract Time, City will assess liquidated damages in the amount of$1,000 per day for each day of unexcused delay in completion, and such liquidated damages may be deducted from City's payments due or to become due to Contractor under this Contract. 7. Labor Code Compliance. 7.1 General. This Contract is subject to all applicable requirements of Chapter 1 of Part 7 of Division 2 of the Labor Code, including requirements pertaining to wages, working hours and workers' compensation insurance, as further specified in Article 9 of the General Conditions. 7.2 Prevailing Wages. This Project is subject to the prevailing wage requirements applicable to the locality in which the Work is to be performed for each craft, classification or type of worker needed to perform the Work, including employer payments for health and welfare, pension, vacation, apprenticeship and similar purposes. Copies of these prevailing rates are available online at http://www.dir.ca.gov/DLSR. 7.3 DIR Registration. City may not enter into the Contract with a bidder without proof that the bidder and its Subcontractors are registered with the California Department of Industrial Relations to perform public work pursuant to Labor Code section 1725.5, subject to limited legal exceptions. 8. Workers' Compensation Certification. Pursuant to Labor Code section 1861, by signing this Contract, Contractor certifies as follows: "I am aware of the provisions of Labor Code section 3700 which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work on this Contract." 9. Conflicts of Interest. Contractor, its employees, Subcontractors and agents, may not have, maintain or acquire a conflict of interest in relation to this Contract in violation of any City ordinance or requirement or in violation of any California law, including Government Code section 1090 et seq., or the Political Reform Act, as set forth in Government Code section 81000 et seq. and its accompanying regulations. No officer, official, employee, consultant, or other agent of the City("City Representative") may have, maintain, or acquire a"financial interest" in the Contract, as that term is defined under the Political Reform Act (Government Code section 81000, et seq., and regulations promulgated thereunder); or under Government Code section 1090, et seq.; or in violation of any City ordinance or requirement while serving as a City Representative or for one year thereafter. Any violation of this Section constitutes a material breach of the Contract. 10. Independent Contractor. Contractor is an independent contractor under this Contract and will have control of the Work and the means and methods by which it is performed. Contractor and its Subcontractors are not employees of City and are not entitled to participate in any health, retirement, or any other employee benefits from City. Storm Drain Cleaning/CCTV Inspection Services Project CONTRACT Project Number 2019-107 Page 22 11. Notice. Any notice, billing, or payment required by or pursuant to the Contract Documents must be made in writing, signed, dated and sent to the other party by personal delivery, U.S. Mail, a reliable overnight delivery service, or by email as a PDF file. Notice is deemed effective upon delivery, except that service by U.S. Mail is deemed effective on the second working day after deposit for delivery.. Notice for each party must be given as follows: City: Name: City of Cupertino Address: 10300 Torre Avenue City/State/Zip: Cupertino, CA 95014 Phone: 408-777-3354 Attn: Jo Anne Johnson Email:joannej@cupertino.org Copy to: pwinvoices@cupertino.org Contractor: Name: AIMS/PVIC CA, LLC dba AIMS Companies Address: 1616 Doolittle Drive City/State/Zip: San Leandro, California, 94577 Phone: 510-922-8627 Attn: Craig Releford Email: creleford@aimscompanies.com Copy to: s u son aimscompanies.com 12. General Provisions. 12.1 Assignment and Successors. Contractor may not assign its rights or obligations under this Contract, in part or in whole, without City's written consent. This Contract is binding on Contractor's and City's lawful heirs, successors and permitted assigns. 12.2 Third Party Beneficiaries. There are no intended third party beneficiaries to this Contract. 12.3 Governing Law and Venue. This Contract will be governed by California law and venue will be in the Santa Clara County Superior Court, and no other place. Contractor waives any right it may have pursuant to Code of Civil Procedures Section 394, to file a motion to transfer any action arising from or relating to this Contract to a venue outside Santa Clara County, California. 12.4 Amendment. No amendment or modification of this Contract will be binding unless it is in a writing duly authorized and signed by the parties to this Contract. 12.5 Integration. This Contract and the Contract Documents incorporated herein, including authorized amendments or Change Orders thereto, constitute the final, complete, and exclusive terms of the agreement between City and Contractor. 12.6 Severability. If any provision of the Contract Documents, or portion of a provision, is determined to be illegal, invalid, or unenforceable, the remaining provisions of the Contract Documents will remain in full force and effect. Storm Drain Cleaning /CCTV Inspection Services Project CONTRACT Project Number 2019-107 Page 23 12.7 Iran Contracting Act. If the Contract Price exceeds $1,000,000, Contractor certifies, by signing below, that it is not identified on a list created under the Iran Contracting Act, Public Contract Code§ 2200 et seq. (the"Act'), as a person engaging in investment activities in Iran, as defined in the Act, or is otherwise expressly exempt under the Act. 12.8 Authorization. Each individual signing below warrants that he or she is authorized to do so by the party that he or she represents, and that this Contract is legally binding on that party. If Contractor is a corporation, signatures from two officers of the corporation are required pursuant to California Corporation Code section 313. [Signatures are on the following page.] Storm Drain Cleaning /CCTV Inspection Services Project CONTRACT Project Number 2019-107 Page 24 The parties agree to this Contract as witnessed by the signatures below: CONTRACTOR AIMS/PVIC CA, LLC dba AIMS Companies CITY OF CUPERTINO <insert full nam of ractor above> A Municipal Cor or ion BY By Name Ste en J Hudson Roger Lee Title Chief Operating Officer Director of Pub rc Works Date Date 8/8/2019 By Name Title Date APPROVED AS TO FORM: By 7� Name e" e C vh• W\:n rNe City Attorney Date ATTEST.- Grace Schmidt City Clerk Date 0 Contract Amount:yi 1 lno ODD P.O. No. Account No. lot)- `b 5— a 11�- ?oc)_ 7D2 END OF CONTRACT Storm Drain Cleaning/CCTV Inspection Services Project CONTRACT Project Number 2019-107 Page 25 AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/8/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT sandy Coons Lovitt&Touche-Tempe PHONE 1050 W Washington Street, Suite 233 c No Ext:602-956-2250 aC No: Tempe AZ 85281 E-MAIL p ADDRESS: scoonS lovitt-touche.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Starr Indemnity&Liabilily Co 38318 INSURED PIPEVID-Cl INSURER B:Amerisure Mutual Insurance 23396 AIMS/PVIC CA, LLC dba AIMS Companies INSURER c:AXIS SURPLUS INS CO 1616 Doolittle Dr. 26620 San Leandro CA 94577 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:302257015 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDLSUBR EXP LTR TYPE OF INSURANCE WVDPOLICY NUMBER MM/DDY/YYYY MM/DDY LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y P2107185 1/1/2019 1/1/2020 EACH OCCURRENCE $1,000,000 y CLAIMS-MADE rXI OCCUR PREMISES Ea occurrence) $500,000 MED EXP(Any one person) $15,000 X Contractual Liab PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY1XI JEC LOC PRODUCTS-COMP/OP AGG $2,OD0,000 OTHER: BI/PD Per Occ Ded $$1,000 B AUTOMOBILELIABILITY Y Y CA2107230 1/1/2019 1/1/2020 V EOMaBIcNdEeDtSINGLELIMIT $1,000,000 JX ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR Y Y 1000584821191 1/1/2019 1/1/2020 EACH OCCURRENCE $1 00,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 0,000,000 DED X RETENTION$ $ B WORKERS COMPENSATION Y WC 2107187 1/1/2019 1/1/2020 X SPERTATUTE ER CA AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑Y E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH)If yes,describe under E.L.DISEASE-EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Pollution Liabilty(Ded$5,000) Y Y CM003084-02 1/1/2019 1/1/2020 imit/Agg $2,000,000 C ProfLiability(Ded 25,000) CM003084-02 1/1/2019 1/1/2020V Limit/Agg $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder and owner(if applicable)are additional insureds on the General Liability,Automobile Liability, Excess liability(follow form;GL,Auto, Employers Liability)and Pollution Liability if required by written contract. Waiver of Subrogation applies to the General Liability,Automobile liability,Workers Compensation, Excess Liability and Pollution Liability If required by written contract. The General Liability,Automobile liability,and Excess Liability insurance are primary and certificate holder's insurance is non-contributory if required by written contract.For any statutorily permitted reason other than nonpayment of premium,30 Day Notice of Cancellation applies. Worker Comp Excluded Members Chris Mihaletos and Maria Mihaletos Professional Liability Retro Date 11-12-14 $1,000,000 Professional Liability Retro Date 2-22-17 $2,000,000 Professional Liability Retro Date 7-12-19 $5,000,000 CERTIFICATE HOLDER CANCELLATION 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 10300 Torre Avenue AUTHORIZED REPRESENTATIVE Cupertino CA 95014 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT — FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy-Number Agency Number Policy Effective Date �P2107185 0705003 01/01/2019 P licy Expira 'an' ate Date Account Number 0 701/2020 12/19/2018 20063179 Named Insured Agency Issuing Company AIMS/PVIC CA, LLC dba AIMS Companies Lovitt & Touch6, Inc. Amerisure Mutual Insurance 1. a. SECTION 11-WHO IS AN INSURED is amended to add as an additional insured any person or organization: (1) Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business; or (2) Who is named as an additional insured under this policy on a certificate of insurance. b. The written contract, written agreement, or certificate of insurance must: (1) Require additional insured status for a time period during the term of this policy; and (2) Be executed prior to the "bodily injury', "property damage", or"personal and advertising injury' leading to a claim under this policy. c. If, however: (1) "Your work" began under a letter of intent or work order; and (2) The letter of intent or work order led to a written contract or written agreement within 30 days of beginning such work; and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specified in this endorsement. 2. The insurance provided under this endorsement is limited as follows: a. That person or organization is an additional insured only with respect to liability caused, in whole or in part, by: (1) Premises you: (a) Own; (b) Rent; (c) Lease; or (d) Occupy; (2) Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to "bodily injury"or"property damage"occurring after: Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 10 15 Pages 1 of 4 (a) All work to be performed by you or on your behalf for the additional insured(s)at the site of the covered operations is complete, including related materials, parts or equipment(other than service, maintenance or repairs); or (b) That portion of"your work"out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working for a principal as a part of the same project. (3) Completed operations coverage, but only if: (a) The written contract, written agreement, or certificate of insurance requires completed operations coverage or"your work" coverage; and (b) This coverage part provides coverage for"bodily injury"or"property damage" included within the"products-completed operations hazard". However, the insurance afforded to such additional insured only applies to the extent permitted by law. b. If the written contract, written agreement, or certificate of insurance: (1) Requires"arising out of language; or (2) Requires you to provide additional insured coverage to that person or organization by the use of either or both of the following: (a) Additional Insured—Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG 20 10 10 01; or (b) Additional Insured—Owners, Lessees or Contractors—Completed Operations endorsement CG 20 37 10 01; then the phrase"caused, in whole or in part, by" in paragraph 2.a. above is replaced by"arising out of'. c. If the written contract, written agreement, or certificate of insurance requires you to provide additional insured coverage to that person or organization by the use of: (1) Additional Insured—Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13; or (2) Additional Insured—Owners, Lessees or Contractors—Completed Operations endorsement CG 20 37 07 04 or CG 20 37 04 13; or (3) Both those endorsements with either of those edition dates; or (4) Either or both of the following: (a) Additional Insured —Owners, Lessees or Contractors—Scheduled Person Or Organization endorsement CG 20 10 without an edition date specified; or (b) Additional Insured—Owners, Lessees or Contractors—Completed Operations endorsement CG 20 37 without an edition date specified; then paragraph 2.a. above applies. d. Premises, as respects paragraph 2.a.(1)above, include common or public areas about such premises if so required in the written contract or written agreement. e. Additional insured status provided under paragraphs 2.a.(1)(b) or 2.a.(1)(c) above does not extend beyond the end of a premises lease or rental agreement. f. The limits of insurance that apply to the additional insured are the least of those specified in the: (1) Written contract; (2) Written agreement; (3) Certificate of insurance; or (4) Declarations of this policy. The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. ' Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 4 CG 70 48 10 15 g. The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or "personal and advertising injury"arising out of an architect's, engineer's, or surveyor's rendering of, or failure to render, any professional services, including but not limited to: (1) The preparing, approving, or failing to prepare or approve: (a) Maps; (b) Drawings; (c) Opinions; (d) Reports; (e) Surveys; (f) Change orders; (g) Design specifications; and (2) Supervisory, inspection, or engineering services. h. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance is deleted and replaced with the following: 4. Other Insurance. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether: a. Primary; b. Excess; c. Contingent; or d. On any other basis; but if the written contract, written agreement, or certificate of insurance requires primary and non- contributory coverage, this insurance will be primary and non-contributory relative to other insurance available to the additional insured which covers that person or organization as a Named Insured, and we will not share with that other insurance. I. If the written contract, written agreement, or certificate of insurance as outlined above requires additional insured status by use of CG 20 10 11 85, then the coverage provided under this CG 70 48 endorsement does not apply except for paragraph 2.h. Other Insurance. Additional insured status is limited to that provided by CG 20 10 11 85 shown below and paragraph 2.h. Other Insurance shown above. ADDITIONAL INSURED- OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Blanket Where Required by Written Contract, Agreement, or Certificate of Insurance that the terms of CG 20 10 11 85 apply (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of"your work"for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 10 15 Pages 3 of 4 j. The insurance provided by this endorsement does not apply to any premises or work for which the person or organization is specifically listed as an additional insured on another endorsement attached to this policy. Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 4 CG 70 48 10 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS GENERAL LIABILITY EXTENSION ENDORSEMENT TABLE OF CONTENTS Page 1. Additional Definitions 9 2. Aggregate Limits Per Location 7 3. Aggregate Limits Per Project 7 4. Blanket Contractual Liability—Railroads 3 5. Broadened Bodily Injury Coverage 11 6. Broadened Knowledge Of Occurrence 8 7. Broadened Legal Liability Coverage For Landlord's Business Personal Property 8 8. Broadened Liability Coverage For Damage To Your Product And Your Work 10 9. Broadened Who Is An Insured 3 10. Co-Employee Bodily Injury Coverage for Managers, Supervisors, Directors or Officers 4 see provision 9, Broadened Who Is An Insured, paragraph 2.a. 1 11. Contractual Liability—Personal And Advertising Injury 3 12. Damage To Premises Rented To You—Specific Perils and Increased Limit 7 13. Designated Completed Projects—Amended Limits of Insurance 11 14. Extended Notice Of Cancellation And Nonrenewal 9 15. Incidental Malpractice Liability 7 16. Increased Medical Payments Limit And Reporting Period 7 17. Mobile Equipment Redefined 9 18. Nonowned Watercraft And Nonowned Aircraft Hired, Rented Or Loaned With Paid Crew 3 19. Product Recall Expense 2 20. Property Damage Liability—Alienated Premises 2 21. Property Damage Liability—Elevators And Sidetrack Agreements 2 22. Property Damage Liability—Property Loaned To The Insured Or Personal Property In The Care, 2 Custody And Control Of The Insured 23. Reasonable Force—Bodily Injury or Property Damage 10 24. Supplementary Payments 3 25. Transfer Of Rights Blanket Waiver Of Subrogation) 9 26. Unintentional Failure To Disclose Hazards 8 Includes copyrighted material of Insurance Services Office, Inc. CG 70 49 04 17 Page 1 of 11 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Under SECTION I—COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY,paragraph 2. EXCLUSIONS, provisions 1.through 6.of this endorsement are excess over any valid and collectible insurance (including any deductible) available to the insured,whether primary,excess or contingent(SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4.Other Insurance is changed accordingly). Provisions 1.through 6.of this endorsement amend the policy as follows: 1. PROPERTY DAMAGE LIABILITY—ALIENATED PREMISES A. Exclusion j. Damage to Property, paragraph(2)is deleted. B. The following paragraph is also deleted from Exclusion j. Damage to Property: Paragraph(2)of this exclusion does not apply if the premises are"your work"and were never occupied, rented or held for rental by you. 2. PROPERTY DAMAGE LIABILITY—ELEVATORS AND SIDETRACK AGREEMENTS A. Exclusion j. Damage to Property, paragraphs(3), (4), and(6)do not apply to the use of elevators. B. Exclusion k. Damage to Your Product does not apply to: 1. The use of elevators;or 2. Liability assumed under a sidetrack agreement. 3. PROPERTY DAMAGE LIABILITY—PROPERTY LOANED TO THE INSURED OR PERSONAL PROPERTY IN THE CARE,CUSTODY AND CONTROL OF THE INSURED A. Exclusion j. Damage to Property, paragraphs(3)and(4)are deleted. B. Coverage under this provision 3.does not apply to"property damage"that exceeds$25,000 per occurrence or$25,000 annual aggregate. 4. PRODUCT RECALL EXPENSE A. Exclusion n. Recall Of Products,Work Or Impaired Property does not apply to'product recall expenses"that you incur for the"covered recall'of"your product". This exception to the exclusion does not apply to'product recall expenses' resulting from: 1. Failure of any products to accomplish their intended purpose; 2. Breach of warranties of fitness,quality, durability or performance; 3. Loss of customer approval or any cost incurred to regain customer approval; 4. Redistribution or replacement of"your product',which has been recalled, by like products or substitutes; 5. Caprice or whim of the insured; 6. A condition likely to cause loss,about which any insured knew or had reason to know at the inception of this insurance; 7. Asbestos, including loss,damage or clean up resulting from asbestos or asbestos containing materials; 8. Recall of"your product(s)"that have no known or suspected defect solely because a known or suspected defect in another of"your product(s)"has been found. B. Under SECTION III—LIMITS OF INSURANCE, paragraph 3.is replaced in its entirety as follows and paragraph 8.is added: 3. The Products-Completed Operations Aggregate Limit is the most we will pay for the sum of: Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 11 CG 70 49 04 17 a. Damages under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY because of"bodily injury"and"property damage"included in the"products-completed operations hazard"and b. "Product recall expenses". 8. Subject to paragraph 5.above(of the CGL Coverage Form], $25,000 is the most we will pay for all "product recall expenses"arising out of the same defect or deficiency. 5. NONOWNED WATERCRAFT AND NONOWNED AIRCRAFT(HIRED, RENTED OR LOANED WITH PAID CREW) Exclusion g.Aircraft,Auto or Watercraft, paragraph(2)is deleted and replaced with the following: [This exclusion does not apply to:] (2) A watercraft you do not own that is: (a) Less than 75 feet long; and (b) Not being used to carry any person or property for a charge, Exclusion g.Aircraft,Auto or Watercraft, paragraph(6)is added as follows: [This exclusion does not apply to:] (6) An aircraft you do not own, provided that: (a) The pilot in command holds a currently effective certificate issued by the duly constituted authority of the United States of America or Canada, designating that person as a commercial or airline transport pilot; (b) The aircraft is rented to you with a trained, paid crew;and (c) The aircraft is not being used to carry any person or property for a charge. 6. BLANKET CONTRACTUAL LIABILITY—RAILROADS Under SECTION V—DEFINITIONS, paragraph c.of"Insured Contract"is deleted and replaced by the following: c. Any easement or license agreement; 'Under SECTION V—DEFINITIONS, paragraph f.(1)of"Insured Contract"is deleted. 7. CONTRACTUAL LIABILITY—PERSONAL AND ADVERTISING INJURY Under SECTION I—COVERAGE B.,paragraph 2. Exclusions, paragraph e. Contractual Liability is deleted. 8. SUPPLEMENTARY PAYMENTS Under SECTION I—SUPPLEMENTARY PAYMENTS—COVERAGES A AND B,paragraphs 1.b.and 1.d. are deleted and replaced with the following: b. Up to$5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit", including actual loss of earnings up to$1,000 a day because of time off from work. 9. BROADENED WHO IS AN INSURED SECTION II—WHO IS AN INSURED is deleted and replaced with the following: 1. If you are designated in the Declarations as: a. An individual,you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. Includes copyrighted material of Insurance Services Office, Inc. CG 70 49 04 17 Page 3 of 11 b. A partnership or joint venture,you are an insured. Your members,your partners,and their spouses are also insureds, but only with respect to the conduct of your business. C. A limited liability company,you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership,joint venture or limited liability company,you are an insured.Your"executive officers"and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust,you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Your"volunteer workers'only while performing duties related to the conduct of your business, or your"employees,"other than either your"executive officers," (if you are an organization other than a partnership,joint venture or limited liability company)or your managers(if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these"employees'or"volunteer workers" are insured for: (1) "Bodily injury'or"personal and advertising injury': (a) To you,to your partners or members(if you are a partnership or joint venture),to your members(if you are a limited liability company),to a co-"employee"while in the course of his or her employment or performing duties related to the conduct of your business,or to your other"volunteer workers"while performing duties related to the conduct of your business; (b) To the spouse,child, parent,brother or sister of that co-"employee"or"volunteer worker as a consequence of paragraph(1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraphs(1)(a)or(b)above;or (d) Arising out of his or her providing or failing to provide professional health care services except as provided in provision 10.of this endorsement. Paragraphs(1)(a), (1)(b)and(1)(c)above do not apply to your"employees'who are: (i) Managers; (ii) Supervisors, (iii) Directors; or (iv) Officers; with respect to"bodily injury"to a co-"employee". (2) 'Property damage"to property: (a) Owned,occupied or used by; (b) Rented to, in the care,custody or control of,or over which physical control is being exercised for any purpose by you, any of your"employees,""volunteer workers", any partner or member(if you are a partnership or joint venture),or any member(if you are a limited liability company). b. Any person(other than your"employee"or"volunteer worker"), or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only; Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 11 CG 70 49 04 17 (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Form. e. Your subsidiaries if: (1) They are legally incorporated entities; and (2) You own more than 50%of the voting stock in such subsidiaries as of the effective date of this policy. If such subsidiaries are not shown in the Declarations,you must report them to us within 180 days of the inception of your original policy. f. Any person or organization, including any manager, owner, lessor, mortgagee, assignee or receiver of premises,to whom you are obligated under a written contract to provide insurance such as is afforded by this policy, but only with respect to liability arising out of the ownership, maintenance or use of that part of any premises or land leased to you, including common or public areas about such premises or land if so required in the contract. However,no such person or organization is an insured with respect to: (1) Any'occurrence"that takes place after you cease to occupy or lease that premises or land; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. g. Any state or political subdivision but only as respects legal liability incurred by the state or political subdivision solely because it has issued a permit with respect to operations performed by you or on your behalf. However, no state or political subdivision is an insured with respect to: (1) "Bodily injury", "property damage", and"personal and advertising injury"arising out of operations performed for the state or municipality; or (2) "Bodily injury"or"property damage"included within the"products-completed operations hazard." h. Any person or organization who is the lessor of equipment leased to you to whom you are obligated under a written contact to provide insurance such as is afforded by this policy, but only with respect to their liability arising out of the maintenance,operation or use of such equipment by you or a subcontractor on your behalf with your permission and under your supervision. However, no such person or organization is an insured with respect to any'occurrence"that takes place after the equipment lease expires. L Any architect, engineer, or surveyor engaged by you under a written contract but only with respect to liability arising out of your premises or"your work." However, no architect, engineer,or surveyor is an insured with respect to"bodily injury,""property damage,"or"personal and advertising injury"arising out of the rendering of or the failure to render any professional services by or for you, including: (1) The preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys,change orders, designs or specifications;or (2) Supervisory, inspection,or engineering services. This paragraph L does not apply if a separate Additional Insured endorsement providing liability coverage for architects, engineers, or surveyors engaged by you is attached to the policy. If the written contract,written agreement, or certificate of insurance requires primary and non-contributory coverage,the insurance provided by paragraphs f.through L above will be primary and non-contributory Includes copyrighted material of Insurance Services Office, Inc. CG 70 49 0417 Page 5 of 11 relative to other insurance available to the additional insured which covers that person or organization as a Named Insured,and we will not share with that other insurance. 3. Any organization you newly acquire or form, other than a partnership,joint venture or limited liability company and over which you maintain ownership or majority interest,will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded until the end of the policy period. b. Coverage A does not apply to"bodily injury"or"property damage"that occurred before you acquired or formed the organization. C. Coverage B does not apply to"personal and advertising injury"arising out of an offense committed before you acquired or formed the organization. d. Coverage A does not apply to"product recall expense"arising out of any withdrawal or recall that occurred before you acquired or formed the organization. 4. Any person or organization (referred to below as vendor)with whom you agreed under a written contract to provide insurance is an insured, but only with respect to"bodily injury"or"property damage"arising out of"your products"that are distributed or sold in the regular course of the vendor's business. However, no such person or organization is an insured with respect to: a. "Bodily injury"or"property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement. b. Any express warranty unauthorized by you; c. Any physical or chemical change in"your product"made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration,testing, or the substitution of parts under instructions from the manufacturer,and then repackaged in the original container; e. Any failure to make such inspections, adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of"your products"; f. Demonstration, installation, servicing or repair operations,except such operations performed at the vendor's premises in connection with the sale of"your product"; g. "Your products"which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. h. "Bodily injury"or"property damage"arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However,this exclusion does not apply to: (1) The exceptions contained in subparagraphs d.or f.; or (2) Such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. This paragraph 4.does not apply to any insured person or organization from which you have acquired "your product", or any ingredient, part, or container, entering into, accompanying or containing "your product". This paragraph 4.also does not apply if a separate Additional Insured endorsement, providing liability coverage for"bodily injury"or"property damage"arising out of"your product"that is distributed or sold in the regular course of a vendor's business,is attached to the policy. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured in the Declarations. Includes copyrighted material of Insurance Services Office, Inc. Page 6 of 11 CG 70 49 04 17 10. INCIDENTAL MALPRACTICE LIABILITY As respects provision 9.,SECTION II—WHO IS AN INSURED, paragraph 2.a.(1)(d)does not apply to any nurse, emergency medical technician or paramedic employed by you to provide medical or paramedical services, provided that you are not engaged in the business or occupation of providing such services,and your"employee'does not have any other insurance that would also cover claims arising under this provision, whether the other insurance is primary, excess, contingent or on any other basis. Under SECTION II—LIMITS OF INSURANCE,provisions 11.through 14.of this endorsement amend the policy as follows: 11. AGGREGATE LIMITS PER PROJECT The General Aggregate Limit applies separately to each of your construction projects away from premises owned by or rented to you. 12. AGGREGATE LIMITS PER LOCATION The General Aggregate Limit applies separately to each of your locations, but only when required by written contract,written agreement or certificate of insurance. As respects this provision 12.,your locations are premises you own, rent or use involving the same or connecting lots or premises whose connection is interrupted only by a street, roadway,waterway or right-of-way of a railroad. However,your locations do not include any premises where you, or others acting on your behalf, are performing construction operations. 13. INCREASED MEDICAL PAYMENTS LIMIT A. SECTION III—LIMITS OF INSURANCE,paragraph 7.,the Medical Expense Limit, is subject to all of the terms of SECTION III—LIMITS OF INSURANCE and is the greater of: 1. $10,000; or 2. The amount shown in the Declarations for Medical Expense Limit. B. This provision 13.does not apply if COVERAGE C MEDICAL PAYMENTS is excluded either by the provisions of the Coverage Form or by endorsement. 14. DAMAGE TO PREMISES RENTED TO YOU—SPECIFIC PERILS AND INCREASED LIMIT A. The word fire is changed to"specific perils'where it appears in: 1. The last paragraph of SECTION I—COVERAGE A,paragraph 2. Exclusions; 2. SECTION IV, paragraph 4.b. Excess Insurance. B. The Limits of Insurance shown in the Declarations will apply to all damage proximately caused by the same event,whether such damage results from a"specific peril'or any combination of"specific perils." C. The Damage To Premises Rented To You Limit described in SECTION III—LIMITS OF INSURANCE, paragraph 6., is replaced by a new limit,which is the greater of: 1. $1,000,000; or 2. The amount shown in the Declarations for Damage To Premises Rented To You Limit. D. This provision 14.does not apply if the Damage To Premises Rented To You Limit of SECTIONI— COVERAGE A is excluded either by the provisions of the Coverage Form or by endorsement. E. "Specific Perils"means fire;lightning; explosion;windstorm or hail; smoke; aircraft or vehicles; riot or civil commotion;vandalism, leakage from fire extinguishing equipment;weight of snow,ice or sleet; or"water damage'. "Water damage"means accidental discharge or leakage of water or steam as the direct result of the breaking or cracking of any part of a system or appliance containing water or steam. 15. BROADENED LEGAL LIABILITY COVERAGE FOR LANDLORD'S BUSINESS PERSONAL PROPERTY Under SECTION I—COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Includes copyrighted material of Insurance Services Office, Inc. CG 70 49 04 17 Page 7 of 11 Exclusions,j. Damage to Property,the first paragraph following paragraph(6)is deleted and replaced with the following: Paragraphs(1), (3)and(4)of this exclusion do not apply to"property damage"(other than damage by fire)to a landlord's business personal property that is subject to, or part of, a premises lease or rental agreement with that landlord. The most we will pay for damages under this provision 16.is$10,000. A$250 deductible applies. Under SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, provisions 16.through 18.of this endorsement amend the policy as follows: 16. BROADENED KNOWLEDGE OF OCCURRENCE Under 2. Duties In The Event Of Occurrence,Offense, Claim, Or Suit,paragraph a,is deleted and replaced and paragraphs e.and f.are added as follows: a. You must see to it that we are notified as soon as practicable of an"occurrence"or an offense, regardless of the amount,which may result in a claim. Knowledge of an"occurrence"or an offense by your"employee(s)"shall not, in itself,constitute knowledge to you unless one of your partners, members, "executive officers", directors, or managers has knowledge of the"occurrence"or offense. To the extent possible,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. e. If you report an"occurrence"to your workers compensation carrier that develops into a liability claim for which coverage is provided by this Coverage Form,failure to report such an"occurrence"to us at the time of the"occurrence"shall not be deemed a violation of paragraphs a., b.,and c.above. However, you shall give written notice of this"occurrence"to us as soon you become aware that this"occurrence" may be a liability claim rather than a workers compensation claim. f. You must see to it that the following are done in the event of an actual or anticipated"covered recall"that may result in"product recall expense": (1) Give us prompt notice of any discovery or notification that"your product"must be withdrawn or recalled. Include a description of"your product"and the reason for the withdrawal or recall; (2) Cease any further release, shipment,consignment or any other method of distribution of like or similar products until it has been determined that all such products are free from defects that could be a cause of loss under the insurance. 17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph 6.Representations is deleted and replaced with the following: 6. Representations By accepting this policy,you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; C. We have issued this policy in reliance upon your representations; and d. This policy is void in any case of fraud by you as it relates to this policy or any claim under this policy. We will not deny coverage under this Coverage Form if you unintentionally fail to disclose all hazards existing as of the inception date of this policy.You must report to us any knowledge of an error or omission in the description of any premises or operations intended to be covered by this Coverage Form as soon as practicable after its discovery. However,this provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. Includes copyrighted material of Insurance Services Office, Inc. Page 8 of 11 CG 70 49 04 17 t 18. TRANSFER OF RIGHTS(BLANKET WAIVER OF SUBROGATION) Paragraph 8.Transfer of Rights Of Recovery Against Others To Us is deleted and replaced with the following: 8. If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring"suit"or transfer those rights to us and help us enforce them. However, if the insured has waived rights to recover through a written contract,or if"your work"was commenced under a letter of intent or work order, subject to a subsequent reduction to writing with customers whose customary contracts require a waiver,we waive any right of recovery we may have under this Coverage Form. 19. EXTENDED NOTICE OF CANCELLATION AND NONRENEWAL Paragraph 2.b.of A.Cancellation of the COMMON POLICY CONDITIONS is deleted and replaced with the following: b. 60 days before the effective date of the cancellation if we cancel for any other reason. Under SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 9.When We Do Not Renew is deleted and replaced with the following: 9. When We Do Not Renew If we decide not to renew this Coverage Part,we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. 20. MOBILE EQUIPMENT REDEFINED Under SECTION V—DEFINITIONS, paragraph 12."Mobile equipment", paragraph f. (1) does not apply to self-propelled vehicles of less than 1,000 pounds gross vehicle weight. 21. ADDITIONAL DEFINITIONS 1. SECTION V—DEFINITIONS,paragraph 4."Coverage territory" is replaced by the following definition: "Coverage territory" means anywhere in the world with respect to liability arising out of"bodily injury," "property damage,"or"personal and advertising injury," including"personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in a settlement to which we agree or in a"suit"on the merits,in the United States of America(including its territories and possessions), Puerto Rico and Canada. 2. SECTION V—DEFINITIONS is amended by the addition of the following definitions: "Covered recall" means a recall made necessary because you or a government body has determined that a known or suspected defect, deficiency, inadequacy, or dangerous condition in"your product"has resulted or will result in"bodily injury"or"property damage". "Product Recall expenses"mean only reasonable and necessary extra costs,which result from or are related to the recall or withdrawal of"your product"for: a. Telephone and telegraphic communication, radio or television announcements, computer time and newspaper advertising; b. Stationery,envelopes, production of announcements and postage or facsimiles; c. Remuneration paid to regular employees for necessary overtime or authorized travel expense; d. Temporary hiring by you or by agents designated by you of persons, other than your regular employees,to perform necessary tasks; e. Rental of necessary additional warehouse or storage space, Includes copyrighted material of Insurance Services Office, Inc. CG 70 49 04 17 Page 9 of 11 f. Packaging of or transportation or shipping of defective products to the location you designate; and g. Disposal of"your products"that cannot be reused. Disposal expenses do not include: (1) Expenses that exceed the original cost of the materials incurred to manufacture or process such product;and (2) Expenses that exceed the cost of normal trash discarding or disposal, except as are necessary to avoid"bodily injury'or"property damage". 22. REASONABLE FORCE—BODILY INJURY OR PROPERTY DAMAGE Under SECTION I—COVERAGE A., paragraph 2. Exclusions, subparagraph a. Expected Or Intended Injury is deleted and replaced with the following: [This insurance does not apply to:] a. Expected Or Intended Injury "Bodily injury"or"property damage'expected or intended from the standpoint of the insured. This exclusion does not apply to"bodily injury"or"property damage'resulting from the use of reasonable force to protect persons or property. 23. BROADENED LIABILITY COVERAGE FOR DAMAGE TO YOUR PRODUCT AND YOUR WORK A. Under SECTION I—COVERAGE A., paragraph 2. Exclusions, exclusion k. Damage to Your Product and exclusion I. Damage to Your Work are deleted and replaced with the following: [This insurance does not apply to:] k. Damage to Your Product "Property damage"to"your product'arising out of it or any part of it,except when caused by or resulting from: (1) Fire; (2) Smoke: (3) "Collapse';or (4) Explosion. For purposes of exclusion k. above, "collapse'means an abrupt falling down or caving in of a building or any part of a building with the result that the building or part of the building cannot be occupied for its intended purpose. I. Damage to Your Work "Property damage"to"your work"arising out of it or any part of it and included in the "products-completed operations hazard". This exclusion does not apply: (1) If the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor;or (2) If the cause of loss to the damaged work arises as a result of: (a) Fire; (b) Smoke; (c) "Collapse"; or (d) Explosion. For purposes of exclusion I. above,"collapse'means an abrupt falling down or caving in of a building or any part of a building with the result that the building or part of the building cannot be occupied for its intended purpose. B. The following paragraph is added to SECTION III—LIMITS OF INSURANCE: Includes copyrighted material of Insurance Services Office, Inc. Page 10 of 11 CG 70 49 0417 Subject to 5.above[of the CGL Coverage Form],$100,000 is the most we will pay under Coverage A for the sum of damages arising out of any one"occurrence"because of"property damage'to"your product" and"your work"that is caused by fire, smoke,collapse or explosion and is included within the "product-completed operations hazard". This sublimit does not apply to"property damage'to'your work" if the damaged work, or the work out of which the damage arises,was performed on your behalf by a subcontractor. 24. BROADENED BODILY INJURY COVERAGE Under SECTION V—DEFINITIONS,the definition of"bodily injury'is deleted and replaced with the following: 3. 'Bodily injury' a. Means physical: (1) Injury; (2) Disability; (3) Sickness; or (4) Disease; sustained by a person, including death resulting from any of these at any time. b. Includes mental: (5) Anguish; (6) Injury; (7) Humiliation; (8) Fright; or (9) Shock; directly resulting from any"bodily injury"described in paragraph 3.a. c. All"bodily injury'described in paragraph 3.b.shall be deemed to have occurred at the time the "bodily injury"described in paragraph 3.a.occurred. 25. DESIGNATED COMPLETED PROJECTS—AMENDED LIMITS OF INSURANCE When a written contract or written agreement between you and another party requires project-specific limits of insurance exceeding the limits of this policy; A. for"bodily injury'or"property damage'that occurs within any policy period for which we provided coverage, and B. for"your work"performed within the"products-completed operation hazard"; and C. for which we previously issued Amendment Of Limits Of Insurance(Designated Project Or Premises)CG 71 94 either during this policy term or a prior policy term; and D. that designated project is now complete; the limits of insurance shown in the CG 71 94 schedule will replace the limits of insurance of this policy for the designated project and will continue to apply for the amount of time the written contract or written agreement requires, subject to the state statute of repose for the project location. These limits are inclusive of and not in addition to the replaced limits. Includes copyrighted material of Insurance Services Office, Inc. CG 70 49 04 17 Page 11 of 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADVANTAGE COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. The premium for this endorsement is$ INCLUDED 1. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS -CANCELLATION, Paragraph A.2.is replaced by the following: 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 60 days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED SECTION II-LIABILITY COVERAGE A.1.WHO IS AN INSURED is amended by the addition of the following: d. Any organization you newly acquire or form, other than a partnership,joint venture or limited liability company, and over which you maintain ownership or a majority interest,will qualify as a Named Insured. However, (1) Coverage under this provision is afforded only until the end of the policy period; (2) Coverage does not apply to"accidents"or"loss"that occurred before you acquired or formed the organization;and (3) Coverage does not apply to an organization that is an"insured" under any other policy or would be an "insured"but for its termination or the exhausting of its limit of insurance. e. Any"employee" of yours using: (1) A covered"auto"you do not own, hire or borrow, or a covered"auto"not owned by the"employee" or a member of his or her household,while performing duties related to the conduct of your business or your personal affairs; or (2) An"auto"hired or rented under a contractor agreement in that"employee's"name,with your permission,while performing duties related to the conduct of your business. However,your "employee"does not qualify as an insured under this paragraph (2)while using a covered"auto" rented from you or from any member of the"employee's"household. f. Your members, if you are a limited liability company,while using a covered"auto"you do not own,hire, or borrow,while performing duties related to the conduct of your business or your personal affairs. g. Any person or organization with whom you agree in a written contract,written agreement or permit,to provide insurance such as is afforded under this policy,but only with respect to your covered "autos". This provision does not apply: (1) Unless the written contract or agreement is executed or the permit is issued prior to the"bodily injury"or"property damage"; Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 Page 1 of 5 (2) To any person or organization included as an insured by an endorsement or in the Declarations; or (3) To any lessor of"autos"unless: (a) The lease agreement requires you to provide direct primary insurance for the lessor; (b) The"auto"is leased without a driver;and (c) The lease had not expired. Leased"autos"covered under this provision will be considered covered"autos"you own and not covered "autos"you hire. h. Any legally incorporated organization or subsidiary in which you own more than 50% of the voting stock on the effective date of this endorsement. This provision does not apply to"bodily injury"or"property damage"for which an"insured" is also an insured under any other automobile policy or would be an insured under such a policy,but for its termination or the exhaustion of its limits of insurance, unless such policy was written to apply specifically in excess of this policy. 3. COVERAGE EXTENSIONS-SUPPLEMENTARY PAYMENTS Under SECTION II-LIABILITY COVERAGE, A.2.a.Supplementary Payments, paragraphs (2)and(4)are deleted and replaced with the following: (2) Up to$2500 for the cost of bail bonds(including bonds for related traffic law violations)required because of an"accident"we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the"insured"at our request,including actual loss of earnings up to $500 a day because of time off from work. 4. AMENDED FELLOW EMPLOYEE EXCLUSION SECTION II-LIABILITY COVERAGE,B.EXCLUSIONS, paragraph 5. Fellow Employee is deleted and replaced by the following: 5. Fellow Employee "Bodily injury"to: a. Any fellow"employee" of the"insured" arising out of and in the course of the fellow"employee's" employment or while performing duties related to the conduct of your business. However,this exclusion does not apply to your"employees"that are officers, managers, supervisors or above. Coverage is excess over any other collectible insurance. b. The spouse, child, parent,brother or sister of that fellow"employee"as a consequence of paragraph a.above. 5. HIRED AUTO PHYSICAL DAMAGE COVERAGE AND LOSS OF USE EXPENSE A. Under SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE,the following is added: If any of your owned covered"autos"are covered for Physical Damage,we will provide Physical Damage coverage to"autos"that you or your"employees"hire or borrow, under your name or the"employee's" name,for the purpose of doing your work. We will provide coverage equal to the broadest physical damage coverage applicable to any covered"auto"shown in the Declarations, Item Three, Schedule of Covered Autos You Own, or on any endorsements amending this schedule. B. Under SECTION III-PHYSICAL DAMAGE COVERAGE,A.4.COVERAGE EXTENSIONS,paragraph b. Loss of Use Expenses is deleted and replaced with the following: b. Loss Of Use Expenses For Hired Auto Physical Damage,we will pay expenses for which an"insured" becomes 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 expenses if caused by: Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 5 CA 71 1511 09 (1) Other than collision, only if the Declarations indicate that Comprehensive Coverage is provided for any covered"auto"; (2) Specified Causes of Loss, only if the Declarations indicate that Specified Causes Of Loss Coverage 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 payfor any expenses for loss of use is$30 per day,to a maximum of $2,000. C. Under SECTION IV—BUSINESS AUTO CONDITIONS, paragraph 5.b.Other Insurance is deleted and replaced by the following: b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered"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 performing 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", nor is any"auto"you hire from any of your"employees",partners(if you are a partnership), members(if you are a limited liability company),or members of their households. 6. LOAN OR LEASE GAP COVERAGE Under SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE, the following is added: If a covered"auto"is owned or leased and if we provide Physical Damage Coverage on it,we will pay, in the event of a covered total"loss", any unpaid amount due on the lease or loan for a covered"auto", less: (a) The amount paid under the Physical Damage Coverage Section of the policy;and (b) Any: (1) Overdue lease or loan payments including penalties, interest or other charges resulting from overdue payments at the time of the"loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Costs for extended warranties, Credit Life Insurance, Health,Accident or Disability Insurance purchased with the loan or lease; (4) Security deposits not refunded by a lessor; and (5) Carry-over balances from previous loans or leases. 7. RENTAL REIMBURSEMENT SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE, paragraph 4.Coverage Extensions is deleted and replaced by the following: 4. Coverage Extensions (a) We will pay up to$75 per day to a maximum of$2000 for transportation expense incurred by you because of covered"loss". We will pay only for those covered"autos"for which you carry Collision Coverage or either Comprehensive Coverage or Specified Causes of Loss Coverage. We will pay for transportation expenses incurred during the period beginning 24 hours after the covered"loss" and ending, regardless of the policy's expiration,when the covered"auto"is returned to use or we pay for its"loss". This coverage is in addition to the otherwise applicable coverage you have on a covered"auto". No deductibles apply to this coverage. (b) This coverage does not apply while there is a spare or reserve"auto"available to you for your operation. Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 Page 3 of 5 8. AIRBAG COVERAGE SECTION III-PHYSICAL DAMAGE,B.EXCLUSIONS, Paragraph 3. is deleted and replaced by the following: We will not pay for"loss"caused by or resulting from any of the following unless caused by other"loss"that is covered by this insurance: a. Wear and tear, freezing, mechanical or electrical breakdown. However,this exclusion does not include the discharge of an airbag. b. Blowouts, punctures or other road damage to tires. 9. GLASS REPAIR-WAIVER OF DEDUCTIBLE SECTION III-PHYSICAL DAMAGE COVERAGE,D. DEDUCTIBLE is amended to add the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 10. COLLISION COVERAGE-WAIVER OF DEDUCTIBLE SECTION III-PHYSICAL DAMAGE COVERAGE,D. DEDUCTIBLE is amended to add the following: When there is a"loss" to your covered"auto"insured for Collision Coverage, no deductible will apply if the "loss"was caused by a collision with another"auto"insured by us. 11. KNOWLEDGE OF ACCIDENT SECTION IV-BUSINESS AUTO CONDITIONS,A.LOSS CONDITIONS,2. DUTIES IN THE EVENT OF ACCIDENT,CLAIM, SUIT OR LOSS, paragraph a. is deleted and replaced by the following: a. You must see to it that we are notified as soon as practicable of an"accident",claim,"suit"or"loss". Knowledge of an"accident",claim,"suit"or"loss" by your"employees"shall not,in itself, constitute knowledge to you unless one of your partners, executive officers, directors,managers, or members(if you are a limited liability company)has knowledge of the"accident",claim, "suit"or"loss". Notice should include: (1) How,when and where the"accident"or"loss" occurred; (2) The"insured's"name and address;and (3) To the extent possible, the names and addresses of any injured persons and witnesses. 12. TRANSFER OF RIGHTS (BLANKET WAIVER OF SUBROGATION) SECTION IV-BUSINESS AUTO CONDITIONS A.S.TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is deleted and replaced by the following: 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 organization must do everything necessary to secure our rights and must do nothing after"accident"or"loss"to impair them. However, if the insured has waived rights to recover through a written contract, or if your work was commenced under a letter of intent or work order,subject to a subsequent reduction in writing with customers whose customary contracts require a waiver,we waive any right of recovery we may have under this Coverage Form. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, B.GENERAL CONDITIONS, 2. CONCEALMENT, MISREPRESENTATION OR FRAUD is amended by the addition of the following: We will not deny coverage under this Coverage Form if you unintentionally fail to disclose all hazards existing as of the inception date of this policy. You must report to us any knowledge of an error or omission in your representations as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 5 CA 71 1511 09 14. BLANKET COVERAGE FOR CERTAIN OPERATIONS IN CONNECTION WITH RAILROADS When required by written contract or written agreement,the definition of"insured contract'is amended as follows: — The exception contained in paragraph H.3. relating to construction or demolition operations on or within 50 feet of a railroad; and — Paragraph H.a. are deleted with respect to the use of a covered"auto"in operations for, or affecting, a railroad. Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 Page 5 of 5 POUCY NUMBER:CA2107230 COMMERCIAL AUTO CA 71 65 09 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY NON-CONTRIBUTORY COVERAGE WHEN REQUIRED BY INSURED CONTRACT OR CERTIFICATE This endorsement modifies insurance provided under the BUSINESS AUTO COVERAGE FORM The provisions of the Coverage Form apply unless changed by this endorsement. This endorsement identifies person(s)or organization(s)who are"insured"under the Who Is An Insured Provision of the Coverage Form. This endorsement changes the policy on the inception date of the policy,unless another date is shown below. Endorsement Effective: 1/1/2019 Countersigned By: Named Insured: on File with Company AIMS/PVIC CA, LLC dba AIMS Companies (Authorized Representative) (No entry may appear above. If so,information to complete this endorsement is in the Declarations.) 1. Section II —Liability Coverage,A. Coverage, 1.Who Is An Insured is amended to add: Any person or organization with whom you have an"insured contract"which requires: i. that person or organization to be added as an"insured"under this policy or on a certificate of insurance:and ii. this policy to be primary and non-contributory to any like insurance available to the person or organization. Each such person or organization is an"insured"for Liability Coverage. They are an"insured"only if that person or organization is an"insured"under in SECTION II of the Coverage Form. The contract between the Named Insured and the person or organization is an"insured contract'. 2. Section IV— Business Auto Conditions, B. General Conditions,5. Other Insurance,paragraph d. is deleted and replaced by the following for the purpose of this endorsement only: d. When coverage provided under this Coverage Form is also provided under another Coverage Form or policy,we will provide coverage on a primary, non-contributory basis. Includes copyrighted material of Insurance Services Office, Inc.with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION REQUIRED BY WRITTEN CONTRACT OR CERTIFICATE OF INSURANCE This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is require only when this orsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. wc2107I87 Endorsement No. Insured Pipeline Video Inspection, LC; Premium $ AIMS/PVIC CA, LLC dba AIMS Compani Insurance Company Countersigned by Signature on File WC 04 03 06 Hart Forms&Services (Ed. 4-84) Copyright 1999 National Council on Compensation Insurance, Inc. Reorder No.14-2420 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION, NONRENEWAL OR MATERIAL CHANGE - THIRD PARTY This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL UMBRELLA LIABILITY COVERAGE FORM GARAGECOVERAGEFORM MOTOR CARRIER COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM TRUCKERS COVERAGE FORM Subject to the cancellation provisions of the Coverage Form to which this endorsement is attached,we will not: 1. Cancel; 2. Nonrenew;or, 3. Materially change (reduce or restrict) this Coverage Form, except for nonpayment of premium, until we provide at least 3 o days written notice of such cancellation, nonrenewal or material change.Written notice will be to the person or organization named in the Schedule. Such notice will be by certified mail with return receipt requested. This notification of cancellation, nonrenewal or material change to the person or organization named in the Schedule is intended as a courtesy only. Ourfailure to provide such notification will not: 1. Extend any Coverage Form cancellation date; 2. Negate the cancellation as to any insured or any certificate holder; 3. Provide any additional insurance that would not have been provided in the absence of this endorsement; or 4. Impose liability of any kind upon us. This endorsement does not entitle the person or organization named in the Schedule to any benefits, rights or protection underthis Coverage Form. SCHEDULE Name Of Person Or Organization Mailing Address Any person or organization holding a certificate of insurance issued The address shown for that person or organization in for you, provided the certificate: that certificate of insurance 1. Refers to this policy; 2. States that notice of: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; will be provided to that person or organization; 3. Is in effect at the time of the: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; and 4. Is on file at your agent or broker's office for this policy IL 70 66 07 14 Bond No. SU57015 Performance Bond The City of Cupertino ("City") and AIMS Companies ("Contractor") have entered into a contract, dated , 20 ("Contract")for work on the Storm Drain Cleaning/CCTV Inspection Services Project ("Project"). The Contract is incorporated by reference into this Performance Bond ("Bond"). 1. General. Under this Bond, Contractor as Principal and Aspen American Insurance Company, its surety ("Surety"), are bound to City as obligee for an amount not less than$160,000.00 to ensure Contractor's faithful performance of its obligations under the Contract. This Bond is binding on the respective successors, assigns, owners, heirs, or executors of Surety and Contractor. 2. Surety's Obligations. Surety's obligations are co-extensive with Contractor's obligations under the Contract. If Contractor fully performs its obligations under the Contract, including its warranty obligations under the Contract, and Contractor has timely provided a warranty bond as required under the Contract. Surety's obligations under this Bond will become null and void upon City's acceptance of the Project, excluding any exceptions to acceptance, if any. Otherwise Surety's obligation will remain in full force and effect until expiration of the one year warranty period under the Contract. 3. Waiver. Surety waives any requirement to be notified of and further consents to any alterations to the Contract made under the applicable provisions of the Contract Documents, including changes to the scope of Work or extensions of time for performance of Work under the Contract. Surety waives the provisions of Civil Code sections 2819 and 2845. 4. Application of Contract Balance. Upon making a demand on this Bond, City will make the Contract Balance available to Surety for completion of the Work under the Contract. For purposes of this provision, the Contract Balance is defined as the total amount payable by City to Contractor as the Contract Price minus amounts already paid to Contractor, and minus any liquidated damages, credits, or back charges to which City is entitled under the terms of the Contract. 5. Contractor Default. Upon written notification from City of Contractor's termination for default under Article 13 of the Contract General Conditions, time being of the essence, Surety must act within the time specified in Article 13 to remedy the default through one of the following courses of action: 5.1 Arrange for completion of the Work under the Contract by Contractor, with City's consent, but only if Contractor is in default solely due to its financial inability to complete the Work; 5.2 Arrange for completion of the Work under the Contract by a qualified contractor acceptable to City, and secured by performance and payment bonds issued by an admitted surety as required by the Contract Documents, at Surety's expense; or 5.3 Waive its right to complete the Work under the Contract and reimburse City the amount of City's costs to have the remaining Work completed. 6. Surety Default. If Surety defaults on its obligations under the Bond, City will be entitled to recover all costs it incurs due to Surety's default, including legal, design professional, or delay costs. Storm Drain Cleaning/CCTV Inspection Services Project PERFORMANCE BOND Project Number 2019-107 Page 28 7. Notice. Any notice to Surety may be given in the manner specified in the Contract and sent to Surety as follows: Attn: Lauri Arnett Address: 840 W Sam Houston Pkwy N., Suite 420 City/State/Zip: Houston,TX 77024 Phone: 713-730-7228 Fax: 602-279-5899 Email: Lauri.Arnett@aspen-insurance.com 8. Law and Venue. This Bond will be governed by California law, and venue for any dispute pursuant to this Bond will be in the Santa Clara County Superior Court, and no other place. Surety will be responsible for City's attorneys'fees and costs in any action to enforce the provisions of this Bond. 9. Effective Date; Execution. This Bond is entered into and effective on August 8 , 2019 SURETY: Aspen American Insurance Company Business Name s/ Jere Polk,Attor -in-F Name/Title [print] (Acknowledgment with Notary Seal for Surety and Surety's Power of Attorney must be attached.) CONTRACTOR: AIMS Companies oul ness Name s/ Name/Title Date: 1srhl / 9 s/ Name/Title Date: END OF PERFORMANCE BOND Storm Drain Cleaning/CCTV Inspection Services Project PERFORMANCE BOND Project Number 2019-107 Page 29 ACKNOWLEDGEMENT State of Arizona County of Maricopa On D before me personally appeared Jeremy Polk whose identity was proven to me on the basis of satisfactory evidence to be the person who he or she claims to be and acknowledged that he or she signed the attached document. r r r \ (Seal) Notary Public State of Arizona Maricopa County Notary Signature Matthew Stanton Erra My Commission Expires 03r09r2022 Commission Number 203332556 Matthew Stanton Erra Commission Expires March 91h, 2022 Acknowledgement Form State of Arizona )ss.. County of Maricopa ) 9 On the day of 4b4k/j�- in the year ,�before me, the undersigned notary public,personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument,the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. Notary Public AIMEE E. IHLING NOTARY PUBLIC-ARIZONA > MARICOPA COUNTY COMMISSION#564257 MY COMMISSION EXPIRES MAY 10,2023 c��i11 EN1 .3 3:JMiA AVIOS;iiA i 1 J8U4 Yf1Ai c'to o Yl OU00 At4O'DMAM Nasty*00188IMMOO ?3H19X3 001821MMOD YM " F.SOS,0 t YAM AS PEE N Aspen American Insurance Company 175 Capital Boulevard,Rocky Hill,CT 06067 POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS,THAT Aspen American Insurance Company,a corporation duly organized under the laws of the State of Texas,and having its principal offices in Rocky Ifill,Connecticut,(hereinafter the"Company")does hereby make,constitute and appoint: Jeremy Polk and Jessica Hollaender of USI Insurance Services its trite arid lawful Attorney(s)-in-Fact,with full power and authority hereby conferred to sign,execute and acknowledge on behalf of the Company,at any place within the United States,the following instrument(s)by iris/her sole signature and act:any and all bonds,recognizances,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking and any and all consents incident thereto,and to bind the Company thereby as Fully and to the sonic extent as if the same were signed by the duly authorized officers of the Company.All acts of said Attorney(s)-in-Fact done pursuant to the authority herein given are hereby ratified and confirmed, This appointment is made under and by authority of the following Resolutions of the Board of Directors of said Company effective on April 7,2011,which Resolutions are now in full force and effect; i VOTED:All Executive Officers of the Company(including the President,any Executive,Senior or Assistant Vice President,any Vice President,any Treasurer,Assistant Treasurer,orSecretary or Assistant Secretary)may appoint Altonheys-in-Fact to act for and on behalfof the Company to sign with Ore Componys name and seal with the Company's seal,bonds,recognizances,arid other writings obligatory in the nature of a band,recognizance,or conditional undertaking,and any ofsaid Executive Officers at any time may remove any such appointee and revoke the power given him or her. VOTED:The foregoing authority for certain classes of officers of the Company to appoint Attomeys-in-Fact by virtue of a Power of Attorney to sign and seal bonds, j recognizances,and other writings obligatory in the nature of'abond,recognizance,orconditional undertaking,as well as to revoke any such Power of Attorney,is hereby granted specifically to the following individual officers of Aspen Specialty Insurance Management,Inc.: Michael Toppi,Executive Vice President,Scott Sadowsky,Senior Vice President,Kevin W.Gillen,Senior Vice President,Mathew Raino, Senior Vice President, Ryan Field,Senior Vice President;Timothy P. Griffin,Vice President, Keith Flannery,Vice President,Mary Durosko,Vice President, Frank Campiglia,Vice President and Ray Philippomn,Assistant Vice President. This Power of Attorney may he signed and scaled by facsimile(mechanical or printed)under and by authority of the following Resolution voted by the Boards of Directors of Aspen American Insurance Company,which Resolution is now in full force and effect: VOTED:That the signature of any of the 011icers identified by title or specifically named above may be affixed by facsimile to any Powcr of Attomey far proposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof;and any and al l consents incident thereto,arid any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company.Any such power so executed and certified by such facsimile signature and/or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking so executed. IN WITNESS WHEREOF,Aspen American Insurance Company has caused this instrument to be signed and its corporate seal to be hereto affixed this 8th day of December,2017 Aspen America insurance Company STATE OF CONNECTICUT SS. ROCKY HILL ! {l�t, 'ttrn COUNTY OF HARTFORD Mary Dur• ko,We President On this 8th day of December,2017 before me personally came Mary Durosko,to rue known,who being by me duly sworn,did depose and say;that lie/she is Vice President,of Aspen American Insurance Company,llte Company described in and which executed the above instrument;fiat he/she knows the seal ofsaid corporation;that the seal affixed to the said instrument is such corporate seal;mid that he/she executed Ilie said instrument on behalfof the Company by authority of his/her office under the above { Resolutions dhereof. Vanessa Arias Y Notary Public Notary Public State of Connecticut My commission expires:February 280',2019 My Commission Expires February 28,2019 CERTIFICATE I,the undersigned Mary Durosko,of Aspen American Insurance Company,a stock corporation of the State ofToxas,do hereby certify dhat tie foregoing Power of Attorney remains in fill force told has not been revoked;and furthermore,that the Resolutions of the Boards of Directors,as set forth above,are now and remain in fill force and effect. Given under my hand and seal of said Company,in Rocky Hill,Connecticut,this 8 day of August 2019 .....in go By _ �t3 Name:Mary Durosko,Vice President i *For verificairan of the authenticity of the Power of Attorney you may call(860)760-7725 or email:Vanessa.arias@aspenspecialty.ponh i Bond No. SU57015 Payment Bond The City of Cupertino ("City") and AIMS Companies ("Contractor") have entered into a contract, dated , 20_("Contract")for work on the Storm Drain Cleaning/CCTV Inspection Services Project("Project"). The Contract is incorporated by reference into this Payment Bond ("Bond"). 1. General. Under this Bond, Contractor as principal and Aspen American Insurance Company, its surety("Surety"), are bound to City as obligee in an amount not less than$160,000.00, under California Civil Code sections 9550, et seq., to ensure payment to authorized claimants. This Bond is binding on the respective successors, assigns, owners, heirs, or executors of Surety and Contractor. 2. Surety's Obligation. If Contractor or any of its Subcontractors fails to pay a person authorized in California Civil Code section 9100 to assert a claim against a payment bond, any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of Contractor and its Subcontractors, under California Unemployment Insurance Code section 13020, with respect to the work and labor, then Surety will pay the obligation. 3. Beneficiaries. This Bond inures to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon this Bond. Contractor must promptly provide a copy of this Bond upon request by any person with legal rights under this Bond. 4. Duration. If Contractor promptly makes payment of all sums for all labor, materials, and equipment furnished for use in the performance of the Work required by the Contract, in conformance with the time requirements set forth in the Contract and as required by California law, Surety's obligations under this Bond will be null and void. Otherwise, Surety's obligations will remain in full force and effect. 5. Waivers. Surety waives any requirement to be notified of alterations to the Contract or extensions of time for performance of the Work under the Contract. Surety waives the provisions of Civil Code sections 2819 and 2845. City waives the requirement of a new bond for any supplemental contract under Civil Code section 9550. Any notice to Surety may be given in the manner specified in the Contract and delivered or transmitted to Surety as follows: Attn: Lauri Arnett Address: 840 W Sam Houston Pkwy N, Suite 420 City/State/Zip: Houston, TX 77024 Phone: 713-730-7228 Fax: 602-279-5899 Email: Lauri.Arnett@aspen-insurance.com 6. Law and Venue. This Bond will be governed by California law, and venue for any dispute pursuant to this Bond will be in the Santa Clara County Superior Court, and no other place. Surety will be responsible for City's attorneys' fees and costs in any action to enforce the provisions of this Bond. Storm Drain Cleaning/CCTV Inspection Services Project PAYMENT BOND Project Number 2019-107 Page 26 7. Effective Date; Execution. This Bond is entered into and is effective on August 8 2019. SURETY: Aspen American Insurance Company Business Name s/ Jeremy Polk, Attorne - act Name/Title Date: August 8, 2019 (Attach Acknowledgment with Surety's Notary Seal and Power of Attorney.) CONTRACTOR: AIMS Companies Busi a Name s/ Name/Title Date: Z�//0,6 9 s/ Name/Title END OF PAYMENT BOND Storm Drain Cleaning/CCTV Inspection Services Project PAYMENT BOND Project Number 2019-107 Page 27 ACKNOWLEDGEMENT State of Arizona County of Maricopa On before me personally appeared Jeremy Polk whose identity was proven to me on the basis of satisfactory evidence to be the person who he or she claims to be and acknowledged that he or she signed the attached document. (Seal) ' Notary Public State of Arizona Notary Signature Maricopa County Matthew Stanton Erra Commission03 2 Commission Number 203332,%6 Matthew Stanton Erra Commission Expires March 9th, 2022 Acknowledgement Form State of Arizona ) )SS.: County of Maricopa ) On the day ofN�J�,UZ- in the year before me, the undersigned notary public, personally appeared � �`�b"' personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. Notary Public AIMEE E.IHLING NOTARY PUBLIC-ARIZONA MARICOPA COUNTY o COMMISSION#564257 a+? MY COMMISSION EXPIRES MAY 10,2023 am uHi 3 33MIA AIAOS!RA -)� ISU9YWAI�"A P,3Hl9X-1 00- YA ASPEN Aspen American Insurance Company 175 Capital Boulevard,Rocky hill,CT 06067 POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS,THAT Aspen American Insurance Company,.a corporation duty organized under the haws of the State of Texas,and having its principal offices in Rocky hill,Connecticut,(hereinafter the"Company")does hereby make,constitute and appoint: Jeremy Polk and Jessicn Hollaender of USI Insurance Services its true and lawful Attorney(s)-in=Fact,with till power and authority hereby conferred to sign,execute and acknowledge oil behalf of the Company,at any place within the United States,the following instruments)by his/her sole signature and act:any and all bonds,reeognizances,aid other writings obligatory in die nature of a bond,recognizance,or conditional undertaking and any and all consents incident thereto,and to bind the Company thereby as filly and to the smile extent as if the sane were signed by the duty authorized officers of tine Company.All acts of said Attorney(s)-in-Fact done pursuant to the authority herein given are hereby ratified and confirmed 'I'his appointment is made under and by authority of the following Resolutions of the Board of Directors of said Company effective on April 7,2011,which Resolutions are now in full force and effect; VOTED:All Executive Officers of the Company(including die President;any Executive,Senior or Assistant Vice President,any Vice President,any Treasurer,Assistant Treasurer,or Secretary or Assistant Secretary)may appoint Attorneys-in-Fact to act for and on behalf of the Company to sign with the Compmiy's name and seat with die Company's seal,bonds,recognizances,raid other m itings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said Executive Officers at anytime may retrieve any such appointee and revoke the power given him or her. VOTED:The foregoing authority for certain classes of officers of the Company to appoint Altomeys-in-Fact by virtue of a Poiver ofAttomey to sign mad seal bonds, recognizances,and other writings obligatory in die nature of bond,recognizance,or conditional undertaking,as well as to revoke any such Power ofAttomey,is hereby granted specifically to die following individual officers of Aspen Specialty Insurance Management,Inc.: Michael Toppi,Executive Vice President;Scott Sadowsky,Senior Vice President,Kevin W.Gillen,Senior Vice President,Nlathew Raino, Senior Vice President, Ryian Field,Senior Vice President;Timothy P. Griffin,Vice President, Keith Flannery;Vice President,Mary Durosko,Vice President, Frank Campiglin,Vice President thud Ray Philippon,Assistant Vice President. This Power of Attorney may be signed and scaled by facsimile(mechanical or printed)under and by authority of the following Resolution voted by (lie Boards of Directors of Aspen American Insurance Company,which Resolution is now in full force arid effect: I' VOTED:That the signature of any of the Officers identified by title or specifically named above may be affixed by facsimile to any Power ofAttomey for purposes only of executing mid attesting bonds and undertakings and other writings obligatory in tine nature thereof,and any and all consents incident thereto,and any such.Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid mad binding upon the Company.Any such power so executed and certified by such facsimile signature and/or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking so executed. IN WITNESS WHEREOF,Aspen American Insurance Company has caused this instrument to be signed and its corporate seal to be hereto affixed this 8th day of December,2017 Aspen Annericar Insurance Company STATE OF CONNECTICUT I I 1 �j�y ilff SS. ROCKY HILL COUNTY OF HARfFOKD Miny Diu•. ko" ce President On this 8th day of December,2017 before me personally cane May Durosko,to me known,who being by me duty swom,did depose and say;that he/she is Vice President,of Aspen American Insurance Company,the Company described in aid which executed the above instrument;that he/she knows lie seal ofsaid corporation;dial the seal affixed-to the said anstr anent is such corporate seal;and that he/she executed Elie said instrument on behalfofdie Compmiy by authority of his/her office under the above ItSlialns thereof. Vanessa Arias iCGtGC�' Notary Public Notary Public State of Connecticut My commission expires:February 280',2019 My Commission Expire,February 28,2019 CERTIFICATE I,the undersigned Mary Durosko,of Aspen American Insurance Company,a stock corporation of the State of Texas,do hereby certify that the foregoing Power of Attorney remains in flail force road has not been revoked;and furthermore,that the Resolutions of the Boards of Directors,as set forth above,are now and remain in hill force and effect, Given under my hand and seal of said Company,in Rocky Hill,Connecticut,this 8 day of August 2019 y4a. Ui' 4s '6.nnau"aoo i By.: Name:Mary Durosko,Vice President *For verification of the authenticity of lie Power of Attorney you may call(860)760.7725 or emai1:Vanessa.arias arias@aspenspecialty.com ' i � Form W-9 Request for Taxpayer Give Form to the (Rev.October2018) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. AIMS/PVIC CA LLC 2 Business name/disregarded entity name,if different from above dba AIMS Companies (D 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to CF) following seven boxes. certain entities,not individuals;see a C ❑ C Corporation instructions on page 3): o ❑ Individual/sole proprietor or poration ❑ S Corporation ❑ Partnership ❑Trust/estate N single-member LLC ai c Exempt payee code(if any) ❑✓ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► `o w Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting to LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that code(if any) 1 o is disregarded from the owner should check the appropriate box for the tax classification of its owner. o see instructions y ❑ Other( )► (Applies to accounts meintelned outside the U.S.) N 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional) m In 1616 Doolittle Drive 6 City,state,and ZIP code San Leandro CA 94577 7 List account number(s)here(optional) IMU Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security,number backup withholding.For individuals,this is generally your social security number(SSN).However,for a -m - resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN,later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and I Employer identification number Number To Give the Requester for guidelines on whose number to enter. M46 - 1 6 1 6 7 9 2 LEM Certification Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later. Sign Signature of E2 f July 15,, 2019 Here U.S.person► Date 0- General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise .Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its Instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number(ITIN),adoption taxpayer identification number(ATIN),or employer identification number •Form 1099-A(acquisition or abandonment of secured property) (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018)