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17-171 Bleyco Incorporated, Mary Ave Bridge Lighting System RepairsCITY OF El Purchase Order No.)olg ,1s::,if- PUBLIC WORKS CONTRACT OF $45,000 OR LESS WITH Bleyco Incorporated FOR Mary Ave. Bridge Lighting System Repairs CUPERTINO 1. PARTIES Th.is public works contract is entered into by and between the City of Cupertino, a municipal corporation, and Bleyco Incorporated a Electrical Contractor, pursuant to Public Contract Code Section 22032, for work on Mary Ave. Bridge Lighting System. 2. SCOPE OF WORK Contractor will perform and provide all labor, materials, equipment, supplies, transportation, and any and all other items or services necessary to perform and complete the work required for the Project ("Work"), as specified in Attachment A, Scope of Work, and according to the terms and conditions of this Contract, including all attachments and any other documents and statutes incorporated by reference. If any attachment contains provisions that conflict or are inconsistent with the te1ms set forth in the body of this Contract, the Contract tem1s will control. 2. TIME FOR COMPLETION The Work required shall commence on TBD or on the date shown on a written Notice to Proceed (''NTP"). The City Engineer will not issue Contractor a written notice to proceed (''NTP") with the Work for the Project until the Contract is fully executed by both parties and City has received,all insurance documentation pursuant to Section 13 below and any bonds required for contracts of $25,000 or more, pursuant to Section 14 below. Contractor must fully complete the Work within 90 calendar days from the commencement date ("Contract Time"). Time is of the essence for completion of the Work within the Contract Time. 3. COMPENSATION AND PAYMENT For satisfactory completion of the Work, City will pay Contractor a total not to exceed $10,000.00 ("Contract Price"). Contractor must submit an invoice on the first day of each month during the for the Work performed during the preceding month, itemizing labor, materials, equipment and any incidental costs incUITed. City will pay Contractor 95% of the undisputed amount(s) billed, within 30 days after City's receipt of each properly submitted invoice. Any undisputed retention will be released and included with the final payment to Contractor within 60 days after City accepts the Work for the Project as complete. Contractor wall'ants that title to all work, materials and equipment incorporated into the Work will pass to City free of any claims, liens, or encumbrances upon payment to Contractor. 4. LIQUIDATED DAMAGES Liquidated damages in the amount of $200.00 will be charged each day of unexcused delay, or City may deduct said amount from payments. Liquidated damages are based on reasonably foreseeable consequences of delay, including actual costs incurred by City and intangible damages such as loss of or interference with use of public property or public inconvenience. Upon receiving prompt notice from Contractor of unanticipated events, City may excuse minor unavoidable delays but Contractor will not Public Works Project & ConJ:ractor Public Works Contract-$45,000/Rev. Oct 4, 2017 Page I Purchase Order No. --- be entitled to additional compensation, subject to provisions of Public Contract Code Section 7102. 5. LICENSES AND PERMITS Contractor must possess a California Contractor's License in good standing for the following classification(s): ClO. Contractor must obtain a City business license before beginning Work. Contractor is solely responsible for obtaining any required building pe1mits or similar governmental authorizations for the Work, at Contractor's sole expense. · 6. LABOR CODE COMPLIANCE Unless the Contract Price is $1,000 or less, this Contract is subject to all applicable requirements of Chapter 1 of Pait 7 of Division 2 of the Labor Code, beginning at Section 1720, and the related regulations, including but not limited to requirements pe1taining to wages, working hours and workers' compensation insurance. Contractor must also post all job site notices required by laws or regulations pursuant to Labor Code Section 1771.4. Prevailing Wages. Contractor must pay prevailing wages applicable in Santa Clara County for each craft, classification or type of worker needed to pe1form the Work, including but not limited to employer payments for health, pension, vacation, apprenticeship. The prevailing wage rates are on file with the City Engineer's office and are available online at http://www.dir.ca.gov/DLSR. Pursuant to Labor Code Section 1775, Contractor/subcontractor are required to make aggrieved workers whole and to pay City a penalty up to $200.00 per day or portion thereof, for each worker not paid prevailing wag~s. Working Day. Pursuant to Labor Code Section 1810, a legal day's work is eight hours of labor. Pursuant to Labor Code Section 1813, Contractor will pay City a penalty of $25 for each day workers of Contractor or subcontractors are required or pe1mitted to work more than eight hours a day, or more than 40 hours per calendar week, unless such workers are paid overtime wages under Labor Code Section 1815. The Work must be done during regular City working days/ hours unless otherwise specified in Attachment A or authorized in writing by City. Payroll Records. Contractor must maintain certified payroll records in compliance with Labor Code Sections 17.76 and 1812, and DIR implementing regulations. Contractor and subcontractors must ce1tify under penalty of perjury that the information in payroll records is trne and correct, as required by Labor Code Sections 1771, 1811 and 1815. Contractor must electronically submit ce1tified payroll records to the Labor Commissioner unless the Contract is exempt from DIR registration. Apprentices. If the Contract Price is $30,000 or more, Contractor must comply with the apprenticeship requirements in Labor Code Section 1777. 5. DIR Monitoring, Enforcement, and Registration. This Contract is subject to compliance, monitoring and enforcement by the DIR pursuant to Labor Code Section 1725 .5, unless exempted as indicated below. Contractor/subcontractors must be registered with the DIR to perfo1m public works projects. (1) The registration requirements of Labor Code Section 1725.5 or for electronic submission of certified payroll records do not apply if the Contract is for: (a) constmction, alteration, demolition, installation, or repair and under $25,000; or (b) maintenance and under $15,000. (2) "Maintenance" includes routine, recurring and usual work for the preservation, protection and keeping of any publicly owned or publicly operated facility for its intended purposes in a safe and continually Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 2017 Page2 Purchase Order No. --- usable condition for which it has been designed, improved, constructed, altered or repaired, carpentty, electrical, plumbing, glazing, touchup painting, and other craft work designed to preserve the publicly owned or publicly operated facility in a safe, efficient and continuously usable condition for which it was intended, including repairs, cleaning and other operations on machine1y and other equipment pe11nanently attached to the building or realty as fixtures, and landscape maintenance including mowing, watering, trimming, pruning, planting, replacement of plants, and servicing of irrigation and sprinkler systems. Workers' Compensation Certification. Pursuant to Labor Code Section 1861, by signing this Contract, Contractor certifies: "I am aware of Labor Code Section 3700 which requires 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 Work on this Contract." 7. AMENDMENTS AND CHANGE ORDERS All amendments or change orders must be in writing and duly authorized and executed by City and Contractor. Contractor's request for a change order must specify the proposed changes in the Work and any adjustments in Conh·act Price or Contract Time. Each such request must be accompanied by all supporting documentation, including but not limited to plans/drawings, detailed cost estimates, and impacts on schedule and completion date. 8. STANDARDS AND COMPLIANCE Contractor will use its best efforts to complete the Work in a professional and expeditious manner as required by this Contract and all pe1mit requirements. Contractor's workmanship must meet or exceed industry standards and comply with applicable local, state, and federal laws, regulations, rules, and requirements. By executing this Contract Contractor warrants that all Work will be pe1formed by qualified and experienced personnel, and that neither Contractor nor its subcontractors or employees are employees of City or have any other relationship with City officials, employees or consultants that would create a conflict of interest. 9. INDEPENDENT CONTRACTOR Contractor is an independent contractor and is responsible for the Work and the means and methods by which it is performed. Contractor is not a City employee nor entitled to any employee benefits. 10. COMPLIANCE WITH LAWS Contractor must comply with all applicable local, state and federal laws, rules and regulations. Contractor will promptly advise City of any change in applicable laws or other conditions that may affect City's project or Contractor's ability to perfo1m. In addition, Contractor is solely responsible for verifying the identity and employment authorization of all of its employees and subcontractors performing the Work, pursuant to the Immigration Reform and Control Act or similar federal or state rules and regulations governing employment of immigrants. Contractor must indemnify and hold City harmless from and against any loss, damage, liability, costs or expenses arising from Contractor's failure to comply with this section. 11. NON-DISCRIMINATION Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 2017 Pagc3 Purchase Order No. --- Discrimination against any person, prospective, or present employee of Contractor in connection with this Contract in violation of federal, state or local law is prohibited. There shall be no discrimination on the basis of race, religious creed, color, ancestry, national origin, ethnicity, handicap, disability, marital status, pregnancy, age, sex, gender, sexual orientation, or any other protected classification, including gender identity, Acquired-Immune Deficiency Syndrome (AIDS), AIDS-Related Complex (ARC) Contractor, its employees and subcontractors, must comply with all anti-discrimination laws, including but not limited to civil rights laws, the California Fair Employment and Housing Act, Gov. Code Sec. 11135, and Labor Code Sec. 1735 and 3077.5. Violations of this provision constitute a material breach. 12. INDEMNITY To the fullest extent allowed by law, Contractor must indemnify, defend, and hold harmless City, its City Council, boards and commissions, officers, officials, agents, employees, consultants and volunteers ("Indemnitees") from and against any and all liability, claims, stop notices, actions, causes of action, demands, losses, damages, and expenses (including legal expenses) whatsoever, including liability arising from injuty or death of any person, or damage to property or other liability of any nature, arising out of, pertaining to, or related to the Work or perfo1mance of this Contract ("Liability"), including failure to comply with any obligations herein by Contractor or Contractor's directors, officers, officials, employees, agents or subcontractors. This indemnity obligation does not extend to Liability caused by the sole negligence or willful misconduct of an Indemnitees. Contractor's failure or refusal to timely accept a tender of defense will be deemed a material breach of the Contract. City will timely notify Contractor upon City's receipt of any third-party claim relating to the Contract, as required by Public Contract Code Section 9201. No Indemnitee will be personally liable to Contractor or Contractor's directors, officers, officials, employees, agents or subcontractors for any Liability. Contractor's indemnity obligations under this Contract are not limited by any limitation of the amount or type of damages or compensation payable under the workers' compensation laws or other employee benefit statutes, or by the insurance coverage or bond limits required under this Contract, and will smvive the expiration or any early te1mination of the Contract. 13. INSURANCE Contractor shall comply with all the insurance requirements in Attachment C -Insurance Requirements, attached and incorporated herein by reference. Contractor shall not commence any work or provide any Services until after all insurance requirements are met. Coverage must include the policy types and limits specified below, insuring against claims for injuries to persons or damages to prope1ty that may arise or relate to Contractor's perfo1mance under the Contract. City will not execute the Contract nor issue a NTP until Contractor has submitted satisfactory certificates of insurance and endorsements, evidencing the type, amount, class of operations covered, and the effective dates and dates of expiration of the insurance coverage required below. The insurance must be issued by a company or companies acceptable to City and licensed to do business in the State of California, and each insurer must have an A.M. Best's financial strength rating of "A" or better and a financial size rating of "VII" or better. If Contractor fails to provide or maintain any of the required insurance coverage, City may, in its sole discretion and without prior notice to Contractor, purchase such insurance at Contractor's expense, deduct costs from payments to Contractor, or terminate the Contract for default. 14. BONDS Public Works Project & Contractor Public Works Contract-$45,000/Rev. Oct 4, 2017 Page4 Purchase Order No. --- If the Contract Price is $25,000 or more, City will not execute the Contract and issue the NTP until Contractor has provided City with a payment bond and a pe1f01mance bond for the Work, each in the penal sum of not less than 100% of the Contract Price, using the bond forms included in this Contract under Attachment B, Bond Forms. Each bond must be issued by a surety admitted in California. If an issuing surety cancels a bond or becomes insolvent, Contractor must provide a substitute bond from a surety acceptable to City, within seven calendar days after written notice from City. If Contractor fails to substitute an acceptable surety within the specified time, City may, in its sole discretion and without prior notice to Contractor, purchase such bond(s) at Contractor's expense and deduct the cost from payments otherwise due to Contractor, or terminate the Contract for default. 15. ASSIGNMENT AND SUCCESSORS Contractor may not transfer or assign its rights or obligations under this Contract, in part or in whole, without City's prior written consent. The terms and conditions of this Contract are binding on Contractor's heirs, successors, and assignees. 16. SUBCONTRACTORS Contractor may use qualified, competent subcontractors to perform up to 0% of the Work, provided each subcontract expressly requires subcontractors to be bound by the provisions of this Contract, including but not limited to the indemnity and insurance requirements. It is Contractor's responsibility to ensure that Subcontractors maintain the required insurance certificates, minimum coverage, additional insureds endorsements, indemnity, and waivers of subrogation. Contractor agrees to include these insurance requirements and indemnity provisions in any contract with a Subcontractor. Contractor shall require Subcontractors to provide valid certificates of insurance and endorsements prior to commencement of Work and shall provide proof of compliance to City. Subcontractors must agree to be bound to Contractor and City in the same manner and to the same extent as Contractor is bound to City under the Contract Documents. Subcontractors must include these requirements in any contract with a Sub-subcontractor. A copy of this Agreement and its insurance provisions will be furnished to the Subcontractor upon request. City reserves the right to reject any subcontractor of any tier, and to bar a subcontractor from pe1fom1ing further Work on the Project, if City, acting in its sole discretion, determines that the subcontractor's performance or failure to perfo1m does not meet the requirements of this Contract, or for any of the reasons set forth in Public Contract Code Section 4107. If City rejects a subcontractor pursuant to this section, Contractor must either self-perform the Work of that subcontractor or replace the subcontractor with one that is acceptable to City, at no additional cost to City. 17. UTILITIES, TRENCIIlNG AND EXCAVATION A. Contractor must call the Underground Service Alert ("USA") 811 hotline for marking of utility locations before digging. For underground service alerts for City street lighting and traffic signal conduits, Contractor must also, before commencing any Work, call the City of Cupertino Service Center at (408) 777-3269. B . As required by Government Code Section 4215, if, while performing the Work, Contractor discovers utilities or utility facilities not identified by City, Contractor must immediately provide written notice to City and to each known utility. Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 2017 Page 5 Purchase Order No. __ _ C. As required by Government Code Section 7104, Contractor must promptly notify City in writing if Contractor finds any of the three conditions listed below, and wait for fmther direction from City before disturbing such condition(s). Following such notice, City will promptly investigate and if City finds that one or more of the following three conditions is or are present and that the presenters of any such condition will cause a decrease or increase in Contractor's cost of or time required for pe1formance of the Work, City will amend the Contract Time or Contract Price for the Work as required by law: (1) Material that Contractor believes may be a hazardous waste as defined in Health and Safety Code Section 25117, that is required to be removed to a Class I, Class II, or Class III disposal site in accordance with the law; (2) Subsurface or latent physical conditions at the Project worksite differing from those indicated by information about the worksite made available to Contractor; and (3) Unknown physical conditions at the Project worksite of any unusual nature, materially different from those ordinarily encountered and from those generally recognized as inherent in the character of the Work. D. As required by Labor Code Section 6705, if the Contract Price exceeds $25,000 and the Work includes excavation of any trench or trenches five feet or more in depth, a detailed plan must be submitted to City, or its civil or strnctural engineer, for acceptance in advance of the excavation. The detailed plan must show the design of shoring, bracing, sloping, or other provisions for worker ~ prot~cjiQr1Jr21APOtential hazards of cavingJ~round. If the glan varies from the shoring~xstenL _ _ _ standards, it must be prepared by a registered civil or structw·al engineer. Use of a shoring, sloping, or protective system less effective than that required by the Construction Safety Orders is prohibited. 18. RECORDS AND DAILY REPORTS Contractor must maintain daily reports on the Work and submit them to City upon request and at completion of Project. Daily reports must describe: the Work pe1formed that day; the number of workers and hours performing the Work; the equipment and hours oflabor used for each task; a description of weather conditions; and any circumstances affecting the planned progress of the Work. All such reports are the exclusive property of City, but Contractor is permitted to retain copies for its records. Unless otherwise specified in Attachment A, Contractor must maintain and update a separate set of as- built drawings during performance of the Work, showing any changes to the Work Scope in Attachment · A, or any drawings incorporated into this Contract. The as-built drawings must be updated as changes occur, on a daily basis if necessary. Actual locations to scale must be identified on the as-built drawings for all major components of the Work, including but not limited to, as applicable: mechanical, electrical and plumbing work; HV AC systems; utilities and utility connections; and any other components City determines should be included in the final record drawings of the Project. Deviations from the original drawings must be shown in detail, and the location of all main rnns, including but not limited to piping, conduit, ductwork, and drain lines, must be shown by dimension and elevation. 19. CONFLICTS OF INTEREST ·· Contractor warrants it does not have a conflict of interest in connection with this Contractor or the Work. Contractor shall comply with conflict of interest laws under Government Code section I 090 et Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 20 l 7 Page6 Purchase Order No. --- seq., the Political Reform Act, Government Code section 81000 et seq., and all accompanying regulations. Contractor wanants that neither Contractor, subcontractor, nor their employees are employed by City or have any other relationship with City officials, employees or consultants that would create an unlawful conflict of interest. If Contractor acts in a staff capacity or makes governmental decisions during the Contract Te1m, Contractor may be required to fill out a conflict of interest fmm pursuant to Title 2, Division 6, Section 18700 of the California Code of Regulations. 20. NOTICES All notices, demands, requests or approvals under this Contract must be given or made in writing and sent to the other party by personal delivery, U.S. Mail, a reliable overnight delivery service, facsimile, or by email as a PDF (or comparable) file. Notice is deemed effective upon delivery unless otherwise specified. Notice for each party must be given as follows: City of Cupertino 10300 Tone Avenue Cupertino CA 95014 Attention: Brad Alexander Copy to: Jonathan Ferrante Email: brada@cupertino.org 21. URBAN RUNOFF MANAGEMENT Contractor: Bleyco Incorporated Address: 11425 Cull Canyon Rd. Castro Valley, CA. 94552 Attention: Renee Juarez Copy to: Ruth Bley Email: rjuarez@bleyco.com All Work on the Project must fully comply with federal, state, local and City regulations concerning stormwater management. Contractor must avoid creating excess dust when breaking asphalt or concrete and during excavation and grading. If water is used for dust control, Contractor will use only the amount of water necessruy to dampen the dust. Contractor will take all steps necessary to keep wash water out of the streets, gutters and storm drains. Contractor will also develop and implement erosion and sediment controls to prevent pollution of storm drains. Contractor must implement these controls prior to the strui of the Work, upgrade them due to weather conditions or as otherwise required by City, maintain them during construction or other Work phases to provide adequate protection, and remove them at the end of construction and completion of the Work. Such controls must include, but will not be limited to, the following requirements: A. Install sto1m drain inlet protection devices such as sand bag baniers, filter fabric fences, and block and gravel filters at all drain inlets impacted by construction. During the annual rainy season, October 15 through June 15, storm drain inlets impacted by construction work must be filter-protected from onsite de-watering activities and saw-cutting activities. Shovel or vacuum saw-cut sluny and remove from the Work site. B. Cover exposed piles of soil or construction material with plastic sheeting. Store all construction materials in containers. C. Sweep and remove all materials from paved surfaces that drain to streets, gutters and storm drains prior to rain and at the end of each work day. When the Work is completed, wash the streets, collect and dispose of the wash water offsite in lawful manner . D. After breaking old pavement, remove debris to avoid contact with rainfall/runoff. Public Works Project & Contractor Public Works Contract-$45,000/Rcv. Oct 4, 2017 Page? Purchase Order No. --- E. Maintain a clean work area by removing trash, litter, and debris at the end of each work day and when Work is completed. Clean up any leaks, drips, and other spills as they occur. F. The requirements stated above are intended to be used in conjunction with the Califomia Sto1mwater Quality Association and Califomia Best Management Practices Municipal and Construction Handbooks, local program guidance materials from municipalities, and any other applicable documents on stormwater quality controls for construction. Contractor's failure to comply with this section will result in the issuance of noncompliance notices, citations, Work stop orders and regulatory fines. 22. EARLY TERMINATION City may terminate this Contract for convenience or for cause, upon written notice to Contractor. Contractor's failure or refusal to perform the Work as required will be deemed a default. If not cured to City's satisfaction within two days after delivery of written notice of default to Contractor, City may, in its sole discretion, elect to do one or more of the following: A. Te1minate the Contract immediately, upon written notice to Contractor. B. Complete the Work using City's own forces and charge Contractor for all resulting costs and expenses, including City staff time. C. Retain another contractor to complete the Work and charge Contractor for costs and expenses. D. Require the performance bond surety to pay for completion of the Work. E. Pursue any other remedy available to City at law or under this Contract. If City terminates the Contract, City will owe Contractor only for Work satisfactorily performed before Contract termination date. Nothing in Section 23 below is intended to delay, abridge or bar City's right to terminate this Contract early pursuant to this section. 23. DISPUTE RESOLUTION, LAW AND VENUE Contract disputes are subject to the dispute resolution procedures of Public Contract Code Section 20104 et seq., incorporated here by reference. Interpretation and enforcement of this Contract are governed by California law, and venue for any legal action shall be the Superior Court for the County of Santa Clara, Califomia. Contract disputes are subject to the requirements of the California Government Claims Act. 24. ADVERTISEMENT Contractor may not post, exhibit, or display any advertising signage at the Project site without prior written approval from City. This section does not apply to signage intended or required for general safety while Work is in progress. 25. WAIVER City waiver of any breach of a contract provision or condition, or the acceptance of work or payment for Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 2017 Page 8 Purchase Order No. --- said work, shall not constitute a waiver of any other breach of this Contract. 26. WARRANTY Contractor guarantees the Work and materials used or provided for the Project for a period of one year, beginning upon City's acceptance of the Work as complete ("Wairnnty Period"). During the Wairnnty Period, upon notice from City of any Work defects, Contractor must, at its sole expense, promptly repair or replace the defective Work or materials and any other Work or materials that ai·e displaced or damaged during the wa11·anty work, excepting any damage resulting from ordinary weai· and tear. 27. INTEGRATION This Contract, attachments, a11d documents and statutes attached, referenced, or expressly incorporated herein, including any duly authorized and executed amendments or change orders, constitute the full and complete understanding of every kind or nature between City and Contractor with respect to the Work and the Project. No oral agreement or implied covenant will be enforceable against City. If any term or provision of this Contract is determined by a court to be illegal, invalid or unenforceable, the legal portion of said provision and all other contract provisions shall remain in full force and effect. 28. SURVIVAL Section 12 (Indemnity), Section 23 (Dispute Resolution), and Section 26 (Warranty) expressly survive termination or expiration of the Contract. 29. INSERTED PROVISIONS Each provision a11d clause mandated by law will be deemed to be included in this Contract for purposes of interpretation and enforcement. If through mistake or otherwise any such provision was omitted or inco1rnctly inserted, the Contract will be deemed amended accordingly. The Pai·ties will work in good faith to give meaning to the intent of this Contract. 30. CAPTIONS The captions in this Contract ai·e for convenience only and are not a part of the Contract. They do not affect, limit or amplify the terms or provisions of the Contract. 31. AUTHORIZATION The persons signing below warrant they have the authority to enter into this Agreement and legally bind their respective Parties. If Contractor is a corporation, signatures from two officers of the corporation ai·e required pursuant to California Corporations Code Section 313. IN WITNESS WHEREOF, the pai·ties have caused this Contract to be executed. Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 2017 Page 9 CONTRACTOR Bleyco Incorporated, By:~ RuthB!ey' Title: President Purchase Order No. CITY OF CUPERTINO, a Municipal Co=,p~n By:,. 4 _/ /_ ,/-Timm Bortlen / Title: Director of Public Works -- Date: -~lA_~ 5_· l_)-____ _ Date: ~jz ----+7 ~-,,7 ~-------- APPROVED AS TO FORM: -Br, w ~Randolph Hom Title: City Attorney City Attorney's Office Date: ------------ Public Works Project & Contractor ATTEST: ~--r)J H By: Gr fu ~ Title: City Clerk City of Cupertino Date: / 2... -l ! ~ / 7 Page 10 Contract Amount: $10,000.00 P.O. No. 2018-00000307 Account No. 100-85-848-700-702 Public Works Contract -$45,000/Rev. Oct 4, 2017 Attachment A -Scope of Work Contractor will perform the following Work for the Project, within the Contract Time set forth in Section 2 and for the Contract Price set fo1th in Section 3 of this Contract: Contractor to supply all labor and materials to trouble shoot and make repairs to the Mary Ave. bridge lighting system. See attached Quote El 717 Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 2017 Page 11 ATTACHMENT C -INSURANCE REQUIREMENTS A. Required Policies and Limits. The following insurance policies and limits are required for this Contract, unless otherwise specified in Attachment A: (1) Commercial General Liability (''CGL'') Insurance: The CGL policy must be issued on an occurrence basis, written on a comprehensive general liability form, and must include coverage for liability arising from Contractor's or its subcontractor's acts or omissions in the performance of the Work, including contractor's protected coverage, blanket contractual, completed operations, vehicle coverage and employer's non-ownership liability coverage, with limits of at least $2,000,000 per occurrence and $4,000,000 in the aggregate. TI1e CGL policy must protect against any and all liability for personal injury, death, or property damage or destruction arising directly or indirectly in the performance of the Contract. The CGL coverage may be a1Tanged under a single policy for the full limits required or by a combination of underlying policies with the balance provided by excess or umbrella policies, provided each such policy complies with the requirements set forth in this Contract. a. It will be a requirement under this agreement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits will be made available to the Additional Insured and will be (1) the minimum coverage and limits specified in this agreement; or (2) the broader coverage and maximum limits of coverage of any Insurance policy, whichever is greater. b. The Additional Insured coverage under the Contractor's policy will be "primary and non- contributory" and will not seek contribution from the City's insurance or self-insurance and will be at least as broad as CG 20 01 04 12. c. The limits of Insurance required in this agreement may be satisfied by a combination of primary and umbrella or excess Insurance. Any umbrella or excess Insurance will contain or be endorsed to contain a provision that such coverage will also apply on a primary and non-contributory basis for the benefit of City (if agreed to in a written contract or agreement) before the City's own insurance or self- insurance will be called upon to protect it as a named insured. Contractor will maintain insurance as required by this contract to the fullest amount allowed by law and will maintain insurance for a minimum of five years following the completion of this project. In the event contractor fails to obtain or maintain completed operations coverage as required by this agreement, the City at its sole discretion may purchase the coverage required and the cost will be paid by the contractor. (2) Comprehensive Automobile Liability Insurance: The automobile liability policy must be issued on an occurrence basis, with limits of at least $1,000,000 per occmTence for bodily injury and $1,000,000 per occurrence for property damage, or combined single limit of $1,000,000 per occmTence, covering owned, non-owned and hired automobiles. (3) Workers' Compensation Insurance and Employer's Liability Insurance: The workers' compensation and employer's liability policy or policies must comply with the requirements of the California Workers' Compensation Insurance and Safety Act, providing coverage of at least $1,000,000 Public Works Project & Contractor Public Works Contract -$45,000/R.ev. Oct 4, 2017 Page 12 or as otherwise required by the statute. If Contractor is self-insured, Contractor must provide its Certificate of Pem1ission to Self-Insure, duly authorized by the DIR B. Builder's Risk Insurance. Contractor must provide builder's risk insurance only if the box below is checked. D Builder's Risk coverage is required for this Contact. The builder's risk policy must be issued for course of construction on an occurrence basis, for all-risk coverage on a 100% completed value basis on the insurable portion of the Project for the benefit of City, and name the City as a loss payee as its interest may appear. If the Project does not involve new or major reconstruction, the City may elect, acting in its sole discretion, to accept an installation floater policy instead of builder's risk. The installation floater policy must provide property damage coverage for any building, structure, machinery, or equipment damaged, impaired, broken, or destroyed during the performance of the Work, including during transit, installation, and testing at the City's site. C. Additional Insureds. City, including its City Council, boards and commissions, officers, officials, agents, employees, consultants and volunteers, must be named as additional insureds under Contractor's insurance policies required under this section, except under the worker's compensation policy. The naming of an additional insured will not affect any recovery to which the additional insured would be entitled to under the policy if not named as an additional insured. An additional insured will not be held liable for any premium, deductible portion of any loss, or expense of any nature under the policy or any extension thereof. Any other insurance held by an additional insured will not be required to contribute anything toward any loss or expense covered by Contractor's insurance. D. Notice. Each ce1iificate of insurance must state that the coverage afforded by the policy or policies is in force and will not be reduced, cancelled or allowed to expire without at least 30 days advance written notice to City, unless due to non-payment of premiums, in which case ten days advance written notice must be provided to City. Such notice must be sent to City via certified mail and addressed to the attention of the City Manager. E. Waiver of Subrogation. Each required policy must include an endorsement providing that the carrier agrees to waive any right of subrogation it may have against City. F. Required Endorsements. The CGL policy, the automobile liability policy and the builder's risk or installation floater policy, if required, must include the following endorsements: (1) The inclusion of more than one insured will not operate to impair the rights of one insured against another, and the coverages afforded will apply as though separate policies have been issued to each insured. (2) The insurance provided is primary and no insurance held or owned by City may be called upon to contribute to a loss. (3) This policy does not exclude explosion, collapse, underground excavation hazard, or removal of lateral support. . Public Works Project & Contractor Public Works Contract -$45,000/Rev. Oct 4, 2017 Page 13 G. Forms of Certificates of Insurance and Endorsements. Each ce11ificate of insurance and endorsement must provide the nan1e and policy number of each carrier and policy, using a form and format acceptable to City. H. Subcontractors. Contractor must ensure that each subcontractor maintains the same insurance coverage required under this section with respect to its performance of Work on the Project, including those requirements related to the naming of additional insureds and waivers of subrogation. END OF ATTACHMENTC Public Works Project & Contractor Public Works Contract· $45,000/Rev. Oct 4, 2017 Page 14 DATE: October 11, 2017 City of Cupertino From: Chris Berge RE: Mary Street Bridge Brad Alexander: BLEYco· License #540588 Per your conversation with Chris Berge please find our rates. Description Hourly Rate Bucket Truck $ 68.45 Electrician: Foreman $177.46 Please call our office or Chris Berge at 510-557-1506 should you have any questions. E1717 Mary St Br. 10-11-17 SAN FRANCISCO OFFICE : 401 Terry A. Francois Blvd. #122 San Francisco, CA 94158-2133 (416) 896·6072 FAX (416) 896-6073 MAILING ADDRESS : 11425 Cull Canyon Road Castro Valley, CA 94552 (610) 638-6228 FAX (610) 638-6229 BENCIA SHOP : 4690 E. 2"" St. #8 Benicia, CA 94510 (707) 746-6292 FAX (707) 747-6290 Page 1 of2 BLEYC-1 OP ID: JC ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/00/YYYY) ~ 10/18/2017 THIS CERTIFICATE IS ISSUED AS A MATIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF I NSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ~~~~cT Certificate Dept. Legacy Risk & Insurance Svcs r.JJgNNEo Extl: 925-482-1000 I rffc Nol: 925-482-1001 CA License #OH66758 1850 Mt. Diablo Blvd, Ste #400 ioMo~~ss, Certificates@legacyrisk.net Walnut Creek, CA 94596 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Hartford Fi re Insurance Co. 19682 INSURED Bleyco, Inc. INSURER B : Hartford Casualty Ins Co . 29424 11425 Cull Canyon Rd. Castro Valley, CA 94552 INSURER C : INSURER D: INSURER E: INS URER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED . NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AN D CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . INSR TYPE OF INSURANCE AUDL :;uBt< (~~Jclg~, (~~Jclg~ LIMITS LTR '"'"0 ,.n,n POLICY NUMBER D X COMMERCIAL GENERAL LIABILITY EAC H OCCURRENCE $ 1,000,000 -~ CLAIMS -MADE 0 OCCUR LJAMAlic \ Yi r<ci. I cu X X 57UEAFM7668 10/01/2017 10/01/2018 PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person ) s 5,000 x Per Project Agg PERSON AL & ADV INJURY $ 1,000,000 1-- GEN 'L AGGREGATE LIMIT APPLIES PER: GENER AL AGG REG ATE $ 2,000,000 R D PRO-D LOC PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER : Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMB INED SINGLE LIMIT $ 1,000,000 /Ea accidentl -A X ANY AUTO X X 57UEAFM7669 10/01 /2017 10/01/2018 BODILY INJURY (Per person ) $ --ALL OWN ED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S -X X NON-OWNED PROPERTY DAM AG E $ HIRED AUTOS t'oYiTsq ~oo /Per acc identl -X Comp $1000 X s UMBRELLA LIAB H OCCUR EAC H OCCURRENCE $ 5,000,000 1-- C X EXCESS LIAB CLA IMS -M ADE 57RHAFM7914 10/01/2017 10/01/2018 AG GREGATE $ 5,000,000 OED I X I RETENTION$ 0 $ WORKERS COMPENSATION X I ~ffrnTE I I OTH- AND EMPLOYERS ' LIABILITY ER Y/N B ANY PROPRIETOR/PARTNER/EXECUTI VE D X 57WEAAA6N28 10/01/2017 10/01/2018 E.L. EACH ACC IDENT $ 1,000,000 OFF ICER/MEMBER EXC LUDED? N/A (Mandatory in NH) E.L . DISE AS E -EA EMPLOYEE S 1,000,000 If yes , describe under DESCRIPTION OF OPERATIONS below E.L. DISE ASE -POLICY LI MIT $ 1,000,000 A Leased/Rent Equip 57UUMFM8326 10/01/2017 10/01/2018 Limit 300,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is re quired) RE: J17P-Ma:x Street L~hts C i!)' of Cu~e mo, inclu mg its City Council, boards and commissions, officers, o icials, agents, employees, consultants and volunteers are named as Additional Insureds. Insureds coverage is Primary. Waiver of Subrogation applies to GL, Auto & WC. Umbrella follows form. CERTIFICATE HOLDER CANCELLATION CUPERTI 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. Brad Alexander 10300 Torre Avenue AUTHORIZED REPRESENTATIVE L__~ 'Co::>~ Cupertino, CA 95015 -~ I . r '.. ---- I ~ . . ~ r © 1988-2014 ACORD CORPORATION. All rights reserved. AC ORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NOTEPAD 1NsURED's NAME Bleyco, Inc . BLEYC-1 OP ID: JC ***THE FOLLOWING ENDORSEMENTS APPLY ONLY AS INDICATED IN DESCRIPTION OF OPERATIONS AND IF REQUIRED BY WRITTEN CONTRACT*** GENERAL LIABILITY: * Additional Insured if required by written contract per attached Form HS 24 80 0713 * Coverage is Primary/Non-Contributory if required by written contract per attached Form HS 24 80 0713 * Waiver of Subrogation if required by written contract per attached Form CG 2 4 04 0509 AUTOMOBILE LIABILITY: * Additional Insured if required by written contract per attached Form HA 9916 0312 * Waiver of Subrogation if required by written contract per attached Form HA 9916 0312 WORKERS' COMPENSATION: * Waiver of Subrogation if required by written contract per attached Form WC 04 03 06 PAGE 2 Date 1011812017 POLICY NUMBER: 57UEA FM 7668 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -OPTION I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Addltlonal Insured Person(s) Designated Project(s) Or Locatlon(s) Or Organization(s): Of Covered Operations: Information required to complete this Schedule if not shown above will be shown in the Declarations. A. With respect to those person(s) or organization(s) shown in the Schedule above when you have agreed in a written contract or written agreement to provide insurance such as is afforded under this policy to them, Subparagraph f., Any Other Party, under the Additional Insureds When Required By Written Contract, Written Agreement Or Permit Paragraph of Section II - Who Is An Insured is replaced with the following : f. Any Other Party Any other person or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liabllity for "bodily injury", "property damage" or "personal and advertising Injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations for such additional insured at the project(s) or locatlon(s) designated in the Schedule: (2) In connection with your premises owned by or rented to you and shown In the Schedule; or Form HS 24 80 0713 © 2013 , The Hartford (3) In connection with "your work" for the additional insured at the project(s) or location(s) designated In the Schedule and included within the "products- completed operations hazard", but only if: (a) The written contract or written agreement requires you to provide such coverage to such additional insured at the project(s) or location(s) designated in the Schedule; and (b) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products-completed operations hazard". The insurance afforded to the additional insured shown in the Schedule applies: (1) Only if the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed: (a) During the policy period ; and (b) Subsequent to the execution of such written contract or written agreement; and Page 1 of2 (Includes copyrighted material of Insurance Services Office, Inc., with its permission .) I I I i I J (c) Prior to the expiration of the period of time that the written contract or written agreement requires such insurance be provided to the additional insured. (2) Only to the extent permitted by law; and (3) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. With respect to the insurance afforded to the person(s) or organization(s) that are additional insureds under this endorsement, the following additional exclusion applies: This Insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings , op inions, reports, surveys, field orders , change orders , designs or specifications: or (2) Supervisory, Inspection, architectural or engineering activities. The limits of Insurance that apply to the additional insured shown In the Schedule are described in the Limits Of Insurance section. How this Insurance applies when other insurance is available to the additional insured is described in the Other Insurance Condition in Section IV - Commercial General Liability Conditions, except as otherwise amended below. B. With respect to insurance provided to the person(s} or organization(s) that are additional insureds under this endorsement, the When You Add Others As An Additional Insured To This Insurance subparagraph, under the Other Insurance Condition of Section IV -Commercial General Liability Conditions is replaced with the following: Page 2 of 2 When You Add Others As An Additional Insured To This Insurance (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this Insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Paragraph (c) below . This insurance does not apply to other insurance to which the additional insured in the Schedule has been added as an add itional insured. (b) Primary And Non-Contributory To Other Insurance When Required By Contract This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (I} The additional insured in the Schedule is a Named Insured under such other insurance; and (ii) You have agreed in a written contract or written agreement that this insurance would be prlmary and would not seek contribution from any other insurance available to the additional insured in the Schedule. (c) jMethod Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. All other terms and conditions In the policy remain unchanged. Form HS 24 80 0713 I I l I I I I I j i f I ' I ~ l i I f ! ! I ! ! I J i ! I POLICY NUMBER: 5 7UEAFM7 6 6 8 COMMERCIAL GENERAL LIABILITY CG 2404 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recovery we may have against the person or organization shown In the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or · organization shown in the Schedule above. CG 240405 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 Bleyco , Inc . Policy #5 7 UE AFM7669 Term : 1 0/0 1 /20 1 7 t o 1 0/0 1 /20 1 8 COMMERCIAL AUTOMOBILE HA 9916 0312 TH IS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement mod ifies insurance provided under the following : BUS IN ESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broade r benefits to the "insured" than other provisions of the Coverage Form , the provisions of this endorsement apply. 1 . BROAD FORM INSURED A . S ub s idiaries and New ly Acq ui red or Fo rme d Organ izat ions The Named Insured shown in the Declarations is amended to include: (1) Any legal business entity other than a partnership or joint venture , formed as a subsid iary in which you have an ownership interest of more than 50% on the effective date of the Coverage Form. However, the Named Insured does not include any subs idiary that is 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 Limi t of Insurance . (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. Howeve r, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture , (b) That is an "insured" under any other policy , ( c) That has exhausted its Limi t of Insurance under any other policy, or (d) 180 days or more after its acquisit ion or formation by you , unless you have given us notice of the acquis ition or formation. Coverage does not apply to "bodily injury " or "property damage" t hat results from an "accident" that occurred before you formed or acquired the organi zation. B. Employees as Insureds Pa ragraph A.1. -WHO IS AN INS URED -of SECTION II -LIABILI TY COVE RA G E is amended to add: d. Any "employee" of yours while us ing a covered "auto" you don't own , hire or borrow in you r business or your personal affairs . C. Lessors as Insureds Paragraph A.1. -WHO IS AN INSURED -of Section II -Liability Coverage is amended to add : e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if : (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is lea sed without a driver. Such a leased "auto" wil l be considered a covered "auto " you own and not a covered "auto" you hire . D. Add itional Insured if Required by Contract (1) Parag raph A.1 . -WHO IS AN INSURED -of Section II -Li ability Coverage is amended to add: f . When you have ag reed , in a written contract or written agreement, that a person or orga n iza t ion be added as an addi t ional insured on your business au to poli cy, such person or organi zati on is a n "i nsured ", bu t only to t he ext ent such person or organization is liable for "bodily injury " or "pro perty damage" ca used by the con duct of an "insured " under pa rag raphs a. or b. of Who Is An Insure d w it h reg ard to the ownersh ip, main te nan c e or use of a cove red "auto ." Form HA 9916 0312 © 2011 , The Hartfo rd (I ncludes co pyrighted materi al of ISO Pro pertie s, In c., w ith it s permi ss ion .) Page 1 of 5 The insurance afforded to any such additional insured applies only if the "bodily injury" or "property damage" occurs : ( 1) During the policy period, and (2) Subsequent to the execution of such written contract, and (3) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured. (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations . Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non- contributory with the additional insured's own insurance . (4) Duties in The Event Of Accident, Claim , Suit or Loss If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy , the additional insured shall be required to comply with the provisions in LOSS CONDITIONS 2 . -DUTIES IN THE EVENT OF ACCIDENT, CLAIM , SUIT OR LOSS -OF SECTION IV - BUSINESS AUTO CONDITIONS , in the same manner as the Named Insured. E. Primary and Non-Contributory if Required by Contract Only with respect to insurance provided to an additional insured in 1.0. -Additional Insured If Required by Contract, the following provisions apply : (3) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance 5.d. (4) Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (3) and (4) do not apply to other insurance to which the additional insured has been added as an additional insured . When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance . We will share the remaining loss, if any, by the method described in Other Insurance 5.d. 2. AUTOS RENTED BY EMPLOYEES Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire . The OTHER INSURANCE Condition is amended by adding the following: Form HA 9916 0312 © 2011 , The Hartford (Includes copyrighted material of ISO Properties , Inc., with its permission .) Page 2 of 5 If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction , this insurance will be primary to the "employee's" personal insurance . 3. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5. -FELLOW EMPLOYEE -of SECTION II -LIABILITY COVERAGE does not apply if you have workers' insurance in-force covering "employees". compensation all of your Coverage is excess over any other collectible insurance . 4 . HIRED AUTO PH YSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $100 ,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property , whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning . Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions , we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident". This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 5 . PHYSICAL DAMAGE ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a . of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1 ,000. 6. LOAN/LEASE GAP COVERAGE Under SECTION Ill -PHYSICAL DAMAGE COVERAGE, in the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the loan/lease . "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges ; lease termination fees ; security deposits not returned by the lessor; costs for extended warranties, credit life Insurance , health , accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. 7. AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS -of SECTION Ill PHYSICAL DAMAGE COVERAGE , the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 8. ELECTRONIC EQUIPMENT -BROADENED COVERAGE a. The exceptions to Paragraphs B.4 EXCLUSIONS -of SECTION Ill -PHYSICAL DAMAGE COVERAG E are replaced by the following: Exclusions 4 .c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that , at the time of "loss", is: (1) Permanently installed in or upon the covered "auto"; (2) Removable from a housing unit which is permanently installed in or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above ; or Form HA 9916 0312 © 2011 , The Hartford (Includes copyrighted material of ISO Properties , Inc ., with its permission .) Page 3 of 5 (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. b. Section Ill -Version CA 00 01 03 10 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance, Paragraph C.2 and Version CA 00 01 10 01 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance , Paragraph C are each amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is : ( 1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 9. EXTRA EXPENSE BROADENED COVERAGE Under Paragraph A. -COVERAGE -of SECTION Ill -PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR -WAIVER OF DEDUCTIBLE Under Paragraph D. -DEDUCTIBLE -of SECTION Ill -PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 11. TWO OR MORE DEDUCTIBLES Under Paragraph D. -DEDUCTIBLE -of SECTION Ill -PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident", the following applies:, (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible , it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible . 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT,CLAIM, SUIT OR LOSS -of SECTION IV -BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 14. HIRED AUTO -COVERAGE TERRITORY Paragraph e. of GENERAL CONDITIONS 7. - POLICY PERIOD, COVERAGE TERRITORY - of SECTION IV BUSINESS AUTO CONDITIONS is replaced by the following: e. For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 15. WAIVER OF SUBROGATION TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -of SECTION IV - BUSINESS AUTO CONDITIONS is amended by adding the following: Form HA 99 16 03 12 © 2011, The Hartford (Includes copyrighted material of ISO Properties, Inc., with its permission.) Page 4 of 5 We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make fo r damages under this Coverage Form. 16. RES ULTANT MENTAL ANGUISH COVERAGE The definition of "bodily inj ury" in SECTION V- DEFINITIONS is replaced by the following : "Bodily injury" means bodi ly injury, sic kness or disease sustained by any person , including mental anguish or death resulting from any of these . 17 . EXT EN D ED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS -CANCELLATION -applies except as follows : If we cancel for any reason other t han nonpayment of premium , we will mail or delive r to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. 18 . HYBR ID, ELECTRIC , OR NATURAL GAS VEH IC L E PAYMENT COVERAGE In the event of a total loss to a "non-hybrid" auto for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form , then such Phys ica l Damage Coverages are amended as follows: a .I f the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natura l gas, we will pay an additional 10%, to a maximum of $2,500, of the "non-hybrid" auto's actual cash value or replacement cost , whichever is less, b.The auto must be replaced and a copy of a bil l of sale or new lease agreement received by us within 60 calendar days of the date of "loss ," c. Regardless of th e numbe r of autos deemed a total loss, the mo st we wi ll pay under this Hybrid , Electric , or Natural Gas Veh icle Payment Coverage provis ion fo r any one "loss" is $10,000. For the purposes of the coverage provision , a .A "non -hybrid" auto is defi ned as an auto that uses only an in terna l com bu stion engin e to move the auto bu t does not include a utos powered solely by electric ity or natural gas. b.A "hybrid " auto is defined as an auto with an internal combustion eng ine and one or more electric motors ; and that uses the internal combustion engine and one or more electric motors to move the auto , or the internal combustion engine to charge one or more electric motors , which move the auto. 19. VEHICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive , Specified Causes of Loss, or Collision coverages are provided under this Coverage Form , then such Physica l Damag e Coverages are amended to add t he following : In addition to the actual cash val ue of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the t ime of total loss. Regardless of the number of autos deemed a total loss , t he most we will pay under this Vehicle Wrap Coverage provision fo r any one "loss" is $5 ,000. For pu rposes of thi s coverage provision , sign s or othe r graphics painted or magnet ically affi x ed to the vehicle are not considered vehicle wraps. Form HA 99 16 03 12 © 2011 , The Hartford (Include s copyrighted mate rial of ISO Properties , Inc ., with its permission .) Page 5 of 5 Bleyco , Inc. Pol i cy 57W EAAA6N28 Term : 10/0 1 /20 1 7 to 1 0/0 1 /20 1 8 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERSENDORSEMENT-CALIFORN~ 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 otherwise due on such remuneration . % of the California workers' compensation premium SCHEDULE Person or Organization Form WC 04 03 06 Process Date: Cou nte rsigned by (1) Printed in U.S.A. Job Description -------------------Authorized Representative Policy Expiration Date: i l I I I I !