HomeMy WebLinkAboutItem No. 10 Amend No. 2 Ext of Agrmnt J&S Striping CompanyText File
City of Lake Elsinore 130 South Main Street
Lake Elsinore, CA 92530
www.lake-elsinore.org
File Number: ID# 17-224
Agenda Date: 6/13/2017 Status: Consent AgendaVersion: 1
File Type: ReportIn Control: City Council
Agenda Number: 10)
Page 1 City of Lake Elsinore Printed on 6/8/2017
Page 1 of 1
REPORT TO CITY COUNCIL
To:Honorable Mayor and Members of the City Council
From:Grant Yates, City Manager
Approved by: Jason Simpson, Assistant City Manager
Prepared by: Catherine Eakins – Administrative Assistant
Date:June 13, 2017
Subject:Amendment No. 2 – Extension of Agreement for Contract Services (On-
Call) for J&S Striping Company
Recommendation
Approve and authorize the City Manager to execute Amendment No. 2 to the On-Call Contract
Services Agreement with J&S Striping Company, to allow for a one (1) year renewal term in the
not to exceed amount of $175,000, in such final form as approved by the City Attorney.
Background
On August 11, 2015, City Council approved the award to J&S Striping Company for On-Call
Contract Services for the Annual Traffic Striping Maintenance Program. Amendment No. 1
dated July 1, 2016 extended the contract a further 12-month term.
Discussion
As a part of the regular street maintenance items, traffic striping is performed throughout the
City. The work to be performed under this contract shall consist of painting traffic lanes, parking
lanes, and thermoplastic directional arrows, crosswalks, and legends. All striping shall conform
to Caltrans Standard Plans and Specifications.
Fiscal Impact
Funds in the amount of $175,000 have been allocated for the Annual Traffic Striping
Maintenance Program for FY 17/18 Project No. Z10004.
Exhibits
J&S Striping Company – Exhibit A Amendment No. 2
J&S Striping Company – Exhibit B Amendment No.1
J&S Striping Company – Exhibit C Original Agreement
AMENDMENT NO. 2
TO AGREEMENT FOR CONTRACTOR SERVICES (ON-CALL)
J&S Striping Company, Inc.
Annual Traffic Striping Maintenance Program Project No. Z10004
This Amendment No. 2 to Agreement for Contractor Services (“Amendment No. 2”) is
made and entered into as of July 1, 2017 by and between the City of Lake Elsinore, a municipal
corporation (“City), and J&S Striping Company, Inc., a Corporation (“Contractor”).
RECITALS
A.The City and Contractor have entered into that certain Agreement for Contractor
Services dated as of August 11, 2015 (the “Original Agreement”). Except as otherwise defined
herein, all capitalized terms used herein shall have the meanings set forth for such terms in the
Original Agreement.
B.The Original Agreement provided for compensation to Contractor in an amount not
to exceed One Hundred Seventy Five Thousand dollars ($175,000) for Fiscal Year 2015/2016.
C.The term of the Original Agreement was for seven (7) months and allows the City
to extend the term on a 12-month basis, not to exceed three (3) additional 12 month renewals.
D.Amendment No. 1 dated July 1, 2016 extended the agreement a further 12-month
term for Fiscal Year 2016/2017.
E.The parties now desire to extend the term for such services as set forth in this
Amendment No 2.
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth
herein, City and Contractor agree as follows:
1.Section 2, subpart C, Term, of the Original Agreement is hereby amended to add
the following:
Unless earlier terminated as provided elsewhere in the Original
Agreement, this Amendment No. 2 shall continue in full force and effect for
a period of twelve (12) months, commencing on July 1, 2017 and ending
on June 30, 2018. The City may, at its sole discretion, extend the term of
this Agreement on a 12-month basis not to exceed one (1) additional
twelve (12) month renewal terms by giving written notice thereof to
Contractor not less than thirty (30) days before the end of the contract term,
such notice to be exercised by the City Manager.
2. Except for the changes specifically set forth herein, all other terms and conditions of
the Original Agreement shall remain in full force and effect.
IN WITNESS WHEREOF, the parties have caused this Amendment No. 2 to be executed
on the respective dates set forth below.
“CITY”
CITY OF LAKE ELSINORE, a municipal
corporation
Grant Yates, City Manager
Date:
ATTEST:
City Clerk
APPROVED AS TO FORM:
City Attorney
“CONTRACTOR”
J&S Striping Company, Inc., a Corporation
By:
Date:
Attachments: Exhibit A – Amendment No. 1
Exhibit B – Original Agreement
EXHIBIT B
EXHIBIT B
ORIGINAL AGREEMENT
[ATTACHED]
AMENDMENT NO. 1
TO AGREEMENT FOR CONTRACTOR SERVICES (ON -CALL)
J &S Striping Company, Inc.
Annual Traffic Striping Maintenance Program
Project No. Z10004
This Amendment No. 1 to Agreement for Contractor Services (On -Call) ( "Amendment No.
1") is made and entered into as of July 1, 2016 by and between the City of Lake Elsinore, a
municipal corporation ( "City), and J &S Striping Company, Inc., a Corporation ( "Contractor ").
RECITALS
A. The City and Contractor have entered into that certain Agreement for Contractor
Services dated as of August 11, 2015 (the "Original Agreement "). Except as otherwise defined
herein, all capitalized terms used herein shall have the meanings set forth for such terms in the
Original Agreement.
B. The Original Agreement provided for compensation to Contractor in an amount not
to exceed One Hundred Seventy -Five Thousand dollars ($175,000).
C. The term of the Original Agreement was for ten (10) months and allows the City to
extend the term on an annual basis, for a total of two (2) years.
D. The parties. now desire to extend the term for such services as set forth in this
Amendment No 1.
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth
herein, City and Contractor agree as follows:
1. Section 2, Time of Performance, of the Original Agreement is hereby amended to
add the following:
Unless earlier terminated as provided elsewhere in the Original
Agreement, this Amendment No. 1 shall continue in full force and effect
until June 30, 2017. The City may, at its sole discretion, extend the term
of this Agreement on an annual basis not to exceed one (1) additional
renewal term, such notice to be exercised by the City Manager.
2. Except for the changes specifically set forth herein, all other terms and conditions
of the Original Agreement shall remain in full force and effect.
IN WITNESS WHEREOF, the parties have caused this Amendment No. 1 to be executed
on the respective dates set forth below.
CITY"
CITY OF LAKE ELSINORE, a municipal
corporation
Grant n"s, City Manager
Date : q14 &
ATTES
City Clerk
Attachments: Exhibit B — Original Agreement
CONTRACTOR"
J &S Striping Company., a Corporation
J&S Striping Company, a corporation
Date:_'
EXHIBIT B
ORIGINAL AGREEMENT
ATTACHED]
EXHIBIT B
AGREEMENT FOR CONTRACTOR SERVICES (ON -CALL)
J & S Striping Company, Inc.
Annual Traffic Striping Maintenance Program, Project No. Z10004
This Agreement for Contractor Services (On -Call) (the "Agreement ") is made and entered
into as of August 11, 2015, by and between the City of Lake Elsinore, a municipal corporation
City ") and J & S Striping Company Inc., a Corporation ( "Contractor").
RECITALS
A. The City has determined that it requires the following services: Citywide traffic
striping maintenance in conformance with Caltrans Standards.
B. The City has prepared a request for a proposals and Contractor has submitted to
City a proposal, dated July 6, 2015, both of which are attached hereto as Exhibit A (collectively,
the "Contractor's Proposal ") and incorporated herein, to provide services and related work to the
City pursuant to the terms of this Agreement.
C. Contractor possesses the skill, experience, ability, background, certification and
knowledge to perform the services and related work described in this Agreement on the terms
and conditions described herein.
D. City desires to retain Contractor to perform the services and related work asprovidedhereinandContractordesirestoprovidesuchservicesandrelatedworkassetforthin
this Agreement.
AGREEMENT
1. Sea a of Services. Contractor shall perform the services and related work
described in Contractor's Proposal (Exhibit A). Contractor shall provide such services and related
work at the time, place, and in the manner specified in Contractor's Proposal (Exhibit A), subject
to the direction of the City through its staff that it may provide from time to time. Contractor
acknowledges that the Scope of Services provides for 24 hour -a -day, 7 day -a -week, on-call
support on an as needed basis.
2. Time of Performance.
a. Time of Essence. Time is of the essence in the performance of this
Agreement. The time for completion of the services and related work to be performed by
Contractor is an essential condition of this Agreement. Contractor shall prosecute regularly and
diligently the services and related work contemplated pursuant to this Agreement consistent withContractor's Proposal (Exhibit A) and shall provide, furnish and pay all labor, materials, necessary
tools, expendable equipment, and all taxes, utility and transportation services required to perform
such the services and related work.
b. Performance Schedule. Contractor shall commence the services and
related work pursuant to this Agreement upon receipt of a written notice to proceed and shall
perform all services and related work within the time period(s) established in the Contractor's
On -Call) For Annual Traffic Striping Maintenance Program - FinalPage 1
Proposal (Exhibit A). When requested by Contractor, extensions to the time period(s) specified
may be approved in writing by the City Manager.
Term and Compliance with Task/Work Order System.
Unless earlier terminated as provided elsewhere in this Agreement, this
Agreement shall continue in full force and effect for a period of Ten (10) Months, commencing on
August 11, 2015 and ending on June 30, 2016. The City may, at its sole discretion, extend the
term of this Agreement on a 12 -month basis not to exceed Two (2) additional twelve (12) month
renewal terms by giving written notice thereof to Contractor not less than thirty (30) days before
the end of the contract term, such notice to be exercised by the City Manager.
Contractor hereby agrees and acknowledges that any and all work or
services performed pursuant to this Agreement shall be based upon the issuance of a Task/Work
Order by the City. Contractor acknowledges that it is not guaranteed any minimum or specific
amount of work or services as all work or services shall be authorized through a Task/Work Order
issued by the City.
3. Compensation and Cost of Living Ad'ustment. Compensation to be paid to
Contractor shall be in accordance with the fees set forth in Contractor's Proposal (Exhibit A),
which is attached hereto and incorporated herein by reference. In no event shall Contractor's
compensation for the initial term exceed One Hundred Seventy Five Thousand Dollars
175,000) without additional written authorization from the City. Compensation for any extended
renewal term shall not exceed One Hundred Seventy Five Thousand Dollars ($175,000) annually,
subject only to the cost of living adjustment as provided for herein below, without additional written
authorization from the City. Notwithstanding any provision of Contractor's Proposal to the
contrary, out of pocket expenses set forth in Exhibit A shall be reimbursed at cost without an
inflator or administrative charge. Payment by City under this Agreement shall not be deemed a.
waiver of defects, even if such defects were known to the City at the time of payment.
The compensation paid to Contractor may be adjusted on Each July 1
following the first anniversary of the commencement of the term of this Agreement, provided thattherequestforcostoflivingadjustmentshallbepresentedtotheCitynolaterthanJune1stofa
particular year and, if approved by the City, will become effective on July 1st of that year. Any
adjustment will be based on the Los Angeles- Riverside - Orange County Consumer Price Index
CPI) but in no event shall the price adjustment exceed five percent (5 %).
4. Method of Pa meat. Contractor shall promptly submit billings to the City describing
the services and related work performed during the preceding month to the extent that such
services and related work were performed. Contractor's bills shall be segregated by project task,
if applicable, such that the City receives a separate accounting for work done on each individual
task for which Contractor provides services. Contractor's bills shall include a brief description of
the services performed, the date the services were performed, the number of hours spent and by
whom, and a description of any reimbursable expenditures. City shall pay Contractor no later
than forty -five (45) days after receipt of the monthly invoice by City staff.
5. Suspension or Termination.
a. The City may at any time, for any reason, with or without cause, suspend
or terminate this Agreement, or any portion hereof, by serving upon the Contractor at least ten
10) days prior written notice. Upon receipt of such notice, the Contractor shall immediately cease
Page 2
all work under this Agreement, unless the notice provides otherwise. If the City suspends or
terminates a portion of this Agreement such suspension or termination shall not make void or
invalidate the remainder of this Agreement.
b. In the event this Agreement is terminated pursuant to this Section, the City
shall pay to Contractor the actual value of the work performed up to the time of termination,
provided that the work performed is of value to the City. Upon termination of the Agreement
pursuant to this Section, the Contractor will submit an invoice to the City, pursuant to Section
entitled "Method of Payment" herein.
6. Ownership of Documents. All plans, studies, documents and other writings
prepared by and for Contractor, its officers, employees and agents and subcontractors in the
course of implementing this Agreement, except working notepad internal documents, shall
become the property of the City upon payment to Contractor for such work, and the City shall
have the sole right to use such materials in its discretion without further compensation to
Contractor or to any other party. Contractor shall, at Contractor's expense, provide such reports,
plans, studies, documents and other writings to City upon written request. City acknowledges
that any use of such materials in a manner beyond the intended purpose as set forth herein shall
be at the sole risk of the City. City further agrees to defend, indemnify and hold harmless
Contractor, its officers, officials, agents, employees and volunteers from any claims, demands, .
actions, losses, damages, injuries, and liability, direct or indirect (including any and all costs and
expenses in connection therein), arising out of the City's use of such materials in a manner beyond
the intended purpose as set forth herein.
a. Licensing of Intellectual Property. This Agreement creates a nonexclusive
and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights,
designs, and other intellectual property embodied in plans, specifications, studies, drawings,
estimates, and other documents or works of authorship fixed in any tangible medium of
expression, including but not limited to, physical drawings or data magnetically or otherwise
recorded on computer diskettes, which are prepared or caused to be prepared by Contractor
under this Agreement ( "Documents & Data"). Contractor shall require that all subcontractors
agree in writing that City is granted a nonexclusive and perpetual license for any Documents &
Data the subcontractor prepares under this Agreement. Contractor represents and warrants that
Contractor has the legal right to license any and all Documents & Data. Contractor makes no
such representation and warranty in regard to Documents & Data which were prepared by design
professionals other than Contractor or provided to Contractor by the City. City shall not be limited
in any way in its use of the Documents & Data at any time, provided that any such use not within
the purposes intended by this Agreement shall be at City's sole risk.
b. Confidential. All ideas, memoranda, specifications, plans, procedures,
drawings, descriptions, computer program data, input record data, written information, and other
Documents & Data either created by or provided to Contractor in connection with the performance
of this Agreement shall be held confidential by Contractor. Such materials shall not, without the
prior written consent of City, be used by Contractor for any purposes other than the performance
of the services under this Agreement. Nor shall such materials be disclosed to any person or
entity not connected with the performance of the services under this Agreement. Nothing
furnished to Contractor which is otherwise known to Contractor or is generally known, or has
become known, to the related industry shall be deemed confidential. Contractor shall not use
City's name or insignia, photographs relating to project for which Contractor's services arerendered, or any publicity pertaining to the Contractor's services under this Agreement in any
Page 3
magazine, trade paper, newspaper, television or radio production or other similar medium without
the prior written consent of City.
7. Contractor's Books and Records.
a. Contractor shall maintain any and all ledgers, books of account, invoices,
vouchers, canceled checks, and other records or documents evidencing or relating to charges for
services, or expenditures and disbursements charged to City for a minimum period of three (3)
years, or for any longer period required by law, from the date of final payment to Contractor to
this Agreement.
b. Contractor shall maintain all documents and records which demonstrate
performance under this Agreement for a minimum period of three (3) years, or for any longer
period required by law, from the date of termination or completion of this Agreement.
C. Any records or documents required to be maintained pursuant to this
Agreement shall be made available for inspection or audit, at any time during regular business
hours, upon written request by the City Manager, City Attorney, City Auditor or a designated
representative of these officers. Copies of such documents shall be provided to the City for
inspection at City Hall when it is practical to do so. Otherwise, unless an alternative is mutually
agreed upon, the records shall be available at Contractor's address indicated for receipt of notices
in this Agreement.
d. Where City has reason to believe that such records or documents may be
lost or discarded due to dissolution, disbandment or termination of Contractor's business, City
may, by written request by any of the above -named officers, require that custody of the records
be given to the City and that the records and documents be maintained in City Hall. Access to
such records and documents shall be granted to any party authorized by Contractor, Contractor's
representatives, or Contractor's successor -in- interest.
S. Independent Contractor. It is understood that Contractor, in the performance of
the work and services agreed to be performed, shall act as and be an independent contractor and
shall not act as an agent or employee of the City.
g_ PERS Eligibility Indemnification. In the event that Contractor or any employee,
agent, or subcontractor of Contractor providing services under this Agreement claims or is
determined by a court of competent jurisdiction or the California Public Employees Retirement
System (PERS) to be eligible for enrollment in PERS as an employee of the City, Contractor shall
indemnify, defend, and hold harmless City for the payment of any employee andlor employer
contributions for PERS benefits on behalf of Contractor or its employees, agents, or
subcontractors, as well as for the payment of any penalties and interest on such contributions,
which would otherwise be the responsibility of City.
Notwithstanding any other federal, state and local laws, codes, ordinances and
regulations to the contrary, Contractor and any of its employees, agents, and subcontractors
providing service under this Agreement shall not qualify for or become entitled to, and herebyagreetowaiveanyclaimsto, any compensation, benefit, or any incident of employment by City,
including but not limited to eligibility to enroll in PERS as an employee of City and entitlement toanycontributiontobepaidbyCityforemployercontributionand/or employee contributions for
PERS benefits.
Page 4
10. Interests of Contractor. Contractor (including principals, associates and
management employees) covenants and represents that it does not now have any investment or
interest in real property and shall not acquire any interest, direct or indirect, in the area covered
by this Agreement or any other source of income, interest in real property or investment which
would be affected in any manner or degree by the performance of Contractor's services
hereunder. Contractor further covenants and represents that in the performance of its duties
hereunder no person having any such interest shall perform any services under this Agreement.
Contractor is not a designated employee within the meaning of the Political Reform Act
because Contractor:
a. will conduct research and arrive at conclusions with respect to his /her
rendition of information, advice, recommendation or counsel independent of the control and
direction of the City or of any City official, other than normal agreement monitoring; and
b. possesses no authority with respect to any City decision beyond rendition
of information, advice, recommendation or counsel. (FPPC Reg. 18700(a)(2).)
11. Ability of Contractor. City has relied upon the training and ability of Contractor to
perform the services hereunder as a material inducement to enter into this Agreement. Contractor
shall therefore provide properly skilled personnel to perform all services under this Agreement.
All work performed by Contractor under this Agreement shall be in accordance with applicable
legal requirements and shall meet the standard of quality ordinarily to be expected of competent
contractors in Contractor's field of expertise.
12. Compliance with Laws. Contractor shall use the standard of care in its profession
to comply with all applicable federal, state and local laws, codes, ordinances and regulations.
13. Licenses. Contractor represents and warrants to City that it has the licenses,
permits, qualifications, insurance and approvals of whatsoever nature which are legally required
of Contractor to practice its profession. Contractor represents and warrants to City that Contractor
shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this
Agreement, any licenses, permits, insurance and approvals which are legally required ofContractortopracticeitsprofession. Contractor shall maintain a City of Lake Elsinore business
license.
14. Indemnity. Contractor shall indemnify, defend, and hold harmless the City and its
officials, officers, employees, agents, and volunteers from and against any and all losses, liability,
claims, suits, actions, damages, and causes of action arising out of any personal injury, bodily
injury, loss of life, or damage to property, or any violation of any federal, state, or municipal law
or ordinance, to the extent caused, in whole or in part, by the willful misconduct or negligent acts
or omissions of Contractor or its employees, subcontractors, or agents, by acts for which they
could be held strictly liable, or by the quality or character of their work. The foregoing obligation
of Contractor shall not apply when (1) the injury, loss of life, damage to property, or violation of
law arises from the sole negligence or willful misconduct of the City or its officers, employees,
agents, or volunteers and (2) the actions of Contractor or its employees, subcontractor, or agents
have contributed in no part to the injury, loss of life, damage to property, or violation of law. It is
understood that the duty of Contractor to indemnify and hold harmless includes the duty to defend
as set forth in Section 2778 of the California Civil Code. Acceptance by City of insurance
certificates and endorsements required under this Agreement does not relieve Contractor from
liability under this indemnification and hold harmless clause. This indemnification and hold
Page 5
harmless clause shall apply to any damages or claims for damages whether or not such insurance
policies shall have been determined to apply. By execution of this Agreement, Contractor
acknowledges and agrees to the provisions of this Section and that it is a material element of
consideration.
15. Insurance Requirements.
a. Insurance. Contractor, at Contractor's own cost and expense, shall
procure and maintain, for the duration of the contract, unless modified by the City's Risk Manager,
the following insurance policies.
i. Workers' Compensation Coverage. Contractor shall maintain
Workers' Compensation Insurance and Employer's Liability Insurance for his /her
employees in accordance with the laws of the State of California. In addition, Contractor
shall require each subcontractor to similarly maintain Workers' Compensation Insurance
and Employer's Liability Insurance in accordance with the laws of the State of California
for all of the subcontractor's employees. Any notice of cancellation or non - renewal of all
Workers' Compensation policies must be received by the City at least thirty (30) days prior
to such change. The insurer shall agree to waive all rights of subrogation against City, its
officers, agents, employees and volunteers for losses arising from work performed by
Contractor for City. In the event that Contractor is exempt from Worker's Compensation
Insurance and Employer's Liability Insurance for his /her employees in accordance with
the laws of the State of California, Contractor shall submit to the City a Certificate of
Exemption from Workers Compensation Insurance in a form approved by the City
Attorney.
ii. General Liability Covera e. Contractor shall maintain commercial
general liability insurance in an amount not less than one million dollars ($1,000,000) per
occurrence for bodily injury, personal injury and property damage. If a commercial general
liability insurance form or other form with a general aggregate limit is used, either the
general aggregate limit shall apply separately to the work to be .performed under this
Agreement or the general aggregate limit shall be at least twice the required occurrence
limit. Required commercial general 'liability coverage shall be at least as broad as
Insurance Services Office Commercial General Liability occurrence form CG 0001 (ed.
11/88) or insurance Services Office form number GL 0002 (ed. 1173) covering
comprehensive General Liability and Insurance Services office form number GL 0404
covering Broad Form Comprehensive General Liability. No endorsement may be attached
limiting the coverage.
iii. Automobile Liability Coverage. Contractor shall maintain
automobile liability insurance covering bodily injury and property damage for all activities
of the Contractor arising out of or in connection with the work to be performed under this
Agreement, including coverage for owned, hired and non -owned vehicles, in an amount
of not less than one million dollars ($1,000,000) combined single limit for each occurrence.
Automobile liability coverage must be at least as broad as Insurance Services Office
Automobile Liability form CA 0001 (ed. 12/90) Code 1 ( "any auto "). No endorsement may
be attached limiting the coverage.
b. Endorsements. Each general liability and automobile liability insurance
policy shall be with insurers possessing a Best's rating of no less than A:VII and shall be
endorsed with the following specific language:
Page 6
i. The City, its elected or appointed officers, officials, employees,
agents and volunteers are to be covered as additional insured with respect to liability
arising out of work performed by or on behalf of the Contractor, including materials, parts
or equipment furnished in connection with such work or operations.
ii. This policy shall be considered primary insurance as respects the
City, its elected or appointed officers, officials, employees, agents and volunteers.
Any insurance maintained by the City, including any self- insured retention the City may
have, shall be considered excess insurance only and shall not contribute with it,
iii. This insurance shall act for each insured and additional insured as
though a separate policy had been written for each, except with respect to the limits of
liability of the insuring company.
iv. The insurer waives all rights of subrogation against the City, its
elected or appointed officers, officials, employees or agents.
V. Any failure to comply with reporting provisions of the policies shall
not affect coverage provided to the City, its elected or appointed officers, officials,
employees, agents or volunteers.
vi. The insurance provided by this Po {icy shall not be suspended,
voided, canceled, or reduced in coverage or in limits except after thirty (30) days written
notice has been received by the City.
C. Deductibles and Self- Insured Retentions. Any deductibles or self - insured
retentions must be declared to and approved by the City. At the City's option, Contractor shall
demonstrate financial capability for payment of such deductibles or self- insured retentions.
d. Certificates of Insurance. Contractor shall provide certificates of insurance
with original endorsements to City as evidence of the insurance coverage required herein..
Certificates of such insurance shall be filed with the City on or before commencement of
performance of this Agreement. Current certification of insurance shall be kept on file with the
City at all times during the term of this Agreement.
18. Notices. Any notice required to be given under this Agreement shall be in writing
and either served personally or sent prepaid, first class mail. Any such notice shall be addressed
to the other party at the address set forth below. Notice shalt be deemed communicated within
48 hours from the time of mailing if mailed as provided in this section.
If to City City of Lake Elsinore
Attn: City Manager
130 South Main Street
Lake Elsinore, CA 92530
With a copy to: City of Lake Elsinore
Attn: City Clerk
130 South Main Street
Lake Elsinore, CA 92530
Page 7
If to Contractor: J & S Striping Company Inc.
Attn: Robert Aragon
1544 s. Vineyard Ave
Ontario, CA. 91761
17. Entire Agreement. This Agreement constitutes the complete and exclusive
statement of Agreement between the City and Contractor. All prior written and oral
communications, including correspondence, drafts, memoranda, and representations, are
superseded in total by this Agreement.
18. Amendments. This Agreement may be modified or amended only by a written
document executed by both Contractor and City and approved as to form by the City Attorney.
19. Assignment and Subcontractin The parties recognize that a substantial
inducement to City for entering into this Agreement is the reputation, experience and competence
of Contractor. Contractor shall be fully responsible to City for all acts or omissions of any
subcontractors. Assignments of any or all rights, duties or obligations of the Contractor under this
Agreement will be permitted only with the express consent of the City. Contractor shall not
subcontract any portion of the work to be performed under this Agreement without the written
authorization of the City. If City consents to such subcontract, Contractor shall be fully responsible
to City for all acts or omissions of those subcontractors. Nothing in this Agreement shall create
any contractual relationship between City and any subcontractor nor shall it create any obligation
on the part of the City to pay or to see to the payment of any monies due to any such subcontractor
other than as otherwise is required by law.
20. Waiver. Waiver of a breach or default under this Agreement shall not constitute a
continuing waiver of a subsequent breach of the same or any other provision under this
Agreement.
21. Severa1?1&. If any term or portion of this Agreement is held to be invalid, illegal,
or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this
Agreement shall continue in full force and effect.
22. Controlling Law Venue. This Agreement and all matters relating to it shall be
governed by the laws of the State of California and any action brought relating to this Agreement
shall be held exclusively in a state court in the County of Riverside.
23. Litigation Ex enses and Attorne s' l=ees. If either party to this Agreement
commences any legal action against the other party arising out of this Agreement, the prevailing
party shall be entitled to recover its reasonable litigation expenses, including court costs, expert
witness fees, discovery expenses, and attorneys' fees.
24. Mediation. The parties agree to make a good faith attempt to resolve any disputes
arising out of this Agreement through mediation prior to commencing litigation. The parties shall
mutually agree upon the mediator and share the costs of mediation equally. If the parties are
unable to agree upon a mediator, the dispute shall be submitted to JAMS or its successor in
interest. JAMS shall provide the parties with the names of five qualified mediators. Each party
shall have the option to strike two of the five mediators selected by .LAMS and thereafter the
mediator remaining shall hear the dispute. If the dispute remains unresolved after mediation,
either party may commence litigation.
Page 8
25. Authority to Enter Agreement. Contractor has all requisite power and authority to
conduct its business and to execute, deliver, and perform the Agreement. Each party warrants
that the individuals who have signed this Agreement have the legal power, right, and authority to
make this Agreement and to bind each respective party. The City Manager is authorized to enter
into an amendment or otherwise take action on behalf of the City to make the following
modifications to the Agreement: (a) a name change; (b) grant extensions of time; (c) non -
monetary changes in the scope of services; and /or (d) suspend or terminate the Agreement.
26. Prohibited Interests. Contractor maintains and warrants that it has not employed
nor retained any company or person, other than a bona fide employee working solely for
Contractor, to solicit or secure this Agreement. Further, Contractor warrants that it has not paid
nor has it agreed to pay any company or person, other than a bona fide employee working solely
for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration
contingent upon or resulting from the award or making of this Agreement. For breach or violation
of this warranty, City shall have the right to rescind this Agreement without liability. For the term
of this Agreement, no member, officer or employee of City, during the term of his or her service
with City, shall have any direct interest in this Agreement, or obtain any present or anticipated
material benefit arising therefrom.
27. Equal Opportunity Employment. Contractor represents that it is an equal
opportunity employer and it shall not discriminate against any subcontractor, employee or
applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex
or age. Such non - discrimination shall include, but not be limited to, all activities related to initial
employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or
termination.
28. Prevailing Waqes. Contractor is aware of the requirements of California Labor
Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8,
Section 16000, et seq., ( "Prevailing Wage Laws "), which require the payment of prevailing wage
rates and the performance of other requirements on "public works" and "maintenance" projects.
Contractor agrees to fully comply with all applicable federal and state labor laws (including,
without limitation, if applicable, the Prevailing Wage Laws). It is agreed by the parties that, in
connection with the work or services provided pursuant to this Agreement, Contractor shall bear
all risks of payment or non- payment of prevailing wages under California law, and Contractor
hereby agrees to defend, indemnify, and hold the City, and its officials, officers, employees, agents, and volunteers, free and harmless from any claim or liability arising out of any failure or
alleged failure to comply with the Prevailing Wage Laws. The foregoing indemnity shall survive
termination of this Agreement.
29. Execution. This Agreement may be executed in several counterparts, each of
which shall constitute one and the same instrument and shall become binding upon the parties
when at least one copy hereof shall have been signed by both parties hereto. In approving this
Agreement, it shall not be necessary to produce or account for more than one such counterpart.
Signatures on next page]
Page 9
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the
date first written above.
CITY"
CITY OF LAKE ELSINORE, a municipal
corporation
Gra ates, City Manager
ATTEST:
AoA -tr15 City Cler
APPRQVED AS T M:
Cit Attorney
CONTRACTOR"
J & S Striping Company Inc., a Corporation
Contractor
Attachments: Exhibit A — Contractor's Proposal
By: d OW
Its: '
Page 10
EXHIBIT A
CONTRACTOR'S PROPOSAL
ATTACHED]
EXHIBIT A
tr lWi J 12k it Mau - cpalum: n " - i'f. r s isw ti '= i ;g Vik.. .,. elk ° a I '-- _ _
CITY OF LAKE ELSINORE
PROPOSAL - SCHEDULE
PROJECT NO. Z10004
ANNUAL TRAFFIC STRIPING MAINTENANCE PROGRAM
FY 15116
PROPOSER J &S STRIPING COMPANY, INC
Contractor Name)
DRnPnCAI I7FAAC OC Fnl OVUM'
ITEM
I
vv W v ` ___ .. _.
UNIT TOTAL
CODE DESCRIPTION OF ITEMS
ESTIMATED
QUANTITY
PRICE COST
NO. FIGURES) FIGURES)
1 S
4" Center Line Yellow Caltrans Std Detail 1, 97,000 L.F. V50 _
4" Center Line White Caltrans Std Detail 8 0.0's
4" Solid Line White Caltrans Std Detail 276, Z"tiEt; L.F- 2 S 4" Solid Line Yellow Caltrans Std Detail 24 la3 c oa 0, 0110 6,180
3 S No Passing Zone — Two direction (No RPM) 130,000 L.F.
0.1
D
Caltrans Std Detail 21
4 S No Passing Zone — Two direction with RPM 10,000 L.F. 0.2`1
O
Caltrans Std Detail 22
5 S
Bike Lane Line 6" Solid Line Caltrans Std 28,000 L.F.
0. LtDetail39
6 S 8" Solid Line Caltrans STD Detail 38A 20,000 L.F. p,13 2a r
7 S 8" Solid Line with RPM Caltrans STD 38 4,000 L.F. p 23
jZOco
Thermoplastic 12" Solid Line, White or
8 Yellow Crosswalk and Limit Line Caltrans 32,000 L.F- 2S
2. ` 7z ppD
STD Detail A24E
9 4" Solid line w/ skip Yellow per Caltrans 15,000 L.F. 0.12
00 '
i, $oo '" STD Detail 15
10 4" Solid line w/ skip Yellow and RPM 5,000 L.F. 0.23 ti 50
a
Caltrans STD Detail 16
11 Thermoplastic Pavement Marking Words 15,000
S'F SS
2
a,
H2g7 So ` Caltrans STD A24D, A24E
Thermoplastic Pavement Marking S.F
12 Symbols and Numerals Caltrans STDy
85
2
A24C 5,000
13
Thermoplastic Pavement Marking Arrows 25,000
S.F
Z- Caltrans STD A24A, A246
TOTAL FOR ITEMS
Based on estimated quantities of items 1 through 13 2 'ikl00C)9;L
L_ --
I WAI
NOTE:
CITY OF LAKE ELSINORE
PROPOSAL-SCHEDULE
PROJECT NO. Z10004
ANNUAL TRAFFIC STRIPING MAINTENANCE PROGRAM
FY 15/16
PROPOSER: AS STRIPING COMPANY, INC
Contractor Name)
a. The lowest responsible Proposer will be determined by comparing the cumulative total of all
items (PCC 20103.8 b).
b. The City has the discretion to select any or all Items for the Award of the Contract.
c. The City reserves the right to add or subtract items by Contract Change Order at the prices
proposed.
Estimated quantities are for the purpose of comparison only, and payments will be made on a basis
of actual measurement of work completed.
The line item cost include, but not be limited to, sales tax and all other applicable taxes and fees.
Codes:
D) Deduct
F) Final Pay Quantities
S) Specialty Item
Units of Measurement-
LF lineal foot
SF square foot
Total amount in WORDS for Items only (Based in Estimated Quantities of Items 1 through 13:
U
15 -B
14.1: ocH S r
f.t.. —n,.,,, > //- . .. _..Y . 5z w.... ..;Gii ... .. -iYu mms.;.,o .. ,r , v Z- , f&MK N&Ui4 a— « ti . .,...- . —t —
CITY 0
LAKE , LSINOP E
I)REA&1 EXlltF.MF.
ADDENDUM NO. 2
REQUEST FOR PROPOSALS
ANNUAL TRAFFIC STRIPING MAINTENANCE PROGRAM
JULY 9, 2015
Q1: Is there a Bid Bond Required?
Al: NO
Q2: If this is a maintenance /re- stripe contract, will one (1) or two (2) coats of paint be
Required?
A2: a) REPAINTING OF EXSISTING LINES OR MARKINGS WILL ONLY REQUIRE ONE (1)
COAT OF PAINT
b) PAINTING OF NEW LINES AND /OR MARKINGS WILL REQUIRE TWO (2) COATS
OF PAINT
Q3: I have found that the contract mentions layout, removals and curb markings but I
Do not see line items for them. Should there be line items?
A3: YES THERE SHOULD BE ADDITIONAL LINES ITEMS
14 LAYOUT OF MARKINGS
J
PER
HOUR
L.F.
260 2.60
15 CURB PAINTING /MARKING (1 ZS
COAT)
I25 1
16 REMOVAL OF PAINTED L.F.
STRIPING 0. T7
T
0,177
L.F. 17 REMOVAL OF THERMOPLASTIC
STRIPING 0.27 27
S.F. 18 REMOVAL OF PAINTED
MARKINGS 0.82 d $
19 REMOVAL OF THERMOPLASTIC S.F.
MARKINGS 0'$Z
J-: 1. - ' i a TJ-W . 0"— . JJWSWWAMi 1 S :.* . _ ...2.f r.':DZ3 . &I — a -1 rs..4+a- s "lM+r:l . — - -". .r r c, c ,.
Q4: Is there and exception to the required rapid set epoxy adhesive for the pavement
Markers, such as hot melt bituminous adhesive?
A4: YES, PROVIDED THE MATERIAL USED IS THE SAME AS or EQUIVALENT TO THE
STATED RAPID SET EPDXY ADHESIVE
Q6: Line item 2 seems low, is It accurate?
A6: NO, THE ESTIMATED QUANTITY SHOULD BE CLOSER TO 103,000 L.F.
Q7: Line Item 12 seems like a high number of symbols and number markings, is It an
Accurate number?
A7: NO, THE ESTIMATED QUANTITY SHOULD BE CLOSER TO 5,000 S.F.
DATE (MM- DNYYY)
CERTIFICATE OF LIABILITY INSURANCE 8/25/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER Patriot Risk & Insurance Services e _
100 Spectrum Center Drive, Suite #400 PHONE _L94% a8s..795t 5 -
FAX
4. X1i:- 48fi''7900 (AIC, Ho):
Irvine, CA 92618 AIL
INSURERtS1 AFFORDING COVERAGE _ NAIC q
vrww.patrisk -com OG55454 INSURER A: Ohio Secur±ty, Insurance GDmpany 24082
INSURED INSUr:ERB: American, Fire & Casualtinsurance, Company— 24066
1 & S Striping, Inc, INSURER C.' State Compensation jnsuranaa Fund 33 076
1544 S• Vineyard Avenue -
Ontario CA 91761 INSURER D
T
tNSURER E
COVERAGES CERTIFICATE NUMBER: 2611/251 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
NSR TYPE OF INSURANCE
ADOL sU "91t PODGY EPF - POLICY FJrP LIMITS
LTR INSD POLICY NUMBER {MM1ODIYYYYI I IMWODNYYYI
A COMMERCIAL GENERAL LIABILITY y.
BKO1656433437 3129/2015 13/29/2016 , EACHCCCURRIENCe s 1,000.00[
A6aAa=RFNT1 $ 500,00(
CLAIMS -MADE /_ OCCUR —
v $5,000 Deductible I I MED EXP (Any one pwaan ) $ 1 O,OOt
I
I
PERSONAL& ADV INJURY $ 1,000,001
I -- -- ' - -- — — — - - -- - -- -- I I
GENERAL AGGREGATE $
I GEN'L AGGREGATEATE LIMIT APPLIES PER -
PRO- PRODUCTS - C_OM_P /OP_A_GG_ S
2,000,000
2,000,000
I POLICY r JECT LOC
5
OTHER:
B AUTOMOBILE LIABILITY 1 BAA1656433437 1
3/29/2015 3/29/2016 aacs r IIhOtEMI7 $ BOO ,lH3tJ
BODILY INJURY (Per person) S
V ANY AUTO _
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS PROPERTYOAMAGF S
w NON -OWNED (Par acGdenl _
HIRED AUTOS AUTOS $
1,000,000Uninsuredmotoristcom
B UMBRELLA LIAB OCCUR
USA1656433437 3/29/2015 3/29/2016 EACH OCCURRENCE S 4,000,000
EXCESS LIAB CLAIMS -MADE
AGGREGATE a _ 4,000,000
DED V RETENTION 3 10,000
S
C WORKERS COMPENSATION 90506282015 312912015 3/2912016 - --
j AND EMPLOYERS' LIABILITY YIN I EL EACH ACCIDENT : 1,000,006
ANY PROPRIETOR /PARTNER /EXECUTIVE NIAA IOFFICERIMEMBEREXCLUDEDJ E L. DISEASE - EA EMPLOYE S 000,000
Mandatory In NH) 1.'000.000IfyesgesrrlCe antler E L DISEASE - POLICY LIMIT
DESf'RIPTiON OF OPERATIONS 1-1—
i
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES ( ACORD 101, Addhlonal Remarks Schedule, may be attached If more space Is required)
1 Re Job #Z10004 l JSJN #3774 -S. Annual Traffic Striping Maintenance Program FY2015.2016, Lake Elsinore, CAagentsandvolunteersarenamedasAdditional Insured, includesCity of Lake Elsinore, its elected or appointed officers, officials, employees, Primary and Non - contributory respects to General Liability and Auto Liability per endorsement attached where required by written contract.
Waiver of subrogation applies to GL, Auto and Workers" Compensation per attached endorsements
30 days notice of cancellation, 10 days for non - payment of premium.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Cl tr of Lake Elsinore THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
130 S. Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Lake Elsinore CA 92530
AUTHORIZED REPRESENTATIVE _
Leonard E Ziminsky
1988 -2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
1175_ l5 1•+ 3L;A11 /CMR,1iC Annezte RC1.10 9/25/201_ 2:20: 22 PM (PDT' Page - of 10
BKO1656433437
J'& S Striping, Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL LIABILITY GOLD ENDORSEMENT - CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SECTION I — COVERAGES
COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY
2. Exclusions
Item 2.g. 2) is replaced with the following:
2.g. 2) a watercraft you do not own that is:
a) less then 50 feet long; and
b) Not being used to carry persons or property for a charge.
Item 2.g. 6) is added:
6) An aircraft In which you have no ownership Interest and that you have chartered with crew.
The last paragraph of 2. Exclusions is replaced with the following:
Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises
while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under
a written agreement with the owner_ A separate limit of insurance applies to this coverage as described in
Section III — Limits of Insurance.
SECTION I — COVERAGES
COVERAGE C. MEDICAL PAYMENTS
If Medical Payments Coverage is provided under this policy, the following Is changed:
3. Limits
The medical expense limit provided by this policy shall be the greater of.
a. $10,000; or
b. The amount shown in the declarations.
Coverage C. Medical Payments is primary and not contributing with any other Insurance, even If that other
insurance is also primary.
The following is added:
COVERAGE D. PRODUCT RECALL NOTIFICATION EXPENSES
Insuring Agreement
We will pay "product recall notification expenses" Incurred by you for the withdrawal of your products,
provided that:
a. Such withdrawal Is required because of a determination by you during the policy period, that the use or
consumption of your products could result in "bodlly Injury' or "property damage "; and
b. The "product recall notification expenses" are incurred and reported to us during the policy period.
The most we will pay for "product recall notification expenses" during the policy period is $100,000.
SUPPLEMENTARY PAYMENTS — COVERAGES A AND B
Item b. and d. are replaced with:
b. The cost of ball 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 $500 a day because of time off from work.
Includes copyrighted material of Insurance Services Offices Inc., with Its permission.
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SECTION It — WHO IS AN INSURED
Item 4, Is replaced with:
4. Any subsidiaries, companies, corporations, firms, or organizations you acquire or form during the policy
period over which you maintain a controlling Interest of greater than 50% of the stock or assets, will qualify as
a Named Insured It
a) you have the responsibility of placing Insurance for such entity; and
b) coverage for the entity is not otherwise more specifically provided; and
c) the entity Is incorporated or organized under the laws of the United States of America.
However, coverage under this provision does not apply to 'bodily injury or "property damage" that
occurred before you acquired or formed the entity, or "personal injury" or "advertising injury" arising out of
an offense committed before you acquired or formed the entity.
Coverage under this provision is afforded only until the end of the policy period, or the twelve (12) month
anniversary of the policy Inception date whichever Is earlier.
SECTION III — LIMITS OF INSURANCE
Paragraph 2. Is amended to Include:
The General Aggregate Limit of Insurance applies separately to each "location" owned by you, rented to you, or
occupied by you with the permission of the owner.
Paragraph 6. is replaced with the following:
6. Subject to 5, above, the Fire Damage Limit Is the most we will pay under Coverage A for damages because of
property damage" to promises while rented to you, temporarily occupied by you with permission of the owner,
or managed by you under a written agreement with the owner, arising out of any one fire, explosion or
sprinkler leakage incident.
The Fire Damage Limit provided by this policy shall be the greater of:
a. $500,000 or
b. The amount shown In the Declarations.
SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS
Item 2. a. is replaced with:
2. Duties In The Event of Occurrence, Offense, Claim or Suit
a. You must promptly notify us. Your duty to promptly notify us is effective when any of your executive
officers, partners, members, or legal representatives Is aware of the 'occurrence ", offense, claim, or'suit ".
Knowledge of an 'occurrence ", offense, claim or'suit" by other employee(s) does not Imply you also have
such knowledge. To the extent possible, notice to us 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 ", offense, claim or
suit ".
Item 4. b. 1) b) is replaced with:
b. Excess Insurance
1) b) That is Fire, Explosion or Sprinkler Leakage Insurance for premises while rented to you,
temporarily occupied by you with permission of the owner, or managed by you under a written
agreement with the owner; or
Item 6. is amended to include:
6. Representations
d. If you unintentionally fall to disclose any hazards existing at the inception date of your policy, we will not
deny coverage under this Coverage Part because of such failure. However, 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 Offices Inc., with its permission.
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Item 8. is replaced with:
8. Transfer of Rights Of Recovery Against Others To Us
a, If the Insured has rights to recover all or part of any payment we have made under this Coverage Part,
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.
b. If required by a written "insured contract", we waive any right of recovery we may have against any
person or organization because of payments we make for Injury or damage arising out of your ongoing
operations or "your work" done under that written "insured contract" for that person or organization and
included In the "products - completed operations hazard ".
Item 10. and Item 11, are added:
10. Cancellation Condition
If we cancel this policy for any reason other than nonpayment of premium we will mail or deliver written notice
of cancellation to the first Named Insured at least 60 days prior to the effective date of cancellation.
11. Liberallzation
If we adopt a change In our forms or rules which would broaden your coverage without an extra charge, the
broader coverage will apply to this policy. This extension Is effective upon the approval of such broader
coverage In your state.
SECTION V — DEFINITIONS
The following definitions are added or changed:
9. "Insured contract"
a. Is changed to:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that
Indemnifies any person or organization for damage by tire, explosion or sprinkler leakage to premises
white rented to you, or temporarily occupied by you with permission of the owner, or managed by you
under a written agreement with the owner is not an "Insured contract ".
23. and 24. are added:
23. "Location" means premises 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.
24. "Product recall notification expenses" means the reasonable additional expenses (including, but not
limited to, cost of correspondence, newspaper and magazine advertising, radio or television
announcements and transportation cost), necessarily incurred in arranging for the return of products, but
excluding costs of the replacement products and the cash value of the damaged products.
The following Provisions are also added to this Coverage Part:
A. ADDITIONAL INSUREDS — BY CONTRACT, AGREEMENT OR PERMIT
1. Paragraph 2. under SECTION II — WHO IS AN INSURED Is amended to Include as an insured any
person or organization when you and such person or organization have agreed In writing in a contract,
agreement or permit that such person or organization be added as an additional insured on your policy to
provide insurance such as is afforded under this Coverage Part. Such person or organization Is not
entitled to any notices that we are required to send to the Named Insured and is an additional Insured
only with respect to liability arising out of:
a. Your ongoing operations performed for that person or organization; or
b. Premises or facilities owned or used by you.
With respect to provision 1.a. above, a person's or organization's status as an insured under this
endorsement ends when your operations for that person or organization are completed.
With respect to provision 1.b. above, a person's or organization's status as an insured under this
endorsement ends whan their contract or agreement with you for such premises or facilities ends.
Includes copyrighted material of Insurance Services Offices Inc., with its permission.
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2. This endorsement provision A. does not apply:
a. Unless the written contract or agreement has been executed, or permit has been Issued, prior to the
bodily injury", "property damage" or "personal and advertising injury";
b. To 'bodily Injury" or "property damage" occurring after:
1) All work, Including materials, parts or equipment furnished In connection with such work, In the
project (other than service, maintenance or repairs) to be performed by or on behalf of the
additional insured(s) at the site of the covered operations has been completed; or
2) That portion of 'your work" out of which the Injury or damage arises has been put to Its Intended
use by any person or organization other than another contractor or subcontractor engaged in
performing operations for a principal as a part of the same project;
c. To the rendering of or failure to render any professional services including, but not limited to, any
professional architectural, engineering or surveying services such as:
1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders or drawings and specifications; and
2) Supervisory, inspection, architectural or engineering activities:
d. To 'bodily injury", "property damage" or 'personal and advertising injury" arising out of any act, error
or omission that results from the additional Insured's sole negligence or wrongdoing;
e. To any person or organization specifically designated an additional insured for ongoing operations by
a separate ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS endorsement
Issued by us and made a part of this policy
S. PRIMARY NON - CONTRIBUTORY ADDITIONAL INSURED EXTENSION
Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS Is
amended as follows:
a. The following Is added to paragraph a. Primary Insurance:
if an additional insured's policy has an Other Insurance provision making its policy excess, and you have
agreed In a written "construction contract" to provide the additional Insured coverage on a primary and
noncontributory basis, this policy shall be primary and we will not seek contribution from the additional
Insured's policy for damages we cover.
For the purposes of this endorsement, 'construction contract" means a written contract or written
agreement other than a premises lease, facilities rental contract or agreement, an equipment rental or
lease agreement, or a permit issued by a state, county, municipality or other governmental authority.
b. The following is added to paragraph b. Excess Insurance:
3) Except as specified in paragraph a., above, any other Insurance In which a party who is an additional
insured hereunder Is designated as a Named Insured.
Regardless of the terms of any written agreement between you and an additional insured, this Insurance
Is excess over any other Insurance whether primary, excess, contingent or on any other basis for which
the additional Insured has been added as an additional Insured.
Includes copyrlghled materiel of Insurance Services Offices Inc.. with its permisafon
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BAA1656433437
COMMERCIAL AUTO GOLD ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SECTION II - LIABILITY COVERAGE
A. COVERAGE
1. WHO IS AN INSURED
The following is added:
d. Any organization, other than a partnership orjoint venture, over which you maintain ownership or
a majority interest on the effective date of this Coverage Form, if there is no similar insurance
available to that organization.
e. Any organization you newly acquire or form other than a partnership or joint venture, and over
which you maintain ownership of a majority interest. However, coverage under this provision
does not apply:
1) If there is similar insurance or a self - insured retention plan available to that organization; or
2) To "bodily injury" or "property damage" that occurred before you acquired or formed the
organization.
f. Any volunteer or employee of yours while using a covered "auto" you do not own, hire or borrow
in your business or your personal affairs. Insurance provided by this endorsement is excess over
any other insurance available to any volunteer or employee.
g. Any person, organization, trustee, estate or governmental entity with respect to the operation,
maintenance or use of a covered "auto" by an insured, if:
1) You are obligated to add that person, organization, trustee, estate or governmental entity as
an additional insured to this policy by:
a) an expressed provision of an "insured contract ", or written agreement; or
b) an expressed condition of a written permit issued to you by a governmental or
public authority.
2) The "bodily injury" or "property damage" is caused by an "accident" which takes place after:
a) You executed the "insured contract" or written agreement; or
b) the permit has been issued to you.
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2. COVERAGE EXTENSIONS
a. Supplementary Payments.
Subparagraphs (2) and (4) are amended as follows:
2) Up to $2500 for 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 earning
up to $500 a day because of time off from work.
SECTION III - PHYSICAL DAMAGE COVERAGE
A. COVERAGE
The following is added:
S. Hired Auto Physical Damage
a. Any "auto" you lease, hire, rent or borrow from someone other than your employees or partners
or members of their household is a covered "auto" for each of your physical damage coverages.
b. The most we will pay for "loss" in any one "accident' is the smallest of:
1) $50,000
2) The actual cash value of the damaged or stolen property as of the time of the "loss'; or
3) The cost of repairing or replacing the damaged or stolen property with other property of like
kind and quality.
If you are liable for the "accident ", we will also pay up to $500 per "accident" for the actual loss of
use to the owner of the covered "auto'.
c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by
an amount that is equal to the amount of the largest deductible shown for any owned "auto" for
that coverage. However, any Comprehensive Coverage deductible shown in the Declarations
does not apply to "loss" caused by fire or lightning.
d. For this coverage, the insurance provided is primary for any covered "auto" you hire without a
driver and excess over any other collectible insurance for any covered "auto" that you hire with a
driver.
6. Rental Reimbursement Coverage
We will pay up to $75 per day for up to 30 days, for rental reimbursement expenses incurred by you
for the rental of an "auto" because of 'loss" to a covered "auto'. Rental Reimbursement will be
based on the rental of a comparable vehicle, which in many cases may be substantially less than $75
per day, and will only be allowed for a period of time it should take to repair or replace the vehicle
with reasonable speed and similar quality, up to a maximum of 30 days. We will also pay up to $500
for reasonable and necessary expenses incurred by you to remove and replace your materials and
equipment from the covered "auto'.
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If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay
under this coverage only that amount of your rental reimbursement expenses which is not
already provided under paragraph 4. Coverage Extension.
7. Lease Gap Coverage
If a long -term leased "auto" is a covered "auto" and the lessor is named as an Additional Insured -
Lessor, In the event of a total loss, we will pay your additional legal obligation to the lessor for any
difference between the actual cash value of the "auto" at the time of the loss and the "outstanding
balance" of the lease.
Outstanding balance" means the amount you owe on the 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; and lease termination fees.
B. EXCLUSIONS
The following is added to Paragraph 3
The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not
apply to the accidental discharge of an airbag.
Paragraph 4 is replaced with the following:
4. We will not pay for "loss" to any of the following:
a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with
audio, visual or data electronic equipment.
b. Equipment designed or used for the detection or location of radar.
c. Any electronic equipment that receives or transmits audio, visual or data signals.
Exclusion 4.c does not apply to:
1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by
use of the power from the "auto's" electrical system, in or upon the covered "auto'; or
2) Any other electronic equipment that is:
a) Necessary for the normal operation of the covered "auto" or the monitoring of the
covered "auto's "operating system; or
b) An integral part of the same unit housing any sound reproducing equipment described in (1)
above and permanently installed in the opening of the dash or console of the covered "auto"
normally used by the manufacturer for installation of a radio.
D. DEDUCTIBLE
The following is added: No deductible applies to glass damage if the glass is repaired rather than
replaced.
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SECTION IV. BUSINESS AUTO CONDITIONS
A. LOSS CONDITIONS
Item 2.a. and b. are replaced with:
2. Duties In The Event of Accident, Claim, Suit, or Loss
a. You must promptly notify us. Your duty to promptly notify us is effective when any of your
executive officers, partners, members, or legal representatives is aware of the accident, claim,
suit", or loss. Knowledge of an accident, claim, "suit ", or loss, by other employee(s) does not
imply you also have such knowledge.
b. To the extent possible, notice to us should include:
1) How, when and where the accident or loss 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 accident or loss.
The following is added to 5.
We waive any right of recovery we may have against any additional insured under Coverage A. 1.
Who Is An Insured g., but only as respects loss arising out of the operation, maintenance or use of
a covered "auto" pursuant to the provisions of the "insured contract ", written agreement, or permit.
B. GENERAL CONDITIONS
9. is added
9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Your unintentional failure to disclose any hazards existing at the effective date of your policy will not
prejudice the coverage afforded. However, we have the right to collect additional premium for any
such hazard.
COMMON POLICY CONDITIONS
2.b. is replaced by the following:
b. 60 days before the effective date of cancellation if we cancel for any other reason.
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ENDORSEMENT AGREEMENT
WAIVER OF SUBROGATION
BLANKET BASIS
HOME OFFICE
iAN FRANCISCO EFFECTIVE MARCH 29, 2015 AT 12. 01 A.M.
AND EXPIRING MARCH 29, 2016 AT 12.01 A.M.
LL EFFECTIVE DATES ARE
T 12:01 AM PACIFIC
TANDARD TIME OR THE
IME INDICATED AT
ACIFIC STANDARD TIME
J & S STRIPING, INC
1544 S VINEYARD AVE
ONTARIO, CA 91761
REP C2
9050628 -15
RENEWAL
SP
5- 84 - 90 - 63
PAGE 1 OF
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.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE
2.00% OF THE TOTAL POLICY PREMIUM.
SCHEDULE
PERSON OR ORGANIZATION
ANY PERSON OR ORGANIZATION
FOR WHOM THE NAMED INSURED
HAS AGREED BY WRITTEN
CONTRACT TO FURNISH THIS
WAIVER
JOB DESCRIPTION
BLANKET WAIVER OF
SUBROGATION
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
MARCH 6, 2015
1
uh DATE (MMIDD /YYYY)
ih
CERTIFICATE OF LIABILITY INSURANCE 8!2912016
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 Patriot Risk & Insurance Services NANMEi
100 Spectrum Center Drive, Suite #400 PHONE 4sfr 7gQ0 F r°c Na,
Irvine, CA 92618 (AICA o, EM): (948). (949)48fi-795t1.-
ADDRESS: --
INSURER(S) AFFORDING COVERAGE NAIC #
www.patrisk.com OK07568 INSURERA: Ohio Security Insurance Company 24082
INSURED INSURER B: State Compensation iFISUrrance Fund _ 35076
J & S Striping, Inc.
1544 - Vine and Avenue NSt1RERC: —
Ontario CA 91761 INSURER
INSURER E:
INSURER F:_ _
f'CDTIUIf' ATC A11111AMCD• oa r;A411n RFVISION 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 ADDLISUa RI POUCYEFF I POLICYEXP LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER - M D1YYYY MMIDD /YYYY
A COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ` 1/ OCCUR
ACCORDANCE WITH THE POLICY PROVISIONS.
12BKO1756433437 3/29/2016 3/29/2017 EACH OCCURRENCE
0-AM-AZ ETORENT U
RREMtgEs ffnaccurrenee
1,000,000
500,000
S,OQR DBdUCtli3 e
Leonard E. Ziminsky
MED EXP (Any, one person) 10,000
PERSONAL & ADV INJURY 1,000,000
GENERAL AGGREGATE _ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
2,000,000
POLICY f PRO- E LOC PRODUCTS - COMP /OP AGG
OTHER:
A AUTOMOBILE LIABILITY 2BAA1756433437 3/29/2016 3/29/2017 QMBlcINdEDSI GL rMIT $ 000 000
ANY AUTO
I - -
OWNED SCHEDULEDj
AUTOS ONLY AUTOS
I HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
BODILY $
PROPERTYOAMAGE $
Per aaoldantl
Uninsured motorist comtl $ 1,000,000
A / UMBRELLA LIAR ?/ OCCUR 2USA1756433437 3/2912016 3129/2017 EACH OCCURRENCE $ 4.000,000
EXCESS LIAB 1 CLAIMS -MADE AGGREGATE _ - $ 4,000,000
DED I I RETENTION$ 10,000
B WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR /PARTNER /EXECUTIVE Yom,
90506282016 3/29/2016 3/29/2017 STATUTE FOR
E.L. EACH ACCIDENT _ 1,000,000
E.L. DISEASE - EA EMPLOYEE 1 000 000OFFICER /MEMBER EXCLUDED? u
Mandatory in NH)
NIA
E.L DISEASE - POLICY LIMIT 1 $ 1,000,000Ifyes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
Re: Job #210004 Amendment No. 1 1 JSJN #3914 -3, Annual Traffic Striping Maintenance Program FY2015.2016, Lake Elsinore, CA
City of Lake Elsinore, its elected or appointed officers, Officials, employees, agents and
VOILlnteers are named as Additional Insured, includes Primary and Non - contributory respects to General Liability and Auto
Liability per endorsement attached where required by written contract - Waiver of subrogation applies to GL, Auto and Workers'
Compensation per attached endorsements- 30 days notice of cancellation, 10 days for non - payment of premium.
r.Tlr_rA n U1 l neo r'Aldf•`CI I ATIfIM
U T`Jtlt5 -LU'10 NVVMLJ %,UMr'VRF111VIV. NII rltyllt5 FU5t!UVeU.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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This cercilicate cancels and supersedes ALL previously issued certifica Les
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Lake Elsinore THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
130 S. Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Lake Elsinore CA 92530
AUTHORIZED REPRESENTATIVE
Leonard E. Ziminsky
U T`Jtlt5 -LU'10 NVVMLJ %,UMr'VRF111VIV. NII rltyllt5 FU5t!UVeU.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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This cercilicate cancels and supersedes ALL previously issued certifica Les
2BKO1756433437
J & S Striping, Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL LIABILITY GOLD ENDORSEMENT - CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SECTION I - COVERAGES
COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY
2. Exclusions
Item 2.g. 2) is replaced with the following:
2.g, 2) a watercraft you do not own that is:
a) less than 50 feet long; and
b) Not being used to carry persons or property for a charge.
Item 2.g. 6) is added:
6) An aircraft in which you have no ownership interest and that you have chartered with crew.
The last paragraph of 2. Exclusions is replaced with the following:
Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises
while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under
a written agreement with the owner. A separate limit of Insurance applies to this coverage as described in
Section III - Limits of Insurance.
SECTION I - COVERAGES
COVERAGE C. MEDICAL PAYMENTS
If Medical Payments Coverage is provided under this policy, the following Is changed:
3. Limits
The medical expense limit provided by this policy shall be the greater of:
a. $10,000; or
b. The amount shown in the declarations.
Coverage C. Medical Payments is primary and not contributing with any other Insurance, even if that other
insurance is also primary.
The following is added:
COVERAGE D. PRODUCT RECALL NOTIFICATION EXPENSES
Insuring Agreement
We will pay "product recall notification expenses" Incurred by you for the withdrawal of your products,
provided that:
a. Such withdrawal Is required because of a determination by you during the policy period, that the use or
consumption of your products could result In "bodily injury" or "property damage "; and
b. The "product recall notification expenses" are incurred and reported to us during the policy period.
The most we will pay for "product recall notification expenses" during the policy period is $100,000.
SUPPLEMENTARY PAYMENTS -COVERAGES A AND B
Item b. and d. are replaced with:
b. The 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 $500 a day because of time off from work.
Includes copyrighted material of Insurance Services Offices Inc., with Its permission,
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This COED i L icaLe cancels and supersedes ALL previously issued certificates.
SECTION I1— WHO IS AN INSURED
Item 4. is replaced with:
4. Any subsidiaries, companies, corporations, firms, or organizations you acquire or form during the policy
period over which you maintain a controlling interest of greater than 50% of the stock or assets, will qualify as
a Named Insured if:
a) you have the responsibility of placing insurance for such entity; and
b) coverage for the entity Is not otherwise more specifically provided; and
c) the entity is incorporated or organized under the laws of the United States of America.
However; coverage under this provision does not apply to "bodily injury" or "property damage" that
occurred before you acquired or formed the entity, or "personal injury" or "advertising Injury" arising out of
an offense committed before you acquired or formed the entity.
Coverage under this provision is afforded only until the and of the policy period, or the twelve (12) month
anniversary of the policy inception date whichever Is earlier.
SECTION III — LIMITS OF INSURANCE
Paragraph 2. is amended to include:
The General Aggregate Limit of Insurance applies separately to each "location" owned by you, rented to you, or
occupied by you with the permission of the owner.
Paragraph 6. is replaced with the following:
6. Subject to 5. above, the Fire Damage Limit is the most we will pay under Coverage A for damages because of
property damage" to premises while rented to you, temporarily occupied by you with permission of the owner,
or managed by you under a written agreement with the owner, arising out of any one fire, explosion or
sprinkler leakage incident.
The Fire Damage Limit provided by this policy shall be the greater of:
a. $500,000 or
b. The amount shown In the Declarations.
SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS
Item 2. a. is replaced with:
2. Duties In The Event of Occurrence, Offense, Claim or Suit
a. You must promptly notify us, Your duty to promptly notify us is effective when any of your executive
officers, partners, members, or legal representatives is aware of the "occurrence ", offense, claim. or "suit ".
Knowledge of an *occurrence", offense, claim or "suit" by other employee(s) does not imply you also have
such knowledge. To the extent possible, notice to us 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 ", offense, claim or
suit'.
Item 4. b. 1) b) is replaced with:
b. Excess Insurance
1) b) That is Fire, Explosion or Sprinkler Leakage Insurance for premises while rented to you,
temporarily occupied by you with permission of the owner, or managed by you under a written
agreement with the owner; or
Item 6. Is amended to include:
6. Representations
d. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not
deny coverage under this Coverage Part because of such failure. However, 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 Offices Inc., with its permission.
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This cerLificaLe cancels and supersedes ALL previously issued certificates.
Item 8. is replaced with:
8. Transfer of Rights Of Recovery Against Others To Us
a. If the Insured has rights to recover all or part of any payment we have made under this Coverage Part,
those rights are transferred to us. The Insured must do nothing after loss to impair thews. At our request,
the insured will bring suit or transfer those rights to us and help us enforce them.
b, If required by a written "Insured contract ", we waive any right of recovery we may have against any
person or organization because of payments we make for injury or damage arising out of your ongoing
operations or "your work" done under that written "insured contract" for that person or organization and
included in the "products - completed operations hazard".
Item 10. and Item 11. are added:
10. Cancellation Condition
If we cancel this policy for any reason other than nonpayment of premium we will mail or deliver written notice
of cancellation to the first Named Insured at least 60 days prior to the effective date of cancellation.
11. Liberalization
If w.a adapt a change in our forms or rules which would broaden your coverage without an extra charge, the
broader coverage will apply to this policy. This extension is effective upon the approval of such broader
coverage in your state.
SECTION V — DEFINITIONS
The following definitions are added or changed:
9. "Insured contract"
a. Is changed to:
a. A contract for a lease of promises. However, that portion of the contract for a lease of premises that
indemnifies any person or organization for damage by fire, oxplosion or sprinkter leakage to premises
while rented to you, or temporarily occupied by you with permission of the owner, or managed by you
under a written agreement with the owner Is not an "insured contract ".
23. and 24. are added:
23. "Location" means premises involving the same or connecting tots, or premises whose connection is
interrupted only by a street, roadway, waterway or right -of -way of a railroad.
24, "Product recall notification expenses" means the reasonable additional expenses (including, but not
limited to, cost of correspondence, newspaper and magazine advertising, radio or television
announcements and transportation cost), necessarily incurred in arranging for the return of products, but
excluding costs of the replacement products and the cash value of the damaged products.
The following Provisions are also added to this Coverage Part:
A. ADDITIONAL INSUREDS — BY CONTRACT, AGREEMENT OR PERMIT
1. Paragraph 2. under SECTION It — WHO IS AN INSURED is amended to include as an insured any
person or organization when you and such person or organization have agreed in writing in a contract,
agreement or permit that such person or organization be added as an additional insured on your policy to
provide insurance such as is afforded under this Coverage Part. Such person or organization is not
entitled to any notices that we are required to send to the Named Insured and is an additional insured
only with respect to liability arising out of:
a. Your ongoing operations performed for that person or organization; or
b. Premises or facilities owned or used by you.
With respect to provision 1.a. above, a person's or organization's status as an insured under this
endorsement ends when your operations for that person or organization are completed,
With respect to provision 1.b. above, a person's or organization's status as an insured under this
endorsement ends when their contract or agreement with you for such premises or facilities ends.
Includes copyrighted material of Insurance Services Offices Inc., with Its permission.
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Thie certificate cancels and supersedes ALL previously issued cert i Eieates,
2. This endorsement provision A. does not apply:
a. Unless the written contract or agreement has been executed, or permit has been issued, prior to the
bodily injury", "property damage" or "personal and advertising injury";
b. To "bodily injury" or "property damage" occurring after:
1) All work, Including materials, parts or equipment furnished in connection with such work, in the
project (other than service, maintenance or repairs) to be performed by or on behalf of the
additional insured(s) at the site of the covered operations has been completed; or
2) That portion of "your work" out of which the Injury or damage arises has been put to its intended
use by any person or organization other than another contractor or subcontractor engaged in
performing operations for a principal as a part of the same project;
c. To the rendering of or failure to render any professional services including, but not limited to, any
professional architectural, engineering or surveying services such as:
1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders or drawings and specifications; and
2) Supervisory, inspection, architectural or engineering activities;
d. To "bodily injury", "property damage" or "personal and advertising injury" arising out of any act, error
or omission that results from the additional Insured's sole negligence or wrongdoing;
e. To any person or organization specifically designated an additional insured for ongoing operations by
a separate ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS endorsement
issued by us and made a part of this policy
B. PRIMARY NON - CONTRIBUTORY ADDITIONAL INSURED EXTENSION
Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is
amended as follows;
a. The following Is added to paragraph a. Primary Insurance:
If an additional insured's policy has an Other Insurance provision making its policy excess, and you have
agreed in a written "construction contract" to provide the additional insured coverage on a primary and
noncontributory basis, this policy shall be primary and we will not seek contribution from the additional
insured's policy for damages we cover.
For the purposes of this endorsement, "construction contract" means a written contract or written
agreement other than a premises lease, facilities rental contract or agreement, an equipment rental or
lease agreement, or a permit Issued by a state, county, municipality or other governmental authority.
b. The following is added to paragraph b. Excess Insurance:
3) Except as specified in paragraph a., above, any other insurance in which a party who is an additional
insured hereunder is designated as a Named insured.
Regardless of the terms of any written agreement between you and an additional insured, this insurance
is excess over any other insurance whether primary, excess, contingent or on any other basis for which
the additional Insured has been added as an additional Insured.
Includes copyrighted material of Insurance Services Offices Inc., with its permission.
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This cereii irate cancels and supersedes ALL previously issued certificates.
Page 4 of 4
2BAA1756433437
COMMERCIAL AUTO GOLD ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SECTION II - LIABILITY COVERAGE
A. COVERAGE
1. WHO IS AN INSURED
The following is added:
d. Any organization, other than a partnership orjoint venture, over which you maintain ownership or
a majority interest on the effective date of this Coverage Form, if there is no similar insurance
available to that organization.
e. Any organization you newly acquire or form other than a partnership or joint venture, and over
which you maintain ownership of a majority interest. However, coverage under this provision
does not apply:
1) If there is similar insurance or a self - insured retention plan available to that organization; or
2) To "bodily injury" or "property damage" that occurred before you acquired or formed the
organization.
f. Any volunteer or employee of yours while using a covered "auto" you do not own, hire or borrow
n your business or your personal affairs. Insurance provided by this endorsement is excess over
any other insurance available to any volunteer or employee.
g. Any person, organization, trustee, estate or governmental entity with respect to the operation,
maintenance or use of a covered "auto" by an insured, if:
1) You are obligated to add that person, organization, trustee, estate or governmental entity as
an additional insured to this policy by:
a) an expressed provision of an "insured contract ", or written agreement; or
b) an expressed condition of a written permit issued to you by a governmental or
public authority.
2) The "bodily injury" or "property damage" is caused by an "accident" which takes place after:
a) You executed the "insured contract" or written agreement; or
b) the permit has been issued to you.
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i:iiS ccrLiLica[c cancels and supersedes ALL previously issued certificates.
2. COVERAGE EXTENSIONS
a. Supplementary Payments.
Subparagraphs (2) and (4) are amended as follows:
2) Lip to $2500 for 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 earning
up to $500 a day because of time off from work.
SECTION III - PHYSICAL DAMAGE COVERAGE
A. COVERAGE
The following is added:
5. Hired Auto Physical Damage
a. Any "auto' you lease, hire, rent or borrow from someone other than your employees or partners
or members of their household is a covered "auto" for each of your physical damage coverages.
b. The most we will pay for "loss" in any one "accident" is the smallest of:
1) $50,000
2) The actual cash value of the damaged or stolen property as of the time of the 'loss'; or
3) The cost of repairing or replacing the damaged or stolen property with other property of like
kind and quality.
If you are liable for the "accident', we will also pay up to $500 per "accident" for the actual loss of
use to the owner of the covered "auto'.
c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by
an amount that is equal to the amount of the largest deductible shown for any owned "auto' for
that coverage. However, any Comprehensive Coverage deductible shown in the Declarations
does not apply to 'loss" caused by fire or lightning.
d. For this coverage, the insurance provided is primary for any covered "auto' you hire without a
driver and excess over any other collectible insurance for any covered "auto' that you hire with a
driver.
6. Rental Reimbursement Coverage
We will pay up to $75 per day for up to 30 days, for rental reimbursement expenses incurred by you
for the rental of an "auto' because of 'loss" to a covered "auto'. Rental Reimbursement will be
based on the rental of a comparable vehicle, which in many cases may be substantially less than $75
per day, and will only be allowed for a period of time it should take to repair or replace the vehicle
with reasonable speed and similar quality, up to a maximum of 30 days. We will also pay up to $500
for reasonable and necessary expenses incurred by you to remove and replace your materials and
equipment from the covered "auto'.
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Tnis cerLifica Le cancels and supersedes ALL previously issued cerL i fica Le S.
If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay
under this coverage only that amount of your rental reimbursement expenses which is not
already provided under paragraph 4. Coverage Extension.
7. Lease Gap Coverage
If a long -tern leased "auto" is a covered "auto" and the lessor is named as an Additional Insured -
Lessor, In the event of a total loss, we will pay your additional legal obligation to the lessor for any
difference between the actual cash value of the "auto" at the time of the loss and the "outstanding
balance" of the lease.
Outstanding balance" means the amount you owe on the 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; and lease termination fees.
B. EXCLUSIONS
The following is added to Paragraph 3
The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not
apply to the accidental discharge of an airbag.
Paragraph 4 is replaced with the following:
4. We will not pay for "loss" to any of the following:
a. "tapes, records, disks or other similar audio, visual or data electronic devices designed for use with
audio, visual or data electronic equipment.
b. Equipment designed or used for the detection or location of radar.
c. Any electronic equipment that receives or transmits audio, visual or data signals.
Exclusion 4.c does not apply to:
1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by
use of the power from the "auto's" electrical systern, in or upon the covered "auto "; or
2) Any other electronic equipment that is:
a) Necessary for the normal operation of the covered "auto" or the monitoring of the
covered "auto's "operating system; or
b) An integral part of the same unit housing any sound reproducing equipment described in (1)
above and permanently installed in the opening of the dash or console of the covered "auto"
normally used by the manufacturer for installation of a radio.
D. DEDUCTIBLE
The following is added: No deductible applies to glass damage if the glass is repaired rather than
replaced.
CFCA 701 (01/07) Includes copyrighted material of Tnsurancc Services offices, Toe. with its permission page 3 of 4
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This ce ri it icaLC cancels and supersedes ALL previously issued certificates.
SECTION IV. BUSINESS AUTO CONDITIONS
A. LOSS CONDITIONS
Itern 2.a. and b. are replaced with;
2. Duties In The Event of Accident, Claim, Suit, or Loss
a. You must promptly notify us. Your duty to promptly notify us is effective when any of your
executive officers, partners, members, or legal representatives is aware of the accident, claim,
suit ", or loss. Knowledge of an accident, claim, "suit ", or loss, by other employee(s) does not
imply you also have such knowledge.
b. To the extent possible, notice to us should include:
1) How, when and where the accident or loss 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 accident or loss.
The following is added to 5.
We waive any right of recovery we may have against any additional insured under Coverage A. 1.
Who Is An Insured g., but only as respects loss arising out of the operation, maintenance or use of
a covered "auto" pursuant to the provisions of the "insured contract ", written agreement, or permit.
B. GENERAL CONDITIONS
9. is added
9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Your unintentional failure to disclose any hazards existing at the effective date of your policy will not
prejudice the coverage afforded. However, we have the right to collect additional premium for any
such hazard.
COMMON POLICY CONDITIONS
2.b. is replaced by the following:
b. 60 days before the effective date of cancellation if we cancel for any other reason.
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This ccrLificaLc cancels and supersedes ALL previously issued certificates.
ENDORSEMENT AGREEMENT
WAIVER OF SUBROGATION
BLANKET BASIS
HOME OFFICE
SAN FRANCISCO EFFECTIVE MARCH 29, 2016 AT 12. 01 A.M.
AND EXPIRING MARCH 29, 2017 AT 12. 01 A.M.
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
J & S STRIPING, INC
1544 S VINEYARD AVE
ONTARIO, CA 91761
REP C2
9050628 -16
RENEWAL
SP
5- 84 - 90 - 63
PAGE 1 OF
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.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE
2.00% OF THE TOTAL POLICY PREMIUM.
SCHEDULE
PERSON OR ORGANIZATION
ANY PERSON OR ORGANIZATION
FOR WHOM THE NAMED INSURED
HAS AGREED BY WRITTEN
CONTRACT TO FURNISH THIS
WAIVER
JOB DESCRIPTION
BLANKET WAIVER OF
SUBROGATION
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
MARCH 25, 201
315;1212 1 16/ 17 :; 1.iAkpitihiii /wAOTHGRilFtE), - -REI RSEN IT I E21 PM (PDT) I Page 10 of 10 PRESIDENT AND CEO
sl3LFcFEYAIVI«' kiDfl9a '(fiE7a gytJy;crsc.ie,: ALL [3—w6j— .r..—d certificates.
1
2572
OLD DP 217
.'t
AGREEMENT FOR CONTRACTOR SERVICES (ON-CALL)
J & S Striping Company, lnc.
Annual Traffic Striping Maintenance Program, Project No. 210004
This Agreement for contractor services (on-call) (the "Agreement") is made and entered
into as of August 1 1 , 2015, by and between the City of Lake Elsinore, a municipal corporation
("City") and J & S Striping Company lnc., a Corporation ("Contractot'').
RECITALS
A. The City has determined that it requires the following services: Citywide traffic
striping maintenance in conformance with Caltrans Standards-
B. The City has prepared a request for a proposals and Contractor has submitted to
City a proposal, dated July 6, 2015, both of which are attached hereto as Exhibit A (collectively,
tne "Contiaaor;s Proposai") and incorporated herein, to provide services and related work to the
City pursuant to the terms of this Agreement
c. contractor possesses the skill, experience, ability, background, certification and
knowledge to perform the services and related work described in this Agreement on the terms
and conditions described herein.
D.CitydesirestoretaincontractortoperformtheServicesandrelatedworkas
provided herein and contractor desires to provide such services and related work as set forth in
this Agreement.
AGREEMENT
1. Scooe of services. contractor shall perform the services and related work
described ln contrraors eroposat (Exhibit A). Contractor shall provide such services and related
*oi1
"t
tn" ti.", place, and in the manner specified in contractor's Proposal (Exhibit A)' subject
io the direction oi the City through its staff that it may provide from time to time. Contractor
,"rno*r"og". that the scope of- Services provides for 24 hour-a-day, 7 day-a-week, on-call
support on an as needed basis.
2. Time of Performance.
a. Time of Essence. Time is of the essence in the performance of this
Agreement.tetimetorcomptetionoftheservicesandrelatedworktobeperformedby
C6nto"tot. is an essential condiiion of this Agreement. Contractor shall prosecute regularly and
O,fiJ""tfVln" r"*ices and related work conteinplated pursuant to this Agreement consistent with
co"ntrr,ioi. proposal (ExhibitA) and shall provide, furnish and pay all labor, materials, necessary
toors, e*penoaule equipment, ,nd
"ll
t"r"t, utility and transportation services required to perform
such the services and related work.
b.PerformanceSchedule.contractorShallcommencetheservicesand
related work pursuant to this Agreen eni upon receipt of a written notice to proceed and shall
p;;; ,ti r&ices and related' work within the time period(s) established in the Contractor's
(On-Call) For Annual Traffic Striping Maintenancr Program - FinalPage 1
Proposal (Exhibit A). When requested by Contractor, extensions to the time period(s) specified
may be approved in writing by the City Manager.
c. Term and Compliance with TaskMork Order Svstem.
Unless earlier terminated as provided elsewhere in this Agreement, this
Agreement shall continue in full force and effect for a period of Ten (10) Months, commencing on
August 11, 2015 and ending on June 30, 2016. The city may, at its sole discretion, extend the
term of this Agreement on a 12-month basis not to exceed Two (2) additional twelve (12) month
renewal terma by giving written notice thereof to Contractor not less than thirty (30) days before
the end of the contract term, such notice to be exercised by the City Manager.
Contractor hereby agrees and acknowledges that any and all work or
services performed pursuant to this Agreement shall be based upon the issuance of a Task/Work
Order by the City. bontractor acknowledges that it is not guaranteed any minimum-or specific
amount of work or services as all work or services shall be authorized through a TaskMork Order
issued by the City.
3.CompensationandCostofLivinqAdiustment.compensationtgPj.paidto
Contractor snatt Oe in accorOance witfr tne fees set forth in Contractor's Proposal (Exhibit A),
which is attached hereto and incorporated herein by reference. ln no event shall Contractor's
compensation for the initial term exceed one Hundred seventy Five Thousand Dollars
iCr i'i,ooot *mout additional written authorization from the City. Compensation for-anY extended
ienewat teim shall not exceed One Hundred Seventy Five Thousand Dollars ($175,000) annually,
suUjea onty to tne cost of living adjustment as provided forherein below, without additional written
authorization from the city. - notwltnstanding any provision of contractor's Proposal to the
contrary, out of pocket exfenses set forth in Exhibit A shall be reimbursed at cost without an
inflator or administrative charge. Payment by City under this Agreement shall not be deemed a
waiver of defects, even if such defects were known to the city at the time of payment
The compensation paid to Contractor may be adjusted on each July 1
following the first anniversary oi tn" commencement of the term of this Agreement, provided that
the reqriest for cost of living adjustment shall be presented to the City no later than.June 1st of a
p"rti.ri", year and, if approved by the City, will become effective on July 1st of that year. Any
aJiustmeni will be based on the Los Angeles-Riverside-Orange County Consumer Price lndex
(Ci,t) Out in no event shall the price adiustment exceed five percent (5%)'
4. Method of pavment. Contractor shall promptly submit billings to the City describing
the services ano rerateo worr performed during the preceding month to the extent that such
services and related work were performed. Contiactor's bills shall be segregated by project task'
it
"ppfi*Uf",
such that the City ieceives a sep_arate accounting for work done on each individual
task for which Contractor ptorid"t services. Contractor's bills shall include a brief description of
the services performed, the date the services were performed, the number of hours spent and by
wr.,om, ano a description of any reimbursable expenditures. city shall pay contractor no later
than forty-five (45) days after receipt of the monthly invoice by City staff'
5. SusPension or Termination.
a. The City may at any time, for any reason, with or without cause' suspend
or terminate this Agreement, br any portion hereof, by serving upon the Contractor at least ten
if OiJ"Vr prior writt6n notice. Uponieceipt of such notice, the Contractor shall immediately cease
Page 2
all work under this Agreement, unless the notice provides otherwise. lf the City suspends or
terminates a portion of this Agreement such suspension or termination shall not make void or
invalidate the remainder of this Agreement.
b. ln the event this Agreement is terminated pursuant to this Section, the City
shall pay to Contractor the actual value of the work performed up to the time of termination,
provided that the work performed is of value to the City. Upon termination of the Agreement
pursuant to this Section, the Contractor will submit an invoice to the City, pursuant to Section
entitled "Method of Payment" herein.
6. Ownershio of Documents. All plans, studies, documents and other writings
prepared by and for Contractor, its officers, employees and agents and subcontractors in the
course of implementing this Agreement, except working notepad internal documents, shall
become the property oithe City upon payment to Contractor for such work, and the City shall
have the soie iignf to use such materials in its discretion without further compensation to
Contractor or to any other party. Contractor shall, at Contractor's expense, provide such reports,
plans, studies, doiuments and other writings to City upon written request. City acknowledges
in"t "ry
use oi such materials in a manner beyond the intended purpose as set forth herein shall
be at tlhe sole risk of the City. City further agrees to defend, indemnify and hold harmless
Contractor, its officers, officiali, agents, employees and volunteers from any claims, demands,
actions, losses, damages, injuries, and liability, direct or indirect (including any and all costs and
exfenses in connectio-n therein), arising out of the City's use of such materials in a manner beyond
the intended purpose as set forth herein
a. Licensinq of lntellectual Propertv. This Agreement creates a nonexclusive
and perpetual license foi6ity to copy, use, modify, reuse, or sublicense any and all copyrights,
J"tignt, and other intellectual property embodied in plans, specifications, studies, drawings,
estiriates, and other documents or works of authorship fixed in any tangible medium of
expression, including but not limited to, physical drawings or data magnetically or otherwise
recorded on compuGr diskettes, which are prepared or caused to be prepared by Contractor
,na"1 inir Agreement ("Documents & Data"). contractor shall require that all subcontractors
"g; i" writing that City is granted a nonexclusive and perpetual license for any.Documents &
Dita tne subcontractor prepares under this Agreement. Contractor represents and warrants that
Coniractor has the legal right to license any and all Documents & Data. Contractor makes no
iuch representation and winanty in regard to Documents & Data which were prepared by design
protessionats other than Contracior or [rovided to Contractor by the City City shall not be limited
in
"nV
*"V in its use of the Documents & Data at any time, provided that any such use not within
the plrpoies intended by this Agreement shall be at City's sole risk'
b.Confidentialitv.Allideas,memoranda,specifications,plans,procedures,
drawings, descriptions, computer program data, inp_ut record data, written information, and other
Documlnts & Data either created by oi provided to Contractor in connection with the performance
oitni" ngr""."nt shall be held confidential by Contractor. Such materials shall not, without the
prioi *rii"n consent of City, be used by Contractor for any purposes other than the performance
bf ihe s"rvic"s under this Agreement. Nor shall such materials be disclosed to any person or
"n tV not connected with tie performance of the services under this Agreement. Nothing
trrni'.n"a to Contractor which is otherwise known to Contractor or is generally known' or has
become known, to the related industry shall be deemed confidential. contractor shall not use
Cityt n"n1" or insignia, photographi relating to project for which Contractor's services are
renOereO, o, any pr-blicity pertaining to the Contractor's services under this Agreement in any
Page 3
magazine, trade paper, newspaper, television or radio production or other similar medium without
the prior written consent of City.
7. Contractor's Books and Records.
a. Contractor shall maintain any and all ledgers, books of account, invoices,
vouchers, canceled checks, and other records or documents evidencing or relating to charges for
services, or expenditures and disbursements charged to City for a minimum period of three (3)
years, or for any longer period required by law, from the date of final payment to Contractor to
this Agreement.
b. Contractor shall maintain all documents and records which demonstrate
performance under this Agreement for a minimum period of three (3) years, or for any longer
period required by law, from the date of termination or completion of this Agreement.
c. Any records or documents required to be maintained pursuant to this
Agreement shall be made available for inspection or audit, at any time during regular business
hJurs, upon written request by the City Manager, City Attorney, City Auditor or a designated
,"pr"i"nt"tir" of these officerl. Copies of such documents shall be provided to the City for
inipection at City Hall when it is practical to do so. Otherwise, unless an alternative is mutually
agieed upon, the records shall be available at Contractor's address indicated for receipt of notices
in this Agreement.
d.WhereCityhasreasontobelievethatsuchrecordsordocumentsmaybe
lost or discarded due to dissoluiion, disbandment or termination of Contractor's business' City
may, oy written request by any of the above-named officers, require that custody of the records
U" ifir.i" to the City and t-hat t-he records and documents be maintained in City Hall. Access to
suc[ records and dbcuments shall be granted to any party authorized by Contractor, Contractor's
representatives, or Contractor's successor-in-interest.
g. lndependent Contractor. lt is understood that Contractor, in the performance of
the work and servffis agreA to be performed, shall act as and be an independent contractor and
shall not act as an agent or employee of the City.
g. pERS Eliqibilitv lndemnification. ln the event that contractor or any employee,
agent,oiSubffingservicesunderthiSAgreementclaimsoris
JEGrrin"o by a court of competent jurisdiction or the California Public Employees Retirement
SV"t", tFf n'Sl to be eligible for enroilment in PERS as an employee of the City, Contractor shall
,t"r.ity, deiend, and hold harmless City for the payment of any employee and/or employer
lontriUrtion. for PERS benefits on behalf of Contractor or its employees, agents, or
suucontractors, as well as for the payment of any penalties and interest on such contributions,
which would otherwise be the responsibility of City.
Notwithstanding any other federal, state and local laws, codes, ordinances and
regulations to the contrary, Contrictor and any of its employees, agents,.and subcontractors
piSriJrl r".i"e under this Agreement shall not qualify for or become entitled to, and hereby
!gi"" iJ*"iu" any claims to, aiy compensation blnefit, or any incident of employment by City,
in""frAing but not limited to etigibility to enroll in PERS as an employee of City and entitlement to
"nv "o"irfuriion
to oe paio ui city tor employer contribution and/or employee contributions for
PERS benefits.
Page 4
10. lnterests of Contractor. Contractor (including principals, associates and
management employees) covenants and represents that it does not now have any investment or
interest in real property and shall not acquire any interest, direct or indirect, in the area covered
by this Agreement or any other source of income, interest in real property or investment which
would be affected in any manner or degree by the performance of Contractor's services
hereunder. Contractor further covenants and represents that in the performance of its duties
hereunder no person having any such interest shall perform any services under this Agreement.
Contractor is not a designated employee within the meaning of the Political Reform Act
because Contractor:
a. will conduct research and arrive at conclusions with respect to his/her
rendition of information, advice, recommendation or counsel independent of the control and
direction of the City or of any City official, other than normal agreement monitoring; and
b. possesses no authority with respect to any City decision beyond rendition
of information, advice, recommendation or counsel. (FPPC Reg. 18700(aX2).)
11. Abilitv of Contractor. City has relied upon the training and ability of Contractor to
perform the services hereunder as a material inducement to enter into this Agreement. Contractor
shall therefore provide properly skilled personnel to perform all services under this Agreement
All work performed by Contractor under this Agreement shall be in accordance with applicable
legal requirements and shall meet the standard of quality ordinarily to be expected of competent
contractors in Contractor's field of expertise.
12. Compliance with Laws. Contractor shall use the standard of care in its profession
to compty witn all applicabte federal, state and local laws, codes, ordinances and regulations.
13. Licenses. Contractor represents and warrants to City that it has the licenses,
permits, qualificat'ro-nsinsurance and approvals of whatsoever nature which are legally required
of Contractor to practice its profession. Contractor represents and warrants to City that Contractor
shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this
Agreement, any licenses, permits, insurance and approvals which are legally required of
C6ntractor io practice its profession. Contractor shall maintain a City of Lake Elsinore business
license.
14. lndemnitv. Contractor shall indemnify, defend, and hold harmless the City and its
officials, officers, ernployees, agents, and volunteers from and against any and all losses, liability'
claims, suits, actions, d'amagei, and causes of action arising out of any personal injury, bodily
iniury,'toss oi lif", or. damage to property, or any violation of any federal, state, or municipal law
oi ordinrn"", to the extent iaused, in whole or in part, by the willful misconduct or negligent acts
or omissions of contractor or its employees, subcontractors, or agents, by acts for which they
could be held strictly liable, or by the qu;lity or character of their work. The foregoing obligation
of Contractor shall not apply when (1) the injury, loss of life, damage to property, or violation of
law arises from the sole negligence or willful misconduct of the City or its officers, employees,
atents, or volunteers and (2lthe actions of contractor or its employees, subcontractor, or agents
hive contributed in no part to the injury, loss of life, damage to property, or violation of .law lt is
understood that the duty of Contractor io indemnify and hold harmless includes the duty to defend
as set forth in Section 2778 ol the California Civil Code. Acceptance by City of insurance
certificates and endorsements required under this Agreement does not relieve Contractor from
tiaUitity ,nOe, this indemnification and hold harmless clause. This indemnification and hold
Page 5
harmless clause shall apply to any damages or claims for damages whether or not such insurance
policies shall have been determined to apply. By execution of this Agreement, Contractor
acknowledges and agrees to the provisions of this Section and that it is a material element of
consideration.
15. lnsuranceRequirements.
a. lnsurance. Contractor, at Contractor's own cost and expense, shall
procure and maintaln, for the duration of the contract, unless modified by the City's Risk Manager,
the following insurance policies.
i. Workers' Compensation Coveraqe. Contractor shall maintain
workers' compensation lnsurance and Employer's Liability lnsurance for his/her
employees in accordance with the laws of the State of California. ln addition, Contractor
shall require each subcontractor to similarly maintain Workers' Compensation lnsurance
and Employer's Liability lnsurance in accordance with the laws of the State of California
for all of the subcontraitor's employees. Any notice of cancellation or non-renewal of all
workers' compensation policies must be received by the city at least thirty (30) days prior
to such change. The insurer shall agree to waive all rights of subrogation.against City, its
officers, ageits, employees and volunteers for losses arising from work _performed by
Conlractor-for City. in the event that Contractor is exempt from Worker's Compensation
lnsurance and Employeis Liability lnsurance for his/her employees in accordance with
the laws of the State of California, Contractor shall submit to the City a Certificate of
ExemptionfromWorkerscompensationlnsuranceinaformapprovedbytheCity
AttorneY.
ii. General Liabilitv Coveraqe. Contractor shall maintain commercial
general liability insura ce in an amount not less than one million dollars ($1,000,000) per
6ccurrence foi bodily injury, personal injury and property damage. lf a commercial.general
liability insurance form- oi oiher form with a general aggregate limit is used, either the
gene;l aggregate limit shall apply separately to the work to be performed under this
[gr""r"n-t-o, ine general aggregate limit shall be at least twice the required occurrence
li;it. Required commercial-general liability coverage shall be at least as broad as
lnsurance Services Office Coirmercial General Liability occurrence form CG 0001 (ed.
.11/88) or lnsurance Services office form number GL 0002 (ed. 1/73) covering
compiehensive General Liability and lnsurance Services Office form number GL 0404
covering Broad Form comprehensive General Liability. No endorsement may be attached
limiting the coverage.
iii.AutomobileLiabilitvCoveraqe.Contractorshall--maintain
automobile liability insurance covering bodily injury and property damage for all activities
of the contractor arising out of or in connection with the work to be performed under this
Agreement, including c-or"rag" for owned, hired and non-owned vehicles, in an amount
oinot less than one million doilars ($1,000,000) combined single limit for each occurrence.
Automobile liability coverage must be at least as broad as lnsurance Services office
Automobile Liability form CA 0OO1 (ed. 12190) Code 'l ("any auto"). No endorsement may
be attached limiting the coverage
b. Endorsements. Each general liability and automobile liability insurance
policy shall ue witn in.sur"rs possessing a Best's rating of no less than A:vll and shall be
endorsed with the following specific language:
Page 6
i. The City, its elected or appointed officers, officials, employees'
agents and volunteers are to be covered as additional insured with respect to liability
arising out of work performed by or on behalf of the Contractor, including materials, parts
or equipment furnished in connection with such work or operations.
ii. This policy shall be considered primary insurance as respects the
City, its elected or appointed officers, officials, employees, agents and volunteers'
Any insurance maintained by the city, including any self-insured retention the city may
have, shall be considered excess insurance only and shall not contribute with it.
iii. This insurance shall act for each insured and additional insured as
though a separate policy had been written for each, except with respect to the limits of
liability of the insuring company.
iv. The insurer waives all rights of subrogation against the City, its
elected or appointed officers, officials, employees or agents.
v. Any failure to comply with reporting provisions of the policies shall
not affect coverage prorided to the city, its elected or appointed officers, officials,
emPloYees, agents or volunteers.
vi. The insurance provided by this Policy shall not be suspended'
voided, canceled, or reduced in coverage or in limits except after thirty (30) days written
notice has been received by the City.
c. Deductibles and Self-lnsured Retentions. Any deductibles^or self-insured
retentions must be declared to and approved by the city. At the city's option, contractor shall
demonstrate financial capability for payment of such deductibles or self-insured retentions'
d. Certificates of lnsurance. Contractor shall provide certificates of insurance
with original endorsefrEii!-to-Tfr as evidence of the -insurance
coverage required herein'
certificates of such insurance sh'all be filed with the city on or before commencement of
ferformance of this Agreement. Current certification of insurance shall be kept on file with the
City at all times during the term of this Agreement.
.16. Notices. Any notice required to be given under this Agreement shall be in writing
and either servEllEEonally or sent prepaid, first class mail. Any such notice shall be addressed
to ttre otner party at the address seiforth below. Notice shall be deemed communicated within
48 hours from the time of mailing if mailed as provided in this section'
lf to City:City of Lake Elsinore
Attn. City Manager
130 South Main Street
Lake Elsinore, CA 92530
City of Lake Elsinore
Attn: City Clerk
130 South Main Street
Lake Elsinore, CA 92530
With a copy to:
Page 7
lf to Contractor: J & S Striping Company lnc.
Attn: Robert Aragon
1544 s. Vineyard Ave
Ontario, CA. 91761
17. Entire Aqreement. This Agreement constitutes the complete and exclusive
statement of Agreement between the City and Contractor. AII prior written and oral
cOmmuniCations, including correspondence, drafts, memoranda, and representations, are
superseded in total by this Agreement.
18. Amendments. This Agreement may be modified or amended only by a written
document executed by both contractor and city and approved as to form by the Gity Attorney.
,19. Assiqnment and subcontractinq. The parties recognize that a substantial
inducement to City ior entering into this Agreement is the reputation, experience and competence
of Contractor. iontractor shall be fully responsible to City for all acts or omissions of any
subcontractors. Assignments of any or all rights, duties or obligations of the Contractor under this
Agreement will be permitted only with the express consent of the City. Contractor shall not
sribcontract any portion of the work to be performed under this Agreement without the written
authorization oftn" City. lf City consents to such subcontract, Contractor shall be fully responsible
to City for all acts or omissions of those subcontractors. Nothing in this Agreement shall create
any contractual relationship between City and any subcontractor nor shall it create any obligation
on the part of the city to pay or to see to the payment of any monies due to any such subcontractor
other than as otherwise is required by law.
20. Waiver. Waiver of a breach or defaull under this Agreement shall not constitute a
continuing waiver of a subsequent breach of the same or any other provision under this
Agreement.
21. Severabilitv. lf any term or portion of this Agreement is held.to be invalid, illegal,
or otherwise unenforceable by a tourt of competent jurisdiction, the remaining provisions of this
Agreement shall continue in full force and effect.
22. Controllinq Law Venue. This Agreement and all matters relating to it shall be
governed Uy tne taws ot tne State ot California and any action brought relating to this Agreement
snatt Ue net'O exclusively in a state court in the County of Riverside
23. Litiqation Expenses and Attornevs' Fees. lf either party to this Agreement
commences any tegal action against the other party arising out of this Agreement, the prevailing
party shall Ue entitteO to recover its reasonable litigation expenses, including court costs, expert
witness fees, discovery expenses, and attorneys' fees.
24. Mediation. The parties agree to make a good faith attempt to resolve any disputes
arising out of tnis ng-reement through mLdiation prior to cornmencing litigation. The parties shall
mutuity agree upo-n the mediator and share the costs of mediation equally. lf the parties are
unable 1o agree upon a mediator, the dispute shall be submitted to JAMS or its successor in
interest. lnilS shall provide the parties with the names of five qualified mediators. Each party
shall have the option to strike two of the five mediators selected by JAMS and thereafter the
."airto, remaining shall hear the dispute. lf the dispute remains unresolved after mediation,
either party may commence litigation.
Page 8
25. Authoritv to Enter Aqreement. Contractor has all requisite power and authority to
conduct its business and to execute, deliver, and perform the Agreement. Each party warrants
that the individuals who have signed this Agreement have the legal power, right, and authority to
make this Agreement and to bind each respective party. The City Manager is authorized to enter
into an amendment or otherwise take action on behalf of the City to make the following
modifications to the Agreement: (a) a name change; (b) grant extensions of time; (c) non-
monetary changes in the scope of services; and/or (d) suspend or terminate the Agreement.
26. Prohibited lnterests. Contractor maintains and warrants that it has not employed
nor retained any company or person, other than a bona fide employee working solely for
Contractor, to solicit or secure this Agreement. Further, Contractor warrants that it has not paid
nor has it agreed to pay any company or person, other than a bona fide employee working solely
for ContraCtor, any fee, commission, percentage, brokerage fee, gift or other consideration
contingent upon or resulting from the award or making of this Agreement. For breach or violation
of this wananty, City shall have the right to rescind this Agreement without liability. For the term
of this Agreement, no member, officer or employee of City, during the term of his or her.service
with City, shall have any direct interest in this Agreement, or obtain any present or anticipated
material benefit arising therefrom.
27. Eoual opportunitv Emplovment. contractor represents that it is an equal
opportunity emptoyer ano it shall not discriminate against any subcontractor, employee or
applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex
or age. Such non-discrimination shall include, but not be limited to, all activities related to initial
empioyment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or
termination.
2g. prevailinq Waqes. Contractor is aware of the requirements of California Labor
Code Section 1720, et seq., ana nn, et seq., as well as California Code of Regulations, Title 8,
Section 16000, et seq., ("Prevailing wage Laws"), which require the payment of prevailing wage
rates and the performance of othei requirements on "public works" and "maintenance" projects'
Contractor agiees to fully comply with all applicable federal and state labor laws (including,
without limitaiion, if applitable, the Prevailing Wage Laws). lt is agreed by the parties that, in
connection with the work or services provided pursuant to this Agreement, Contractor shall bear
all risks of payment or non-payment of prevailing wages under california law, and contractor
hereby agrees to defend, indemnify, and hold the city, and its officials, officers, employees,
agents, aiO volunteers, free and haimless from any claim or liability arising out of any failure or
,it"g"d f"ilrt" to comply with the Prevailing Wage Laws. The foregoing indemnity shall survive
termination of this Agreement.
29. Execution. This Agreement may be executed in several counterparts, each of
which shall constitute one and the same instrument and shall become binding upon the parties
when at least one copy hereof shall have been signed by both parties hereto ln approving this
Agreement, it shall noibe necessary to produce or account for more than one such counterpart.
[Signatures on next page]
Page I
lN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the
date first written above.
Aoti1l
.CITY'
CITY OF LAKE ELSINORE, a municiPal
corporation
Attachments: Exhibit A - Contractor's Proposal
"CONTRACTOR'
J & S Striping Company lnc., a Corporation
Contractor
Page '10
ates, City Manager
EXHIBIT A
CONTRACTOR'S PROPOSAL
[ATTACHED]
EXHIBIT A
CITY OF LAKE ELSINORE
PROPOSAL - SCHFqU,LE
PROJECT NO.210004
ANNUAL TRAFFIC STRIPING MAINTENANCE PROGRAM
FY 1s/16
PRoPoSER: J&S ST,RIPING COMPANY, INC
(Contractor Name)
PROPOSAL ITEMS AS FOLLOWS:
ITEM
NO.CODE DESCRIPTION OF ITEMS ESTIMATED
QUANTITY
UNIT
PRICE
(FrcuRES)
TOTAL
COST
(FTGURES)
1 5 4" Center Line Yellow Caltrans Std Detail '1,
4" Center Line White Caltrans Std Detail 8
97,000 L.F.O.os {,:6oE
2 S
4" Solid Line White Caltrans Std Detail 27B,
4" Solid Line Yellow Caltrans Std Detail24 ,es6
l$e.3on
L.F.O. ob L,tBoq
3 S No Passing Zone - Two direction (No RPM)
Caltrans Std Detail 21 130,000 L.F.o.l{l8,zooe
4 S No Passing Zone - Two direction with RPM
Caltrans Std Detail 22 10,000 L.F.o.21 o(,
2,noo *
5 S Bike Lane Line 6" Solid Line Caltrans Std
Detail 39 28,000 L.F.o.l,t 3,oBo*
6 S 8" Solid Line Caltrans STD Detail3BA 20,000 L.F.o. t3 2,tco B
7 S S" Solid Line with RPM Caltrans STD 38 4,000 L.F.o.23 12.o"3
8
Thermoplaslic 12" Solid Line, White or
Yellow Crosswalk and Limit Line Caltrans
STD DetailA24E
32,000 L.F.Lx c()72,sQ^
9 4" Solid line w/ skip Yellow per Caltrans
STD Detail '15 15,000 L,F.o. tz l,too "A
'10 4" Solid line w/ skip Yellow and RPM
Caltrans STD Detail 16 5,000 L.F.o. 23 rob
l, l5o -
11
Thermoplastic Pavement Marking Words
Caltrans STD A24D, A24E 15,000 SF Lzs \?,-t 5o*
12
Thermoplastic Pavement Marking
Symbols and Numerals Caltrans STD
A24C
ffi0&
5,ooo
S.F .. 85
L
B1l\,25o -
13
Thermoplastic Pavement Marking Arrows
Caltrans STD A24A, A24B
25,000 S.F ^8sL-go/l,2so-
TOTAL FOR ITEMS
(Based on estimated quantities of items I through 13
$
2.tt,13o9
l5-A
NOTE:
a.
CITY OF LAKE ELSINORE
PBOPOSAL - SCHEDULE
PROJECT NO.210004
ANNUAL TRAFFIC STRIPING MAINTENANCE PROGRAM
FY t5/r6
pRopOSER. J&S STRIPING COMPANY, INC
(Contractor Name)
The lowest responsible Proposer will be determined by comparing the cumulative total of all
items (PCC 20103.8 b).
The City has the discretion to select any or all ltems for the Award of the Contract.
The City reseryes the right to add or subtract items by Contract Change Order at the prices
proposed.
b.
c.
Estimated quantities are for ihe purpose of comparison only, and payments will be made on a basis
of actual measurement of work completed.
The line item cost include, but not be limited to, sales tax and all other applicable taxes and fees.
Codes:(D) Deduct(F) Final Pay Quantities(S) Specialty ltem
Units of Measurement:LF linealfootSF square foot
Totalamount in WORDS for ltems only (Based in Estimated Quantities of ltems 1 through 13:
I 5-B
Crrv.r, A
rc..@,F1nrone
ry [)xrrN [XrRrMr.
ADDENDUM NO.2
REQUEST FOR PROPOSATS
ANNUAL TRAFFIC STRIPING MAINTENANCE PROGRAM
JULY 9, 2015
Ql: ls there a Bid Bond Required?
A1: NO
Q2: lf this is a maintenance/re-stripe contract, will one {1} or two (2} coats of paint be
Required?
A2: a) REPAINTING OF EXSISTING LTNES OR MARKINGS WlLt ONIY REQUIRE ONE (1)
COAT OF PAINT
bI PAINTING OF NEW LINES AND/OR MARKINGS WITT REQUIRE TWO (2)COATS
OF PAINT
I have found that the contract mentions layout, removals and curb markings but I
Do not see line items for them. Should there be line items?
YES THERE SHOUTD BE ADOITIONAL LINES ITEMS
Q3:
A3:
l4 LAYOUT OF MARKINGS PER
HOUR Tt og 2aog
15 cuRB PATNTTNG/MARKING (1
COAT)
L.F.t25t-,L5\-
15 REMOVAI OF PAINTED
STRIPING
L.F.
o.27 o"tt
t7 REMOVAT OF THERMOPTASTIC
STRIPING
L.F.
o.T7 o. z?
18 REMOVAT OF PAINTED
MARKINGS
s.F.
o.tz o.aL
19 REMOVAL OF THERMOPLASTIC
MARKINGS
s.F.
O.BL o.,L
Q4: ts there and exception to the required rapid set epoxy adhesive for the pavement
Markers, such as hot melt bituminous adhesive?
A4: YES, PROVIDED THE MATERIAL USED 15 THE SAME AS or EQUIVALENT TO THE
STATED RAPID SET EPOXY ADHESIVE
Line item 2 seems low, is it accurate?
NO, THE ESTIMATED QUANTITY SHOULD BE CLOSER TO 1O3,OOO L.F.
Line item 12 seems like a high number of symbols and number markings, is it an
Accurate number?
NO, THE ESTIMATED QUANTITY SHOUTD BE CLOSER TO 5,OOO S.F.
Q6:
46:
Q7:
A7:
--.ORif CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
8t25t2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTTFICATE HOLDER. TH]S
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE TSSUTNG TNSURER(S), AUTHORTZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorced. lf SUBROGATION lS 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 Patriot Risk & lnsurance Services
100 Spectrum Center Drive, Suite #400
lrvine,'CA 92618
vrww.patrisk.com 0G55454
CONTAC I
NAME:
[i3.Nf.. e,t), (949) a86-7900 I ifi6. Nor' L9-49
E.MAIL
ADORESS:
4q0i s!
INSURER(S) AFFOROING COVERAGE NAIC #
rNsuRER A : Ohio Security lnsurance Company 24082
INSURED
J&SStrioino. lnc.
1544 S. VineVard Avenue
Ontario CA 91761
r Nsu RER B : Ame rica n Fj E &_C aqUgl!!!SqA!_ael9!!pa Dl
rNsuRER c : State Compensation lnsuralce Fullll 35076
INSURER D :
INSIJRER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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 SHO\^N MAY HAVE BEEN REDUCED BY PAID CLAIMS.
iNsR TYPE OF INSURANCE
ADDL
tNsn
SUBRWN POLICY NUMBER
POLICY EFF
(MM/OD/YYYY}
POLICY EXP
(MM/DD/YYYY)LIMITS
A t_COMMERCIAL GENERAL LIABILITY
' l ---l
i clarus.unoe L/ occuR
$5 000 Deductible
8KO1656433437 3t29t2015 3t29t20't6 EACH OCCURRENCE s 1,000,00(
DAMAGE IORENITU
PRFMISFS 1Fa occrrrence)E 500,00(
MED EXP (Any one person)$ 10,00c
PERSONAL & ADV INJURY $ 1,000,00c
GEI
-i_l
I'L AGGREGATE LIMIT APPLIES PER
,o.-,.' k-l!E& [l .-o.
GENERAL AGGREGATE $ 2,000,00c
PRODUCTS. COMP/OP AGG $ 2,000,00c
e
B AUI
1j
.OMOBILE LIABILITY
ANY AUTO
ALL O\AJNED
AUTOS
HIRED AUTOS
f--l scxeorl-eoI I ArrrosT_l NoN-o\ NEDI I Aurost'l
BAA1656433437 3t29t2015 3129t2016 )MBINED SINGLE LIMIT $__ 1,000,9!!
BODILY INJURY (Per person)$
BODILY INJURY (Per accident)
FROFEFTY DAMAGE-'
/Par a.ci.lenll
$
$
Uninsured motorist coml $ 1,000,00c
B UMBRELLA LIAB
EXCESS LIAB
/ I occun
I "*,r.-roo,
usAl 656433437 3t29t2015 3t29t2016 EACH OCCURRENCE $ 4,000,000
AGGREGATE $ 4,000,000
n-"n-f7T*or.r s 10,000 $
c WORKERS COMPENSATION
AND EMPLOYERS', LIABILITY Y / N
ANY PPOPRIFTOR/PARTNER/EXECTJTIVE T-]N/A
9050628201 5 3t29t2015 3t29t2016 -IPER I IOIH-,/ISTATIJTEI IER
E,L, EACH ACCIDENT s 1,000,00C
oirrbE'nrrrreMeen EXcLUDED" L__l(Mandatory in NH)
lf ves describe underniqeprprrrlru oF oPFRATtoNS betow
E.L, OISEASE . EA EMPLOYEE s 1,000,00C
E,L, DISEASE . POLICY LINNIT s 1,000,00C
DESCRtPTIONOFOpERAT|ONS/LOCATTONS/VEHICLES (ACORDlOl,AddilionalRemarksschedule,maybeattachedifmoresPaceisrequired)
Re. Job #Z1OOO4 / JSJN #3774-5, Annual Traffic Striping Maintenance Program FY2015-2016, Lake Elsinore, CA
Citvbi uift Eliinore, its etected oi appointed officers, oiiicials, employees,-agents and volunteers are named as Additional lnsured, includes
F;iil,;* ;;a r.ton-coritrioutory respecti to General Liability and Autb Liability fer endorsement attached where required by written contract.
Waivei of subrogation applies to GL, Auto and Workers' Compensation per attached endorsements.
30 days notice oJ canceilation, 10 days for non-payment of premium.
CERTIFICATE HOLDER CANCELLATION
Citv of Lake Elsinore
136 S. Main Street
Lake Elsinore CA 92530
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE wlLL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
;f
Leonard E
@ 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORDACORD 25 (20141011
6111261 I 15/16 GL/AU/IJI4B/WC I AEette Romero I S/25/20r5 2t2O:22 PM QDT) Page I' of 10
8KO1656433437
J'& S Striping, lnc.
THIS ET.IDORSEMEI{? CHANGES THE PQLICY. PLEASE REAB IT CAREFULLY.
COM II'IERC NL LhBIL}TY GO LT} EN BORSEM E T.IT . CONTRACTO RS
This endorsament modifiss insurance provided under tha fcllowing:
COMiilERCIAL GENERAL LIABILITY COVERAGE PART
sEcTlON r * COVIRAGES
COVERAGS A. BOSILY II'IJI}RY ANT} PROFERTY DAMAGE LIABIUTY
2. Excluelons
Item 2.9. 2) is replacad with the following:
!"9. 21 a watercraft you do not own that is:
al lesr than 50 feet long; and
b) Not boing ussd to carry parsans or propxty for a charga.
Item 2.9. 6) is add*d:
6I An aircraft in which you have no ownership interest and that you have cha*ered with craw.
Th* last paragraph cf ?. Exclusions is replacsd with the following:
Exclusions c" through n. do not apply to damage by fire, axplosicn. sprinkler leakage, or llghlnlng to pramists
while rented to you, temporarity oecupied by you with tha parmissiun of th€ own6r, or man€gsd by you under
a written agrs6m6nt with the ourner- A saparate limit of lnsutante applies to this coYsrags as described in
Ssctlon lll - Llmlte of lnsurancs.
SECTIOTT I - COVERAGES
COVERAGE C. i,lEOlCAL PAYtiENTS
lf Medieal Paymants Coverage is provided under thi$ policy. the following is changed:
3. Llmlts
The madical experlse limit provided by this policy shatl be th* grsatar of:
a. $10,000; or
b. The amount shown ln the declarations.
Covarage C, Medicat Payments is prirnary and not contributing with any othEr lnsuranc&, €ven lf thst othBr
insurance is also primary.
The following is added:
COVER.AGE S. PRO$U CT RECALL }.IOTIFICATIEN EXFEil$ES
lnsurlng Agroement
We will pay 'product recatl notification expenses" incuned by you for the withdrawal of your products.
provided that:
a. Such withdrawal is requirEd because cf a detarmination by you during the policY pefiod, that ths use or
consumption of your praducts could result in "bodily injury" or "property damaga"; and
b. The "produet recall notificEtion oxpenBes' are incurred and reported to us during the policy period.
The most we will pay for "product recall notilication expanses" during lhe policy Boriod is $100,000.
SUPPLEMENTARY PAYKIENTS -COVERAGES AAND g
Item b. and d. ars replacsd with:
b. Ths cost of bail bonds required becauae of sccider{s or traffic laur vialatlons arising o$t of tha usa of any
vehicla to which tho Bodily tniury Liability Coveragx applias. lIt/E do noi havs to furnish thase bonds.
d. All rsasonabla expenses insurred by the insured &t our rsquesl lc asslst us in the investigation or dsfense
of the cleim or "suit' inctuding actu*l loss of earnings up to $$00 a day because cf time off from $/ork.
lneludes copyrightid mat8riat of ln*urnncc Sr/vlcos Offisee lnc,. wllh llt F.fma$$lon.
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Page I of tt
SECTION ll - Url{O lS At'l INSUREO
Item 4. ls raplaced with:
4. Any subsidiar,ies, companies, corporalions, flrms, or organizations you acquira or form during the policy
period ovar which you maintein a controlling intaresl ol groater than 50% of the stock or assets, wlll quallfy as
a Named lnsured if:
a) you have ths responslbllity of placing insuranca for such entity; and
b) covsrags for lhe entity is not othenriss mora spaclfically provided; and
c) the enti$ is lncorporalad or organlzed under the laws of the United $tates of Amerlca.
Howevar; coverage under this provision doas not apply to 'bodily injury" or "property damage" that
occuned bafore you acquired or formed the entlty, or "personal iniury. or'advertising injury" srising out of
an offonse sommltted befora you acquirad or formed the entity.
Covarage under thls provision is afforded otly until the snd of the policy perlod, or tha twelv* ('12) month
anniversary of the policy inceptlon date whichaver is earlier.
$ECTION m* LlillrTs 0F |N$I.'RAHCE
Paragraph 2. is amended to lnclude:
The General ,qggrasats Limit of Nnsuranca applies *oparately to sa*h "location" crvned by you, rented to you, or
occupled by you with the perrnission of lhe owner.
Paragraph 6. is raflaced wlth the following:
6. Subjecl to 5. above, tha Fire Oamage Limit is tha rnost we wlll pay under Coverage A for damag6$ hecause of
"proparty damago" to premisas while rented to you, temporarily occupiad by you with permis$ion of the owneF,
or rnanaged by you under a rryritten agrs€msnt with the ourn€ri arising out of any on6 flre, explo*lon or
sprinkler leahnge insident.
The Firs Damaga Limit provided by tlris policy shall be the greater of;
a. $500,000 or
b- The amouni shown ln the Beclaratlons.
SECTIOH IV - SOM'h.iERCIAI- GEI{HRAL LIABILITY COiIDITIOH$
Item 2. a. is replaced wlth:
2. Dutlss ln The Eyenlof Occur&nce, Offonss, Clalm orSuit
a. You must promptly notify us. Your duty to promptly notify us is effectlve r*hen any of your executive
officsrs, partner$, momber$, or legal repreaantratives ie gware of the 'occurrsncs", offens€, claim, or "suit'.
Knowladg* of an "occurrens8", offanss, claim or "suit' by oth*r employae(s] does not lmply you also hava
such knowledge. To tho axtent possible, nstice lo us should include:
1) How. whsn and whers the "occunance" or ofiense took placa;
2) ThB namas and addresses of any injured persons and witnessas; and
3) The nature and location of any injury cr damage arising out of ths "eccunence", offen&e, clalm or*suit".
Item 4. b. f ) b) is roplacad with:
b. Excessln*urance
1) b) Thal is Flre, Exptosion or Sprinkler Laakage insurance for premises whlte rented to you,
temporarily occupied by you with p*rmlsslon of the ownorr or managed by you under a wrlttan
agreament with the 0un6r; or
It6m B. is amendsd to includs:
6. Reprcsenhtionr
d. lf you uninlentionally fail to disctose any haaards existing at the inceptlon date of your policy, we wlll not
dany coverage under this Goverags Fart becausa of such fallure. However, this provision dces not affact
our right to collect additional premium or exsrcise our right af cancellation sr non-reneural..
lncludaa copyrQhlod msGrlal ol lnsuranca $oilhrs Ofttcss lnc,, x,ith rta permlreion.
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Itern L is replaced with:
8. Transler of Rlghts Of Recovery Agalnst Others Ts Us
a. !f the insured has rights to racover all or part of eny paymoni we hava made under this Coverago Part.
those righte are transfened to us. The insured must do nothing after loss to lmpair thsm" At our requast,
{he in.sured will bring suit or transfer thosa rights ts us and help us enforcc them.
b. lf requlred by a written "insured contract", we walvs any rlght of recovery ws may have agalnst any
psrson or organization because rf payments we maka for iniury or damage ari$ln$ out of your ongoing
operations or "your work" don6 under that written "insured cantract" for lhat psrson or arganizatlon and
included in lhe "products-complated operations hazErd".
Item 10. and ltem 11. ara added:
I 0. Cancellation Condltion
lf we cancel this policy for any raason other than nonpayment ol pramium we will mail or deliver written notisa
of cancellation to the ftrst Named lnsured at least 60 days prior to the effective date of cancellation.
11. Liberalizatlcn
lf we adopt a ehange in our forms or rules which would braeden your csverage without an €xlra charga, the
broader coveftrge will apply to this pollcy. This extension is efisctive upon the approval of such broader
covsrage ln your state.
SECTION v - DEFllillTlOtlS
The followlng definitions ers added or changed:
9. "lnsured ccntraet"
a. ls changed to:
a. A contract for a lease of premises. Howevar, that po$on of the contract for a leasa of premises that
indernnifies sny parson or organization for damage by fire, explosion or sprlnkler leakage to premises
r,vhile rented to you. or temporarily occupied by you with parmission of the owner, or managed by you
under a written agreemant with the owner is not an "lnsured contract".
23. and 24. are adcled:
23. "Location" means premises lnvolving the sarne ar connecling lots, or premis€$ whose conngclion is
interrupted only by a street. roadway, ''rratarway or right-of-way of a railroad.
24. "Froduet r*call notificetion axpenses* means ths reasonalla additional expanses (includlng. but not
limitad to. coet of conespondanca, newspapar and magazina advertising. radio or tslovlrlon
announcemsnts and tran*portatlon cost), neceaserily incungd in arranging for the refurn of producls, but
excluding costs of the replaeement products and tha cash valua of ihe damaged products.
The follswlng Provielons are sleo added to thls Coverage Parl:
A. ABOITIOftAL INSUREDS. BY COHTRACT, AGREEIIENT OR FERMIT
1. Paragraph 2. under SECTION ll - WHO lS AU INSI RED b amanded to indude as an insured any
person or organization when you and such person or organhation hava agreed In writing in a contracl,
agr6em6nt or permit that Euch person or organization be added as an addltional insured En your poliry to
provide insurance sLteh as is afforded under this Cuv*ragr Part. Such por$on cr organlzatlon iE not
entitt*d to any notices that we are required to send to the Named lnsured and is an addltlonal insured
only with respeet to ltabill$ arising out of:
a. Your ongolng operatlons performed for that psrson ar organization; or
b. Premises or facilities owned or used by you.
With respact to provision 1.a. *bove, a person's or organlzatlon's status as an ingured under lhin
endorsemsnt ends when your operations for that pirscn or organization ara completad.
With respect tc provision 1.b. above, a person'B or organizalisn's status as an lnsured undsr thls
endorsemenl ends whan their contract or agr€smsnl with you for such premisas or facilitiss ends.
lneludes copyrlghted material ol lnsurance $sn icBs Olflcag lnc.. $ilh its parmisrion.
GECG 970 ($1n{}
6111261 I 15/16 GL/AU/IJMBIWC I Annelte Romero I e/25/2o15 2:2o;22 PM (PDT) | Page 4 of 10
Page 3 of{
2, This endorsement provision A. does not apply:
a. Unlase ths written contracl or agreernant has baen €xecutad, or psrmit has bsen issued, prlor to the
"brdily injury', "Broporty damage" or'personal and advertising injury";
b. To 'bodily injury" or'property damags'occunlng aft*r:
{t} All worlt, lnsluding matoriah, parf$ or equipment fumishad in connection with such wark, in the
proiect {othar than service, maintsnence or repalrs) to be performed by or on behalf of the
additisnal insured(s) al the site of the covered operations hes been completod; or
{2} That portion of "your work' out of which the inlury or damage arises has been put to lts intended
use by any percon or organization othsr than another contraclor or subcontractor engagad ln
performing operations for a prlncipal as a part of the same proJ*ct;
c. To ths rendaring of or failure to render any profussional seruices including, bul not limited to, any
profaerional architsctural, englnesring or surveying s*rvlces such a$:
{l} Tha preparing, approvlng, or failing to praparo or approve. maps. shop drawings, opinlons,
reporls" surv*ys, fisld ordErs, change ordars or drawings and epeci8cationg; and
{?} $upsrvisory, inspection, architsctural or enginearlng aclivilies:
d. To "bodily injury", "property damago" cr "per*onal and advs*ising injury' arising aut of any act, snor
or omission thal r*sults from tha additional lnsursd's sole negligence or wr$ngdoing;
s. To any per$on or organization spacifically dasignatad an addltlonel Insured for ongolng aperatlons by
a separate A9DITIONAL INSURED * OWNER$, LES$EES OR CONTRACTORS *ndoraernant
issued by us and made a part of this policy
B. PFI{iiIARY NON.SONTSIAUTORY ADOITIOI{AL IilSURED SXTEHSIOfi
Condltion 4" Other lnsurance of SECTION lV - COIIiMERCIAL GENERAL LIABILITY COilOlTlOt{S }s
amanded as follows:
a. The following is added to paragraph a. Prlmary lnsuranca;
lf an addilional insured"e pnlioy has an Otlrer lnsurance provision making its policy oxcass, and you have
agread in a wdtten "coastruction conlract* to provida the addltlonal insured coverage on a primary and
noncanlribulory ba$is, lhis policy shall be prlmary and rtle will not saak eontfbution from ths addlttonal
insurod's polioy for dannages wB covcr,
For ths purposes of ihis endorsement, "construction contragt" means a wdtten contract or written
agrsernant other thsn a pramises leass, facilities rontal conlraci or agreemeilt, an aquipmant rental or
leese agresmsnt, or a pernit issued by a state, county, municipality or other governmental authority.
b. The followlng ls added to paragraph b. Excess lnsuranca:
(3) Except as specified in paragraph a., abova, any other insurance in which a party who is an additional
insured heraunder is designatod as a ldamed lnsur*d.
Regardless of the lerms of any writlen agreement betweon you and an additional insurEd. this insurance
is sxcsss over any cther insurance whether primary, excess, contlngant or on any othar basis for which
the addlllonalinsurs$ has besn added as an addltlonalinsured.
lncludsfi copyrl$htsd rnalqrisl o{ lnsuranc,E $t;vlco* Ofllcoe l**.. wilh lls perrrl$$lon.
GECG S?0 (011111
6111261 I 15116 GI./AU/UMB/WC i Annette Romero I A/25/2Oa5 2t2Ot22 PVi IPD'[) Page 5 of 10
Page { of4
8AA1656433437
COMMERCIAL AUTO GOLD ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SECTION II. LIABILITY COVERAGE
A. COVERAGE
1. WHO IS AN INSURED
The following is added:
d. Any organization, other than a partnership or joint venture, over which you maintain ownership or
a malority interest on the effective date of this Coverage Form, if there is no similar insurance
available to that organization.
e. Any organization you newly acquire or form other than a partnership or joint venture, and over
which you maintain ownership of a majority interest. However, coverage under this provision
does not apply:
(1) lf there is similar insurance or a self-insured retention plan available to that organization; or
(2) To "bodily injury'' or "property damage" that occuned before you acquired or formed the
organization.
f. Any volunteer or employee of yours wtrile using a covered "auto" you do not own, hire or borrowin your business or your personal atfairs. lnsurance provided by this endorsement is excess over
any other insurance available to any volunteer or employee.
g. Any person, organization, trustee, estate or governmental entity with respect to the operation,
maintenance or use of a covered "auto" by an insured, if:
(1) You are obligated to add that person, organization, trustee, estate or governmental entity as
an additional insured to this policy by:
(a) an expressed provision of an "insured confact", or written agreement; or
(b) an expressed condition of a written permit issued to you by a governmental or
public authority.
(2) The "bodity injury" or "property damage" is caused by an "accident" which takes place after:
(a) You executed the "insured contract" or written agreement; or
(b) the permit has been issued to you.
GECA 701 (01/07) Includcs copyrighrcd nratrrial offnsurancu Ssrvicos Oflicus, Inc. rrith itr pcrnrission Pagc | 1f 4
6111:61 15/16 GLlAU//uMB/riC ] Annette Romero I A/25/20L5 2t2O:22 pt4 (pDT) I page 6 of 10
2. COVERAGE EXTENSIONS
a. SupplementaryPayments.
Subparagraphs (2) and (4) are amended as follows:
(2) Up to $2500 for 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 "lnsured" at our request, including actual loss of earning
up to $500 a day because of time off from work.
SECTION III. PHYSICAL DAMAGE COVERAGE
A. COVERAGE
The following is added:
5. Hired Auto Physical Damage
a. Any "auto" you lease, hire, rent or borrow from someone other than your employees or partners
or members of their household is a covered "auto" for each of your physical damage coverages.
b. The most we will pay for "loss" in any one "accident" is the smallest of:
(1) $s0,000
(2) The actual cash value of the damaged or stolen property as of tlre time of the "ioss"; or
(3) The cost of repairing or replacing the damaged or stolen property with other property of tike
kind and quality.
lf you are liable for the "accident", we will also pay up to $500 per *accident" for the actual loss of
use to the owner of the covered "auto".
c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by
an amount that is equal to the amount of the largest deductible shown for any owned nauto" for
that coverage. However, any Gomprehensive Coverage deductible shown in the Declarations
does not apply to "loss" caused by fire or lightning.
d. For this coverage, the insurance provided is primary for any covered "auto" you hire without a
driver and excess over any other collectible insurance for any mvered "auto" that you hire with a
driver.
6. Rental Reimbursement Coverage
We will pay up to $75 per day for up to 30 days, for rental reimbursement expenses incurred by you
for the rental of an "auto" because of 1oss" to a covered natrto". Rental Reimbursement will bebased on the renta! of a comparable vehide, which irr nrany cases may be substantially less than $75per day, and will only be allowed for a period of time it should take to repair or replace the vehidewith reasonable speed and similar quality, up to a maximum of 30 days. We will also pay up to 9500for reasonable and necessary expenses incurred by you to remove and replace your materials and
equipment from the covered "auto".
GF,CA 701 (01ruD Includcs copyrightcd matoriel of Insurancc Scn'iccs Officcs, Inu with its pcrrnission Pagc ? of {
6111261 i 75/15 cL/AU/tx4B/wc Annerre Romero I B/2s/2ots 2t20.22 pM {pDT) | page 7 of 10
lf "lcss" results from tlre total theft of a covered "auto" of the private passenger type, we will pay
under this coverage only that amounl of your rental reimbursemenl expenses which is not
already provided under paragraph 4. Coverage Extension.
7. Lease Gap Coverage
lf a long-term leased "auto" is a covered "auto' and the lessor is named as an Additional lnsured -
Lessor, ln the event of a total loss, we will pay your additional legal obligation to the lessor for any
difference between the actual cash value of the "auto" at the time of the loss and the 'outstanding
balance" of the lease.
"Outstanding balance" means the amount you owe on the lease at the time of loss less any amounts
representing taxes, overdue payments; penahies, interest or charges resulting from overdue
payments; additional mileage charges; excess wear and tear charges; and lease terminalion fees.
B. EXCLUSIONS
The following is added to Paragraph 3
The exclusion for "loss" caused by or resulting from mechanical or electrica! breakdown does not
apply to the accidental discharge of an airbag.
Paragraph 4 is replaced with the following:
4. We will not pay for "loss" to any of the following:
a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with
audio, visual or data electronic equipment.
b. Equipment designed or used for the detection or location of radar.
c. Any electronic equipment that receives or transmits audio, visual or data signals.
Exclusion 4.c does not apply to:
(1) Electronic equipment that receives or transrnits audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by
use of the power from the "auto's" electrical system, in or upon the covered "auto"; or
(2) Any other electronic equipment that is:
(a) Necessary for the normal operation of the covered "auto" or the monitoring of the
covered "auto's"operating system; or
(b) An integral part of the same unit housing any sound reproducing equipment described in (1)
above and permanently itrstalled in the opening of the dash or console of the covered "auto"
normally used by the manufacturer for installation of a radio.
D. DEDUCTIBLE
The following is added: No deductible applies to glass damage il the glass is repaired rather than
replaced.
GEC^ 70r (0r/0?)Includus cupyrightcd rnatcriel of Insurencc Scn'iccs Officrs, fnc. with its pcr:nission
51r.r.251 I 15/16 cLlAU,/tMB/wC I Annette Romero I 8/25/20t5 2t2O:22 iln (pDT) I page 8 of 10
Pagc 3 uf 4
SECTION IV. BUSINESS AUTO CONDITIONS
A. LOSS CONDITIONS
Item 2.a. and b. are replaced with:
2. Duties ln The Event of Accident, Claim, Suit, or Loss
a. You must prompdy notify us. Your duty to promptly notify us is effective when any of your
executive officers, partners, members, or legal representatives is aware of the accident, daim,
'suit", or loss. Knowledge of an accident, claim, nsrJit", or loss, by other employee(s) does not
imply you also have such knowledge.
b. To the extent possible, nolice to us should include:
(1) How, when and where the accident or loss 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 accident or loss.
The following is added to 5.
We waive any right of recovery we may have against any additional insured under Coverage A- 1.
Who ls An lnsured 9., but only as respects loss arising out of the operation, maintenance or use of
a covered "auton pursiJant to the provisions of the 'insured cohtract", uiritten agreement, or permit.
B. GENERAL CONDITIONS
f. is added
9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Your unintentional failure to disdose any hazards existing at the effective date of your policy will not
prejudice the coverage afforded. However, we have the right to collect additional premium for any
such hazard.
COMMON POLICY CONDITIONS
2.b. is replaced by the following:
b. 50 days before the effective date of cancellation if we cancel for any other reason.
GF.CA 701 (01ru7) Inr:ludus copyrightcd maturirl of Insurencc Scn'iccs Officrs, fnc wath its psrmission Pagr 4 of 4
6111251 i 15116 GLlAU/wB/wC I Annet.te Romero i a/2s/2ot5 2:2ot22 pM (pDT) | page 9 of 10
ENDORSEMENT AGREEMENT
WAIVER OF ST'BROGAT IONffi
HOME OFFICE;arv'inarrrciSco EFTECTM I{ARCH 29, 2015 AT 12 . 01 A.M.
AND EXPTRTNG MARCH 29, 2Ot6 AT 12.01 A.M.
\LL EFFECTIVE DATES ARE
tT '12:01 AM PACIFIC
iTANDABD TIME OB THE
lME INDICATED AT
,ACIFIC STANDARD TIME
J & S STRIPING, INC
1544 S VINEYARD AVE
oNTARTO, CA 91761
PEP C2
9050628-15
PENEWAI,
SP
5-84-90-53PAGE 1 OE
WE HAVE THE R] GTIT TO RECOVER OUR PAYI'IENTS FROM ANYONE
LIABLE FOR AN INJURY COVERED EY THIS POLICY. WE ViILL
NOT ENFORCE OUR RIGTIT AGAINST TTIE PERSON OR
OR,GANIZATION NAI,{ED IN THE SCHEDULE.
THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU
PERFOE]"I WORK UNDER A WRITTEN CONTRACT TTIAT REQUIRES YOU
TO OETAIN THIS AGREE}.,IENT FROM US.
THE ADDITIONAL PREMIW FOR THIS ENDORSE},IENT STIALL BE
2.OOZ OF THE TOTAL POLICY PREMIUM.
SCHEDULE
PERSON OR ORGANIZATION JOE DESCRIPTION
ANY PERSON OR ORGANIZATION ELANKET 'dIAIVER OF
FOR VII{OM THE NAMED INSURED SUBROGATION
rIAS AGREED BY WRITIEN
CONIRACT TO FURNI SH THIS
VIAIVER
NOTHING IN THIS ENOORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTENO ANY OF THE TERMS. CONDITIONS, AGBEEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTIIING ELSEWHERE IN THIS POLICY SHALL BE
I{ELD TO VABY, ALTER, WAIVE OR LIMIT THT TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:,, ,RCH
STATE
COMPE NSAIION
FUND
PUBLIC WORKS ROUTING
Once the attached documents have been reviewed, please sign and return to Public
Works, at exl. 241
Reviewing Department Signature Date
08t26t15
Public Works Review
City Attorney
Gity Manager
City CIerk
NAME OF VENDOR:
SUPPORT DOCUMENTS:
lnsurance(s)
Proposal:
Bonds:
COMMENTS:
J & S Striping Gompany, !nc.
Yes
Yes
8.aa'
%/
RECEIVED
AUG 2 6 2015
GITY CLERK'S OFFICE
43'{
N/A