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HomeMy WebLinkAboutRP Landscape - Amendment No. 3 DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA AMENDMENT NO. 3 TO AGREEMENT FOR CONTRACTOR SERVICES RP Landscape & Irrigation, Inc. Annual Citywide Landscape Maintenance Services This Amendment No. 3 to Agreement for Contractor Services is made and entered into as of 8/8/2023, by and between the City of Lake Elsinore, a municipal corporation ("City), and RP Landscape & Irrigation, Inc., a Corporation ("Contractor"). RECITALS A. The City and Contractor have entered into that certain Agreement for Contractor Services dated as of 10/27/2020, (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 of Seven Hundred Forty-Three Thousand Forty-Two dollars ($743,042.00). C. The Original Agreement had a term commencing on November 1, 2020, and ending June 30, 2023. The City may, at its discretion, extend the term of this Agreement on a 12- month basis not to exceed 2 additional twelve (12) month renewal terms. D. Amendment No. 1 to the Original Agreement was executed on 6/28/2022 to increase the amount of compensation by Two Hundred Six Thousand Dollars and Zero Cents ($206,000.00). E. Amendment No. 2 to the Original Agreement was executed on 7/11/2023 to increase the amount of compensation by Ninety-Eight Thousand Five Hundred and Zero Cents ($98,500.00). F. The parties now desire to increase the payment for such services as set forth in this Amendment No 3. NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, City and Contractor agree as follows: 1. Section 3, Compensation, of the Original Agreement is hereby amended to read in its entirety as follows: 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 annual compensation exceed One Million One Hundred Nine Thousand Four Hundred Sixty-Two Dollars and Fourteen Cents. ($1,109,462.14) without additional written authorization from the City Council. 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. DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA 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. 3 to be executed on the respective dates set forth below. "CITY" "CONTRACTOR" CITY OF LAKE ELSINORE, a municipal RP Landscape & Irrigation, Inc., a Corporation corporation DocuSigned by: �asel�t, SIKAfSel& DocuSigned by: City Manager Fr _ Roy Perez, Owner Date: 8/11/2023 8:20 AM PDT Date:8/11/2023 7:56 AM PDT ATTEST: L igned by: City Clerk APPROVED AS TO FORM: F Docu®Signed by: Ocu- {-.riLbO GGG --- City Attorney DocuSigned by: Sew Assistant City Manager Attachments: Exhibit A-1 — Contractor 's Proposal DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA EXHIBIT A-1 CONTRACTOR 'S PROPOSAL [ATTACHED] DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA RP Landscape& Irrigation DECEIVED PO Box 1200 San Bernardino, CA 92402 JUL 0 5 2023 DATE INVOICE NO. ����0D ACCOUNTS PAYABLE 6/29/2023 10252 JUL 6 0 2023 BILL TO JOB NAME W. City of Lake Elsinore Finance Department 130 S Main Street Lake Elsinore,CA 92530 P.O. NO. TERMS DUE DATE Due on receipt 6/29/2023 DESCRIPTION QTY RATE AMOUNT Landscape maintenance service for the month of June 2023. Alberhill Park 5,368.60 5,368.60 Canyon Hill Park 4,831.74 4,831.74 Christiansen Park 1,543.47 1,543.47 City Park 1,073.72 1,073.72 Creekside Park 1,879.01 1,879.01 Lakepoint Park 3,355.37 3,355.37 Lincoln Park 590.54 590.54 Machado Park 1,342.15 1,342.15 McVicker Park 6,979.18 6,979.18 Oak Tree Park 536.86 536.86 Rosetta Canyon Park 5,637.03 5,637.03 Serenity Park 1,610.58 1,610.58 Summerhill Park 939.50 939.50 Summerlake Park 4,294.88 4,294.88 Summerly Park 7,784.47 7,784.47 Swick&Matich Park 1,879.01 1,879.01 Tuscany Hills Park&School Parking Lot 1,879.01 1,879.01 Yarborough Park 805.29 805.29 888 Park 134.21 134.21 Equestrian Trail 429.48 429.48 Downtown Riverwalk 2,415.87 2,415.87 Public Works City Yard 53.68 53.68 Senior Center 53.68 53.68 Seaport Boat Launch 1,073.72 1,073.72 Elm Grove Beach/parking lot 1,879.01 1,879.01 Whiskers Beach/parking lot 402.64 402.64 Davis Street Fishing Beach 268.43 268.43 We appreciate your prompt payment. Total Phone# Fax# E-mail 909-889-9987 909-889-9897 rplandscapeinc@gmail.com DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA RP Landscape&Irrigation PO Box 1200 San Bernardino, CA 92402 DATE INVOICE NO. 6/29/2023 10252 BILL TO JOB NAME City of Lake Elsinore Finance Department 130 S Main Street Lake Elsinore,CA 92530 P.O. NO. TERMS DUE DATE Due on receipt 6/29/2023 DESCRIPTION QTY RATE AMOUNT The Small Cove Levee 268.43 268.43 Launch Pointe Boat Launch/Parking Lot 1,536.86 1,536.86 Railroad Canyon Road Parkways 536.86 536.86 Central Avenue 536.86 536.86 We appreciate your prompt payment. Total $61,920.14 Phone# Fax# E-mail 909-889-9987 909-889-9897 rplandscapeinc@gmail.com DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 07/06/2023 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 CONTACT Patricia Wagner,CIC,CISR NAME: Central City Insurance Agency,Inc. (AHC. Ext: (909)307-6076 IX No): (909)798-4107 1030 Nevada Street E-MAIL pwa @ y centralcit insurance.com ADDRESS: gner Suite 106 INSURER(S)AFFORDING COVERAGE NAIC# Redlands CA 92374 INSURERA: Scottsdale Ins Co 41297 INSURED INSURER B: Palomar Specialty Insurance Company 20338 Roy Perez dba R P Landscape&Irrigation INSURER C: P.O.Box 1200 INSURER D: INSURER E: San Bernardino CA 92402 INSURER F: COVERAGES CERTIFICATE NUMBER: 2022-2023 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE F OCCUR PRIM SES Ea oNcE ence $ 100,000 MED EXP(Any one person) $ 5,000 A Y CPS7669677 10/19/2022 10/19/2023 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000 X JECT LOC PRODUCTS-COMP/OP AGG $POLICY ❑ PRO 4,005,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED Y BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Theft Prevention $ UMBRELLA LIAB '"'"'M `"W"Ny OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? NIA PSIC12300-02 01/10/2023 01/10/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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.and are named as Additonal Insured per Blanket Additional Insured endorsement GLS150s 07 09 Primary and Non Contributory applies per endorsement CG 20 01 12-19,Waiver of Subrogation for General Liability applies per endorsement CG 24 04 12 19 30 day notice for cancellation,10 day notice for cancellation by non-payment CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Lake Elsinore ACCORDANCE WITH THE POLICY PROVISIONS. 521 N Langstaff Street AUTHORIZED REPRESENTATIVE Lake Elsinore CA 92530 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA DATE(MMIDD/YYYY) AC D® CERTIFICATE OF LIABILITY INSURANCE 16.. � 07/18/2023 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(les) 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 endorsements. PRODUCER CONTACT Gabby Mora StateFarm State Farm PHONE 579-5100 FAX No Extl: (626) AIC No N/A Hector Feria,Agent E-MADDAIL RIESS, gabby.mora.vabkt3@statefarm.com m 4531 Philadelphia St Suite 106-B INSURER($)AFFORDING COVERAGE NAIC A Chino Ca 91710 INSURER A: State Farm General Insurance Company 25151 INSURED INSURER B: RP Landscape&Irrigation INSURER C: Attn;Roy Perez INSURER D: P.O Box 1200 INSURER E: San Bernardino Ca 92402 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MIDDfYYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MAQE OCCUR DAMAGE TO RENTED PREMISES a occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT 0 LOC PRODUCTS-COMPIOPAGG $ OTHER: $ AUTOMOBILE LIABILITY 767 3731-DI 2-75rLOMBI deDtS1NGLE LIMIT $ 1,006,000 ANY AUTO BODILY INJURY(Per person) E A OWNED �/ SCHEDULED X. X 2016 Toyota Tundra Pickup 06129/2023 06/29/2024 AUTOS ONLY /� AUTOS BODILY INJURY(Per accident) $ HIRED NON OVhNED VIN:5TFRM5F13GX108980Ft<UFtK AUTOS ONLY AUTOS ONLY Per aodden! $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- $ AND EMPLOYERS'LIABILRY ANY PROPRIETORlPARTNER/EXECUTIVE YIN . OFFICERIMEMBER EXCLUDED? ❑ N/A E.L EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ i i DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is requlmd) The City of Lalke Elsinore,its directors,officials,officers,employees,agents and volunteers are named as additionally insured in respects to General Liability and Auto Liability policies per attached endorsements#8675309&#90210. General Liability and Auto insurance is deemed primary and certificate holders insurance shall be non-contributory per attached Endorsement#123456 I I I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Lake Elsinore ACCORDANCE WITH THE POLICY PROVISIONS. 130 S Main St AUTHORIZED REPRESENTATIVE Lake Elsinore,Ca 92324 1 • ��/L ©1988-2015 ACOR RPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132e4s.14 04-13-2D22 DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 0 Insurance Services Office, Inc„ 2018 Page 1 of 1 DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA POLICY NUMBER: CPS7669677 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the fallowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS. UNITED STATES Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss, This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 0412 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA SCOTTSDALE INSURANCE COMPANY® ENDORSEMENTNO. ATTACHED TO AND ENDORSEMENT EFFECTIVE DATE FORMING A PART OF NAMED INSURED POLICYNUMBER (12A1A.M.STANDARDTIME) AGENTNO. CPS7669677 10/19/2022 ROY PEREZ DHA R P LANDSCAPE & IRRIGATION 04027 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to this endorsement, SECTION II—WHO IS a. All work, including materials, parts or equip- AN INSURED is amended to include as an additional in- ment furnished in connection with such work, sured any person or organization whom you are required to on the project (other than service, mainte- add as an additional insured on this policy under a written nance or repairs) to be performed by or on contract,written agreement or written permit which must be: behalf of the additional insured(s) at the loca- a. Currently in effect or becoming effective during tion of the covered operations has been com- the term of the policy;and pleted; or b. Executed prior to the "bodily injury,' "property b. That portion of"your work"out of which the in- damage,"or"personal and advertising injury." jury or damage arises has been put to its in- tended use by any person or organization The insurance provided to these additional insureds is lim- other than another contractor or subcontrac- ited as follows: for engaged in performing operations for a 1. That person or organization is an additional insured principal as a part of the same project. only with respect to liability for "bodily injury," 3. The limits of insurance applicable to the additional "property damage' or 'personal and advertising insured are those specified in the written contract, injury" caused, in whole or in part, by: written agreement or written permit or in the Decla- rations for this policy, whichever is less. These lim- a. Your acts or omissions; or its of insurance are inclusive of, and not in addition b. The acts or omissions of those acting on your to, the Limits of Insurance shown in the Declara- behalf. tions for this policy. A person's or organization's status as an addi- 4. Coverage is not provided for "bodily injury," tional insured under this endorsement ends when "property damage," or "personal and advertising your operations for that additional insured are injury" arising out of the sole negligence of the completed. additional insured. 2. With respect to the insurance afforded to these 6. The insurance provided to the additional insured additional insureds, the following exclusions are does not apply to"bodily injury,""property damage,' added to item 2. Exclusions of SECTION I— or "personal and advertising injury" arising out of COVERAGES: an architect's, engineer's or surveyor's rendering This insurance does not apply to "bodily injury," of or failure to render any professional services including: "property damage" or "personal and advertising injury"occurring after: Includes copyrighted material of ISO Properties,Inc.,with its permission. Copyright,ISO Properties,Inc.,2004 GLS-150s(7-06) Page 1 of 2 DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA a. The preparing, approving or failing to prepare written contract specifically requires that this insur- or approve maps, shop drawings, opinions, re- ance be primary. ports, surveys, field orders, change orders or When this insurance is excess, we will have no du- drawings and specifications; and ty under SECTION I—COVERAGES to defend the b. Supervisory, inspection, architectural or engi- additional insured against any "suit" if any other in- neering activities. surer has a duty to defend the additional insured against that "suit." If no other insurer defends, we ti. Any coverage provided hereunder will be excess will undertake to do so, but we will be entitled to the over any other valid and collectible insurance avail-able to the additional insured whether primary, ex- additional insured's rights against all chose other cess, contingent or on any other basis unless a insurers. AUTHORIZED REPRESENTATIVE DATE Includes copyrighted material of ISO Properties,Inc.,with its permission. Copyright,ISO Properties,Inc.,2004 GLS-150s(7-06) Page 2 of 2 DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC ON 04 WS A (Ed. 01-19) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Blanket Waiver:The additional premium for this endorsement shall be 2%of the California workers'compensation premium otherwise due on such remuneration. Specific Waiver:The additional premium for this endorsement shall be 5%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver of Subrogation As respects to all CA jobs performed by the named insured during the policy period where by written contract a waiver of subrogation is required prior to the commencement of work. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective:01/10/2023 Policy No.:PSIC12300-02 Endorsement No.: Insured Perez, Roy dba R P Insurance Company Palomar Specialty Insurance Company Landscape& Irrigation Countersigned By / WC ON 04 WS A(Ed.01-19) Print Date: 1/7/2023 DocuSign Envelope ID:773295DB-BE88-40CB-A93C-28561CD59EAA BUSINESS LICENSE CITY OF LAKE ELSINORE This business license is issued for revenue purposes only and does not grant authorization Administrative Services-Licensing to operate a business. This business license is issued without verification that the holder is 130 South Main Street, Lake Elsinore, CA 92530 subject to or exempted from licensing by the state,county,federal government,or any PH (951) 674-3124 other governmental agency. Business Name: RP LANDSCAPE&IRRIGATION BUSINESS LICENSE NO. 025530 Business Location: 1905 W RIALTO AVE Business Type: LANDSCAPING CONTRACTOR SAN BERNARDINO,CA 92410-1618 Owner Name(s): ROY PEREZ Issue Date: 12/1/2022 Expiration Date: 11/30/2023 RP LANDSCAPE& IRRIGATION PO BOX 1200 SAN BERNARDINO, CA 92402-1271 Starting January 1,2021,Assembly Bill 1607 requires the prevention of gender-based discrimination of business establishments.A full notice is available in English or other languages by going to:https://www.dca.ca.gov/publications/ TO BE POSTED IN A CONSPICUOUS PLACE THIS IS YOUR LICENSE • NOT TRANSFERABLE