Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2200 - Ortco, Inc. - Removal and Installation of Sally Tanner Park Playground Project
A�ROe CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD Y Y) x/24/2021 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 Edgewood Partners Insurance Center (EPIC) 19000 MacArthur Blvd. PH Floor Irvine, CA 92612 NAME: CONTACT PHONEgag 2x3-osos IFA No): sax 2s3-osos E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICM INSURERA: Admiral Insurance Company 24856 www.edgewoodins.com INSURED Ortco, Inc. 2163 N. Glassell Avenue Orange CA 92186 INSURER B: Infinity Select Insurance Company 001252 INSURERC: Cypress Insurance Company 10855 INSURER D: Ohio Security Insurance Company 24082 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 64136101 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 R OF INSURANCE ADDLTYPE IVSD UBR POLICYNUMBER MMIDDPOLICY EFF M LI Y EXIO MM DrYYNN'l LIMITS A COMMERCIAL GENERAL LUUNLITY CA000005173-18 6/21/2021 6/21/2022 EACHOCCURRENCE $1000000 CLAIMS -MADE Fil OCCUR PREMISES Ea occurrence $50,000 MED EXP (Any one person) $ Excluded V 5 000 Ded per Occurence PERSONAL BADVI NJURY $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 POLICY IRO LOC PRODUCTS-COMP/OPAGG $2000000 $ OTHER: B AUTOMOBILE LIABILITY 504610158968001 6/21/2021 6/21/2022 ERMBINd DISINGLE LIMIT $1000000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per acadert) $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE $ Were den HIRED NONOWNED AUTOS ONLY AUTOS ONLY $ 1 000 ded C m oil UMBRELLA LIAB ,/ OCCUR GX000004483-01 6121/2021 6/21/2022 EACHOCCURRENCE $4000,000 AGGREGATE $4000000 EXCESS LIAR CLAIMS -MADE DED RETENTION$O Policyon Folow Form s ID WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE —7 ORWC209374 10/1/2021 10/1/2022 ,/ STATUTE ER RRH- E. L. EACH ACCIDENT $1000000 OFFICERMIEMBEREXCLUDED9 NIA (MandaEury in NN) E. L. DISEASE - EA EMPLOYEE E E. L. DISEASE - POLICY LIMIT $1000000 If yes, describe under DESCRIPTION OF OPERATIONS beau Property BKS57316068 6/21/2021 6/21/2022 Equipment Leased or Rented im Others Limit: $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Addiaunal Remarb Schedule, may be attacher) if mom space is required/ Re: Sally Tanner Park, 47011899 Delta Ave., Rosemead, CA 91770 Certificate Holder is additional insured as respects General Liability performs CG2010 and CG2037 ,but only if required by signed written contract with Named Insured prior to an occurrence. Blanket Primary Wording form CG2001, and Blanket Waiver of Subrogation farm CG24040509 apply to General Liability.Workers Compensation Blanket Waiver of Subrogation per Form WC99041 OC but only if required by written Contract . Subject to all policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Clty of Rosemead SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 8838 E. Valley Blvd. ACCORDANCE WITH THE POLICY PROVISIONS. Rosemead CA 91770 AUTHORIZEDREPRESENTATIVE / AnthonyD'Asam ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 64136101 1 21-11 Master I Denise Yamada 1 9/24/2021 3:36:42 PM IMT) I Page 1 Of 6 AGENCY CUSTOMER ID: LOC #: ACORO® ADDITIONAL REMARKS SCHEDULE Page of AGENCY Edgmood Partners Insurance Center (EPIC) NAMED INSURED 2Orto )JI�Glassell Avenue Orange CA 92186 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16 HOLDER: City of Rosemead ADDRESS: 8838 E. Valley Blvd. Rosemead CA 91770 Additional Insureds: The City of Rosemead, including its officers, officials, employees and agents. ACORD 101 (2008101) C 2008 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD ADDENDUM 64136101 121-22 Master I Denise Yamada 19/24/2021 3:36:42 PM (PDT) I Page 2 of 6 Ortco, Inc. Policy Number: CA000005173-18 9/24/2021 CG 20 10 04 13 Effective Date: 06/21/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or Organization(s) Locations Of Covered Operations ANY PERSON OR ORGANIZATION THAT IS AN ALL LOCATIONS OTHERWISE COVERED BY THIS OWNER OF REAL PROPERTY OR PERSONAL INSURANCE PROPERTY ON WHICH YOU ARE PERFORMING ONGOING OPERATIONS, OR A CONTRACTOR ON WHOSE BEHALF YOU ARE PERFORMING ONGOING OPERATIONS, BUT ONLY IF COVERAGE AS AN ADDITIONAL INSURED IS REQUIRED BY A WRITTEN CONTRACT OR WRITTEN AGREEMENT THAT IS AN -INSURED CONTRACT", AND PROVIDED THAT THE BODILY INJURY", "PROPERTY DAMAGE" OR "PERSONAL AND ADVERTISING INJURY" FIRST OCCURS SUBSEQUENT TO THE EXECUTION OF THE CONTRACT OR AGREEMENT. Information required to complete this Schedule, if not shown above. will be shown in the Declarations. A. Section 11— Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your be- half, in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the con- tract or agreement to provide for such additional in- sured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 0 64136101 1 21-22 Master I Denise Yamatla 1 9/24/2021 3J6:42 PM (PDT) I Page 3 of 6 B. With respect to the insurance afforded to these addi- tional insureds, the following additional exclusions ap- ply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the pro- ject (other than service, maintenance or repairs) to be performed by or on behalf of the additional in- sureds) at the location 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 con- tractor or subcontractor engaged in performing op- erations for a principal as a part of the same project. CG 20 10 04 13 C. With respect to the insurance afforded to these addi- tional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is re- quired by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of in- surance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Lim- its of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 64136101 1 21-22 Master I Denise Yamada 1 9/24/2021 3:36:42 PM (PUT) J Page 4 of 6 Page 2 of 2 0 Ortco, Inc. Policy Number: CA000005173-I8 9/24/2021 CG 20 37 04 13 Effective Date: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Location And Description Of Or Organization(s) Completed Operations ANY PERSON OR ORGANIZATION THAT IS AN ALL LOCATIONS EXCEPT LOCATIONS WHERE OWNER OF REAL PROPERTY OR PERSONAL PROP- "YOUR WORK" IS OR WAS RELATED TO A JOB OR ERTY FOR WHOM YOU WORK OR HAVE WORKED, PROJECT INVOLVING SINGLE-FAMILY DWELLINGS, OR A CONTRACTOR ON WHOSE BEHALF YOU MULTI -FAMILY DWELLINGS (OTHER THAN RENTAL WORK OR HAVE WORKED, BUT ONLY IF COVER- APARTMENTS IN AN APARTMENT BUILDING: (a) AGE AS AN ADDITIONAL INSURED EXTENDING TO ORIGINALLY CONSTRUCTED AND AT ALL TIMES "BODILY INJURY" OR "PROPERTY DAMAGE" IN- USED FOR SUCH PURPOSE; OR (b) CONVERTED CLUDED IN THE "PRODUCTS -COMPLETED OPERA- FROM A COMMERCIAL BUILDING), CONDOMINI- TIONS HAZARD" IS REQUIRED BY A WRITTEN CON- UMS, TOWNHOMES, TOWNHOUSES, TIME-SHARE TRACT OR WRITTEN AGREEMENT THAT IS AN UNITS, FRACTIONAL OWNERSHIP UNITS, COOPER - "INSURED CONTRACT" AND PROVIDED THAT THE ATIVES AND/OR ANY OTHER STRUCTURE OR "BODILY INJURY" OR "PROPERTY DAMAGE" FIRST SPACE USED OR INTENDED TO BE USED AS A RESI- OCCURS SUBSEQUENT TO THE EXECUTION OF THE DENCE. CONTRACT OR AGREEMENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 13 64136101 121-22 Master Denise Yamada 19/24/2021 3:36:42 PM (PUT) I Page 5 Of 6 A. Section 11— Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the lo- cation designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations haz- ard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such addi- tional insured. B. With respect to the insurance afforded to these addi- tional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is re- quired by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2011 Page 2 of 2 ❑ 64136101 121-22 Master I Denise Yamada 19/24/2021 3:36:42 PM (POT) I Page 6 of 6 ACORO°CERTIFICATE OF LIABILITY INSURANCE DAT 6/24/2DIYI'YY) s/za/2022 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 endorsement(s). PRODUCER Edgewood Partners Insurance Center (EPIC) 19000 MacArthur Blvd. PH Floor Irvine. CA 92612 www.edgewoodins.com CONTACT NAME PHONE sas zs3-osos FAXUJC NR: sas 2s3-osos E-MAIL ADDRE INSURER(S) AFFORDING COVERAGE NAICa INSURERA: Admiral Insurance Company 24856 INSUREDOrtc 2163 N. Glassell Avenue Inc. 2163 Orange CA 92186 INSURERB: Infinity Select Insurance Company 20260 INSURERC: C Cypress Insurance Company 10855 INSURERD: OlgioSecurity Insurance Company 24082 NSURER E1 INSURER F CoUVERAGED UtH ft-icATE NuNIFFR• RRori,327 laovrmnu u,uaracm. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVEFORTHE 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. (NSR TR TYPE OF INSURANCE ADEL 99—BR iWorPOLICYNUMBER PoLIDY EFF MMA)D PoLICY EXP MMIDD/YYYY LIMITS A/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 12VI OCCUR CA00000517319 6/21/2022 6/21/2023 EACH OCCURRENCE $1,000,000 PREMISES Be occurrence$50000 J 5 D00 Ded per Occurrence MED EXP (Any one person) s Excluded PERSONAL S ADV INJURY $1000000 GEN'L AGGREGATE LIMIT APPLIES PER: RO- POLICY Z JECT [�] LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMPIOP AGO $2,000000 $ OTHER'. B AUTOMOBILE ✓ LIABILITY ANY AUTO 504610158968001 6/21/2022 6/21/2023 CEOMaBINEeDLSINGLE LIMIT $1000000 BODILY INJURY (Per person) 5 OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Peraccident) $ PROPERTYdimt) AGE $ Per nt ✓ $1.00( ded C m oil $ A UMBRELLALIAB ,/ OCCUR GX00000448302 6/21/2022 6/21/2023 EACHOCCURRENCE $4000000 ✓ EXCESS LIAR CLAIMS -MADE AGGREGATE $4 000,000 DED I I RETENTION $0 Policy On FOIOw Form $ 1 1 C WORKERSCOMPENSATION AND EMPLOYERS'LIABILITY YIN OFFICE P EMBEANYPRIETORIPARTNER/EXECUTIVE OFFICEWMEMBEREXCLUDEp4 � N/A ORWC209374 10/1/2021 10/1/2022 ✓ STATUTE ETH E.L. EACH ACCIDENT $1,000000 E.L. DISEASE-EAEMPLOVEE $ (Mandatory in NH) if yes describe under E.L. DISEASE POLICY LIMIT 1 $1000000 Equipment Leased or Rented from Others D DESCRIPTION OF OPERATIONS belox PropertySKS57316068 6/21/2022 6/21/2023 Limit: $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addibonal Remarks Schedule, may Be attached d more space is required) Re: Sally Tanner Park, 4701-4899 Delta Ave., Rosemead, CA 91770 Certificate Holder is additional insured as respects General Liability per forms CG2010 and CG2037 , but only if re Lined by signed written Contract with Named Insured prior to an occurrence. Blanket Primary Wording per attached and GL Blanket Waiver of Subrogation included per attached.Workers Compensation Blanket Waiver of Subrogation per attached form but only if required by written contract . Subject to all policy terms and Conditions. ClN of Rosemead 8838 E. Valley Blvd. Rosemead CA 91770 Ma Umu LD (LUIDIU3) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRESENTATIVE / 1988.2015 ACORD The ACORD name and logo are registered marks of ACORD E8P0338] 1 22-23 M—tei I Deaisa '(arrana 1 6/24/2022 11:23:50 AM IPD, I Page 1 of 6 reserved. A This page -DO NOT DISCARD A repart 0 20201163337 4k tAft: ;FP + Recorded/Filed in Official Records %Foto* 09/24/20 AT 08:04AM FEES: 0.00 TAXES: 0.00 OTHER: 0.00 PAID: 0.00 A A II 101 1101 0I II iiiii iii I I II II II III II H II I Ill IIi EQ: 01 II DI III DIII iii ID III 111110 II 11111 DIII hull U ill 111110 I Ill Ill III A IIIIII11111III1WI�IIIII11111011111IVnIp�IIIII�IIIG A •RECORDJNG REQUESTED BY CITY OF ROSEMEAD 18956782 111111111111111111111111111111111111 AND WHEN RECORDED MAIL TO: Batch Number: 11215706 Name City of Rosemead IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Street Address 8838 E. Valley Blvd. City&State Rosemead, CA 91770 - ATTN: CITY CLERK SPACE ABOVE THIS LINE FOR RECORDER'S USE Notice of Completion Notice is hereby given that: 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full name of the undersigned is: City of Rosemead 3. The full address of the undersigned is: 8838 E. Valley Blvd., Rosemead, CA 91770 4. The nature of the title of the undersigned is: In fee (If other than fee,strike"In fee"and insert,for example,"purchaser under contract of purchase",or"lessee") 5. The full names and full addresses of all persons, if any,who hold title with the undersigned are: Names Addresses N/A N/A 6. The names of the predecessors in interest of the undersigned, if the property was transferred subsequent to the commencement of the work of improvement herein referred to: Names Addresses N/A N/A (If no transfer made,insert,"none".) 7. A work of improvement on the property hereinafter described was completed on: June 25,2020 8. The name of the contractor, if any for such work of improvement was: Ortco, Inc., 2163 N. Glasse!! Street, Orange, CA 92865 9. The property on which said work of improvement was completed is in the City of Rosemead County of Los Angeles ,State of California, and is described as follows: Removal and Installation of the Sally Tanner Park Playground Project 10. The street address of said property is: as listed in No. 9 (If no street address has been officially assigned,insert"none") Signature of owner named G...1 Dated: 9 z/1/7 a U in paragraph 2: Chris Daste Director of Public Works By: City of Rosemead - f I certify(or declare) under penalty of perjury that the foregoing is true and correct. q/e/2-' 0Date Chris Daste Director of Public Works City of Rosemead, California Rosemead, CA Place of Execution . • • T CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California� 11 County of r°0 r i f J} _ On t f IOU before me, 1""`64Q o W 4400 1 \k"114VW)Ci Date (� Here Insert Name and Title of the Officer personally appeared V\rS Vint Name%of Signer(( who proved to me on the basis of satisfactory evidence to be the persor)4whose name(isfe arsubscribed to the within instrument and acknowledged to me that he 14etheg executed the same irf his#ITenr r- authorized capacity, and that by him*signature f on the instrument the personKor the entity upon behalf of which the persons acted, executed the instrument. : .NATALIE HAWORr:H I certify under PENALTY OF PERJURY under the `�t"---,',.. Nrtary Public-California t• laws of the State of California that the foregoing `_ , , = Los Angeles County _ ; paragraph is true and correct. Commission N 22720b0 _°""'+ My Comm.Expires Dec 20,2022 i WITNESS my hand and official seal. Signature J (ØJJJLr Place Notary Seal and/or Stamp Above Signature of otary Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached DocumerL `,,�, Title or Type of Docu ent: mo, NY�� ct-\\6 \ Document Date: lit) VAN Number of Pages: %.3 Signer(s) Other Than Named Above: Itl lln Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— 0 Limited 0 General ❑ Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator 0 Trustee 0 Guardian of Conservator ❑ Other: 0 Other: Signer is Representing: Signer is Representing: ©2017 National Notary Association A0 `® 058 E M dO� l O CIVIC PRIDE ITT 0 14CORPORATE4.*) CONSTRUCTION CONTRACT REMOVAL AND INSTALLATION OF THE SALLY TANNER PARK PLAYGROUND PROJECT (ORTCO, INC.) 1. PARTIES AND DATE //�� This Contract is made and entered into this j ��, day o r fl ,2020 (Effective Date) by and between the City of Rosemead, a municipa corporation of the State of California, located at 8838 E. Valley Blvd., Rosemead, California 91770, ("City") and Ortco, Inc.with its principal place of business at 2163 N. Glassel Street(hereinafter referred to as"Contractor"). City and Contractor are sometimes individually referred to as"Party"and collectively as "Parties" in this Contract. 2. RECITALS 2.1 Contractor • Contractor desires to perform and assume responsibility for the Removal and Installation of the Sally Tanner Park Playground Project by the City on the terms and conditions set forth in this Contract. Contractor represents that itis experienced in providing such work services to public clients, that it and its employees or subcontractors have all necessary licenses and permits to perform the Services in the State of California, and that is familiar with the plans of City. 2.2 Project City desires to engage Contractor to render such services described herein as Project ("Project") as set forth in this Contract. 3. TERMS 3.1 Scope of Services and Term 3.1.1 General Scope of Services. Contractor promises and agrees to furnish to the City all labor, materials, tools, equipment, services, and incidental and customary work ORTCO, INC. Page 2 of 11 necessary to fully and adequately supply the professional construction services necessary for the Project ("Services"). The Services are more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. All Services shall be subject to, and performed in accordance with, this Contract, the exhibits attached hereto and incorporated herein by reference, and all applicable local, state and federal laws, rules and regulations. 3.1.2 Term. The term of this Contract shall be from Effective Date shown above to December 31, 2020, unless earlier terminated as provided herein. Contractor shall complete the Services within the term of this Contract, and shall meet any other established schedules and deadlines. The Parties may, by mutual, written consent, extend the term of this Contract if necessary to complete the Services. 3.2 Responsibilities of Contractor. 3.2.1 Control and Payment of Subordinates; Independent Contractor. The Services shall be performed by Contractor or under its supervision. Contractor will determine the means, methods and details of performing the Services subject to the requirements of this Contract. City retains Contractor on an independent contractor basis and not as an employee. Contractor retains the right to perform similar or different services for others during the term of this Contract. Any additional personnel performing the Services under this Contract on behalf of Contractor shall also not be employees of City and shall at all times be under Contractor's exclusive direction and control. Contractor shall pay all wages, salaries, and other amounts due such personnel in connection with their performance of Services under this Contract and as required by law. Contractor shall be responsible for all reports and obligations respecting such additional personnel, including, but not limited to: social security taxes, income tax withholding, unemployment insurance, disability insurance, and workers' compensation insurance. 3.2.2 Schedule of Services: Contractor shall perform the Services expeditiously,within the term of this Contract, and within the schedules timeline. Contractor represents that it has the professional and technical personnel required to perform the Services in conformance with such conditions. In order to facilitate Contractor's conformance with the Schedule, City shall respond to Contractor's submittals in a timely manner. Upon request of City, Contractor shall provide a more detailed schedule of anticipated performance to meet the Schedule of Services. 3.2.3 Conformance to Applicable Requirements. All work prepared by Contractor shall be subject to the approval of City. 3.2.4 City's Representative. The City hereby designates the City Manager, Gloria Molleda, or her designee, to act as its representative for the performance of this Contract ("City's Representative"). City's Representative shall have the power to act on behalf of the City for all purposes under this Contract. Contractor shall not accept direction or orders from any person other than the City's Representative or his or her designee. 3.2.5 Contractor's Representative. Contractor hereby designates Lynn A. Ortlieb, or her designee, to act as its representative for the performance of this Contract ("Contractor's Representative"). Contractor's Representative shall have full authority to ORTCO, INC. Page 3 of 11 represent and act on behalf of the Contractor for all purposes under this Contract. The Contractor's Representative shall supervise and direct the Services, using his/her best skill and attention, and shall be responsible for all means, methods, techniques, sequences and procedures and for the satisfactory coordination of all portions of the Services under this Contract. 3.2.6 Coordination of Services. Contractor agrees to work closely with City staff in the performance of Services and shall be available to City's staff, consultants and other staff at all reasonable times. 3.2.7 Standard of Care; Performance of Employees. Contractor shall perform all Services under this Contract in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Contractor represents and maintains that it is skilled in the professional calling necessary to perform the Services. Contractor warrants that all employees and subcontractors shall have sufficient skill and experience to perform the Services assigned to them. Finally, Contractor represents that it, its employees and subcontractors have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Services, including a City Business License if applicable, and that such licenses and approvals shall be maintained throughout the term of this Contract. As provided for in the indemnification provisions of this Contract, Contractor shall perform, at its own cost and expense and without reimbursement from the City, any services necessary to correct errors or omissions which are caused by the Contractor's failure to comply with the standard of care provided for herein. Any employee of the Contractor or its sub-contractors who is determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project, a threat to the safety of persons or property, or any employee who fails or refuses to perform the Services in a manner acceptable to the City, shall be promptly removed from the Project by the Contractor and shall not be re-employed to perform any of the Services or to work on the Project. 3.2.8 Laws and Regulations. Contractor shall keep itself fully informed of and in compliance with all local, state aind federal laws, rules and regulations in any manner affecting the performance of the Project or the Services, including all Cal/OSHA, AQMD requirements, and shall give all notices required by law. Contractor shall be liable for all violations of such laws and regulations in connection with Services. If the Contractor performs any work knowing it to be contrary to such laws, rules and regulations and without giving written notice to the City, Contractor shall be solely responsible for all costs arising therefrom. Contractor shall defend, indemnify and hold City, its officials, directors, officers, employees and agents free and harmless, pursuant to the indemnification provisions of this Contract, from any claim or liability arising out of any failure or alleged failure to comply with such laws, rules or regulations. 3.2.9 Insurance: Contractor shall maintain, prior to the beginning of and for the duration of this Contract, insurance coverage as specified in Exhibit B attached to and part of this Contract. 3.2.10 Safety. Contractor shall execute and maintain its work so as to avoid ORTCO,INC. Page 4 of 11 injury or damage to any person or property. In carrying out its Services, the Contractor shall at all times be in compliance with all applicable local, state and federal laws, rules and regulations, and shall exercise all necessary precautions for the safety of employees appropriate to the nature of the work and the conditions under which the work is to be performed. Safety precautions as applicable shall include, but shall not be limited to: (A) adequate life protection and life saving equipment and procedures; (B) instructions in accident prevention for all employees and subcontractors,such as safe walkways, scaffolds, fall protection ladders, bridges, gang planks, confined space procedures, trenching and shoring, equipment and other safety devices, equipment and wearing apparel as are necessary or lawfully required to prevent accidents or injuries; and (C)adequate facilities for the proper inspection and maintenance of all safety measures. 3.2.11 Prevailing Wages. Contractor is aware of the requirements of California Labor Code Section 1720, etseq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 1600, 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. If the Services are being performed as part of an applicable"public works"or"maintenance"project, as defined by the Prevailing Wage Laws, and if the total compensation is$1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Contract. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the Services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 3.2.12 Bonds. 3.2.12.1 Performance Bond: If specifically requested by City, Contractor shall execute and provide to City concurrently with this Contract a Performance Bond in the amount of the total, not-to-exceed compensation indicated in this Contract, and in a form provided or approved by the City. If such bond is required, no payment will be made to Contractor until it has been received and approved by the City. 3.2.12.2 Payment Bond. If required by law or otherwise specifically requested by City, Contractor shall execute and provide to City concurrently with this Contract a Payment Bond in the amount of the total, not-to-exceed compensation indicated in this Contract, and in a form provided or approved by the City. If such bond is required, no payment will be made to Contractor until it has been received and approved by the City. 3.2.12.3 Bond Provisions. Should, in City's sole opinion, any bond become insufficient or any surety be found to be unsatisfactory, Contractor shall renew or replace the affected bond within 10 days of receiving notice from City. In the event the surety or Contractor intends to reduce or cancel any required bond, at least thirty (30) days prior written notice shall be given to the City, and Contractor shall post acceptable replacement bonds at least ten (10)days prior to expiration of the original bonds. No further ORTCO, INC. Page 5 of 11 payments shall be deemed due or will be made under this Contract until any replacement bonds required by this Section are accepted by the City. To the extent, if any, that the total compensation is increased in accordance with the Contract, the Contractor shall, upon request of the City, cause the amount of the bonds to be increased accordingly and shall promptly deliver satisfactory evidence of such increase to the City. To the extent available, the bonds shall further provide that no change or alteration of the Contract(including,without limitation, an increase in the total compensation, as referred to above), extensions of time,or modifications of the time, terms, or conditions of payment to the Contractor, will release the surety. If the Contractor fails to furnish any required bond, the City may terminate this Contract for cause. 3.2.12.4 Surety Qualifications. Only bonds executed by an admitted surety insurer, as defined in Code of Civil Procedure Section 995.120, shall be accepted. The surety must be a California-admitted surety with a current A.M. Best's rating no less than A:Vlll and satisfactory to the City. If a California-admitted surety insurer issuing bonds does not meet these requirements, the insurer will be considered qualified if it is in conformance with Section 995.660 of the California Code of Civil Procedure, and proof of such is provided to the City. 3.3 Fees and Payments. 3.3.1 Compensation. The total compensation shall not exceed Ten Thousand Two Hundred Dollars ($10,200)without advance written approval of City's project manager. Extra Work may be authorized, as described below, and if authorized, will be compensated at the rates and manner set forth in this Contract. 3.3.2 Payment of Compensation. Contractor shall submit to City a monthly itemized statement that indicates work completed and hours of Services rendered by Contractor. The statement shall describe the amount of Services and supplies provided since the initial commencement date, or since the start of the subsequent billing periods, as appropriate, through the date of the statement. City shall, within 45 days after receiving such statement, review the statement and pay all approved charges. The payments will be subject to a 5% retention amount,which would be released and paid after all work under the Contract has been satisfactorily completed, and 35 days after a Notice of Completion is filed with the County of Los Angeles. 3.3.3 Reimbursement for Expenses. Contractor shall not be reimbursed for any expenses unless authorized in writing by City. 3.3.4 Extra Work. At any time during the term of this Contract, City may request that Contractor perform Extra Work. As used herein, "Extra Work" means any work that is determined by City to be necessary for the proper completion of the Project, but which the parties did not reasonably anticipate would be necessary at the execution of this Contract. Contractor shall not perform, nor be compensated for, Extra Work without written authorization from City's Representative. 3.4 Accounting Records. ORTCO, INC. Page 6 of 11 3.4.1 Maintenance and Inspection. Contractor shall maintain complete and accurate records with respect to all costs and expenses incurred under this Contract. All such records shall be clearly identifiable. Contractor shall allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Contract. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to the Contract for a period of three (3) years from the date of final payment under this Contract. 3.5 General Provisions. 3.5.1 Termination of Contract. 3.5.1.1 Grounds for Termination. City may, by written notice to Contractor, terminate the whole or any part of this Contract at any time and without cause by giving written notice to Contractor of such termination, and specifying the effective date thereof, at least seven (7) days before the effective date of such termination. Upon termination, Contractor shall be compensated only for those services that have been adequately rendered to City, and Contractor shall be entitled to no further compensation. Contractor may not terminate this Contract except for cause. 3.5.1.2 Effect of Termination. If this Contract is terminated as provided herein, City may require Contractor to provide all finished or unfinished Documents and Data and other information of any kind prepared by Contractor in connection with the performance of Services under this Contract. Contractor shall be required to provide such document and other information within fifteen (15) days of the request. 3.5.1.3 Additional Services. In the event this Contract is terminated in whole or in part as provided herein, City may procure, upon such terms and in such manner as it may determine appropriate, services similar to those terminated. 3.5.2 Delivery of Notices. All notices permitted or required under this Contract shall be given to the respective parties at the following address, or at such other address as the respective parties may provide in writing for this purpose: CONTRACTOR: Ortco, Inc. 2163 N. Glasse!! St. Orange, CA 92865 Attn: Lynn A. Ortlieb CITY: City of Rosemead 8838 E. Valley Boulevard Rosemead, CA 91770 Attn: Erik Garwick, Public Works Department ORTCO,INC. Page 7 of 11 Such notice shall be deemed made when personally delivered or when mailed, forty-eight (48) hours after deposit in the U.S. Mail, first class postage prepaid and addressed to the party at its applicable address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. 3.5.3 Cooperation; Further Acts. The Parties shall fully cooperate with one another, and shall take any additional acts or sign any additional documents as may be necessary, appropriate or convenient to attain the purposes of this Contract. 3.5.4 Attorney's Fees. If either party commences an action against the other party, either legal, administrative or otherwise, arising out of or in connection with this Contract, the prevailing party in such litigation shall be entitled to have and recover from the losing party reasonable attorney's fees and all other costs of such action. 3.5.5 Indemnification. Contractor shall defend, indemnify and hold the City, its officials, officers, employees, volunteers and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful death, in any manner arising out of or incident to any alleged acts, omissions or willful misconduct of Contractor, its officials, officers, employees, agents, consultants and contractors arising out of or in connection with the performance of the Services, the Project or this Contract, including without limitation the payment of all consequential damages and attorneys fees and other related costs and expenses. Contractor shall defend, at Contractor's own cost, expense and risk, any and all such aforesaid suits, actions or other legal proceedings of every kind that may be brought or instituted against City, its directors, officials, officers, employees, agents or volunteers. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against City or its directors, officials, officers, employees, agents or volunteers, in any such suit, action or other legal proceeding. Contractor shall reimburse City and its directors, officials, officers, employees, agents and/or volunteers, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by the City, its directors, officials, officers, employees, agents or volunteers. 3.5.6 Entire Contract. This Contract contains the entire Contract of the parties with respect to the subject matter hereof, and supersedes all prior negotiations and understandings. This Contract may only be modified by a writing signed by both parties. 3.5.7 Governing Law. This Contract shall be governed by the laws of the State of California. Venue shall be in Los Angeles County. 3.5.8 Time of Essence. Time is of the essence for each and every provision of this Contract. 3.5.9 City's Right to Employ Other Contractors. City reserves right to employ other contractors in connection with this Project. 3.5.10 Successors and Assigns. This Contract shall be binding on the successors and assigns of the parties. ORTCO, INC. Page 8 of 11 3.5.11 Assignment or Transfer. Contractor shall not assign, hypothecate, or transfer, either directly or by operation of law, this Contract or any interest herein without the prior written consent of the City. Any attempt to do so shall be null and void, and any assignees, hypothecates or transferees shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. 3.5.12 Construction; References; Captions. Since the Parties or their agents have participated fully in the preparation of this Contract, the language of this Contract shall be construed simply, according to its fair meaning, and not strictly for or against any Party. Any term referencing time, days or period for performance shall be deemed calendar days and not workdays. All references to Contractor include all personnel, employees, agents, and subcontractors of Contractor, except as otherwise specified in this Contract. All references to City include its elected officials, officers, employees, agents, and volunteers except as otherwise specified in this Contract. The captions of the various articles and paragraphs are for convenience and ease of reference only, and do not define, limit, augment, or describe the scope, content, or intent of this Contract. 3.5.13 Amendment; Modification. No supplement, modification, or amendment of this Contract shall be binding unless executed in writing and signed by both Parties. 3.5.14 Waiver. No waiver of any default shall constitute a waiver of any other default or breach, whether of the same or other covenant or condition. No waiver, benefit, privilege, or service voluntarily given or performed by a Party shall give the other Party any contractual rights by custom, estoppels, or otherwise. 3.5.15 No Third Party Beneficiaries. There are no intended third party beneficiaries of any right or obligation assumed by the Parties. 3.5.16 Invalidity; Severability. If any portion of this Contract is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. 3.5.17 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 Contract. 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 Contract. For breach or violation of this warranty, City shall have the right to rescind this Contract without liability. For the term of this Contract, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Contract, or obtain any present or anticipated material benefit arising therefrom. 3.5.18 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 ORTCO, INC. Page 9 of 11 recruitment advertising, layoff or termination. Contractor shall also comply with all relevant provisions of City's Minority Business Enterprise program, Affirmative Action Plan or other related programs or guidelines currently in effect or hereinafter enacted. 3.5.19 Labor Certification. By its signature hereunder, Contractor certifies that it is aware of the provisions of Section 3700 of the California Labor Code that require every employer to be insured against liability for Worker's Compensation or to undertake self- insurance in accordance with the provisions of that Code, and agrees to comply with such provisions before commencing the performance of the Services. 3.5.20 Authority to Enter Contract. Contractor has all requisite power and authority to conduct its business and to execute, deliver, and perform the Contract. Each Party warrants that the individuals who have signed this Contract have the legal power, right, and authority to make this Contract and bind each respective Party. 3.5.21 Counterparts. This Contract may be signed in counterparts, each of which shall constitute an original. 3.6 Subcontracting. 3.6.1 Prior Approval Required. Contractor shall not subcontract any portion of the work required by this Contract, except as expressly stated herein, without prior written approval of City. Subcontracts, if any, shall contain a provision making them subject to all provisions stipulated in this Contract. [SIGNATURES ON NEXT PAGE] ORTCO, INC. Page 10 of 11 CITY OF ROSEMEAD ORTCO, INC. 7 , 4 V loria Molle•a, City Manager ate ignate Date Name: ���n Ort/tk) 11 Print • Attest: C Titie:�' td jjeb oma. D /2422. t Ericke Hernandez, City Clerk Date [If Corporation,TWO SIGNATURES, President OR Vice President AND Secretary,AND CORPORATE SEAL OF CONTRACTOR REQUIRED] Approved as to Form: / aL By: c).exvi4 / / wovsty rko Rachel Richman, City Clerk Date Name ;' (IflL L.,L . C)(+Iftb VPTitle: 1 �,. ORTCO, INC. Page 10 of 11 CITY OF ROSEMEAD ORTCO, INC. By: %/t11 r' ' if atiaC Gloria Molleda, City Manager Date Signat?e Date Name:Linn O r+I t h Print Attest: (t.t. XXaaa� Title: a t Ericka Hernandez, City Clerk Date [If Corporation,TWO SIGNATURES, President OR Vice President AND Secretary,AND CORPORATE SEAL OF CONTRACTOR REQUIRED] Approved as to Form: By: C4e-f117)(Atitel-7 Rachel Richman, City Clerk Date Name ` c:)r'+Ile,b Title: VP irt) ORTCO, INC. EXHIBIT A SCOPE OF CONTRACT SERVICES SEE ATTACHED BID SCHEDULE/PROPOSAL - f ORTCO . INC. 2163 N.Glassell Street Orange,CA 92865 Office:714-998-3998 Fax:714-998-3996 info@ortcoplays.com Proposal for • SallyTanner Park ByOrtco, Inc. Ortco, Inc. 2163 N. Glassell St. Orange, CA 92865 P: 714-998-3998 F: 714-998-3996 U ORTCO, INC 2163 N.Glassell Street Orange,CA 92865 • Office:714-998-3998 Fax:714-998-3996 info@ortcoplays.com ' Dear City of Rosemead, This proposal will include the statement of qualifications, three references, our company project approach and the wage determination we are using for the labor portion of this project as laid out in the Request for Proposal provided by the city. It will provide a clear picture of the steps that will be taken by Ortco to complete this project in a timely manner and to meet all manufacturers' specifications and all requests by the City. We are company with:hundreds of installation over the past 30+years and our quality of work. . Ortco, Inc. 2163 N. Glassell St. Orange, CA 92865 P: 714-998-3998 F: 714-998-3996 ORTCO INC. 2163 N.GlasseII Street Orange,CA 92865 Office:714-998-3998 Fax:714-998-3996 info@ortcoplays.com Ortco, Inc. Proposal for Sally Tanner Park The following will be included in this proposal: ➢ Ortco, Inc. Statement of Qualification > Three references > Ortco, Inc. Project Approach ➢ DIR wage determination being used for this proposal Ortco, Inc. 2163 N. Glassell St. Orange, CA 92865 P: 714-998-3998 F: 714-998-3996 11.1 ORTCO, INC.. 2163 N.Glassell Street Orange,CA 92865 Office:714-998-3998 Fax:714-998-3996 info@ortcoplays.com Friday,May 8,2020 Statement of Qualification Ortco,Inc.—State of California License No.657695,B,C61,D3,D12,D34 Ortco, Inc. has been a contractor within the State of California since 1986 and has been a Miracle Recreation Certified Installer for over two decades with hundreds of installation in the Orange,Riverside, San Bernardino and Los Angeles counties. We are a general contractor that specializes in the installation of playground equipment, sail and shade structures,rubberized safety surfacing and outdoor fitness equipment. Ortco, Inc. is DIR registered and we are compliant with all DIR requirements as well as OSHA safety regulations for our industry. Ortco, Inc. has an industry reputation for reliability, commitment, dedication and high quality construction. Ortco,Inc. is a family ran company known for its collaboration of flexibility to partner with. • Ortco, Inc. 2163 N. Glassell St. Orange, CA 92865 P: 714-998-3998 F: 714-998-3996 111 bRTCO INC. 2163 N.Glasse!!Street Orange,CA 92865 Office:714-998=3998 Fax:714-998-3996 info@ortcopfays:coin Friday,May 8,2020 Reference Letter City of Anaheim—Yorba and Boysen Park Contract Amount-Yorba Park-$24,310 and Boysen Park$14,980.00 Description Installation of play equipment and pour-in-place rubber surfacing Contact-Linda McDonald(714)765-5100 City of Seal Beach—Edison Park Contract Amount-$6,800 Description—Installation of Shade Shelter Contact—Joseph Talarico(562)431-2524 Ext 1318 City of Yucaipa—Ave I Park Contract Amount-$29,742.83 Description—Demo of existing equipment,installation of new playground equipment and concrete ADA ramp. Contact—Scott Washburn(909)649-5981 Ortco, Inc. 2163 N. Glassell St. Orange, CA 92865 P: 714-998-3998 F: 714-998-3996 1 ORiCQJNC� 2163 N.Glasse11 Street Orange,CA 92865 Phone 714.996.3998 FAX 714.998.3996 Email ortcopiaysOaol.com Our proposal includes,removing and disposing of the existing playground while leaving the saddle seat in place at Sally Tanner Park.The installation of the new Miracle Recreation playground equipment following the manufacturer's specifications.We will install the playground according to the Miracle drawing R0036_4380215156. Ortco is a certified playground installer.After completion we will then hire a third party certified playground inspector to inspect the playground. If you have any questions please feel free to contact me directly at 714-998-3998 or by email at lynn@ortcoplays.com. Best Regards, Lynn A. Ortlieb President Ortco, Inc. 2163 N. Glassell St. Orange, CA 92865 P: 714-998-3998 F: 714-998-3996 ; 1' Tanner Park - Playground Replacement Option 2 Rosemead, CA wr<xnsxGIS • 2-12 WELCOME SIGN II ': :NDING: - -12 ../:: Existing Saddle Seat e BONGO STEPS TRANSFER W/HAND SUPPORTS POINT RAVINE SWOOP Existing Swings ,♦, /�O/ VE / HULA , 'I:I'I:I:I:I:ICLIMBER■■ ■•■ CHAM:LEON I SUOE \�� , dt �47 CHAME ON II ��r100„ki. L-SLIDE VOR y D•UBLE EN"Y SLIDE HOW T �' RUPAN.L I C • ELEON I SLIDE �� `�l it5'HONEYCOM• CLIMBER ,, Miracle. . To R0036 43802615156 by promote safe and proper equipment use MIRACLE PLAYGROUND SALES, INC. bychitdren.Miraderecommendstne Installation of either a Mirade safety sign or 9106 Pulsar Ct,Suite C PHONE NO:{800)264-7225 — other appropriate safety signage near each Corona,CA FAX NO:(877)215-3869 playsystem s main entry point(s)to inform parents and supervisors of the age appropriateness ene al rules�o�e playysystem and AN ENERGY ABSORBING PROTECTIVE GROUND SPACE 2r-0"x 36•-0" playsystem PROTECT(VEAREk 39%6"x 36-6- SURFACE IS REQUIRED UNDER&AROUND ALL PLAY SYSTEMS RAWN BY:Robert Fryhoff I DATE 12132019 ` r� l/ ORTCO INC. License#657695 'QUOTE 2163 N.Glassell Street DATE QUOTE# Orange,CA 92865 714 998-3998 5/11/2020 2019-891 714 998-3996 Fax DIR#1000001641 NAME/ADDRESS CITY OF ROSEMEAD 8838 EAST VALLEY BLVD ROSEMEAD,CA 91770 PROJECT TANNER PARK OPTION 2 ITEM DESCRIPTION QTY COST TOTAL DEMO DEMO AND DISPOSE OF EXISTING EQUIPMENT(SWINGS AND SADDLE 3,200.00 3,200.00 SEAT TO REMAIN IN PLACE) INSTALL INSTALLATION ONLY OF MIRACLE RECREATION EQUIPMENT-REFER 7,000.00 7,000.00 TO MREC DRAWING R0036_43802615156 TO BE INSTALLED PER MANUFACTURER'S SPECIFICATIONS. ORTCO IS A MREC CERTIFIED INSTALLER INSPECTION THIRD PARTY INSPECTOR TO BE HIRED BY THE CITY.ORTCO IS NOT RESPONSIBLE TO PROVIDE THE CERTIFIED PLAYGROUND SAFETY INSPECTOR. EXCLUSIONS EXCLUSIONS:DELIVERY/UNLOADING,DEMO AND/OR REMOVAL OF ANY EXISTING EQUIPMENT OR STRUCTURES,SAFETY SURFACING, ASPHALT,CONCRETE,BORDERS,CURBS,SUB-BASE AND COMPACTION. ANY OTHER ITEMS OTHER THAN THOSE SPECIFICALLY STATED IN THIS QUOTE. PERMITS NOT INCLUDED. AREA TO BE CLEAR di LEVEL. UNDERGROUND UTILITIES MUST BE MARKED. NOT RESPONSIBLE FOR DELAYS CAUSED BY WEATHER. DIR REQUIREME... WHEN REQUIRING CERTIFIED PAYROLL TO BE UPLOADED ON THE DIR WEBSITE,PLEASE FORWARD YOUR DIR PROJECT NUMBER TO US ALONG WITH YOUR PO BEFORE COMMENCEMENT OF THE PROJECT SO WE MAKE SURE WE ARE COMPLIANT IN SUBMITTING ALL PAYROLLS IN A TIMELY MANNER. PRICES PRICES ARE GOOD FOR 60 DAYS IF YOU HAVE ANY QUESTIONS PLEASE CALL BILLY POLICE TOTAL $10,200.00 AT 714.998.3998 SIGNATURE ORTCO INC • 2163 N.Glassell Street Orange,CA 92865 Office:714-998-3998 Fax:714-998-3996 info@ortcoplays.com Wage Determination provided by the DIR SC-23-102-2-2019-2 Expiration Date 6/30/2020 Laborer Group 3 Ortco, Inc. 2163 N. Glassell St. Orange, CA 92865 P: 714-998-3998 F: 714-998-3996 111111 } GENERAL PREVAILING WAGE DETERMINATION MADE BY THE DIRECTOR OF INDUSTRIAL RELATIONS PURSUANT TO CALIFORNIA LABOR CODE PART 7,CHAPTER 1,ARTICLE 2,SECTIONS 1770, 1773 AND 1773.1 FOR COMMERCIAL BUILDING,HIGHWAY,HEAVY CONSTRUCTION AND DREDGING PROJECTS CRAFT: #LABORER AND RELATED CLASSIFICATIONS DETERMINATION: SC-23-102-2-2019-2 ISSUE DATE:August 22,2019 EXPIRATION DATE OF DETERMINATION:June 30,2020**The rate to be paid for work performed after this date has been determined.If work will extend past this date,the new rate must be paid and should be incorporated in contracts entered into now.Contact the Office of the Director-Research Unit for specific rates at(415)703-4774. LOCALITY: All localities within Imperial,Inyo,Kern,Los Angeles,Mono,Orange,Riverside,San Bernardino,San Luis Obispo, Santa Barbara,and Ventura counties. Employer Payments Straight-Time Overtime Hourly Rates Classification a Basic Health Pension Vacation/ Training Other Hours Total Dailyb Saturdayb0 Sunday (Journeyperson) Hourly and and Payment Hourly and Rate Welfare Holidayd Rate 1 I/2X 1 1/2X Holiday CLASSIFICATION GROUPS Group 1 $35.24 7.47 8.90 4.87 0.69 0.61 8 57.78 75.400 75.400 93.02 Group 2 35.79 7.47 8.90 4.87 0.69 0.61 8 58.33 76.225 76.225 94.12 (Gsoii 3f 13G.34-.�.-7:47 ;8;90--1- `t3.7 0 69 T_0 61-.- $-_ 5�88 v7.7,.050 7.7:050 -9-52T--). Group 4 37.89 7.47 -8.90 4.87 0.69 0.61 8 60.43 79.375 79.375 98.32 Group 5 38.24 7.47 8.90 4.87 0.69 0.61 8 60.78 79.900 79.900 99.02 • #Indicates an apprenticeable craft. The current apprentice wage rates are available on the Internet @ http://www.dir.ca.gov/OPRLIPWAppWage/PWAppWageStart.asp. To obtain any apprentice wage rates as of July 1,2008 and prior to September 27,2012,please contact the Division of Apprenticeship Standards or refer to the Division of Apprenticeship Standards'website at http://www.dir.ca.gov/das/das.html. a For classification within each group,see page 14. b Any hours worked over 12 hours in a single workday are double(2)time. Saturdays in the same work week may be worked at straight-time if job is shut down during work week due to inclement weather or similar Act of God,or a situation beyond the employers control. d Lncludes an amount per hour worked for supplemental dues RECOGNIZED HOLIDAYS:Holidays upon which the general prevailing hourly wage rate for Holiday work shall be paid,shall be all holidays in the collective bargaining agreement,applicable to the particular craft,classification,or type of worker employed on the project,which is on file with the Director of Industrial Relations. If the prevailing rate is not based on a collectively bargained rate,the holidays upon which the prevailing rate shall be paid shall be as provided in Section 6700 of the Government Code. You may obtain the holiday provisions for the current determinations on the Internet at http:/lwww:dir.ca.gov/OPRL/DPreWageDetermination.htm. Holiday provisions for current or superseded determinations may be obtained by contacting the Office of the Director-Research Unit at(415)703-4774. TRAVEL AND/OR SUBSISTENCE PAYMENT:In accordance with Labor Code Sections 1773.1 and 1773.9,contractors shall make travel and/or subsistence payments to each worker to execute the work. You may obtain the travel and/or subsistence provisions for the current determinations on the Internet at http://www.dir.ca.gov/OPRL/DPreWageDetermination.htm. Travel and/or subsistence requirements for current or superseded determinations may be obtained by contacting the Office of the Director- Research Unit at(415)703-4774. 13 DETERMINATION:SC-23-102-2-2019-2 CLASSIFICATION GROUPS GROUP 1 GROUP 2(continued), Boring Machine Helper(Outside) Tank Scaler and Cleaner Certified Confined Space Laborer Tree Climber,Faller,Chain Saw Operator,Pittsburgh Chipper and similar type Cleaning and Handling of Panel Forms Brush Shredders Concrete Screeding for Rough Strike-Off Underground Laborer,including Caisson Bellower Concrete,Water Curing Demolition Laborer,the cleaning of brick if performed by an employee GROUP 3 performing any other phase of demolition work,and the cleaning of lumber Asphalt Installation of all fabrics Fiberoptic Installation,Blowing,Splicing,and Testing Technician on public Buggymobile Man right-of-way only Compactor(alt types including Tampers,Barko,Wacker) Fire Watcher,Limbers,Brush Loaders,Pilers and Debris Handlers Concrete Cutting Torch Flagman Concrete Pile Cutter Gas,Oil and/or Water Pipeline Laborer Driller,Jackhammer,21/2 ft.drill steel or longer Laborer,Asphalt-Rubber Material Loader Dri Pak-it Machine Laborer,General or Construction Gas,Oil and/or Water Pipeline Wrapper-6-inch pipe and over by any method, Laborer,General Cleanup inside and out Laborer,Jetting Impact Wrench,Multi-Plate Laborer,Temporary Water and Air Lines Kettlemen,Potmen and Men applying asphalt,lay-kold,creosote,lime caustic Plugging,Filling of Shee-Bolt Holes;Dry Packing of Concrete and Patching and similar type materials Post Hole Digger(Manual) tiailforecizeirceEi.lelffl Railroad Maintenance,Repair Trackman and Road Beds;Streetcar and Railroad Material Hoseman(Walls,Slabs,Floors and Decks) Construction Track Laborers Operators of Pneumatic,Gas,Electric Tools,Vibrating Machines,Pavement Rigging and Signaling Breakers,Air Blasting,Come-Alongs,and similar mechanical tools not Scaler separately classified herein;operation of remote controlled robotic tools in Slip Form Raisers connection with Laborers work Taxman and Mortar Man Pipelayer's backup man,coating,grouting,making of joints,sealing,caulking, Tool Crib or Tool House Laborer diapering and including rubber gasket joints,pointing and any and all other Traffic Control by any method services \Vater Well Driller Helper Power Post Hole Digger Window Cleaner Rock Slinger Wire Mesh Pulling-All Concrete Pouring Operations Rotary Scarifier or Multiple Head Concrete Chipping Scarifier Steel Headerboard Man and Guideline Setter GROUP 2 Trenching Machine,Hand Propelled Asphalt Shoveler Cement Dumper(on 1 yard or larger mixer and handling bulk cement) GROUP 4 Cesspool Digger and Installer Any Worker Exposed to Raw Sewage Chucktender Asphalt Raker,Luteman,Ironer,Asphalt Dumpman,and Asphalt Spreader Chute Man,pouring concrete,the handling of the chute from readymix trucks, Boxes(all types) such as walls,slabs,decks,floors,foundations,footings,curbs,gutters and Concrete Core Cutter(walls,floors or ceilings),Grinder or Sander sidewalks Concrete Saw Man,Cutting Walls or Flat Work,Scoring old or new concrete Concrete Curer-Impervious Membrane and Form Oiler Cribber,Shorey,Lagging,Sheeting and Trench Bracing,Hand-Guided Lagging Cutting Torch Operator(Demolition) Hammer Fine Grader,Highways and Street Paving,Airport,Runways,and similar type Head Rock Slinger heavy construction High Scaler(including drilling of same) Gas,Oil and/or Water Pipeline Wrapper-Pot Tender and Form Man Laborer,Asphalt-Rubber Distributor Bootman Guinea Chaser Laser Beam in connection with Laborer's work Headerboard Man-Asphalt Oversize Concrete Vibrator Operator,70 pounds and over Installation of all Asphalt Overlay Fabric and Materials used for Reinforcing Pipelayer Asphalt Prefabricated Manhole Installer Laborer,Packing Rod Steel and Pans Sandblaster(Nozzleman),Water Blasting,Porta Shot-Blast Membrane Vapor Barrier Installer Subsurface Imaging Laborer Power Broom Sweepers(small) Traffic Lane Closure,certified Riprap,Stonepaver,placing stone or wet sacked concrete Roto Scraper and Tiller GROUP 5 Sandblaster(Pot Tender) Blasters Powdennan Septic Tank Digger and Installer(leadman) Driller Toxic Waste Removal Welding,certified or otherwise in connection with Laborers'work 14 SURETEC INSURANCE COMPANY The Final Premium is BOND NO. 4435075 Predicated on the Final Contract Price PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: That we, ORTCO, INC., as Principal, and SURETEC INSURANCE COMPANY, a TEXAS corporation, as Surety, are held and firmly bound unto CITY OF ROSEMEAD as Obligee, in the sum of TEN THOUSAND TWO HUNDRED AND 00/100 DOLLARS ($10,200.00), for which sum, we bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, by these presents. WHEREAS, the Principal entered into a contract with the Obligee for SALLY TANNER PARK PLAYGROUND, which contract is by reference made a part hereof and is hereafter referred to as.the Contract: NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That, if the Principalshall faithfully perform said contract according to its terms, covenants, and conditions, then this obligation shall be void; otherwise it shall remain in full force and effect. The warranty period for this bond shall be one year from date of acceptance of work by Obligee. . Dated this 19TH day of JUNE, 2020. ORTCO, INC. . . By: PRINCIPAL SURETEC INSURANCE COMPANY MATTHEW R. DOBYNS, A ORNEY-IN-FACT POA#: 510014 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas,and having its principal office in Houston,Harris County, Texas,does by these presents make,constitute and appoint Randy Spohn,Matthew R.Dobyns,Ashley M.Spohn its true and lawful Attorney-in-fact,with full power and authority hereby conferred in its name,place and stead,to execute,acknowledge and deliver any and all bonds,recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for,providing the bond penalty does not exceed Five Million and 001100 Dollars($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO,sealed with the corporate seal of the Company and duly attestedby its Secretary, hereby refitting and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute,acknowledge and -. deliver,any and all bonds,recognizanccs,contracts,agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile.and any power of attorney or certificate bearing facsimile signature or tkesimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.'(Adopted ata meeting held on 20a,of April, 1999) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its CEO,and its corporate seal to be hereto affixed this 2nd day of May ,A.D.2019. ��aaNp SURETEC 'TTCE ' 'ANY ,�'• A 4G � •Q �' By: w{ r,1 Ir John . Jr.,C^s? State of Texas ss: 7d,1,,� d .Y County of Harris �--•� On this 2nd day of May ,A.D.2019 before me personally came John Knox Jr.,to me known,who,being by me duly sworn,did depose and say,. that he resides in Houston,Texas,that he is CEO of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument;that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the Board of Directors of said Company;and that he signed his name thereto by like order. tag P'0 fJ„rarvu•.:,e.`:r,rn of ,exc4. -�'• t4 Con,•,.,rri,:r ..:09-10-2020 I � '. ,vsu y : 129117059 Xe avez,Notary Public =Y 7LNI commission expires September 1 ,2020 I,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set out in the Power of Attorney are in full force and effect. 19th June 2020 Given under my hand and the seal of said Company at Houston,Texas this day of / ,A.D. Br t :eaty,Assi tant Secreta Any instrument Issued In excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call(713)812-0800 any business day between B:30 am and 5:00 pm CST. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy,or validity of that document. State of CALIFORNIA County of ORANGE On June 19th, 2020 before me,ASHLEY MARIE SPOHNP NOTARY PUBLIC. personally appeared MATTHEW R. DOBYNS ►: who proved to me on the basis of satisfactory evidence to be the person(s) whose name( is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity O, and that by his/her/their signature(s) on the y, instrument the person(s), or the entity upon behalf of which the person(s) ` ASHLEY MARIE SPOHN IF acted, executed the instrument. COMM.#2188665 NOTARY PUBLIC CALIFORNIA a ♦' 4?% ORANGE COUNTY N I certify under PENALTY OF PERJURY under the laws of the State of j� My cornexpiresMar.27.2021 t California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. , WO/Lk Sig re of Notary --. Y Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL O CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ►�� ATTORNEY-IN-FACT ❑ TRUSTEE(S) ® GUARDIAN/CONSERVATOR ❑ OTHER SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) ,f. SURETEC INSURANCE COMPANY BOND NO. 4435075 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS: That ORTCO, INC.,(hereinafter called the Principal),_ as Principal, and SURETEC INSURANCE COMPANY. a TEXAS corporation (hereinafter called Surety), as Surety, are held and firmly bound unto CITY OF ROSEMEAD. as Obligee(hereinafter called Owner), in the amount of TEN THOUSAND TWO HUNDRED AND 00/100 DOLLARS ($10.200.00), for the payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns,jointly and severally,firmly by these presents. Whereas, Principal entered into a contract with Owner SALLY TANNER PARK PLAYGROUND, in accordance with drawings and specifications, which contract is by reference made a part hereof, and a copy thereof is or may be attached.hereto. Now, Therefore, The Condition of This Obligation Is Such, That, if the Principal shall pay, or cause to be paid in full, the claims of all persons designated in Sections 3110 or 3112 of the Civil Code of the State of California then this obligation shall be void; otherwise it shall remain in full force and effect. This bond is executed for the purpose of complying with the laws of the State of California as contained in Sections 3235 to 3241 inclusive of the Civil Code and all acts amendatory thereof, and this bond shall inure to the benefit of any and all persons designated in Sections 3110 or 3112, Civil Code of the State of California,so as to give such persons a right of action to recover upon this bond in any suit brought to foreclose the liens provided for by the laws of the State of California, or in a separate suit brought on this bond. No right of action shall accrue hereunder to or for the use of any persons expect persons designated in Section 3110 or 3112, Civil.Code of the State of California as foresaid. The total amount of the Surety's liability under this bond to any and all persons shall in no event exceed the amount named in the first paragraph hereof. No suit, action or proceeding to recover on this bond shall be sustained unless the same be commenced within six (6) months from the completion of said structure or work of improvement, as°completion"is defined in Section 3086 of the Civil Code of California. Signed and sealed this 190'day of JUNE.2020. ORTCO, INC. By: PRINCIPAL SURETEC SURANCE COMPANY By: ( _ MATTHEW R. DOBYNS,ATTORNEY -FACT POA e, 510014 pp SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and „f existing under the laws of the State of Texas, and having its principal office in Houston,Harris County, Texas,does by these presents. . make,constitute and appoint Randy Spohn,Matthew R.Dobyns,Ashley M.Spohn its true and lawful Attorney-in-fact,with full power and authority hereby conferred in its name,place and stead,to execute,acknowledge and deliver any and all bonds,recognizances, undertakings or other insttvments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for,providing the bond penalty does not exceed Five Million and 001100 Dollars($5,000,000.00) end to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO,sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute,acknowledge and deliver,any and all bonds,recognizances,contracts,agreements or indemnity and other conditional or obligatory undertakings and any and all noticesand documents canceling or terminating the Company's liability thereunder, and any such instruments so executedby any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved.that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and anypower of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 206 of Apra 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signedby its CEO, and its corporate seal to be hereto affixed this 2osd day of May ,A.D.2019. SURETEC CE, PANY �SURANCF � �V J -7 C\ By: 1 iIw,0' John l"Jr.,C^a State of Texas ss: 1,%. 4 G'A'Y ? County of Harris On this 2nd day of May ,A.D.2019 before me personally came John Knox Jr.,to me known,who,being by me duty sworn,did depose and say, that he resides in Houston,Texas, that he is CEO of SURETEC INSURANCE COMPANY,the company described in and which executed the above instrument;that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the Board of Directors of said Company;and that he signed his name thereto by like order. sPW19 11 - v'•.. tR= (;omn.,•exiu•es u9-!0•2.02C°;• iD 12f.#117659 Xe ' avez,Notary Public ° commission expires September 1 2020 1,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set out in the Power of Attorney are in.full force and effect. Given under my hand and the seal of said Company at Houston,Texas this 19thday of June 2020 A.D. e � Br t :eaty,Ass' tent Secrete Any Instrument issued In excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call(713)812-0800 any business day between 8:30 am and 5:00 pm CST. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT -- - _..a A notary public or other officer completing this certificate verifies only the identity of the • individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of ORANGE June 19th, 2020 On before me, ASHLEY MARIE SPOHN. NOTARY PUBLIC, personally appeared MATTHEW R. DOBYNS ►Z� who proved to me on the basis of satisfactory evidence to be the person(s) whose namc(s)is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(les), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the persons} ASHLEY MARIE SPOHNacted, executed the instrument. Nl �� `�•� COMM.#2188665 I';4;Lr NOTARY PUBLIC CALIFORNIA 5o vizor. ORANGE COUNTY N I certify under PENALTY OF PERJURY under the laws of the State of My comm.expires Mar.27,2021 It California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ti • A Si a ure of Notary (7. - -- - - ...__-- _ .r y�- — �� ,r}f }r _ _ _ _ _ _ _ Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) 0 LIMITED e ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) ORTCO, INC. EXHIBIT B INSURANCE REQUIREMENTS Prior to the beginning of and throughout the duration of the Work, Contractor will maintain insurance in conformance with the requirements set forth below. Contractor will use existing coverage to comply with these requirements. If that existing coverage does not meet the requirements set forth here, Contractor agrees to amend, supplement or endorse the existing coverage to do so. Contractor acknowledges that the insurance coverage and policy limits set forth in this section constitute the minimum amount of coverage required. Any insurance proceeds available to City in excess of the limits and coverage required in this Contract and which is applicable to a given loss, will be available to City. Contractor shall provide the following types and amounts of insurance: Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance with coverage at least as broad as Insurance Services Office form CG 00 01, in an amount not less than $1,000,000 per occurrence, $2,000,000 general aggregate, for bodily injury, personal injury, and property damage, and a $2,000,000 completed operations aggregate. The policy must include contractual liability that has not been amended. Any endorsement restricting standard ISO "insured contract" language will not be accepted. Automobile liability insurance. Contractor shall maintain automobile insurance at least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with Work to be performed under this Agreement, including coverage for any owned, hired, non-owned or rented vehicles, in an amount not less than $1,000,000 combined single limit for each accident. Workers' compensation insurance. Contractor shall maintain Workers' Compensation Insurance (Statutory Limits) and Employer's Liability Insurance (with limits of at least $1,000,000) for Contractor 's employees in accordance with the laws of the State of California, Section 3700 of the Labor Code 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, Section 3700 for all of the subcontractor's employees. Excess or Umbrella Liability Insurance. (Over Primary)Contractorshall obtain and maintain an umbrella or excess liability insurance policy that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automobile liability, and employer's liability. Such policy or policies shall include the following terms and conditions: Contractor shall obtain and maintain an umbrella or excess liability insurance policy that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automobile liability, and employer's liability. Such policy or policies shall include the following terms and ORTCO, INC. conditions: • A drop down feature requiring the policy to respond in the event that any primary insurance that would otherwise have applied proves to be uncollectable in whole or in part for any reason; • Pay on behalf of wording as opposed to reimbursement; • Concurrency of effective dates with primary policies; and • Policies shall "follow form" to the underlying primary policies. • Insureds under primary policies shall also be insureds under the umbrella or excess policies. Builder's risk insurance. Upon commencement of construction and with approval of Agency, Contractor shall obtain and maintain builder's risk insurance for the entire duration of the Project until only the Agency has an insurable interest. The Builder's Risk coverage shall include the coverages as specified below. The named insureds shall be Contractor and Agency, including its officers, officials, employees, and agents.All Subcontractors (excluding those solely responsible for design Work) of any tier and suppliers shall be included as additional insureds as their interests may appear. Contractor shall not be required to maintain property insurance for any portion of the Project following transfer of control thereof to Agency. The policy shall contain a provision that all proceeds from the builder's risk policy shall be made payable to the Agency. The Agency will act as a fiduciary for all other interests in the Project. Policy shall be provided for replacement value on an "all risk" basis for the completed value of the project. There shall be no coinsurance penalty or provisional limit provision in any such policy. Policy must include: (1) coverage for any ensuing loss from faulty workmanship, Nonconforming Work, omission or deficiency in design or specifications; (2) coverage against machinery accidents and operational testing; (3)coverage for removal of debris, and insuring the buildings, structures, machinery, equipment, materials, facilities, fixtures and all other properties constituting a part of the Project; (4) Ordinance or law coverage for contingent rebuilding, demolition, and increased costs of construction; (5) transit coverage (unless insured by the supplier or receiving contractor), with sub-limits sufficient to insure the full replacement value of any key equipment item; (6)Ocean marine cargo coverage insuring any Project materials or supplies, if applicable; (7) coverage with sub-limits sufficient to insure the full replacement value of any property or equipment stored either on or off the Site or any staging area. Such insurance shall be on a form acceptable to Agency to ensure adequacy of terms and sublimits and shall be submitted to the Agency prior to commencement of construction. Insurance procured pursuant to these requirements shall be written by insurers that are admitted carriers in the state of California and with an A.M. Bests rating of A-or better and a minimum financial size VII. General conditions pertaining to provision of insurance coverage by Contractor. Contractor and City agree to the following with respect to insurance provided by ORTCO,INC. Contractor: 1. Contractor agrees to have its insurer endorse the third party General liability policies shall provide or be endorsed to provide that Agency and its officers, officials, employees, agents, and volunteers shall be additional insurer under such policies using standard ISO endorsement No. CG 2010. Contractor also agrees to require all contractors, and subcontractors to do likewise. 2. No liability insurance coverage provided to comply with this Contract shall prohibit Contractor, or Contractor's employees, or agents, from waiving the right of subrogation prior to a loss. Contractor agrees to waive subrogation rights against City regardless of the applicability of any insurance proceeds, and to require all contractors and subcontractors to do likewise. 3. All insurance coverage and limits provided by Contractor and available or applicable to this Contract are intended to apply to the full extent of the policies. Nothing contained in this Contract or any other Contract relating to the City or its operations limits the application of such insurance coverage. 4. None of the coverage required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved of in writing. 5. No liability policy shall contain any provision or definition that would serve to eliminate so-called "third party action over"claims, including any exclusion for bodily injury to an employee of the insured or of any contractor or subcontractor. 6. All coverage types and limits required are subject to approval, modification and additional requirements by the City, as the need arises. Contractor shall not make any reductions in scope of coverage (e.g. elimination of contractual liability or reduction of discovery period) that may affect City's protection without City's prior written consent. 7. Proof of compliance with these insurance requirements, consisting of certificates of insurance evidencing all of the coverage required and an additional insured endorsement to Contractor's general liability policy, shall be delivered to City at or prior to the execution of this Contract. In the event such proof of any insurance is not delivered as required, or in the event such insurance is canceled at any time and no replacement coverage is provided, City has the right, but not the duty, to obtain any insurance it deems necessary to protect its interests under this or any other Contract and to pay the premium. Any premium so paid by City shall be charged to and promptly paid by Contractor or deducted from sums due Contractor, at City option. 8. Certificate(s) are to reflect that the insurer will provide 30 days notice to City of any cancellation of coverage. Contractor agrees to require its insurer to modify such certificates to delete any exculpatory wording stating that failure of the insurer to ORTCO, INC. mail written notice of cancellation imposes no obligation, or that any party will "endeavor" (as opposed to being required) to comply with the requirements of the certificate. 9. It is acknowledged by the parties of this Contract that all insurance coverage required to be provided by Contractor or any subcontractor, is intended to apply first and on a primary, noncontributing basis in relation to any other insurance or self insurance available to City. 10.Contractor agrees to ensure that subcontractors, and any other party involved with the project who is brought onto or involved in the project by Contractor, provide the same minimum insurance coverage required of Contractor. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Contractor agrees that upon request, all Contracts with subcontractors and others engaged in the project will be submitted to City for review. 11.Contractor agrees not to self-insure or to use any self-insured retentions or deductibles on any portion of the insurance required herein and further agrees that it will not allow any contractor, subcontractor, Architect, Engineer or other entity or person in any way involved in the performance of work on the project contemplated by this Contract to self-insure its obligations to City. If Contractor's existing coverage includes a deductible or self-insured retention, the deductible or self- insured retention must be declared to the City. At that time the City shall review options with the Contractor, which may include reduction or elimination of the deductible or self-insured retention, substitution of other coverage, or other solutions. 12.The City reserves the right at any time during the term of the contract to change the amounts and types of insurance required by giving the Contractor ninety (90) days advance written notice of such change. If such change results in substantial additional cost to the Contractor, the City will negotiate additional compensation proportional to the increased benefit to City. 13.For purposes of applying insurance coverage only, this Contract will be deemed to have been executed immediately upon any party hereto taking any steps that can be deemed to be in furtherance of or towards performance of this Contract. 14.Contractor acknowledges and agrees that any actual or alleged failure on the part of City to inform Contractor of non-compliance with any insurance requirement in no way imposes any additional obligations on City nor does it waive any rights hereunder in this or any other regard. 15.Contractor will renew the required coverage annually as long as City, or its employees or agents face an exposure from operations of any type pursuant to this Contract. This obligation applies whether or not the Contract is canceled or ORTCO, INC. terminated for any reason. Termination of this obligation is not effective until City executes a written statement to that effect. 16.Contractor shall provide proof that policies of insurance required herein expiring during the term of this Contract have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. A coverage binder or letter from Contractor's insurance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City within five days of the expiration of the coverage. 17.The provisions of any workers' compensation or similar act will not limit the obligations of Contractor under this Contract. Contractor expressly agrees not to use any statutory immunity defenses under such laws with respect to City, its employees, officials and agents. 18.Requirements of specific coverage features or limits contained in this section are not intended as limitations on coverage, limits or other requirements nor as a waiver of any coverage normally provided by any given policy. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue, and is not intended by any party or insured to be limiting or all-inclusive. 19.These insurance requirements are intended to be separate and distinct from any other provision in this Contract and are intended by the parties here to be interpreted as such. 20.The requirements in this Section supersede all other sections and provisions of this Contract to the extent that any other section or provision conflicts with or impairs the provisions of this Section. 21.Contractor agrees to be responsible for ensuring that no contract used by any party involved in any way with the project reserves the right to charge City or Contractor for the cost of additional insurance coverage required by this Contract. Any such provisions are to be deleted with reference to City. It is not the intent of City to reimburse any third party for the cost of complying with these requirements. There shall be no recourse against City for payment of premiums or other amounts with respect thereto. Contractor agrees to provide immediate notice to City of any claim or loss against Contractor arising out of the work performed under this Contract. City assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve City. l ® DATE(MM/DD/YYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 6/22/2020 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). CONTACT PRODUCER Edgewood Partners Insurance Center(EPIC) NAME: 19000 MacArthur Blvd.PH Floor (A/CC.No,Ext): (949)263-0606 ONE INC,No): (949)263-0906 Irvine, CA 92612 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# www.edgewoodins.com INSURERA: Admiral Insurance Company 24856 INSURED INSURER B: Redwood Fire and Casualty Insurance Co 11673 Ortco, Inc. 2163 N.Glassell Avenue INSURER C: Cypress Insurance Company 10855 Orange CA 92186 INSURER D: RSUI Indemnity Company 22314 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 56099594 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 INSURANCE ADDL SUBR POLICY NUMBER (MM/POLDD/ /YYYY) (MM/CY EFF DDIIYYYYY) LIMITS Y EXP LTR INSD WVD A / COMMERCIAL GENERAL LIABILITY CA000005173-17 6/21/2020 6/21/2021 EACH OCCURRENCE $1,000,000 DAMAGE RENTED CLAIMS-MADE ,/ OCCUR PREM SESO(Ea occurrence) $50,000 ,/ 5,000 Ded per Occurrence MED EXP(Any one person) $Excluded PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _GENERAL AGGREGATE $2,000,000 POLICY I ECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 01APM02105202 6/21/2020 6/21/2021 COMBINEDtSINGLE LIMIT $1,000,000 (Ea acANY AUTO BODILY INJURY(Per person) $ OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY ✓ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY $1,000 ded Comp/Coll (Per accident) ✓ $2,500 ded Cc,m Coll (Trailers only) $ D UMBRELLA LIAB / OCCUR NHA249682 6/21/2020 6/21/2021 EACH OCCURRENCE $1,000,000 ,/ EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED RETENTION SO Policy on Folow Form $ C WORKERS COMPENSATION ORWC006714 10/1/2019 10/1/2020 �/ STATUTE ETH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Sally Tanner Park,4701-4899 Delta Ave.,Rosemead,CA 91770 Certificate Holder is additional insured as respects General Liability per forms CG2010 and CG2037&Auto per form M5876 05/16 ,but only if required by signed written contract with Named Insured prior to an occurrence.Blanket Primary Wording form CG2001,and Blanket Waiver of Subrogation form CG24040509 apply to General Liability.Workers Compensation Blanket Waiver of Subrogation per Form WC99041 OA but only if required by written contract.Subject to all policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Rosemead THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 8838 E.Valley Blvd. ACCORDANCE WITH THE POLICY PROVISIONS. Rosemead CA 91770 AUTHORIZED REPRESENTATIVERwsli pi'. 1 Anthony D'Asaro (` ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 56099594 120-21 Master 1 Denise Yamada 16/22/2020 10:24:08 AM (PDT) 1 Page 1 of 6 AGENCY CUSTOMER ID: LOC#: ACCORD ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Edgewood Partners Insurance Center(EPIC) Ortco Inc. 2163 N.Glasse!!Avenue POLICY NUMBER Orange CA 92186 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:Certificate of Liability(03/16) HOLDER: City of Rosemead ADDRESS:8838 E.Valley Blvd.Rosemead CA 91770 Additional Insureds: The City of Rosemead, including its officers, officials, employees and agents. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 56099594 l 20-21 Master 1 Denise Yamada 1 6/22/2020 10:24:06 AM (PDT) I Page 2 of 6 6/22/2020 Ortco, Inc. Policy Number: CA000005173-17 CG 2010 04 13 Effective Date:06/21/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s)Of Covered Operations ANY PERSON OR ORGANIZATION THAT IS AN ALL LOCATIONS OTHERWISE COVERED BY THIS OWNER OF REAL PROPERTY OR PERSONAL INSURANCE PROPERTY ON WHICH YOU ARE PERFORMING ONGOING OPERATIONS,OR A CONTRACTOR ON WHOSE BEHALF YOU ARE PERFORMING ONGOING OPERATIONS,BUT ONLY IF COVERAGE AS AN ADDITIONAL INSURED IS REQUIRED BY A WRITTEN CONTRACT OR WRITTEN AGREEMENT THAT IS AN "INSURED CONTRACT",AND PROVIDED THAT THE "BODILY INJURY","PROPERTY DAMAGE"OR "PERSONAL AND ADVERTISING INJURY"FIRST OCCURS SUBSEQUENT TO THE EXECUTION OF THE CONTRACT OR AGREEMENT. ;Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to include However: as an additional insured the person(s)or organization(s) shown in the Schedule,but only with respect to liability 1. The insurance afforded to such additional insured for"bodily injury","property damage"or"personal and only applies to the extent permitted by law;and advertising injury"caused,in whole or in part,by: 2. If coverage provided to the additional insured is 1. Your acts or omissions;or required by a contract or agreement,the insurance afforded to such additional insured will not be 2. The acts or omissions of those acting on your be- broader than that which you are required by the con- half; tract or agreement to provide for such additional in- in the performance of your ongoing operations for the sured. additional insured(s)at the location(s)designated above. CG 20 10 04 13 ©Insurance Services Office,Inc.,2012 Page 1 of 2 ❑ 56099594 1 20-21 Master 1 Denise Yamada 1 6/22/2020 10:24:08 AM (PDT) 1 Page 3 of 6 B. With respect to the insurance afforded to these addi- C. With respect to the insurance afforded to these addi- tional insureds,the following additional exclusions ap- tional insureds,the following is added to Section III— ply: Limits Of Insurance: This insurance does not apply to "bodily injury"or If coverage provided to the additional insured is re- "property damage"occurring after: quired by a contract or agreement,the most we will pay 1. All work,including materials,parts or equipment on behalf of the additional insured is the amount of in- furnished in connection with such work,on the pro- surance: ject(other than service,maintenance or repairs)to 1. Required by the contract or agreement;or be performed by or on behalf of the additional in- 2. Available under the applicable Limits of Insurance sured(s)at the location of the covered operations shown in the Declarations; has been completed;or whichever is less. 2. That portion of"your work"out of which the injury This endorsement shall not increase the applicable Lim- or damage arises has been put to its intended use by its of Insurance shown in the Declarations. any person or organization other than another con- tractor or subcontractor engaged in performing op- erations for a principal as a part of the same project. CG 2010 04 13 ©Insurance Services Office,Inc.,2012 Page 2 of 2 0 56099594 120-21 Master I Denise Yamada 16/22/2020 10:24:08 AM (PDT) I Page 4 of 6 6/22/2020 Ortco, Inc. Policy Number: CA000005173-17 CG 20 37 04 13 Effective Date: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Or Organization(s) Completed Operations ANY PERSON OR ORGANIZATION THAT IS AN ALL LOCATIONS EXCEPT LOCATIONS WHERE OWNER OF REAL PROPERTY OR PERSONAL PROP- "YOUR WORK"IS OR WAS RELATED TO A JOB OR ERTY FOR WHOM YOU WORK OR HAVE WORKED, PROJECT INVOLVING SINGLE-FAMILY DWELLINGS, OR A CONTRACTOR ON WHOSE BEHALF YOU MULTI-FAMILY DWELLINGS(OTHER THAN RENTAL WORK OR HAVE WORKED,BUT ONLY IF COVER- APARTMENTS IN AN APARTMENT BUILDING:(a) AGE AS AN ADDITIONAL INSURED EXTENDING TO ORIGINALLY CONSTRUCTED AND AT ALL TIMES "BODILY INJURY"OR"PROPERTY DAMAGE"IN- USED FOR SUCH PURPOSE;OR(b)CONVERTED CLUDED IN THE"PRODUCTS-COMPLETED OPERA- FROM A COMMERCIAL BUILDING),CONDOMINI- TIONS HAZARD"IS REQUIRED BY A WRITTEN CON- UMS,TOWNHOMES,TOWNHOUSES,TIME-SHARE TRACT OR WRITTEN AGREEMENT THAT IS AN UNITS,FRACTIONAL OWNERSHIP UNITS,COOPER- "INSURED CONTRACT"AND PROVIDED THAT THE ATIVES AND/OR ANY OTHER STRUCTURE OR "BODILY INJURY" OR"PROPERTY DAMAGE"FIRST SPACE USED OR INTENDED TO BE USED AS A RESI- OCCURS SUBSEQUENT TO THE EXECUTION OF THE DENCE. CONTRACT OR AGREEMENT Information required to complete this Schedule,if not shown above,will be shown in the Declarations. CG 20 37 04 13 ©Insurance Services Office,Inc.,2012 Page 1 of 2 0 56099594 1 20-21 Master 1 Denise Yamada 1 6/22/2020 10,24:08 AM (PDT) 1 Page 5 of 6 A. Section II—Who Is An Insured is amended to in- B. With respect to the insurance afforded to these addi- dude as an additional insured the person(s)or organi- tional insureds,the following is added to Section III— zation(s)shown in the Schedule,but only with respect Limits Of Insurance: to liability for"bodily injury"or"property damage" If coverage provided to the additional insured is re- caused,in whole or in part,by"your work"at the lo- quired by a contract or agreement,the most we will cation designated and described in the Schedule of this pay on behalf of the additional insured is the amount endorsement performed for that additional insured and of insurance: included in the"products-completed operations haz- ard". 1. Required by the contract or agreement;or However: 2. Available under the applicable Limits of Insurance shown in the Declarations; 1. The insurance afforded to such additional insured only applies to the extent permitted by law;and whichever is less. 2. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement,the insurance Limits of Insurance shown in the Declarations. afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such addi- tional insured. CG 20 37 04 13 ©Insurance Services Office,Inc.,2011 Page 2 of 2 56099594 120-21 Master I Denise Yamada 16/22/2020 10:24:08 AM (PDT) 1 Page 6 of 6