HomeMy WebLinkAboutCSG, Inc. (9) CONSULTING SERVICES AGREEMENT BETWEEN
THE TOWN OF LOS ALTOS HILLS AND
CSG CONSULTANTS, INC.
THIS AGREEMENT for consulting services is made by and between the Town of Los Altos Hills
'Town")and CSG Consultants, Inc. ("Consultant") (together sometimes referred to as the "Parties")as of
til , 2012 (the"Effective Date").
Section 1. SERVICES. Subject to the terms and conditions set forth in this Agreement, Consultant
shall provide to Town the services described in the Scope of Work attached as Exhibit A at the time and
place and in the manner specified therein. In the event of a conflict in or inconsistency between the terms
of this Agreement and Exhibit A, the Agreement shall prevail.
1.1 Term of Services. The term of this Agreement shall begin on the Effective Date and shall
end on July 13, 2012, and Consultant shall complete the work described in Exhibit A on or
before that date, unless the term of the Agreement is otherwise terminated or extended, as
provided for in Section 8. The time provided to Consultant to complete the services
required by this Agreement shall not affect the Town's right to terminate the Agreement, as
referenced in Section 8.
1.2 Standard of Performance. Consultant shall perform all services required pursuant to this
Agreement in a manner consistent with the level of care and skill ordinarily exercised by
other professionals providing the same services in the San Francisco Bay Area.
1.3 Assignment of Personnel. Consultant shall assign only competent personnel to perform
services pursuant to this Agreement. In the event that Town, in its sole discretion,at any
time during the term of this Agreement, desires the reassignment of any such persons,
Consultant shall, immediately upon receiving notice from Town of such desire of Town,
reassign such person or persons.
1.4 Time. Consultant shall devote such time to the performance of services pursuant to this
Agreement as may be reasonably necessary to meet the standard of performance
provided in Section 1.1 above and to satisfy Consultant's obligations hereunder.
1.5 Public Works Requirements. Because the services described in Exhibit A include"work
performed during the design and preconstruction phases of construction including, but not
limited to, inspection and land surveying work,"the services constitute a public works
within the definition of Section 1720(a)(1) of the California Labor Code. As a result,
Consultant is required to comply with the provisions of the Labor Code applicable to public
works, to the extent set forth in Exhibit C.
Section 2. COMPENSATION. Town hereby agrees to pay Consultant a sum not to exceed $23,325,
notwithstanding any contrary indications that may be contained in Consultant's proposal,for services to be
performed and reimbursable costs incurred under this Agreement. In the event of a conflict between this
Agreement and Consultant's proposal, attached as Exhibit A, regarding the amount of compensation,the
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Agreement shall prevail. Town shall pay Consultant for services rendered pursuant to this Agreement at
the time and in the manner set forth herein. The payments specified below shall be the only payments from
Town to Consultant for services rendered pursuant to this Agreement. Consultant shall submit all invoices
to Town in the manner specified herein. Except as specifically authorized by Town in writing, Consultant
shall not bill Town for duplicate services performed by more than one person.
Consultant and Town acknowledge and agree that compensation paid by Town to Consultant under this
Agreement is based upon Consultant's estimated costs of providing the services required hereunder,
including salaries and benefits of employees and subcontractors of Consultant. Consequently,the parties
further agree that compensation hereunder is intended to include the costs of contributions to any pensions
and/or annuities to which Consultant and its employees, agents, and subcontractors may be eligible. Town
therefore has no responsibility for such contributions beyond compensation required under this Agreement.
2.1 Invoices. Consultant shall submit invoices, not more often than once a month during the
term of this Agreement, based on the cost for services performed and reimbursable costs
incurred prior to the invoice date. Invoices shall contain the following information:
• Serial identifications of progress bills; i.e., Progress Bill No. 1 for the first invoice,
etc.;
• The beginning and ending dates of the billing period;
• A Task Summary containing the original contract amount, the amount of prior
billings, the total due this period, the balance available under the Agreement, and
the percentage of completion;
• At Town's option, for each work item in each task,a copy of the applicable time
entries or time sheets shall be submitted showing the name of the person doing
the work,the hours spent by each person, a brief description of the work,and
each reimbursable expense;
• The total number of hours of work performed under the Agreement by Consultant
and each employee, agent, and subcontractor of Consultant performing services
hereunder;
• The Consultant's signature;
• Consultant shall give separate notice to the Town when the total number of hours
worked by Consultant and any individual employee,agent, or subcontractor of
Consultant reaches or exceeds 800 hours within a 12-month period under this
Agreement and any other agreement between Consultant and Town. Such notice
shall include an estimate of the time necessary to complete work described in
Exhibit A and the estimate of time necessary to complete work under any other
agreement between Consultant and Town, if applicable.
2.2 Monthly Payment. Town shall make monthly payments, based on invoices received, for
services satisfactorily performed,and for authorized reimbursable costs incurred. Town
shall have 30 days from the receipt of an invoice that complies with all of the requirements
above to pay Consultant.
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2.3 Final Payment. Town shall pay the last /o of the total sum due pursuant to this
Agreement within 60 days after completion of the services and submittal to Town of a final
invoice, if all services required have been satisfactorily performed.
2.4 Total Payment. Town shall pay for the services to be rendered by Consultant pursuant to
this Agreement. Town shall not pay any additional sum for any expense or cost
whatsoever incurred by Consultant in rendering services pursuant to this Agreement.
Town shall make no payment for any extra,further, or additional service pursuant to this
Agreement.
In no event shall Consultant submit any invoice for an amount in excess of the maximum
amount of compensation provided above either for a task or for the entire Agreement,
unless the Agreement is modified prior to the submission of such an invoice by a properly
executed change order or amendment.
2.5 Hourly Fees. Fees for work performed by Consultant on an hourly basis shall not exceed
the amounts shown on the compensation schedule attached hereto as Exhibit B.
2.6 • it C•C •
that challnot be-exeeeded.
2.7 Payment of Taxes. Consultant is solely responsible for the payment of employment taxes
incurred under this Agreement and any similar federal or state taxes.
2.8 Payment upon Termination. In the event that the Town or Consultant terminates this
Agreement pursuant to Section 8,the Town shall compensate the Consultant for all
outstanding costs and reimbursable expenses incurred for work satisfactorily completed as
of the date of written notice of termination. Consultant shall maintain adequate logs and
timesheets to verify costs incurred to that date.
2.9 Authorization to Perform Services. The Consultant is not authorized to perform any
services or incur any costs whatsoever under the terms of this Agreement until receipt of
authorization from the Contract Administrator.
Section 3. FACILITIES AND EQUIPMENT. Consultant shall, at its sole cost and expense, provide all
facilities and equipment that may be necessary to perform the services required by this Agreement.
Section 4. INSURANCE REQUIREMENTS. Before beginning any work under this Agreement,
Consultant, at its own cost and expense, unless otherwise specified below, shall procure the types and
amounts of insurance listed below against claims for injuries to persons or damages to property that may
arise from or in connection with the performance of the work hereunder by the Consultant and its agents,
representatives, employees,and subcontractors. Consistent with the following provisions, Consultant shall
provide proof satisfactory to Town of such insurance that meets the requirements of this section and under
forms of insurance satisfactory in all respects, and that such insurance is in effect prior to beginning work to
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the Town. Consultant shall maintain the insurance policies required by this section throughout the term of
this Agreement. The cost of such insurance shall be included in the Consultants bid. Consultant shall not
allow any subcontractor to commence work on any subcontract until Consultant has obtained all insurance
required herein for the subcontractor(s)and provided evidence that such insurance is in effect to Town.
Verification of the required insurance shall be submitted and made part of this Agreement prior to
execution. Consultant shall maintain all required insurance listed herein for the duration of this Agreement.
4.1 Workers'Compensation. Consultant shall,at its sole cost and expense, maintain
Statutory Workers'Compensation Insurance and Employer's Liability Insurance for any
and all persons employed directly or indirectly by Consultant. The Statutory Workers'
Compensation Insurance and Employer's Liability Insurance shall be provided with limits of
not less than $1,000,000 per accident. In the alternative, Consultant may rely on a self-
insurance program to meet those requirements, but only if the program of self-insurance
complies fully with the provisions of the California Labor Code. Determination of whether a
self-insurance program meets the standards of the Labor Code shall be solely in the
discretion of the Contract Administrator. The insurer, if insurance is provided, or the
Consultant, if a program of self-insurance is provided, shall waive all rights of subrogation
against the Town and its officers, officials, employees,and volunteers for loss arising from
work performed under this Agreement.
4.2 Commercial General and Automobile Liability Insurance.
4.2.1 General requirements. Consultant, at its own cost and expense,shall maintain
commercial general and automobile liability insurance for the term of this
Agreement in an amount not less than$1,000,000 per occurrence, combined
single limit coverage for risks associated with the work contemplated by this
Agreement. If a Commercial General Liability Insurance or an Automobile Liability
form or other form with a general aggregate limit is used, either the general
aggregate limit shall apply separately to the work to be performed under this
Agreement or the general aggregate limit shall be at least twice the required
occurrence limit. Such coverage shall include but shall not be limited to, protection
against claims arising from bodily and personal injury, including death resulting
therefrom,and damage to properly resulting from activities contemplated under
this Agreement, including the use of owned and non-owned automobiles.
4.2.2 Minimum scope of coverage. Commercial general coverage shall be at least as
broad as Insurance Services Office Commercial General Liability occurrence form
CG 0001 (most recent edition) covering comprehensive General Liability on an
"occurrence"basis. Automobile coverage shall be at least as broad as Insurance
Services Office Automobile Liability form CA 0001, Code 1 (any auto). No
endorsement shall be attached limiting the coverage.
4.2.3 Additional requirements. Each of the following shall be included in the
insurance coverage or added as a certified endorsement to the policy:
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a. The Insurance shall cover on an occurrence or an accident basis, and not
on a claims-made basis.
b. Town, its officers, officials, employees,and volunteers are to be covered
as insureds as respects: liability arising out of work or operations
performed by or on behalf of the Consultant; or automobiles owned,
leased, hired, or borrowed by the Consultant
c. For any claims related to this Agreement or the work hereunder,the
Consultant's insurance covered shall be primary insurance as respects
the Town, its officers, officials, employees, and volunteers. Any insurance
or self-insurance maintained by the Town, its officers,officials, employees,
or volunteers shall be excess of the Consultant's insurance and shall not
contribute with it.
d. Each insurance policy required by this clause shall be endorsed to state
that coverage shall not be canceled by either party, except after 30 days'
prior written notice has been provided to the Town.
4.3 Professional Liability Insurance.
4.3.1 General requirements. Consultant, at its own cost and expense, shall maintain
for the period covered by this Agreement professional liability insurance for
licensed professionals performing work pursuant to this Agreement in an amount
not less than $1,000,000 covering the licensed professionals'errors and
omissions. Any deductible or self-insured retention shall not exceed$150,000 per
claim.
4.3.2 Claims-made limitations. The following provisions shall apply if the professional
liability coverage is written on a claims-made form:
a. The retroactive date of the policy must be shown and must be before the
date of the Agreement.
b. Insurance must be maintained and evidence of insurance must be
provided for at least five years after completion of the Agreement or the
work, so long as commercially available at reasonable rates.
c. If coverage is canceled or not renewed and it is not replaced with another
claims-made policy form with a retroactive date that precedes the date of
this Agreement, Consultant shall purchase an extended period coverage
for a minimum of five years after completion of work under this
Agreement.
d. A copy of the claim reporting requirements must be submitted to the Town
for review prior to the commencement of any work under this Agreement.
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4.3.3 Additional Requirements. A certified endorsement to include contractual liability
shall be included in the policy
4.4 All Policies Requirements.
4.4.1 Acceptability of insurers. All insurance required by this section is to be placed
with insurers with a Bests' rating of no less than A-:VII. Should any
CONSULTANTS insurers' ratings change during the middle of a policy year,
CONSULTANT has until the policy renewal date to remedy the situation.
4.4.2 Verification of coverage. Prior to beginning any work under this Agreement,
Consultant shall furnish Town with complete copies of all policies delivered to
Consultant by the insurer, including complete copies of all endorsements attached
to those policies. All copies of policies and certified endorsements shall show the
signature of a person authorized by that insurer to bind coverage on its behalf. If
the Town does not receive the required insurance documents prior to the
Consultant beginning work, it shall not waive the Consultant's obligation to provide
them. The Town reserves the right to require complete copies of all required
insurance policies at any time.
4.4.3 Deductibles and Self-Insured Retentions. Consultant shall disclose to and
obtain the written approval of Town for the self-insured retentions and deductibles
before beginning any of the services or work called for by any term of this
Agreement. At the option of the Town, either:the insurer shall reduce or eliminate
such deductibles or self-insured retentions as respects the Town, its officers,
employees, and volunteers;or the Consultant shall provide a financial guarantee
satisfactory to the Town guaranteeing payment of losses and related
investigations, claim administration and defense expenses.
4.4.4 Wasting Policies. No policy required by this Section 4 shall include a'Wasting"
policy limit(i.e. limit that is eroded by the cost of defense).
4.4.5 Waiver of Subrogation. Consultant hereby agrees to waive subrogation which
any insurer or contractor may require from vendor by virtue of the payment of any
loss. Consultant agrees to obtain any endorsements that may be necessary to
affect this waiver of subrogation.
The Workers'Compensation policy shall be endorsed with a waiver of subrogation
in favor of the entity for all work performed by the consultant, its employees,
agents,and subcontractors.
4.4.6 Subcontractors. Consultant shall include all subcontractors as insureds under its
policies or shall furnish separate certificates and certified endorsements for each
subcontractor. All coverages for subcontractors shall be subject to all of the
requirements stated herein.
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4.5 Remedies. In addition to any other remedies Town may have if Consultant fails to provide
or maintain any insurance policies or policy endorsements to the extent and within the time
herein required,Town may,at its sole option exercise any of the following remedies, which
are alternatives to other remedies Town may have and are not the exclusive remedy for
Consultant's breach:
• Obtain such insurance and deduct and retain the amount of the premiums for such
insurance from any sums due under the Agreement;
• Order Consultant to stop work under this Agreement or withhold any payment that
becomes due to Consultant hereunder,or both stop work and withhold any payment,
until Consultant demonstrates compliance with the requirements hereof; and/or
• Terminate this Agreement.
Section 5. INDEMNIFICATION AND CONSULTANTS RESPONSIBILITIES. Consultant shall,to the
fullest extent allowed by law,with respect to all Services performed in connection with this Agreement,
defend with counsel acceptable to Town, indemnify,and hold Town, its officers, employees, agents, and
volunteers, harmless from and against any and all claims to the extent they arise out of, pertain to, or relate
to the negligence, recklessness, or willful misconduct of the Consultant, ("Claims"). Consultant will bear all
losses, costs, damages, expense and liability of every kind, nature and description to the extent they arise
out of, pertain to, or relate to such Claims, whether directly or indirectly("Liability"). Such obligations to
defend, hold harmless and indemnify the Town shall not apply to the extent that such Liabilities are caused
by the sole negligence, active negligence, or willful misconduct of the Town.
With respect to third party claims against the Consultant, the Consultant waives any and all rights of any
type of express or implied indemnity against the Indemnitees.
Notwithstanding the forgoing, to the extent this Agreement is a"construction contract"as defined by
California Civil Code section 2783, as may be amended from time to time, such duties of Consultant to
indemnify shall not apply when to do so would be prohibited by California Civil Code Section 2782.
Section 6. STATUS OF CONSULTANT.
6.1 Independent Contractor. At all times during the term of this Agreement, Consultant shall
be an independent contractor and shall not be an employee of Town. Town shall have the
right to control Consultant only insofar as the results of Consultant's services rendered
pursuant to this Agreement and assignment of personnel pursuant to Subparagraph 13;
however, otherwise Town shall not have the right to control the means by which
Consultant accomplishes services rendered pursuant to this Agreement. Notwithstanding
any other Town, state,or federal policy, rule, regulation, law, or ordinance to the contrary,
Consultant and any of its employees, agents, and subcontractors providing services under
this Agreement shall not qualify for or become entitled to, and hereby agree to waive any
and all claims to, any compensation, benefit, or any incident of employment by Town,
including but not limited to eligibility to enroll in the California Public Employees Retirement
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System (PERS) as an employee of Town and entitlement to any contribution to be paid by
Town for employer contributions and/or employee contributions for PERS benefits.
6.2 Consultant Not an Agent. Except as Town may specify in writing, Consultant shall have
no authority, express or implied,to act on behalf of Town in any capacity whatsoever as an
agent. Consultant shall have no authority, express or implied, pursuant to this Agreement
to bind Town to any obligation whatsoever.
Section 7. LEGAL REQUIREMENTS.
7.1 Governing Law. The laws of the State of California shall govern this Agreement.
7.2 Compliance with Applicable Laws. Consultant and any subcontractors shall comply with
all laws and regulations applicable to the performance of the work hereunder, including but
not limited to, the California Building Code,the Americans with Disabilities Act, and any
copyright, patent or trademark law. Consultant's Failure to comply with any law(s)or
regulation(s) applicable to the performance of the work hereunder shall constitute a breach
of contract.
7.3 Other Governmental Regulations. To the extent that this Agreement may be funded by
fiscal assistance from another governmental entity, Consultant and any subcontractors
shall comply with all applicable rules and regulations to which Town is bound by the terms
of such fiscal assistance program.
7.4 Licenses and Permits. Consultant represents and warrants to Town that Consultant and
its employees, agents,and any subcontractors have all licenses, permits, qualifications,
and approvals of whatsoever nature that are legally required to practice their respective
professions. Consultant represents and warrants to Town that Consultant and its
employees, agents, any subcontractors shall, at their sole cost and expense, keep in effect
at all times during the term of this Agreement any licenses, permits,and approvals that are
legally required to practice their respective professions. In addition to the foregoing,
Consultant and any subcontractors shall obtain and maintain during the term of this
Agreement valid Business Licenses from Town.
7.5 Nondiscrimination and Equal Opportunity. Consultant shall not discriminate,on the
basis of a person's race, religion,color, national origin, age, physical or mental handicap or
disability, medical condition, marital status,sex, or sexual orientation, against any
employee, applicant for employment, subcontractor, bidder for a subcontract, or participant
in, recipient of, or applicant for any services or programs provided by Consultant under this
Agreement. Consultant shall comply with all applicable federal,state,and local laws,
policies, rules, and requirements related to equal opportunity and nondiscrimination in
employment,contracting, and the provision of any services that are the subject of this
Agreement, including but not limited to the satisfaction of any positive obligations required
of Consultant thereby.
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Consultant shall include the provisions of this Subsection in any subcontract approved by
the Contract Administrator or this Agreement.
Section 8. TERMINATION AND MODIFICATION.
8.1 Termination. Town may cancel this Agreement at any time and without cause upon
written notification to Consultant.
Consultant may cancel this Agreement upon thirty (30)days'written notice to Town and
shall include in such notice the reasons for cancellation.
In the event of termination, Consultant shall be entitled to compensation for services
performed to the effective date of termination;Town, however, may condition payment of
such compensation upon Consultant delivering to Town any or all documents,
photographs, computer software,video and audio tapes, and other materials provided to
Consultant or prepared by or for Consultant or the Town in connection with this
Agreement.
8.2 Extension. Town may, in its sole and exclusive discretion, extend the end date of this
Agreement beyond that provided for in Subsection 1.1. Any such extension shall require a
written amendment to this Agreement, as provided for herein. Consultant understands and
agrees that, if Town grants such an extension, Town shall have no obligation to provide
Consultant with compensation beyond the maximum amount provided for in this
Agreement. Similarly, unless authorized by the Contract Administrator,Town shall have
no obligation to reimburse Consultant for any otherwise reimbursable expenses incurred
during the extension period.
8.3 Amendments. The parties may amend this Agreement only by a writing signed by all the
parties.
8.4 Assignment and Subcontracting. Town and Consultant recognize and agree that this
Agreement contemplates personal performance by Consultant and is based upon a
determination of Consultant's unique personal competence,experience, and specialized
personal knowledge. Moreover,a substantial inducement to Town for entering into this
Agreement was and is the professional reputation and competence of Consultant.
Consultant may not assign this Agreement or any interest therein without the prior written
approval of the Contract Administrator. Consultant shall not subcontract any portion of the
performance contemplated and provided for herein, other than to the subcontractors noted
in the proposal, without prior written approval of the Contract Administrator.
8.5 Survival. All obligations arising prior to the termination of this Agreement and all
provisions of this Agreement allocating liability between Town and Consultant shall survive
the termination of this Agreement.
8.6 Options upon Breach by Consultant. If Consultant materially breaches any of the terms
of this Agreement,Town's remedies shall include, but not be limited to, the following:
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8.6.1 Immediately terminate the Agreement;
8.6.2 Retain the plans, specifications,drawings, reports,design documents,and any
other work product prepared by Consultant pursuant to this Agreement;
8.6.3 Retain a different consultant to complete the work described in Exhibit A not
finished by Consultant; or
8.6.4 Charge Consultant the difference between the costs to complete the work
described in Exhibit A that is unfinished at the time of breach and the amount that
Town would have paid Consultant pursuant to Section 2 if Consultant had
completed the work.
Section 9. KEEPING AND STATUS OF RECORDS.
9.1 Records Created as Part of Consultant's Performance. All reports, data, maps,
models,charts, studies, surveys, photographs, memoranda, plans, studies, specifications,
records,files,or any other documents or materials, in electronic or any other form,that
Consultant prepares or obtains pursuant to this Agreement and that relate to the matters
covered hereunder shall be the property of the Town. Consultant hereby agrees to deliver
those documents to the Town upon termination of the Agreement. It is understood and
agreed that the documents and other materials, including but not limited to those described
above, prepared pursuant to this Agreement are prepared specifically for the Town and are
not necessarily suitable for any future or other use. Town and Consultant agree that, until
final approval by Town, all data, plans, specifications, reports and other documents are
confidential and will not be released to third parties without prior written consent of both
parties.
9.2 Consultant's Books and Records. Consultant shall maintain any and all ledgers, books
of account, invoices, vouchers, canceled checks,and other records or documents
evidencing or relating to charges for services or expenditures and disbursements charged
to the Town under this Agreement for a minimum of 3 years, or for any longer period
required by law, from the date of final payment to the Consultant to this Agreement.
9.3 Inspection and Audit of Records. Any records or documents that Section 9.2 of this
Agreement requires Consultant to maintain shall be made available for inspection, audit,
and/or copying at any time during regular business hours, upon oral or written request of
the Town. Under California Government Code Section 8546.7, if the amount of public
funds expended under this Agreement exceeds$10,000.00, the Agreement shall be
subject to the examination and audit of the State Auditor, at the request of Town or as pail
of any audit of the Town,for a period of 3 years after final payment under the Agreement.
Section 10 MISCELLANEOUS PROVISIONS.
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10.1 Attorneys' Fees. If a party to this Agreement brings any action, including an action for
declaratory relief, to enforce or interpret the provision of this Agreement, the prevailing
party shall be entitled to reasonable attorneys'fees in addition to any other relief to which
that party may be entitled. The court may set such fees in the same action or in a
separate action brought for that purpose.
10.2 Venue. In the event that either party brings any action against the other under this
Agreement,the parties agree that trial of such action shall be vested exclusively in the
state courts of California in the County of Santa Clara or in the United States District Court
for the Northern District of California.
10.3 Severability. If a court of competent jurisdiction finds or rules that any provision of this
Agreement is invalid,void,or unenforceable, the provisions of this Agreement not so
adjudged shall remain in full force and effect. The invalidity in whole or in part of any
provision of this Agreement shall not void or affect the validity of any other provision of this
Agreement.
10.4 No Implied Waiver of Breach. The waiver of any breach of a specific provision of this
Agreement does not constitute a waiver of any other breach of that term or any other term
of this Agreement.
10.5 Successors and Assigns. The provisions of this Agreement shall inure to the benefit of
and shall apply to and bind the successors and assigns of the parties.
10.6 Use of Recycled Products. Consultant shall prepare and submit all reports, written
studies and other printed material on recycled paper to the extent it is available at equal or
less cost than virgin paper.
10.7 Conflict of Interest. Consultant may serve other clients, but none whose activities within
the corporate limits of Town or whose business, regardless of location, would place
Consultant in a"conflict of interest,"as that term is defined in the Political Reform Act,
codified at California Government Code Section 81000 et seq.
Consultant shall not employ any Town official in the work performed pursuant to this
Agreement. No officer or employee of Town shall have any financial interest in this
Agreement that would violate California Government Code Sections 1090 et seq.
Consultant hereby warrants that it is not now, nor has it been in the previous 12 months,
an employee, agent, appointee,or official of the Town. If Consultant was an employee,
agent, appointee,or official of the Town in the previous twelve months, Consultant
warrants that it did not participate in any manner in the forming of this Agreement.
Consultant understands that, if this Agreement is made in violation of Government Code
§1090 et seq.,the entire Agreement is void and Consultant will not be entitled to any
compensation for services performed pursuant to this Agreement, including reimbursement
of expenses, and Consultant will be required to reimburse the Town for any sums paid to
the Consultant. Consultant understands that, in addition to the foregoing, it may be subject
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to criminal prosecution for a violation of Government Code§ 1090 and, if applicable, will
be disqualified from holding public office in the State of California.
10.8 Solicitation. Consultant agrees not to solicit business at any meeting, focus group, or
interview related to this Agreement, either orally or through any written materials.
10.9 Contract Administration. This Agreement shall be administered by Richard Chiu
('Contract Administrator"). All correspondence shall be directed to or through the Contract
Administrator or his or her designee.
10.10 Notices. Any written notice to Consultant shall be sent to:
Ed Slintak, P.E.
CSG Consultants, Inc.
1700 South Amphlett Boulevard, 3rd Floor
San Mateo, CA 94402
Any written notice to Town shall be sent to:
Richard Chiu Jr.
Town of Los Altos Hills
26379 Fremont Road
Los Altos Hills, CA 94022
10.11 Professional Seal. Where applicable in the determination of the contract administrator,
the first page of a technical report,first page of design specifications, and each page of
construction drawings shall be stamped/sealed and signed by the licensed professional
responsible for the report/design preparation. The stamp/seal shall be in a block entitled "Seal
and Signature of Registered Professional with report/design responsibility," as in the following
example.
Seal and Signature of Registered Professional with
report/design responsibility.
10.12 Integration. This Agreement, including the scope of work attached hereto and
incorporated herein as Exhibits A, B, and C represents the entire and integrated
agreement between Town and Consultant and supersedes all prior negotiations,
representations, or agreements, either written or oral.
Exhibit A Scope of Services
Exhibit B Payment Schedule
Exhibit C Public Works Requirements
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10.13 Counterparts. This Agreement may be executed in multiple counterparts, each of which
shall be an original and all of which together shall constitute one agreement.
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The Parties have executed this Agreement as of the Effective Date.
TOWN OF LOS ALTOS HILLS CONSULTANT
Carl Cahil Manager , 'yr_us Ki.••:•
/W/Atttteesst: !/'��/�/l�--
Deborah Pa van 4 own Clerk
Approved as to Form:
Steven T. Mattes, Town Attorney
1071914.1
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EXHIBIT A
SCOPE OF SERVICES
Consulting Services Agreement between [EFFECTIVE DATE]
Town of Los Altos Hills and CSG Consultants, Inc.--Exhibit A Page I of 1
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EXHIBIT A
May 10, 2011
Town of Los Altos Hills
Richard Chiu, P.E.
City Engineer/Public Works Director
26379 Fremont Road
Los Altos Hills, CA
Subject: Town of Los Altos Hills — Hilltop Drive Drainage Project
Dear Mr. Chiu:
CSG Consultants (CSG) is pleased to present this proposal to the Town of Los Altos
Hills (Town) for the survey and design services of the Hilltop Drive Drainage Project.
On Wednesday, April 25, 2012, CSG met with the Town for a field walk along Hilltop
Drive to gain an understanding of the road's drainage issues.
The Town identified the location of excess surface water located on the road at 12370
Hilltop Drive. During the field walk, the location of all potholing done by the Cal-water
was identified, and the limit of the excess ground water was approximated to be at
12100 Hilltop Drive.
It is our understanding that the excess surface water may be caused by several different
sources, including excessive water use within the above watershed area and/or an
inadequate drainage ditch and culvert system. Our approach to remedying these issues
would include completing a detailed field survey of right of way located at 12370 Hilltop
Drive, identifying high and low points along the road and in the drainage ditch, construct
a cutoff apron at the drainage inlet, construct a subdrain pipe to carry the water from the
cutoff apron at the drainage ditch to outfall near the existing culvert on the far side of the
road, and reconstruct the intersection's drainage ditch and culvert. This new subdrain
will be aligned and constructed to go under the existing water mains when crossing the
road.
The proposed improvements may not completely prevent the excess water in the
roadway, as the source of the excessive water is not known. Additional work may be
required after a period of evaluation determines how the proposed improvements have
affected the problem area.
1700 South Ampblett Boulevard.3°Floor: San Mateo.CA 94402
Phone:650-522-2500;Fax 650-522-2599
Email:csgstaff csgengr.com;Online at www
4110
Town of Los Altos Hills
Hilltop Drive Drainage Project
Attn: Richard Chiu, P.E.
May 10, 2012
Page 2 of 4
SCOPE OF WORK
Below are the tasks that outline the scope of work required to complete this project:
Task 1 — Field Survey and Mapping
• Conduct a field survey and create a topographic map and base sheets of the
area, which shall include the roadway, driveways, dikes, shoulders, striping,
signs, utilities, vegetation, storm drain ditch alignment and cross sections, and
storm drain facilities.
• Research existing utility maps and right of way maps and incorporate findings
into mapping.
Task 2— Preliminary 60% Design
• Prepare preliminary design layout and details
• Develop preliminary construction estimate
• Outline technical specifications
• Meet/Discuss with the Town the proposed 60% design
Task 4—90% Design
• Implement 60% comments and prepare 90% plans
• Develop specifications
• Updated construction cost estimate
• 90% Design Town Review Meeting
Task 5— Final 100% Design
• Finalize construction plans, specifications, and construction cost estimate
TASK 6 — Bid and Construction Support
• Preparation of addenda
• Respond to bidder's questions
• Attendance at pre-construction meeting
• Review and comment on technical submittals
• Preparation of responses to Requests for Information (RFI)
• Preparation and production of Record Drawings based on Town's redlined plans
1700 South Amphletl Boulevard,3"Floor; San Mateo,CA 94402
Phone:650-522.2500:Fax:650-522-2599
Email:csgstaf@csgengr.com;Online at www.csgwebsite.com
V
Town of Los Altos Hills
Hilltop Drive Drainage Project
Attn: Richard Chiu, P.E.
May 10,2012
Page 3 of 4
Assumptions
• All topographic mapping and design plan files will be developed in AutoCAD.
• Field survey will be based on an assumed coordinate system and datum.
• Right of Way information will be provided by the Town. No right of way resolution
is assumed.
• No permitting and/or environmental clearance is included.
• Traffic control drawings are not included.
• Reproduction of bid documents is not included.
• Construction management/inspection is not included.
DELIVERABLES
• 60% Design: Preliminary plans, specifications outline and estimate, submitted
via email in PDF, XCL, and DOC format
• 90% Design: PS&E, submitted via email in PDF, XCL, and DOC format
• Construction Documents: PS&E. Electronic files submitted via email in PDF,
Excel & CAD files; Hardcopy files (wet-signed copies) submitted via delivery.
• Record Drawings: Plans, submitted via email in PDF and hardcopy.
SCHEDULE
CSG approximates the work to be completed within 6 to 8 weeks after receiving the
notice to proceed. This schedule assumes that weather permits and City review
comments are received in a timely manner.
• Field Survey and Mapping 1 week (weather permitting)
• Preliminary 60% Design 1 —2 weeks
• Town Review 1 week
• 90% Design 1 — 2 weeks
• Town Review 1 week
• Final Design 1 week
1700 South Amp01elt Boulevard,3'Floor; San Mateo,CA 94402
Phone:650-522-2500;Fax:650-522-2599
Email.csgstafl@csgengr corn;Online at www.cs9website corn
V V
Town of Los Altos Hills
Hilltop Drive Drainage Project
Attn: Richard Chiu, P.E.
May 10, 2012
Page 4 of 4
COST PROPOSAL
The cost estimate for providing these services is $23,325. A detailed breakdown of this
estimated is found in the attached "Work Cost Proposal and Resource Allocation' sheet.
If you have any questions, please call Ed Slintak, P.E. at 650-522-2533.
Sincerely,
CSG Consultants, Inc.
Ed Slintak, PE
Design Manager
1700 South Amphlett Boulevard,3'' Floor; San Mateo,CA 94402
Phone:650-522-2500:Fax:650-522-2599
Email.csgstaff osgengr corn:Online at vmw.csgwebsite.com
40.
EXHIBIT B
COMPENSATION SCHEDULE
Consulting Services Agreement between [EFFECTIVE DATE]
Town of Los Altos Hills and CSG Consultants, Inc.--Exhibit B Page 1 of 1
0 V
CITY OF LOS ALTOS HILLS-HILLTOP DRIVE DRAINAGE PROJECT
RESOURCE ALLOCATION ESTIMATE-05/09/12
i0
cE
Task Description g. g 1 g 9 g , m % 1 .2 • t Totals
'En o_ c mc : orc et n.
qC � — n m tom c t l E
6 W N W < W :6518M c Lm e 0 6 N
Cate•o Notes $175 $160 $140 $120 $110 $100 $275 $80 Hours Cost
I i8- eggi Vis:;•zr;$y e;, , ; s.'.:.:. $SNWegranteti
Field Survey _ 18 16 $4,400
Utility Map Research _ 1 2 3 $360
Project setup 1 1 $140
Survey mapping/create base sheets 1 8 2 11 $1,320
Subtotal Tskl 0 0 3 8 4 0 16 0 31 $6,220
-"?'111-19 111"TIFi• tieSINSWAtanrer4924 :6 rte, '.74$
�L u
Layout and design 2 4 I 20 4 34 $1,395
Details8 1 4 0 1331095
TechnicalOutlineTechnical Specifications4_ 1 1 2 4 $555
Meetingslcoordinetion 2 2 —__ 4 - --$520
Estimate 1 2 4 7 $935
Subtotal-Task2 5 0V 17 38 4 0 0 0 62 I $8,015
rt."—ntaak':
V
EXHIBIT C
PROVISIONS REQUIRED FOR PUBLIC WORKS CONTRACTS
PURSUANT TO CALIFORNIA LABOR CODE SECTION 1720 ETSEQ.
HOURS OF WORK:
A. In accordance with California Labor Code Section 1810, 8 hours of labor in performance of the
services described in Exhibit A shall constitute a legal day's work under this contract.
B. In accordance with California Labor Code Section 1811,the time of service of any worker
employed in performance of the services described in Exhibit A is limited to eight hours during
any one calendar day, and forty hours during any one calendar week, except in accordance with
California Labor Code Section 1815, which provides that work in excess of eight hours during any
one calendar day and forty hours during any one calendar week is permitted upon compensation
for all hours worked in excess of eight hours during any one calendar day and forty hours during
any one calendar week at not less than one-and-one-half times the basic rate of pay.
C. The Consultant and its subcontractors shall forfeit as a penalty to the Town$25 for each worker
employed in the performance of the services described in Exhibit A for each calendar day during
which the worker is required or permitted to work more than 8 hours in any one calendar day,or
more than 40 hours in any one calendar week, in violation of the provisions of California Labor
Code Section 1810 and following.
WAGES:
A. In accordance with California Labor Code Section 1773.2, the Town has determined the general
prevailing wages in the locality in which the services described in Exhibit A are to be performed
for each craft or type of work needed to be as published by the State of California Department of
Industrial Relations, Division of Labor Statistics and Research,a copy of which is on file in the
Town Public Works Office and shall be made available on request. The Consultant and
subcontractors engaged in the performance of the services described in Exhibit A shall pay no
less than these rates to all persons engaged in performance of the services described in Exhibit
A.
B. In accordance with Labor Code Section 1775, the Consultant and any subcontractors engaged in
performance of the services described in Exhibit A shall comply with California Labor Code
Section 1775, which establishes a penalty of up to$50 per day for each worker engaged in the
performance of the services described in Exhibit A that the Consultant or any subcontractor pays
less than the specified prevailing wage. The amount of such penalty shall be determined by the
Labor Commissioner and shall be based on consideration of the mistake, inadvertence, or
neglect of the Consultant or subcontractor in failing to pay the correct rate of prevailing wages,or
the previous record of the Consultant or subcontractor in meeting applicable prevailing wage
obligations,or the willful failure by the Consultant or subcontractor to pay the correct rates of
Consulting Services Agreement between [EFECTIVE DATE]
Town of Los Altos Hills and CSG Consultants, Inc.--Exhibit C Page 1 of 3
6
prevailing wages. A mistake, inadvertence, or neglect in failing to pay the correct rate of
prevailing wages is not excusable if the Consultant or subcontractor had knowledge of their
obligations under the California Labor Code. The Consultant or subcontractor shall pay the
difference between the prevailing wage rates and the amount paid to each worker for each
calendar day or portion thereof for which each worker was paid less than the prevailing wage
rate. If a subcontractor worker engaged in performance of the services described in Exhibit A is
not paid the general prevailing per diem wages by the subcontractor,the Consultant is not liable
for any penalties therefore unless the Consultant had knowledge of that failure or unless the
Consultant fails to comply with all of the following requirements:
1. The contract executed between the Consultant and the subcontractor for the
performance of part of the services described in Exhibit A shall include a copy of the
provisions of California Labor Code Sections 1771, 1775, 1776, 1777.5, 1813,and 1815.
2. The Consultant shall monitor payment of the specified general prevailing rate of per diem
wages by the subcontractor by periodic review of the subcontractor's certified payroll
records.
3. Upon becoming aware of a subcontractor's failure to pay the specified prevailing rate of
wages,the Consultant shall diligently take corrective action to halt or rectify the failure,
including, but not limited to, retaining sufficient funds due the subcontractor for
performance of the services described in Exhibit A.
4. Prior to making final payment to the subcontractor,the Consultant shall obtain an
affidavit signed under penalty of perjury from the subcontractor that the subcontractor
has paid the specified general prevailing rate of per diem wages for employees engaged
in the performance of the services described in Exhibit A and any amounts due pursuant
to Califomia Labor Code Section 1813.
C. In accordance with California Labor Code Section 1776,the Consultant and each subcontractor
engaged in performance of the services described in Exhibit A shall keep accurate payroll
records showing the name,address, social security number,work, straight time and overtime
hours worked each day and week,and the actual per diem wages paid to each journeyman,
apprentice,worker,or other employee employed in performance of the services described in
Exhibit A. Each payroll record shall contain or be verified by a written declaration that it is made
under penalty of perjury, stating both of the following:
1. The information contained in the payroll record is true and correct.
2. The employer has complied with the requirements of Sections 1771, 1811, and 1815 for
any work performed by the employer's employees on the public works project.
The payroll records required pursuant to California Labor Code Section 1776 shall be certified
and shall be available for inspection by the Owner and its authorized representatives,the
Consulting Services Agreement between [EFECTIVE DATE]
Town of Los Altos Hills and CSG Consultants, Inc.--Exhibit C Page 2 of 3
v
Division of Labor Standards Enforcement, the Division of Apprenticeship Standards of the
Department of Industrial Relations and shall otherwise be available for inspection in accordance
with California Labor Code Section 1776.
D. In accordance with California Labor Code Section 1777.5, the Consultant, on behalf of the
Consultant and any subcontractors engaged in performance of the services described in Exhibit
A, shall be responsible for ensuring compliance with California Labor Code Section 1777.5
governing employment and payment of apprentices on public works contracts.
E. In case it becomes necessary for the Consultant or any subcontractor engaged in performance
of the services described in Exhibit A to employ for the services described in Exhibit A any
person in a trade or occupation (except executive, supervisory, administrative, clerical, or other
non manual workers as such)for which no minimum wage rate has been determined by the
Director of the Department of Industrial Relations,the Contractor shall pay the minimum rate of
wages specified therein for the classification which most nearly corresponds to services
described in Exhibit A to be performed by that person. The minimum rate thus furnished shall be
applicable as a minimum for such trade or occupation from the time of the initial employment of
the person affected and during the continuance of such employment.
Consulting Services Agreement between [EFECTIVE DATE]
Town of Los Altos Hills and CSG Consultants, Inc.—Exhibit C Page 3 of 3
V
EXHIBIT D
REIMBURSABLE EXPENSES
Consulting Services Agreement between [EFFECTIVE DATE]
Town of Los Altos Hills and CSG Consultants, Inc.—Exhibit D Page 1 of 1
iiiill
"✓de CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYVY)
12/15/2011
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(§), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsements).
PRODUCER 0726293 1-415-546-9300 CONTE'
ACT Don Tarantino
NM
Arthur S. Gallagher E Co. PRONEFAX
insurance Brokers of California, Inc.. License *0726293 . 415-536-8617 ,(NC No, 415-536-8627
Ona Market Plaza, Spear Tower ADDRESS: don_tarantirmaajg.com _
Suit. 200 - -
San Francisco, CA 94105 INSURER(S)AFFORDING COVERAGE NAM
INSURER A' TRAVELERS PROP CAB CO OF AMER 25674
INSURED INSURER B: SENTINEL INS CO LTD 11000
CSO Consultants Inc. ARCH INS CO
INSURER C.. 11150
1700 S. Amphlett Blvd 3rd Floor INSURER D:
San Mateo, CA 94402 Ixau0.E0.E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 24484519 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
(NSR ADOL SUBR - POLICY EFF Policy EXP
TYPEOF INSURANCE WLIMITSLTRINSRMj
POLICY NUMBER IMMNDIYYYYI IMDM•WI
A GENERAL LIABILITY X 600394M0850-TIL-11 12/04/11 12/04/12 EACH OCCURRENCE § 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMSFS Ev RENTED $ 1,000,000
CLAIMS-MADE I X I OCCUR MED EXP(Any one person) $10,000
PERSONAL SADV INJURY S 1,000.000
GENERAL AGGREGATE _§_2.000,000
GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS.COMP/OP AGG S 2.000.000
PRPOLICY IFCT X LOC $
A AUTOMOBILE LIABILITY X ' BA461M7612 12/04/1112/04/12 COMBINED SINGLE LIMIT $ 1,000,000
(Eadwil
% ANY AUTO ' BODILY INJURY Per persue) §
ALL OWNED SCHEDULED ' BODILY INJURY(Per accident) $
AUTOS
HIREDAUTOS IPVcGI
NONO-OWNED PROPERTY DAMAGE $
X AUTOS I eEen&
A X UMBRELLA LIAB X OCCUR COP]94M10601]/04/11 12/04/12 EACH OCCURRENCE -_- $ 5,000,000
EXCESS LMB LLAIMS.MADE AGGREGATE $ 5,000,000
DED RETENTION§ Following Porn $
B WORMERS COMPENSATION X 57WE104360 12/04/11 12/04/12 X TWRYI NIOPT
FR
AND EMPLOYERS'LIBILIYYIN '"
ANY PROPRIETORPARTNERrcXECUTIVE 7 NIA EL.EACH ACCIDENT $ 1,000,000
OFFICEWMEMBER EXCLUDED?
(Mandatory In NH) EL.DISEASE-EA EMPLOYEE S 1,000,000
Byes,deeclee under
DESCRIPTION OF OPERATIONS below
EL.DISEASE-POLICY LIMIT.$ 1,000,000
C Prof Liability ASP004731500 12/04/11 12/04/12 Limit 3X11/3M11
Retention 50,000
I 1 I
DESCRIPTION OF OPERATIONS(LOCATIONS/VEHICLES(Mach ACORD 101,Additional Remarks.schedule.If mon apace is required)
Blanket MC waiver of subrogation applies. All Operations, town of Los Altos Hills, its elected & appointed officers,
employees are Additional Insured per endorsement attached.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Los Altos Hills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
26379 Fremont Road AUTHORIZED REPRESENTATIVE
Los Altos Hills, CA 94022
OSA
I
X)1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
moheineen
]4484519
V
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTO COVERAGE PLUS ENDORSEMENT
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement,the provisions of the Coverage Forn apply unless modi-
fied by the endorsement.
GENERAL DESCRIPTION OF COVERAGE-This endorsement broadens coverage.However,coverage for any
injury, damage or medical expenses described In any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part,and these coverage broadening provisions do not apply to
the extent that coverage Is excluded or limited by such an endorsement. The following listing is a general cover-
age description only.Limitations and exclusions may apply to these coverages.Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights,duties, and what Is and is not covered.
A. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC
B. EMPLOYEE HIRED AUTO EQUIPMENT-INCREASED LIMIT
C. EMPLOYEES AS INSURED I. WAIVER OF DEDUCTIBLE-GLASS
D. SUPPLEMENTARY PAYMENTS -INCREASED A PERSONAL EFFECTS
LIMBS K. AIRBAGS
E. TRAILERS-INCREASED LOAD CAPACITY L. AUTO LOAN LEASE GAP
F. HIRED AUTO PHYSICAL DAMAGE M. BLANKET WAIVER OF SUBROGATION
G. PHYSICAL DAMAGE - TRANSPORTATION
EXPENSES-INCREASED LIMIT
• A. BLANKET ADDITIONAL INSURED performing duties related to the conduct of
.,= your business.
The following is added to Paragraph A.1.,Who Is
An Insured, of SECTION II - LIABILITY COV- 2. The following replaces Paragraph b. In B.S.,
mr= ERAGE: Other Insurance, of SECTION IV - BUST-
® Any person or organization who is required under NESS AUTO CONDITIONS:
a written contract or agreement between you and b. For Hired Auto Physical Damage Cover-
that person or organization, that is signed and age, the following are deemed to be coy-
executed by you before the "bodily Injury" or ered"autos"you own:
•
"property damage" occurs and that is in effect (1) Any covered "auto" you lease, hire,
during the policy period,to be named as an addi- rent or borrow;and
Lionel insured is an "Insured" for Liability Cover- •
(2) Any covered"auto" hired or rented by
age, but only for damages to which this insurance "employee" antler a contract in
applies and only to the extent that person or or- your
ganization qualifies as an Insured" under the that individual "employee's" name,
Who Is An Insured provision contained In Section with your permission, while perform-
II. ing duties related to the conduct of
B. EMPLOYEE HIRED AUTO your business.
I. The following is added to Paragraph A.1.. However, any"auto"that is leased, hired,
Who Is An Insured, of SECTION Il - LI- rented or harrowed with a driver is not a
•
covered"auto
r.M ABILITY COVERAGE:
I� C. EMPLOYEES AS INSURED
An "employee" of yours is an "insured" while The following Is added to Paragraph A.1.,Who Is
operaunder all a coveredastor "auto" hired ort nted
An Insured, of SECTION II - LIABILITY COV-
under contract or agreement in that "em- •
ployee's" name, with your permission, while ERAGE:
•
CA T4 20 07 10 02010 The TraNtsm Indemnity Company.All rights reserved. Page 1 of
Includes capyrlgMed material of Insurance Services Office,Ina with Its permission.
00113
V
COMMERCIAL AUTO
Any"employee"of yours Is an "Insured"while us- (3) If a repair or replacement results In better
Ing a covered"auto"you don't own,hire or borrow than like kind or quality,we will not pay for the
in your business or your personal affairs. amount of betterment,
D. SUPPLEMENTARY PAYMENTS — INCREASED (4) A deductible equal to the highest Physical
LIMITS Damage deductible applicable to any owned
1. The following replaces Paragraph A.2.a.(2)of covered"auto".
SECTION II—LIABILITY COVERAGE: (5) This Coverage Extension does not apply to:
(2) Up to $3,000 for cost of bail bonds (in- (a) Any "auto" that is hired, rented or bor-
ciuding bonds for related traffic law viola- rowed with a driver, or
tions) required because of an "accident" (b) Any "auto" that is hired, rented or bor-
we cover. We do not have to furnish rowed from your"employee".
these bonds. G. PHYSICAL DAMAGE — TRANSPORTATION
2. The following replaces Paragraph A.2.a.(4)of EXPENSES—INCREASED LIMIT
SECTION II—LIABILITY COVERAGE:
All incurred by the The following replaces the first sentence in Para-
(4) "ill reasonableaexpenseseincugraph A.4.a., Transportation Expenses, of
COVER-
loss of "eaat our re up to $500la day actualbaSECTION III — PHYSICAL DAMAGE cause of time off from work. AGE:
E. TRAILERS—INCREASED LOAD CAPACITY We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense In-
The following replaces Paragraph C.1. of SEC- cuffed by you because of the total theft of a cov-
TION I—COVERED AUTOS: ered"auto"of the private passenger type.
1. 'Trailers" with a load capacity of 3,000 H. AUDIO, VISUAL AND DATA ELECTRONIC
pounds or less designed primarily for travel EQUIPMENT—INCREASED LIMIT
on public roads. Paragraph C.2.. Limit Of Insurance, of SEC-
F. HIRED AUTO PHYSICAL DAMAGE TION III — PHYSICAL DAMAGE COVERAGE is
The following Is added to Paragraph A.4., Cover- deleted.
age Extensions, of SECTION III — PHYSICAL I. WAIVER OF DEDUCTIBLE—GLASS
DAMAGE COVERAGE: The following Is added to Paragraph D., Deducti-
Hired Auto Physical Damage Coverage ble, of SECTION ill — PHYSICAL DAMAGE
If hired "autos" are covered "autos" for Liability COVERAGE:
Coverage but not covered "autos" for Physical No deductible for a covered "auto" will apply to
Damage Coverage, and this policy also provides glass damage If the glass Is repaired rather than
Physical Damage Coverage for an owned "auto", replaced.
then the Physical Damage Coverage Is extended J. PERSONAL EFFECTS
to'autos"that you hire, rent or borrow subject to
the following: The following is added to Paragraph A.4.. Cover-
(1) The most we will pay for "loss" in any one age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:
"accident" to a hired, rented or borrowed
"auto"is the lesser of: Personal Effects Coverage
(a) $50,000; We will pay up to $400 for "loss" to wearing ap-
(b) The actual cash value of the damaged or parel and other personal effects which are:
stolen property as of the time of the (1) Owned by an"insured"; and
"loss or (2) In or on your covered"auto"
(c) The cost of repairing or replacing the This coverage only applies in the event of a total
damaged or stolen property with other theft of your covered"auto".
property of like kind and quality. No deductibles apply to Personal Effects cover-
(2) An adjustment for depreciation and physical age.
condition will be made in determining actual
cash value in the event of a total'loss",
Page 2 of 3 n 2010 The Travelers Indemnity Company.NI fights reserved. CA 74 20 07 10
Includes copyrighted materiel of Insurance Services Office,Inc.with Its permission.
V J
COMMERCIAL AUTO
a K. AIRBAGS (2) Any:
The following is added to Paragraph B.3., Exclu- (a) Overdue lease or loan payments at the
sions, of SECTION III — PHYSICAL DAMAGE time of the"loss";
COVERAGE: (b) Financial penalties imposed under a
Exclusion 3.a.does not apply to "loss" to one or lease for excessive use, abnormal wear
more airbags In a covered"auto"you own that In- and tear or high mileage;
flate due to a cause other than a cause of"loss" (c) Security deposits not returned by the les-
set forth In Paragraphs A.1.b. and A.1.c., but sor;
only: (d) Costs for extended warranties, Credit Life
a. If that"auto" is a covered "auto"for Compre- Insurance, Health, Accident or Disability
hensive Coverage under this policy; Insurance purchased with the loan or
b. The airbags are not covered under any war- lease;and
ranty; and (e) Carry-over balances from previous loans
c. The airbags were not intentionally Inflated. or leases.
We will pay up to a maximum of $1,000 for any M. BLANKET WAIVER OF SUBROGATION
one"loss". The following replaces Paragraph AS., Transfer
L. AUTO LOAN LEASE GAP Of Rights Of Recovery Against Others To Us,
The following Is added to Paragraph A.4., Cover- of SECTION IV — BUSINESS AUTO CONDI-
age Extensions, of SECTION III — PHYSICAL EONS:
DAMAGE COVERAGE: S. Transfer Of Rights Of Recovery Against
Auto Loan Lease Gap Coverage for Private Others To Us
Passenger Type Vehicles We waive any right of recovery we may have
In the event of a total"loss"to a covered"auto"of against any person or organization to the ex-
the private passenger type shown in the Schedule tem required of you by a written contract axe-
or Declarations for which Physical Damage Coy cuted prior to any "accident" or loss", pro-
erage Is provided, we will pay any unpaid amount vided that the"accident"or"loss"arises out of
due on the lease or loan for such covered "auto° the operations contemplated by such con-
less the following: tract.The waiver applies only to the person or
▪ (1) The amount paid under the Physical Damage organization designated in such contrast.
Coverage Section of the policy for that"auto";
and
HEMe
ar• m
e lm
CA T4 20 07 10 ®2010 The Travelers Indemnity Company.Al rights reserved. Page 3 of 3
Includes copyrighted material of Insurance Services Office,Inc with M permission.
001540
4r
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OTHER INSURANCE - ADDITIONAL INSUREDS
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL UABILITY COVERAGE PART
PROVISIONS b. The"personal Injury'or'advertising Injury'for
COMMERCIAL GENERAL LIABILITY CONDITIONS wNch coverage Is sought arises out of an of-
(Section IV), Paragraph 4. (Other Insurance), Ie tense committed
amended as ollows: subsequent to the signing and execution of that
1. The following Is added to Paragraph a. Primary contract or agreement by you.
Insurance: 2. The first Subparagraph (2) of Paragraph b, Ex-
However,If you specifically agree In written con- ease Insurance regarding any other primary In-
trad or written agreement that the Insurance pro- aursnce available to you Is deleted.
vided to an additional Insured under this 3. The following la added to Paragraph Is. Escape
Coverage Pert must apply on a primary basis, or Insurance, as an additional subparagraph under
a primary and non-contributory basis, This Maur- Subparagraph(1):
Nice Is primary to other insurance that Is avail- That Is available to the Inured when the Insured
able to such additional insured which covers such Is added as an additional Insured under any other
additional Insured as a named insured, and we
wl3 not share with that other insurance, provided policy,Including any umbrella or excess policy,
Mat
a. The 'bodily Injury' or "property damage" for
which coverage Is sought occurs;and
CG DO 37 04 0$ Copyright 2005 The St.Pad Travelers Companies, Inc.All rights reserved. Page 1 of 1
ilrj V
COMMERCIAL GENERAL LIABIUTY
POLICY NUMBER:G80-294M0850-TIL-1 I ISSUE DATE: 11-07-11
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
(ARCHITECTS, ENGINEERS AND SURVEYORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON(S)OR ORGANIZATION(8):
PER SCHEDULE ON FILE WITH AGENT
PROJECT/LOCATION OF COVERED OPERATIONS:
"jib PROVISIONS
'- A. The following is added to WHO IS AN INSURED The Insurance provided to such additional Insured
.e (Section II): Is limited as follows:
- The person or organization shown In the Sched- d. This insurance does not apply to the render-
_- ule above is an additional insured on this Cover- Ing of or failure to render any "professional
— age Pad, but only with respect to liability for"bod- servicesTM,
om- ily Injury', "property damage" or"personal injury"
e. The limits of Insurance afforded to the adds-
- caused, In whole or in part, by your acts or omis- tonal insured shall be the limits which you
.li= sions or the acts or omissions of those acting on agreed in that"contract or agreement requir-
your behalf: ing insurance" to provide for that additional
'.S a. In the performance of your ongoing opera- Insured, or the limits shown in the Declare-
tions; tions for this Coverage Part, whichever are
b. In connection with premises owned by or less.This endorsement does not Increase the
® rented to you;or limits of insurance stated in the LIMITS OF
INSURANCE (Section III) for this Coverage
c c. In connection with "your work" and Included Part
within the "products-completed operations
ahazero". B. The following Is added to Paragraph a. of 4.
B Other Insurance in COMMERCIAL GENERAL
Such person or organization does not qualify as LIABILITY CONDITIONS(Section IV):
an additional insured for"bodily injury", "property However,if you specifically agree In a"contract or
damage" or "personal injury" for which that per-
son or organization has assumed liability in a con- agreement requiring insurance that,for the addi-
Iract or agreement. tlonel Insured shown In the Schedule, the Insur-
once provided to that additional Insured under this
CG D3 82 09 07 02007 The Trawlers Companies.Inc. Page 1 of 2
Includes the copyrighted material or Insurance Services Office,Inc..with its permission
ower•
COMMERCIAL GENERAL LIABILITY
Coverage Pad must apply on a primary basis, or injury"arising out of"your work"on or for the pro-
a primary and non-contributory basis, this Insur- ject. or at the location, shown in the Schedule
ance is primary to other insurance that is avail- above, performed by you, or on your behalf, un-
able to such additional Insured which covers such der a"contract or agreement requiring insurance"
additional Insured as a named insured, and we with that additional insured. We waive these
will not share with the other insurance, provided rights only where you have agreed to do so as
that: part of the"contract or agreement requiring insur-
ance The bodily injury" or "properly damage° for ance" 'with that additional insured entered into by
which coverage is sought occurs; and you before, and In effect when, the"bodily Injury"
(2) The "personal Injury" for which coverage is or"property damage"occurs, or the "personal in-
sought arises out of an offense committed; in-
jury"offense Is committed.
D. The following definition is added to DEFINITIONS
after you have entered Into that "contract or (Section V):
agreement requiring insurance" for such addi-
tional insured. But this insurance still Is excess "Contract or agreement requiring insurance"
over valid and collectible other Insurance, means that part of any contract or agreement un-
whether primary, excess, contingent or on any der which you are required to include the person
other basis, that Is available to the additional in- or organization shown In the Schedule as an ad-
sured when the additional insured Is also an addl- ditional insured on this Coverage Part, provided
tional insured under any other Insurance. that the"bodily injury"and "property damage"oc-
curs, of-
C. The following is added to Paragraph B. Transfer and the"personal injury"Is caused by an fense committed:
Of Rights Of Recovery Against Others To Us
in COMMERCIAL GENERAL LIABILITY CON- a. After you have entered into that contract or
DITIONS(Section IV): agreement;
We waive any rights of recovery we may have b. While that part of the contract or agreement is
against the additional Insured shown in the In effect;and
Schedule above because of payments we make c. Before the end of the policy period.
for'bodily injury", "property damage"or"personal
Page 2 of 2 02007 The Travelers Companies,Inc. CG D3 82 09 07
Includes the copyrighted materiel of Insurance Services Office,Inc.,with Its permission
--. .. illi _.. 4....
It
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WORKERS' COMPENSATION BROAD FORM ENDORSEMENT
EXTENDED OPTIONS
.mi~ P Key Number. 57 WE EP4360 Endorsement Number:
en Effective Date; 12/04/11 Effective hour Is the seine as stated on the Information Page of the policy.
o
Nam d Insured and Address: CSG CONSULTANTS INC
N
o 1700 S ANPHLETT BLVD 3RD FL
N
ca SAN MATEC, CA 94402
o
MbM
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PI Section I of this endorsement expands coverage provided under WC 00 00 00.
,^e Section II of this endorsement provides additional coverage usually only provided by endorsement.
0
N Sedan III of this endorsement Is a Schedule of Covered States.
O You may use the Index to locate these coverage features quickly;
N
en
,
® SUBJECT PAGE SUBJECT PARE
v
seem SECTIONI 2 B. Part One Does Not Apply 3
® PARTS ONE and TWO 2 C. Application of Coverage 3
®
DI We Will Also Pay 2 D. Additional Exclusions 9
® PART-THREE 2 E. West Virginia 9
® 02 How This Insurance Works 2 EXTENDED OPTIONS 4
® PART-SIX 2 01 Employers'Liability Insurance 4
® 03 Transfer of Your Rights and Duties 2 02 Unintentional Failure to Disclose 4
® 04 Liberalization 2 Hazards
® SECTION II 2 03 Weaver of Our Right to Recover from 4
® VOLUNTARY COMPENSATION INSURANCE 2 Others
..=.▪ 06 Voluntary Compensation Insurance 04 Foreign Voluntary Compensation 4
® A. How This Insurance Applies 2 A. How This Reimbursement Applies 4
am B. We Will Pay 2 U. We Will Reimburse 4
® C. Exclusions 3 C. Exclusions 4
M D. Before We Pay 3 D. Before We Pay 5
B E. Recovery From Others a E. Recovery From Others 6
® F. Employers'Liability Insurance 3 F. Reimbursement For Actual Lass 5
® BJPLOYERS'LIABILITY STOP OAP 3 Sustained
m ENDORSEMENT 3 G. Repatriation 5
0e Employee'Liability Stop Gap H. Endemic Disease 6
Coverage 3 06 Longehore and Harbor Workers' 6
A. Slop Gap Coverage Limited to Compensation Act Coverage
® Montana,North Dakota,Ohio, 3 Endorsement
e Washington,West Virginia and SECTION Iii 6
® Wyoming 01 Schedule of Covered&fates - 3
Fara WCW 030313 Printed In USA(Ed.8/00) Pag IDIS
Process Dat : 11/16/11 Polley Expiration Det : 12/04/12
®2000,The Hartford
L,
SECTION I
PARTS ONE and TWO PART THREE
1. WE WILL ALSO PAY 2. How Thls Insurance Applies
D. We Will Also Pay of Pad One (WORKERS' Paragraph 4.of A. How Mlle (neurone Applf a
COMPENSATION INSURANCE);and of Pan 3 (Other States Insurance) Is replaced by
F. We Will Also Pay of Part TWo(EMPLOYERS' the following:
LIABILITY INSURANCE) is replaced by the 4. If you have work on the effective date of this
following: policy In any state not listed In Item SA of the
We Will Also Pay Information Page, coverage will not be
afforded for that state unless we are notified
We will also pay these costs, In addition to within sixty days.
other amounts payable under this insurance,
as part of any claim, proceeding, or suit we PART SIX
defend:
1. reasonable expenses Incurred at our 3. Transfer Of Your Rights and Duties
request,INCLUDING loss of earnings; C. inflator Of Your Rights and Dull a of Part 6
(Conditions)Is replaced by the following:
2. premiums for bands to release Your rights or duties under thispolicy may
attachments and for appeal bonds in bond be transferred or without our written this not
amounts up to the limit of our liabilityconsent.
under this insurance; It you die and we receive notice within sixty
3. litigation costs taxed against you; days after your death,we will cover your legal
4. Interest on a judgment as required by law representative as Insured.
until we offer the amount due under this 4. Liberalization
law;and 11 we adopt a change in this form that would
5. expenses we Incur. broaden the coverage of this form without extra
charge, the broader coverage will apply to this
policy. It will apply when the change becomes
effective in your state.
SECTION II
VOLUNTARY COMPENSATION AND EMPLOYERS' S. The bodily Injury must occur In the United
LIABILITY COVERAGE States of America. Its territories or
5. V lunfary Compensation Insurance possessions, or Canada, and may occur
A. H wThla Insurance Applies if the employee is a United
Applies Slates or Canadian citizen, or otherwise
This Insurance applies to bodily Injury by legal resident,and legally employed,in the
accident or bodily Injury by disease. Bodily United States or Canada and temporarily
Injury Includes resulting death. away from those places.
1. The bodily Injury must be sustained by any 4. Bodily injury by accident must occur
officer or employee not subject to the during the policy period.
workers' compensation law of any state 5, Bodily injury by disease must be caused
shown in Item 3A. of the Information or aggravated by the conditions of the
Page.
2, The bodily Injury must arise out of and In
the course of employment or incidental to
work In a state shown in Item S.A.of the
information Page.
F rut WC 09 03 09 B Printed in U.S,A.(Ed.6/00) Peg 2of6
i10 V
officer's or employee's employment, The if the persona entitled to the benefits of this
officer's or employee's last day of last insurance make a recovery from others, they
exposure to the conditions causing or must reimburse us for the benefits we paid
aggravating such bodily Injury by disease them.
must occur during the policy period. F. Employers'Liability Insurance
B. We Will Pay Pan Two (Employers' Liability Insurance)
We will pay an amount equal to the benefits applies to bodily Injury covered by this
that would be required of you as If you and endorsement as though the State of
your employees wore subject to the workers' Employment was shown In tem 3.A. of the
compensation law of any state shown In Item Information Page.
n S.A. of the information Page. We will pay This provision 5. does not apply in New Jersey or
mthose amounts to the persona who would be Wisconsin.
m o entitled to them under the law. EMPLOYERS'LIABILITY STOP GAP COVERAGE
C. Exclusion
•+ This insurance does not cover. S. Employers'Liability Stop Gap Coverall
.aA. This coverage only applies In Montana,North
o 1. any obligation Imposed by workers'
0 Dakota, Ohio, Washington, West Virginia and
w compensation or occupational disease law
dm, or any similar law. WVo ming.
B. Part One (Workers' Compensation Insurance)
2. bodily Injury Intentionally caused or does not apply to work in states shown In
n aggravated by you. Paragraph A above.
0 9. officers or employees who have elected C. Part Two (Employers' Llabtilty Insurance)
n not to be subject to the state workers'
applies In the states,shown In Paragraph A.,
e compensation law. as though they were shown in Item 3.A.of the
® 4. partners or sole proprietors not covered Information Page.
under the Standard Sole Proprietors, D. Part Two, Section C. Exclusions is changed
v Partners, Officers and Others Coverage by adding these exclusions.
se a=aEndorsement. This insurance does not coven
® D. Before We Pay
a 5. bodily Injury intentonally caused or
IS Before we pay benefits to the persons entitled aggravated by you or in Ohio bodly Injury
m to them,they must: retuning from an act which Is determined
e
1. Release you and us, In writing, of all by an Ohio court of law to have been
responsibility for the Injury or death. committed by you with the belief than an
® 2. Transfer to us their right to recover from Injury is substantially tlty defending to occur.
others who may be responsible for the However, the cost of such
® Injury or death. claims or suits In Ohio Is covered.
3. Cooperate with us and do everything 13. bodily Injury sustained by any member of
e necessary to enable us to enforce the right the tying crew of any aircraft.
B to recover from others. . 14. any claim for bodily injury with respect to
® if the persons entitled to the benefits of this which you are deprived of any defense or
® Insurance fall to do those things, our duty to defenses or am otherWse subject to
I® pay ends at once. If they claim damages from penalty because of default In premium
ms.
you or from us for the Injury or death,our duty under the provisions of the worker'
to pay ends at once. compensation law or laws of a state mee
shown in Paragraph A.
ma E. Recovery From Others E. This Ineuranos applies to damages for which
c If we make a recovery from others, we win you are liable under West Vhginia Code Annot.
wowkeep an amount equal to our expenses of 323-4-2.
= recovery and the benefits we paid. We will
® pay the balance to the persons entitled to It
F nn WC990303B Primed In U.S.A. (Ed.8N0) Page3 f
EXTENDED OPTIONS
1. Enpl yore'Liability Insurance 4. Foreign Voluntary Compensation and
Item 3.B.of the Information Page Is replaced by Employers'Liability Reimbursement
the following: A. How This Reimbursement Applies
B. Employers'Liability Insurance: This reimbursement provision applies to bodily
1. Part Two of the policy applies to work In injury by accident or bodily Injury by disease.
each mate listed In Item 3M. Bodily Injury includes resulting death.
1. The bodily Injury must be sustained by an
The Limits of Liability under Part Two are officer or employee.
the higher of: 2. The bodily injury must occur In the course
of employment necessary or Incidental to
Bodily Injury work In a country not listed in Exclusion
by Accident $500,000 Each Accident C.I.of this provision.
3. Bodily injury by accident must occur
Bodily Injury during the policy period.
by Disease $500,000 Policy Limit 4. Bodily Injury by disease must be caused
or aggravated by the conditions of your
Bodily Injury employment. The officer or employee's
by Disease $500,000 Each Employee last exposure to Those conditions of your
employment must occur during the policy
OR period.
B. We Will Reimburse
2, The amount shown In the Information We will reimburse you for all amounts paid by
Page. you whether such amounts are:
This provision I of EXTENDED OPTIONS does not I. voluntary payments for the benefits that
apply in New York because the Units 01 Our would be required of you if you and your
Liability me unlimited. officers or employeeslsubject to any
In this provision the limits are changed from workers'compensation laww off the state of
$500,000 to$1,000,000 In California. hire of the individual employee.
2. Unlnt ntlonal Failure to Disclose Hazards 2. sums to which Part Two (Employers'
II you unintentionally should fag to disclose all liability Insurance) would apply If the
existing hazards at the inception date of your Country of Employment were shown in
policy, we shall not deny coverage under this Item 3.A.of the Information Page.
policy because of such failure. C. Exclusions
3, Waiver of Our Right To Recover From Others This Insurance does nut cover:
A. We have the right to recover our payments I. any occurrences in the United States,
from anyone liable for an Injury covered by this Canada, and any county or jurisdiction
policy. We will not enforce our right against which is the*subject of trade or economic
any person or organization for whom you sanctions imposed by the laws or
perform work under a written contract that regulations of the United Stales of
requires you to obtain this agreement from us. America in effect es of the hiceplan date
This agreement shall not operate directly or of this policy.
Indireotiy to benefit anyone not named In the 2. any obligation Imposed by a workers'
agreement. compensation or occupational disease
B. This provision 3. does not apply In the states law,or similar law.
of Pennsylvania and Utah. 3. bodily Injury Intentionally caused or
aggravated by you.
F rm WC 00 03 OS B Printed In U.S,A.(Ed.13/00) Page 4 f
41110 11111)
' 4. liability for any consequence, whether of America necessarily incurred as a direct
direct or Indirect, of war, Invasion, act of result of bodily injury.
Foreign enemy,hostilities(whether war be Our reimbursement shall be limited as follows:
declared or not), civil war, rebellion, the amount
to 1. expenses
revolution, insurrection or military or to exceed the normal whichct suchensea
exp
usurped power. No endorsement now orreturning the
subsequently attached to this policy shall officer or employee II in good health,or
be construed as overriding or waiving this 2. In the event of death, to the amount by
limitation unless specific reference is which such expenses exceed the normal
made thereto. cost of returning the officer or employee U
D. Before We Pay alive and In good health.
ren Before we reimburse you for the benefits to the In no event shell our reimbursement exceed
m persons entitled to them,you must have thorn: the bodily injury by accident limit shown In
Item 3.B. of the Information Page as respects
I. release you and us, In writing, of all any one such officer or employee whether
er responsibility for the Injury or death, dead or alive.
0
0ri 2. transfer to us their right to recover from H. Endemic Disease
0. others who may be responsible for their The word "disease" Includes an endemic
v, injury or death, Y
d' diseases.
Ma 3. cooperate with us and do everything
necessary to enable us to enforce the right The coverage applies as if endemic diseases
CI to recover from others. were Included In the provisions of the workers'
m II the persons entitled to the benefits paid fall compensation law.
to do these things,our duty to reimburse ands 6. Longshore and Harbor Workers'Canpeneati n
il
at once. If they claim damages from us for the Act Coverage
® Injury or death, our duly to reimburse ends at general Section C. Workers' Compensation
= once. Law Is replaced by the following:
®eE. Recovery From Others C. Workers'Compensation Law
® If we make a recovery from others, we will Workers' Compensation Law means the
o keep an amount equal to our expenses of workers or workers' compensation law and
recovery and the beneils we reimbursed. We occupational disease law of each state or
o will pay the balance to the persons entitled to territory named in item S.A.of the Information
B it. If persons entitled to the benefits make a Page and the Longshore and Harbor Workers'
recovery from others, they must repay us for Compensation Act (33 USC Sections 901-
rail
the amounts that we have reimbursed you. 950). It includes any amendments to those
F. Reimbursement for Actual Loss Sustained laws that are In effect during the policy period.
® It does not Include any other federal workers
® This endorsement provides only for
al
mewreimbursement for the loss you actually or workers' compensation eatlon law, other provisionsfedeof
sustain. In order for you to recover loss or occupational disease law or the of
® expenses under this reimbursement you must: any law that provide nonoccupational disability
benefits.
NIAM 1. actually sustain end pay the loss or Pan Two (Employers' Liability Insurance), C.
ail
expense In money after trial,or Exclusions, exclusion 8, does not apply to
Mil
® 2. secure our consent for the payment of the work subject to the Longshora and Harbor
wee loss or expense. Workers'Compensation Act.
e O. Repatriation This coverage does not apply to work subject
® Our reimbursement Includes the additional to the Defense Bese Act, the Outer
® expenses of repatriation to the United States Continental Shelf Lands Act, or the
Feel Nonappropriated Fund InatrumentalUles Act.
=
IMM
F nm WC 98 08 03 B Printed In U.S.A. (Ed.8/00) Pap 6 of 6
SECTION III
1. SCHEDULE OF COVERED STATES B. It a state,shown In Item 3A.of the Information
A. This endorsement only applies In the states Page, approves this endorsement after the
listed In this Schedule of Covered States. effective date of this policy, this endorsement
will apply to this policy. The coverage will
apply In the new state on the effegNe date of
the state approval.
C. Schedule of Covered States:
CA
Countersigned by
Augtadzed Representative
F rm WC 9SOSOSB Printed In U.S.A.(Ed.S/00) Peg 6of6
w _
40
DATE
SUPPLEMENT TO CERTIFICATE OF INSURANCE 12/15/2011
NAME OF INSURED: csu consultants Inc.
Additional Descdotion of Ooerations/Remarks from Paae 1.
Additional Information:
SUPP(05/04)