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HomeMy WebLinkAboutPhoenix Electric Company, Inc. 2/2024MINOR CONSTRUCTION AGREEMENT FOR SANITARY SEWER WORK BETWEEN THE TOWN OF LOS ALTOS HILLS AND PHOENIX ELECTRIC CO. This Agreement (this "Agreement") is made and entered into between the Town of Los Altos Hills, a Gener 1 Layv City ("Town") and Phoenix Electric Company, Inc. ("Contractor") effective as of (the "Effective Date"). Town and Contractor are hereinafter collectively referred to as the " arties"). In consideration of their mutual covenants, the Parties hereby agree as follows: 1. Scone of Work. Contractor shall provide the following services and/or materials ("the Work"): Perform nineteen (19) tasks at various locations to improve the Town's sanitary sewer infrastructure • Contractor shall provide certified payroll for this contract. • Contractor is not required to have an excavation or encroachment permit for this work Or, as more particularly described in the Scope of Work, attached hereto and incorporated herein as Exhibit A. The Work shall commence on 3/4/24 and shall be completed to the satisfaction of the Town by 4/4/24 unless such date is extended or otherwise modified by the Town in writing. 2. Payment. Town shall pay Contractor an amount not to exceed: Fifty Thousand and Nine Hundred Dollars ($50,900) for the full and satisfactory completion of the Work in accordance with the terms and conditions of this Agreement. The calculation of payment for the Work shall be set forth as described in the Compensation Form, attached hereto and incorporated herein as Exhibit B. The amount stated above is the entire compensation payable to Contractor for the Work performed hereunder, including all labor, materials, tools and equipment furnished by Contractor. (A) Invoices. Town shall make monthly payments, based on invoices received, for Work satisfactorily performed. Town shall have thirty (30) days from the receipt of an invoice that complies with all of the requirements above to pay Contractor. (B) False Claims Act. Presenting a false or fraudulent claim for payment, including a change order, is a violation of the California False Claims Act and may result in treble damages and a fine of five thousand ($5,000) to ten thousand dollars ($10,000) per violation. (C) Retention and Final Pam. Town shall retain five percent (5%) of each payment, which shall be paid within sixty (60) days after acceptance of the services, as described in Section 11, and submittal to Town of a final invoice, if all services required have been satisfactorily performed. Contractor may substitute securities or establish an escrow in lieu of retainage, pursuant to Public Contract Code Section 22300. 3. Independent Contractor. It is understood and agreed that this Agreement is not a contract of employment and does not create an employer-employee relationship between the Town and Contractor. At all times Contractor shall be an independent contractor and Contractor is not authorized to bind the Town to any contracts or other obligations without the express written consent of the Town. 4. Indemnification. To the fullest extent permitted by law, Contractor shall indemnify, defend (with counsel acceptable to the Town), and hold harmless the Town and its elected and appointed officers, officials, employees, agents, contractors and consultants (collectively, the "Town Indemnitees") from and against any and all liability, loss, damage, claims, expenses and costs (including, without limitation, attorneys' fees and costs of litigation) (collectively, "Liability") of every nature arising out of or in connection with Contractor's performance of the Work or Contractor's failure to comply with this Agreement, except such Liability caused by the gross negligence or willful misconduct of the Town Indemnitees. 5. Excavations. In accordance with Public Contracts Code Section 714, Contractor shall promptly notify the Town in writing of discovery of any material Contractor believes may be hazardous waste as defined in Section 25117 of the Health and Safety Code or of any subsurface or latent physical conditions at the site of any unusual nature differing materially from those generally inherent in the work described in Exhibit A. Upon receipt of such communication, Town shall promptly investigate the conditions and if conditions do materially differ, shall issue a change order providing for additional time or payment of additional costs. 6. Relocation of Utilities. In the event that the completion of the services described in Exhibit A requires the removal or protection of main or trunk line public utility facilities, the Town shall be responsible for removal and protection of such public utilities pursuant to Government Code Section 4215. 7. Insurance. Prior to beginning the Work and continuing throughout the term of this Agreement, Contractor (and any subcontractors) shall, at Contractor's (or subcontractor's) sole cost and expense, furnish the Town with certificates of insurance evidencing that Contractor has obtained and maintains insurance in the following amounts: A. Workers' Compensation that satisfies the minimum statutory limits. B. Commercial General Liability and Property Damage Insurance in an amount not less than TWO MILLION DOLLARS ($2,000,000) combined single limit per occurrence, FIVE MILLION DOLLARS ($5,000,000) annual aggregate, for bodily injury, property damage, products, completed operations and contractual liability coverage. The policy shall also include coverage for liability arising out of the use and operation of any Town -owned or Town -furnished equipment used or operated by the Contractor, its personnel, agents or subcontractors. C. Comprehensive automobile insurance in an amount not less than ONE MILLION DOLLARS ($1,000,000) per occurrence for bodily injury and property damage including coverage for owned and non -owned vehicles. All insurance policies shall be written on an occurrence basis and shall name the Town Indemnitees as additional insureds. The certificates shall contain a statement of obligation on the part of the carrier to notify the Town of any material change, cancellation, termination or non -renewal of the coverage at least thirty (30) days in advance of the effective date of any such material change, cancellation, termination or non -renewal. Further, if the Contractor's insurance policy includes a self-insured retention that must be paid by a named insured as a precondition of the insurer's liability, or which has the effect of providing that payments of the self-insured retention by others, including additional insureds or insurers do not serve to satisfy the self-insured retention, such provisions must be modified by special endorsement so as to not apply to the additional insured coverage required by this agreement so as to not prevent any of the parties to this agreement from satisfying or paying the self-insured retention required to be paid as a precondition to the insurer's liability. Additionally, the certificates of insurance must note whether the policy does or does not include any self-insured retention and also must disclose the deductible. 8. General Warranties and Guarantee. Contractor warrants that: (A) All Work, Products and/or Services are as described in this Agreement, including any exhibits incorporated] conform to all drawings, samples, descriptions and specifications; (B) All Work, Products and/or Services delivered are new and of good merchantable quality, free from material defects of workmanship and fit for the purpose for which sold or provided; (C) Contractor has good title to all Products delivered and all Products delivered are free from liens and other encumbrances; and (D) Contractor's Work will be in strict conformity with all applicable local, state, and federal laws. For purposes of this warranty, any parts not meeting the foregoing quality shall be deemed defective. Contractor shall guarantee the Work to be free of defects in material and workmanship for a period of one (1) year following the Town's acceptance of the Work ("Contractor's Guarantee"), as described in Section 11. As part of Contractor's Guarantee, Contractor agrees to make, at Contractor's own expense, any repairs or replacements made necessary by defects in material or workmanship which become evident within the one-year guarantee period. The Contractor's Guarantee is effective regardless of whether or not a maintenance bond is required by the Town for this Agreement. 9. Contract Bonds. 9.1 General. Before the Town executes this Agreement, the Contractor shall file with the Town surety bonds satisfactory to the Town in the amounts and for the purposes noted in this Section 9. Bonds shall be duly executed by an admitted surety insurer, authorized to issue such bonds in the State of California and secured through an authorized agent with an office in California. The Contractor shall pay all bond premiums, costs, and incidentals. Each bond shall be signed by both the Contractor and surety and the signature of the authorized agent of the Surety shall be notarized. The Contractor shall provide two good and sufficient surety bonds: the payment bond and the faithful performance bond. 9.2 Payment Bond. The Payment Bond (material and labor) shall be for not less than one -hundred percent (100%) of the estimated cost of the construction and completion of the Work hereunder, as security for the payment of all persons performing labor and providing materials in connection with this Agreement and to satisfy claims of material suppliers and of mechanics and laborers contracted for the Work. The bond shall be maintained by the Contractor in full force and effect until the completed Work is accepted by the Town, and until all claims for materials and labor are paid. The bond shall provide that if the Contractor fails to pay any of its obligations, the surety will pay the obligation and, if an action is brought to enforce the liability on the bond, reasonable attorney's fees. 9.3 Faithful Performance Bond. The Faithful Performance Bond shall be for 100% of the of the estimated cost of the construction and completion of the Work hereunder to guarantee faithful performance of all Work, within the time prescribed, in a manner satisfactory to the Town. 9.4 Warranty Bond. <Reserved> 9.5 Bond Renewal and Extension If any bond becomes insufficient, the Contractor shall immediately replace the bond with a substitute upon request from the Town, and the effective date of the bond shall be from the beginning of Work. If any surety at any time is unsatisfactory to the Town, the Town will give notice to the Contractor. No further payments shall be deemed due or will be made under the Agreement until a new surety qualifies and is accepted by the Town. Changes in the Work, or extensions of time, made under the Agreement, shall not release the Contractor or surety from their obligations. The surety must waive notice of such changes or extensions. 10. Licenses. Contractor represents and warrants that Contractor possesses all licenses, permits, and qualifications legally required for the performance of the Work, including but not limited to a business license from the Town and payment of any applicable business license tax. Contractor shall, at Contractor's sole cost and expense, maintain all such licenses, permits and qualifications in full force and effect throughout the term of this Agreement. 11. Damage to Town Facilities and Site Safety. Damage to Town or public facilities or private property caused by the Contractor or by its subcontractors during performance of the Work shall be repaired and/or replaced in kind at no cost to the Town. The worksite shall be kept clean and free of hazards at all times during installation. After work is completed at the site, Contractor shall clean the surrounding area to the condition prior to performance of the Work. 12. Final Inspection and Work Acceptance. All Work shall be subject to final inspection and acceptance or rejection by the Town. Contractor shall guarantee the Work to be free of defects in material and workmanship for a period of one (1) year following the Town's acceptance of the Work. 13. Compliance with all Applicable Laws. A. Contractor shall comply with all applicable local, state and federal laws, regulations and ordinances in the performance of this Agreement. B. Contractor shall not discriminate in the provision of service or in the employment of persons engaged in the performance of this Agreement on account of race, color, national origin, ancestry, religion, gender, marital status, sexual orientation, age, physical or mental disability in violation of any applicable local, state or federal laws or regulations. C. Contractor shall comply with the requirements of the Secretary of Labor and the latest amendments to: Executive Orders 11246 and 11375, as supplemented in Department of Labor regulations (41 C.F.R. chapter 60); the Copeland "Anti - Kickback" Act (18 U.S.C. § 847) as supplemented in Department of Labor regulations (29 C.F.R. part 3); Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. §§ 1701 et seq.); Title VI of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000); Section 109 of Title I of the Housing and Community Development Act of 1974 (42 U.S.C. §§ 5301 et seq.); the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101 et seq.); and Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §§ 701 et seq.) 14. Payment of Taxes; Tax Withholding. Contractor is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes. To be exempt from tax withholding, Contractor must provide Town with a valid California Franchise Tax Board form 590 ("Form 590"). Unless Contractor provides Town with a valid Form 590 or other valid, written evidence of an exemption or waiver from withholding, Town may withhold California taxes from payments to Contractor as required by law. Contractor shall obtain, and maintain on file for three (3) years after the termination of this Agreement, Form 590s (or other written evidence of exemptions or waivers) from all subcontractors. Contractor accepts sole responsibility for withholding taxes from any non -California resident subcontractor and shall submit written documentation of compliance with Contractor's withholding duty to Town upon request. 15. Prevailing Wage. A. The wages to be paid for a day's work to all classes of laborers, workmen, or mechanics on the work contemplated by this Agreement, shall be not less than the prevailing rate for a day's work in the same trade or occupation in the locality within the state where the work hereby contemplates to be performed as determined by the Director of Industrial Relations pursuant to the Director's authority under Labor Code Section 1770, et seq. Each laborer, worker or mechanic employed by Contractor or by any subcontractor shall receive the wages herein provided for. The Contractor shall pay two hundred dollars ($200), or whatever amount may be set by Labor Code Section 1775, as may be amended, per day penalty for each worker paid less than prevailing rate of per diem wages. The difference between the prevailing rate of per diem wages and the wage paid to each worker shall be paid by the Contractor to each worker. The Town will not recognize any claim for additional compensation because of the payment by the Contractor for any wage rate in excess of prevailing wage rate set forth. The possibility of wage increases is one of the elements to be considered by the Contractor. NOTE: An error on the part of an awarding body does not relieve the Contractor from responsibility for payment of the prevailing rate of per diem wages and penalties pursuant to Labor Code Sections 1770-1775. i. Posting of Schedule of Prevailing Wage Rates and Deductions. If the schedule of prevailing wage rates is not attached hereto pursuant to Labor Code Section 1773.2, the Contractor shall post at appropriate conspicuous points at the site of the project a schedule showing all determined prevailing wage rates for the various classes of laborers and mechanics to be engaged in work on the project under this contract and all deductions, if any, required by law to be made from unpaid wages actually earned by the laborers and mechanics so engaged. ii. Payroll Records. Each Contractor and subcontractor shall keep an accurate payroll record, showing the name, address, social security number, work week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed by the Contractor in connection with the public work. Such records shall be certifies and submitted weekly as required by Labor Code Section 1776. 16. Patents. The Contractor shall assume all costs arising from the use of patented materials, equipment, services, or processes used on or incorporated in the Work, and agrees to indemnify and save harmless the Town of Los Altos Hills, the City Council, and the Engineer, and their duly authorized representatives, for all suits at law, or actions of every nature for, or on account of the use of any patented materials, equipment, services, or processes. 17. Dispute Resolution. Prior to initiating litigation in a court of competent jurisdiction, both Contractor and Town shall undergo alternative dispute procedures as outlined in Public Contract Code Section 20104, et seq. The Parties also expressly agree that such procedures are incorporated as though fully set forth in this Agreement. 18. Prevailing. In the event that either party to this Agreement commences any legal action or proceeding (including but not limited to arbitration) to interpret the terms of this Agreement, the prevailing party in such a proceeding shall be entitled to recover its reasonable attorney's fees associated with that legal action or proceeding. 19. Termination. Town may terminate or suspend this Agreement at any time and without cause upon written notification to Contractor. Upon receipt of notice of termination or suspension, Contractor shall immediately stop all work in progress under this Agreement. The Town's right of termination shall be in addition to all other remedies available under law to the Town. 20. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 21. Entire Agreement. This Agreement represents the entire and integrated agreement between the Parties. This Agreement may be modified or amended only by a subsequent written agreement signed by both Parties. 22. Non -Liability of Officials, Employees and Agents. No officer, official, employee or agent of Town shall be personally liable to Contractor in the event of any default or breach by Town or for any amount which may become due to Contractor pursuant to this Agreement. 23. Execution in Counterparts. This Agreement may be executed in counterparts and/or by facsimile or other electronic means, and when each Party has signed and delivered at least one such counterpart, each counterpart shall be deemed an original, and, when taken together with other signed counterpart, shall constitute one Agreement, which shall be binding upon and effective as to all Parties. 24. Choice of Law: Venue. The applicable law shall be that of the State of California 25. Notice. All notices and other communications which are required or may be given under this Agreement shall be in writing and shall be deemed to have been duly given (i) when received if personally delivered; (ii) when received if transmitted by telecopy, if received during normal business hours on a business day (or if not, the next business day after delivery) provided that such facsimile is legible and that at the time such facsimile is sent the sending Party receives written confirmation of receipt; (iii) if sent for next day delivery to a domestic address by recognized overnight delivery service (e.g., Federal Express); and (iv) upon receipt, if sent by certified or registered mail, return receipt requested. In each case notice shall be sent to the respective Parties as follows: Contractor: Town: PHOENIX ELECTRIC COMPANY, INC. 1350 Van Dyke Ave San Francisco, CA 94124 DANIEL LIANG, UTILITY ENGINEERING MANAGER Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 IN WITNESS WHEREOF, the Parties have executed this Agreement as of the date written above. TOWN: By. Peter Pimejad City Manager LI -A Print Name: Eugene Briody Title: Project Manager Task 36 - Secure MH Frame RIEPORT ON CONDITIONS MEQUIRING FOLLOW-UP LOW-UWORK EXHIBIT A �41 V J:�. DATE: MAIN LINE DESIGNATION /ADDRESS /MANHOLE/ SUBASIN hUr' CCTV NEEDED): 1 t t" 7' e —.. L 9A 'i 1 _ REASON SUBMITTED (CIRCL): (Follow-up, needs repair work, mainline only, CCTV) Y\ �l Ol 61 1 Cil rr'" >'�` v,/ 1 yl VV G 0,0 S. % n Cq h Gt Ii n e, REPORTED BY: ENT DISPOSITION: . 1% f 1,� 4�i Signature EVALUATION/ACTION INITIATED: pinnafiiralDncirinn L?z4.rc,;i r., A DATE: 3- 33 ^ A©R_q DATE: � F � f � s � f � s �•, . • •t ..� � .. h � :I �. � I`r`e{'� � U a Task 37 - Rehab Manhole REPORT ON GONDIT NS REQUIRING PooLLOW-UP WORK EXHIBIT DATE � S• illi 2 -012:E - MAIN LINE DESIGNATION /ADDRESS / MANHOLE/ SIJBASIN P( IF CCN NEEDED): '-Z-ice H i O co h -t LA k -t REASON SUBMITTED (CIRCL): (Foilo�,v-up, needs repair work, mainlins only, CCTV) .- M i H fwd :A to y in c,h av1nicA c;-Vnq n c n�'Z. A 1,i w COW �Yn�-U- rv-\Ck%n kN-nd, REPORTED BY: Vi 6, {-o,,e— t , --t v— ,,► eA ENDT DISPOSITIO T l) O f, DATE- S - d d - 2w(2 1 � ' Signature EVALUATION/ACTION INITIATED: Signature/Position DATE: Task 37 - Rehab Manhole `} t TASK 41 - Replace Manhole Cover EXHIBIT A REPORT ON CONDITIONS REQUIRING •WORK DATE: MAIN LINE DESIGNATION / ADDRESS / MANHOLE/ SUBASIN #(IF CCTV NEEDED): a/ /I/ REASON SUBMITTED (CIRCL): (Follow-up, needs repair work, mainline only, CCTV) L_ REPORTED BY: SUPERINTENDENT DISPOSITION: DATE: - — Signature EVALUATION/ACTION INITIATED: Signature/Position DATE: On-line input N:/Forms/MD-344 EXHIBIT A TASK 42 - Replace Manhole Cover FOLLOW-UP WORK EXHIBIT A TASK 44 - Locate Manhole L-1A�-A REPORT ON COND"ITION 'SQUIRING FOLL0W-UP WORK DATE: 1 l �.� .� U MAIN LINE DESIGNATION /ADDRESS 1 MANHOLE) SUBASIN #( IF CCTV NEEDED): k\A 1 0 nI L4 - REASON SUBM ITTED (CIRCL): (Fallow -up, needs repelr work, mefnllne only, CCN) REPORTED BY: � � � \—o r SUPERINT NDENTDISPOSITION: DATE; I`] `cX�'JJ LA. l Signature EVALUATION/ACTION INITIATED: Signature/Position f1n-11nm Inn: if DATE: A 1. 11-__--19,11 •,A TASK 45 - Rehab Manhole REPORT ON CONDITIONS FOLLOW-UP O RK DATE:MAINLINE DESIGNATION /ADDRESS/ MANHOLE/ SUBASIN #(IF CCTV NEEDED): �, �A REASON SUBM ITTED (CIRCL): (Follow-up, needs repair work, mainline only, CCTV) 1- c A to r o vn �c,�n � G uv,� >1-f--�� �, vn S e �t rYt t✓ in j— REPORTED BY: � y C�>� L; SUPERINTENDENT DISPOSITION: DATE: i �- / Signature EVALUATION/ACTION INITIATED: Signature/Position On-line input DATE: EXHIBIT I" -i -`i H- TASK 46 - Locate Lamp Hole REPORT ON OND"'! TO 'ING ONS REQU15 R FOLLOW-UP WORK MAIN LINE DESIGNATION /ADDRESS/ MANHOLE/ SUBASIN #( IF CCTV NEEDED): -- EXHIBIT A DATE: -1 -'Z- 4--, - 1�-Cy)-112— REASON SUBMITTED (CIRC[.}: (Follow-up, needs repatrwork, mainline only, CCTV) UAV �. CA 1 A/ REPORTED BY: SUPERINTENDENT DISPOSITION: DATE: 1I-W)-a6vd- L Nc. v, rl 6 - Signature EVALUATION/ACTION INITIATED: Signature/Position DATE: On-11ne Innut nA 4 EXHIBIT A p TASK 48 - Locate Manhole REPORT ON CONDITIONS REQUIRING WORK sm DATE: t+ 2.6 - t 2 MAIN LINE DESIGNATION / ADDRESS / MANHOLE/ SUBASIN #( IF CCTV NEEDED): v REASON SUBMITTED (CIRCL): (Follow-up, needs repair work, mainline only, CCTV) - S , �.z, Tv o� � � n-�`� c i� cis ►� �1c � r� �n Ct nu s L \N aS 6'_;r'1d REPORTED BY: V C C -D 4-- k�e' Y- !\, &t "IA Signature EVALUATION/ACTION INITIATED: DATE: EMH1105 is located on 26011 Torello Lane. See record drawing Daniel Liang, Town of Los Altos Hills Signature/Position 1/28/24 On-line input N•/Fnrmq/NAn-344 EXHIBIT TASK 50 - Locate Lamp Hole REPORT ON CONDITIONS REQUIRING FOLLOW-UP WORK DATE: �)/1 -7 ` MAIN LINE SUBASIN #(IF CCTV NIOEDE� DRESS /MANHOLE/ /� t M C�' I Fr' o� REASON SUBMITTED (CIRCL) (Dilow-up, needs repair work, mainline only, CCN} �l,' )teCr.5e: VCS .00i2_ , REPORTED BY: NTENDENT DISPRSITION: n - t DATE: \ - 1 Signature EVALUATIONIACTION INITIATED: DATE: Signature/Position On-line Input N:/Forms/MD-344 TASK 51 - Repair Flow Channel EXHIBIT.A REPORT ON CONDITIONS REQUIRING FOLLOW-UP WORK DATE: '71Z J2 MAIN LINE DESIGNATION / ADDRESS / MANHOLE/ SUBASIIN #(IF CCTV NEEDED): � �� �-� �} `j Z REASON SUBMITTED (CIRCL): (Follow-up,e=Fepaii%�:or�rnainline only, CCTV) C iv. P SGS 6 . ('�J REPORTED BY: C �� t`C' t- �. C�' , G; SUPERINTENDENT DISPOSITION: / DATE: Signature EVALUATION/ACTION INITIATED: DATE: Signature/Position On-line input N:/Forms/b1D-344 TASK 52 - Repair Flow Channel EXHIBIT A REPORT ON CONDITIONS REQUIRING FOLLOW-UP WORK DATE: 7 rz i 1� _ MAIN LINE DESIGNATION / ADDRESS / MANHOLE/ SUBASIN #( IF CCTV NEEDED): a l 61�ow � REASON SUBMITTED (CIRCL): (Follow-up, need pair work, mainline only, CCTV) re REPORTED BY: ` 1 l A's, C SUPERINTENDENT DISPOSITION: DATE: Signature EVALUATION/ACTION INITIATED: DATE: Signature/Position On-line input NJForms/MD-344 EXHIBIT A TASK 56 - Locate Lamp Hole I N RIN REPORT ON CON61110 8 ktw G FOLLOW-UP WORK DATE: 121'2 '2C.. -,?)- MAINLINE DESIGNATION /ADDRESS/ MANHOLE/ SUBASIN#(IFCCTV NEEbED): cc) I OC) k , REASON $UbMITTED(CIRCL): (Follow-up, needs repalr work, rn'qlnllne only, CCN 0 C, C&- VC 4 0--V71 J. REPORTED BY SUPERINTENDENT DISPOSITION: DA L A- 0 1. _If AA1f- Signature EVALUATION/ACTION INITIATED: DATE: Unable to read the first letter. Is the Manhole 11) BC0 100 1 ? Please respond. Danne' bang', 1125/24 Signature/Position EXHIBIT A TASK 58 REPORT ON CONDITIONS REQUIRING FOLLOW-UP WORK DATE: a Luel MAIN LINE DESIGNATION l ADDRESS / MANHOLE/ SUBASIN #( IF CCTV NEEDED): Lf p [ —dDe cccv1'Zc7_ Los At 10-S 1-411/5A REASON SUBMITTED ((C�I`RCL `_"Q(Follow-u, needs repair work, mainline only, ccTN) (� cal C..,,- j c c L ti c c -f C- / REPORTED BY: -\. (j SUPERINj�NDENT DISPOSITION: DATE: 5h e.6t ; ue GOrA' t'je Signature _ EVALUATIOWACTION INITIATED: DATE: Signature/Position On-line input N:IForms/MD-344 TASK 59 EXHIBIT A REPORT ON CONDITIONS REQUIRING FOLLOW-UP WORK DATE: , MAINLINE DESIGNATION /ADDRESS / MANHOLE/ SU BASIN #( IF CCTV NEEDED: ) �(`C,�-.�7� Q/' 1416 L2 REASON SUBMITTEDCIRCL a, ( ) (Follow-up needs repair work, mainline only, CCTV) r Mn Cia 'Icl e 0_A 1a t� r z.. REPORTED BY: SUPERINTENDENT DISPOSITION: Signature EVALUATION/ACTION INITIATED: Signature/Position DATE: Z1,01 —/ r ",)i DATE: On-line input WForms/MD-344 TASK 61 - Raise Manhole Ring EXHIBIT A : 1 , RE 0 0 R'T ON C ONb I T - IONS REQUIRING FOLLOW-UP WORK DATE: I I z MAIN LINE DESIGNATION /ADDRESS I MANHOLE/ SUBASIN #(IF CCTV NEEDED): REASON SUBMITTED (GIRCL): (Follo*up, needs repair work, mainline only, CCTV) -2- REPORTED BY: SUPERINTENDENT DISPOSITION: DATE: V .—,,) / Signature EVALUATION/ACTION INITIATED: Signature/Position DATE: On-line Input NlForms=-344 J , / 44 +� 4, Ah s.Will �! ~ _ mob- �' ,�• EXHIBIT A TASK 62 - Locate Lamp Hole REPORT ON CONDITIONS REQUIRING FOLLOW-UP WORK DATE: �Z /Z-/ MAINLINE DESIGNATION /ADDRESS/ MANHOLE/ SUBASIN #( IF CCTV NEEDED): Cf - REASON REASON SUBMITTED (CIRCL): (Follow-up, needs repair work, mainline only, CCTV) �) � CI,5_e E, IAJ C � ('Ct ,>. C,_/+ REPORTED BY: CCS SUPERINTENDENT DISPOSITION: DATE: Signature EVALUATION/ACTION INITIATED: DATE: Signature/Position On-line input NIFormsIVID-344 Task 65 - Repair Flow Channel EXHIBIT A REPORT ON CONDITIONS REQUIRING FOLLOW-UP WORK DATE: 10/27/2020 MAINLINE DESIGNATION / ADDRESS/ MANHOLE#: MANHOLE GMH1066 PAGE MILL EA REASON SUBMITTED: (Follow-up, needs repair work, mainline only) MANHOLE CHANNEL SEVERLY DETERIORATED RECOMMEND REPAIR REPORTED BY: LXM SUPERINTENDENT DISPOSITION: Signature EVALUATION/ACTION INITIATED: Signature/Position DATE: DATE: N:/Forms/MD-344 t � I �-..rte._ ,y��" t _ .. _N�3�a��•. ��. A ., � • .. . ' i LAH EMH1197-EMH1243 LAH EMH1197 EMH1243 C VCP 92.800 ft. EMM 1 500 Laurel Street Menlo Park, CA 94025 PH(650) 321-0384 Fax: (650) 321-4265 www.westbaysanitary.org Main Inspections SNELL EA BRANCH 2 202012021 _r cl End d ' 10!1312021 10:44 AM 13102021105718 Width. 6 in. Work osier no.: F Completed Observatic-ric Dts,-,,ncc her. FromjT'o Code Modifier Rating 0.0 ft. D 1 AMH 0.0 ft D I MWL 4.9 ft. L, 31 TF 05.9 ft. D 12 1 TF 92.2 ft. D 1 LL 2 12 8 ft. D J LL 92.8 ft. D f MSA Main Inspections LAH EMH1197-EMH1243 LAH EMH 1197 EMH1243 C VCP 13.300 ft. EMM 1 SNELL EA 10/14/2021 9:03 AM 6 in. F Completed Observations 500 Laurel Street Menlo Park, CA 94025 PH (650) 321-0384 Fax. (650) 321-4265 www.westbaysanitary org BRANCH 2 202012021 1410202191124 Distance Dir. ' From/To Code Modifier Rating ------------- 0.0 ft. U / AMH 0.0 ft. U / MWL 3.0 ft. U 2 1 TF 13.3 ft. U 1 LR 13.3 ft. U ! MGO 13.3 ft. U I MSA Main Inspections Page 1 of 1 EXHIBIT B 2/28/2024 Task Report No. Item Date Address Scope of Work Subtotal 36 Rehab manhole 3/16/22 26055 Newbridge Dr HMH1113 - Construct new concrete collar to $ 2,500 secure frame, replace MH cover 37 Rehab manhole 3/16/22 26985 Orchard Hill Dr IMH1065 - Remove roots and rehab MH, $ 2,500 replace MH cover. 41 Install manhole 11/30/23 11/30/23 11853 Murietta Lane - Replace wood lid with a metal $ 600 cover MH cover on a private property 42 Raise manhole 11/28/22 12840 Normandy Ln LMH1068 - Raise manhole cover, construct $ 2,500 frame concrete collar, replace MH cover Locate & rehab KMH1094 - Locate manhole, raise MH frame, 44 7/19/22 25810 Vinedo Ln rehab MH, construct concrete collar, and $ 4,000 manhole replace MH cover OMH1046 - Locate manhole, raise MH frame, Locate & rehab 45 7/21/22 Rhus Ridge rehab MH, construct concrete collar, and $ 4,000 manhole replace MH cover 46 Locate lamp hole 7/26/22 26930 Orchard Hill Ln IC01006 - IMH1040 - Locate lamp hole $ 1,200 ICO1006. Find CO at 13480 Robleda Rd EMH1105 - Locate manhole, raise MH frame, 48 Locate manhole 4/25/22 26011 Torello Lane construct concrete collar, rehab MH, see $ 3,500 record drawing 50 Locate lamp hole 8/17/21 14188 Stanford Ct DC01002 - Locate lamp hole $ 1,000 56 Locate lamp hole 12/22/22 27985 Via VentanaWa GCO1001 - locate lamp hole $ 1,000 Y 58 Locate lamp hole 5/18/21 26347 Esperanza ECO1008 - locate lamp hole $ 1,200 59 Locate manhole 5/18/21 11800 Murietta Ln OMH1012 - locate manhole, raise MH frame, $ 3,500 construct concrete collar, replace cover Raise manhole EMH1032 - raise MH frame, construct 61 frame 4/18/21 26405 Ascension Dr concrete collar, replace MH cover $ 2 500 62 Locate lamp hole 4/21/21 26966 BC01005 - locate lamp hole $ 1,200 Fremont Rd 63 Investigate lamp 1/20/21 13091 La Paloma Dr HMH1054 - field verify if the lamp hole is $ 1,200 hole abandoned Page Mill near 65 Repair MH 10/27/20 27979 Via Ventana GMH1066 - repair flow channel $ 2,500 channel Way Raise manhole EMH1052 - raise MH frame, construct 67 frame 12/7/23 26327 Esperanza Dr concrete collar, replace MH cover. $ 2,500 70 Remove cap 10/19/21 12008 Adobe Creek OMH1026 - OMH1027 - remove cap in DSMH $ 1,000 ' Lodge Rd (OMH1026) 71 Realign sewer pipe 10/14/21 26640 Snell Ct EMH1197 - EMH1198 - Realign 20' of pipe $ 10,000 from DSMH to avoid sharp turns. See as -built Performance & Payment Bondsl $ 2,500 TOTAL $ 50,900 Note: Manhole covers are furnished by the Town PHOEELE-01 SHUDS '4coRv CERTIFICATE OF LIABILITY INSURANCE DATE I20120Y 11 /20/203 23 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Shanel Hudson Panorama Risk & Insurance Solutions, LLC PHONE FAX 52 S 1st Street, #310 A/C, No, Ext): (A/C, No): San Jose, CA 95113 ADDRESS: shudson@panorama360.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Indemnity Company Of Connecticut (The) 25682 INSURED INSURER B: Travelers Indemnity Company Of America (the) 25666 Phoenix Electric Co. INSURER C: Homesite Insurance Company Of Florida .11156 1350 Van Dyke Ave. INSURER D: Travelers Property Casualty Company of America 25674 San Francisco, CA 94124 _- - INSURER E: Ironshore Specialty Ins Co 25445 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN D WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCURDT22-CO-4X12122A-TCT-23 11/2/2023 11/2/2024 DAMAGE TO RENTED 300,000 X X PREMISES _.(Ea occurrence -_ -j- - _ MED EXP_(Any one person) 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X PRO- LOC 2,000,000 JECT PRODUCTS - COMP/OP AGG $ OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident__. -_- --- $ _ X ANY AUTO X X 810 -4X004641 -23-26-G 11/2/2023 11/2/2024 BODILY INJURY tPerperson) $ - OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE -. AUTOS ONLY AUTOS ONLY (per accident) _ $ C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5'000'000 X EXCESS LIAB CLAIMS -MADE CXP-011888-01 11/2/2023 11/2/2024 AGGREGATE $ 5,000,000 DED RETENTION $ $ D WORKERS COMPENSATION X AND EMPLOYERS' LIABILITY Y / N STATUTE ERH ANY PROP RI ETOR/PARTNER/EXECUTIVE - X UB -4X172697 -23-26-G 11/2/2023 11/2/2024 1,000,000 OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT _ (Mandatoryin NH) E.L. DISEASE - EA EMPLOYEE', $ 1'000'000 If yes, describeunder 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT $ E Pollution/Mold ICELLUW00148274 5/19/2023 5/19/2024 Each occurrence 2,000,000 E Pollution/Mold ICELLUW00148274 5/19/2023 5/19/2024 General Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Westwind Community Barn. Per written contract with the Named Insured. The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers"s are an Additional Insured, as respects general liability, perform CG D2 46 04 19 attached. General Liability Primary and Non-contributory applies per form CCG T1 00 02 19 attached. General Liability waiver of subrogation applies per form CG D3 16 02 19 attached. Auto Additional Insured and Auto Primary Non-contributory wording applies per form CA T4 99 02 16 attached. Auto waiver of subrogation applies per form CA T353 02 15 attached. Workers Compensation waiver of subrogation applies per form WC 99 03 76 (A) attached. 30 day notice of cancellation, except 10 day notice of cancellation for non-payment of premium. CIR form attached. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Los Altos Hills -Contracts THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town TownFremont Road ACCORDANCE WITH THE POLICY PROVISIONS. Los Altos Hills, CA 94022 AUTHORIZED REPRESENTATIVE — ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ARO � AGENCY CUSTOMER ID. PHOEELE-01 LOC #: 1 ADDITIONAL REMARKS SCHEDULE SHUDSON Page 1 of 1 AGENCY NAMED INSURED Panorama Risk & Insurance Solutions, LLC Phoenix Electric Co. 1350 Van Dyke Ave. San Francisco, CA 94124 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Contractual Insurance Requirements - CIR Form The attached Certificate of Insurance is provided as part of our service, to our client, the insured. If special endorsements have been provided, they are also indicated attached. You may find that these documents do not comply with all the terms and conditions of the underlying contract between the Certificate Holder and the Insured due to the insurance company's insuring conditions, limitations, exclusions and other terms. If you have any questions, please contact the undersigned. Panorama Risk & Insurance Solutions 52 S. First St., #310 San Jose, CA 95113 CA License #6001592 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Named Insured: Phoenix Electric Company Policy No.: DT22-CO-4X12122A-TCT-23 Policy Term: 11-2-23/24 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit' is brought against insured does not apply to: the additional insured: CG D2 46 0419 0 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 Named Insured: Phoenix Electric Company; Policy No.: DT22-CO-4X12122A-TCT-23 Policy Term: 11-2-23/24 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. d. Primary And Non -Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis, this insurance is primary to other insurance that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: c. The first Named Insured must keep records of a. Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request. b. Regarding websites, only that part of a website 6. Representations that is about your goods, products or services By accepting this policy, you agree: for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 © 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Named Insured: Phoenix Electric Company Policy No.: DT22-CO-4X12122A-TCT-23 Policy Term: 11-2-23/24 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 this 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 coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured — Unnamed Subsidiaries B. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Operations PROVISIONS A. WHO IS AN INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION II — WHO IS AN INSURED: C. Incidental Medical Malpractice D. Blanket Waiver Of Subrogation E. Contractual Liability — Railroads F. Damage To Premises Rented To You a. An organization other than a partnership, joint venture or limited liability company; or b. A trust; as indicated in its name or the documents that govern its structure. Any of your subsidiaries, other than a partnership, B. BLANKET ADDITIONAL INSURED — joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR not shown as a Named Insured in the AUTHORIZATIONS RELATING TO OPERATIONS Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: a. Before you maintained an ownership interest of more than 50% in such subsidiary; or The following is added to SECTION II — WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury", "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II — Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the "products -completed operations hazard". CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE 1. The following replaces Paragraph b. of the definition of "occurrence" in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician or paramedic; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. D. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; 4. The following exclusion is added to subsequent to the execution of the contract or Paragraph 2., Exclusions, of SECTION I — agreement. COVERAGES — COVERAGE A — BODILY E. CONTRACTUAL LIABILITY — RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY: 1. The following replaces Paragraph c. of the Sale Of Pharmaceuticals definition of "insured contract" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or c. Any easement or license agreement; ordinance relating to the sale of Page 2 of 3 © 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured a. Any premises while rented to you or contract" in the DEFINITIONS Section is temporarily occupied by you with permission deleted. of the owner; or F. DAMAGE TO PREMISES RENTED TO YOU b. The contents of any premises while such The following replaces the definition of "premises premises is rented to you, if you rent such damage" in the DEFINITIONS Section: premises for a period of seven or fewer "Premises damage" means "property damage" to: consecutive days. CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Named Insured: Phoenix Electric Company Policy No.: 810 -4X004641 -23-26-G Policy Term: 11-2-23/24 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE CONTRACTORS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS, 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION fl -- COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured", 2. The following is added to Paragraph B.S., Other Insurance of SECTION IV -- BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d, of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other Insurance under which an additional insured person or organization is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non- contributory. CA T4 99 02 16 6 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. Named Insured: Phoenix Electric Company Policy No.: 810 -4X004641 -23-26-G Policy Term: 11-2-23/24 COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or 'loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or"loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How - N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Named Insured: Phoenix Electric Company Policy Term: 11-2-23/24 TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — POLICY NUMBER: UB -4X172697 -23-26-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 11-2-23 Policy No. UB -4X172697 -23-26-G Endorsement No. Insured phoenix Electric Company Premium Insurance Company Countersigned by Travelers Property Casualty Company of America DATE OF ISSUE: - - ST ASSIGN: Page 1 of 1