HomeMy WebLinkAboutAgr 2020-11-04 (First Serve Productions) TOWN OF TIBURON
1505 Tiburon Boulevard,Tiburon CA 94920
CONSTRUCTION SERVICES AGREEMENT
Teather Park Tennis Court Resurfacing Project
Agreement No. 20-PK-06
DATE: November 4, 2020
1. IDENTIFICATION OF CONTRACTOR:
CONTRACTOR: First Serve Productions, Inc.
LICENSE NO: 773811
2. SCOPE OF THE WORK
See Full Scope of Work attached as Appendix A.
3. COMPENSATION FOR WORK. Contractor's total compensation for the Work performed under this Agreement
(Contract Sum) is $21,275.00, to be paid as (check one): (1) X lump sum; (2) ❑ lump sum with progress
payments; (3) ❑ per attached schedule of rates and charges, up to a guaranteed not-to-exceed amount of
$ . All payments(check one): ❑ shall X shall not be subject to a five percent (5%) retention.
4. SCHEDULE OF PERFORMANGE FOR THE WORK Contractor shall commence and complete the Work by the
following dates:
Commencement Date shall be on the date established in the Notice to Proceed. Owner reserves the right to
modify or alter the Commencement Date of the Work.
Final Completion Date: Within 30 calendar days of Notice to Proceed date.
5. TERMS AND CONDITIONS.
5.01 Contractor shall perform the Work in accordance with the terms and conditions of this Agreement and the
following attachments (together, Contract Documents):
A. Appendix A—Scope of Work
B. Appendix B—General Conditions
C. Appendix C—Insurance
5.02 The Contract Documents are the sole and exclusive provisions that govern the Work described herein. Any
provision contained in any purchase order issued in connection with this Agreement or the Work described
herein shall be null and void and shall have no force or effect.
5.03 Agreement number must appear on all invoices and correspondence. Send invoices in duplicate immediately
upon performance of Work ordered hereon to:
Town of Tiburon, Department of Public Works, 1505 Tiburon Boulevard,Tiburon, CA 94920
Construction Services Agreement
Project No.: 20-PK-06 00 5205-1
CONTRACTOR: First Serve Production�,Inc. OWN ;To of Tiburon
' nature Sign ure
Chane ohnson ,� G��.�,�r �f� .�'��-�,-�--�
Prink Name&Title Print Na e&Title
11 i4i�o �� /s/ � �
Date Date
T4WN ATTORNEY: (Approved As To Form)
�- -
Signature
Benjamin L. Stock
Print Name&Title
11/12/2020
Date
Construction Services Agreement
ProJect No.: 20-PK-OB 00 5205-2
Appendix A to Construction Services Aqreement
SCOPE OF WORK
Repairing and resurfacing of 2 tennis courts
1. Flood test for waterholes and mark for inspection to review. Approximately 5 on Court
#1.
2. Clean and prepare surFace for repair work, clean out all cracks.
3. Fill all cracks with court patch binder.
4. Sand down all repaired areas before coating surface.
5. Apply 2 coats of acrylic resurfacer to tennis courts.
6. Apply 2 coats of full color acrylic to tennis courts. Color TBD
7. Apply approved white line paint to USTA standards.
8. Furnish and install crack repair tape system to approximately 775 LF of cracks. Court
#1 (next to parking lot) 225 LF. Court#2 (furthest from parking lot) 550 LF.
Construction Services Agreement
Project No.: 20-PK-06 00 5205-3
Appendix B to Construction Services Aqreement
GENERAL CONDITIONS
ARTICLE 1 TERMS OF PERFORMANCE
1.01 Construction Services Agreement (Agreement) Force and Effect. The provisions of the Agreement and
other Contract Documents constitute the entire agreement between the Contractor and Owner regarding the
Work described herein. No representation, term or covenant not expressly specified in the Contract Documents
shall, whether oral or written, be a part of this agreement. The Agreement and other Contract Documents shall
govern the Work described herein (whenever performed), and shall supersede all other purchase orders and
agreements between Contractor and Owner, and any proposal, with respect to the Work described herein.
1.02 No Modification or Waiver. The Contract Documents may not be modified, nor may compliance with any of its
terms be waived, except by written instrument executed and approved by fully authorized representatives of
Owner and Contractor. Contract Documents headings are for convenience only and do not affect the
construction of the Contract Documents.
1.03 Performance of Work/No Assignment. Time is of the essence in the perFormance of the Work. Contractor
will perform the Work in a skillful and workmanlike manner; comply fully with criteria established by Owner, and
with applicable laws, codes, and all applicable industry standards. Contractor shall maintain its work area in a
clean and sanitary condition, clear debris and trash at the end of each work day, and shall not damage or
disrupt any property unless specifically part of the scope of the Agreement. Contractor shall not contract any
portion of the Work or otherwise assign the Agreement without prior written approval of Owner. (Contractor
shall remain responsible for compliance with all terms of the Contract Documents, regardless of the terms of
any such assignment.) The Contractor shall permit Owner (or its designees) access to the work area,
Contractor',s shop, or any other facility, to permit inspection of the Work at all times during construction and/or
manufacture and fabrication. The granting of any progress payment, and any inspections, reviews, approvals
or oral statements by any Owner representative, or certification by any governmental entity, shall in no way limit
Contractor's obligations under the Contract Documents. Either party's waiver of any breach, or the omission or
failure of either party, at any time, to enforce any right reserved to it, or to require strict performance of any
provision of the Contract Documents, shall not be a waiver of any other right to which any party is entitled, and
shall not in any way affect, limit, modify or waive that party's right thereafter to enforce or compel strict
compliance with every provision hereof. Owner shall have, at all times, set-off rights with respect to any
payment and Contractor's failure to perform the terms of the Contract Documents.
ARTICLE 2 LEGAL AND MISCELLANEOUS
2.01 Records and Payment Requests. Contractor shall submit all billings with all necessary invoices or other
appropriate evidence of proper performance, after which Owner shall make payment within thirty (30) days.
Upon Owner's written request, Contractor shall make available to Owner, its authorized agents, officers, or
employees, any and all ledgers, books of accounts, invoices, vouchers, cancelled checks, and other records or
documents evidencing or relating to the Work or the expenditures and disbursement charged to Owner, and all
correspondence, internal memoranda, calculations, books and accounts, records documenting its Work under
the Agreement, and invoices, payrolls, timecards, records and all other data related to matters covered by the
Agreement. Contractor shall furnish to Owner, its authorized agents, officers, or employees, such other
evidence or information as Owner may require with regard to the Work or any such expenditure or
disbursement charged by Contractor. Contractor shall maintain all such documents and records prepared by or
furnished to Contractor during the course of performing the Work for at least five years following completion of
the Work, except that all such items pertaining to hazardous materials shall be maintained for at least thirty (30)
years. Contractor shall permit Owner to audit, examine and make copies, excerpts and transcripts from such
records. The State of California or any federal agency having an interest in the subject of the Agreement shall
have the same rights conferred to Owner by this section. Such rights shall be specifically enforceable.
2.02 Independent Contractor. Contractor is an independent Contractor and does not act as Owner's agent in any
capacity, whatsoever. Contractor is not entitled to any benefits that Owner provides to Owner employees
including, without limitation, insurance, worker's compensation benefits or payments, pension benefits, health
benefits or insurance benefits. Terms within the Contract Documents regarding directives apply to and concern
the result of the Contractor's provision of Work not the means, methods, or scheduling of the Contractor's Work.
Contractor shall be solely responsible for the means, methods, techniques, sequences and procedures with
respect to its provision of Work under the Contract Documents. Contractor shall pay all payroll taxes imposed
by any governmental entity and will pay all other taxes not specifically identified in the Contract Documents as
Owner's responsibility.
Construction Services Agreement
Project No.: 20-PK-06 00 5205-5
2.03 IndemnitylLiability. Contractor shall defend, indemnify, and save harmless, to the fullest extent permitted by
law, the Owner and each of its Council Members, officers, directors, representatives, agents and employees
("Indemnitees"), against all claims, suits, actions, loss, cost, damage, expense, and liability directly or indirectly
arising out of, connected with, resulting from, or related to bodily injury to or death of any person or damage to
any property, or resulting from performance of the Work, failure to perform the Work, or condition of the Work
that is caused in whole or part by any act or omission of Contractor, Subcontractors, anyone directly or
indirectiy employed by any of them, or anyone for whose acts any of them may be liable, resulting from any
cause whatsoever except the Indemnitees' sole negligence, willful misconduct, or active negligence.
Notwithstanding any provision of the Contract Documents, Owner shall not be liable to Contractor or anyone
claiming under it, in contract or tort, for any special, consequential, indirect or incidental damages arising out of
or in connection with the Contract Documents or the Work. Owner's rights and remedies, whether under the
Agreement or other applicable law, shall be cumulative and not subject to limitation.
2.04 Defective Work; Warranties. Contractor warrants that all construction services shall be performed in
accordance with generally accepted professional standards of good and sound construction practices, all
Contract Documents requirements, and all laws, codes, standards, licenses, and permits. Contractor warrants
that all materials and equipment shail be new, of suitable grade of their respective kinds for their intended uses,
and free from defects. Contractor hereby grants to Owner for a period of one year following the date of
completion its unconditional warranty of the quality and adequacy of all of the Work including, without limitation,
all labor, materials and equipment provided by Contractor and its Subcontractors of all tiers. If either prior to
completion of the Work, or within one year after completion, any Work (completed or incomplete) is found to
violate any of the foregoing warranties (Defective Work), Contractor shall promptly, without cost to Owner and
in accordance with Owner's written instructions, correct, remove and replace the Defective Work with
conforming Work, and correct, remove and replace any damage to other Work or other property resulting
therefrom. If Contractor fails to do so, Contractor shall pay all of the Owner's resulting claims, costs, losses and
damages. Where Contractor fails to correct Defective Work, or defects are discovered outside the correction
period, Owner shall have all rights and remedies granted by law.
2.0� Compliance with Laws; Conflict of Interests. Contractor agrees fo comply with all applicable fiederal and
state laws, regulations and policies, as amended, including those regarding discriminafiion, unfair labor
practices, anti-kick-back, collusion, and the provisions of the Americans with Disability Act. Contractor, its
officer, partners, associates, agents, and employees, shall not make, participate in making, or in anyway
attempt to use the position afforded them by the Contract Documents to influence any governmental decision in
which he or she knows or has reason to know that he or she has a financial interest under applicable state,
federal and local conflict of interest regulations. Contractor warrants that no person or agency has been
employed or retained to solicit or obtain the Agreement upon an agreement or understanding for a contingent
fee, except a bona fide employee or agency.
2.06 Termination; Suspension; Disputes. Owner may direct Contractor to terminate, suspend, delay, interrupt or
accelerate Work, in whole or in part, for such periods of time as Owner may determine in its sole discretion.
Owner will issue such directives in writing, and may do so, in whole or in part, for its convenience or due to
Contractor's fault. Owner will compensate Contractor for extra costs resulting from such directives only to the
extent that Owner issues such directives for its convenience and not due to Contractor's fault (but Owner shall
not compensate Contractor for costs, profit or overhead anticipated to be earned or incurred on Work
terminated for Owner's convenience.) Contractor shall continue its Work throughout the course of any dispute,
and Contractor's failure to continue Work during a dispute shall be a material breach of the Contract
Documents. All claims by Contractor against Owner shall be submitted in writing to Owner, and shall be
governed by Public Contract Code Sections 20104 — 20104.6, after which time the one year time period in
Government Code Section 911.2 shall be, pursuant to Government Code Section 930.2, reduced to 90 days.
Should Contractor be terminated for default, and such termination is subsequently determined to be wrongful,
such termination will be converted to a termination for convenience as provided herein.
2.07 Execution; Venue; Limitations. The Agreement shall be deemed to have been executed in Marin County,
California. Enforcement of the Contract Documents shall be governed by the laws of the State of California,
excluding its conflict of laws rules. Except as expressly provided in the Contract Documents, nothing in the
Contract Documents shall operate to confer rights or benefits on persons or entities not party to the Agreement.
As between the parties to the Agreement, any applicable statute of limitations for any act or failure to act shall
commence to run on the date of Owner's issuance of the final Certificate for Payment, or termination of the
Contract Documents, whichever is earlier, except for latent defects, for which the statute of limitation shall begin
running upon discovery of the defect and its cause.
Construction Services Agreement
Project No.: 20-PK-06 00 5205-6
2.08 Employee Wages; Records; Apprentices. Contractor shall pay prevailing wages to its employees on any
contract in excess of$1,000.00 (one thousand dollars). Copies of the prevailing rate of per diem wages are on
file at Owner's principal office. Contractor shall comply with the 8-hours per day/40 hours per
week/overtime/working hours restrictions for all employees, pursuant to the California Labor Code. Contractor
and all subcontractors shall keep and maintain accurate employee payroll records for Work performed under
the Agreement. The payroll records shall be certified and submitted as required by law, including Labor Code
Section 1771.4 (if applicable) and 1776, including (if the Agreement is awarded on or after April 1, 2015 or
continues on or after January 1, 2016) to the Labor Commissioner no less frequently than monthly. Contractor
shall comply fully with Labor Code Section 1777.5 in the hiring of apprentices for work relating to the
Agreement. If the Agreement exceeds $2,000 and is funded with federal funds, then Contractor shall pay
federal Davis Bacon wages and comply with applicable federal requirements.
2.09 Mandatory Contractor and Subcontractor Registration. Pursuant to Labor Code Section 1771(a), Contractor
represents that it and all of its Subcontractors are currentiy registered and qualified to perform public work
pursuant to Labor Code Section 1725.5. Contractor covenants that any additional or substitute Subcontractors
will be similarly registered and qualified.
2.10 Worker's Compensation. Pursuant to Labor Code Sections 1860 and 1861, in accordance with the provisions
of Section 3700 of the Labor Code, every contractor will be required to secure the payment of compensation to
his employees. Contractor represents that it is aware of the provisions of Labor Code Section 3700 that require
every employer to be insured against liability for workers' compensation or to undertake self-insurance in
accordance with the provisions of that Code, and Contractor shall comply with such provisions before
commencing the performance of the Work.
2.11 Construction Performance Bond; Construction Labor and Materials Payment Bond; Securities in Lieu of
Retention Escrow Account.
A. If Contract Sum under the Agreement exceeds (or is expected to exceed) $25,000, Contractor shall provide a
construction performance bond in form attached hereto as A�pendix D —Construction Performance Bond, and
a construction labor and material payment bond, in accordance with Civil Code Section 9550 and in form
attached hereto Appendix E—Construction Labor and Materials Pavment Bond. Contractor may not substitute
cash in lieu of the required bond(s).
B. If the Agreement specifies performance retention, Contractor may elect to substitute securities or direct
payment to an escrow account, pursuant to Public Contract Code Section 22300 (incorporated herein by this
reference).
2.12 Earthwork and Underground Facilities. If the Work involves digging trenches or other excavations that
extend deeper than four feet below the surface, Contractor shall notify Owner in writing of any material that
Contractor believes may be hazardous waste that is required to be removed in accordance law, subsurface or
latent physical conditions at the site differing from those indicated by information about the site made available
to bidders prior to the deadline for submitting bids, or unknown physical conditions at the site of any unusual
nature, different materially from those ordinarily encountered and generally recognized as inherent in work of
the character provided for in the Contract Documents, pursuant to Section 7104 of the Public Contract Code.
For any Work involving trench shoring that costs in excess of$25,000, Contractor shall submit and Owner(or a
registered civil or structural engineer employed by Owner) must accept, in advance of excavation, a detailed
plan showing the design of shoring, bracing, sloping, or other provisions to be made for worker protection from
the hazard of caving ground during the excavation of such trench or trenches, pursuant to Labor Code Section
6705. If such plan varies from the shoring system standards, the plan shall be prepared by a registered civil or
structural engineer. Consistent with Government Code Section 4215, as between Owner and Contractor,
Owner will be responsible for the timely removal, relocation, or protection of existing main or trunk line utility
facilities located on the Site only if such utilities are not identified in the Contract Documents or information
made available for bidding.
Construction Services Agreement
Project No.: 20-PK-06 00 5205-7
Appendix C to Construction Services Aqreement
INSURANCE
1. Commercial General Liability Insurance, written on an "occurrence" basis, which shall provide coverage for bodily
injury, death and property damage resulting from operations, liability for slander, false arrest and invasion of
privacy, blanket contractual liability, broad form endorsement, and completed operations, personal and advertising
liability, with limits of not less than [$1,000,000] general aggregate and [$1,000,000] each occurrence, subject to a
deductible of not more than [$1,000] payable by Contractor.
2. Business Automobile Liability Insurance with limits not less than [$1,000,000] each occurrence including coverage
for owned, non-owned and hired vehicles, subject to a deductible of not more than [$1,000] payable by Contractor.
3. Workers' Compensation Employers' Liability limits not less than [$1,000,000] each accident, [$1,000,000] per
disease and [$1,000,000] aggregate. Contractor's Workers' Compensation Insurance policy shall contain a Waiver
of Subrogation against the Town of Tiburon, its officers, directors, officials, agents, employees and volunteers. In
the event Contractor is self-insured, it shall furnish Certificate of Permission to Self-Insure signed by Department of
Industrial Relations Administration of Self-Insurance, State of California.
'�.
4. Bui � � surance mcluding, without limitation, coverage against loss or damage t c by fire,
lightening, wind, h� iot, vehicle damage, explosion, smoke, falling ob�e ism, malicious mischief,
collapse, and other such hazar s mally covered by suc . Such insurance shall be in amount
equal to the replacement cost (without deduc io on and subject to stipulated value in lieu of average
clause) of all construction constitutin e Work, e cost of excavations, of grading and filling
of the land, and except nsurance may be subject to deductible c to exceed [$10,000] for any
one loss. � rance will not cover loss or damage to Contractor's equipment, sca ��the_r materials
e consumed in the construction of the Work. The insurer shall waive all rights of subrogation aga�P1�'r
5. Insurance policies in Appendix C shall contain an endorsement containing the foliowing terms:
5.01 Town of Tiburon, its officers, directors, officials, agents, employees, and volunteers, shall be named as
additional insureds, but only with respect to liability arising out of the activities of the named insured, and there
shall be a waiver of subrogation as to each named and additional insured.
5.02 The policies shall apply separately to each insured against whom claim is made or suit is brought except with
respect to the limits of the company's liability.
5.03 Written notice of cancellation, non-renewal or of any material change in the policies shall be mailed to Owner
thirty (30) days in advance of the effective date thereof.
5.04 Insurance shall be primary insurance and no other insurance or self-insured retention carried or held by any
named or additionai insureds other than Contractor shall be called upon to contribute to a loss covered by
insurance for the named insured.
6. Certificates of Insurance and Endorsements shall have clearly typed thereon the Project Name, shall cleariy
describe the coverage and shall contain a provision requiring the mailing of written notices of cancellation described
in clause 5.03 above.
7. All policies of insurance shall be placed with insurers acceptable to Owner. The insurance underwriter(s) must be
duly licensed to do business in the State of California. Required minimum amounts of insurance may be increased
should conditions of Work, in the opinion of Owner, warrant such increase. Contractor shall increase required
insurance amounts upon direction by Owner.
Construction Services Agreement
Project No.: 20-PK-06 00 5205-8
�'►C�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
11/04/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 coNrncr Christi Buchanan
NAME:
ARM Multi Insurance Services AI�NNo Ext; �530)662-4613 q�c,No: (530)662-1710
11 West Ct St E-MAIL christi.buchanan@arm-i.com
ADDRESS:
SUIfO D INSURER(S)AFFORDING COVERAGE NAIC#
Woodland CA 95695 iNsuRERA: Associated Industries Ins.Company 23140
INSURED INSURER B; UI11t0CJ FII1811CIal C2SU8I�/C011lpally 11770
First Serve Productions,Inc irusuReR c: Markel Insurance Company 38970
451 Starmont Court INSURER D:
INSURER E:
Danvilie CA 94526 INSURER F:
COVERAGES CERTIFICATE NUMBER: 20-21 All Lines REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE�OW 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 POLICY EFF POLICY EXP �IMITS
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY
X COMMERCIALGENERALLIABILITY EACHOCCURRENCE � 2,000,000
A N ED 100,000
CLAIMS-MADE �OCCUR PREMISES Eaoccurrence S
� � � MED EXP(Any one person) g 5,000 '�
A Y Y AES103527205 07/07/2020 08/01/2021 pERSONALRADVINJURY g 1,000,000
GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE $ 2�000,000
POLICY �X PR� ❑ LOC PRODUCTS-COMP/OPAGG $ 2�000,000
JECT
OTHER: $
AUTOMOBIIE LIABILITY COMBINED SINGLE LIMIT g 2�000,000
Ea accident
X ANY AUTO BODILY INJURY(Per person) $
B OWNED SCHEDULED 019526821 09/18/2020 03/18/2021 BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONIY AUTOS ONLY Per accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ �
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION X STATUTE E�RH
ANDEMPLOYERS'LIABIIITY y�N 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
C OFFICER/MEMBEREXCLUDED? � NIA Y MWCO008788-10 OH/O1/2020 08/01/2021
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 701,Additional Remarks Schedule,may be attached if more space is required)
Re:Teather Park Tennis Court Resurfacing ProjectAgreement No.20-PK-06.Town of Tiburon,its officers,directors,officials,agents,employees,and
volunteers,shall be named as additional insureds,but oniy with respect to liability arising out of the activities of the named insured,and there
shall be a waiver of subrogation as to each named and additional insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELI.ED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Town of Tiburon ACCORDANCE WITH THE POLICY PROVISIONS.
1505 Tiburon Blvd
AUTHORIZED REPRESENTATIVE
Tiburon CA 94920 � ����y
��
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY MWC 1400 OS 10
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right
against any person or organization named in the Schedule. (This agreement applies only to the extent that you perform work
under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work
described in the Schedule.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
1. Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Premium:
The additional premium charge for this endorsement shall be 3 percent of the California Workers' Compensation pre-mium
otherwise due subject to a minimum premium of$750 per policy.
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 OS/01/2020 Policy No. MWC0008788-10 Endorsement No.
Insured: FIRST SERVE PRODUCTIONS INC Premium(See Attached)
Insurance Company: Markel Insurance Company Countersigned by
M WC 14000510
Includes copyrighted materia)of National Council on Compensation Insurance with its permission
Copyright 1983 Nationai Council on Compensation Insurance.
36 of 42
POLICY NUMBER: COMMERCIAL GENERAI. LIABILITY
CG 20 33 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
This�ndursement modifics insuranee provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An insured is amended to B. With respect to the insurance afforded to these
inciude as an additional insured any person or additional i�sureds, the following additional
organization for whom you are performing exclusion5 apply:
operations when you and such per�on or This insurance does not apply to:
organization have agreed in writing in a contract or
agreement that $uch person or organization be �• "B���Y injwry", "property damage" or "personal
ecided as an aciditionai in�ured on yowr policy. and �dvertising injury" arising out of the
Such person or organization is an additional rendering of, or the failure to render, �ny
insured only wi#fi re�pect to liability for "bodily profe�sional architeetural, engineering or
� ,. „ ., surveying�enrices, inciudir�g:
injury , property damage or personal and
advcrtising injury"caused, in whole or in part, by: a. TMe preparing, �pproving, or failing tc�
1. Your acts or omissions;or {xepare or approve, maps, shop drawings,
2. The aets or omissions of those acting on your opinions, reports, surveys, fieicl order�,
ehange orders or drawings and
beMalf; specifications; or
in the performance of your ongoing operations for p, 5upervisory, inspection, architeetural or
the additional insured. �ngineering activities.
However, the insuranc� afforded to such fihis �xclusion applie5 even if the claims again�t
additional insared: any insured allege negligence or other wrongdoing
1. Only applies to the extent permitted by law; in the supervision, hiring, employment, training or
and monitoring of others by that i�sured, if the
2. Will not be broader than tfiat which you are "occurrenee" which caused the "bodily injury" or
required by the contract or agreement to °t�'operty damage", or the off�nse which c�useci
provide for such additional insured. the "personal and advertising injury", ir�vohred the
rend€;ring of or the failure to render any
A person's or organization's status as an prof�ssio�al arehitectural, engineering or
addi#ion�! insureci under this endorsement ends surveying services.
when your operations for that addidonal insured
are eompleted.
CG 3�33 0413 �Inswrance S�rvices Office,Inc.,2012 Page 1 of 2
2. "Bodily injury" or "property damage" occurring C. With respect to the insurance afforded to these
after: additional insureds, the following is added to
a. Ali work, including materials, parts or Section 111—Limits Of Insurance:
equipment furnished in connec�on with The most we will pay on behalf of the additional
such work, on the project (other than insured is the amount of insuranee:
service, maintenance or repairs) to be 1. Required by the contract or agreement you
pErf'ormed by or on behalf of the additional have entered into with the addidonal insured;
insured(s) at the location of tfie covered or
operations has been completed; or
b. That ortion of" our work" ou#of which the Z• Available under the applicable Limits of
p Y Insurance shown in the Declarations;
injury or damage arises has been put to its
intended use by any person or organization whichever is less.
other than another contractor or This endorsement �hall not inarease tMe
subcontractor engaged in performing applicable Limits of Insurance shown in the
operations for a prineipal as a part of the Declarations.
same projeet.
Page 2 of 2 �Insutance Services O�ce, inc.,2012 CG 2�33 0413
�LI�l(�1111���R,AES1035272 05 COM(U�RCipl�C3ENNERAi�LIABILITY
Cti 24 3?p7 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
������o��� ��vsu��� - av�rv��s, �.��s��s o�
CC)I��"R�A►CTt�RS - CClN111PLETEt� C���RAT"IORIS
T��s enc�r�era�er�t m�ciiFies ir�suran�e provided unc�r the f�lla��r�g:
CC3Nt���tC1AL G�hl�F2AL LIABILITY CGVE�ACE PART
SCHE�ULE
Nam�of Additionai Insured PersarKs)or Location and Description of Compi�ted �w��_.�
Ar anixatiants)._ _.__.�._....— ....___—�__ Operatians_.._.__.__.______-------.___ __..__
A16 p�r�ar�s c�r orgar��z�tioras wrhe��writt�n c�rr'tract with ' - ----
the r+l�m�i Insi�red r�cguir�s�dc#itior�l ir��ur�i
���I�t�d Qpe��ti�n�c�v�r�c,�, �"hi�f�ra�doe�not
a t� caur work on residentia���e_._�i__._._..,. _-- - -..._ ___._�---.�.___ _�.
_infarm�ti�r� r�c��sir�d tm com��tc tF'is Sct°�du9�, if�ro�t st�erwr���crv�, r�±iEl be�how�a.ir�ti�_D�cl�rations:----._._._..—_
Sectinn 11 – Who Is An Insured i� amended to
incl�rc� as an �t�iitiar�al inst�r�d tt� p�erson{sj or
organ�zatian(s) sho�m in tN�e Schedule, k�,ot on�+w�th
re�p�ct to liat�lity for"`b�tlil�+injury`"or"prop�:rty dam-
age,� c�us�eci, in whol� or� in p�rt, by 'your wa�rk° at
t!-� lcxa�on design�ted aract describ�ci in tt�e schedP
ule of this en�rrsement�rerform�f�r tt�at�a�tlitior�l
insured anci irticlu�c�d in tl� "products-complet�d
�p�eratiar�s hazard",
CG Zp 37 07 p� �►I�c�Rro�rties, Inc.:, �4 page 1 of 1 f�
Pt��ICY NU�IB�R_ AES1035272 05 COI�IMERCIAL[3ENERAL LIABILITY
NX GL QQ9 Q8 tM9
THIS ENDORSEMENT"CNANGES THE POLICY. PLEASE READ IT CAREFULLY.
�����R�r �N� r�arv�C4N�"RIBUTING INSU�AI�CE
(THIR��PA��`t"1r'�
"i'his�nc�r��nn�nt rr7a�ifi�s i�ur�n��pr�vid�!urtcl�r tt�f�llowdr�g:
G4(�MERCIAL GENERAL LIABILITY C4VERAGE PART
scH�uLE
Third P�rty:
A6i p�rsan�or o�g��iz�tg�r�s where r�q�rirer9 by writt�r�contr�ct with th� �larv��d I�sur�d
(At�s�rse��f a�{�cifi�lly r�r�ed�hir�Party�i�ve rr�an��i�t t�ps�visi�r�s of this enc�or�r��r�t��ly�s
r�qc�ired�iy writ�en ca�r�tract�i agreera��nt wit��ny Third Rar#y fcsr wtt�rrr�+esu�r��r#c�rrnir�v�rc�rk-�
�aragraph 4.of S�TIQN IV:COMMERCIAL GENERAI� LIABILiTY'GOND#TI�NS is rep�aced by th�faNlaw+ing:
4. Other In�urance,
�+V�h r�s��t ta�the'Third F'�r�y�ho�dr�at�v�, thR�i��r���s��arim��y arsd r�on-cQr�t�6�tatar�; A�r a�l�I�
���er v�lic��r�c��olM�ct�b�e i�urance av�Al�b�e tg sa,�h°Third Party in r�{�ct�f w�rk p�rforme�by ysu ur�der
�norotken contrac#uaW agr�m�nts���th s�td'Thard Party fcar loss cc�verec�by t�is�I�cy, shall�n no�r�t�r�ce k�
c�nsi�red as p�mary,��-ins�rar�c�, or co�tnb�tin�insur�nc�. ��the�, any such��t�r ir�urance sk►�li be
consMt�red ex��s over and abc��e the ir�u�an�e prpv�c�d by this�lic�y,
NX C�L Q09 08 09 P�e 1 of 1
ir�clud�s ct�g�yright�ci m�tr�ri�l of Inse�r�nc�S�rvic�s Offi�, Inc.,with its�rrnissf��
P�OLICY�9UMBER: AES1035272 05 CORI�AE�2CIAL GENERAL LIABILITY
Ct3 24 04 05 09
WAIVER f,�� TRANS�ER �F RIC�HTS C)� REC4VERY
AGA�lNSl' C3THER� T4 US
Ti�is�rx�rs�m�nt marlifi�s ir�sur�nc�provid�i ur�i��th�t�ll�+ing�
CQ�IIMERCIAL Ca��1�F2A�LlABILITY CO�RAG� P'A�F�T
f'RO�U�TS/�COt�PL�TED C}PCRATIC�fJS LIA�9LITY Ci�VERAGE F'AR�
SCH�DULE
Plar�ee Of F'erson p�Or�anizatian:
All pers�r�s ar orgar�i�atioa�s wh�r�r�uired�}/�nrnrittten cc��tract with tl�B�ar�d Inst�ced
9nfvr��tim�r� uir�e�to c�m l�t��his S�t�edul� if r�t sB�wn al�v�,will k�st�wro i�th���cl�r�tions.
�`h�f�lro�ri�g i�added to�ar�gsap#i�.7fansfer Of
Rights Qf Recov�y Against OtF��s To Us of
Section IV�-Condi#icns:
!Ne wa�r�any rig�t of recovery�+e�ay h�ve aga�r�st
th�p�rr�o�csr orgarai��tiesn stic�wr�ir�the Sct�dul�
a�ave b�c��se of p�yrr�nts w�r��k�for injury�r
d�rt�age�ra�i�o�k of�y�u�on�ing op��atis�r�s��
'"yo���rork"dorse under a oantract r�i#h that p�rson
er er�niz�tion�rad ia�el�l�ci ir�t�s�etl�c�fucts-
c�rn�l�tec�o�era�ions k�az�r�`°. "fhis wraiver applies
�n�r t��h���sor�c�r�rgani�ati�n shae�n in th�
Scherl�l�at�v�.
CC3 24 Q�4 OS O�S �In�uranc�Servic�s C�'fic�, Inc., 20�8 Pag�1 of 1 ❑