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HomeMy WebLinkAboutContracts & Agreements_117-2019NPS -2 1 (2/6/19) AGREEMENT TO PERFORM NON-PROFESSIONAL SERVICES FOR EQUIPMENT AND SUPPLIES This agreement for the provision of pick up and disposal of hazardous waste materials ("Agreement") is made and entered in this 18th day of June, 2019 ("Effective Date"), by and between the City of Redlands, a municipal corporation ("City") and Haz Mat Trans, Inc ,("Contractor") City and Contractor are sometimes individually referred to herein as a "Party" and, together, as "Parties " In consideration of the mutual promises contained herein, City and Contractor agree as follows ARTICLE 1 — ENGAGEMENT OF CONTRACTOR 1 1 City hereby engages Contractor to perform pick up and disposal of hazardous waste materials services for City (the "Services") 1 2 The Services shall be performed by Contractor in a professional manner, and Contractor represents that it has the skill and the professional expertise necessary to provide the Services to City at a level of competency presently maintained by other practicing professional Contractors in the industry providing Iike and similar types of Services ARTICLE 2 — SERVICES OF CONTRACTOR 2 1 The Services that Contractor shall perform are more particularly described in Exhibit "A," entitled "Scope of Services," which is attached hereto and incorporated herein by reference 2 2 Contractor shall comply with applicable federal, state and local laws and regulations in the performance of this agreement including, but not limited to, State prevailing wage laws ARTICLE 3 — RESPONSIBILITIES OF CITY 3 1 City shall make available to Contractor information in its possession that may assist Contractor in performing the Services 3 2 City designates Chris Boatman, Quality of Life Director, as City's representative with respect to performance of the Services, and such person shall have the authority to transmit instructions, receive information, interpret and define City's policies and decisions with respect to performance of the Services ARTICLE 4 — PERFORMANCE OF SERVICES 4 1 Contractor shall perform and complete the Services in a prompt and diligent manner in accordance with the schedule set forth in Exhibit "A," entitled "Scope of Services," which is attached hereto and incorporated herein by reference The Services shall commence immediately after the Effective Date of this Agreement 4 2 The term of this Agreement shall be for a period of one (1) year from the Effective Date of this Agreement (the "Initial Term"). The City shall have the option to extend the Initial Term of this Agreement by two (2) additional one-year terms (each, an "Extended Term"), 1 L leaklinnAgreements11-Iaz Mat Trans Agreement.NPS 2 1 docx.jn NPS -2 1 (2/6/19) on the same terms and conditions, by providing written notice to Contractor at least thirty (30) days prior to the expiration of the Initial Term or any Extended Term The Initial Term and the Extended Terms are collectively referred to herein as the "Term" of this Agreement 4 3 If Contractor's Services include deliverable electronic visual presentation materials, such materials shall be delivered in a form, and made available to the City, consistent with City Council adopted policy for the same It shall be the obligation of Contractor to obtain a copy of such policy from City staff ARTICLE 5 — PAYMENTS TO CONTRACTOR 5 1 The compensation for Contractor's performance of the Services shall not exceed the amount of Fifty Two Thousand Two Hundred Thirty Dollars Thirty Cents ($52,230 30) for the Services provided during the Initial Term Should this Agreement be renewed, the compensation for Contractor's performance for the Services shall not exceed the amount of Fifty Two Thousand Two Hundred Thirty Dollars Thirty Cents ($52,230 30) for the second Renewal Term, and Fifty Two Thousand Two Hundred Thirty Dollars Thirty Cents ($52,230 30) for the third Renewal Term, bringing the total possible amount of compensation to a not -to -exceed amount of One Hundred Fifty Six Thousand Six Hundred Ninety Dollars Ninety Cents ($156,690.90). For the Initial Term and each Renewal Term, City shall pay Contractor on a time and materials basis up to the not to not -to -exceed amount in accordance with the rates specified in Exhibit "B," entitled "Price and Fee Bid," which is attached hereto and incorporated herein by reference 5 2 Contractor shall submit monthly invoices to City describing the Services performed during the preceding month Contractor's invoices shall include a brief description of the Services performed, the dates the Services were performed, the number of hours spent and by whom, and a description of reimbursable expenses related to the Services City shall pay Contractor no later than thirty (30) days after receipt and approval by City of Contractor's invoice 5.3 Any notice or other communication required, or which may be given, pursuant to this Agreement, shall be in writing Any such notice shall be deemed delivered (i) on the date of delivery in person, (11) five (5) days after deposit in first class registered mail, with return receipt requested, (111) on the actual delivery date if deposited with an overnight courier, or (iv) on the date sent by facsimile, if confirmed with a copy sent contemporaneously by first class, certified, registered or express mail; in each case properly posted and fully prepaid to the appropriate address set forth below, or such other address as a Party may provide notice in accordance with this section City City Clerk City of Redlands 35 Cajon Street P 0 Box 3005 (mailing) Redlands, CA 92373 jdonadlson c(r�cityofredlands org 2 L-1caldimlAgreementsltiaz Mat Trans Agreement.NPS 2 1 docxjn Contractor Mike Hammer, General Manager Haz Mat Trans, Inc 230 East Dumas Street San Bernardino, CA 92408 mikehammer@hazmattrans com (909) 889-5607 NPS 2 1 (2/6/19) (909) 798-7531 ARTICLE 6 — INSURANCE AND INDEMNIFICATION 6 1 The following insurance coverage required by this Agreement shall be maintained by Contractor for the duration of its performance of the Services Contractor shall not perform any Services unless and until the required insurance listed below is obtained by Contractor Contractor shall provide City with certificates of insurance and endorsements evidencing such insurance prior to commencement of the Services Insurance policies shall include a provision prohibiting cancellation or modification of the policy except upon thirty (30) days prior written notice to City A Workers' Compensation and Employer's Liability insurance in the amount that meets statutory requirements with an insurance carrier acceptable to City, or certification to City that Contractor is self-insured or exempt from the workers' compensation laws of the State of California Contractor shall execute and provide City with Exhibit "C" entitled "Workers' Compensation Insurance Certification," which is attached hereto and incorporated herein by this reference prior to performance of the Services B Comprehensive General Liability insurance with carriers acceptable to City in the minimum amount of One Million Dollars ($1,000,000) per occurrence and Two Million Dollars ($2,000,000) aggregate, for public liability, property damage and personal injury is required City shall be named as an additional insured and such insurance shall be primary and non-contributing to any insurance or self-insurance maintained by City C Business Auto Liability coverage, with minimum limits of One Million Dollars ($1,000,000) per occurrence, combined single limit bodily injury liability and property damage liability This coverage shall include all Contractor owned vehicles used in connection with Contractor's provision of the Services, hired and non -owned vehicles, and employee non -ownership vehicles City shall be named as an additional insured and such insurance shall be primary and non-contributing to any insurance or self- insurance maintained by City 6 2 Contractor shall defend, indemnify and hold harmless City and its elected officials, employees and agents from and against any and all claims, losses or liability, including attorneys' fees, arising from injury or death to persons or damage to property occasioned by any negligent act or omission by, or the willful misconduct of, Contractor, or its officers, employees and agents in performing the Services ARTICLE 7 — CONFLICTS OF INTEREST 7 1 Contractor covenants and represents that it does not have any investment or interest in any real property that may be the subject of this Agreement or any other source of income, interest in real property or investment that would be affected in any manner 01 degree by the performance of Contractor's Services Contractor further covenants and represents that in the performance of its duties hereunder, no person having any such interest shall perform any Services under this Agreement. 3 L 1caldjmlAgreements\Haz Mat Trans Agreement.NPS-2 1 docx jn NPS -2 1 (2/6/19) 7 2 Contractor agrees it is not a designated employee within the meaning of the Political Reform Act because Contractor A Does not make a governmental decision whethei to (i) approve a rate, rule or regulation, or adopt or enforce a City law, (ii) issue, deny, suspend or revoke any City permit, license, application, certification, approval, order or similar authorization or entitlement, (111) authorize City to enter into, modify or renew a contract, (iv) grant City approval to a contract that requires City approval and to which City is a party, or to the specifications for such a contract, (v) grant City approval to a plan, design, report, study or similar item, (vi) adopt, or grant City approval of, policies, standards or guidelines for City or for any subdivision thereof B Does not serve in a staff capacity with City and, in that capacity, participate in making a governmental decision or otherwise perform the same or substantially the same duties for City that would otherwise be performed by an individual holding a position specified in City's Conflict of Interest Code under Government Code section 87302 7 3 In the event City determines that Contractor must disclose its financial interests, Contractor shall complete and file a Fair Political Practices Commission Form 700, Statement of Economic Interests, with the City Clerk's office pursuant to the written instructions provided by the City Clerk ARTICLE 8 — GENERAL CONSIDERATIONS 8 1 In the event any action is commenced to enforce or interpret any of the terms or conditions of this Agreement the prevailing Party shall, in addition to any costs and other relief, be entitled to the recovery of its reasonable attorneys' fees, including fees for the use of in- house counsel by a Party 8 2 Contractor shall not assign any of the Services, except with the prior written approval of City and in strict compliance with the terms and conditions of this Agreement. Any assignment or attempted assignment without such prior written consent may, in the sole discretion of City, results in City's immediate termination of this Agreement 8 3 Contractor is for all purposes under this Agreement an independent contractor and shall perform the Services as an independent contractor Neither City nor of its agents shall have control over the conduct of Contractor or Contractor's employees, except as herein set forth Contractor shall supply all necessary tools and instrumentalities required to perform the Services Assigned personnel employed by Contractor are for its account only, and in no event shall Contractor or personnel retained by it be deemed to have been employed by City or engaged by City for the account of, or on behalf of City Contractor shall have no authority, express or implied, to act on behalf of City in any capacity whatsoever as an 4 L \ca\djm1Agreements\Haz Mat Trans Agreement.NPS 2 1 docr jn NPS -2 1 (2/6/19) agent, nor shall Contractor have any authority, express or implied, to bind City to any obligation 8 4 This Agreement may be terminated by City, in its sole discretion, by providing not less than ten (10) days prior written notice to Contractor of City's intent to terminate If this Agreement is terminated by City, an adjustment to Contractor's compensation shall be made, but (1) no amount shall be allowed for anticipated profit or unperformed Services, and (2) any payment due Contractor at the time of termination may be adjusted to the extent of any additional costs to City occasioned by any default by Contractor Upon receipt of a termination notice, Contractor shall immediately discontinue its provision of the Services and, within five (5) days of the date of the termination notice, deliver or otherwise make available to City, copies (in both hard copy and electronic form, where applicable) of project related data, drawings, specifications, reports, summaries and such other information and materials as may have been accumulated by Contractor in performing the Services Contractor shall be compensated on a pro -rata basis for Services completed up to the date of termination 8 5 Contractor shall maintain books, ledgers, invoices, accounts and other records and documents evidencing costs and expenses related to the Services for a period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor pursuant to this Agreement Such books shall be available at reasonable times for examination by City at the office of Contractor. 8 6 This Agreement, including the Exhibits incorporated herein by reference, represents the entire agreement and understanding between the Parties as to the matters contained herein, and any prior negotiations, written proposals or verbal agreements relating to such matters are superseded by this Agreement Except as otherwise provided for herein, any amendment to this Agreement shall be in writing, approved by City and signed by City and Contractor 8 7 This Agreement shall be governed by and construed in accordance with the laws of the State of California 8 8 If one or more of the sentences, clauses, paragraphs or sections contained in this Agreement is declared invalid, void or unenforceable by a court of competent jurisdiction, the same shall be deemed severable from the remainder of this Agreement and shall not affect, impair or invalidate the remaining sentences, clauses, paragraphs or sections contained herein, unless to do so would deprive a Party of a material benefit of its bargain undei this Agreement 5 L IcaldjmlAgreements\Haz Mat Trans Agreement.NPS 2 1 docx jn NPS -2 1 (216/19) IN WITNESS WHEREOF, duly authorized representatives of City and Contractor have signed in confirmation of this Agreement CITY OF REDLANDS I-IAZ MAT TRANS, INC By By -F ATTEST Davis, Mayor Pro Tem Jtfine Donaldson, City Clerk 6 L•Icaldjm\Agreements\Haz Mat Trans Agreement.NPS 2 1.docx.�n ike Hammer, General Manager NPS 2 1 (216119) EXHIBIT "A" SCOPE OF SERVICES Contractor shall pick up and dispose of Hazardous Waste Materials to an Approved Treatment Storage Disposal Facility (TSDF) Services provided will be on quarterly basis or as requested by Fleet Manager Manifests will need to be provided for every service and hand delivered to Equipment Maintenance Project Assistant and/or Fleet Manager Contractor shall provide the following services on an as needed basis • Vacuum tanker, Non Hazardous/Hazardous per test results Liquid Clarifier service o Clarifier 1 (truck wash bay) o Clarifier 2 (mechanic shop wash bay) ■ Truck tires transported to an Approved TSDF for disposal, • Supply 55 Gallon 011 Filter barrels for filters, absorbent, and contaminated fuel, • Supply 5 Gallon Poly Pail, • Supply 4' Light Box and 8' Light Box, ■ Pick up and disposal of fluorescent light bulbs/tubes, • Supply 55 Gallon barrels for asphalt emulsion and diesel fuel mixture, • Pick up Asphalt Emulsion and Diesel Fuel Mixture, ■ Pick up and disposal of unused water and/or oil based paint 5 gallon containers, • Pick up and disposal of Universal Batteries to an Approved TSDF for disposal • Pick up and disposal of Waste Oil, and ■ Pick up used absorbent (floor dry/oil absorbent) ■ Trained Driver/Environmental Technician must be On -Site when material is being picked up for disposal Items described are required waste items and is expected to be handled and transported from Corporate Yard ■ Fluorescent bulbs/tubes • Absorbents ■ Oil, absorbent rags • Drained oil filters ■ Water and oil based unused paint • Oil absorbent socks and pads ■ Waste oiI ■ Waste gas and diesel 7 L Icaldjm\Agreements\Haz Mat Trans Agreement.NPS 2 1 docxp NPS -2 1 (216/19) EXHIBIT "B" PRICE AND FEE BID SECTION A — Tire Disposal Item No Description A Unit of Measure B Estimated Quantity C Unit Price D Total Price (B x C= 0) Al Truck Tires transported to an Approved TSDF for Disposal, per tire Each 3000 $ 5 00 $ 15,000 00 A2 *Transportation Cost from Redlands Corporate Yard to an approved TSDF location per transport/disposal 12 $ 300 00 $ 3,600 00 A3 Manifest and Labeling Fee Each 12 $ 0 $ 0 Al - A3 SUBTOTAL $ 18,600.00 SECTION B — Non Hazardous Solids or Liquids Item No Description A Unit of Measure B Estimated Quantity C Unit Price D Total Price (B x C = 0) B1 55 Gallon Oil Filter Drums Each 12 $ 0 $ 0 B2 55 Gallon Drums for Disposal to an Approved TSDF Waste Non Hazardous Solid Crushed or Drained Oil Filters Each 12 $ 65 00 $ 780 00 B3 *Transportation Cost from Redlands Corporate Yard to an approved TSDF location per transport/disposal 12 $ 150 00 $ 1,800 00 B4 Manifest and Labeling Fee Each 12 $ 20 00 $ 240 00 Bl - B4 SUBTOTAL $ 2,820 00 SECTION C — Fluorescent Tubes or Batteries Item No Description A Unit of Measure B Estimated Quantity C Unit Price D Total Price (B x C = D) C1 5 Gallon Poly Pail Each 10 $ 18 00 $ 180 00 C2 4' Light Box Each 4 $ 10 00 $ 40 00 C3 8' Light Box Each 2 $ 10 00 $ 20 00 C4 Disposal of Universal Batteries to an Approved TSDF Each 2 $ 50 00 $ 100 00 C5 Universal Fluorescent Tubes for Disposal, Per Foot Foot 4,752 $ 0 20 $ 950 40 C6 U -Lamps for Disposal, Per Lamp Each 30 $ 0 95 $ 28 50 C7 5 Gallon Pail Disposal to an Approved TSDF Waste Non RCRA Hazardous Non PCB Ballast, Per Lb Pound 264 $ 0 75 $ 198 00 C8 5 Gallon Pail Disposal to an Approved TSDF Waste RCRA Hazardous Non PCB Ballast, Per Lb Pound 40 $ 125 $ 50 00 8 L Icaldjm\Agreements\Haz Mat Trans Agreement.NPS 2 1 docx.jn NPS 2 1 (2/6/19) C9 HID Lamps for Disposal, Per Lamp Each 12 $ 145 $ 17 40 C10 *Transportation Cost from Redlands Corporate Yard to an approved TSDF location per transport/disposal 10 $ 150 00 $ 1,500 00 C11 Manifest and Labeling Fee Each 10 $ 0 $ 0 Cl - C11 SUBTOTAL $ 3,084 30 SECTION D — Clarifier Removal and Pumping Item No Description A Unit of Measure B Estimated Quantity C Unit Price 0 Total Price (B x C = D) Di Pumping and Transportation Charge Each 6 $ 750 00 $ 4,500 00 D2 Disposal Fees Each 6 $ 900 00 $ 5,400 00 D3 Solid Surcharge < 15% Solids Each 6 $ 0 $ 0 D4 Manifest and Labeling Fee Each 6 $ 0 $ 0 01— D4 SUBTOTAL $ 9,900 00 SECTION E — Asphalt, Sludge, and Diesel Removal Item No Description A Unit of Measure B Estimated Quantity C Unit Price 0 Total Price (B x C = D) El Supply - 55 Gallon Metal Drum - Closed Top Each 12 $ 43 00 $ 516 00 E2 55 Gallon Drums for Disposal to an Approved TSDF Waste Non RCRA Diesel, Asphalt Tack & Water Sludge Each 12 $ 85 00 $ 1,020 00 E3 *Transportation Cost from Redlands Corporate Yard to an approved TSDF location per transport/disposal 12 $ 100 00 $ 1,200 00 E4 Manifest and Labeling Fee Each 12 $ 20 00 $ 240 00 El - E4 SUBTOTAL $ 2,976 00 SECTION F -- 011 and Water Based Paint Removal Item No Description A Unit of Measure B Estimated Quantity C Unit Price D Total Price (B x C= 0) Fl Removal of unused oil based paint in 5 Gallon containers transported to an Approved TSDF for Disposal, per unit Each 5 $ 125 00 $ 625 00 F2 Removal of unused water based paint in 5 Gallon containers transported to an Approved TSDF for Disposal, per unit Each 5 $ 125 00 $ 625 00 F3 Commodity pack of water based paint 55 gallon drum Each 20 $ 200 00 $ 4 000 00 F4 Commodity pack of oil based paint 55 gallon drum Each 20 $ 325 00 $ 6,500 00 9 L 1ca\djm'Agreements\Haz Mat Trans Agreement.NPS 2 1 docx‘n NPS 2 1 (2/6/I9) BID TOTALS *Transportation Cost from Redlands Corporate per $ 52,230 30 F5 Yard to an approved TSDF location transport/disposal 5 $ 600 00 $ 3,000 00 F6 Manifest and Labeling Fee Each 5 $ 20 00 $ 100 00 F1 - F6 SUBTOTAL $ 14,850 00 BID TOTALS TOTAL (IN FIGURES) Bid Total - Add subtotals in sections A - F $ 52,230 30 *Transportation Cost from Redlands Corporate Yard to an approved TSDF location must include all additional and related fees such as staging labor, and testing fees pertaining to hazardous waste commodity 10 L lcaldlrrtlAgreements\Haz Mat Trans Agreement.NPS 2 1 docx jn NPS 2 1 (216/19) EXHIBIT "C" WORKERS' COMPENSATION INSURANCE CERTIFICATION Every employer, except the State, shall secure the payment of compensation in one or more of the following ways (a) By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State (b) By securing from the Director of Industrial Relations, a certificate of consent to self -insure, either as an individual employer, or as one employer in a group of employers, which may be given upon furnishing proof satisfactory to the Director of Industrial Relations of ability to self -insure and to pay any compensation that may become due to his or her employees CHECK ONE V I am aware of the provisions of Section 3700 of the Labor Code which requires every employer to be insured against liability for Workers' Compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the work and activities required or permitted under this Agreement (Labor Code §1861) I affirm that at all times, in performing the work and activities required or permitted under this Agreement, I shall not employ any person in any manner such that I become subject to the workers' compensation laws of California However, at any time, if I employ any person such that 1 become subject to the workers' compensation laws of California, immediately 1 shall provide the City with a certificate of consent to self -insure, or a certification of workers' compensation insurance I certify under penalty of perjury under the laws of the State of California that the information and representations made in this certificate are true and correct HAZ MAT TRANS, INC. 4y , / z0(77,-(7- Mike Hammer, General Manager 11 L Icaldjm\Agreements\Haz Mat Trans Agreement.NPS 2 1 docx.jn Date X/P Form w-9 (Rev October 2018) Department of the Treasury internal Revenue Serv+ce Request for Taxpayer Identification Number and Certification ► Go to www.irs.gov/FormW9 for instructions and the latest information Give Form to the requester. Do not send to the IRS N m to 1 Name (as shown on your income tax return) Name is required on this line do not leave this line blank HAZ MAT TRANS, INC 2 Business name/disregarded entity name rf different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1 iolkiwing seven boxes ❑ Individual/sole proprietor or 10 C Corporation ❑ S Corporation ❑ Partnership single -member LLC ❑ Limited liability company Enter the tax classification (C=C corporation S=S corporation P=Partnership) ► Note: Check the appropriate box in the line above for the tax classification of the single -member owner Do not check LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner tor U.S federal tax purposes Otherwise a single -member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner Check only one of the 0 Trust/estate ❑ Other (see instructlonsl ► 5 Address (number street and apt or suite no.) See instructions 230 E DUMAS STREET 8 City stale and ZIP code SAN BERNARDINO, CA 92408 4 Exemptions (codes apply only to certain entities. not individuals see instructions on page 3) Exempt payee code (if anyi Exemption from FATCA reporting code (if any) irrakis ro accoc'rs rt,arla.nea Requester's name and address (optional) 7 List account number(s) here (optional) FMB Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box The TIN provided must match the name given on line 1 to avoid backup withholding For individuals this is generally your social security number (SSN) However for a resident alien sole proprietor or disregarded entity see the instructions for Part I, later For other entities, it is your employer identification number (EIN) If you do not have a number, see How to get a TIN later Note' If the account is in more than one name, see the instructions for line 1 Also see What Name and Number To Give the Requester for guidelines on whose number to enter Social security number or Employer identification number 3 3 0 7 8 4 9 0 Part II Certification Under penalties of perjury I certify that 1 -he number shown on this forrn is my correct taxpayer identification number {or I am waiting for a number to be issued to me). and 2 lam not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been not+tied by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding and 3 I am a U S citizen or other U.S person (defined below) and 4 The FATCA code(s) entered on this form lit any) indicating that I am exempt from FATCA reporting is correct Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return For real estate transactions, item 2 does not apply For mortgage interest paid acquisition or abandonment of secured property, cancellation of debt contributions to an individual retirement arrangement (IRA). and generally, payments other than interest and dividends. you are not required to sign the certification but you must provide your correct TIN See the instructions for Part II later Sign Here Signature of U.S. person e General Instructions /i3a4r)/_z_d Section references are to the Internal Revenue Code unless otherwise noted Future developments For the latest information about developments related to Form W-9 and its instructions such as legislation enacted after they were published go to www.irs.gov/FormW9 Purpose of Form An individual or entity (Form W 9 requester) who is required to fite an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN) individual taxpayer identification number {ITIN), adoption taxpayer identification number (ATIN) or employer identification number (EIN) to report on an information return the amount paid to you or other amount reportable on an information return Examples of information returns include but are not limited to the following • Form 1099 INT (interest earned or paid) r. - -19 • Form 1099 DIV (dividends including those from stocks or mutual funds) • Form 1099 MISC (various types of income prizes awards, or gross proceeds) • Form 1099 B {stock or mutual fund sales and certain other transactions by brokers) • Form 1099 S (proceeds from real estate transactions) • Form 1099 K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098 E (student loan interest), 1098 T (tuition) • Form 1099 C (canceled debt) • Form 1099 A (acquisition or abandonment of secured property) Use Form W 9 only if you are a U S person (including a resident alien) to provide your correct TIN If you do not return Form W 9 to the requester with a T1N you might be subject to backup withholding See What is backup withholding, later Cat No 10231X Form W-9 (Rev 10-2018: ACRO OF LIABILITY INSURANCE 4/....------ DATE {M MfDDlYYYY) 4!312019 4/3/2019 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 be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on thts certificate does not confer rights to the certificate holder in lieu of such endorsements) PRODUCER Wood Gutmann & Bogart 15901 Red Hill Ave , Suite 100 Tustin CA 92780 NAAMEACF Dawn Stephens-Wnght PHONE FAX /A1C, No. Eat!. 714-505-7000 (A/C, No). 714-573-1770 ADDRESS. dawn@wgbib com INSURER(S) AFFORDING COVERAGE NAIC ft INSURER A Star- Indemnity & Liability Co COMMERCIAL GENERAL LIABILITY INSURED HAZMA-2 Haz Mat Trans Inc 230 E Dumas Street San Bernardino CA 92408 INSURER B 1000066169191 INSURERC. 4/1/2020 INSURER D. 51,000,000 INSURER E , INSURER F . X COVERAGES CERTIFICATE NUMBER 490045590 REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADDL 1NSD SUBR WYD POLICY NUMBER POLICY EFF (MMIDOIYYYYI POLICY EXP IMMIDDryYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 1000066169191 4/1/2019 4/1/2020 EACH OCCURRENCE 51,000,000 CLAIMS -MADE X OCCUR AMAGE RENTED PREM SESO a occurrence) 5 100.000 MED EXP (Any one person) 5 5,000 X Ea0 PERSONAL. & ADV INJURY 5 1,000,000 GEN'L AGGREGATE POLICY OTHER LIMIT APPLIES SECT- PER LOC GENERAL AGGREGATE 52,000,000 PRODUCTS COMP/OPAGG 52.000.000 S A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X X SCHEDULED AUTOS AU OSWNED MCS90 1000066169191 4112019 411/2020 COMBINED SINGLE LIMIT (Ea accident) $ 1.000.000 5 BODILY INJURY (Per person) BODILY INJURY (Per accident) 5 PerrecERTY RdentDAMAGE ) 5 A X UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE 1000336879191 411/2019 4/112020 EACH OCCURRENCE 5 5,000,000 AGGREGATE S 5,000,000 DED 1 RETENTION 5 $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETORIPARTNERJEXECUTIVE OFFiCERJMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N!A 1000066169191 4/1/2019 4/112020 X PTATUTE OH ER E.L EACH ACCIDENT 51,000,000 E.L DISEASE EA EMPLOYEE 6 1,000,000 E.L DISEASE POLICY LIMIT $1.000,000 A Contractors Poll 1000066169191 4/1/2019 4112020 Occurrence 1,000.000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101 Additional Remarks Schedule may be attached If more space is required) City of Redlands is named as additional insured on the General Liability OG 023 which includes Primary and Non Contributory wording and Waiver of Subrogation as required by written contract subject to the terms and conditions of the policy Auto additional insured applies per attached SICA 1024 Auto Primary and Non Contributory wording applies per attached SICA 1017 Auto Waiver applies per attached CA 04 4410 13 CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101} © 1988 2014 ACORD CORPORATION All rights reserved The ACORD name and logo are registered marks of ACORD City of Redlands P 0 Box 3005 Redlands CA 92373 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE i t� l` ilsir,f,,YI ACORD 25 (2014101} © 1988 2014 ACORD CORPORATION All rights reserved The ACORD name and logo are registered marks of ACORD f y � Starr Indemnity& LiabilityCom an Y Dallas TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS Policy Number SISIPCA08366619 Effective Date 04/01/2019 at 12 01 AM Named Insured Haz Mat Trans, Inc This policy is amended as follows BUSINESS AUTO COVERAGE FORM Section IV — Business Auto Conditions, B , General Conditions, 5., Other Insurance, c , is amended by the addition of the following sentence The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of Toss arising out of such accident All other terms and conditions remain unchanged Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, President an Chief Executive Officer xem /: ,1= Nehemiah E Ginsburg, General Counsel SICA 1017 (02112) Page 1 of 1 Copyright © C V Starr & Company and Starr Indemnity & Liability Company AB rights reserved Includes copyrighted material of ISO Properties, Inc , used with its permission Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY Policy Number. S1SIPCA08366619 Effective Date. 04/01/2019 at 12 01 AM Named Insured. Haz Mat Trans, Inc ADDITIONAL INSURED - Where Required Under Contract or Agreement (Additional Insured Schedule) This policy is amended as follows BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED Blanket where required by a written contract 1 SECTION 11 — LIABILITY COVERAGE A Coverage, 1 Who is insured, is amended to add d Any person or organization shown in the schedule above to whom you become obligated to include as an additional insured under this policy as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy but only with respect to liability arising out of use of a covered "auto" However the insurance provided will not exceed the lesser of (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement Signed for STARR INDEMNITY & LIABILITY COMPANY Charles H Dangelo,'President Nehemiah E Ginsburg, GeneraIUCounsel SICA 1024 (04/12) Page 1 of 1 Copyright @ C V Starr & Company and Starr Indemnity & Liability Company All rights reserved Includes copyrighted material of ISO Properties, inc., used with its permission POLICY NUMBER SISIPCA08366619 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below Named Insured. Haz Mat Trans, Inc Endorsement Effective Date 04/01/2019 SCHEDULE Name(s) Of Person(s) Or Organization(s) Blanket where required by a wntten contract Information required to complete this Schedule if not shown above, will be shown in the Declarations The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived pnor to the "accident" or the "loss" under a contract with that person or organization CA 04 44 10 13 © Insurance Services Office, Inc , 2011 Page 1 of 1 f: - Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 Primary and Non-contributory, Additional Insured and Waiver of Subrogation Policy Number 1000066169191 Effective Date• 04/01/2019 at 12 01 A M Named Insured. Haz Mat Trans, Inc This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page Please read the endorsement and respective policy(ies) carefully Commercial General Liability Coverage Form Owners and Contractors Protective Liability Coverage form Products/Completed Operations Liability Coverage Form Contractors Pollution Liability Coverage Form Professional Liability Coverage Form Site Pollution Liability Coverage Form SCHEDULE Where Required By Written Contract A SECTION II WHO IS AN INSURED is amended to include as an insured the person or organization shown in the schedule of this endorsement, but only with respect to liability arising out of "your work" for that insured by or for you B As respects additional insureds as defined above, this insurance also applies to "bodily injury" or "property damage' arising out of your negligence when the following written contract requirements are applicable 1, Coverage available under this coverage part shall apply as primary insurance Any other insurance available to these additional insured s shall apply as excess and not contribute as primary to the insurance afforded by this endorsement 2 We waive any nght of recovery we may have against these additional insured's because of payments we make for injury or damage arising out of "your work" done under a written contract with the additional insured 3 The term insured is used separately and not collectively, but the inclusion of more than one insured shall not increase the limits or coverage provided by this insurance Insureds and Agents are advised that certificates of insurance should be used only to provide evidence of insurance in lieu of an actual copy of the applicable insurance policy Certificates should not be used to amend expand or otherwise alter the terms of the actual policy All other terms and conditions of this Policy remain unchanged Signed for STARR INDEMNITY & LIABILITY COMPANY Charles H Dagelo, President Nehemiah E Ginsburg, General)Counsel OG 023 (06111) Page 1 of 1 Copyright flC C V Starr & Company and Starr Indemnity & Liability Company Ali rights reserved Includes copyrighted material of ISO Properties, Inc., used with its permrssron