HomeMy WebLinkAboutContracts & Agreements_75-2008_CCv0001.pdf AGREEMENT
THIS AGREEMENT, made and entered into this 3" day of June, 2008, by and between the City of Redlands, a
Municipal Corporation, organized and existing under the laws of the State of California, hereinafter referred to as
the "City," and Palm Canyon Contractors of Yucaipa, County of San Bernardino, State of California., hereinafter
referred to as the"Contractor."
WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, agree as follows:
1. Scope of Work. The Contractor will furnish all materials and will perform all of the work to perform
construction of Sports Park Parking Lot Paving project,complete, all as shown, specified, and made a part of
Contract No.240300-7230/47105.
2. For the Contract Sum of$131,250.00,in accordance with the terms and conditions ofthe Contract Documents.
Pursuant to Section 22300 of the California Public Contract Code,Contractor has the option to deposit securities
with an Escrow Agent as a substitute for retention of earnings requirement to be withheld by the City pursuant
to and Escrow Agreement,
3. Time for Completion. The work shall be completed within twenty(20)work days from and after the date of
the Notice to Proceed.
4. Liquidated Damages. Failure of the Contractor to complete the work within the time allowed will result in
damages being sustained by the City. Such damages are,and will continue to be, impracticable and extremely
difficult to determine. The Contractor shall pay to the City,or have withheld from monies due it,the sum as set
forth in the General Provisions for each consecutive calendar day in excess of the specified time for completion
of the work.
Execution of the contract shall constitute agreement by the City and Contractor that the liquidated damages
amount per day is the minimum and actual damage caused by the failure of the Contractor to complete the work
within the allowed time. Such sum is liquidated damages and shall not be construed as a penalty, and may be
deducted frorn payments due the Contractor if such delay occurs.
5. Contract Documents. The complete contract includes all of the contract documents set forth herein, to wit:
Notice Inviting Bids;Instructions to Bidders;Proposal and Bid Forms;Bid Bond;Agreement; Performance and
Payment Bonds; Standard Specifications and Standard Plans for Public Works Construction; Contract
Documents and Supplemental Specifications; all referenced specifications; and any Addenda thereto.
6. Attorney Fees. In the event any legal action is commenced to enforce or interpret the terms or conditions of
this contract the prevailing party shall, in addition to any costs and other relief, be entitled to recovery of its
reasonable attorney's fees.
7. Defense Obligation. The Contractor shall defend the City,its elected officials,officers,agents,and employees
from and against any and all claims, losses, damages, and causes of action, including death, brought by any
person or persons for or on account of any wrongful or negligent act or omission of the Contractor,its employees
or agents in connection with,the performance of the Contractor's obligation under this contract.
8. Insurance. All policies of general liability and business automobile insurance required by this contract shall
name the City,its elected officials,employees,and agents as additional insureds. Any insurance required under
this contract shall be primary with respect to the City and non-contributing to any insurance or self-insurance
maintained by the City.
9. Resolution of Construction Claims. Claims made by the Contractor in the amount of$375,000.00 or less shall
be processed by the City pursuant to the provisions of Part 3,Chapter 1,Article 1.5 of the Public Contracts code
(commencing with Section 20104). All claims shall be in writing and include the documents necessary to
substantiate the claim. Nothing in subdivision (a)of the Public Contracts Code Section 20104.2 shall extend
the time limit or supersede the notice requirements provided in this case from filing claims by the Contractor.
Pursuant to Public Contract Code section 9201, if the City receives a third party claim in relation to this
Contract, the City shall timely notify the Contractor, The City shall be entitled to recover reasonable costs
incurred in providing the notification required by Public Contract Code section 9201(b).
10. Eligibility of Contractor/Subcontractor. Contractor and any subcontractor agree to abide by California Public
Contract Code Section 6109 and California Labor Code Sections 1777.1 and/or 1777.7 and certify that they are
not debarred and are eligible to work on this project.
11. Assignment of Agreement. No assignment by a party hereto of any rights or interests under this agreement will
be binding on another party without the written consent of the party sought to be bound.
12. Successors and Assigns. The City and Contractor each binds itself, its partners, successors,assigns and legal
representatives in respect to all covenants, agreements and obligations contained in the contract documents.
13. Severability. Any provision or part of the contract documents held to be void or unenforceable under any law
or regulation shall be deemed stricken,and all remaining provisions shall continue to be valid and binding upon
the City and Contractor.
IN WITNESS WHEREOF,the parties hereto have executed this Agreement in duplicate on the day and year first
written above.
CITYSEAL
By:
Mayor,City af Redlands
,/County of San Bernardino,California
ATTEST:
kE
City Clerk,City of Red] ads 1
County'of San Berra` uk—,,California
Palm Canyon Contractors
Name of Contractor
An,
COAITR,4CTOR SEAL By:
Signature of Authorized Agent
U6 kc
Signatory's Title
Signature of Authorized Agent (i 'necessary)
Signatory's patory's Title (if necessary)
823760
Contractor's License No.
WORKERS' COMPENSATION INSURANCE CERTIFICATION
SPORTS PARK PARKING LOT PAVING
CONTRACT No, 240300-7230/47105
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 in one or more insurer 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.
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 of this
contract, (Labor Code Section 1861)
Date
Palm Canyon Contractors
Name of Contractor
I n
I Y
By:
Signature of Authorized Agent
I N
,>
Signatory's Title
823760
Contractor's License No.
�.:5. .v
PERFORMANCE BOND
ISSUED IN ONE ORIGINAL COUNTERPART BOND NO. 661121958
PREMIUM: $3,069.00
WHEREAS, the City Council of the City oi"Redlands, State of California(hereinafter designated as"City"), and
Palm Canyon Contractors(hereinafter designates]as"Principals')have entered into an agreement whereby Principal
agrees to install and complete certain designated public improvements,which by said agreement dated.lune 3,2408,
and identified as Contract No.240300-7230/47105, is hereby referrer[to and made a part hereof; and
VMEREAS, under the terms of said agreement,Principal is required before entering upon the performance of the
work,to furnish a good and sufficient faithful performance bond with the City.
NOW,'I'HREM , said Principal and the undersigned as corporate:surety,are held and firmly bound unto the
City in the sum of (1) dollars($ 131,250.00 )
for the payment of which sum well and truly to be made,we bind ourselves, our.heirs, successors,executors and
administrators,jointly and severally,firmly by these presents.
(1) One Hundred Thirty One Thousand Two Hundred Fifty and 00/100's
The condition.ofthis obligation is such that ifthe above bounded Principal,his or herheirs,executors,administrators,
successors or assigns,shall in a.11 things stand to and abide by,and well and truly keep and perform the covenants,
conditions,and provisions in the said agreement and any alteration thereof made as therein provided,or his or her
part, to be kept and performed at the time and in the manner therein specified,and in all respects according to their
true intent and meaning,and shall defend,indemnify and save harmless the City,its elected officials,officers,agents,
and employees,as therein stipulated,then this obligation shall become null and void;otherwise it shall be and,remaia
in full force and effect,
As a part of the obligation secured hereby and,in addition the face amount specified therefor,there shall be included
costs and reasonable expenses and fees,including attorney's fees incurred by the City in successfully enforcing such
obligation,all to be taxed as costs and. included u1 any judgement rendered.
The surety hereby stipulates and agrees that no change,extension of time,alteration or addition to the term,-,sof the
agreement or to the work to be performer)thereunder or the specifications accompanying the same shall in anywise
affect its obligations on this bond,and it does hereby waive notice of any such change,extension of time,alteration
or addition to the terms of the agreemetlt or to the work or to the specifications.
IN Wf"I<'Nu S WHEREOF, this instrument has been duly executed by the Principal and surety named,
on June 11 ,200& Bond No. 661121958
Palm Canyon Contractors,lnc. (SEAT) Lincolw;Ceneral Insurance Company
Principal 9'l1FC
Signature lure Julia B. Gl addi ng, Attorney-16-Fact:
ddress: 701 treet Suite 2100
San Diego, CA 92101
(1Imirial Acknowledgments of Principal and Surety) Telephone: 903-5489
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of Riverside
no
JUN 11 20 Mlchele M. Qualls Notary Public
On before me, ,
Date Here Insert Name and Trtle of the Officer
personally appeared Julia B. G1 addi nq
Name(s)of Signer{s)
i
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that
'�ICHELE K QUA
LS
he/she/they executed the same in his/her/their authorized
rk C0MM. #1704204
NOTARY PUBLIC-CALIFORNIA T capacity(ies), and that by his/her/their signature(s) on the
s t RIVERSIDE COUNTY instrument theerson s , or the entityupon behalf of
as p My Comm Expire Nov_11,2010 p ( ) p
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
Signature
i � f C ,#
� � � 6)u'd' /0j
Place Notary Seal Above Signature of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document
Description of Attached Document
Title or Type of Document:
Document Date: _ Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
0 Individual 0 Individual
0 Corporate Officer—Title(s): 0 Corporate Officer—Title(s):
0 Partner—0 Limited 0 General 0 Partner—10 Limited 0 General _
0 Attorney in Fact e +• 0 Attorney in Fact � R
0 Trustee
Top of thumb here Top of thumb here
❑Trustee
Cl Guardian or Conservator 0 Guardian or Conservator
_1 Other: 0 Other:
Signer Is Representing: Signer Is Representing:
02007 National Notary Association•9350 De Soto Ave_RO.Box 2402•Chatsworth,CA 91313,2402+www-NationalNotary.org Item#5907 Reordtlr,Call Tall-Free 1-800.876.6827
LINCOLN GENERAL INSURANCE GUMHANY
ISSUED IN ONE ORIGINAL COUNTERPART PO 'VTR OF ATTORNEY BOND NO. 66112195$
I ,,`0W ALL MEN,BY THESE PRESENTS,nat Lincoln General Insurance Compa:ty,organized and existing by virtue of the
Laws of the Con-unonwealth of Peni'syl4 aria,docs hereby nom in<te,constitute and appoint:
Kenneth A. Coate, Julia B. Gladding
Its true and lath=ful Attorneys}-in-Fact to sigh, seat and execute for and on its,behalf, as spray,bands,undet-takings,and other
obligatory instruments of similar nature,and to bind it thereby as fully and to the same extent as if such instruments s=ere signed
by a duly authorized officer of the corporation,and all the acts of said Attorney,pursuant to the authority hereby given are hereby
ratified aril confit, ed.
RESOL'VF-D that
t
notarized,with facsimile signatures and.seats under
autlt;
Ser efollo-*ng res9 utipas adopted by the Board of Directors'of Llneblff Gener9 Insurdria Ciirnpany oil the 4'day of
el? s
RESOLVED JI VEiJ that the Piestdetit an By6cutrve PT$m. or Vice President,or any Vice President of the.CompanX;together with the
Seerdtary or any Assistant Secretary aro hereby auth&i ed to execute Potaers of Attorney appainftng the person(s)named as
Attorney() iri:Fact to dare,execute sign seas srrd deliver on'bchatf of the.Coinpahy,Sdetitj and surety lignds,uri o. .icings,an
other smutar:'contracts of suiretyshtp,and,any rel4ted dorufnents:
RESOLVED FURTHER that-the stgnatuies of the officers making the appointmenr, and the'signature of any officer certifying
the validity and current status of the appointment,may be facsimile representations of those signatures;and the signature and seat
of any no and the seri' of the Company,rnay be.facsnnile representations of those signatures;and seats,and such facsimile
representations of those signatures and seals, and such facsiinile representations shall have the same force and effect as if
manually affixed. The facsimitereprest ntationsreferred to herein may be affixed by stamping,printing typing or photocopying.,
IN GVITNESS`WHEREOF,Lincoln General Insurance Company has caused its corporate,seal to be affixed.and these presents to:
be signed by its duly authorized officers this l 5`t`day of October,2004. 0�u„anuu�urrrrrrl,
S�tia y(N S j/p9+Grr
X20�4yoRMAT, -'•;�'
X 977 :0
S�cz`e#any Presiu�er. '.v
Z
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���44ttrttrnniflnit��t��
On this 15`t'day of October,2004,before the personally`came John T.Clark,to me known,who being duty sworn,did depose
and say:that he is the President of the Corporation described in and which executed the above instrumett:that he knows the seal
affixed to the aforesaid ih-istrument is such corporate seal and was affixed thereto by order and authority of the Board of Directors
ofsaid Company;and that be executed the said instrument by like order and authori tty and the same was his free act and deed.
The Commonwealtfi of Pennsylvania
York County 1
IAL 94
E t KRiVACSr
Notcsry Public {_ ?
YORK Cfir t)w cou Y
MY Commisoml Expim Oct 29,20M �
I,Gary,1.Or idorff,Secretary of I: ncoln Geri”Insurance"Cornpanyk,•a carpo ati art of.the.Cornnulnwvealth of Pennsylvania do
her6ly certi'f±that f�c above and foregoing,is:a full,true and cart^ect copy cif power of Attorney issued by said Co y,an o
the whole of the,original and.'that the,said Pow "Of'Attorney is still in.full Force and efieet and has.not been revoked, and
fqi ttiittnirejhai the Resolution,pri e board of"13irectors,set forth in the said Power of Attorney is tiMW in force,
IN 'v�ITN ES�b MOP, I,have hereunto se' y,h d afflzed the seal of said Coippany,.at York, Pennsylvania, this
r t m hand and
11th June
tiwv %INS
ti. g A Y
r
ff {}MATSr
"d 1977 `"=
��tf�'If�ttittrntt�sttitxi�iwwtiti�vw
PAYMENT BOND PREMIUM:NO661121958NCLUDED IN THE PREMIUM
ISSUED IN ONE ORIGINAL COUNTERPART CHARGED FOR THE PERFORMANCE BOND
WHEREAS, the City Council of the City of Redlands, State of California(hereinafter designated as"City"),and
Palm Canyon Contractors(hereinafter designated as"Principal")have entered into an agreement whereby Principal
agrees to install and complete certain designated public improvements,which by said agreement dated.lune 3,2008,
and identified as Contract No,240300-7230/47105,is hereby referred to and made a part hereof;and
WDEREA,S, under the tet riffs of'said agreement,Principal is required before entering upon the performance of the
work,to furnish a good and sufficient labor and materials payment bend with the City to secure the claims to which
reference is made in Title 15(commencing with Section 3082)of Part 4 of Division 3 of the Civil Cede of the State
of California.
NOW,TIi[MFORE, said.Principal and the undersigned as corporate surety,are held and firmly bound unto the
City and all contractors,subcontractors,laborers,materialmen,and any other persons employed in the performance
of the aforesaid agreement and referred to in the aforesaid Civil Code of the state of California in the sum of
(1) dollars(s 131,250.QQ )f
- , 250A
furnished or labor thereon of any bind,or fbr amounts due under the UnemploymentInsurance Act with respect to
such work or labor,that said surety will pay the same in an amount not exceeding the amount herein above set forth,
and also in case suit is brought upon this bond,will pay,in addition to the face amount thereof,costs and reasonable
expenses and fees, including reasonable attorney's fees, incurred by the City in successfully enforcing such
obligation,to be awarded and fixed by the court,and to be taxed as casts and to be included in the judgement therein
rendered. Mone Hundred Thirty One Two Hundred Fifty and 001100's
It is hereby expressly stipulated and agreed that this band shall,inure tothe benefit of any and all persons,companies
and corporations entitled to file claims under Title 15(commencing with Section 3082)of Part 4 of Division 3 of the
Civil Code,so as to give a right of action to them or their assigns in any suit brought upotr,this bond.
Should the condition of this bund be fully performed,then this obligation shall become null and void;otherwise it
shall be and remain in full force and effect.
The surety hereby stipulates and agrees that no change,extension of time,alteration or addition to the terms of the
agreement or to the work to be performed thereunder or the specifications accompanying the same shall in agnosia
affect its obligations on this bond,and it does hereby waive notice of any stich change,extension of time,alteration
or addition to tate terms of the agreement or to the work or to the specifications.
IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and surety named,
on June 11 ,2008. Bond No. 661121958
a te, ('anvnn tonYrac or , Ian (SEAL) Lincoln neral insurance Compan
Principal Surety
ley:
Signature gm
Julia B. Cladding, Attorney-ict-Fact"
;..
A re3S> 01 B. Street Suite 2100
San Dietro, CA 92101
(Notarial Acknowftdgmerts of Principal I rcty) Telephone. { 800 903-5489
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of Riverside
on JUN 12008 before me, Michele M. Qualls, Notary Public
Date Here Insert Name and Title of the officer
personally appeared Julia B. G1 addi n
Names}of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized
I capacity(ies), and that by his/her/their signature(s) on the
COMM #17'04204
cc = � taoTARY augt,Ic-CALIFORNIA instrument the person(s), or the entity upon behalfof
€ which the person(s) acted, executed the instrument.
° RIVER$tOF COUNTY
My Comm.Expires Nov.11,2016
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
Signature l rl � %,^ &aZ&
Place Notary Seal Above Signature of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s)Other Than Named Above:
Capacity(les) Claimed by Signer(s)
Signer's Name: Signers Name:
0 Individual it Individual
0 Corporate Officer—Title(s): 0 Corporate Officer—Title(s):
0 Partner—0 Limited 0 General 0 Partner—0 Limited 0 General
0 Attorney in Fact • 0 Attorney in Fact y • "
Trustee Top of thumb here 0 Trustee Top of thumb here
0 Guardian or Conservator 0 Guardian or Conservator
0 Other: 0 Other:
Signer Is representing: Signer Is Representing:
02007 Nahonal Notary A5,4octation•9350 De Soto Ave.,Po.Box 2402•Chatsworth,CA 91313.2402•www.NationalNotary.org Item#5907 Reorder:Call TWI-Free 1-800-878.8827
LINCOLN GENERAL INSURANCE COMPANY
PONATR OF ATTOWNTY
ISSUED IN ONE ORIGINAL COUNTERPART BOND NO. 661121958
KNOW ALL MEN BY THESE PRESENTS;That Lincoln General Insurance Conipany,orgatlizM and existing by virtue of the
Laws of the Commonwealth of Pennsylvania,does hereby nominate,constitute and appoint,
Kenneth A. Coate, Julia B. Gladding
Its true and lawful Attorndy(s)-in-Fact to sign, seal and execute for and on its behalf, as surety,bonds, undertakings,and other
obligatory instruments of similar nature,and to bind it thereby as fully and to the same extent as if such instruments were signed
by a duly authorized offices of the corporation,and all,the ac6 of said Attorney,pursuant to the:authority hereby given are hereby
ratified and confirmed,
RESOLVED that this Power of Attorney is granted and is signed,scaled and notarized with facsimile signatures and seals under
authority of the following resql I utipris adopted by the Board of Directorsof Lincoln General Insurance Cornpany on the 0 day of
September,2002.
RESOLVED that the President,an Executivc or Senior Vice President,or any Vice President of the Company,together with the
Secretary Or any Assistant Secretary are-hereby authorized,to execute Powers' of Attorney ne appointing the person(s) named as
Attbrwiey(s)-bi7Fact to date;execute sign,seal and deliver on behalf of the Oompany,fidelity and'surety bonds,undertakings,and
other similar contracts of suretyship,,and any related documents.
RESOLVED FURTHER.that the signatures of the officers making the appointment,and the signature of.any officer certifying
the validity and current status of the appointirient,may be facsimile representations;of those signatures,and the signature and seal
of any notary,and the seal of the Company,may be facsimile representations of diose hose s I ignatures and seals,and such facsimile
representations of those signatures and seals, and such facsimile representations shall have the same force and effect as if
manually affixed. The facsimite'represt.-ntationsreferred to herein may be affixed by stamping,printing,typing or photocopying.
IN WITNESS WHEREOF,Lincoln General Insurance Company has caused its Corporate seal to,be of and these presents to
be signed by its duly authorized of this 15'h day of October,2004,
I N S
4,�.........
00-re C)•a
fiC-)
iz, 1977 o
Sevretai-
y Presider
On this 15'h day of October,2004,before fine personally came John T.Clark,to me kno-,),m, who being duly sworn,did depose
and say,that he is the President of the Corporation described in and which executed the above instrument:that he knows the seat
affixed to the aforesaid instrument is such corporate seal and was affixed thereto by order and authority of the Board of birectors
of said Company;and that he e-xccutcd the said instrument by like order and authority and the same was his free act and decd.
The Commonwealth of Pennsylvania
York County NOV$&41
RENEE L KRIVACW
Notchy Pubrf--
YORK CITYYORK COLM
mycommWC61EXPItes Oct 29,2008
1,Gary J.OrridorT,Secretary of Lincoln'Gerietal Ingurahce'Company,a eorporattion.of the Commonwealth of Pennsylvania do
hereby certify that the above and,foregoing is a full,true and correct copy of Power of Attorney issued by said Cornpa.ny,and of
the whole of the,original and that the said Power of Attorney is still in full force and effect and has not been revoked, and
fiirthdintire that the Resolution ofthe' of Directors,set forth in the said Power of Attorney is no*in force,
IN WITNESS,WHERE017. I have hereunto set my hand and affixed the seal of said Company,at York, Pennsylvania, this
11th day of June l 008
INS
OPATE
0
.0 iE
Z 1977 :0=
1��0% g-
Company Profile u4 Ut
Company Profile
LINCOLN GENERAL INSURANCE E COMPANY
P.O. BOX 3709
YORK, PA 17402
804-876-3350
Agent for Service of Process
JERE KEPRIOS, C/O CT CORPORATION SYSTEM 818 WEST SEVENTH STREET, 2ND FLOOR
LOS ANGELES, CA 90017
Unable to Locate the Agent for Service of_Process`?
Reference Information
NAIC #: 33855
MAIC Group #: 1.3.26
California Company ID #: 4679-7
Date authorized in California: May 11, 2001.
License Status: UNLIMITED-NORMAL
Company Type: Property & Casualty
State of Domicile: PENNSYLVANIA
Lines of Insurance Authorized to Transact
The company is authorized to transact business within these lines of insurance. For an explanation of
any of these terms, please refer to the glossary.
AUTOMOBILE
BURGLARY
COMMON CARRIER LIABILITY
FIRE
LIABILITY
MARINE
MISCELLANEOUS
PLATE GLASS
SPRINKLER
SURETY
TEAM AND VEHICLE
WORKERS' COMPENSATION
http:/Iinteraetive.web.insurance.ca. ovlwebuserlidb co_prof_utl. ;et co`prcf?p IsID 02386 6118/2008
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UA IC lmmruurf,,.J
AC:-)RD,. CERTIFICATE OF LIABILITY INSURANCE 06/17/2008
PRODUCER (909)792-2345 FAX (909)792-0159 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Beall Financial & Insurance Svcs, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
130 W. Vine Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Redlands, CA 92373
Richard Beall INSURERS AFFORDING COVERAGE MAIC#
INSURED PALM CANYON CONTRACTORS INSURERA: Travelers Indemnity Co. of CT 25682
P.O. BOX 656 INSURER 8:
YUCAIPA, CA 92399 INSURER C.
INSURER 0:
INSURER E:
r4OVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSK OWL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POUCY EXPIRATION LIMITS
DATE(MMiDDIYYI DATE tMM1ODrM
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
—1
CLAIMS MADE r OCCUR PRFMISCS IF,a=xan�)
MED EXP(Any one Person)
PERSONAL&ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG III
j LOC
POLICY f PERC0j r
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY III
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGO $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR El CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND DTEUS6416L87507 1010112007 10/01/2008 X I H-
EMPLOYERS'LIABILITY � IT I
A ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000
IfIges,describe under
SPECIAL
AL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
OTHER
I I I I I
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
EVIDENCE OF COVERAGE.
3OB LOCATION: DEARBOURNE & PIONEER, REDLANDS, CA
306 DESCRIPTION: CONTRACT #24300-7230/47105 SPORTS PARK PARKING LOT PAVING
WAIVER OF SUBROATION APPLIES TO THE WORKERS COMP PER ATTACHED WIC 04 03 06 01.
10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM.
CERTIFICATE HOL12ER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
CITY OF REDLANDS *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
PUBLIC WORKS DEPT. BUT FAILURE TO MAIL.SUCH NOTICE SHALL WPOSE NO OBLIGATION OR LIABILITY
P.O. BOX 3005 OF ANY KIND UPON THE INSURER,ITS A OR"R:E7PRES TIA:'t?,
REDLANDS, CA 92373 AUTHORIZED REPRESENTATIVE
RICHARD BEALL
ACORD 25(2001/08) ACORD CORPORATION 198E
AO
TravelersPropertyCasualty %k
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 04 03 06(01) —
POLICY NUMBER: DTEUB6416LS7507
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 the 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.
THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE %OF THE CALIFORNIA WORKERS'
COMPENSATION PREMIUM OTHERWISE DUE ON SUCH REMUNERATION.
SCHEDULE
PERSON OR ORGANIZATION JOB DESCRIPTION
CITY OF REDLANDS AND THEIR OFFICERS, CONTRACT#24300-7230/47105 SPORTS PARK
EMPLOYEES,ELECTED OFFICIALS,AND PARKING LOT PAVING
AGENTS
DATE OF ISSUE:
ST ASSIGN,
ACORP, CERTIFICATE OF LIABILITY INSURANCE 06/,1.7.12,008
PRODUCER (909)792-2345 FAX (909)792-0159 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Beall Financial & Insurance Svcs, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
130 W. Vine Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Redlands, CA 92373 INSURERS AFFORDING COVERAGE MAIC#
INSURED PALM CANYON CONTRACTORS INSURERA: Travelers Prop & Cas Co of Ame 25674
P.O. BOX 656 INSURERS
YUCAIPA, CA 92399 INSURER C:
INSURER 0:
INSURER E:
COVERAGES
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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
AJ& TYPE OF INSURANCE POLICY NUMBER DATE IMMIDD=1 DATE(MWDQ=) LIMITS
GENERAL LIABILITY DTEC09322BS92 11/05/2007 11/05/2008 EACH OCCURRENCE $ 11000,0001
7X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $
CLAIMS MADE I r-U-1 qFS(Fa =jr,nca) 300,0001
A I OCCUR MED EXP(Any one person) $ S'000
A PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000
X1 POLICYF-]J`ERCO� f—]LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGO $
EXCESSIUMBRELLA LIABILITY DTSMCUP9322BS92 11/05/2007 11/05/2008 EACH OCCURRENCE $ 1,000,000
OCCUR CLAIMS MADE AGGREGATE $ 1,000,000
A $ 1,000,000
DEDUCTIBLE $
RETENTION $
WORKERS COMPENSATION ANDWC STA
I TORY LI
EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT
OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $
If yes.describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT: $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES i EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
I I
DENCE OF COVERAGE. CERTIFICATE HOLDER, THEIR OFFICERS, EMPLOYEES, ELECTED OFFICIALS AND AGENTS ARE
AMED AS ADDITIONAL INSURED PER ATTACHED CG D2 49 08 OS. WAIVER OF SUBROGATION & PRIMARY
-CONTRIBUTORY APPLIES TO THE GL PER ATTACHED CG D3 16 07 04. 308 LOCATION: DEARBOURNE
PIONEER,
IONEER, REDLANDS, CA JOB DESCRIPTION: CONTRACT #24300-7230/47105 SPORTS PARK PARKING LOT PAVING
k10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM.
CERTIFI!gATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
CITY OF REDLANDS *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
PUBLIC WORKS DEPT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
P.O. BOX 3005 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES,
REDLANDS, CA 92373 AUTHORIZED REPRESENTATIVE
RICHARD BEALL
44
ACORD 25(2001/08) OcACORD C6kF''ORATION 1988
CG D2 48 08 05 Page I of 2
CG DZ 48 tib 06
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ rr CAREFULLY.
BLANKET ADD17 ONAL INSURED
(CONTRACTORS OPERATIONS)
'this aridorsernnt modros lrtaee eco r prareride d uodw the fo*yMng:
CUMWJWIAL GENERAL LIABILITY COVERAGE PART
1. WHO is AN INSURED—(Sector► 10 Is emanated to cede arty person or orgw*Ation that you agree in a
Naftten contract requiring insurances'to include as are additional Insured on this Cavo age Parts but:
a) Only wits respect to liability for"bodily k4tW."property damage'or"personal k**Y`;and
b) t, and only to the extent stead. the Injury or dammer is oauasd by acts or omissions of you or your
subcontractor In the perf re"lMi soft of "your WOrIK"" to which the -written wMnwt reWiring insura sW
applies. The person or organization does not qual ty as an additional insured with respect to the
independent acts or o+rnissians of such person art organization.
2, The insurance provided to the additional insured by this endorsement Is limited as follows:
a) In the event that the Limits of Insurance of this Covcarage hart shown in the Declarations exceed the limits
of kabilly re"red by the"written contract requift insurarn ".the insurance provided to the additional
Intoned shall be limited to the penins of liability required by that"written contract requiring insurance". This
endorsement shell not inc .w to t mss of insurance described In Section M—Limits o(lnsurance.
b) The insurance provided to the additional tssunMd does not apply to"boder InW, "property damage"or
"personal k4urY" arising out of the rendering of. or failure to rende c any professional architectural,
anginimirg►orr tisurveying Services„Including: �}�.� �y��iri�
I. The preparing+ �rq.or falling to prepare or approve, maps, shop dra Mngs, opinions, reports.
surveys.fiend orders or change orders,or the preparing, approvIM or failing to prepare or approve,
drawings and speakcations:and
ii. Supervisory,inspection,architectural or engineering activities.
C) The insurance provided to the additional insured does not apply to"toddy v*kY or*property damage"
caused by"your worts"and included in the" operations hazar .".
3.
Tho Insurance provided to the additional insured by this endorsernent is excess over any vallti and oollactible
"rather Irrsura nee".wheth r prprrary,excess,contingent or on any other basis,that is available to the additional
irrsmed fon a loss we carver under this srtdcrsernent. However, If 9w "written contract rewiring Insurance'
specillcaly requires that this insurance appy an a pdmary basis or a primary and non-contributory basis.this
insurance Is primary ry to "other erw ranee" wobble to t s, additional insured which covers that person or
organizallon as a ranted insured for such loss, and we will not share with that "otter insurwwoO. But the
insoranca provided to the a ddWo AW insured by this ertdax wnant still Is excess over any vakd and collectible
"other irmoance",whedfeer primary.excess.contngernt or on any rather basis.that Is wailable to the addhional
Umpvd when that parson or organdxalon Is an additional Insured under such"ether insurance".
4. As a condAw of covsrage provided 10 the additional insured by this andorsement;
a) The additional Insurted must give us written n1o6ca as scram as pradkWe of an"occurrence"or an o fence
which may nesuit in ant dom. ra the extent possible,such notice should Include:
L draw,when and where the"occurrerwe or offense tools placer.
ill. The names and addresses of any injured persons and witnesses;and
Ill. The nature.and loci of any Injury or damage arising out of the*occurrence*or offense.
bl if e clam is or"snit"is t)rougbt against tate additional insured,the additional insured must;.
I. Immadately record the specifics of eluent or"saris"and the date received:and
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CG lag 48 08 05 Pages 2 of 2
ii. Nobly us as soon as practkabie.
The awJdiboned #U ured must $ee to it the# we receive written notice of the dahn or 'suW,as soon as
pradic abia
c) The addibmW Insured must irnrneKfiatetyr send us copies of ad tegai papers received in connection with
the d6m or"suit". cooperate wM,us in the kwestigsdfon or settyernent of the dadm or defense against the
'auiC",and cittae WIM cm*with of poky condit]on&
A Ther addwtio W hots and must boder the defense and indemnity of any claim or-SW b any providw of
"other Ins wanc er which would cow the addWorW Msuraad for a Mss wee cowr under this endorsement.
Nawrem,lhis cor~does not anted whedaer the hsufance provided to the addilonat insured by this
endosm"Oflit is Wknwy b"other insurarOW aiveRable,to the additional insured whrich covers the#person
or orgarft&tion as a naaned insured as desa1bed in parch&move.
S. The blowing dei" ion is added b SECTION V.—DEEFINMONS:
"Whim Contract red*vv in*Carmnoe means that peat of any*rift"contract or agreement under which
you we required to inciude a parson or ogpv iu#m as an additionat insured on this Coverage Part,
provided that We"boft kr*W and"property damage`omm and the'perstmai Injury"a caused by an
offense torn d:
& After the signing and execution of the contract or agreement by you;
b I Wft that part of the contract or agreement is in effect and
c. Before,the end of the poNcy period.
CG d2 48 08 tin
Qatar i l.�e�.
e nol Tale Traveaem Companies,Int.
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CG D3 16 07 04 Page I of
CG D3 16 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REAM IT CAREFULLY.
1
CONTRACTORS XTERD ENDORSEMENT
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL L"ILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE - Provisions A.4t and J.-N. of this endorsement broaden coverage, and
provision L of this andoraement may W'Nt coverage. The following fisting Is a genal coverage description only.
Lirnitatitms and exclusions may apply to these coverages. Read all the PROVISIONS of this endoresment drat* to
determine rights,duties,and what Is and is not covered.
A. Broadened Named Insured
B. Extension of Coverage-Damage To Premises Rented To You
• Peas of fvs,explosion.lightning,smoke,water
• Lint increased to$300,0
C. Blanket Waiver of Subrogation
Cr. Blanket Additional Insured-Managers or Lessors of Premises
E. Incidental Medical Melprac t
F. Extension of Coverage--S lily Injury
G. Contractual Liability-Railroads
N. Additional insured-State or Political Subdivisions
I. Other Insurance Condition
J. Increased SupplOrnentary Payments
• Cost of be#bonds increased to$2.5500
• Loss of earnings Increased to$504 per day
K. Knowledge and Notice of Occurrence rence or Offense
L. Unintentional Omission
M. Personal hjury-Assumed by Contract
N. Blanket Additional Insured---L..sasor of Leased Equip sit
PROVISION$
A. BROADMED NAMED INSURED
1. The Named Insured In Item 1.of the Declarations is as follows:
The person or organization named in item 1.of the Qectaratlons and any organization, oar than a partnership,
joint venture or limited liability company, of which you nu ain ownershlp or In which you maintain the m*ft
Interoo on the effective date of the policy. However, coverage kyr any such additional organization wig cesse as
of the data. if any, during the policy period, Ihat you no longer maWM M owners*of, or the moo*Interem in,
such organization.
2. WHO IS AN INSURED(Section 4)Item"I$deleted and replaced by ttfe tftwkV.
a. Coverage under this prevision Is afforded only ur#M ft 18ft day oftr you acquire or form the aeganizalion or
lie end of the policy period,whir-ever is earlier.
. This Provision A.does not apply to any person or orgargzation for which cove Is excluded by endorsement
6, EXTENSION OF COVERAGE-DAMAGE TO PREMISES RENTED TO YOU
1. The last paragraph of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I -
CG D3 16 07 04 Page,2 of 6
Coverages)is deleted and replaced by the following:
Exclusions c.through n.do not apply to damage to premises while rented to you, or temporarily occupied by you
with permission of the owner,caused by:
a. pore,
b. Explosion;
c. Lightning;
d. Smoke resulting from such fire,expWIon,or lightning;or
a. Water.
A separate limit of insurance applies to this coverage as described in Section IN Lhft Of Insurance.
2. This insurance does not apply to damage to promises while rented to you, or teddy occupied by you with
permission of the owner,caused by:
a. Rupture, bursting,or operation of pressure relief devices;
b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or
resulting from water,
c. Explosion of steam bollers.steam pipesstearn vVi nes.or steam turbines.
3. Paragraph t of LIMITS OF INSURANCE(Section IN)Is deleted and replaced by the following:
Subject to& above,the Damage To Premises Rented To You Linnit Is the most we will pay under COVERAGE A.
W the sum of all damages because of"property damage"to any one promises while rented to you,or temporarily
occupied by you with permission of the owner, caused by: Are; explosion; lightning; smoke resulting from such
fire, explosion, or lightning, or water. The Damage To Premises Rented To You Urnit will apply to all"property
damage" proximately caused by the same *occurrence", whether such damage results from. fire; explosion;
lightning. smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these
causer.
The Damage To Premises Rented To You Limit will be the higher of
a. VIN,000;or
b. The amount shown on the Declarations for Damage To Premises Rented To You Limit.
4. Paragraph a. of the definition of*Insured contract" (DEFINITIONS —Section V) Is deleted and replaced by the
Wowing.
a. A contract fora lease of premises. However, that portion of the contract for a lease of premises that
indemnities any person or organization for damage to promises while rented to you, or tenqKwarlly occupied
by you with permission of the owner, caused by: Ike, explosion; lightning; smoke resulting from such &*,
explosion,or lightft or water,is not an*hsw*od oontract%
5. This Provision B.does not apply If coverage for Damage To Premises Rented To You of COVERAGE A. BODILY
INJURY AND PROPERTY DAMAGE LIABILITY(Section I—Coverages)Is excluded by endorsement
C. BLANKET WAIIAW OF SUBROGATION
We waive any right of recovery we may hove against any person or organmation become of payments we make kW
injury or damage aft" out of promises owned or occupied by or rented or loaned to you, ongoing operations
perWned by you or on your behalf, done under a contract with that person or organization; *your work"; or "your
producW. We won this right whom you have agreed to do so as part of a written contract executed by you before
the"bodily"ury-or-property demago'occurs or Ow-personal Injury'or-advertising kW offense Is committed.
0. BLANKET ADDITIONAL INSURED—MANAOM OR LESSM OF PREMISES
WHO IS AN INSURED(Section N)is amended to Include as an Irwed any person or organizAtion(referred to below
as "additional Insured) with whom you have agreed in a written contact executed before the "bodly Injury" or
Oproperty damage occurs or the "personal kqury* or "advertising Injury" offense Is cornmitted, to name as an
additional Insured, but only with respect to liability arising out of the ownership, maintenance or use of that part of any
premises leased to you,subject to the following provisions:
1. Limits of Insurance.The limits of insurance afforded to the additional insured she#be the limits which you agreed
to provide in the written conn trad,or the limits shown on the Declarations,whichever are less.
2. The insurance afforded to the additional insured does not apply to:
CG D3 16 07 04 Page 3 of 6
a. Any"bodily injury"or"Prop" damage" that occurs, or"personal injury"or "advertising Injury"caused by an
offense which is committed,after you cease to be a tenant in that promises;
b. Any promises,f0r which coverage is excluded by eodorsement or
c. Structural alterations, new construction or demolition operations perforrned by or on behalf of such additional
insured.
3. The insumoe afforded to the additional insured Is excess over any valid wW collectible "other hsurw)W
available to such addWnal Insured, unless you have agreed In ft written contract that this insurance must be
primary to,or non-contributoty with.such sotverinaxsnW.
E. INCIDENTAL MEDICAL MALPRACTICE
1. The following Is added to paragraph 1. Inswing Agreement of COVERAGE A. - BODILY INJURY AND
PROPERTY DAMAGE LIABILITY(Section I-Coverages):
"Bodily Injury"adsing out of the rendering of, or fallure to render, the following will be deemed to be caused by an
*I"
'cr
a. Medical,surgical,dental,laboratory,x-ray or nursing service,**Ice or Instruction,or the related furrilshing of
food or beverages;
b. The furnishing or dispensing of drugs or medical,dental,or surgical supplies or appliances;
c. First aid;or
d. *Good Samaritan services.' As used In this Provision E., "Good Samaritan services" are those medical
services rendered or provided In an emergency and for which no remuneration Is demanded or received.
2. Paragraph 2.s.(1)(d) of WHO IS AN INSURED (Section 11) does not apply to any registered nurse, licensed
practical nurse, emergency medical technician or paramedic employed by you, b4A only while performing the
services described in paragraph 1. above and while acting within the scope of their employment by you. Any
"emptoyeW rende*q "Good Samaritan services" will be deemed to be acting **Nn the scope of their
employment by you.
3. The following exclusion is added to paragraph Z Exclusions of COVERAGE A. - BODILY INJURY AND
PROPERTY DAMAGE LIABILITY(Sectlori I-Coverages}:
(This insurance does not apply to-1"Bodily Injury-or-property darnage-arising out of the willful violation of a penal
statute or ordnance relating to the sale of pharmaceuticals committed by or with the knowledge or consent of the
insured.
A. For the purposes of determining the applicable limits of Insurance, any act or omission together with 90 related
acts or omissions In the furnishing of the services described In pa rograph 1, above to any one person WIN be
deemed one"occurrence".
s. This Provision E. does not apply if you are in the business or occupation of providing any of the services
described in paragraph 1. above.
6. The insurance provided by this Provision E. shall be excess over any valid and collectible "other insurance"
available to the Insured,whether prWnW. excess, contingent or on any other basis, except for Insurance that you
bought specifically to apply In ucess of the Limits of Insurance shown on the Declarations of this Coverage Part.
F. EXTENSION Of COVERAGE-BODILY INJURY
The definition of-bodily INLW(DEFINITIONS-Section V)is deleted and replaced by the following:
"bodily Injury" means bodily Injury, mental anguish, mental Injury, shock, fright, disability, humiliation, sickness or
disease sustained by a person,Including death resulting from any of these at any time.
0. CONTRACTUAL LIABILITY-RAILROADS
i. ParaWaph c. of the definition of"Insured contract'" (DEFINITIONS -Section V) is deleted and replaced by the
following:
c. Any easement or license agreement;
z. Paragraph f.(1)of the definition of"insured contract*(DEFINITION$-Section V)Is deleted.
H. ADDITIONAL INSURED—STATE OR POLITICAL SUBDIVISIONS—PERMITS
INHO IS Al INSURED (Section 11) is arnended to include as an insured any state or political subdivision, subject to
the following provisions.,
CG D3 16 07 04 Page 4 of 6-
1. This insurance aplrWs only when required to be provided by you by an ordinance, taw or building code and only
with respect to operations perrfomned by you or on your behalf for which the state or political subdivision has
issued a permit
2. This insurance does not apply to.
a. "Bodily Injury,""property damage,""personal Injury"or"advertising injury"arising out of operations performed
for the state or political subdivision;or
b. "Boder wry"or"property damage"included In the"products-c:ornpieted operations hazard".
1. OTHER INSURANCE COMMON
A. CCM+4MMIAL GENERAL LIABILITY CONQITKM(Section IV"). paragraph 4. (Other Insurance) Is deleted and
replaced by the k4owing.
4. tither Insurance
If valid and collectible"other insurance"is available to the Insured for a loss we cover under Coverages A or S
of this Coverage Part,our obligations ars wed as follows:
a. Primary Insurance
This insurance Is primary except when b. below applies. if this insurance is primary, our obligations are
not affected unless any of the"other insurance" is also primary. Then, we will share with all that"other
Insurance"by the method described In e-below.
b. Excess Insurance
This Insorance Is excess over any of the"other insurance",whether primary,excess,contingent or on any
other basis:
(1) That is Fire, Extended Coverage.Builder's Risk,Installation Risk,or similar coverage for"your worts";
(2) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of
the owner,
(3) That is insurance purchased by you to cover your liability as a tenant for "property damage" to
premises rented to you or temporarily occupied by you with permission of the owner,or
(4) If the loss arises out of the maintenance or use of aircraft, "autos", or watercraft for the extent not
subject to Exclusion 9-of-Section i-Coverage A-Bodify Injury And Property Damage Liability; or
(S) That'is available to the insured when the insured is an additional insured ander any other policy,
including any umbrells or excess policy.
When this Insurance is excess, we will have no duty under Coverages A or B to defend the insured
against any"auir if any provider of"other Insurance"has a duty to defend the insured against that"suit",
if no provider of "other insuranW defends, we will undertake to do so, but we will be entitled to the
insured's rights against all those providers of"other insurance".
Wean this insurance is excess over"other jnsuranW, we wig pay only our share of the amount of the
loss,if any,that exceeds the sura of:
(1) The total amount that all such "other insurance" would pay for the loss In the absence of this
insurance;and
(2) The total of all deduce and self-lnsured amounts nor that"~insurance".
We win shute the remaining lass, if any, with any "other Insurance" that is not described in this Excess
hwuranc a provisloin.
c. Method Of Sharing
if all of the"other insurance"permits contribution by equal shares,we will follow this method also. tinder
this approach each pro ider of Insurance contributes equal amounts until it has paid Its applicable limit of
insurance or mane of thoe loss remains,whichever fiirst
if any of the"other insurance"does not permit contribution by equal shares, we will contribute by Omits.
t Under this method, the,share of each provider of Insuran€ is based on the ratio of its applicable limit of
insurance to the total a iknits of Insurance of all providers of insurance.
B.
The following definition is added to DEFINITIONS(Section Y).
s t
#
ar: • E �+ « • 't t : • • «>r r f • t t' r •
R �t r .•.. -a ;iG t' -:+, «�. a t-t, w: I i iii- r: •
r -r •. r
i I - • i M - }: a R i « t;. t i f - r t b' • � '
N :t'i - t # t s• - h:. t • t - •• t i- M • r ! }: •
• ::t t "
( t,': • 4- f - •4•• �.. X i i. t MX i': #- - • • i ! t f i -
f-M • t... r' 1 4 if
' i..ti't i t ■- � •s:". -,f fy k. f ♦L M ?!: s. • _# i t` -• t
'f • s•.= t4 ttl"..i t i .• Wt: - t 'il r' s.- ►: _ AY' t= •t ^i s t «. Cf• _■ `
CG D3I60704
Page 6 of 6
"personal injury proved:
(a) Llability to such party for,or for the cost of, that party's defense has also been assumed in the some"insured
contra";and
(b) Such attorney fees and lltigatim expenses are for defense of that party against a civil or alternative dispute
resolution proceeding In which damages to which this insurance applies are alleged.
2. Paragraph 2.d.of SUPPLEMENTARY PAYMENTS--COVERAGES A AND B(SWW I—Coverages)Is deleted
and replaced by the Wowing:
d. The allegations in the"suit"and the information we know about the"oxurrence"or offense are such that no
conflict appears to exist between the Interests of the insured acrid the Interests of the Indemnitees;
3. The turd sentence of Paragraph 3 of SUPPLEMENTARY PAYMENTS — COVERAGES A AND B (Section 1
Cove")Is deleted and replaced by the following:
Notwithstanding the provisi" of Paragraph Zb.(2) of Section 1 -- Coverage A — Bodily hjury And Property
Damage Uabllity,or the provisions of Paragraph 2.e.(1)of Section i—Coverage B—Personal",Advertises
Injury And Web Site Injury Liability, such payments will not be deemed to be dames for"boafly Injury" and
"Property damage",Or darnages for"personal k*W.and will not reduce the limits of Insurance.
4. This provision M.does not apply if coverage for"personal miry"liability is excluded by endorsement.
N. BLANKET ADDITIONAL INSURED—LESSOR OF LEASED EQUIPMENT
WHO IS AN INSURED(Section tI) Is amended to include as an insured any person or organization(referred to below
as "additional insured") with whom you have agreed in a written contact, executed before the "bodily injury" or
"property damage" occurs or the "personal injury" or "advertising injury" offense is committed, to name as an
additional insured, but only with respect to their Habiltty for "bodily Injury". "property damage", "personal Injury" or
"advertising Indy" amused, in whole or in pact, by your acts or omissions in the maintenance, operation or use of
equipment leased to you by such additional Insured,subject to the following provisions:
4. Limits of Insurance. The limits of insurance afforded to the additional insured shalt be the ernits which you agreed
to provide in the written contract,or the limits shown on the Declarations.whichever are less.
2. The Insurance afforded to the additional insured does not apply to any "bodily Injury"or"property damage"that
occurs, or"personal injury"or"advertising Injury"caused by an offense which is comnnitted, after the equipment
leasee expires.
3. The insurance afforded to the additional Insured is excess over any valid and collectible "other insurarnce"
available to such additional insured, unless you have agreed in the written contract that this insurance must be
primary to,or non-contributory with,such"other Insurance".
CG D316 07 04 .
02W av*W1 .Ine-
AC- T. CERTIFICATE OF LIABILITY INSURANCE 4j17/2008
PRODUCER (909)792-2345 FAX (909)792-01S9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Beall Financial & Insurance Svcs, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
130 W. Vine Street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Redlands, CA 92373
INSURERS AFFORDING COVERAGE NAIL#
INSURED PALM CANYON CONTRACTORS INSURER Travelers Prop & Cas Co of Aisle 25674
P.O. BOX 6S6 INSURER B
YUCAIPA, CA 92399 INSURER C:
INSURER D;
INSURER E:
COVERAGES
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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
INSR AD0*L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE(MMIDO/YYJ
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $
irprica)
CLAIMS MADE [:]OCCUR MED EXP(Any one person) $
PERSONAL&ADV INJURY III
GENERAL AGGREGATE $
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $
POLICYjPERc0j [—]LOC
AUTOMOBILE LIABILITY DT8109322BS92 OS/12/2008 05/12/2009 COMBINED SINGLE LIMIT $
X ANY AUTO (Ea accident) 1'000'00O
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
A —
X HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
F (Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGO $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE III
DEDUCTIBLE $
RETENTION $ $
�&YSTATUf 11-
LIM
WORKERS COMPENSATION AND S1 1 0&
EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $
ffXes under
SPECIAL
describe
IIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1 $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT)SPECIAL PROVISIONS
VIDENCE OF COVERAGE. CERTIFICATE HOLDER, THEIR OFFICERS, EMPLOYEES, ELECTED OFFICIALS AND AGENTS ARE
4AMED AS ADDITIONAL INSURED TO THE AUTO PER ATTACHED CA 20 48 02/99. WAIVER OF SUBROGATION APPLIES PER
kTTACHED CA T3 S3 01 04. 308 LOCATION: DEARBOURNE & PIONEER, REDLANDS, CA
108 DESCRIPTION: CONTRACT #24300-7230/47105 SPORTS PARK PARKING LOT PAVING
110 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM,
CERTIFICATE HOLDER CANCELLATIQN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
CITY OF REDLANDS *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
PUBLIC WORKS DEPT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
P.O. BOX 3005 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES,
777
REDLANDS, CA 92373 AUTHORIZED REPRESENTArIVE 7?
RICHARD BEALL —
ACORD 26(2001108) OCACORD CORPORATION 1981
POLICY NUMBER: DT8109322B592
CA 20 48 02 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
COMMERCIAL AUTO
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by this endorsement.
This endorsement identifies person(s) or organization(s)who are "insureds" under the Who Is An Insured Provision
of the Coverage Form, This endorsement does not alter coverage provided in the Coverage Form.
SCHEDULE
Name of Person(s) or Organization(s):
CITY OF REDLANDS AND THEIR OFFICERS, EMPLOYEES, ELECTED OFFICIALS,
AND AGENTS
(if no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to the endorsement.)
Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that
person or organization qualifies as an "insured under the Who Is An Insured Provision contained in the Section If of
the Coverage Form.
CA 20 48 (02-99)
Privacy/Legal Notices
02004 The St. Paul Travelers Companies,Inc.
form number Page I of 3
CA T3 53 0104
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE EXTENSION FORM
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by
the endorsement.
A. BROAD FORM NAMED INSURED
SECTION 4-LL48UJW COVERAGE,A.1.Who Is An insured provision Is amended by adding the following:
d. Any business entity newiy acquired or formed by you during the policy period, provided you own 50%or more of
the business entity and the business entity is not separately Insured for Business Auto Coverage. Coverage is
extended up to a maximum of 180 days following acquisition or formation of the business entity.
This provision does not apply to any person or organization for which coverage is excluded by endorsement.
8. EMPLOYEES AS INSURED
SECTION 11-LIABILITY COVERAGE,A.I.Who Is An Insured is amended by adding the following:
a. It you are not a sole proprietor, any "employee" of yours is an "insured"while using, in the course and scope of
your business at the time of an"accident",a covered"auto*you don't own,hire or borrow.
If you are a sole proprietor, any"employee"of yours is an "insured"while using, in the course and scope of your
business or personal affairs at the time of an*accident*,a covered"auto"that you don't own,hire or borrow.
C. COVERAGE EXTENSIONS-SUPPLEME"-TARY PAYMENTS
SECTION If- LIABILITY COVERAGE,A. 2. Coverage Extensions, a. Supplementary Payments subparagraphs
(2)and(4)are deleted and replaced by the following:
(2) Up to $3,000 for cost of bail'bonds (including bonds for related traffic law violations) required because of an
"accident"we cover.We do not have to furnish these bonds.
(4) All reasonable expenses Incurred by the *Insured" at our request,including actual toss of earnings up to $500 a
day because of time off from work.
D. HIRED CAR—WORLDWIDE COVERAGE
SECTION It-LIABILITY COVERAGE,A.2.Coverage Extensions is amended by adding the following extension:
c. Hired Car-Worldwide Coverage
(i) We will pay aft sums an "insured" legally must pay as damages because of Obodity injury" or "property
damage to which this Insurance applies, caused by an "accident"which occurs outside the United States of
America, the territories and possessions of the United States of America, Puerto Rico, and Canada resulting
from the operation, maintenance, or use of any covered"auto"of the private passenger type you Lease, hire,
rent,or borrow without a driver for 30 days or less.
(2) With respect to any claim made or"sur Instituted outside the United States of America. the territories and
possessions of am United States of America.Puerto R".and Canada:
(a) You shall undertake the investigation, settlement, and defense of such claims and "suits" and keep us
advised of all proceedings and actions.
(b) You will not make any settlement without out cons
(c) We will reimburse you:
(I) For the amount of damages because of liability imposed upon you by law on amount of*bodily injury"
or"property damage to which this policy applies,and
(11) For all reasonable expenses Incurred with our consent in connection with the investigation, settlement
or defense of such claims or "suits". Reimbursement for expenses will be part of the Limit of
Insurance for Liability Coverage shown in ITEM TWO of the BUSINESS AUTO COVERAGE PART
DECLARATIONS,and not in addition to such limits.
f3) The Urn it of Insurance for Liabihty Coverage shown In ITEM TWO of the BUSINESS AUTO COVERAGE
PART DECLARATIONS is the most we will reimburse you for the sura of all damages imposed on you, as set
form number Page 2 of 3
forth in c.(2)(c)above,and all expense Incurred by you arising out of any single"accident"or"loss".
(4) You must maintain the greater of the following primary auto liability insurance firnift:
(a) Compulsory admitted insurance with limits required to be In-*>rce to satisfy the legal requirements Of the
jurisdlctirsrs where the"accident"occurs,or
(b) Insurance limits required by law and issued by a governmental entity or by an insurer licensed or
permitted by law to do business In the jurisdiction where the wacciclent"occurs;or
(c) Auto liability insurance limits of at least $300,000 Combined Single Link or $100,000 per person/
$31)0,000 per accident Bodily injury,$100,000 Property Damage.
If you fad to comply with the above,this insurance is not invalidated. However, in the event of a"loss", we will
pay only to the extent that we would have been!table had you so compiled.
(5) The Insurance provided by HIRED CAR-WORLDWIDE COVERAGE is excess over any other collectible
insurance available to you whether on a primary,excess contingent or any other basis.
E. HIRED CAR PHYSICAL DAMAGE—LOSS OF USE
SECTION"-LIABILITY COVERAGE,A.2,Coverage Extension*is modified by adding the following:
d, Notwithstanding SECTION 11,LIABILITY B. Exclusions 2.and C,we will pay sums which you legally must pay to
the lessor of a covered"auto"which you have teased without a driver for 30 days or less for the tessoft loss of
use of the covered"auto",provided:
1. This insurance provides comprehensive,specified causes of loss or collision coverage on the covered"auto";
Z The loss of use results from the covered"auto"being damaged in an"accident"while you are leasing it.
We will pay up to$66 per day subject to a maximum limit of$750 for any one"accident".
F. PHYSICAL DAMAGE—TRANSPORTATION
EXPENSE
SECTION NI - PHYSICAL DAMAGE COVERAGE, A. 4. Coverage Extensions, subparagraph a. is deleted and
replaced by the following*
a. Transportation Expenses
We will pay up to$50 per day to a maximum of$1,500 for temporary transportation expense incurred by you
because of the total theft of a covered"auto"of the private passenger type.We will pay only for those covered
"autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for
temporary transportation expenses Incurred during the period beginning 48 hours after the theft and encting,
regardless of the policy's expiration,when the covered"auto"is returned to use or we pay for Its'lose.
If the temporary transportation expense Incurred arises from your rental of an*auto"of the private passenger
type, the most we will pay is the amount it costs to rent an"auto"of the private passenger type which is of a
like kind and quality as the stolen covered"auto".
G. PERSONAL EFFECTS COVERAGE
SECTION IN - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by adding
the following:
c. Personal Effects Coverage
We will pay to$400 for loss to wearing apparel and other personal effects which are:
(I I owned by an insured;and
(2) In or on your covered"auto".
This coverage applies only in the event of a total theft of your covered"auto".
No deductilbles apply to Personal Effects Coverage.
H. NOTICE OF AND KNOWLEDGE OF
OCCURRENCE
SECTION IV - BUSINESS AUTO CONDITIONS, A. 2. Duties In The Event Of Accident, Claim, Suit Or Loss,
subparagraph a.is deleted and replaced by the following:
a, In the event of"accident", claim, "suit'or loss", you must give us or our authorized representative prompt notice
of the'accident*or lose including:
(1) Now.when and where the*accident"or lose occurred;
(2) the'insured'e name and address-,and
form number Page 3 of 3
(3) to the extent possible,the names and addresses of any injured persons and witnesses.
Your duty to give us or out authorized representative prompt notice of the"accident"or"loss" applies only when
the`accident'or*loss*is known to:
i. You.W you are an individual;
2. A partner.if you are a partnership;or
3. An exewov*ofter or Insurance manager,N you are a corporation,
1. BLANKET WAIVER OF SUBROGATION
SECTION IV-BUSINESS AUTO CONDITIONS,A. Loss Conditions,S.Tromfor Of Rights Of Recovery Against
Othws To Us is deleted and replaced by the following:
S. Transfer Of Rights Of Recovery Against Others To Us
We waive any right of recovery we may have against any person or organization to the extent required of you by a
written contract executed prior to any "accident" or "loss", provided that the waccklenr or "toss" arises out of
operations contemplated by such contract The waiver applies only to the person or organization designated in
such contract.
J. UNINTENTIONAL ERRORS OR OMISSIONS
SECTION IV-BUStNESS AUTO CONCHTIONS, B. Gonerat Conditions, 2. Concoabmwt, Misrepresentation, or
Fraud is amended by adding the following:
The unintentional omission of, or unintentional error in, any information given by you shalt not prejudice your rights
under this insurance. How-ever this provision does not affect our right to collect additional premium or exercise our
right of cancellation or non-renewal.
K. MENTAL ANGUISH
SECTION V-DEFtN1T1ONS,Def nitiort C.is amended by adding the following:
*Bodgy injury" also includes mental anguish but only when the mental anguish arises from other bodily injury,
sickness,or disease.
CA T3 53 0104
02007 The Travelers Companies,$no,
'Na