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Contracts & Agreements_258-2022
PUBLIC WORK CONSTRUCTION CONTRACT This Public Work Construction contract ("Contract") is made and entered into this 661 day of December 2022, by and between the City of Redlands, a municipal corporation, organized and existing under the laws of the State of California (hereinafter "City"), and Tryco General Engineering, California corporation (hereinafter "Contractor"). City and Contractor are sometimes individually referred to herein as a "Party" and, together, as the "Parties." In consideration of the mutual promises contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK: Contractor shall furnish all materials and will perform all of the work for the following: 2022 Citywide Sidewalk and ADA Ramp Replacement Project, complete all items as required by the Contract Documents (as herein defined) and Specifications for City's 2022 Citywide Sidewalk and ADA Ramp Replacement, Project No. 400022 (the "Work"). 2. CONTRACT SUM: City shall pay Contractor the sum of one million dollars ($1,000,000) as consideration for its performance of the Work in accordance with the terms and conditions set forth in the Contract Documents. Pursuant to Public Contract Code Section 22300, Contractor has the option to deposit securities with an escrow agent as a substitute for retention of earnings required to be withheld by City pursuant to an escrow agreement as set forth in Public Contract Code section 22300. 3. TIME FOR COMPLETION: The Work shall be completed within One Hundred Fifty (150) calendar days from and after the date of City's issuance of a Notice to Proceed to Contractor. 4. LIQUIDATED DAMAGES: Contractor's failure to complete the Work within the time allowed will result in damages being sustained by City. Such damages are, and will continue to be, impracticable and extremely difficult to determine. Accordingly, Contractor shall pay to City, or have withheld from monies due to Contractor, the sum of Five Hundred dollars ($500) for each consecutive calendar day in excess of the specified time for completion of the Work. Execution of this Contract shall constitute agreement by City and Contractor that Five Hundred dollars ($500) per day is the estimated damage to City caused by the failure of 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 from payments due Contractor if such delay occurs. 5. CONTRACT DOCUMENTS: This Contract incorporates by reference the following: Notice Inviting Bids, Instructions to Bidders, Contractor's Proposal, Bid Bond, Agreement, Performance Bond, Labor and Material Bond, Plans, General Conditions, Special Provisions and Specifications, and any addenda thereto (collectively, the "Contract Documents"). 6. ATTORNEYS' FEES: In the event any action is commenced to enforce or interpret the terms or conditions of this Contract, or the Contract Documents, the prevailing Party in such action, in addition to any costs and other relief, shall be entitled to recover its reasonable attorneys' fees, including fees for use of in-house counsel by a Party. 1 L:\ca\Agreements\Tryco Engineering PW Construction Contract-FY22-0074.doc-jm 7. RESOLUTION OF CONSTRUCTION CLAIMS: Claims by Contractor in the amount of three hundred seventy-five thousand dollars ($375,000) or less shall be made by Contractor and processed by the City pursuant to the provisions of Part 3, Chapter 1, Article 1.5 of the Public Contract 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 Public Contract Code Section 20104.2 shall extend the time limit or supersede the notice requirements provided in this case from filing claims by Contractor. 8. ELIGIBILITY OF CONTRACTOR/SUBCONTRACTOR: Contractor and all of its subcontractors shall 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. 9. ASSIGNMENT OF AGREEMENT: No assignment by a Party of any rights or interests under this Contract shall be binding on another Party without the written consent of the Party sought to be bound. 10. SUCCESSORS AND ASSIGNS: City and Contractor each binds itself and their respective successors and assigns in respect to all covenants, agreements, and obligations contained in th.e Contract Documents. 11. 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 City and Contractor. [SIGNATURES ON FOLLOWING PATE] 2 L:\ca\Agreem.ents\Tryco Engineering PW Construction Contract-FY22-0074.doc-jm IN WITNESS WHEREOF, the Parties hereto have executed this Contract the day and year first written above. (SEAL) ATTEST: e Donaldson, City Clerk Paul T. Barich, Mayor (SEAL) TRYCO GENERAL ENGINEERING Name of Contractor By: Si����Zi�cr-���-: an e of AutYi orized A ent a/iLc v., Title (/ Signature of Authorized Agent (if necessary) Title glaozgs- Contractor's License No. 3 L:\ca\Agreements\Tryco Engineering PW Construction Contract-FY22-0074.doc-jm WORKER'S COMPENSATION INSURANCE CERTIFICATION Description of Contract: City of Redlands Municipal Utilities and Engineering Department 2022 Citywide Sidewalk and ADA Ramp Replacement Project Project No. 400022 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 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 I become subject to the workers' compensation laws of California, immediately I 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. Dated this (Pi day of /L 444'f12i?&✓, 2022. TRYCO GENERAL ENGINEERING Contractor) (Signature) (Official T 4) (SEAL) (Labor Code Section 1861 provides that the above certificate must be signed and filed by the Contractor with the Owner prior to performing the work of the contract.) 4 L:\ca\Agreements\Tryco Engineering PW Construction Contract-FY22-0074.doc-jm Bond No. 54736 Premium: $13,500.00 Premium Based on Final Contract:Amount FAITHFUL PERFORMANCE BOND Whereas, the City of Redlands ("City"), State of California, and Tryco General Engineering (hereinafter designated as "Principal") have entered into an agreement dated December 6, 2022 ("Agreement") whereby Principal agrees to install and complete certain public improvements (the "Work"), which said Agreement is identified as 2022 Citywide Sidewalk and ADA Ramp Replacement Project, Project No. 400022 and is hereby referred to and made a part hereof.; and Whereas, said Principal is required under the terms of the Agreement to furnish a bond for the faith:1bl performance of the Work, now, therefore, we, the Principal and, Western National Mutual Insurance Company" as Surety, are held and :firmly hound unto the City in the penal. sum of one -million. dollars ($1,000,000) lawful money of the United States, for the payment of which sum we bind ourselves, and our heirs, successors, executors and administrators, jointlyan.d severally, firmly by these presents. The condition of this obligation is such that if the above bounded Principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and provisions in the Agreement and any alteration thereof made as therein provided, on his or its 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 faithfully fulfill the one-year guarantee of all materials and workmanship, and shall. defend, indemnify and save harmless the City and its elected officials, officers, agents and employees, as therein stipulated, then this obligation shall become null and void; otherwise it shall he and remain in full. force and effect. As a part of the obligation secured hereby and in addition to the face amount specified therefor, there shall be included costs and reasonable expenses and fees, including reasonable attorneys' fees, incurred by the City in successfully enforcing such obligations, all to be taxed as costs and included in the judgment rendered. As a condition precedent to the satisfactory completion of the Work, the above obligation shall hold good for a period of one (1.) year or longer if required by. the Agreement after the acceptance of the work by the City, during which time if the Principal shall fail to make full, complete, and satisfactory repair and replacements and totally protect the City from loss or damage made evident during this period from the date of completion of the Work, and resulting from or caused by defective materials or faulty workmanship, the above obligation in penal sum thereof shall remain in full force and effect. The obligations of Surety hereunder shall continue so long as any obligation of the Principal. remains. Whenever the Principal shall be, and is declared by the City to be, in default under the Agreement, the City having performed the City obligations thereunder, the Surety shall promptly remedy the defaul.t, or shall promptly, at the City's option: 1. Complete the Work in accordance with its terms and conditions; or 2. Obtain a bid or bids for completing the Work in accordance with its terms and 5 L:\ca\Agreetnents\Tryco Engineering PW Construction Contract-FY22-0074.doc-jm conditions, and upon determination by Surety of the lowest responsive and responsible bidder, arrange for a contract between such bidder and the City, and make available as work progresses sufficient funds to pay the cost of completion of the Work less the balance of the Agreement price, but not exceeding, including other costs and damages for which Surety may be liable hereunder, the amount set forth above. The term "balance of the Agreement price," as used in this paragraph, shall mean the total amount payable to the Principal by the City under the Agreement and any modifications thereto, less the amount previously properly paid by the City to the Principal. Surety expressly agrees that the City may reject any contractor or subcontractor which may be proposed by Surety in fulfillment of its obligations in the event of default by the Principal. Surety shall not utilize the Principal in completing the Work nor shall Surety accept a bid from the Principal for completion of the Work if the City, when declaring the Principal in default, notifies Surety of the City's objection to the Principal's further participation in the completion of the Work. No right of action shall accrue on the bond to or for the use of any person or corporation other than the City named herein or the successors or assigns of the City. Any suit under this bond must be instituted within the applicable statute of limitations period. The said Surety, for value received, 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 any way 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 Agreement or to the work or to the specifications. No final settlement between the City and the Principal shall abridge the right of any beneficiary hereunder whose claim may be unsatisfied. The Principal and Surety agree that if the City is required to engage the services of any attorney in connection with the enforcement of this bond, each shall pay the City' s reasonable attorneys' fees incurred, with or without suit, in addition to the above sum. In witness whereof, this instrument has been duly executed by the Principal and Surety above named, on November 16 , 2022. (SEAL) (SEAL) Tryco General Engineering Western National Mutual Insurance Company (Contract° -) (St ety) (Signa ure) (Signature) Pietro Micciche, Attorney -in -Fact Address: 4700 West 77th Street Edina, MN 55435-4818 6 L:\ca\Agreements\Tryco Engineering PW Construction Contract-FY22-0074.doc-jrn (Seal and Notarial Acknowledgment of Surety) Telephone ( 855 ) 283-8106 7 L:\ca\Agreements\Tryco Engineering PW Construction Contract-FY22-0074.doc-jm CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles ) On ,NOV 1 6 2022 before me, Angel Nunez, Notary Public Date Here Insert Name and Title of the Officer personally appeared Pietro Micciche Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose name() is/il subscribed to the within instrument and acknowledged to me that heixtKedbey executed the same in hisittoakmk authorized capacity(Mf), and that by his/MtAtbsignature(") on the instrument the person(), or the entity upon behalf of which the personN) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Califs i. hat the forego; paragraph is true and correet WITNESS C Signature ANGEL NUNEZ Notary Public - California Los Angeles County ▪ Commission # 2321675 My Comm. Expires Mar 14, 2024 Place Notary Seal Above OPTIONAL official seal Signature • J'otary ublic Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended 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: i Corporate Officer — Title(s): • Partner — ❑ Limited Li General ❑ Individual VI Attorney in Fact Li Trustee -i Other: ❑ Guardian or Conservator Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — C.-1 Limited lJ General Individual C l Attorney in Fact Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ©2014 National Notary Association • www.NationalNotary.org a 1-800-US NOTARY (1-800-876-6827) Item #5907 Bond No. 54736 Premium Included in Performance Bond LABOR AND MATERIAL BOND Whereas, the City Council of the City of Redlands, State of California, and Tryco General Engineering (hereinafter designated as "Principal") have entered into an agreement (the "Agreement") whereby Principal agrees to install and complete certain designated public improvements (the "Work"), which said agreement, dated December 6, 2022,.and identified as 2022 Citywide Sidewalk and ADA Ramp Replacement Project, Project No. 400022 is hereby referred to and made a part hereof; and Whereas, under the terms of the Agreement, Principal is required before commending the performance of the Work, to file a good and sufficient Labor and Material bond with the City of Redlands to secure the claims to which reference is made in Title 3 (commencing with Section. 9550) of Part 6 of Division 4 of the Civil Code of the State of California. Now, therefore, said Principal and the undersigned as corporate surety, are held firmly bound unto the City and all contractors, subcontractors, laborers, material men and other persons employed in the performance of the Agreement and referred to in the aforesaid Code of Civil Procedure in the sum of one million dollars ($1,000,000) for materials furnished or labor thereon of any kind, or for. amounts due under the Unemployment Insurance Act with respect to such work or labor, that said surety will pay the same in an amount not exceeding the amount hereinabove 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 attorneys' fees, incurred by the City in successfully enforcing such obligation, to be awarded and fixed by the court, and to be taxed as costs and to be included. in the judgment therein rendered. It is hereby expressly stipulated and agreed that this bond shall insure to the benefit of any and .all persons, companies and corporations entitled to file claims under Title 3 (commencing with. Section 9550) of Part 6 of Division 4 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond. Should the condition of this bond 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 the specifications accompanying the same shall in any manner affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition. [SIGNATURES ON FOLLOWING PAGE] 8 L:\ca\Agreements\Tryco Engineering PW Construction Contract-FY22-0074.doc-jm In witness whereof, this instrument has been duly executed by the Principal and surety above named, on November 16 , 2022. (SEAL) Tryco General Engineering (Seat and Notarial Acknowledgement of Surety) 9 (SEAL) Western National Mutual Insurance Company (Sit etyyt- (Signature) Pietro Micciche, Attorney -in -Fact Address: 4700 West 77th Street Edina, MN 55435-4818 Telephone: ( 855) 283-8106 L:\ca\Agreements\Tryco Engineering PW Construction Contract-FY22-0074.doc jm CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 ':!.�.�< . �:!�::!s\t:':C< �: t..:.-�a:�t!:�.!:Ca�.. s\rt/Ai'R/:\</`.�:��21.�t/:\:�:!:\t/'1f{:�d' t�•:K/\'f:\'f'\t/'Ci!TG{�C ::�C/:fie/:`C•%�2 1• A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California CountyofLos Angeles On NOV 16 2022 before me, Angel Nunez, Notary Public Date personally appeared Pietro Micciche Here Insert Name and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person() whose names is/i'tde subscribed to the within instrument and acknowledged to me that h%J>rgdy executed the same in his/ r pdkloir; authorized capacity(i ), and that by his/ CsignatureN) on the instrument the person(x), or the entity upon behalf of which the person(4) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foreg g paragraph is true and correct. =r_ ANGEL NUNEZ Notary Public - California Los Angeles County Commission # 2321675 My Comm. Expires Mar 14, 2024 Place Notary Seal Above WITNESS my t d .• nd official sea Signatu Signature of Notary ublic OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended 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: _l Corporate Officer — Title(s): ill Partner — ❑ Limiled ❑ General ❑ Partner — CI Limited ❑ General ❑ Individual ... Attorney in Fact El Individual 1.—..i Attorney in Fact Trustee ❑ Guardian or Conservator ❑ Trustee I._I Guardian or Conservator El Other: ❑ Other: Signer Is Representing: Signer's Name: C Corporate Officer — Title(s): Signer Is Representing: ©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) item #5907 WESTERN NATIONAL The relationship company - POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Western National Mutual Insurance Company, a Minnesota mutual insurance company, does make, constitute, and appoint: Patricia Zenizo, Pietro Micciche, Manuel Reguerra, and Elisabete Salazar , Preferred Bonding Services (#9760) Its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal is required) bond, undertakings recognizances or other written obligations in the nature thereof, (other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, hazardous waste remediation bonds or black lung bonds), as follows: All written instruments in an amount not to exceed an aggregate of Seven Million Five Hundred Thousand and 00/100 ($7 500,000.00). for any single obligation, regardless of the number of instruments issued for the obligation. and to bind Western National Mutual Insurance Company thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This appointment is made under and by authority of the board of directors at a meeting held on September 28, 2010. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of Western National Mutual Insurance Company on September 28, 2010: RESOLVED that the president, any vice president, or assistant vice president in conjunction with the secretary or any assistant secretary, may appoint attorneys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship obligations of all kinds, and said officers may remove any such attorney -in -fact or agent and revoke any Power of Attorney previously granted to such person. RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be required) by a duly authorized attorney -in -fact or agent; or (iii) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of the authority evidenced by the Power of Attorney issued by the Company to such person or persons. RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, Western National Mutual Insurance Company has caused these presents to be signed by its proper officer and its corporate seal to be affixed this 16th day of December , 2020. Jon R. Hebeisen, Secretary STATE OF MINNESOTA, COUNTY OF HENNEPIN Larry A. Byers, Sr. Vice President On this 16th day of December, 2020, personally came before me, Jon R. Hebeisen and Larry A. Byers and to me known to be the individuals and officers of the Western National Mutual Insurance Company who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally dispose and say; that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation. JENNIFER A. YOUNG NOTARY PUBLIC MINNESOTA My Commission Expires 01(31/2026 CERTIFICATE Jennifer A. Young, Notary Public My commission expires January 31, 2026 I, the undersigned, assistant secretary of the Western National Mutual Insurance Company, a Minnesota corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force. 9 Signed and sealed at the City of Edina, MN this' Ch day ofAtnri* , Zv 1/Z Jennifer A. Young, Assistant Secretary VEIUMIRMSUMIUMW IIMMEIWZMWISMOUNOMIAMIMMEMINSIOMPAMISMCWAIMUMENSWIttlffittiMSMOMPESMI l* MI= CITY OF REDLANDS 2023 BUSINESS TAX CERTIFICATE "For Services Provided in tho City of Redlands, California Only" Business Name Business Location Business Owner(s) TRYCO GENERAL ENGINEERING PO BOX 391 RIMFOREST, CA 92378 THIS BUSINESS TAX CERTIFICATE DOES NOT PERMIT A BUSINESS THAT IS OTHERWISE PROHIBITED. WINSIMMUMIROZIPMESM=K013111.1%1 TRYCO GENERAL ENGINEERING: 121N1 TRYCO GENERAL ENGINEERING • , •. . , • ... 25499 Redlands Blvd #113- il,,• ,, .., Business Type Contractor- General ,•• Loma Linda, Ca 92354-2008, (it,-: • :, 14 TRY KIRKLEY Description 'll'•:r1: ti i , • , GENERAL ENGINEERING • , t ,,•.' CONTRACTOR .,.' Certificate Number: 08116604 Effective Date July 01, 2022 Expiration Date June 30, 2023 TO BE POSTED IN A CONSPICUOUS PLACE AND NOT TRANSFERABLE OR ASSIGNABLE For all inquiries regarding thls license, contact HdL Business Tax Support Center at (909)479..2111. MillSOOMMEMPISIDSIAMMEGIMMILIVIUMARMIAMISIIIEW Thank you for your payment on your City of Redlands Business Tax Certificate. ALL CERTIFICATES NIUST BE AVAILABLE FOR INSPECTION UPON REQUEST. If you have questions concerning your business tax certificate, contact the Business Tax Support Center via ernail at: Redlands@hdlgov.com or by telephone at: (909) 479-2111. Keep this portion for your tax certificate separate in case you need a replacement for any lost, stolen, or destroyed tax certificate. A fee may be charged for a replacement or duplicate tax certificate. This certificate does not entitle the holder to conduct business before complying with all requirements of Redlands Municipal code and other applicable laws, nor to conduct business In a zone where conducting such business violates law. If you have a fixed place of business within the city limits of City of Redlands, please display the Business Tax certificate above in a conspicuous place at the premises. Otherwise, every Business Tax Certificate holder not having a fixed place of business in the City shall keep the Business Tax Certificate upon his or her person, or affixed in plain view upon arty cart, vehicle, van or other movable structure or device at all times If required by the Collector. Starting January 1, 2021, Assernbly Bill 1607 requires the prevention of gender -based discrimination of business establishments. A full notice is available in English or other languages by going to: https://www.dca.ca.gov/publications/. BUSINESS SUPPORT CENTER 8839 N CEDAR AVE #212 FRESNO, CA 93720-1832 FID1110413 4000000240 240/1 • .....rtv.t TRYCO GENERAL ENGINEERING •PO BOX 391 RIMFOREST CA 92378-0391 City of Redlands BUSINESS TAX CERTIFICKI E Certificate Number: 08116604 Date of Issue: 07/01/2022 Form (Rev. Depart Interna W-9 )ctober2018) vent of the Treasury Revenue Service 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. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Tryco General Engineering 2 Business name/disregarded entity name, if different from above 3 Check appropriate following seven boxes. ❑ Individual/sole single -member • Limited liability Note: Check the LLC if the LLC another LLC that is disregarded ❑ Other (see instructions) box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions certain entities, instructions Exempt payee Exemption code (if any) (Applies to accounts (codes apply only to not individuals; see on page 3): code (if any) proprietor or • C Corporation SI S Corporation III Partnership III Trust/estate LLC company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) appropriate box in the line above for the tax classification of the single -member owner. is classified as a single -member LLC that is disregarded from the owner unless the is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single from the owner should check the appropriate box for the tax classification of Its owner. ► P.- from FATCA reporting Do not check owner of the LLC is -member LLC that maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. PO Box 391 Requester's name and address (optional) City of Redlands 35 Cajon St. 15A Redlands CA 92373 6 City, state, and ZIP code Rimforest CA 92378 7 List account number(s) here (optional) 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. Part II Social security number or Employer identification number 2 7 5 1 2 1 3 2 7 Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified 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 (if 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 Signature of Here U.S. person ► /71,/ General instructrons 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 file 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) Date ► /1/4 .2 L • 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 TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) DATE IMWDDlYYYY) AC6(triEV 11/16/2022 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. liTifFORTANT:Tifie corafiatie holifiWis an ADDITIONAL INSURED, the poticioes) intiiiileTrTiGiTe7.1. If SUIfiriRiriffiON TRTAIVErl, sut;j7Wir"" the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the CERTIFICATE OF LIABILITY INSURANCE certificate holder in lieu of such endorsement(s). -- "PRODUCER Delaney Insurance Agency, Inc. 8231 White Oak Ave, Rancho Cucamonga CA 91730 INSURED Tryco General Engineering PO Box 391 Rim Forest CA 923713 aCilaTt Lio—g—ero POLFA,(909.481-7222 TrAx.i.A,3_19: 09) 481L-721i - _1,i'\-bmaf;a5;__scbqllegdelastyllns,com JimaergRAF.Er„memcovemcs INSURER A Landmark American Insurance Company INSLMER 13 ; California Autorncyle Insurance Company moos Repstilmark. Inswance Company_ _ lomEs Q; Topa Mein -once Company_ JNISLIRER E Tflyp 11:Turpce_Cornpany__________ U ERr. *I* wa*titl. ma, y ****b********tbn** ** * WI WOW tl Poit..• NOWNIAMM MO **MP -- COVERAGES CERTIFICATE NUMBER REVISION NUMBER: THIS HIS fa CERTIFY THATTHE POLICIES OF INSURANCE CISTETELOOTAVE8E,EN ISSUEBr0 THE INSURED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFIC.wrE MAY BE ISSUED OR MAY PERTAIN, TFIE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOINN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ....... OW - " ' - ADDY. al R POLICY SFr POLICY EXP TYPE OF INSURANCE' PoLI,CDILMR,---. 31.1=IMIL MILIE,Q= LIMIT -------- — — -- — GENERAL LIABILITY 3138 8342 COMMERCIALGENERAL I !ABILITY CLAIMS.MADE ,X OCCUR X LHA141900 GENT AGGREGATE LIMIT APPLIES PER: xi rcpcy POT PRO AUTOMOBILE LIABILITY ANY AUTO ALL OWNED Arms HIRE() AUTOS LIA EXCESS LIAR ELI N PN $ WO 11<bfk$ COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PAR'TNER/EXIECUTIVIT OFFICER/WM[1E1k EXCLUDED? Y.11 (Manciatery In NH) If yes, describe under nuorrioh,oLgREagioNa092.,„,____ SCHEDULED _ AUTOS NON•OWNED AUTOS • OCCUR LAIME.MaDE BA0400000 '733 XL00204178-01 T5 ° 3772 Inland Marine QT-660.2R597661-TIL.21 EASFLOCCLIFIRENCE $ 2,000,000 -}magszso_oicamcao.._ $ 60,090 4/ /' 022 04/19/2023 ED EXPI&A ono Pgrsolt_ ONO ek_RSONAL ADV INJURY 2,000 000 ________ GENERAL AWREGATILm .1_41000,900 PftODUCT, comPiop Aso s 2,000,0 0 0 — cWaluen6iiaLe LIMIT ..‘E.A.araidene_—_-____ 2f°P!42P°_q__—____ BODILY INJURY (Per person) $ OILY INJURY (Per acciden1) $ PROPERTY DAMAGE — _EACH ogconDicx _ /2 /2022 04/19/2023 AGGREGATE 2,90 opoo___ 06/17/2022 06/17/2023 _ El. EACH ACCIDENT $ 1,000,000 oAL5LEA Emile_yEF„ 1,000,000 E.L. DISEASE • POLICY LIMIT 1,000,000 $250,000.00 LBR 04/20/2022 04/20/2023 $382,127.00 Scheduled .... DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addhional Remarks Schedule, If mom space is required) roJect: Citywide Sidewalk and RDA Ramp Replacement Project it 400022 ertificte Holder, It successors and ,assigns are all named as Additional Insureds Coverage Is Primary and Non Contributory Waiver of Subrogation applies **Issuing agency will endeavor to mail 30 days written not co of cancellation; except 10 days notice of cancellation for non-p_aiment of premium.** And** 01*****•„*** M441,*16 CERTIFICATE HOLDER CANCELLATION City of Redlands 35 Cajon Blvd Suite 16A Redlands, CA 92373 LIPMnre MO. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THERE.OP, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. RIZED REPRESENTATIVE Int WM* ,..104„Wliituarizi) — 7 ©1988.2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered rnarks of ACORD ACORD 2)5 (2010/05) LANDMARK AMERICAN INSURANCE COMPANY This Endorsement Changes The Policy. Meese Read It Carefully. ADDITIONAL INSURED BLANKET - YOUR WORK This endorsement modifies insurance provided under the .following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Oppnizotion: Any person or organization to whom or to Which you are obligated by virtue i of a written contract or by the issuance or existence of a written permit, to provide inwranca such as is afforded by this policy. SECTION II - WHO 18 AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the SCHEDULE, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in pert, by; Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations; and/or "your work" defined for the additional insured(s) designated above included in the 'products -completed operations hazard". This endorsement effective 4/19/2022 forms part of Policy Number LHA141900 issued to TRYCO GENERAL ENGINEERING, INC ; TRYCO, INC. by Landmark American Insurance Company RSG 15017 0615 Includes copyrighted material of Insurance Services Office, Inc. 1984 with its permission POLICY NUIVIE3ER: LHA141900 COMMERCIAL GENERAL LIABILITY CO, 20 11 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): ANY PREMISES REQUIRED BY WRITTEN CONTRACT OR AGREEMENT AND AS PER PARAGRAPHS A. AND B. BELOW Name Of Person(s) Or Organization(s) (Additional Insured): ANY PERSON(S) OR ORGANIZATION(S) REQUIRED BY WRITTEN CONTRACT OR AGREEMENT AND AS PER PARAGRAPHS A. AND B. BELOW Additional Premium: $ INCLUDED InformationleguiredisNniplateitits SchedyteLif not shown above, wfll be shown in the Declarations. a A. Section 11 - Who is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the premises leased to you arid shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the ' person(s) or organization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2, If coverage provided to the additional insured is required by ;a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured, B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2„ Available under the applicable limits of insurance; whichever is less, This endorsement shall not increase the applicable limits of insurance. CG 20 11 12 19 Insurance Services Office, Inc., .2018 Page 1 of 1 POLICY NUMBER: LHA141900 COMMERCIAL GENERAL LIABILITY CG20181219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE OR RECEIVE This endorsement modifies insurance provided under the following: COMMERCIAL, GENERAL LIABILITY COVERAGE PART SCHEDULE NarnairiL9f rso rAsy,319r Olganfzaticm(s) ANY PERSON(S) OR IDRGANIZATION(S) RI QUIRED BY WRITTEN CONTRACT OR AGREEMENT AND AS PER PARAGRAPHS A.„ E3., AND C. BELOW Designation Of Premises Information required to complete this Schedule, if riot sh vvn above, will I-44 shown in the Declarations, A. Section II - Who Is An Insured is amended to include as an addition& Insured the person(s) or organization(s) shown in the Schedule, but only with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of the premises by you and shown in the Schedule. However: 1. The Insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 13. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization, C. With respect to the insurance afforded to these additional insureds, the follculing is added to Section III Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 18 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: LHA14190 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDME, T - AGGREGATE LIMITS OF INSURANCE (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENEERAL LIABILITY COVERAGE PART, The General Aggregate Limit under LIMITS OF INSURANCE (SECTION III) applies separately to each of your projects away from premises owned by or rented to you. CG 2503 11 85 Copyright, Insurance Services Office, Inc., 19 4 Page 1 of 1 Policy Number: LHA141900 COM EFtCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRI ARY AND NONCONTRI IJTORY OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes .any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) Tha additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be prirnary and would not seek contribution from any other insurance available to the additional insured. WI 20 01 04 13 Insurance Services Office, Inc,, 2012 Page 1 of 1 LANDMARK AMERICAN INSURANCE COMPANY This Endorsement Changes The Policy. Please Read It Carefully. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGANST OTHERS TO US This endorsement modfles insurance provided under the following: COMMERCIAL GENE.RAL LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Any Person or Organization As Required By Written Contract The following is added to SECTION IV CONDITIONS, 8. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US: We waive any right of recovery we may have against the person or organization shown in the SCHEDULE above because of payment we make for injury or damage arising out of your ongoing operations, °your product or "your work" done under a written contract with that person or organization and included in the "product -completed operations hazard". This waiver applies only to the person or organization shown in the SCHEDULE above. This endorsement effective 4/19/2022 forms part of Policy Number LHA141900 issued to TRYCO GENERAL ENGINEERING, INC ; TRYCO, INC. by Landmark American Insurance Company RSG 14048 1008 includes copyrighted material of Insurance Services Office, Inc. 1992 with its permission. POLICY it 040000052.188 THIS RSMI[T cHANGIT( 'PQUCYN PL5 BP,AD 111' iJAREFULLY. Mercury BusneSS Auto B oad ening EndoreJna .nt Tiffs endursetrient modifies inalferlco provided tmdc;rthe followingt IRISINESS AUTO COVERAGE FORM i.NEWLY ACQUIRED OR FORMED rii\rnri(BitoAD FORM NAMED NSW EO) IL EMPLOYEES ASJI\ISUFIEDS .ILA LITO MATic ADDITIo NAL INS °RED IV. EMPLOYEE HIRED AUTO LIABILITY V„ SUPPLEMEITFARY PAYMENTS 'VI. FELLOW EMPLOYEE COVERAVU.GE ADDflIONALTMNSPOKTATION EXPENSE Vill. HIRED AUTO PHYSICAL. DAMAGE COVERAGE X. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE: IPAWLEA5E GAP COVEBAGE. XL GLASS•REPAIR LICTIE4LE WAIVER XU. • TWO OR MORE DEDUCTIBLxifl ES AMENDED DUTIES IN EVEINfr OF ACCIDENT SUIT OR LOSS XIV. WAIVER OP SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION„ Oft FAILURE TO DISCLOSE HAZARDS XVL EMPLOYEE HIRED AUTO PHYSICAL DAMAGE' • X9II. PRIMARY AND NONCONTRIBuTow IF REQUIRED BY COM:RAO: V111. HIRED AUTO •-• COVERAGE TERRITORY XJXBODILY INJURY REDEFINED1D INCLUDE RESUCIA NT ANGUISH copyright 2,01B Mercury Irosorarwo service5, LLC AIrighp reserved. MCAM01213 includes capyrIghted routorial�fTUrano Seruicau Office, WWL1gs PenTagiou Pagel, of 5 BLISlNk ,SS A.uT' COM -0l atk �i�I1dl l„ IMIIE;.iltI Y ACQUIRED FORMED D ENTITY (Broad l�,d�,t rrn ea llrxlns+a red) following Is added: ,r;Cl'Il�hl II - LIABILITYC(;11PlRA�I,INIhypo during the policy period d„ Any busintlssentiLynewtyacquired rn formed byy r provided von awn fl%ormore L7rthe bu.ines entity arid tile is 4.uidrilluenCityisnot sl;palately, insured for I3usit7 s Auto Coverage. maximum of drays fellowing autuisltTe'rrt or formation of the business entity, Coverage rincertFis pra7r'sirrk Is affordedtil only end Of �< Coverage does not apply to an, . "accident' wtchuG�urr�d Iri��yrr�a��ir�d or r formed the organization. EIV IPi OVL1F S AS INS%JEEEa Who Is AnInsure d lh�; i' �Il¢auuln is �drit d SF.0 l ON II LIABILITY CO' d11�RACr, A. Coverage, ,w a. My rtt;rzmplayee" of yours Is an "Irnnurad' while tl.'ting to covered °ali'kc ;" you door; avun, hirer or harrow in Your business Dr your. Personal affairs. AUTOI♦ IAI11C A4DIIIT ONM INSURED 'ai.iCT1ON II - LI/ABA.11Y COVERAGE, E, A. C()tiek u c , . Who Is .Au Insured2-theft-Mowing Is added. f Any person car orgaraizltiorx rtat yux,t era rear nr a ared 1.13 rnciU ie. EIS a dditional i tell and insured can tlit Coverage er ge form to a tialrrlC+an r,tantr n g+ youuteri kvy before the "iaor tty injury" or °properly dlsunage" incurs end That is a during the policy ,pt,rlgcl is t.rx "[r"tx�raarcall,,rnr Liability Craverags; ht,tl atxlyt'oz darraajge:t to vnrlatrlti this insurance Insured p ai<�ta l i� aand only to tile •� rvavisi"cite or orgenil.alion qualifies' As an 1nsuC0.,ul nlloy' the 1Nho is An Cot"i:airnad In Section II. .iv; hllr'111 Y] 1 El)AUFO LlAUll iI'i1E' Who l5 rrinr>ur d, the Tctl3i�tnriril�is added: S E!.0 ON II - Will 'COVIEERA F'Y A. Cc ver age, I. g. An "anxl,IcvSrnea taf'your,� r is an "Insu =egi" whfia operating an s'euto'r hired car` ranted under a nemtr.act or agreement In `at "e rd tc#: of yatkr' tkzesirreith your permission, wilYie ;perfonuit lit tillt' eS r ted L h .611IPPI IVIENTA Y PAYI1lIEJItl'K•S 1 l Fail°' A. Glave.rage, 2, trtnre age El ensions, a. apple. entarY SECTION :l It N tl I.jAf3II..1 ra're lat,ed by the J&owTh Payk etr , Subparagraphs K . a1dk (a) tend (4 Ir (2) I.lp'I;ct $S,CIE)Ufor cost or I?ai1 bonds an a(ryaidc�txi gw�t• related 1 �u r, '1llde are nA�)bli�i7ud to c Jaw vilalal:ictrlfi) ke�lulred iaL'I:ausa c f furnish these bonds. at Ali reasonable expenses Incurred hy'[he "In;trned"our rzquest, off from work, (�) actual lass of earnings ups to$SUO aday because af t Vi. FEsIU QW EmpLoYJE COVERAGE!, Fellow Employee 5E ir:riDN II — LIAB11�I`l Y CONilifiAGE, B. Exulusictrks, .nce exclusion does not apply Ifyo)u have workers compensationcollectible ct hta insurer c Ip �trtrcu rctverlt7g all LA' . "tills exclusion t;pvernl„o is excess over any other �t cc,pyrigh•201.3 Mercury Insurance rvicAil tight UICHad ay gtk' made' Insurance Se, Office, tgWith patrni Ynn 'ate2ot`t 0121.9 VII; ADDVIONALTRANSPORTATION EVENISF. SECTION III - PHYSIC:AL DGE AMACOVEMEiri, A . Coverage, 4,,Coverage ihdonsions, a, "franspr talon iixperises, is replaced With the followingt . . 'We will pay up to $50 per day tO PI maximum of $1000 for teinporary transportation expense incurred by you because orthe tota.ltbeft of a covered "auto' of the private passenger type. Wo will pay only for those oi overed "autos" for width you carry eitiw Comprehensive or Specified CaliSES.of 1,c0s Coverage, 'We will pay 'kw tempt:nn/ 'transportation expenses incomed duringthe period beginning 48 !won; after the theft and ending, regardless of the policy's expiration, vohen the covered 'Rut oN retUrned to LISB or we pay for its "loss", tf your business shown In the DechgatIons Is other than an auto dotard*, ate will also pay up to $1,000 'for reasonable and necessary costs Incurre.d by you to return a stolen covered auto from the place where It Is recovered to Ito anvil foraging location, Milt. HilitO AUTO PHYSICA1.1)ANIAOg COVERAGO, SECTION III— PHYSICAL DikIVIAGE COVERAGE', A. Coverage„ 4, Coverage EXtenSinns, the ft/1101/4dg is Valle& a. If hired "entos' ere covered °autos" tr Ualillity Coverage irr this policy and ComprelWasive, Specified Camps of Lo,..or Collision coverages ere provided under this coverage form for lorry gento" you own, tlien the Physical Damage coverages providdd are rad:fancied to grottos" you biro, subjeutto the fallowing Ira! (3.) The most we will pay for gloss" t o any hired 'auto is $50,0110 or Actual Cash Value or Cost of Repair, vithIchaver is less . (2) S5C/0 deductible will apply to any loss under this Malnirlige extension, . . except that no deductible shell apply to los? L.,auseci hy fire or lightning '"•Subjectto the above limit and deductible we Will provide c overage equal to the broadest coverap applbible to any cowired "auto" you own of similar size and type,. This covon4e Es:tension N excess coverage over gni, other collectible • Insurance. 1X, .A,CCIDrilTALAIRRM DVPLOYMENT COVOAGE SECTION III PHYSICAL liAIVIAGT,i' COVERAGE, 13. Exclusions, la,„ is amended to add t le following; ' This exclusion does not apply to the accidental discharge. of an airbag. MCAUM0:1.2X3 Copyright 200 iviercury InsuraweService,p, .All right5 reserved,: Includes copyrighted orterial of frisurance services office,Jn with if5 Pennissron X. ILOANJIIitSE 0AP COVIiii,Arg, SEX:T[0N lit PINSICAL DAMAGECOVERAGE' C, Limit of Insurance, the follovving is added; 4. in the evert cfra 'total loss" to a covered "Ptutou shown in the Schedule or declarations for which Collision and Comprehensive Cnverege apply, we will pay any unpalai amount are on the lease or loan for t hat covered ualit0.11 IS:5V the "amonotpd finder the Physical Darnave Coverage Section eithe policy; and b. Any: (i) Civerdue lease/loan payments at tile the of the "fossil; (2) Financial penalties intpo,seci under a lease fel' ESCCOSS1118 1.1,101 anOUT1al ear and teal' or high mileage. (8) Sec urity deposit not returned by I:he lessor; (4) Costs for e)ttended warranties, credit Life Insurance, 1.1ealth, Accident or Disability insurance purchased Mai the loan or lease; 107r1 (5) Cany-over balances from preltious loans or leasXi ZLSes. REPAIR— DED1.1C111411.E WAIVER Sr.,,CTION - PHYSICAL DAMAGE COVERAGE:, D. Deductible, the following N added: No deducilble applies to glass damage if:the ig[ass Is repaired rather than replaced. Xfl Ti/I10 OR MORE DEE)UciVILES SEZ:TION H-PIIYSICAr. DAMAGE COVERAGE„ D. Deductible, The follovdm is added: IF two or more "company' policies or coverage forms epplyto 'the Sarnia Alt:Tied 1. If the applicable Business Auto daducdble is the smaffest, It will be weivacIF or: If the applioe fie 'Business Auto deductible. is not the smallest, Pt will be reduced by the amount c)ftbe smallest deductible; or 8, If the loss irivolv,es two or more'BUISifie56 Auto coverage forms or policiSS the ISM a IreSt Creatletibk1 will be waived. '• • For the purpose oftbla enclOrsement 'company' means the 'company providing this insurance and any of the affiliated inerribers of the Mercury Insurance Group of companies. AMENDED DIIIIES IN EVENT OF ACCiDENT, CLAIM, SUIT011 LOSS • The requirement in SECTION 1V BUSINESS AUTO CONDITIONS„ A. LOSS Conditions, 2. Duties lire The Event Of Ai; cident„ 1srn., Suf1.5 Or Loss, EL, In the event oraccident", you must notify us'of Lent applie.s only Ntrireta t he "accident" is known to (aj You, If you are en fridivikrual; (1) kpartoer, Ifyorr au? El partnership; (3) A member, If yau iire a limited liability congrany; (4) An exp.cuthre officer or insurance MallagOrl if you are flaporatbrL Cf)pyrrght 2.019 Marattl InsSenfices., 1.1111111 rights moanferi, ivICAB51012:13 IncIftries copyrighteq materiel of Insurance Services Office,ffl Witt Permission Pas 84 of'fi latt. 1,111AIVER Of:SUBROGATION SECTION IV - BUSINESS AUTO CONDITIOPJS, A. LOSS Conditions, 5. 'Transfer of Rights Of Recovery ,Agninst Others To FMIltion is replaced by the following: 5. " Transfer Of Rifns Of Recovery Against Others To Us We waive any right of reodvery we mist have against any person or manization to tho extent required of you by a written contract executed prior to anymacorclent" or loss", provided that the "accident or "loss' arises out of tile operations contemplated by such contract. The vvalver applies only to the person or organization designated In such contract. XV. UNINTENTIONAL ERROR/ (XVIISSION, OR FAILURE 'TO DISCLOSE HAZARDS SECTION IV- BUSINE&S Atria cog:41101\1S, B..Genenil Condition 2. Conceahnent, Ntisrepresentat ion, or Fraud, the following is added: Any UnIntentional omission dor error in information given by you, or unintentional failure t o disclose all exposures or hazards existing es ofthe effectiVe date or ;it HUY fine dining tITO.policv periorl`shall not invalidate or adverssdy affect the coverage for such exposure or hazard or prejudice your rights under this insurance., However, you must reportthe undisclosed exposure or hazard to us as soon iRS reasonably possible alter Its discovery. 'fbis provisiofl does not affect our right tocollect additional premium c,r exercise our right of cancellation or non -renewal. EIVIPLOYfENTRED Alin) pHysivia, DIAIVIAIRE SEC TIDAI IV- fiLISINESS AUTO CONDITIONS, B. General conritilons, 5. Other IDSOIWICR, b. For Hired Auto, Physical Dan inc Coveregi:1, is rel,placed by the fe)fierwing: b. FOP Hired Auto Physii-,:a 1 Damage:Coverage, the following ore deemed to be coArerecl "autos" you own: • ' My covered "auto' you hire, rent or borrow; and 2, Any E1Arerer.1 "auto° hired or reneed by your "employee" under a conti•act that ,inciividwid "emproyeF.es" 11E1/1f1R, wxh your perroission„ while parlor rnim dudes related to the conduct of'your business, However, any °WV that IS !erased, hired, rerrtmai or ,borrowed with a driver is not El covered 'auto". PRIIVIARYAND NONCONTRIBUTORY IF REt/LIIREDJif CONTI?ACT ' SECI1CIN IV- BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, the following is acicied and supersedes any provision to the contrary: a. This insurance isiprirriary to and will rlOt StEek contributinn frorn any OthOr alStIllnce available 'LI) OCidittonal insured under your policy provided that: (1) The additional Insured Is a Named Insured urviersucli other fusurence; and (2) YOU have agreed. in voting In, a 4::crntr1ct nr agreernentthatthis insurance would he primary and would m.1-1; seek mntribution from any othsr insurance available, to the additional insured. C0pyrig1#101.3 !Wormy Insurance services:, RC J5ill rtabto reserved, . capyrighted nifititrat ii1SLIMaR StirVic0g0fti,i,kW., With ttg Perapizion PAge of fflJfl AUTO COVERACIE uniuronve SECTI011 IV - BUSINESS AtITO CONDITIONS, F. Genin'al Curiditions„ 7.. Policy Period, Coverig Territaq,, a. Anywhere, in idle world If: is replaced by the ibllowIng: Anywhere iithfl world If; (L) A onvered "auto" Is leased, hired, rented or horrovvecl withouta driver for a period [4'30 days or lass; a rui llze) "insured's" responsil)11111ri:a pay damages fs determined in a 'suit" on the melte', In the United Stit es o ,Atnerica„ the-territ'ories and possessions of tie United Stei:ds °Malarial, Puterto Moo, or finada or in a settlement Eigree to. . XIX. tioDILY INJURY REDIWIN1 3 To irucwor:' RESUL,TAIVT IVIENTALMJJII SECTION 'V-- DEFINITIONS, C'„lFflJfly injury" IS amended by adding the following: "Bridily Injury" also Includes medal anguish but only 'when the irtfirrtal anguish aria other bodily infury, siokriess, or clisease,, MM�W Copyright 2013 Merctry insuronce Servica.s, LLC iil rtt.9 reselveci., incliich`n copyrighted roeteriai of insiiratice SWAM Office, Inc, with its Permission Nile 6 or 6 WORKERS COMPENSATION AND EMPLOYERS 'LIABILITY INSURANCE POLICY WC 04 03 08 (Ed. 04-84) 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 light 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 2.00% of the California workers' compensation premium otherwise due on such remuneration. Person or Organization Any person or organization as required by written contract Schedule Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otheiwise stated. (The Information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Date: 06/17/2022 Policy No.: CST5023772 Endorsement No. Policy Effective Dates: 06/17/2022 06/17/2023 Insured: Tryco General Engineering Carrier Name / Code: Benchmark Insurance Company A WC 04 03 06 Countersigned .by innommrelie•MM.M. (Ed, 04-84) Copyright 1984 National Council on Compensation Insurance, Inc. Page 1 of 11 T WORKERS COMPENSATION AND EMPLOYERS LABILITY !N$URANCE POLICY A M1104,......MIMOMMMIMOMM.14 WC 04 03 06 (Ed. 04-84) 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 2.0.0°6 of the California workerscompensation premium otherwise due on such remuneration. Person or Organization Any person or organization as required by written contract So ledule Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated, (The Information below is required only when this endorsement Is issued subsequent to preparation of the policy.) Endorsement Effective Date: 06/17/2022 Policy No.: C5'T5023772 Endorsement No. Policy Elective Dates: 06/17/2022. - 06/17/20'23 Insured: Tryco General Engineering Carrier Name / Code: Benchmark insurance Company A WC 04 03 06 Countersigned by (Ed.04-84) © Copyright 1984 National Council on Compensation Insurance, Inc, Page 1 of 1