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19-0917_KUNO'S GRADING, INC._Letter Agreement (7713,t item 32400 PASEO ADELANTQ MEMBERS OF THE CRY COUNCIL SAN JUAN CAPISTRANO,CA 92675 (949):493-1171 11[01/311118TROY BOURNE (949)493-1053 FAX esu+ulen 14GI' SERGIO FARIAS 1 rwn sanpIancapistrano•org 1776' • BRIAN L.AIARYOTT • DEREK REEVE JOHN TAYLOR wa0 SEPTEMBER 17,2019 KUNo's GRADING,INC. PO Box 812 SAN JUAN CAPISTRANO,CA 92693 Dear Mr. Kuno, Letter Agreement for Avenida Placida Spoil Removal This letter shall be our Agreement ("Letter Agreement") regarding.the Avenida Placida Spoil Removal described below("Services")to be provided by Kuno's Grading, Inc. ("Contractor") as an independent contractor to the City of San Juan Capistrano (the "City") for the City's Avenida Placida Spoil Removal Project ("Project"). Contractor is retained as independent contractor and is not an employee of the City. City and Contractor are sometimes referred to herein individually as a"Party"and collectively as the"Parties." The Services to be provided include the following: removal of landslide debris from the retention basin and related tasks as more particularly described in the Scope of Services attached hereto as Exhibit"A"and incorporated herein by reference. Services on the Project shall begin September 30,2019 and shall be completed by November 1, 2019, unless extended by the City in writing. Contractor shall perform all Services under this Letter Agreement in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California, and consistent with all applicable laws. Contractor represents that it, its employees and subcontractors have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Services, including any required business license, and that such licenses and approvals shall be maintained throughout the term of this Letter Agreement. Contractor has represented to the City that certain key personnel will perform and coordinate the Services under this Letter Agreement. Should one or more of such personnel become unavailable, Contractor may substitute other personnel of equal competence upon written approval of the City. In the event that the City and Contractor cannot agree as to the substitution of key personnel, the City shall be entitled to terminate this Letter Agreement for cause. The key personnel for • performance of this Letter Agreement are as follows: Greg Kuno. Compensation shall be based on the actual amount of work satisfactorily performed and shall be billed in the amounts set forth in Exhibit"A",attached hereto and incorporated herein by reference. Kuno's Grading,Inc.Letter Agreement—Placida Spoils Removal 1 Kuno's Grading, Inc. • September 17, 2019 Page 2 of 6 The total compensation shall not exceed$36,060,without written approval of the CITY MANAGER. Contractor's invoices shall include a detailed description of the Services performed. Invoices shall be submitted to the City on a monthly basis as performance of the Services progresses. The City shall review and pay the approved charges on such invoices in a timely manner. Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the Services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Letter Agreement upon request. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the Services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. It shall be mandatory upon the Contractor and all subcontractors to comply with all California Labor Code provisions, which include but are not limited to prevailing wages (Labor Code Sections 1771, 1774 and 1775), employment of apprentices (Labor Code Section 1777.5), certified payroll records (Labor Code Sections 1771.4 and 1776),hours of labor (Labor Code Sections 1813 and 1815) and debarment of contractors and subcontractors (Labor Code Sections 1777.1). The requirement to submit certified payroll records directly to the Labor Commissioner under Labor Code section 1771.4 shall not apply to work performed on a public works project that is exempt pursuant to the small project exemption specified in Labor Code Section 1771.4. Since the Services are being performed as part of an applicable"public works" or"maintenance" project, then pursuant to Labor Code Sections 1725.5 and 1771.1, the Contractor and all subcontractors performing such Services must be registered with the Department of Industrial Relations. Contractor shall maintain registration for the duration of the Project and require the same of any subcontractors, as applicable. Notwithstanding the foregoing, the contractor registration requirements mandated by Labor Code Sections 1725.5 and 1771.1 shall not apply to work performed on a public works project that is exempt pursuant to the small project exemption specified in Labor Code Sections 1725.5 and 1771.1. This Project may also be subject to compliance monitoring and enforcement by the Department of Industrial Relations. It shall be Contractor's sole responsibility to comply with all applicable registration and labor compliance requirements. Any stop orders issued by the Department of Industrial Relations against Contractor or any subcontractor that affect Contractor's performance of services, including any delay, shall be Contractor's sole responsibility. Any delay arising out of or resulting from such stop orders shall be considered Contractor caused delay and shall not be compensable by the City. Contractor shall defend, indemnify and hold the City, its officials, Kuno's Grading,Inc.Letter Agreement—Placida Spoils Removal 2 Kuno's Grading, Inc. September 17, 2019 Page 3 of 6 officers, employees and agents free and harmless from any claim or liability arising out of stop orders issued by the Department of Industrial Relations against Contractor or any subcontractor. Contractor shall provide proof of: A. Commercial General Liability Insurance, of at least $1,000,000 per occurrence/$2,000,000 aggregate for bodily injury, personal injury and property damage, at least as broad as Insurance Services Office Commercial General Liability most recent Occurrence Form CG 00 01; B. Automobile Liability Insurance for bodily injury and property damage including coverage for owned, non-owned and hired vehicles, of at least $1,000,000 per occurrence for bodily injury and property damage, at least as broad as most recent Insurance • Services Office Form Number CA 00 01 covering automobile liability, Code 1 (any auto); C. Workers' Compensation in compliance with applicable statutory requirements and Employer's 'Liability Coverage of at least $1,000,000 per occurrence; and D. Consultants providing professional services shall provide Professional Liability (Errors and Omissions) Insurance of at least$1,000,000. Insurance carriers shall be licensed to do business in California and maintain an agent for process within the state. Such insurance carrier shall have not less than an "A-:VII" rating according to the latest Best Key Rating unless otherwise approved by the City. The City, its officials, officers, employees, agents and authorized volunteers shall be named as Additional Insureds on Contractor's policies of Commercial General Liability and Automobile Liability insurance and such coverage provided to the City as an Additional Insured shall apply on a primary and non-contributory basis. Waiver of subrogation endorsements in favor of the City shall be provided on Contractor's policies of Commercial General Liability, Automobile Liability and Workers' Compensation/Employer's Liability insurance. The City may terminate this Letter Agreement at any time with or without cause. If the City finds • it necessary to terminate this Letter Agreement without cause before Project completion, Contractor shall be entitled to be paid in full for those Services adequately completed prior to the notification of termination. Contractor may terminate this Letter Agreement only upon 30 calendar days' written notice to the City only in the event of City's failure to perform in accordance with the terms of this Letter Agreement through no fault of Contractor. To the fullest extent permitted by law, Contractor shall defend (with counsel of City's choosing), indemnify and hold the City, its officials, officers, employees, volunteers, and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury of any kind, in law or equity, to property or persons, including wrongful death, in any manner arising out of, pertaining to, or incident to any acts, errors or omissions, or willful misconduct of Contractor, its officials, officers, employees, subcontractors, consultants or agents in connection with the performance of the Contractor's services, the Project or this Letter Agreement, including without limitation the payment of all damages, expert witness fees and attorney's fees and other related costs and expenses. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by Contractor, the City, its officials, officers, employees, agents, or volunteers. • If Contractor's obligation to defend, indemnify, and/or hold harmless arises out of Contractor's performance of"design professional" services (as that term is defined under Civil Code section 2782.8), then, and only to the extent required by Civil Code section 2782.8, which is fully Kuno's Grading,Inc.Letter Agreement—Placida Spoils Removal 3 Kuno's Grading, Inc. September 17,2019 Page 4 of 6 incorporated herein, Contractor's indemnification obligation shall be limited to claims that arise out of,pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor, and, upon Contractor obtaining a final adjudication by a court of competent jurisdiction, Contractor's liability for such claim, including the cost to defend,shall not exceed the Contractor's proportionate percentage of fault. Contractor shall keep itself fully informed of and in compliance with all local, state and federal laws,rules and regulations in any manner affecting the performance of the Project or the Services, including all Cal/OSHA requirements; all emissions limits and permitting requirements imposed by the California Air Resources Board (CARB) or other governmental agencies; and all water quality laws, rules and regulations of the Environmental Protection Agency, the State Water Resources Control Board and the City. By executing this Letter Agreement,Contractor verifies that it fully complies with all requirements and restrictions of state and federal law respecting the employment of undocumented aliens, including,but not limited to,the Immigration Reform and Control Act of 1986,as may be amended from time to time. Contractor shall maintain records of its compliance, including its verification of each employee, and shall make them available to the City or its representatives for inspection and copy at any time during normal business hours. The City shall not be responsible for any costs or expenses related to Contractor's compliance with the requirements. To the same extent and under the same conditions as Contractor, Contractor shall require all of its subcontractors, sub- subcontractors and consultants performing any work relating to the Project or this Letter Agreement to make the same verifications and comply with all requirements and restrictions provided herein. Contractor's failure to comply or any material misrepresentations or omissions relating thereto shall be grounds for terminating this Letter Agreement for cause. By its signature hereunder, Contractor certifies that it is aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for Workers' Compensation or to undertake self-insurance in accordance with the provisions of that Code, and agrees to comply with such provisions before commencing the performance of the Services. Finally, Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment in violation of state or federal law. As provided for in the indemnity obligations of this Letter Agreement, Contractor shall indemnify City against any alleged violations of this paragraph,including, but not limited to, any fines or penalties imposed by any governmental agency. This Letter Agreement shall be interpreted in accordance with the laws of the State of California. If any action is brought to interpret or enforce any term of this Letter Agreement, the action shall be brought in a state or federal court situated in Orange County, State of California. In addition to any and all contract requirements pertaining to notices of and requests for compensation or payment for extra work,disputed work,claims and/or changed conditions,Contractor must comply with the claim procedures set forth in Government Code sections 900 et seq. prior to filing any lawsuit against the City. Such Government Code claims and any subsequent lawsuit based upon the Government Code claims shall be limited to those matters that remain unresolved after all procedures pertaining to extra work, disputed work, claims, and/or changed conditions have been Kuno's Grading,Inc.Letter Agreement—Placida Spoils Removal 4 Kuno's Grading, Inc. September 17, 2019 Page 5 of 6 followed by Contractor. If no such Government Code claim is submitted, or if any prerequisite contractual requirements are not otherwise satisfied as specified herein,Contractor shall be barred from bringing and maintaining a valid lawsuit against the City. Contractor shall not assign, sublet, or transfer this Letter Agreement or any rights under or interest in this Letter Agreement without the written consent of the City, which may be withheld for any reason. This Letter Agreement may not be modified or altered except in writing signed by both parties. Except to the extent expressly provided for in the termination paragraph, there are no , intended third party beneficiaries of any right or obligation of the Parties. This is an integrated Letter Agreement representing the entire understanding of the,parties as to those matters contained herein,and supersedes and cancels any prior oral br written understanding or representations with respect to matters covered hereunder. Since the Parties or their agents have participated fully in the preparation of this Letter Agreement, the language of this Letter Agreement shall be construed simply, according to its fair meaning, and-not strictly for or against any Party. The captions of the various paragraphs are for convenience and-ease of reference only, and do not define,limit,augment,or describe the scope,content or intent of this Letter Agreement. Contractor warrants that the individual who has signed this Letter Agreement has the-legal power, right and authority to make this Letter Agreement and bind the Contractor hereto. If you agree with the terms of this Letter Agreement, please indicate by signing and dating where indicated below. Kuno's Grading,Inc.Letter Agreement—Placida Spoils Removal 5 Kuno's Grading,Inc. September 17,2019 Page 6 of 6 CITY OF SAN JUAN CAPISTRANO KUNG'S GRADING, INC. Approved By: Sign tore S Lamm Si el l 2 City Manager G1Lc�►rd �l�"n Name Date Title , Attested B ID-3-11 ° O Date Ci . ' erk ' APPROVED AS TO FORM: City Attorney Kuno's Grading,Inc Letter Agreement—Placida.Spoils Removal 6 EXHIBIT "A" SCOPE OF SERVICES , 7 Avenida Placida Spoil Removal Project Task 1. Mobilization: Move on/off equipment from site, insurance, overhead, water, and all other work required to complete the work and clean-up the site, complete. Fee for task 1:$2,500 Task 2. Load, export, and dispose of dirt to offsite dump location and all fees related to loading, transportation, and disposal. Fee for Task 2:$24,760 Task 3.Trim organics from edge of V-ditch and remove debris. Fee for Task 3:$1,500 Task 4.Add sterile Rice rolls. Fee for Task 4: $6,700 Task 5. Bench shaping as directed by City within the basin. Fee for Task 5: $600 Total Estimated Not-to-Exceed Fee for this scope of work=$36,060 8 ARD® CERTIFICATE OF LIABILITY INSURANCE DATE`MM/DDITYYY) 09/26/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS.UPON THE CERTIFICATE HOLDER THIS - CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND.OR ALTER.THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE 'OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED OR PRODUCER,AND THE CERTIFICATE HOLDER. 'IMPORTANT: If the certificate holderis'an ADDITIONAL INSURED,'the policy(ies),must have ADDITIONAL INSURED Provisions or be endorsed. • If SUBROGATION IS WAIVED,.subject to'the'terins and conditions,of the policy,certain policies may-require an endorsement.. A statement on this certificate does.not,confer rights to the.certificate holder in lieu of`such endorsement(s). ._ . _ PRODUCER =CT N<►MEc 'Carol Knox,Debbie S.Taylor or Debbie Waller KGIB;INC: G No-eft_ (714)•744-3300 FAX�). .(714)7,44=6537 KNOX'GENERAL INSURANCE BROKERS E MAIL. arol k ibinc.com,debbie k ibinc.com•or dwaller k ibinc.com • ADDRESS: @ 9 � @ g @ 9 226 SOUTH GLASSELL-STREET INSURER(S)AFFORDING COVERAGE NAICi .ORANGE CA 92866 _ INsuRERA! .HOUSTON SPECIALTY;INSURANCE COMPANY 12936 INSURED INSURER B: NATIONAL LIABILTY&FIRE INSURANCE CO. 20052 KUNOS GRADING,INC INsumEnc-: OHIO CASUALTY INSURANCE COMPANY .24074. P:O.BOX.812 IiusuREtiD: . . INSURER E:_ SAN JUAN.CAPISTRANO: CA 92693 INSURER F:. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE.POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING.ANY REQUIREMENT,TERM OR CONDITION OF ANY.CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY'PERTAIN, THE INSURANCE AFFORDED BY THE.POLICIES DESCRIBED HEREIN,IS SUBJECT TO ALL THE TERMS,. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN.MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYYI - . LIMITS _ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 ' — MED EXP(Any one person) $ .5,000 AX X TEN-22272 '11/30/2018: 11/30/2019 PERSONALS ADV INJURY .$ 1,000,000 GEEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 2,000,000 X POLICY CECT LOC PRODUCTS-COMP/OPAGG ,$ 2,000,000 _ OTHER: $ AUTOMOBILE UANB.TY COMBINED SINGLE LIMIT $ (Ea accident) ' ANY AUTO BODILY INJURY(Per person) I$ OWNED. —,SCHEDULED •_.AUTOS ONLY AUTOS, —N/A— BODILYINJURY(Peracciden) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ O _ .. • $ UMBRELLA LIAB. OCCUR EACHOCCURRENCE $ EXCESS LIAB CLAIMS MADE –N/A– AGGREGATE S. _ DED RETENTIONS $ WORKERS COMPENSATION - - �/ II AND EMPLOYERS'LIABILITY Y/N X I STATUTE I. LK • ANY PROPRIETORIPARTNERIEXECU AVE El.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? Y N/A US01 BH191568004C11 07/01/2019 07/01/2020 (Mandatory In NH) _ E.L.DISEASE-EA EMPLOYEE $ 1,000,000 lives;describe under . DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $ 1,000,000 CONTRACTORS EQUIPMENT $1,000 DEDUCT. $573,214 LIMIT C RENTED/LEASED EQUIPMENT ' 8M058701034 04!14/2019 04/14/2020 $1,000 DEDUCT. $315,000 LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mom-space Ls required) PROJECT: AVENIDA PLACIDA SPOIL REMOVAL. CITY OF SAN JUAN CAPISTRANO,ITS OFFICIALS;OFFICERS,EMPLOYEES;AGENTS AND AUTHORIZED VOLUNTEERS SHALL BE NAMED AS ADDITIONAL INSURED.PER CG2010 7/04 WITH PRIMARY AND NON-CONTRIBUTORY WORDING-PER TEN021 5 01/14,WAIVER OF SUBROGATION PER CG2404 5/09 WITHRESPECTTO GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE.HOLDER CANCELLATION SAN JUAN CAPISTRANO CA 92675 I L�_���� ©1988-2015 ACORD CORPORATION. All rights reserved. • ACORD2S(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TEN-22272. COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR. ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persori(s) Or Organization(s): • Location(s).Of Covered Operations .Only those parties required to be named as an Addi- ALL "tional Insured in a written contract with the Named Insured under this policy,entered into prior to loss or "occurrence". Information required to complete this Schedule, if not shown above,will be shown in the Declarations.. •A. Section II -Who Is An Insured is amended to B. With respect to the_ insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional.exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for "bodily injury", "property This insurance does notapply,to"bOdilyinjury" or damage" or "personal and advertising injury" caused, in whole or in part, by:. "property damage"occurring after: 1. Your acts or omissions;or 1. All work, including materials, parts or equip- ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project(other than service; maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insureds) at the location of the the additional Insured(s) at the locatiort(s) ;desig- covered operations has been completed;or nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contactor or subcontractor .en- gaged in performing operations fora principal as a part of the same project. CG 2010 07 04 ©ISO Properties,Inc.,2004 Page 1 of 1 0 POLICY NUMBER: TEN-22272 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY., TEN0215 01 14 PRIMARY AND NONCONTRIBUTING INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM The following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4: Seddon IV: Commercial General Liability Conditions 4. Other Insurance: d. Notwithstanding the provisions of sub-paragraphs a, b,and c of this paragraph 4,with respect to the Third Party as defined below, it Is understood and agreed'that in the event of a claim or'"suit caused in whole or in part by the Named_Insured's negligence,this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The'Third Party to whom this endorsement applies is: Absence'of a specifically named Third Party above means this endorsement applies only to those third parties required to be named as an Additional Insured as Primary and Non-Contributory coverage specified in a written contract with the Named Insured under this policy,entered into prior to the"lots"or "occurrence". All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. ' TEN0215 01 14 Includes copyright material of Insurance Services Office, Inc. Page 1 of 1 _ , POLICY NUMBER:TEN-22272 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided Under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or OrganizatiOn! Only such Person or Organization where required in a written contract with the Named Insured under this policy, entered into prior to the loss or"occurrence". •_information required to complete this Schedule,if not shown above,will be shown in the Declarations. The following it added to Paragraph 8. Transfer Of • Rights Of Recovery Against Others To Us of Section IV-Conditions: We waive any right of recovery we may have against the person or organization shown in. the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or • "your work" done under a contract with that person or organization and included in the '"products. completed operations'hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc.,2008 Page 1 of 1 0 • ®AC RRCETIFICATE OF LIABILITY INSURANCE . DaTEtM�IDO/mmj `� 09/2512019 THIS CERTIFICATE IS ISSUED AS.A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE.HOLDER.THIS. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE;COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If thecertificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and'conditions of the policy,certain policies may require an endorsement., A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRobucER SECT Giselle.Gonzatez- Winchester&Associates Insurance Services PHONE . 951296-6678 FAx 41856.1vy.St,Suite 110 rtf:Ey,u: ( ) (AJC.No) (951)66.71.8144. Murrieta,CA 92562 ADDRESS: giselte( quotetowin com , License•#:0G58158 INSURERS)AFFORDING COVERAGE . .. _. NAIC# INSURER A: Nationwide Mut Ins Co 23787 INSURED INSURER B: Kuno's Grading Inc INSURER C.: PO Box 812 INSURER D: San Juan Capistrano,_CA 92593 INSURERS: ' - - INSURERF: COVERAGES CERTIFICATE NUMBER: 00000000-0. REVISIONNUMBER: 15 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW.HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN ISSUBJECT TO ALL THETERMS, EXCLUSIONS AND.CONDmONS OF SUCH POLICIES.UMITS SHOWN'MAY HAVE BEEN REDUCED BY PAID CLAIMS, POLICY EFF POLICY EXP UMRS LTR TYPE OF INSURANCE NSD SUER POUCYHUMBER (MMIDDTYYYY) IMMIDD/YYYY) . COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $. TO RENTED i CLAIMS-MACE OCCUR PRS SGES(Eaoccurrence) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GERI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I 12c LOC PRODUCTS-COMPIOPAGG $ OTHER $ A AUTOMOBILELIABIUrY Y ACP3028225967 04/14/2019 64%14/2020 IE�aej INGLEUMIT $ 1,000,000' X ANYAUTO BODILY INJURY(Perperson) $ OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS ONLY _AUTOS I ) HIRED' NON-OWNED, PROPERTY DAMAGE X AUTOS'ONLY X'. AUTOS ONLY (Per acddent) $ $ UMBRELLAUAB OCCUR EACH'OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I RETENTIONS. $ WORKERS COMPENSATION PER -0TH- ' AND.EMPLOYERS'LIABILITY' YIN STATUTE ER ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED?' ;NIA (Mandatory in NH) E.L'DISEASE-EA EMPLOYEE $ If yes,describe under . - DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addtfonal Remark`s Schedule,may be attached if mere space i§required) Project.name:Avenida Placida Spoil Removal *Certificate Holder is named as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof San Juan Capistrano THE EXPIRATION,DATE THEREOF,NOTICE WILL BEDELIVERED.IN P ACCORDANCE WITH THE POLICY-PROVISIONS. 32400 Paseo Adelanto San Juan Capistrano,.CA 92675 AUTHORIZED REPRESENTATIVE0(3)7.-v-A , I !,I/Y ' gibb/ 3/ (GGO) / ©1988'-2015!ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by GGO on September 25,2019 at 12:14PM , WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4-84) 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 wilt 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 5 %of the California workerscompensation premium otherwise due on such remuneration. Schedule Minimum premium per person or organization is$250.00 Person or Organization Job Description EFFECTIVE 02/26/2019 TO CURRENT; CITY OF SAN JUAN CAFiSTRANO SPECIFIC CA EMPLOYEES 32400 PASEO Armaarro SAN JUAN CAPISTRANO,CA 92675 PROJECT:AVENIDA PLACIDA SPOIL REMOVAL 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 •Policy No.US0151-1191568004011 Endorsement No: Insured KUNIO'S GRADING INC Insurance Company:NATIONAL LIABILITY&FIRE INSURANCE COMPANY Countersigned By "7714"--141 WC 04 03 06 NATIONAL LIABILITY&FIRE INSURANCE COMPANY NCCI:19054 USDISH101508004C11 07/01/2019 Printed:09/26/2019 ..-----4".. DATE(MMIDDlYYY)7 nco�e) CERTIFICATE OF. LIABILITY INSURANCE L I09/27/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RiGHTS UPON THE CERTIFICATE HOLDER. THiS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR,ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDMONAL INSURED,the policy(les)must have ADDMONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT" NAME: Carol Krtox,Debbie S.Taylor or Debbie Waller KGiB,INC. PHONE No.Ems; (714)_744-3300 i iAfc,No (714)744-6537 KNOX GENERAL INSURANCE BROKERS -at oBess: carol@kgib(nc•com,debbie@kgibinc.com or dwalier@kgibinc.com 226 SOUTH GLASSELLSTREET INSURER(SIAFFORDING COVERAGE NAICII ORANGE CA 92866 INSURER A: HOUSTON SPECIALTY INSURANCE COMPANY '12936 INSURED INSURER s: NATIONAL LIABILTY&FIRE INSURANCE CO. 20052 KUNOS GRADING,INC • INSURER c: OHIO CASUALTY INSURANCE COMPANY 24074 P.O.BOX 812 INSURER 0: INSURER E: SAN JUAN CAPISTRANO CA 92693 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR I -AODL SUER POLICY EFF POLICY EXP LTR, TYPE OF.INSURANCE INSDjjVvn POLICY NUMBER (MMIDDIVYYYi 4MMIDD1YYYY)I LIMITS ' X I COMMERCIAL GENERAL IJABIUTY . ! EACH OCCURRENCE I$ 1,000,000 DAMAGCLAIMS MADE n OCCURTO RTEN-TED I PREMISES E occurrence) $ 100,000 _ MED EXP(Any one person) $ 5,000 A X X TEN-22272 11/30/2018 11/30/2019 PERSONAL&ADV INJURY $ 1,000,000 • GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000.000 X I POLICY JEOT n LOC --j PRODUCTS•COMP/OP AGG 5 2,000,000 IOTHER: $ • AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1E0 ecddentl ANY AUTO BODILY INJURY(Per person) {$ IOWNE7 SCHEDULED • AUTOS ONLY • AUTOS —NIA-- BODILY INJURY(Per accident) $ h1RED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY „ref'acddent) $ • I Is $ fUMBRELLA UAB OCCUR EACH OCCURRENCE EXCESS L WB I CLAIMS-MADE -N/A- '1 AGGREGATE $ I I I DED I I RETENTIONS $ WORKERS COMPENSATION X i PEATUTE O - AND EMPLOYERS'UABILIiY �,/N Eft ANY PROPRIETOR/PARTNER/EXECUTIVEE L EACH ACCIDENT $ 1,000,000 B OFFICERIMEMBEREXCLUDED? n NI' A X US01BH191568004C11 07101/2019 07/01/2020 (Mandatory lnNH) E.LDISEASE-EAEMPLOYE $ 1,000,000 Ir yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 I CONTRACTORS EQUIPMENT $1,000 DEDUCT, $573,214 LIMIT C RENTED/LEASED EQUIPMENT 6M058707034 04/14/2019 04/14/2020 $1,000 DEDUCT. $315,000 LIMIT DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be'attached If more apace la required) PROJECT: AVENIDA PLACIDA SPOIL REMOVAL. C CITY OF SAN JUAN CAPISTRANO,ITS OFFICIALS,OFFICERS,EMPLOYEES,AGENTS AND AUTHORIZED VOLUNTEERS SHALL BE NAMED AS ADDITIONAL INSURED PER CG2010 7/04 WITH PRIMARY AND NON-CONTRIBUTORY WORDING PER TEN0215 01/14,WAIVER OF SUBROGATION PER CG2404 5/09 WITH RESPECT TO GENERAL LIABILITY AS REQUIRED BY WRITTEN CONTRACT. WORK COMP WAIVER OF SUBROGATION PER WC 04 03 06. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF SAN JUAN CAPISTRANO ACCORDANCE WITH THE POLICY PROVISIONS. 32400 PASEO ADELANTO AUTHORIZED REPRESENTATIVE ' SAN JUAN CAPISTRANO CA 92675 1 � -R- ___1-- - .- @ 1988-2015 ©1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD