The URL can be used to link to this page

Home My WebLink AboutC-5124 - M/RSA for Backflow Device Testing and RepairT f AMENDMENT NO. ONE TO MAINTENANCE/REPAIR SERVICES AGREEMENT WITH ANTHONY USHER, DBA FLOTECH CERTIFIED BACKFLOW SERVICE FOR BACKFLOW DEVICE TESTING AND REPAIR THIS AMENDMENT NO. ONE TO MAINTENANCE/REPAIR SERVICES AGREEMENT ("Amendment No. One') is made and entered into as of this 21st day of December, 2015 ("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("City'), and ANTHONY USHER, a sole proprietor doing business as ("DBA") FLOTECH CERTIFIED BACKFLOW SERVICE ("Contractor"), whose address is 3201 Washington Avenue, Costa Mesa, CA 92626, and is made with reference to the following: RECITALS A. On July 31, 2015, City and Contractor entered into a Maintenance/Repair Services Agreement ("Agreement') to perform maintenance and/or repair services for Backflow Device Testing and Repair for the City of Newport Beach ("Project"). B. The parties desire to enter into this Amendment No. One to reflect additional Services not included in the Agreement, to increase the total compensation, and to add an additional Administrator and person for Notices for City under the Agreement. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. SERVICES TO BE PERFORMED Exhibit A to the Agreement shall be supplemented to include the Supplemental Scope of Services, attached hereto as Exhibit A-1 and incorporated herein by reference ("Supplemental Services" or "Supplemental Work"). Exhibit A to the Agreement and Exhibit A-1 to this Amendment No. One shall collectively be known as "Exhibit A." The City may elect to delete certain Supplemental Services within the Supplemental Scope of Services at its sole discretion. 2. COMPENSATION TO CONTRACTOR Section 4.1 of the Agreement shall be supplemented to include the following additional language: "City shall pay Contractor for the Supplemental Services on a time and expense not -to -exceed basis in accordance with the provisions of this Section and the Supplemental Schedule of Billing Rates attached hereto as Exhibit B-1 and incorporated herein by reference. Contractor's compensation for all Supplemental Work performed in accordance with this Agreement, including all reimbursable items and subconsultant fees, shall not exceed Six Thousand Dollars and 00/100 ($6,000.00), without prior written authorization from City. No billing rate changes shall be made during the term of this Agreement without the prior written approval of City." The total compensation reflects Contractor's additional compensation for the Supplemental Services to be performed in accordance with this Amendment No. One, including all reimbursable items and subconsultant fees, in an amount not to exceed Seventy One Thousand Dollars and 00/100 ($71,000.00) for the Services and Supplemental Services combined. 3. ADMINISTRATION Section 6 of the Agreement is amended in its entirety and replaced with the following: "This Agreement will be administered by the City Manager's Office/Municipal Operations Department. City's Water Quality Coordinator or designee shall be the Project Administrator for the Services and City's Public Information Manager or designee shall be the Project Administrator for the Supplemental Services. Both Project Administrators shall have the authority to act for City under this Agreement as to the respective Services or Supplemental Services and shall represent City in all matters pertaining to such Services and Supplemental Services to be rendered pursuant to this Agreement. 4. NOTICES Section 24 of the Agreement is amended in its entirety and replaced with the following: "All notices, demands, requests or approvals, including any change in mailing address, to be given under the terms of this Agreement shall be given in writing, and conclusively shall be deemed served when delivered personally, or on the third business day after the deposit thereof in the United States mail, postage prepaid, first- class mail, addressed as hereinafter provided. 24.1 All notices, demands, requests or approvals related to the Services from Contractor to City shall be addressed to City at: Attn: Water Quality Coordinator Municipal Operations Department City of Newport Beach 100 Civic Center Drive PO Box 1768 Newport Beach, CA 92658 24.2 All notices, demands, requests or approvals related to the Supplemental Services from Contractor to City shall be addressed to City at: Attn: Public Information Manager City Manager's Office City of Newport Beach 100 Civic Center Drive PO Box 1768 Newport Beach, CA 92658 Anthony Usher, DBA Flotech Certified Backflow Service Page 2 24.3 All notices, demands, requests or approvals from City to Contractor shall be addressed to Contractor at: Attn: Anthony Usher Flotech Certified Backflow Service 3201 Washington Avenue Costa Mesa, CA 92626" 5. INTEGRATED CONTRACT Except as expressly modified herein, all other provisions, terms, and covenants set forth in the Agreement shall remain unchanged and shall be in full force and effect. [SIGNATURES ON NEXT PAGE] Anthony Usher, DBA Flotech Certified Backflow Service Page 3 IN WITNESS WHEREOF, the parties have caused this Amendment No. One to be executed on the dates written below. APPROVED AS TO FORM: CITY ATTORNEY'S OFFICE Date: By: Aaron C. Harp City Attorney ATTEST: Date: By: Leilani I. Brown City Clerk U c %LFORN\P CITY OF NEWPORT BEACH, a California municipal corporation Date: By: (.� a'4� — Carol Jacobs Assistant City Manager CONTRACTOR: Anthony Usher, a sole proprietor doing business as ("DBA") Flotech CeV]fie Backf w Service Date: //�/_�// By: 4. UX" . A holy Owner [END OF SIGNATURES] Attachments: Exhibit A-1 – Supplemental Scope of Services Exhibit B-1 – Supplemental Schedule of Billing Rates Anthony Usher, DBA Flotech Certified Backflow Service Page 4 EXHIBIT A-1 SUPPLEMENTAL SCOPE OF SERVICES • DESCRIPTION OF PROJECT o Furnish all labor, tools, expendable equipment, materials, transportation services necessary for the Backflow Device Testing and Repair as described herein including, but not limited to, the following: Annual testing and certification of approximately twenty eight (28) testable backflow devices located throughout within the Corona del Mar Business Improvement District (CdM BID). Anthony Usher, DBA Flotech Certified Backflow Service Page A-1 EXHIBIT B-1 SUPPLEMENTAL SCHEDULE OF BILLING RATES Anthony Usher, DBA Flotech Certified Backflow Service Page B-1 Fa�W Pogr 0 0 u rb a C�11FOtiN�P COST FILE One of the mandatory attachments that the PlanetBids portal will prompt you for is called a "Cost File." Please upload this document to satisfy the requirement: PLEASE ATTACH COMPANY RATE SHEETS FOR ITEMS NOT LISTED ABOVE. Pricing: 38.00 a. Cost Per Backflow Test & Certification: $ (Must include ALL items necessary for completion of services, including labor, transportation, any and all travel, and delivery of test reports) b. Labor, As -needed Maintenance, Repair, 80.00 Replacement (Per Hour): $ /Hr I. Minimum Labor Charge? Y/N $ 80.00 c. Labor, After Hours As -needed Maintenance, 80.00 Repair, Replacement (Per Hour): $ /Hr i. Minimum Labor Charge? Y/N $ 80.00 ii. Minimum Call out time? Y/N 1 Hr/s_ d. Other/Optional? -Specify Below - The pricing indicated above must be inclusive of any applicable Prevailing Wages. ew c�CtFOR�`P COST FILE The undersigned certifies that submission of this Proposal is made without prior understanding, arrangement, agreement or connection with any corporation, firm or person submitting a Proposal for the same services, and is in all respects fair and without collusion of fraud. The undersigned certifies that they have not entered into any arrangement or agreement with any City of Newport Beach public officer. The undersigned understands collusive practices are a violation of State and Federal law and can result in fines prison sentences, and civil damage awards. Aythov Oshe>' April 14, 2015 Proposer Signature Date Anthony Usher, Owner Printed Name and Title _7" N i t MAINTENANCEIREPAIR SERVICES AGREEMENT U WITH ANTHONY USHER, DBA FLOTECH CERTIFIED BACKFLOW SERVICE FOR BACKFLOW DEVICE TESTING AND REPAIR THIS MAINTENANCE/REPAIR SERVICES AGREEMENT ("Agreement") is made and entered into as of this 31st day of July, 2015 ("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("City"), and Anthony Usher, DBA Flotech Certified Backflow Service, a sole proprietor doing business as ("DBA") ("Contractor'), whose address is 3201 Washington Avenue, Costa Mesa, CA 92626, and is made with reference to the following: RECITALS A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of City. B. City desires to engage Contractor to perform maintenance and/or repair services for Backflow Device Testing and Repair for City ("Project"). C. Contractor possesses the skill, experience, ability, background, certification and knowledge to provide the maintenance and/or repair services described in this Agreement. D. Contractor has examined the location of all proposed work, carefully reviewed and evaluated the- specifications set forth by City for the Project, is familiar with all conditions relevant to the performance of services, and has committed to perform all work required for the compensation specified in this Agreement. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: mil The term of this Agreement shall commence on the Effective Date, and shall terminate on May 1, 2018, unless terminated earlier as set forth herein. SERVICES TO BE PERFORMED 2.1 Contractor shall diligently perform all the services described in the Scope of Services attached hereto as Exhibit A and incorporated herein by reference ("Services" or "Work"). As a material inducement to City entering into this Agreement, Contractor represents and warrants that Contractor is a provider of first class work and Contractor is experienced in performing the Work contemplated herein and, in light of such status and experience, Contractor covenants that it shall follow the highest industry standards in performing the Work required hereunder and that all materials will be of good quality. 2.2 Contractor shall perform all Work required to be performed, and shall provide and furnish all the labor, materials, necessary tools, expendable equipment and all utility and transportation services necessary for the Project. 3. TIME OF PERFORMANCE 3.1 Time is of the essence in the performance of Services under this Agreement and Contractor shall perform the Services in accordance with the schedule included in Exhibit A. In the absence of a specific schedule, the Services shall be performed to completion in a diligent and timely manner. The failure by Contractor to strictly adhere to the schedule set forth in Exhibit A, if any, or perform the Services in a diligent and timely manner may result in termination of this Agreement by City. 3.2 Notwithstanding the foregoing, Contractor shall not be responsible for delays due to causes beyond Contractor's reasonable control. However, in the case of any such delay in the Services to be provided for the Project, each party hereby agrees to provide notice within two (2) calendar days of the occurrence causing the delay to the other party so that all delays can be addressed. 3.3 Contractor shall submit all requests for extensions of time for performance in writing to the Project Administrator as defined herein, not later than two (2) calendar days after the start of the condition that purportedly causes a delay. The Project Administrator shall review all such requests and may grant reasonable time extensions for unforeseeable delays that are beyond Contractor's control. 3.4 For all time periods not specifically set forth herein, Contractor shall respond in the most expedient and appropriate manner under the circumstances, by fax, hand -delivery or mail. 4. COMPENSATION TO CONTRACTOR 4.1 City shall pay Contractor for the Services on a time and expense not -to - exceed basis in accordance with the provisions of this Section and the Schedule of Billing Rates attached hereto as Exhibit B and incorporated herein by reference. Except as otherwise provided herein, no rate changes shall be made during the term of this Agreement without the prior written approval of City. Contractor's compensation for all Services performed in accordance with this Agreement, including all reimbursable items, shall not exceed Sixty Five Thousand Dollars and 00/100 ($65,000.00), without prior written amendment to the Agreement. 4.2 Contractor shall submit monthly invoices to City describing the Work performed the preceding month. Contractor's bills shall include the name and/or classification of employee who performed the Work, a brief description of the Services performed and/or the specific task in the Scope of Services to which it relates, the date the Services were performed, the number of hours spent on all Work billed on an hourly basis, and a description of any reimbursable expenditures. City shall pay Contractor no later than thirty (30) calendar days after approval of the monthly invoice by City staff. Anthony Usher, DBA Flotech Certified Backflow Service Page 2 4.3 City shall reimburse Contractor only for those costs or expenses specifically identified in Exhibit B to this Agreement, or specifically approved in writing in advance by City. 4.4 Contractor shall not receive any compensation for Extra Work performed without the prior written authorization of City. As used herein, "Extra Work" means any Work that is determined by City to be necessary for the proper completion of the Project, but which is not included within the Scope of Services and which the parties did not reasonably anticipate would be necessary at the execution of this Agreement. Compensation for any authorized Extra Work shall be paid in accordance with Exhibit B. 5. PROJECT MANAGER 5.1 Contractor shall designate a Project Manager, who shall coordinate all phases of the Project. This Project Manager shall be available to City at all reasonable times during the Agreement term. Contractor has designated Gary Tegel to be its Project Manager. Contractor shall not remove or reassign the Project Manager or any personnel listed in Exhibit A or assign any new or replacement personnel to the Project without the prior written consent of City. City's approval shall not be unreasonably withheld with respect to the removal or assignment of non -key personnel. 5.2 Contractor, at the sole discretion of City, shall remove from the Project any of its personnel assigned to the performance of Services upon written request of City. Contractor warrants that it will continuously furnish the necessary personnel to complete the Project on a timely basis as contemplated by this Agreement. 6. ADMINISTRATION This Agreement will be administered by the Municipal Operations Department. City's Water Quality Coordinator or designee shall be the Project Administrator and shall have the authority to act for City under this Agreement. The Project Administrator shall represent City in all matters pertaining to the Services to be rendered pursuant to this Agreement. 7. CITY'S RESPONSIBILITIES To assist Contractor in the execution of its responsibilities under this Agreement, City agrees to provide access to and upon request of Contractor, one copy of all existing relevant information on file at City. City will provide all such materials in a timely manner so as not to cause delays in Contractor's Work schedule. 8. TYPE AND INSTALLATION OF MATERIALS/STANDARD OF CARE 8.1 Contractor shall use only the standard materials described in Exhibit A in performing Services under this Agreement. Any deviation from the materials described in Exhibit A shall not be installed or utilized unless approved in advance and in writing by the Project Administrator. Anthony Usher, DBA Flotech Certified Backflow Service Page 3 8.2 All of the Services shall be performed by Contractor or under Contractor's supervision. Contractor represents that it possesses the personnel required to perform the Services required by this Agreement, and that it will perform all Services in a manner commensurate with highest industry standards. All Services shall be performed by qualified and experienced personnel who are not employed by City. By delivery of completed Work, Contractor certifies that the Work conforms to the requirements of this Agreement and all applicable federal, state and local laws and the industry standard. 8.3 Contractor represents and warrants to City that it has, shall obtain and shall keep in full force and effect during the term hereof, at its sole cost and expense, all licenses, permits, qualifications, insurance and approvals of whatsoever nature that is legally required of Contractor to practice its profession. Contractor shall maintain a City of Newport Beach business license during the term of this Agreement. 8.4 Contractor shall not be responsible for delay, nor shall Contractor be responsible for damages or be in default or deemed to be in default by reason of strikes, lockouts, accidents, acts of God, or the failure of City to furnish timely information or to approve or disapprove Contractor's Work promptly, or delay or faulty performance by City, contractors, or governmental agencies. 9. RESPONSIBILITY FOR DAMAGES OR INJURY 9.1 City and all officers, employees and representatives thereof shall not be responsible in any manner for any loss or damage to any of the materials or other things used or employed in performing the Project or for injury to or death of any person as a result of Contractor's performance of the Services required hereunder; or for damage to property from any cause arising from the performance of the Project by Contractor, or its subcontractors, or its workers, or anyone employed by either of them. 9.2 Contractor shall be responsible for any liability imposed by law and for injuries to or death of any person or damage to property resulting from defects, obstructions or from any cause arising from Contractor's Work on the Project, or the Work of any subcontractor or supplier selected by Contractor. 9.3 To the fullest extent permitted by law, Contractor shall indemnify, defend and hold harmless City, its City Council, boards and commissions, officers, agents, volunteers, and employees (collectively, the "Indemnified Parties") from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorneys' fees, disbursements and court costs) of every kind and nature whatsoever (individually, a Claim; collectively, "Claims'), which may arise from or in any manner relate (directly or indirectly) to any breach of the terms and conditions of this Agreement, any Work performed or Services provided under this Agreement including, without limitation, defects in workmanship or materials or Contractor's presence or activities conducted on the Project (including the negligent and/or willful acts, errors and/or omissions of Contractor, its principals, officers, agents, employees, vendors, Anthony Usher, DBA Flotech Certified Backflow Service Page 4 suppliers, consultants, subcontractors, anyone employed directly or indirectly by any of them or for whose acts they may be liable or any or all of them). 9.4 Notwithstanding the foregoing, nothing herein shall be construed to require Contractor to indemnify the Indemnified Parties from any Claim arising from the sole negligence or willful misconduct of the Indemnified Parties. Nothing in this indemnity shall be construed as authorizing any award of attorneys' fees in any action on or to enforce the terms of this Agreement. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by Contractor. 9.5 Contractor shall perform all Work in a manner to minimize public inconvenience and possible hazard, to restore other work areas to their original condition and former usefulness as soon as possible, and to protect public and private property. Contractor shall be liable for any private or public property damaged during the performance of the Work by Contractor or its agents. 9.6 To the extent authorized by law, as much of the money due Contractor under and by virtue of the Agreement as shall be considered necessary by City may be retained by it until disposition has been made of such suits or claims for damages as aforesaid. 9.7 The rights and obligations set forth in this Section shall survive the termination of this Agreement. 10. INDEPENDENT CONTRACTOR It is understood that City retains Contractor on an independent contractor basis and Contractor is not an agent or employee of City. The manner and means of conducting the Work are under the control of Contractor, except to the extent they are limited by statute, rule or regulation and the expressed terms of this Agreement. No civil service status or other right of employment shall accrue to Contractor or its employees. Nothing in this Agreement shall be deemed to constitute approval for Contractor or any of Contractor's employees or agents, to be the agents or employees of City. Contractor shall have the responsibility for and control over the means of performing the Work, provided that Contractor is in compliance with the terms of this Agreement. Anything in this Agreement that may appear to give City the right to direct Contractor as to the details of the performance of the Work or to exercise a measure of control over Contractor shall mean only that Contractor shall follow the desires of City with respect to the results of the Services. 11. COOPERATION Contractor agrees to work closely and cooperate fully with City's designated Project Administrator and any other agencies that may have jurisdiction or interest in the Work to be performed. City agrees to cooperate with Contractor on the Project. Anthony Usher, DBA Flotech Certified Backflow Service Page 5 12. CITY POLICY Contractor shall discuss and review all matters relating to policy and Project direction with City's Project Administrator in advance of all critical decision points in order to ensure the Project proceeds in a manner consistent with City goals and policies. 13. PROGRESS Contractor is responsible for keeping the Project Administrator informed on a regular basis regarding the status and progress of the Project, activities performed and planned, and any meetings that have been scheduled or are desired. 14. INSURANCE Without limiting Contractor's indemnification of City, and prior to commencement of Work, Contractor shall obtain, provide and maintain at its own expense during the term of this Agreement or for other periods as specified in this Agreement, policies of insurance of the type, amounts, terms and conditions described in the Insurance Requirements attached hereto as Exhibit C, and incorporated herein by reference. 15. PREVAILING WAGES Pursuant to the applicable provisions of the Labor Code of the State of California, not less than the general prevailing rate of per diem wages including legal holidays and overtime Work for each craft or type of workman needed to execute the Work contemplated under the Agreement shall be paid to all workmen employed on the Work to be done according to the Agreement by the Contractor and any subcontractor. In accordance with the California Labor Code (Sections 1770 et seq.), the Director of Industrial Relations has ascertained the general prevailing rate of per diem wages in the locality in which the Work is to be performed for each craft, classification, or type of workman or mechanic needed to execute the Agreement. A copy of said determination is available by calling the prevailing wage hotline number (415) 703-4774, and requesting one from the Department of Industrial Relations. The Contractor is required to obtain the wage determinations from the Department of Industrial Relations and post at the job site the prevailing rate or per diem wages. It shall be the obligation of the Contractor or any subcontractor under him/her to comply with all State of California labor laws, rules and regulations and the parties agree that the City shall not be liable for any violation thereof. 16. PROHIBITION AGAINST ASSIGNMENTS AND TRANSFERS Except as specifically authorized under this Agreement, the Services to be provided under this Agreement shall not be assigned, transferred contracted or subcontracted out without the prior written approval of City. Any of the following shall be construed as an assignment: The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate member or cotenant if Contractor is a Anthony Usher, DBA Flotech Certified Backflow Service Page 6 partnership or joint -venture or syndicate or cotenancy, which shall result in changing the control of Contractor. Control means fifty percent (50%) or more of the voting power or twenty-five percent (25%) or more of the assets of the corporation, partnership or joint - venture. ill�*11:101oI►i� 7��]I�I►C�? The subcontractors authorized by City, if any, to perform Work on this Project are identified in Exhibit A. Contractor shall be fully responsible to City for all acts and omissions of any subcontractor. Nothing in this Agreement shall create any contractual relationship between City and any subcontractor nor shall it create any obligation on the part of City to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise required by law. City is an intended beneficiary of any Work performed by the subcontractor for purposes of establishing a duty of care between the subcontractor and City. Except as specifically authorized herein, the Services to be provided under this Agreement shall not be otherwise assigned, transferred, contracted or subcontracted out without the prior written approval of City. 18. OWNERSHIP OF DOCUMENTS Each and every report, draft, map, record, plan, document and other writing produced (hereinafter "Documents"), prepared or caused to be prepared by Contractor, its officers, employees, agents and subcontractors, in the course of implementing this Agreement, shall become the exclusive property of City, and City shall have the sole right to use such materials in its discretion without further compensation to Contractor or any other party. Contractor shall, at Contractor's expense, provide such Documents to City upon prior written request. 19. CONFIDENTIALITY All Documents, including drafts, preliminary drawings or plans, notes and communications that result from the Services in this Agreement, shall be kept confidential unless City expressly authorizes in writing the release of information. 20. RECORDS Contractor shall keep records and invoices in connection with the Services to be performed under this Agreement. Contractor shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any Services, expenditures and disbursements charged to City, for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of City to examine, audit and make transcripts or copies of such records and invoices during regular business hours. Contractor shall allow inspection of all Work, data, Documents, proceedings and activities related to the Agreement for a period of three (3) years from the date of final payment to Contractor under this Agreement. Anthony Usher, DBA Flotech Certified Backflow Service Page 7 21. WITHHOLDINGS City may withhold payment to Contractor of any disputed sums until satisfaction of the dispute with respect to such payment. Such withholding shall not be deemed to constitute a failure to pay according to the terms of this Agreement. Contractor shall not discontinue Work as a result of such withholding. Contractor shall have an immediate right to appeal to the City Manager or his/her designee with respect to such disputed sums. Contractor shall be entitled to receive interest on any withheld sums at the rate of return that City earned on its investments during the time period, from the date of withholding of any amounts found to have been improperly withheld. 22. CITY'S RIGHT TO EMPLOY OTHER CONTRACTORS City reserves the right to employ other contractors in connection with the Project. 23. CONFLICTS OF INTEREST 23.1 Contractor or its employees may be subject to the provisions of the California Political Reform Act of 1974 (the "Act"), which (1) requires such persons to disclose any financial interest that may foreseeably be materially affected by the Work performed under this Agreement, and (2) prohibits such persons from making, or participating in making, decisions that will foreseeably financially affect such interest. 23.2 If subject to the Act, Contractor shall conform to all requirements of the Act. Failure to do so constitutes a material breach and is grounds for immediate termination of this Agreement by City. Contractor shall indemnify and hold harmless City for any and all claims for damages resulting from Contractor's violation of this Section. 24. NOTICES 24.1 All notices, demands, requests or approvals, including any change in mailing address, to be given under the terms of this Agreement shall be given in writing, and conclusively shall be deemed served when delivered personally, or on the third business day after the deposit thereof in the United States mail, postage prepaid, first- class mail, addressed as hereinafter provided. 24.2 All notices, demands, requests or approvals from Contractor to City shall be addressed to City at: Attn: Water Quality Coordinator Municipal Operations Department City of Newport Beach 100 Civic Center Drive PO Box 1768 Newport Beach, CA 92658 Anthony Usher, DBA Flotech Certified Backflow Service Page 8 24.3 All notices, demands, requests or approvals from City to Contractor shall be addressed to Contractor at: Attn: Anthony Usher Flotech Certified Backflow Service 3201 Washington Avenue Costa Mesa, CA 92626 25. CLAIMS Unless a shorter time is specified elsewhere in this Agreement, before making its final request for payment under this Agreement, Contractor shall submit to City, in writing, all claims for compensation under or arising out of this Agreement. Contractor's acceptance of the final payment shall constitute a waiver of all claims for compensation under or arising out of this Agreement except those previously made in writing and identified by Contractor in writing as unsettled at the time of its final request for payment. Contractor and City expressly agree that in addition to any claims filing requirements set forth in the Agreement, Contractor shall be required to file any claim Contractor may have against City in strict conformance with the Government Claims Act (Government Code sections 900 et seq.). 26. TERMINATION 26.1 In the event that either party fails or refuses to perform any of the provisions of this Agreement at the time and in the manner required, that party shall be deemed in default in the performance of this Agreement. If such default is not cured within a period of two (2) calendar days, or if more than two (2) calendar days are reasonably required to cure the default and the defaulting party fails to give adequate assurance of due performance within two (2) calendar days after receipt of written notice of default, specifying the nature of such default and the steps necessary to cure such default, and thereafter diligently take steps to cure the default, the non -defaulting party may terminate the Agreement forthwith by giving to the defaulting party written notice thereof. 26.2 Notwithstanding the above provisions, City shall have the right, at its sole and absolute discretion and without cause, of terminating this Agreement at any time by giving no less than seven (7) calendar days' prior written notice to Contractor. In the event of termination under this Section, City shall pay Contractor for Services satisfactorily performed and costs incurred up to the effective date of termination for which Contractor has not been previously paid. On the effective date of termination, Contractor shall deliver to City all reports, Documents and other information developed or accumulated in the performance of this Agreement, whether in draft or final form. 27. LABOR 27.1 Contractor shall conform with all applicable provisions of state and federal law including, but not limited to, applicable provisions of the federal Fair Labor Standards Act ("FLSA") (29 USCA § 201, et seq.). Anthony Usher, DBA Flotech Certified Backflow Service Page 9 27.2 Whenever Contractor has knowledge that any actual or potential labor dispute is delaying or threatens to delay the timely performance of this Agreement, Contractor shall immediately give written notice to City, and provide all relevant information. 27.3 Contractor represents that all persons working under this Agreement are verified to be U.S. citizens or persons legally authorized to work in the United States. 27.4 To the fullest extent permitted by law, Contractor shall indemnify, defend, and hold harmless City, its City Council, boards and commissions, officers, agents, volunteers, and employees from loss or damage, including but not limited to attorneys' fees, and other costs of defense by reason of actual or alleged violations of any applicable federal, state and local labor laws or law, rules, and/or regulations. This obligation shall survive the expiration and/or termination of the Agreement. 28. STANDARD PROVISIONS 28.1 Recitals. City and Contractor acknowledge that the above Recitals are true and correct and are hereby incorporated by reference. 28.2 Compliance with all Laws. Contractor shall, at its own cost and expense, comply with all statutes, ordinances, regulations and requirements of all governmental entities, including federal, state, county or municipal, whether now in force or hereinafter enacted. In addition, all Work prepared by Contractor shall conform to applicable City, county, state and federal laws, rules, regulations and permit requirements and be subject to approval of the Project Administrator and City. 28.3 Waiver. A waiver by either party of any breach, of any term, covenant or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant or condition contained herein, whether of the same or a different character. 28.4 Integrated Contract. This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions herein. 28.5 Conflicts or Inconsistencies. In the event there are any conflicts or inconsistencies between this Agreement and the Scope of Services or any other attachments attached hereto, the terms of this Agreement shall govern. 28.6 Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of the Agreement or any other rule of construction which might otherwise apply. Anthony Usher, DBA Flotech Certified Backflow Service Page 10 28.7 Amendments. This Agreement may be modified or amended only by a written document executed by both Contractor and City and approved as to form by the City Attorney. 28.8 Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 28.9 Controlling Law and Venue. The laws of the State of California shall govern this Agreement and all matters relating to it and any action brought relating to this Agreement shall be adjudicated in a court of competent jurisdiction in the County of Orange, State of California. 28.10 Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical handicap, medical condition, marital status, sex, sexual orientation, age or any other impermissible basis under law. 28.11 No Attorneys' Fees. In the event of any dispute or legal action arising under this Agreement, the prevailing party shall not be entitled to attorneys' fees. 28.12 Counterparts. This Agreement may be executed in two (2) or more counterparts, each of which shall be deemed an original and all of which together shall constitute one (1) and the same instrument. [SIGNATURES ON NEXT PAGE] Anthony Usher, DBA Flotech Certified Backflow Service Page 11 IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the dates written below. APPROVED AS TO FORM: CITY ATT RNEY'S OFFICE Date: 71101 By: vv Y Aar C. Harp iso City Attorney ATTEST: Date: am A441�-- Leilani I. Brown City Clerk Ol CITY OF NEWPORT BEACH, a California municipal corporation Date:�s_ Z i eQB . e M doch Municipal Operations Department Acting Co -Director CONTRACTOR: Anthony Usher, DBA Flotech Certified Backflow Service, a sole pro qr e r doin siness as ("DBA") Date: By: Aff(KOKY Usher Owner [END OF SIGNATURES] Attachments: Exhibit A — Scope of Services Exhibit B — Schedule of Billing Rates Exhibit C — Insurance Requirements Anthony Usher, DBA Flotech Certified Backflow Service Page 12 EXHIBIT A SCOPE OF SERVICES • DESCRIPTION OF PROJECT o Furnish all labor, tools, expendable equipment, materials, transportation services necessary for the Backflow Device Testing and Repair as described herein including, but not limited to, the following: • Annual testing and certification of approximately three hundred and fifty (350) testable backflow devices located throughout the City. ■ As -needed repairs, replacement and testing of devices. WORKING HOURS o Normal working hours shall be between the hours of 7:00 a.m. and 4:30 p.m., Monday through Friday. No Saturday or Sunday work is to be scheduled without prior written permission from the City, unless it is an emergency situation. o After -Hours As -Needed Services (hereby defined as maintenance, testing, replacement and repair services after work hours, with work hours being Mon -Fri, 7:OOam-4:30pm on non -City observed holidays). • There may be some instances where as -needed services may be required outside of normal work hours. Should such services be requested, Contractor must have the ability to respond accordingly and in an expedient manner. • QUALITY OF WORK AND MATERIALS o The Contractor shall perform all Work required to be performed, and shall provide and furnish all the labor, materials, necessary tools, expendable equipment and all utility and transportation services necessary for the Project, including delivery, storage and handling of products. o All material and equipment furnished by the Contractor shall be high grade, and free from defects and imperfections, unless otherwise hereinafter specified. Workmanship shall be in accord with the best standard practices. Both materials and workmanship shall be subject to the approval of the Project Administrator. o All work shall be performed in accordance with the HIGHEST INDUSTRY STANDARDS, as stated in the specifications described herein. Standards and frequencies may be modified from time to time as deemed necessary by the City for the proper maintenance of the sites. o If, in the judgment of the City, the quality of work is less than that specified herein, the City shall, at its option, in addition to or in lieu of other remedies provided herein, withhold appropriate payment from the Contractor until Anthony Usher, DBA Flotech Certified Backflow Service Page A-1 services are rendered in accordance with specifications set forth within this document and providing no other arrangements have been made between the Contractor and the City. Failure to notify of a change and/or failure to perform an item or work on a scheduled day may, at the City's sole discretion, result in deduction of payment for that date, week, or month. Payment will be retained for work not performed until such time as the work is performed to City standard. RESPONSIBILITY FOR DAMAGES OR INJURY o Any damage done by Contractor outside the area and scope of the work of the contract shall be repaired or replaced as directed at no additional cost to the City. o Contractor shall be responsible for any liability imposed by law and for injuries to or death of any person or damage to property resulting from defects, obstructions or from any cause arising from Contractor's Work on the Project, or the Work of any subcontractor or supplier selected by Contractor. o To the fullest extent permitted by law, Contractor shall indemnify, defend and hold harmless City, its City Council, boards and commissions, officers, agents, volunteers, and employees (collectively, the "Indemnified Parties") from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorneys' fees, disbursements and court costs) of every kind and nature whatsoever (individually, a Claim; collectively, "Claims"), which may arise from or in any manner relate (directly or indirectly) to any breach of the terms and conditions of this Agreement, any Work performed or Services provided under this Agreement including, without limitation, defects in workmanship or materials or Contractor's presence or activities conducted on the Project (including the negligent and/or willful acts, errors and/or omissions of Contractor, its principals, officers, agents, employees, vendors, suppliers, consultants, subcontractors, anyone employed directly or indirectly by any of them or for whose acts they may be liable or any or all of them). SAFETY REQUIREMENTS o All work performed under this contract shall be performed in such a manner as to provide maximum safety to the public and where applicable comply with all safety standards required by CAL -OSHA. The City reserves the right to issue restraint or cease and desist orders to the Contractor when unsafe or harmful acts are observed or reported relative to the performance under this contract. All contractor employees shall have access to a W.A.T.C.H. (Work Area Traffic Control Handbook) at all times. Anthony Usher, DBA Flotech Certified Backflow Service Page A-2 o Contractor's field personnel shall wear easily recognizable uniforms containing Contractor's name. Contractor shall be responsible for supplying all appropriate personal protective equipment including but not limited to safety vests, safety shoes and reflective vests. o The Contractor shall maintain all work sites free of hazards to persons and/or property resulting from his/her operations. Any hazardous condition noted by the Contractor, which is not a result of his/her operations, shall be immediately reported to the City. o Contractor's employees shall be trained in health and safety per CALOSHA TESTING AND INSPECTION SERVICES • Contractor shall properly inspect, certify, replace and repair any and all backflow devices as specified by the Project Administrator and in accordance with City of Newport Beach Municipal Code Chapter 14.10. o Contractor shall provide labor, transportation/travel, equipment and materials necessary to properly test and certify backflow devices, unless otherwise specified by the Project Administrator. o Contractor shall deliver test reports to all proper parties as specified by the Project Administrator. o Contractor shall orchestrate with Project Administrator and each department facility a time in which water shut-off shall not affect operations. All fire services shall be put on test for the period of testing with the fire alarm company. ANNUAL SCHEDULE • Contractor shall provide annual testing and certification of approximately three hundred and fifty (350) testable backflow devices throughout the City, with some located in neighboring water service areas (Irvine Ranch Water District, City of Fountain Valley, and Mesa Water District). • Upon verbal or written request from the Project Administrator, Contractor shall begin yearly testing and certification of City backflow devices. • Annual testing of City of Newport Beach Backflows shall begin in the month of July and be completed prior to Jan 1, and Backflow devices outside the cities service area on an as -needed bases. AS -NEEDED SERVICES • If a backflow device requires additional repairs outside of the basic repair kit (i.e. replacement of valves or device itself) the contractor shall inform the Project Administrator. At that time the project administrator may request a letter proposal for the additional work. Anthony Usher, DBA Flotech Certified Backflow Service Page A-3 • When the need for as -needed services arises, the City shall request in writing, the necessary maintenance repair services required in adequate detail. Contractor shall then provide a letter proposal for Services requested by the City (hereinafter referred to as the "Letter Proposal'). The Letter Proposal shall include the following: o A detailed description of the Services to be provided; o The estimated number of hours and cost to complete the Services; and o The time needed to finish the specific Project. • City will assess the Letter Proposal to ensure that Services and costs proposed are commensurate with those provided in the Schedule of Billing Rates. • No Services shall be provided until the City has provided written acceptance of the Letter Proposal. Once authorized to proceed, Contractor shall diligently perform the duties in the approved Letter Proposal. Anthony Usher, DBA Flotech Certified Backflow Service Page A-4 EXHIBIT B SCHEDULE OF BILLING RATES Anthony Usher, DBA Flotech Certified Backflow Service Page B-1 a 6 CqC/FORN�P COST FILE One of the mandatory attachments that the PlanetBids portal will prompt you for is called a "Cost File." Please upload this document to satisfy the requirement: PLEASE ATTACH COMPANY RATE SHEETS FOR ITEMS NOT LISTED ABOVE. Pricing: 38.00 a. Cost Per Backflow Test & Certification: $ (Must include ALL items necessaryfar completion of services, including labor, transportation, any and all travel, and delivery of test reports) b. Labor, As -needed Maintenance, Repair, 80.00 Replacement (Per Hour): $ /Hr I. Minimum Labor Charge? Y/N $ 80.00 c. Labor, After Hours As -needed Maintenance, 80.00 Repair, Replacement (Per Hour): $ 1Hr I. Minimum Labor Charge? Y/N $ 80.00 ii. Minimum Call out time? Y/N 1 Hr/s_ d. Other/Optional? -Specify Below - The pricing indicated above must be inclusive of any applicable Prevailing Wages. r� C�GIFORN�P COST FILE The undersigned certifies that submission of this Proposal is made without prior understanding, arrangement agreement or connection with any corporation, firm or person submitting a Proposol for the some services, and is in all respects fair and without collusion of froud. The undersigned certifies that they have not entered into any arrangement or agreement with any City of Newport Beach public officer. The undersigned understands collusive practices are a violation of State and Federal law and can result in fines, prison sentences, and civil damage awards. Ah hoy U,shei- April 14, 2015 Proposer Signature Date Anthony Usher, Owner Printed Name and Title EXHIBIT C INSURANCE REQUIREMENTS — MAINTENANCEIREPAIRIJANITORIAL SERVICES 1. Provision of Insurance. Without limiting Contractor's indemnification of City, and prior to commencement of Work, Contractor shall obtain, provide and maintain at its own expense during the term of this Agreement, policies of insurance of the type and amounts described below and in a form satisfactory to City. Contractor agrees to provide insurance in accordance with requirements set forth here. If Contractor uses existing coverage to comply and that coverage does not meet these requirements, Contractor agrees to amend, supplement or endorse the existing coverage. 2. Acceptable Insurers. All insurance policies shall be issued by an insurance company currently authorized by the Insurance Commissioner to transact business of insurance in the State of California, with an assigned policyholders' Rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide, unless otherwise approved by the City's Risk Manager. 3. Coverage Requirements. A. Workers' Compensation Insurance. Contractor shall maintain Workers' Compensation Insurance, statutory limits, and Employer's Liability Insurance with limits of at least one million dollars ($1,000,000) each accident for bodily injury by accident and each employee for bodily injury by disease in accordance with the laws of the State of California, Section 3700 of the Labor Code. Contractor shall submit to City, along with the certificate of insurance, a Waiver of Subrogation endorsement in favor of City, its officers, agents, employees and volunteers. B. General Liability Insurance. Contractor shall maintain commercial general liability insurance and, if necessary, umbrella liability insurance, with coverage at least as broad as provided by Insurance Services Office form CG 00 01, in an amount not less than one million dollars ($1,000,000) per occurrence, two million dollars ($2,000,000) general aggregate. The policy shall cover liability arising from premises, operations, products - completed operations, personal and advertising injury, and liability assumed under an insured contract (including the tort liability of another assumed in a business contract). C. Automobile Liability Insurance. Contractor shall maintain automobile insurance at least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for all activities of Contractor arising out of or in connection with Work to be performed under this Agreement, including coverage for any owned, hired, non -owned or rented Anthony Usher, DBA Flotech Certified Backflow Service Page C-1 vehicles, in an amount not less than one million dollars ($1,000,000) combined single limit each accident. 4. Other Insurance Requirements. The policies are to contain, or be endorsed to contain, the following provisions: A. Waiver of Subrogation. All insurance coverage maintained or procured pursuant to this Agreement shall be endorsed to waive subrogation against City, its elected or appointed officers, agents, officials, employees and volunteers or shall specifically allow Contractor or others providing insurance evidence in compliance with these requirements to waive their right of recovery prior to a loss. Contractor hereby waives its own right of recovery against City, and shall require similar written express waivers from each of its subconsultants. B. Additional Insured Status. All liability policies including general liability, products and completed operations, excess liability, pollution liability, and automobile liability, if required, shall provide or be endorsed to provide that City and its officers, officials, employees, and agents shall be included as insureds under such policies. C. Primary and Non Contributory. All liability coverage shall apply on a primary basis and shall not require contribution from any insurance or self- insurance maintained by City. D. Notice of Cancellation. All policies shall provide City with thirty (30) calendar days notice of cancellation (except for nonpayment for which ten (10) calendar days notice is required) or nonrenewal of coverage for each required coverage. 5. Additional Agreements Between the Parties. The parties hereby agree to the following: A. Evidence of Insurance. Contractor shall provide certificates of insurance to City as evidence of the insurance coverage required herein, along with a waiver of subrogation endorsement for workers' compensation and other endorsements as specified herein for each coverage. Insurance certificates and endorsement must be approved by City's Risk Manager prior to commencement of performance. Current certification of insurance shall be kept on file with City at all times during the term of this Agreement. City reserves the right to require complete, certified copies of all required insurance policies, at any time. B. City's Right to Revise Requirements. City reserves the right at any time during the term of the Agreement to change the amounts and types of insurance required by giving Contractor sixty (60) calendar days advance written notice of such change. If such change results in substantial Anthony Usher, DBA Flotech Certified Backflow Service Page C-2 additional cost to Contractor, City and Contractor may renegotiate Contractor's compensation. C. Right to Review Subcontracts. Contractor agrees that upon request, all agreements with subcontractors or others with whom Contractor enters into contracts with on behalf of City will be submitted to City for review. Failure of City to request copies of such agreements will not impose any liability on City, or its employees. Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that City is an additional insured on insurance required from subcontractors. For CGL coverage, subcontractors shall provide coverage with a format at least as broad as CG 20 38 04 13. D. Enforcement of Agreement Provisions. Contractor acknowledges and agrees that any actual or alleged failure on the part of City to inform Contractor of non-compliance with any requirement imposes no additional obligations on City nor does it waive any rights hereunder. E. Requirements not Limiting. Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. If the Contractor maintains higher limits than the minimums shown above, the City requires and shall be entitled to coverage for higher limits maintained by the Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. F. Self-insured Retentions. Any self-insured retentions must be declared to and approved by City. City reserves the right to require that self-insured retentions be eliminated, lowered, or replaced by a deductible. Self- insurance will not be considered to comply with these requirements unless approved by City. G. City Remedies for Non -Compliance If Contractor or any sub - consultant fails to provide and maintain insurance as required herein, then City shall have the right but not the obligation, to purchase such insurance, to terminate this Agreement, or to suspend Contractor's right to proceed until proper evidence of insurance is provided. Any amounts paid by City shall, at City's sole option, be deducted from amounts payable to Contractor or reimbursed by Contractor upon demand. Anthony Usher, DBA Flotech Certified Backflow Service Page C-3 H. Timely Notice of Claims. Contractor shall give City prompt and timely notice of claims made or suits instituted that arise out of or result from Contractor's performance under this Contract, and that involve or may involve coverage under any of the required liability policies. City assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve City. Contractor's Insurance. Contractor shall also procure and maintain, at its own cost and expense, any additional kinds of insurance, which in its own judgment may be necessary for its proper protection and prosecution of the Work. Anthony Usher, DBA Flotech Certified Backflow Service Page C-4 ACKNOWLEDGMENT A notary public or other officer completing this ndi certificate verifies only the identity of the ividual 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 ) ss. On , 20 before me, Notary Public, personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (seal) ACKNOWLEDGMENT 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 }ss. On 20 before me, Notary Public, personally appeared proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (seal) Anthony Usher, DBA Flotech Certified Backflow Service CERTIFICATE OF INSURANCE CHECKLIST City of Newport Beach This checklist is comprised of requirements as outlined by the City of Newport Beach. * Date Received: 5/18/15 Dept./Contact Received From: Joan Date Completed: 5/21/15 Sent to: Joan By: Renee/Alicia Company/Person required to have certificate: Tony Usher DBA: Flowtech Certified Backflow Service Type of contract: All Other L GENERAL LIABILITY EFFECTIVE/EXPIRATION DATE: 4/23/154/23/16 A. INSURANCE COMPANY: Colony Insurance Company B. AM BEST RATING (A-: VII or greater): A; XII INSURANCE COMPANY: State Farm Mutual Automobile Insurance Co of Bloomington; IL C. ADMITTED Company (Must be California Admitted): Is Company admitted in California? ❑ Yes N No D. LIMITS (Must be $11M or greater): What is limit provided? $1,000,000 / $2,000,000 E. ADDITIONAL INSURED ENDORSEMENT — please attach ® Yes ❑ No F. PRODUCTS AND COMPLETED OPERATIONS (Must ❑ No D. include): Is it included? (completed Operations status does not apply to Waste Haulers or Recreation) ® Yes ® No G. ADDITIONAL INSURED FOR PRODUCTS AND ' E COMPLETED OPERATIONS ENDORSEMENT (completed Operations status does not apply to Waste Haulers) ® Yes ® No H. ADDITIONAL INSURED WORDING TO INCLUDE (The City F. its officers, officials, employees and volunteers): Is it included? N Yes ❑ No I. PRIMARY & NON-CONTRIBUTORY WORDING (Must be ❑ Yes ❑ No included): Is it included? ❑ Yes ❑ No J. CAUTION! (Confirm that loss or liability of the named insured N No H. is not limited solely by their negligence) Does endorsement - ❑ N/A N Yes include "solely by negligence" wording? ❑ Yes N No K. ELECTED SCMAF COVERAGE (RECREATION ONLY): N N/A ❑ Yes ❑ No L. NOTICE OF CANCELLATION: ❑ N/A N Yes ❑ No I1. AUTOMOBILE LIABILITY EFFECTIVEIEXPIRATION DATE: 5/16/15 to 11/16/15 A. INSURANCE COMPANY: State Farm Mutual Automobile Insurance Co of Bloomington; IL B. AM BEST RATING (A- `. VII or greater) A++; XV C. ADMITTED COMPANY (Must be California Admitted): Is Company admitted in California? N Yes ❑ No D. LIMITS - If Employees (Must be $1 M mina BI & PD and $500,000 UM, $2M min for Waste Haulers): What is limits provided? $1,000,000 E LIMITS Waiver of Auto Insurance / Proof of coverage (if individual) (What is limits provided?) N/A F. PRIMARY & NON-CONTRIBUTORY WORDING (For Waste Haelers only): N N/A ❑ Yes ❑ No G. HIRED AND NON -OWNED AUTO ONLY: ❑ N/A ❑ Yes N No H. NOTICE OF CANCELLATION: ❑ N/A N Yes ❑ No III. WORKERS' COMPENSATION EFFECTIVE/EXPIRATION DATE: Exempt A. INSURANCE COMPANY: B. AM BEST RATING.(A-: VII or greater): C. ADMITTED Company (Must be California Admitted): D. WORKERS' COMPENSATION LIMIT: Statutory E. EMPLOYERS' LIABILITY LIMIT (Must be $1M or greater) F. WAIVER OF SUBROGATION (To include): Is it included? G. SIGNED WORKERS' COMPENSATION EXEMPTION FORM: H. NOTICE OF CANCELLATION: ADDITIONAL COVERAGE'S THAT MAYBE REQUIRED IV. PROFESSIONAL LIABILITY V POLLUTION LIABILITY V BUILDERS RISK HAVE ALL ABOVE REQUIREMENTS BEEN MET? IF NO, WHICH ITEMS NEED TO BE COMPLETED? Approved: Agent of Alliant Insurance Services Broker of record for the City of Newport Beach 5/21/15 Date ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ® N/A ❑ Yes ❑ No ❑ N/A ® Yes ❑ No ® NIA ❑ Yes ❑ No ® N/A ❑ Yes ❑ No ® N/A ❑ Yes ❑ No ® Yes ❑ No RISK MANAGEMENT APPROVAL REQUIRED (Non -admitted carrier rated less than _ Self Insured Retention or Deductible greater than $ ) ❑ N/A ® Yes ❑ No Reason for Risk Management approval/exception/waiver: General Liability Carrier is Non -Admitted. Will need Risk Management aooroval. Sheri aooroved 5/21/15. Approved: Risk Management * Subject to the terms of the contract. Date CERTIFICATE OF LIABILITY INSURANCE TRIS CERTIF11ie 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 hostler Is an ADDITIONAL INSURED, tha policy(lea) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the Polley, certain policies may require an endorsement. A statement on this Certificate does not confer rights to the PRODUCER - IWOT Rich Higgins Bannister 6 Associates Insurance Agency Inc. FI NE(714)536-6086 . CA License 40691071 'Ei, gba . iah86ai-ios. com 305 17th Street INSUNN(91 AFFoao Huntington Beach CA 92648-4209 ...... ..n,.T.,,,.. r..�.,. Tony Usher dba Slowtech Certified Backflow Service 3201 Washington Avenue THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOW HAVE BEEN ISSUED TO THE INSURED IVANUO ABOVE F014 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 19 SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. In R TYPEOFINSURANCE -YNMKR LRUTS OENEIIALDABnITY EACH OCCURRENCE 5 1,000,000 A X COUMFAG oENER UArAUTY CWLffiMAOE [j]MOMX Y 01 OL 0011913-03 /13/2015 1/3!/2016 I r 5 1DO,DDO STED EXP(Aftyr penin) 5 5,000 PERSONAL & ADV INJURY S 1,000,00 6ENERAL A09R TE 5 2,000,00_0 GENLAGGREOATE UNIT APPLIES.PFHr PRODUCTS-COMPAPA60 1 2,000, 000 1 - X1 POLICY LOC AUTOM BILE LIABILITY 0=�M LINT ANY AUTO BODILY INJURY (P., person) 5 AU1� D OSIJLEA HREOAVIos AMS'o"'''1EO CWLV INJURY Ne, 1 s — UNBREUA Uke OCCUR - EACH OCCURRENCE EXCFS� o, =MAW AOOR01ATE 5 -- D T ION 1 WORNERSCDNFINIATWN AND EMPLOYERS LIABILITY YIN AW PAOPRBTORNARTWR/FRECUTNE ORICEVIWIRI RA EMAUCE01 (M{ndwrr M NMI Nyymm amPBc uMv OESdRmiOtJOf6PBNTIDNalroiow NIA -- E.L. EACH ACCIDENT 5 ELWGEASE-EAEMPLOVM 1 - -- EL, gFEASE. POLRT LINR 5 IT I D IFTIONWOPERAIIONSILOCA71ON51WHICLEa ALeeA AODlm fet,AaalbNiR{OwOn aclMtlBN,I11n010 {pLEFntaqur�a The City of Newport Beach, its officers, officials, employees and volunteers are named. as addtional insureds with respects general liability policy limits. Primary and non-contributory wording and waiver of subrogation apply with respects general .liability policy limits. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIPATION DATE THEREOF, NOTICE WILL BE DELIVER90 IN City of Newport Beach ACCORDANCE WITH THE POLICY PROVISIONS. Joan Ackerman PO BOX 1766 - AUTNONMEORWIte"WATwE Newport Beach, CA 92658 Richard HigginsWCH "%aa •'ZLi"y� InaucO(mlaystm The ACORD name and logo are registered marks of ACORD C MICATE OF EXEMPMN FROM01WER'S CO MNSATION LAWS I am aware of the provisions of California Labor Code Section 3700, 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. I affirm that at all times in performing the work for which this Certificate.is provided 1 will not empfey arty perm rat ony mw w so that I bewme subject to the Wmkom' Compeiiiwiost Laws of California. I also understand that if while performing the work for which this Certificate is provided I employ someone so that I become.subject to the Workers' Compensation Laws of California, the claim of exemption executed under this form will no longer be valid. I affirm that if I become subject to the Workers' Compensation Laws of California while performing the work for which this Certificate is provided I will obtain a Certificate of Workers' Com, as�tioil htsowtee, stibtttit th* Ce"ifls�le to the ii"sM Att1WIVy immedisRteiy following its effective date, and continuously maintain the coverage provided by the Certificate in accordance with the law. 1 I certify under penalty of perjury under the laws of the State of California that the information provided on this exemption statement is true and accurate. 9ignaWre• Date- Name: Title: �%�J1f�l� / Ft ' L! 'nE a nmwa c$fiel FAA, ,r,, 83 Fab '412 "l6a Stale Farm - 7144650157 P.1 CE RIIFIQIC OF INSMNCE 1 SU a9b tANCE AS RESPECTS THE.WEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT SE OF INSURANCE D0E9 NOT CNANOE THE CMERAGE PROMED BY This oerffl" that 5TA` FAIW MUTVAI, AUroMOBILE, INSURANCE COMPANY ofBktan &m, lAin � STAT FARM FIRE AND CASUALTY COMPANY of a=* g6naga ❑❑ STATE FARM COUNTY MUTUAL INSURANCE! COMPANY TEXAS of Dallas, Texas C7 STATE FARM INDEMNITY COMPANY of OtoominSp% llkQt% or O STATE FARM GUARANTY "WRANCE COWAOY Of WOOm"Igtan, 11"O a .... M L.nu ♦wr xw Ralfn..d.w etn..:.,.1 Ina,..—A — eh— f I— NAMED INSURE@ APTROSY USM 9 - -^ -.. _ - .•.--- ADIOFF NlYt1W 4d$11REQ 3?Oi 'r)ASPING:ON AVA COSTA MASA ':¢ 9262E f—N-`^^-^`- POUGYNUMSEROf @FFEC11Vi QATE $ i 1 �.� m6m CO2d/1d/2Y?3.Y - E DESCRIPTIONOF NSAET37061A96332 ii I VEHICLE tlM+dM V1N! lla6IUTY OOVWIA(ta£ 10 YES 0 NO O YES _ O NO TO YES O NO 1 [i YeS O NO uWTS OF LV,6ILITY a.so* iryury aasa,bob 1?ach AOcid4m ______ b. Pmww Damage o. 904IMW PmpaAY Damage i &ngb Un* i @M I SiOO,bca ._� _._.__.,_.....,..i P � MA(aE M YES a NO it Y@S a NO ❑ YES ONO . j O YES - ONO ` a.Ca a mivt 256 tro"low E 9m!9m 9 Dedwaill S De4nr.W0 j 0 YE5 ONO Q YES © NO ONO [] YES 0 NO b. Colaelon S500 Oodiwbte $,_ d UedeaOia $ DMIrziTlle EiPlQVERBNONG 0 aqR yp }y E O YES. L0 NO C7 YES O NO 0 NO FOYES� L7 YES_ Q NO roRtD CNti.IABalrr ❑ YES ONO C,.! YES 0 NO ONO O YES [] NO . O Y NO O YES ❑ NO I O Mn i I I YE5 0 RFP No. 1-19 - Backfiow Device Testing & Repair -..................................... re? > aF rtml csfieici FAX s, ls5 5?: 5 n CID!, 013; Fab 14 1, 5,'t6a slate Farm _ 754 43501S1 P'l ,w ClL3Ut i1 SgRTIFIC.A 9 OF INSURANCE THE INTEREST OF THE CERTIFICATE HOLDER NMdED BELOW WILL NOT BE WINATED Wn=UT COVING 10 DAYS PRIOR WRITTEN NOTICE TO THE 2 EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM WATE OF INSURANCE 009$ NOT CHANGE THE COVERAGe PROVIDED SY this CCM%a Itret STA FARM MUTUAL AUTOMOBILE INSURANCE COMPANY Of 8100minglan, 10WIS STI\T FARM FIRE AND CASUALTY COMPANY Of SICO hWtOn 16itlofi STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAti W wAss, Texas S'T'ATE FARM INDEMNITY COMPANY of Bloom 40n, 00019, Of ❑ STATE FARM GUARANTY INSURANCE COMPANY of 01aomingtvn.16inok - KAM I K0.1. RNTROeY :"3IiBR ` ADDRESS OFNAMD ' POLICY NUMBER EFFECTIVE DATE 3201 'Ahsl1NC.ON R53 1677 -Sia -'St. AVp COSTA SESA, A 32626 ' 2007 I2032 20 T 3�RYOTN DESCRIPTION OF TnRea7w W6sET37�9tR3963]2 1 j I I. VEMOL.E OnaudHO Vr70 , LII.BILITY COVL' "15 1 10YES 0 NO D YES [] NO M YES Q NO Q YES Q NO LIMITS OF LIABILITY a. Bsdly: AY 5x50'000 AWOM b. PiOPMty Oamapo 65Ud, 000 c, 69ft Injury & PMWty Damp &no Lmt EaCh nl I PHYSICAL DAMAGE COVCRAOES YES ED NO [1 Yes r -j No ❑ YES 0 NO . ' {A YES 0 NO. a. dA'¢ $ 250 OWa $ Duduoaw S Lk4ur�da _.� j E YES 0 NO � OYES ❑ NO YES NO []YES ONO b. Cadhbn $ 500 Oadue" . 5 ----R 3 baduadbk $ badu w EWLOYf1R8 t10K0:1RIE0 LI Yes ED] C7 NO { YES [] NO 0 YES E) NO WA L"UTYCOYPJIACE L-03NO HIM CAR t7AeluryCOwwE 13 YES D NO YES 0 NO Cl YES El NO 0Yes ONO naafi OOVBUOE FOR ALL OVOWAMDUCIMM - [] Y NO f G YES ❑ NO _ ; [j YES E1,40 1 U YES L3 NO COSTA MW CA 924526 RFP No. 1-19 - Backflow Device Testing & Repair THE DATE NI UTTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. This certifies that: ® STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois ❑ STATE FARM FIRE AND CASUALTY COMPANY Of:Biooming0p. Illinois ❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas © STATE FARM INDEMNITY COMPANY of BlaQfr li#n' onois, or 0 STATE FARM GUARANTY, INSURANCE COMPANY of Bloomington, Illinois has coverage In force for the foliovA Nameo Insured as shoWn below: NAMED INSURED: ANTHONY a SANDRA: USHER ADDRESS OF NAMEDINSURED: 3201 NASHINGTON:AVE. COSTA MESA. CA'92626 POLICY NUMBER R55 7647-EI6-75F EFFECTIVE RATE OF POLICY 11/lfi/11-11,/16/12. .2007 ROYOTA DESCRIPTION OF TUNDRA X _. STE'Rv54197X031953 VEHICLE (Indaft VIN) LIABILITY COVERAGE 1@ YES ❑ NO 0 YES Q. NO CJ YES ONO ❑ YES 0 N LIMITS OF LIABILITY a. 80* Injury 11000,000 'v Each Persoo EachAcciderd.. b. Property Damage Each Accident :1,000,000 c. Bodly injury 8 PropertyDamage - - Single Umh . Each Accident 81.000,000 PHYSICAL DAMAGE COVERAGES ® YES ONO OYES, [ N4 [ .YES C NO Q YES ONO a. Comprehensive $`250 Dile $" ,. bfdulCdhla a oeduafieb OYES [} NO OYES [Q NO 4 -YE$] NO E)YES Q NO b. Collision $:900 UMaaa�ne IotaEladucObFe OYm D 13 YES _" YE$ ❑ NO YE3 [J NO CAR RECABILTYHILI [EN YENO �Yfi 0NO ❑ YES 0 NOC FI.EEr. rwtreRAaEFOR AL'OWNDANDMOTORVEHICLI S 0 NO Q YES [ NO:, (3 YES Q NO OYES 0 NO 75-8544 03/15/2012 S of. TMe AgW4 Code NwNlar D. NameandAddressof CerfiflorriAoIrior Name e d' of anti MISE S . FER' 1651-5 0MR ST L STATE FARM USE oRvy-11fteweet permanent Centiode ofworamm rwwilily obwov UN AMENDMENT NO. ONE TO MAINTENANCE AND REPAIR SERVICES AGREEMENT WITH ANTHONY USHER DBA FLOTECH CERTIFIED BACKFLOW SERVICE FOR U BACKFLOW DEVICE TESTING AND REPAIR THIS AMENDMENT NO, ONE TO MAINTENANCE AND REPAIR SERVICES AGREEMENT ("Amendment No. One") is made and entered into as of this 2nd day of January, 2014 ("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("City"), and ANTHONY USHER, a sole proprietor, doing business as ("DBA") FLOTECH CERTIFIED BACKFLOW SERVICE ("Contractor"), whose address is 3201 Washington Avenue, Costa Mesa, CA 92626, and is made with reference to the following: RECITALS A. On May 3, 2012, City and Contractor entered into a Maintenance and Repair Services Agreement ("Agreement") for backflow device testing and repair services ("Project'). B. City desires to enter into this Amendment No. One to increase the total compensation. C. City and Contractor mutually desire to amend the Agreement, as provided below. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. COMPENSATION TO CONTRACTOR Section 4.1 of the Agreement is amended in its entirety and replaced with the following: "City shall pay Contractor for the Services on a time and expense not -to - exceed basis in accordance with the provisions of this Section and the Schedule of Billing Rates attached hereto as Exhibit B and incorporated herein by reference. Contractor's compensation for all Work performed in accordance with this Agreement, including all reimbursable items and subcontractor fees, shall not exceed Sixty Five Thousand Dollars and 001100 ($65,000.00), without prior written authorization from City. No billing rate changes shall be made during the term of this Agreement without the prior written approval of City." The total amended compensation reflects Contractor's additional compensation for additional Services to be performed in accordance with this Amendment No. One, including all reimbursable items and subcontractor fees, in an amount not to exceed Twenty Thousand Dollars and 001100 ($20,000.00). 2. NOTICES Section 14.1 shall be updated to reflect the address for the City of Newport Beach as: Anthony Usher DBA Flotech Certified Backflow Service Page 1 100 Civic Center Drive P.O. Box 1768 Newport Beach, CA 92658 3. INTEGRATED CONTRACT Except as expressly modified herein, all other provisions, terms, and covenants set forth in the Agreement shall remain unchanged and shall be in full force and effect. IN WITNESS WHEREOF, the parties have caused this Amendment No. One to be executed on the dates written below. APPROVED AS TO FORM: CITY ATTORNEY'S OFFICE Date: I ;� - (1— ( � By: vt Aaron C. arp City Attorney (i ATTEST: Date: f By: _440�-'- hw, Leilani I. Brown City Clerk PO RTA%r-- CITY OF NEWPORT BEACH, a California municipal corporation Date: B C—e::�o�;eu och Acting Municipal Operations Director CONTRACTOR: ANTHONY USHER, a sole proprietor DBA FLOTECH CERTIFIED BA KFL_ OW SERVICE Date: a By: nthony Use, r Owner [END OF SIGNATURES] Anthony Usher DBA Flotech Certified Backflow Service Page 2 �Y lt7 U AGREEMENT FOR MAINTENANCE AND REPAIR SERVICES WITH ANTHONY USHER FOR BACKFLOW DEVICE TESTING AND REPAIR THIS AGREEMENT FOR MAINTENANCE AND d REPAIR SERVICES ("Agreement') is made and entered into as of this 34 day of l Bch; 2012 ("Commencement Date') by and between the CITY OF NEWPORT BEACH, a California municipal corporation and charter city ("City"), and ANTHONY USHER, a sole proprietor doing business as ("DBA") Flotech Certified Backflow ("Contractor"), whose principal place of business is 3201 Washington Ave, Costa Mesa, CA 92626 and is made with reference to the following: RECITALS A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of City. B. City requires certified testing and as -needed repair of backflow devices. C. City desires to engage Contractor to perform annual certified testing and as - needed repair services for City owned backflow devices ("Project'). D. Contractor has examined the location of all proposed work, carefully reviewed and evaluated the specifications set forth by the City for the Project, and is familiar with all conditions relevant to the performance of services and has committed to perform all work required for the price specified in this Agreement. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. TERM The term of this Agreement shall commence on the Commencement Date, and shall terminate on .441, 2015, unless terminated earlier as set forth herein. ./a� 2. SCOPE OF WORK 2.1. City and Contractor acknowledge that the above Recitals are true and correct and are hereby incorporated by reference. Contractor shall perform all the work described in the Scope of Work attached hereto as Exhibit A and incorporated herein by this reference ("Services" or "Work"). As a material inducement to the City entering into this Agreement, Contractor represents and warrants that Contractor is a provider of first class work and Contractor is experienced in performing the Work contemplated herein and, in light of such status and experience, Contractor covenants that it shall follow the highest professional standards in performing the Work required hereunder and that all materials will be of good quality. For purposes of this Agreement, the phrase "highest professional standards" shall mean those standards of practice recognized by one or more first-class firms performing similar work under similar circumstances. 2.2. Contractor shall perform everything required to be performed, and shall provide and furnish all the labor, materials, necessary tools, expendable equipment and all utility and transportation services necessary for the Project. 3. TIME OF PERFORMANCE 3.1. Time is of the essence in the performance of Services under this Agreement and Contractor shall perform the Services in accordance with the schedule included in Exhibit A. The failure by Contractor to strictly adhere to the schedule may result in termination of this Agreement by City. 3.2. Notwithstanding the foregoing, Contractor shall not be responsible for delays due to causes beyond Consultant's reasonable control. However, in the case of any such delay in the Services to be provided for the Project, each party hereby agrees to provide notice to the other party so that all delays can be addressed. 3.3. Contractor shall submit all requests for extensions of time for performance in writing to the Project Administrator not later than Five (5) calendar days after the start of the condition that purportedly causes a delay. The Project Administrator shall review all such requests and may grant reasonable time extensions for unforeseeable delays that are beyond Consultant's control. 3.4. For all time periods not specifically set forth herein, Consultant shall respond in the most expedient and appropriate manner under the circumstances, by telephone, fax, hand -delivery or mail. 3.5. Upon written request from the Project Administrator (as defined below in Section 5), Contractor shall provide a letter proposal for As -needed Repair Services requested by the City (hereinafter referred to as the "Letter Proposal"). The Letter Proposal shall include the following: 3.5.1. A detailed description of the Services to be provided; 3.5.2. The position of each person to be assigned to perform the Services, and the name of the individuals to be assigned, if available; 3.5.3. The estimated number of hours and cost to complete the Services; and 3.5.4. The time needed to finish the specific Project. ANTHONY USHER Page 2 3.6. No Services shall be provided until the Project Administrator has provided written acceptance of the Letter Proposal. Once authorized to proceed, Contractor shall diligently perform the duties in the approved Letter Proposal. 4. COMPENSATION 4.1. City shall pay Contractor for the Services on a time and expense not -to - exceed basis, in accordance with the provisions of this Section and the Schedule of Billing Rates attached hereto as Exhibit B and incorporated herein by reference. No rate changes shall be made during the term of this Agreement without the prior written approval of the City. Contractor's total compensation for Services performed in accordance with this Agreement, including all reimbursable items, shall not exceed Forty -Five Thousand Dollars and 00/100 ($45,000.00) without written amendment to the Agreement. 4.2. Contractor shall submit monthly invoices to City describing the Work performed the preceding month. Contractor's bills shall include the name of the person and/or classification of employee who performed the Work, a brief description of the Services performed and/or the specific task from the Scope Services attached hereto which it relates, the date the Services were performed, the number of hours spent on all Work billed on an hourly basis, and a description of any reimbursable expenditures. City shall pay Contractor no later than thirty (30) days after approval of the monthly invoice by City staff. 4.3. City shall reimburse Contractor only for those costs or expenses specifically approved in the Scope of Services attached hereto. Unless otherwise approved, such costs shall be limited and include nothing more than the actual costs and/or other costs and/or payments specifically authorized in advance in writing and incurred by Contractor in the performance of this Agreement. 4.4. Contractor shall not receive any compensation for Extra Work without the prior written authorization of City. As used herein, "Extra Work" means any work that is determined by the Project Administrator to be necessary for the proper completion of the Project, but which is not included within the Scope of Work and which the City and Contractor did not reasonably anticipate would be necessary. Compensation for any authorized Extra Work shall be paid in accordance with the Schedule of Billing Rates set forth in Exhibit B. 5. ADMINISTRATION This Agreement will be administered by the Municipal Operations Department. The Water Quality Coordinator or his/her designee shall be the Project Administrator and shall have the authority to act for City under this Agreement. The Project Administrator or his/her authorized representative shall represent City in all matters pertaining to the Services to be rendered pursuant to this Agreement. ANTHONY USHER Page 3 6. TYPE AND INSTALLATION OF MATERIALS/STANDARD OF CARE 6.1. Contractor shall use only the standard materials described in Exhibit A in performing Services under this Agreement. Any deviation from the materials described in Exhibit A shall not be installed unless approved in advance by the Project Administrator. 6.2. All of the Services shall be performed by Contractor or under Contractor's supervision. Contractor represents that it possesses the personnel required to perform the Services required by this Agreement, and that it will perform all Services in a manner commensurate with highest professional standards. All Services shall be performed by qualified and experienced personnel who are not employed by City, nor have any contractual relationship with City. 7. RESPONSIBILITY FOR DAMAGES OR INJURY 7.1. City and all officers, employees and representatives thereof shall not be responsible in any manner for any loss or damage to any of the materials or other things used or employed in performing the Project or for injury to or death of any person as a result of Contractor's performance of the Services required hereunder; or for damage to property from any cause arising from the performance of the Project by Contractor, or its subcontractors, or its workers, or anyone employed by either of them. 7.2. Contractor shall be responsible for any liability imposed by law and for injuries to or death of any person or damage to property resulting from defects, obstructions or from any cause arising from Contractor's Work on the Project, or the Work of any subcontractor or supplier selected by the Contractor. 7.3. To the fullest extent permitted by law, Contractor shall indemnify, defend and hold harmless City, its City Council, boards and commissions, officers, agents, volunteers, and employees (collectively, the "Indemnified Parties") from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, suits, losses, judgments, fines, penalties, liabilities, costs and expenses (including, without limitation, attorney's fees, disbursements and court costs) of every kind and nature whatsoever (individually, a Claim; collectively, "Claims"), which may arise from or in any manner relate (directly or indirectly) to any breach of the terms and conditions of this Agreement, any Work performed or Services provided under this Agreement including, without limitation, defects in workmanship or materials or Contractor's presence or activities conducted on the Project (including the negligent and/or willful acts, errors and/or omissions of Contractor, its principals, officers, agents, employees, vendors, suppliers, consultants, subcontractors, anyone employed directly or indirectly by any of them or for whose acts they may be liable or any or all of them). 7.4. Notwithstanding the foregoing, nothing herein shall be construed to require Contractor to indemnify the Indemnified Parties from any Claim arising from the ANTHONY USHER Page 4 sole negligence or willful misconduct of the Indemnified Parties. Nothing in this indemnity shall be construed as authorizing any award of attorney's fees in any action on or to enforce the terms of this Agreement. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by the Consultant. 7.5. Contractor shall perform all Project Work in a manner to minimize public inconvenience and possible hazard, to restore other work areas to their original condition and former usefulness as soon as possible, and to protect public and private property. Contractor shall be liable for any private or public property damaged during the performance of the Project Work. 7.6. To the extent authorized by law, as much of the money due Contractor under and by virtue of the Agreement as shall be considered necessary by City may be retained by it until disposition has been made of such suits or claims for damages as aforesaid. 7.7. The rights and obligations set forth in this Section shall survive the termination of this Agreement. 8. INDEPENDENT CONTRACTOR City has retained Contractor as an independent contractor and neither Contractor nor its employees are to be considered employees of the City. The manner and means of conducting the Work are under the control of Contractor, except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment shall accrue to Contractor or its employees. Contractor shall have the responsibility for and control over the means of performing the Work, provided that Contractor is in compliance with the terms of this Agreement. Anything in this Agreement that may appear to give City the right to direct Contractor as to the details of the performance or to exercise a measure of control over Contractor shall mean only that Contractor shall follow the desires of City with respect to the results of the Services. 9. COOPERATION Contractor agrees to work closely and cooperate fully with City's designated Project Administrator and any other agencies that may have jurisdiction or interest in the Work to be performed. City agrees to cooperate with the Contractor on the Project. 10. INSURANCE 10.1. Without limiting Contractor's indemnification of City, and prior to commencement of Work, Contractor shall obtain, provide and maintain at its own expense during the term of this Agreement, policies of insurance of the type and ANTHONY USHER Page 5 amounts described below and in a form satisfactory to City. The cost of such insurance shall be included in Contractor's bid. 10.2. Coverage and Limit Requirements. 10.2.1. Workers' Compensation. Contractor shall maintain Workers' Compensation Insurance providing statutory benefits and employer's liability insurance with limits of at least one million dollars ($1,000,000) each type for Contractor's employees in accordance with the laws of the State of California, Section 3700 of the Labor Code. In addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance and Employer's Liability Insurance in accordance with the laws of the State of California, Section 3700 for all of the subcontractor's employees. The insurer issuing the Workers' Compensation insurance shall amend its policy by endorsement to waive all rights of subrogation against City, its elected or appointed officers, agents, officials, employees and volunteers. Contractor shall submit to City, along with the required certificate of insurance, a copy of such waiver of subrogation endorsement. 10.2.2. General Liability. Contractor shall maintain commercial general liability insurance in an amount not less than one million dollars ($1,000,000) per occurrence, two million dollars ($2,000,000) General Aggregate and two million dollars ($2,000,000) Products and Completed Operations Aggregate for bodily injury, personal injury, and property damage, including without limitation, blanket contractual liability. Coverage shall be at least as broad as that provided by Insurance Services Office form CG 00 01. None of the policies required herein shall be in compliance with these requirements if they include any limiting endorsement that has not been first submitted to City and approved in writing. 10.2.3. Automobile Liability. Contractor shall maintain automobile insurance covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with Work to be performed under this Agreement, including coverage for any owned, hired, non -owned or rented vehicles, in an amount not less than one million dollars ($1,000,000) combined single limit for each accident. 10.2.4. Builders Risk. For Agreements or Contracts with Construction/Builders Risk property exposures, Contractor shall maintain Builders Risk insurance or an installation floater as directed by City, covering damages to the Work for "all risk" or special form causes of loss with limits equal to one hundred percent (100%) of the completed value of contract, with coverage to continue until final acceptance of the Work by City. At the discretion of City, the requirement for such coverage may include additional protection for Earthquake and/or Flood. City shall be included as an insured on such policy, and Contractor shall provide the City with a copy of the policy. 10.3. Other Insurance Provisions or Requirements. ANTHONY USHER Page 6 10.3.1. Evidence of Insurance. Contractor shall provide certificates of insurance to City as evidence of the insurance coverage required herein, along with a waiver of subrogation endorsement for workers' compensation and an additional insured endorsement for general liability. Insurance certificates and endorsements must be approved by City's Risk Manager prior to commencement of performance or issuance of any permit. Current evidence of insurance shall be kept on file with City at all times during the term of this Agreement. All of the executed documents referenced in this Agreement must be returned within ten (10) working days after the date on the "Notification of Award," so that the City may review and approve all insurance and bond documentation. City reserves the right to require complete, certified copies of all required insurance policies, at any time. 10.3.2. General liability insurance provisions. Primary and excess or umbrella liability policies are to contain, or be endorsed to contain, the following provisions: 10.3.2.1. City, its elected or appointed officers, agents, officials, employees, and volunteers are to be covered as additional insureds as respects: liability arising out of activities performed by or on behalf of Contractor, including the insured's general supervision of Contractor; products and completed operations of Contractor; premises owned, occupied or used by Contractor. The coverage shall contain no special limitations on the scope of protection afforded to City, its elected or appointed officers, officials, employees, agents or volunteers. Contractor shall submit to City a copy of the additional insured endorsement along with the required certificates of insurance. 10.3.2.2. Contractor's insurance coverage shall be primary insurance and/or primary source of recovery as respects City, its elected or appointed officers, agents, officials, employees and volunteers as respects to all claims, losses, or liability arising directly or indirectly from the Contractor's operations or services provided to the City. Any insurance or self-insurance maintained by City, its officers, officials, employees and volunteers shall be excess of the Contractor's insurance and shall not contribute with it. 10.3.2.3. Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability. 10.4. Acceptable Insurers. All insurance policies shall be issued by an insurance company currently authorized by the Insurance Commissioner to transact business of insurance in the State of California, with an assigned policyholders' Rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide, unless otherwise approved by the City's Risk Manager. ANTHONY USHER Page 7 10.5. Notice of Cancellation. Contractor agrees to oblige its insurance broker and insurers to provide to City with 30 days notice of cancellation (except for nonpayment for which 10 days notice is required) or nonrenewal of coverage for each required coverage except for builder's risk insurance. The builder's risk policy will contain or be endorsed to contain a provision providing for 30 days written notice to City of cancellation or nonrenewal, except for nonpayment for which 10 days notice is required. 10.6. Self -Insured Retentions. Contractor agrees not to self -insure or to use any self-insured retentions on any portion of the insurance required herein and further agrees that it will not allow any indemnifying party to self -insure its obligations to City. If contractor's existing coverage includes a self-insured retention, the self-insured retention must be declared to City. City may review options with the contractor, which may include reduction or elimination of the self-insured retention, substitution of other coverage, or other solutions. Contractor agrees to be responsible for payment of any deductibles on their policies. 10.7. Timely Notice of Claims. Contractor shall give City prompt and timely notice of any claim made or suit instituted arising out of or resulting from Contractor's performance under this agreement. 10.8. Waiver. All insurance coverage maintained or procured pursuant to this agreement shall be endorsed to waive subrogation against City, its elected or appointed officers, agents, officials, employees and volunteers, or shall specifically allow Contractor or others providing insurance evidence in compliance with these requirements to waive their right of recovery prior to a loss. Contractor hereby waives its own right of recovery against City, and shall require similar written express waivers and insurance clauses from each of its subcontractors. 10.9. Enforcement of Agreement Provisions. Contractor acknowledges and agrees that any actual or alleged failure on the part of the City to inform Contractor of non-compliance with any requirement imposes no additional obligations on the City nor does it waive any rights hereunder. 10.10. Requirements not Limiting. Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. 10.11. City's Remedies. City shall have the right to order the Contractor to stop Work under this Agreement and/or withhold any payment(s) that become due to Contractor hereunder until Contractor demonstrates compliance with the requirements of this article. In the alternative, City may purchase the required coverage and charge Contractor the cost of the premiums or deduct the cost from Contractor's payments. ANTHONY USHER Page 8 10.12. Coverage not Limited. All insurance coverage and limits provided by contractor and available or applicable to this agreement are intended to apply to the full extent of the policies. Nothing contained in this agreement or any other agreement relating to the city or its operations limits the application of such insurance coverage. 10.13. Coverage Renewal. Contractor will renew the coverage required here annually as long as Contractor continues to provide any Services under this or any other contract or agreement with the City. Contractor shall provide proof that policies of insurance required herein expiring during the term of this Agreement have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. A coverage binder or letter from Contractor's insurance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City within five days of the expiration of the coverages. 11. SUBCONTRACTING City and Contractor agree that subcontractors may be used to complete the Work outlined in the Scope of Work provided the Contractor obtains City approval prior to the subcontractor performing any work. Contractor shall be fully responsible to City for all acts and omissions of the subcontractors. Nothing in this Agreement shall create any contractual relationship between City and subcontractor nor shall it create any obligation on the part of City to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise required by law. 12. WITHHOLDINGS City may withhold payment to Contractor of any disputed sums until satisfaction of the dispute with respect to such payment. Such withholding shall not be deemed to constitute a failure to pay according to the terms of this Agreement. Contractor shall not discontinue Work as a result of such withholding. Contractor shall have an immediate right to appeal to the City Manager or his/her designee with respect to such disputed sums. Contractor shall be entitled to receive interest on any withheld sums at the rate of return that City earned on its investments during the time period, from the date of withholding of any amounts found to have been improperly withheld. 13. CONFLICTS OF INTEREST 13.1. The Contractor or its employees may be subject to the provisions of the California Political Reform Act of 1974 (the "Act"), which (1) requires such persons to disclose any financial interest that may foreseeably be materially affected by the Work performed under this Agreement, and (2) prohibits such persons from making, or participating in making, decisions that will foreseeably financially affect such interest. ANTHONY USHER Page 9 13.2. If subject to the Act, Contractor shall conform to all requirements of the Act. Failure to do so constitutes a material breach and is grounds for immediate termination of this Agreement by City. Contractor shall indemnify and hold harmless City for any and all claims for damages resulting from Contractor's violation of this Section. 14. NOTICES 14.1. All notices, demands, requests or approvals to be given under the terms of this Agreement shall be given in writing, to City by Contractor and conclusively shall be deemed served when delivered personally, or on the third business day after the deposit thereof in the United States mail, postage prepaid, first-class mail, addressed as hereinafter provided. All notices, demands, requests or approvals from Contractor to City shall be addressed to City at: Attn: Water Quality Coordinator City of Newport Beach 3300 Newport Blvd. PO Box 1768 Newport Beach, CA 92658 Email: gtegel@newportbeachca.gov Phone: 949-718-3412 Fax: 949-646-5204 14.2. All notices, demands, requests or approvals from City to Contractor shall be addressed to Contractor at: Attn: Anthony Usher Flotech Certified Backflow 3201 Washington Ave, Costa Mesa, CA 92626 Email: tusher52@aol.com Phone: 949-246-3220 Fax: 714-825-0044 15. NOTICE OF CLAIMS 15.1. Unless a shorter time is specified elsewhere in this Agreement, before making its final request for payment under the Agreement, Contractor shall submit to City, in writing, all claims for compensation under or arising out of this Agreement. Contractor's acceptance of the final payment shall constitute a waiver of all claims for compensation under or arising out of this Agreement except those previously made in writing and identified by Contractor in writing as unsettled at the time of its final request for payment. The Contractor and the City expressly agree that in addition to all claims filing requirements set forth in the Agreement, the Contractor shall be required to file ANTHONY USHER Page 10 any claim the Contractor may have against the City in strict conformance with the Tort Claims Act (Govt. Code §§ 900 et seq.). F[-�I:I: !1 IIZENJIM121 16.1. In the event that either party fails or refuses to perform any of the provisions of this Agreement at the time and in the manner required, that party shall be deemed in default in the performance of this Agreement. If such default is not cured within a period of two (2) calendar days, or if more than two (2) calendar days are reasonably required to cure the default and the defaulting party fails to give adequate assurance of due performance within two (2) calendar days after receipt of written notice of default, specifying the nature of such default and the steps necessary to cure such default, the non -defaulting party may terminate the Agreement forthwith by giving to the defaulting party written notice thereof. 16.2. Notwithstanding the above provisions, City shall have the right, at its sole discretion and without cause, of terminating this Agreement at any time by giving seven (7) calendar days prior written notice to Contractor. In the event of termination under this Section, City shall pay Contractor for Services satisfactorily performed and costs incurred up to the effective date of termination for which Contractor has not been previously paid. On the effective date of termination, Contractor shall deliver to City all materials purchased in performance of this Agreement. 17. STANDARD PROVISIONS 17.1. Compliance with all Laws. Contractor shall at its own cost and expense comply with all statutes, ordinances, regulations and requirements of all governmental entities, including federal, state, county or municipal, whether now in force or hereinafter enacted. 17.2. Waiver. A waiver by City of any term, covenant, or condition in the Agreement shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant or condition. 17.3. Integrated Contract. This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and Agreements of whatsoever kind or nature are merged herein. No verbal Contract or implied covenant shall be held to vary the provisions herein. 17.4. Conflicts or Inconsistencies. In the event there are any conflicts or inconsistencies between this Agreement and the Exhibits attached hereto, the terms of this Agreement shall govern. ANTHONY USHER Page 11 17.5. Amendments. This Agreement may be modified or amended only by a written document executed by both Contractor and City and approved as to form by the City Attorney. 17.6. Effect of Contractor's Execution. Execution of this Agreement by Contractor is a representation that Contractor has visited the Project Site, has become familiar with the local conditions under which the Work is to be performed, and has taken into consideration these factors in submitting its Project Proposal and Scope of Work. 17.7. Controlling Law and Venue. The laws of the State of California shall govern this Agreement and all matters relating to it and any action brought relating to this Agreement shall be adjudicated in a court of competent jurisdiction in the County of Orange. 17.8. Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. 17.9. Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of the Agreement or any other rule of construction which might otherwise apply. 17.10. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 17.11. No Attorney's Fees. In the event of any dispute or legal action arising under this Agreement, the prevailing party shall not be entitled to attorney's fees. 17.12. Counterparts. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. [SIGNATURES ON NEXT PAGE] ANTHONY USHER Page 12 IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the dates written below. APPROVED AS TO FORM: CITY ATTORNEY'S OFFICE Date: 3//S//z Aaron`F!. Harp City Attorney ATTEST: Date: �il �! f rr-City Clerk Brown Attachments CITY OF NEWPORT BEACH, A California munici dal corporation Date: B: Y� Mark ,Harmon Municipal Operations Director CONSULTANT: ANTHONY USHER, a Sole Proprietor, DBA Flotech Certified Backflow Date: By: t " er Owner [END OF SIGNATURES] Exhibit A - Scope of Work/ Schedule Exhibit B - Schedule of Billing Rates ANTHONY USHER Page 13 EXHIBIT A SCOPE OF SERVICES ATTACHMENT A: SCOPE OF SERVICES lastmcrions: initial the bottom of each page of the Scope of Service.,. in the spaces provided as remit as part of your proposal as Attachment A. acknawtedging a demonstrated understanding of the scope o/ Services. Any and all exceptions to the stated mandatory m/nlmum requhements shall he indlmted on the Statement of Compliance. The following Is a list of minimum requirements that Contractors must be able to address in potentially providing the City of Newport Beach with annual backflow device testing and as - needed repair. services. 1. Contractor Responsibilities/Provisions: 1.1 Contractor shall designate a single point of contact that can be contacted by the City for Issues regarding backflow device testing and repair. 1.2 Contractor shall properly inspect, certify replace and repair any and all backflow devices as specified by the Project Administrator and in accordance with City of Newport Beach Municipal Code Chapter 14.10. t r. [wstw.tadeoubl ininrz.cam/WNewoortaeadt/html/Newoortacachl4/Newoanliuchl4l OJA,1914.:'p 1.3 Contractor shall provide labor, transportation/travel, equipment and materials necessary to properly test and certify backflow devices, unless otherwise specified by the Project Administrator. Contractor shall deliver test reports to all proper parties as specified by the Project Administrator. 1.4 Contractor shall orchestrate with Project Administrator and each department facility a time in which water shut-off shall not affect operations. All fire services shall be put on test for the period of testing with the fire alarm company. Z. Annual Services (hereby defined as once per year): 2.1. Contractor shall provide annual testing and certification of approximately two - hundred -seventy (270) testable backflow devices throughout the City, with some located In neighboring water service areas (Wine Ranch Water District, City of Fountain Valley, Mesa Consolidated Water District). The majority of devices are between 1" and 8", with the majority being 2". 2.1.1 Upon verbal or written request from the Project Administrator, Contractor shall begin yearly testing and certification of City backflow devices. 2.1.2 Yearly testing shall begin in the month of July, and continue until all devices have been properly tested and certified. Contractor shall coordinate with Project Administrator in completing annual testing of City backflow devices. otyo!Newport Be RFP No. 1.19 aeiJlow Mt ..ca r sil & R1.117 ('mbaxrinidpl—" l r„�yc10 A-1IPage 3. As -Needed Services (hereby defined as maintenance, testing, replacement and repair services outside of the annual testing component): 3.1 Contractor shall coordinate with the Project Administrator or his/her designee and any City Departments in carrying out as -needed maintenance, testing and repair of backflow devices throughout the City with some located in neighboring water service areas. 3.2 Contractor shall provide labor, equipment, transportation/travel and materials necessary to complete any as needed maintenance, testing, replacement and repair, unless otherwise specified by the Project Administrator. 3.3 The City has many departments and if a particular Backflow device should need repairs outside of the basic repair kit (i.e. replacement of valves or device itself), the requesting departments shall submit a separate proposal to the City Cross Connection Specialist In order to obtaln department approval and funding. 4. After -Hours As -Needed Services (hereby defined as maintenance, testing, replacement and repair services after work hours, with work hours being Mon -Fri, 7:00am — 4:30pm on non -City observed holidays). 4.1 There may be some instances where as -needed services may be required outside of normal work hours. Should such services be requested, Contractor must have the ability to respond accordingly and in an expedient manner. arvd Nt p.4: PP no. 1.19 Man. CCV6C TC '&FCrg1 mrorr. w.miy/yL A-21 Page ATTACHMENT D: PROPOSAL OFFER FORM Instructions: Proposers may submit pricing information on their own forms but this Proposal Offer Form must also be completed. Complete this form, sign, and remit as part of your Proposal as Attachment D. Pricing: a. Cost Per Backflow Test & Certification: $ 37.00 (Must include ALL items necessary for completion of services, including labor, transportation, any and all travel, and delivery of test reports) b. Labor, As -needed Maintenance, Repair, Replacement (Per Hour): L Minimum Labor Charge? $ 80.00 /Hr El Y/N $ 80.00 c. Labor, After Hours As -needed Maintenance, Repair, Replacement (Per Hour): $ 80.00 /Hr i. Minimum Labor Charge? Y/N $ 80.00 ii. Minimum Call out time? �Y/N 1 hr/s_ d. Other/Optional? -Specify Below - Flotech Certified Backflow — rev. 2 B-1IPage CERTIFICATE OF INSURANCE CHECKLIST (City of Newport ort Beach This checklist is comprised of requirements as outlined by the City of Newport Beach. Date Received: 5-03-12 Dept./Contact Received From: Raymund Date Completed: 5-03-12 Sent to: Raymund By: Joel Company/Person required to have certificate: Flowtech Certified Backflow Service Type of contract: All Other GENERAL LIABILITY EFFECTIVE/EXPIRATION DATE: 9-01-11/9-05-12 A. INSURANCE COMPANY: Lloyd's of London B. AM BEST RATING (A-: VII or greater): Not Rated B. AM BEST RATING (A-: VII or greater) A++: XV C. ADMITTED Company (Must be California Admitted): Is Company admitted in California? ❑ Yes ❑ No D. LIMITS (Must be $1 M or greater): What is limit provided? 1,000,000 E. ADDITIONAL INSURED ENDORSEMENT — please attach ® Yes ❑ No F. PRODUCTS AND COMPLETED OPERATIONS (Must include): Is it included? (completed Operations status does for Waste Haulers): What is limits provided? 1,000,000 not apply to Waste Haulers or Recreation) ® Yes ❑ No G. ADDITIONAL INSURED FOR PRODUCTS AND COMPLETED OPERATIONS ENDORSEMENT (completed Operations status does not apply to Waste Haulers) ® Yes ❑ No H. ADDITIONAL INSURED WORDING TO INCLUDE (The City its officers, officials, employees and volunteers): Is it ❑ Yes included? ® Yes ❑ No I. PRIMARY & NON-CONTRIBUTORY WORDING (Must be ® No included): Is it included? ® Yes ❑ No J. CAUTION! (Confirm that loss or liability of the named insured is not limited solely by their negligence) Does endorsement include "solely by negligence" wording? ® Yes ❑ No K. ELECTED SCMAF COVERAGE (RECREATION ONLY): ® N/A ❑ Yes ❑ No L. NOTICE OF CANCELLATION: ❑ N/A ® Yes ❑ No U. AUTOMOBILE LIABILITY EFFECTIVE/EXPIRATION DATE: 2-1412/2-1413 A. INSURANCE COMPANY: State Farm Mutual Automobile Ins. Company B. AM BEST RATING (A-: VII or greater) A++: XV C. ADMITTED COMPANY (Must be California Admitted): Is Company admitted in California? ® Yes ❑ No D. LIMITS (Must be $1M min. BI & PD and $500,000 UM, $2M min for Waste Haulers): What is limits provided? 1,000,000 E LIMITS Waiver of Auto Insurance / Proof of coverage (ff individual) (What is limits provided?) N/A F. PRIMARY & NON-CONTRIBUTORY WORDING (For Waste Haulers only): ® N/A ❑ Yes ❑ No G. HIRED AND NON -OWNED AUTO ONLY: ❑ N/A ❑ Yes ® No H. NOTICE OF CANCELLATION: ❑ N/A ® Yes ❑ No III. WORKERS' COMPENSATION EFFECTIVE/EXPIRATION DATE: Exempted A. INSURANCE COMPANY: B. AM BEST RATING (A-: VII or greater): C. ADMITTED Company (Must be California Admitted): D. WORKERS' COMPENSATION LIMIT: Statutory E. EMPLOYERS' LIABILITY LIMIT (Must be $1 M or greater) F. WAIVER OF SUBROGATION (To include): Is it included? G. SIGNED WORKERS' COMPENSATION EXEMPTION FORM: H. NOTICE OF CANCELLATION: ADDITIONAL COVERAGE'S THAT MAYBE REQUIRED IV. PROFESSIONAL LIABILITY V POLLUTION LIABILITY V BUILDERS RISK HAVE ALL ABOVE REQUIREMENTS BEEN MET? IF NO, WHICH ITEMS NEED TO BE COMPLETED? Approved: M�� Agent of Alliant Insurance Services Broker of record for the City of Newport Beach 5-03-12 Date ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ® N/A ❑ Yes ❑ No ❑ N/A ® Yes ❑ No ® N/A ❑ Yes ❑ No ® N/A ❑ Yes ❑ No ® N/A ❑ Yes ❑ No ® Yes ❑ No RISK MANAGEMENT APPROVAL REQUIRED (Non -admitted carrier rated less than Self Insured Retention or Deductible greater than $ ) ❑ N/A ❑ Yes ❑ No Reason for Risk Management approval/exception/waiver: Approved: Risk Management * Subject to the terms of the contract. Date