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HomeMy WebLinkAboutC-5122 - PSA for Marina Park Project (Hazardous Material Survey Services)C11�4 I`O v> v PROFESSIONAL SERVICES AGREEMENT WITH ENVIROCHECK, INC. FOR MARINA PARK PROJECT THIS AGREEMENT FOR PROFESSION, A, L SERVICES ( "Agreement ") is made and entered into as of this JQJ, t day of A ri , 2012 by and between the CITY OF NEWPORT BEACH, a California Municipal Corporation ( "City "), and, ENVIROCHECK, INC., a California corporation ( "Consultant "), whose address is 2211 W. Orangewood Avenue, Orange, CA 92868 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 is planning to construct the Marina Park Project on Balboa Peninsula. C. City desires to engage Consultant to perform hazardous material survey services for the Marina Park Project ( "Project "). D. Consultant possesses the skill, experience, ability, background, certification and knowledge to provide the services described in this Agreement. E. The principal member of Consultant for purposes of Project shall be Vinh Q. Pham. F. City has solicited and received a proposal from Consultant, has reviewed the previous experience and evaluated the expertise of Consultant, and desires to retain Consultant to render professional services under the terms and conditions set forth 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 above written date, and shall terminate on December 31, 2012, unless terminated earlier as set forth herein. 2. SERVICES TO BE PERFORMED City and Consultant acknowledge that the above Recitals are true and correct and are hereby incorporated by reference. Consultant shall diligently perform all the services described in the Scope of Services attached hereto as Exhibit A and incorporated herein by reference ( "Work" or "Services "). The City may elect to delete certain tasks of the Scope of Services at its sole discretion. 3. TIME OF PERFORMANCE 3.1 Time is of the essence in the performance of Services under this Agreement and the Services shall be performed to completion in a diligent and timely manner. The failure by Consultant to perform the Services in a diligent and timely manner may result in termination of this Agreement by City. 3.1.1 Notwithstanding the foregoing, Consultant 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. 3.2 Consultant shall submit all requests for extensions of time for performance in writing to the Project Administrator (as defined in Section 6 below) not later than ten (10) 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. 3.3 For all time periods not specifically set forth herein, Consultant shall respond in the most expedient and appropriate manner under the circumstances, by either telephone, fax, hand - delivery or mail. 4. COMPENSATION TO CONSULTANT 4.1 City shall pay Consultant 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. Consultant's compensation for all Work performed in accordance with this Agreement, including all reimbursable items and subconsultant fees, shall not exceed Twelve Thousand, Eight Hundred Dollars and no /100 ($12,800.00) 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. 4.2 Consultant shall submit monthly invoices to City describing the Work performed the preceding month. Consultant's bills shall include the name of the person 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 Consultant no later than thirty (30) days after approval of the monthly invoice by City staff. 4.3 City shall reimburse Consultant only for those costs or expenses specifically approved in this Agreement, or specifically approved in writing in advance by City. Unless otherwise approved, such costs shall be limited and include nothing more than the following costs incurred by Consultant: 4.3.1 The actual costs of subconsultants for performance of any of the Services that Consultant agrees to render pursuant to this Agreement, which have been approved in advance by City and awarded in accordance with this Agreement. ENVIROCHECK, INC. Page 2 4.3.2 Approved reproduction charges. 4.3.3 Actual costs and /or other costs and /or payments specifically authorized in advance in writing and incurred by Consultant in the performance of this Agreement. 4.4 Consultant 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 the Schedule of Billing Rates as set forth in Exhibit B. 5. PROJECT MANAGER 5.1 Consultant 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. Consultant has designated Vinh Q Pham to be its Project Manager. Consultant 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 Consultant, 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. Consultant warrants that it will continuously furnish the necessary personnel to complete the Project on a timely basis as contemplated by this Agreement. 5.3 If Consultant is performing inspection or construction management services for City, the Project Manager and any other assigned staff shall be equipped with a cellular phone to communicate with City staff. Consultant's cellular phone number will be provided to City. 6. ADMINISTRATION This Agreement will be administered by the Public Works Deparhnent. Iris Lee, Senior Senior Civil Engineer, or her designee, shall be the Project Administrator and shall have the authority to act for City under this Agreement. The Project Administrator or her authorized representative shall represent City in all matters pertaining to the Services to be rendered pursuant to this Agreement. 7. CITY'S RESPONSIBILITIES 7.1 In order to assist Consultant in the execution of its responsibilities under this Agreement, City agrees to, where applicable: 7.1.1 Provide access to, and upon request of Consultant, 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 Consultant's Work schedule. ENVIROCHECK, INC. Page 3 7.1.2 Provide blueprinting and other Services through City's reproduction company for bid documents. Consultant will be required to coordinate the required bid documents with City's reproduction company. All other reproduction will be the responsibility of Consultant and as defined above. 7.1.3 Provide usable life of facilities criteria and information with regards to new facilities or facilities to be rehabilitated. 8. STANDARD OF CARE 8.1 All of the Services shall be performed by Consultant or under Consultant's supervision. Consultant represents that it possesses the professional and technical personnel required to perform the Services required by this Agreement, and that it will perform all Services in a manner commensurate with community 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. By delivery of completed Work, Consultant certifies that the Work conforms to the requirements of this Agreement and all applicable federal, state and local laws and the professional standard of care. 8.2 Consultant represents and warrants to City that it has, shall obtain, and shall keep in full force in 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 Consultant to practice its profession. Consultant shall maintain a City of Newport Beach business license during the term of this Agreement. 8.3 Consultant shall not be responsible for delay, nor shall Consultant be responsible for damages or be in default or deemed to be in default by reason of strikes, lockouts, accidents, or acts of God, or the failure of City to furnish timely information or to approve or disapprove Consultant's Work promptly, or delay or faulty performance by City, contractors, or governmental agencies. 9. HOLD HARMLESS 9.1 To the fullest extent permitted by law, Consultant 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 Consultant's presence or activities conducted on the Project (including the negligent and /or willful acts, errors and /or omissions of Consultant, its principals, officers, agents, employees, vendors, suppliers, subconsultants, subcontractors, anyone employed directly or indirectly by any of them or for whose acts they may be liable or any or all of them). ENVIROCHECK, INC. Page 4 9.2 Notwithstanding the foregoing, nothing herein shall be construed to require Consultant 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 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. 10. INDEPENDENT CONTRACTOR It is understood that City retains Consultant on an independent contractor basis and Consultant is not an agent or employee of City. The manner and means of conducting the Work are under the control of Consultant, except to the extent they are limited by statute, rule or regulation and the expressed terms of this Agreement. Nothing in this Agreement shall be deemed to constitute approval for Consultant or any of Consultant's employees or agents, to be the agents or employees of City. Consultant shall have the responsibility for and control over the means of performing the Work, provided that Consultant is in compliance with the terms of this Agreement. Anything in this Agreement that may appear to give City the right to direct Consultant as to the details of the performance or to exercise a measure of control over Consultant shall mean only that Consultant shall follow the desires of City with respect to the results of the Services. Consultant 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 Consultant on the Project. Consultant 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 Consultant is responsible for keeping the Project Administrator and /or his /her duly authorized designee 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 14.1 Without limiting Consultant's indemnification of City, and prior to commencement of Work, Consultant 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. ENVIROCHECK, INC. Page 5 14.2 Proof of Insurance. Consultant 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. 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. 14.2.1 Consultant shall procure and maintain for the duration of the Agreement insurance against claims for injuries to persons or damages to property, which may arise from or in connection with the performance of the Work hereunder by Consultant, his agents, representatives, employees or subcontractors. The cost of such insurance shall be included in Consultant's bid. 14.3 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. 14.4 Coverage Requirements. 14.4.1 Workers' Compensation Coverage. Consultant shall maintain Workers' Compensation Insurance (Statutory Limits) and Employer's Liability Insurance (with limits of at least one million dollars ($1,000,000)) for Consultant's employees in accordance with the laws of the State of California, Section 3700 of the Labor Code In addition, Consultant shall require each subconsultant 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. 14.4.1.1 Any notice of cancellation or non - renewal of all Workers' Compensation policies must be received by City at least thirty (30) calendar days (ten (10) calendar days written notice of non - payment of premium) prior to such change. 14.4.1.2 Consultant 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. 14.5 General Liability Coverage. Consultant shall maintain commercial general liability insurance in an amount not less than one million dollars ($1,000,000) per occurrence for bodily injury, personal injury, and property damage, including without limitation, blanket contractual liability. 14.6 Automobile Liability Coverage. Consultant shall maintain automobile insurance covering bodily injury and property damage for all activities of the Consultant 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. ENVIROCHECK, INC. Page 6 14.7 Professional Liability (Errors & Omissions) Coverage. Consultant shall maintain professional liability insurance that covers the Services to be performed in connection with this Agreement, in the minimum amount of one million dollars ($1,000,000) limit per claim and in the aggregate. 14.8 Other Insurance Provisions or Requirements. 14.8.1 The policies are to contain, or be endorsed to contain, the following provisions 14.8.1.1 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 Consultant or others providing insurance evidence in compliance with these requirements to waive their right of recovery prior to a loss. Consultant hereby waives its own right of recovery against City, and shall require similar written express waivers and insurance clauses from each of its subcontractors. 14.8.1.2 Enforcement of Agreement Provisions. Consultant acknowledges and agrees that any actual or alleged failure on the part of the City to inform Consultant of non - compliance with any requirement imposes no additional obligations on the City nor does it waive any rights hereunder. 14.8.1.3 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. 14.8.1.4 Notice of Cancellation. Consultant agrees to oblige its insurance agent or broker and insurers to provide to City with thirty (30) days notice of cancellation (except for nonpayment for which ten (10) days notice is required) or nonrenewal of coverage for each required coverage. 14.9 Timely Notice of Claims. Consultant shall give City prompt and timely notice of claims made or suits instituted that arise out of or result from Consultant's performance under this Agreement. 14.10 Additional Insurance. Consultant 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. 15. 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 Consultant, or of the interest of any general partner or ENVIROCHECK, INC. Page 7 joint venturer or syndicate member or cotenant if Consultant is a partnership or joint - venture or syndicate or cotenancy, which shall result in changing the control of Consultant. 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. 16. SUBCONTRACTING The parties recognize that a substantial inducement to City for entering into this Agreement is the professional reputation, experience and competence of Consultant. Assignments of any or all rights, duties or obligations of the Consultant under this Agreement will be permitted only with the express written consent of City. Consultant shall not subcontract any portion of the Work to be performed under this Agreement without the prior written authorization of City. 17. OWNERSHIP OF DOCUMENTS 17.1 Each and every report, draft, map, record, plan, document and other writing produced (hereinafter "Documents'), prepared or caused to be prepared by Consultant, 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 Consultant or any other party. Consultant shall, at Consultant's expense, provide such Documents to City upon prior written request. 17.2 Documents, including drawings and specifications, prepared by Consultant pursuant to this Agreement are not intended or represented to be suitable for reuse by City or others on any other project. Any use of completed Documents for other projects and any use of incomplete Documents without specific written authorization from Consultant will be at City's sole risk and without liability to Consultant. Further, any and all liability arising out of changes made to Consultant's deliverables under this Agreement by City or persons other than Consultant is waived against Consultant and City assumes full responsibility for such changes unless City has given Consultant prior notice and has received from Consultant written consent for such changes. 18. 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 authorizes in writing the release of information. 19. INTELLECTUAL PROPERTY INDEMNITY The Consultant shall defend and indemnify City, its agents, officers, representatives and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in Consultant's drawings and specifications provided under this Agreement. ENVIROCHECK, INC. Page 8 20. RECORDS Consultant shall keep records and invoices in connection with the Work to be performed under this Agreement. Consultant 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 Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of City to examine, audit and make transcripts or copies of such records and invoices during regular business hours. Consultant 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 Consultant under this Agreement. 21. WITHHOLDINGS City may withhold payment to Consultant 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. Consultant shall not discontinue Work as a result of such withholding. Consultant shall have an immediate right to appeal to the City Manager or his /her designee with respect to such disputed sums. Consultant 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. ERRORS AND OMISSIONS In the event of errors or omissions that are due to the negligence or professional inexperience of Consultant which result in expense to City greater than what would have resulted if there were not errors or omissions in the Work accomplished by Consultant, the additional design, construction and /or restoration expense shall be borne by Consultant. Nothing in this paragraph is intended to limit City's rights under the law or any other sections of this Agreement. 23. CITY'S RIGHT TO EMPLOY OTHER CONSULTANTS City reserves the right to employ other Consultants in connection with the Project 24. CONFLICTS OF INTEREST 24.1 The Consultant 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. 24.2 If subject to the Act, Consultant 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. Consultant shall indemnify and hold harmless ENVIROCHECK, INC. Page 9 City for any and all claims for damages resulting from Consultant's violation of this Section. 25. NOTICES 25.1 All notices, demands, requests or approvals 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. All notices, demands, requests or approvals from Consultant to City shall be addressed to City at: Attn: Iris Lee, P.E. Public Works Department City of Newport Beach 3300 Newport Boulevard PO Box 1768 Newport Beach, CA 92658 Phone: (949) 644 -3323 Fax: (949) 644 -3318 25.2 All notices, demands, requests or approvals from CITY to Consultant shall be addressed to Consultant at: Attention: Vinh Q. Pham ENVIROCHECK, INC., 2211 W. Orangewood Avenue Orange, CA 92868 Phone: (714) 937 -0750 Fax: (714) 937 -0755 26. CLAIMS The Consultant and the City expressly agree that in addition to any claims filing requirements set forth in the Agreement, the Consultant shall be required to file any claim the Consultant may have against the City in strict conformance with the Tort Claims Act (Government Code sections 900 et seq.). 27. TERMINATION 27.1 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 ENVIROCHECK, INC. Page 10 party may terminate the Agreement forthwith by giving to the defaulting party written notice thereof. 27.2 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 Consultant. In the event of termination under this Section, City shall pay Consultant for Services satisfactorily performed and costs incurred up to the effective date of termination for which Consultant has not been previously paid. On the effective date of termination, Consultant 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. 28. STANDARD PROVISIONS 28.1 Compliance With all Laws. Consultant 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 Consultant 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. 28.2 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. 28.3 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 agreement or implied covenant shall be held to vary the provisions herein. 28.4 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. 28.5 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. 28.6 Amendments. This Agreement may be modified or amended only by a written document executed by both Consultant and City and approved as to form by the City Attorney. 28.7 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. ENVIROCHECK, INC. Page 11 28.8 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. 28.9 Equal Opportunity Employment. Consultant 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. 28.10 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. 28.11 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 and the same instrument. [SIGNATURES NEXT PAGE] ENVIROCHECK, INC. 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 By: Aaron` . Harp City Attorney ATTEST: Date: 5'l0' IZ BY: dVllcx(MI - e, Leilani I. Brown City Clerk Attachments: CITY OF NEWPORT BEACH, A Californi m icipal corporation Date: Stepheri um is Works Director CONSULTANT: ENVIROCHECK, INC.,, a California Comoration By: I John A. Meado President/CEO Vice President of Operations [END OF SIGNATURES] Exhibit A — Scope of Services Exhibit B — Schedule of Billing Rates ENVIROCHECK, INC. Page 13 EXHIBIT A SCOPE OF WORK SCOPE OF SERVICES The scope of work for this project is to conduct full asbestos and lead based paint surveys for all 64 units within the Marina Park Mobile Home Park The asbestos survey will consist of a visual walls through and assessment of each structure and all accessible and suspect building materials will be sampled for asbestos content. A condition assessment and the estimated quantities (e.g. approximate square footage) of materials determined to be asbestos containing will also be provided. Samples will be taken in accordance with AHERA protocol. Polarized Light Microscopy (PLM) analytical laboratory procedures will be utilized to determine the type and amount of asbestos in each sample. The final written survey report will include a sketch of each structure that was surveyed with the locations of where each sample was collected marked onto the sketch. All samples will be submitted with a properly executed chain of custody. The lead based paint survey will consist of a visual walk through and condition assessment of the structures) /substrate(s), and all suspect components /substrates will be sampled for lead content. Samples will be taken in accordance with HUD protocol using state of the art (Niton) XRF portable technology. A State of California Department of Health Services, Certified Lead Inspector /Assessor, will conduct the survey(s). The final written survey report will include a sketch of each structure that was surveyed with the locations of positive samples marked onto the sketch. In addition to the services described above, ENVIROCHECK, INC. will provide administrative and consulting services that shall include: 1. Obtain and review all applicable site information and documents related to this project. 2. Attend two (2) project coordination meetings. 3. Coordinate with City to schedule inspection dates and times for the subject units. 2211 West Orangewood Avenue o Orange, CA 92868 0 Telephone: (800)665 -7586 0 Fax; (714) 937 -0755 4. Assist the City in the filing the SCAQMD Rule 1403 Notification forms associated with any abatement. 2211 West Orangewood Avenue o Orange, CA 92868 o Telephone: (800)665 -7586 0 Fax: (714) 937 -0755 EXHIBIT B Asbestos o Lead o Microbiology o Industrial Hygiene o Consulting 0 Laboratory 0 Project Management , March 6, 2012 Project Fee for Marina Park Mobile Home Park = $12,800.00 Total Cost includes: • Full asbestos and lead based paint surveys for all 64 units • Attendance of two project coordination meetings • Consulting and administrative services Fee Schedule for 2012: Consulting: • Hourly Rate ............. ............................... ........................$150.00 per hour • Preparation of Procedure 5 Abatement Plan ........................ $595.00 Asbestos: a PLM Bulk Asbestos Analysis ..................... .........................$25.00 per sample a 1000 Point Count Analysis ................ ............................... $75.00 per sample a TEM Bulk Sample Analysis ............... ............................... $200.00 per sample a TEM Dust Micro - vacuum. Samples ................ ........................$200.00 per sample a TEM AHERA Air Samples ........................ ........................$150.00 per sample a PCM Air Sampling ............................ ............................... $495.00 (includes 4 sa I ples) Lead: o Lead Paint Chip Analysis (AAS) ............ ............................... $25.00 per sample a Lead Wipe or Air Samples .................. ............................... $25.00 per sample a Lead Clearance Inspection and Report .. ............................... $500.00 Lead Waste Profiling: • TTLC (Total Threshold Limit Concentration) .......................... $25.00 per sample . • STLC (Soluble Threshold Limit Concentration) ...................... $95.00 per sample • TCLP (Toxicity Characteristic Leaching Procedure) ................ $95.00 per sample 2211 TVest Orangewood Avenue o Orange, CA 92868 0 Telephone: (800)665 -7586 o Fax: (714) 937 -0755 �.®" CERTIFICATE OF LIABILITY INSURANCE pATE 17120/TY oaz7noiz THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such enciorsement(s). PRCOVCER Plmre: 877 - 5871999 Fe•. 1877)373'5508 BACCARELLA INSURANCE SERVICES, INC.'ED 6864 INDIANA AVE. 9 201 RIVERSIDE CA 92506 caned Elizabeth Vanden Akker 077 -587 -0999 ,m. (877) 373-5608 FAN° clizabeth @bacins.com AmREC; INSURERS) AFFORDING COVERAGE NAIL f Agam, ULS. W71933 NEURERA - Endurance American Specialty 41718 INSURED ENVIROCHECK, INC. NsvR=_R0 Century National Insurance Co. NsuRERC Endurance American Specialty 41718 2211 WEST ORANGEWOOD AVE. BLDG 11 ORANGE CA 92868 -1905 INSURER n: State Compensation Insurance Fund L'1URERE $ 50,000 INSURER, COVERAGES CERTIFICATE NUMBER: 73182 REVISION NUMBER: THIS IS TOCERTIFY THATTHE POLICIES OFINSURANCE LISTED BELOWHAVE BEENISSUED TOTHEINSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT. TYPE OF INSU UINCE W POLICY NUMBER nvwrrMm Y P r LIMITS A GENERAL NUVEILm ECC10100207303 07/28111 07/28112 EACH OCCURRENCE $ 1,000,000 • COMMERCw1 GENERAL LIABILITY PR ETO REN E4 E T Ea ODUrerce $ 50,000 CLAIMS -MADE OX OCCUR MED.ERP(Anyalepetsan) $ 5,000 • PROF&POLL COVERAGE PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY JER LOC $ B AWOMO9RE LU1BRnY BAP0175260 03/03/12 03/03/13 °E°t�N.�°EjNeLE I°nT 5 1,000,000 BODILYINJURYiPer Person) Is X ANY ALTO ALL OW ED SCHEDULED AUTOS S HIRED AUTOS 0urros Vm5 EODILY INJURY (Pet eccide .) E I cRrvnunAeE f aLCNM g C NMRRELU uAe X OCCUR EXS10101196900 07128111 07/28/12 EACH OCCURRENCE E 2,000,000 ExcESS LIAR X I CLAIMSP.IADE AGGREGATE $ 2,000,000 IDED I X REFENT10N5 10,000 $ D WORXER$ COMPENSATON AND EMPLOYERS' LIABILITY ANY PROPMETOWPARTNEVEXECUOVE YIN OFFICER/MENSER EXCLUDED? NXI (RI,. NIA 54100023211 05/01/11 05/01/12 X aRr LIMN$ Ea $ E.L. EACH ACCIDENT $ 1,000,000 E L. DISEASE.EAEMPLOYEE E 1,000,000 E.L. DISEASE- POLICYLI.NIT $ 1,000,000 %Ova. u yea. aserMe wUr DE$CPPTIDN OF OPER+.TU15 MJw DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, AddlHoml Remar85 Schedule, if mare spec¢ is r.q.l,.d) *10 DAY NOTICE FOR NON PAYMENT OR NON REPORTING OF PAYROLL* Re: Marina Parks Project -- Balboa Peninsula. City of Newport Beach, Its officers, officials, employees and volunteers are hereby named as Additional Insured per the form FEI- 319 -ECC (07 -08) attached. Insurance Is primary and non - contributory per the form FEI - 548 -ECC (07 -08) attached. Waiver of Subrogation per the form FEI- 320 -ECC (07 -08) attached. Completed Operations is included per the form CG2037 (07 -04) attached. PROF & POLL COVERAGE 2000000 CERTIFICATE HOLDER CANCELLATION CITY OF NEWPORT BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3300 NEWPORT BLVD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NEWPORT BEACH, CA 92658 ACCORDANCE WITH THE POLICY PROVISIONS. A ORLZED REPRE$ENIATNE Attention: k (/Ayn.e •/ lit 6a/ Elizabeth Vanden Akker :ORD 25 (2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Endurance Envirocheck, Inc. Endorsement Number: 5 Automatic Additional Insured — Owners, Lessees or Contractors 'I'his endorsement, efrective 7M /201 1 attaches to and forms apart of Policy Number ECC 101002073 -03. This endorsement changes the Policy. Please read it carefully. FEI- 319 -ECC -0708 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Nnmed Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract. The person or organization shown in this Schedule is included as an insured, but only with respect to that person's or organization's vicarious liability arising out of your ongoing operations performed for that insured. Envirocheck, Inc. Endurance Endorsement Number: 12 Automatic Primary and Non- Contributory Insurance Endorsement Designated Work Or Project(s) This endorsement: effective 7 -28. 11 attaches to and forms a part of Policy Number ECC101002073.0This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and /or Non - contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of an additional premium of $Apl2lic d and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non - contributory to this insurance. FEI- 548 -ECC -0708 Envirocheck, Inc. Endurance Endorsement Number: 6 Automatic Waiver of Subrogation Endorsement This endorsement, effective 7 -25- 11 attaches to and forms a part of Policy Number ECC 101002073 -03rhts endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person(s) or organization(s) to whom the Named insured agrees, in a written contract, to provide a waiver of subrogation. However, this staaas exists only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the insureds work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. FEI- 320 -ECC -0708 I Endurance Envirocheck, Inc. Endorsement Number: Additional Insured — Owners, Lessees or Contractors — Completed Operations This endorsement, effective 7 -28 -1 launches to and forms a part of Policy Number EM01002073- 037his endorsement changes the Policy. Please read it carefitlly. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed O erations Any Person(s) or organization(s) whom the Named Insured agrees, in a Those project locations where this additional written contract, to name as an additional insured. However, this status Insured coverage is required by contract exists only for the project specified in that contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section It — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 © ISO Properties, Inc., 2004 ACCPR® " CERTIFICATE OF LIABILITY INSURANCE lk..� yY., DATF Im3,20, 2 0 3/1 312 01 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this cerilficate does not confer rights to the certificate holder In lieu of such endorsements). _:.tE4 r.,,.,. ?- ... =_arer3 ? IP "TI >.?rcr.> BACCARELLA INSURANCE SERVICES, INC. 6864 INDIANA AVE. ft 201 RIVERSIDE CA 92506 :� • °'i Elizabeth Vanden Akker Tgr tq:y_�- 877 - 587 -4999 _ rry: ,n; (877) 373 -5608 ° "`' ellzabeth @bacins.com Sc!F cj. _....__. INSURER(S) AFFORDING COVERAGE NAIL f I �]JY -ra Xi:.t.= I I L.m.. _.• ,.. -.- Endurance American Specialty 41718 ENVIROCHECK, INC. • >`ECe Century National Insurance Co. i r' _o sJ. i - Endurance American Specialty 41718 2211 WEST ORANGEWOOD AVE. BLDG 11 ORANGE CA 92868 -1905 1 —Xc2z State Compensation Insurance Fund I X' +.REFr AMCO Insurance Company 19100 2:000:000 1 03103113 RCMee.E_3�_"e 4w1 -Ea; COVERAGES CERTIFICATE NUMBER: 72372 REVISION NUMBER: THIS IS TOCERTIFY THATTHE POLICIES OFINSURANCE LISTED BELOWHAVE BEENISSUED TOTHEINSURED NAMED ABOVE FOR. THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'I "F I TYPE OF INSURANCE . =00: SaFP POOGY EFF .._.._,. 'a4 __ _ nebF I .L _POLICY NUMBER M q ;yyyy A ICENERAL MENUTY I ECC10100207303 I 07128/11 PoucY 6 %P I LIMITS I IMM/OOIYTTYI _____ 07/28/12 IEA'11'CCc CA=K9 1,000,000 X v.:_S..CIL •;E•`+ _1 <_;!nr ; I , _ OAAU4F:_6 ?r::EJ i RENASFS IF e -. •5 _ ..50.000 I �]JY -ra Xi:.t.= I I I InE: EMI rur':! 5,000 I .;. -.. _:.0 -E I i r' _o sJ. i 1.000.000 i IGEtc =F AL : -b34E A•'E P 2,000,000 I X' 2:000:000 B IAVfOlA091IF Lueanr j 8AP0175260 � 03103112 03103113 RCMee.E_3�_"e 4w1 -Ea; 1,000,000 i I i cr I: LL -_.. :.ir.l c'.c_ ^1 iP'. `;'.E 'Yp:AV.. •_ :5..____.___ I I _I ,t -C1 X.'UMOREL'? LLLB x .. -�'y` - -� Exs10101196900 onzaill 0712112 z,goo,gog ! EXCESS LIAB X 2,000,000 �OEC I% �:ETEn'i p %1 i 10,000 D WORKER COMPFN 54100023211 05/01!11 1{ 05/01112 ' I r " P•? u s EG L� ULABU AND EMPLOYEF6' LNBIIITT YIR I I I —J— "r. -• ANY PROPRIET00.PARTNERTXECUTVE .— _ I E_ c A. __E.t: • P 1 000,000 OFFICERMEMBEF EXCLUDED? I__,N A ic = ESiE- :�F_e_L•TYEE l i 1,000,000 ,IManaalorym NNl I �•1, 11411; I`- ..SEaSe.c _. _'rn•T F 1:000,000 I ACPCPAA7814799373 11/01111 11/01/12 Deductible $1,000 -- �• ACPCPAA7814799373 11/01111 11/01112 ,$45,500 ;$20,000 Deductible $1,000 VEHICLES JA___� DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES lAlli«I ACORD 101, AGaitional RemarFa SchvGWe, If IN.,. A,.C. IX raculraGl '10 DAY NOTICE FOR NON PAYMENT OR NON REPORTING OF PAYROLL' RE: ^ VERIFICATION FOR INSURANCE PURPOSES ONLY " PROF & POLL COVERAGE 2000000 CERTIFICATE HOLDER CANCELLATION INSURED'S COPY ! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ENVIROCHECK, INC. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2211 WEST ORANGEWOOD AVE. BLDG 11 ACCORDANCE WITH THE POLICY PROVISIONS. ORANGE CA 92868.1905 . -_'E '- -- �'2— d— I-�.- RI —•-7�, —Lf� Attention: �' / ° �-sirc✓ L[KU7ai✓ Elizabeth Vanden Akker I ntl NL_vnu damn Gnu ..qu aln ..U."A luu mm n] ul MI-uw POLICYHOLDER COPY SK P.O. 80X 420807, SAN FRANCISCO,CA 94142 -0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 04 -16 -2012 CITY OF NEWPORT BEACH PUBLIC WORKS DEPT 3300 NEWPORT BLVD NEWPORT BEACH CA 92663 -3816 GROUP: 000541 POLICY NUMBER: 0000232 -2011 CERTIFICATE 10: 125 CERTIFICATE EXPIRES:05 -01 -2012 05 -01- 2011/05 -01 -2012 SK JOB:MARINA PARK PROJECT NEWPORT BEACH CA 92660 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period that will expire or did expire as indicated above. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE ENDORSEMENT #1600 - JOHN A MEADOR P,S T - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 02 -01 -2006 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2012 -04 -16 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF NEWPORT BEACH EMPLOYER ENVIROCHECK INC 2211 W ORANGEWOOD AVE ORANGE CA 92868 SK (B10,SKI tReV.6 -2010) PRINTED : 04 -16 -2012 CERTIFICATE OF INSURANCE CHECKLIST C 4 of Newport Beach This checklist is comprised of requirements as outlined by the City of Newport Beach. * Date Received: 4 -25 -12 Dept. /Contact Received From: Date Completed: 4 -30 -12 Sent to: Tania By: Company /Person required to have certificate: Envirocheck, Inc. Type of contract: All Other GENERAL LIABILITY EFFECTIVE /EXPIRATION DATE: 7- 28- 11/7 -28 -12 Tania A. INSURANCE COMPANY: Endurance American Specialty EFFECTIVE /EXPIRATION DATE: 3 -03- 12/3 -03 -13 B. AM BEST RATING (A-: VII or greater): A: XV INSURANCE COMPANY: Century National Insurance Co. C. ADMITTED Company (Must be California Admitted): AM BEST RATING (A-: VII or greater) A -: IX Is Company admitted in California? ❑ Yes ®No D. LIMITS (Must be $1M 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 UM, $2M min for Waste Haulers): What is limits provided? 1,000,000 CSL include): Is it included? (completed Operations status does LIMITS Waiver of Auto Insurance / Proof of coverage (if individual) not apply to Waste Haulers or Recreation) ® Yes ❑ No G. ADDITIONAL INSURED FOR PRODUCTS AND PRIMARY & NON - CONTRIBUTORY WORDING (For Waste COMPLETED OPERATIONS ENDORSEMENT (completed Haulers only): ® N/A ❑ Yes ❑ No Operations status does not apply to Waste Haulers) ® Yes ❑ No H. ADDITIONAL INSURED WORDING TO INCLUDE (The City NOTICE OF CANCELLATION: ❑ N/A 0 Yes ❑ No its officers, officials, employees and volunteers): Is it included? ® Yes ❑ No I. PRIMARY & NON - CONTRIBUTORY WORDING (Must be 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 II. AUTOMOBILE LIABILITY EFFECTIVE /EXPIRATION DATE: 3 -03- 12/3 -03 -13 A. INSURANCE COMPANY: Century National Insurance Co. B. AM BEST RATING (A-: VII or greater) A -: IX C. ADMITTED COMPANY (Must be California Admitted): Is Company admitted in California? ® Yes ❑ No D. LIMITS - If Employees (Must be $1M min. BI & PD and $500,000 UM, $2M min for Waste Haulers): What is limits provided? 1,000,000 CSL E LIMITS Waiver of Auto Insurance / Proof of coverage (if 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 0 Yes ❑ No 111. WORKERS' COMPENSATION EFFECTIVE /EXPIRATION DATE 5 -01- 11/5 -01 -12 A. INSURANCE COMPANY: State Fund B. AM BEST RATING (A-: VII or greater): Not Rated C. ADMITTED Company (Must be California Admitted): ® Yes ❑ No D. WORKERS' COMPENSATION LIMIT: Statutory ® Yes ❑ No E. EMPLOYERS' LIABILITY LIMIT (Must be $1M or greater) 1,000,000 F. WAIVER OF SUBROGATION (To include): Is it included? ® Yes ❑ No G. SIGNED WORKERS' COMPENSATION EXEMPTION FORM: ® N/A ❑ Yes ❑ No H. NOTICE OF CANCELLATION: ❑ N/A ® Yes ❑ No 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? Needs Risk Management approval for non - admitted GL carder. Approved: Agent of Alliant Insurance Services Broker of record for the City of Newport Beach Date ® 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 $ 1 ❑ N/A ® Yes ❑ No Reason for Risk Management approval /exception /waiver: Approved: �4 r 6 4AAL Risk,Manegement " Subject to the terms of the contract. lf�l �- Date