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HomeMy WebLinkAboutResolution 2016-082 N.C.S. 06/06/2016Resolution No. 2016 -082 N.C.S. of the City of Petaluma, California RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT FOR CONSTRUCTION INSPECTION SERVICES FOR THE PETALUMA BOULEVARD NORTH WATER MAIN REPLACEMENT PROJECT — LAKEVILLE STREET TO B STREET WHEREAS, the City of Petaluma is constructing the Petaluma Boulevard North Water Main Replacement — Lakeville Street to B Street, Project Number C67501304, ( "the Project "); and WHEREAS, this project requires full night time construction inspection services by a qualified consultant for the duration of the project; and WHEREAS, City staff circulated a request for proposals to four firms for construction inspection services and two proposals were received; and WHEREAS, the proposals were received and evaluated and Coastland Civil Engineering, Inc. of Santa Rosa was selected as the consultant for the project; and WHEREAS, Coastland Civil Engineering, Inc.'s ability to inspect construction projects has been demonstrated in other local municipalities; and WHEREAS, staff recommends the City execute a professional services agreement with Coastland Civil Engineering, Inc. for construction inspection services in order to complete construction for the Petaluma Boulevard North Water Main Replacement Project. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Petaluma hereby authorizes the City Manager to execute the attached Professional Services Agreement for construction inspection services with Coastland Civil Engineering, Inc. in the amount not to exceed $227,600.00. REFERENCE AYES: NOES: ABSENT: ABSTAIN: ATTEST: Under the power and authority conferred upon this Council by the Charter of said City. I hereby certify the foregoing Resolution was introduced and adopted by the Appro gd as to Council of the City of Petaluma at a Regular meeting on the 61h day of June, 2016," y`mr by the following vote: City Aorney Albertson, Barrett, Mayor Glass, Healy, Kearney, Vice Mayor King, Miller None None Resolution No. 2016 -082 N.C.S. Page 1 PROFESSIONAL SERVICES AGREEMENT Construction Inspection Services for the Petaluma Boulevard North Water Main Replacement Project (Title of Project) FY 16/17 Fund # Cost Center Object Code 30700 Project # C67501304 Amount $227,600 For multi -year contracts or contracts with multiple accounts: FY Fund # Cost Center Object Code Project # Amount $ FY Fund # Cost Center Object Code Project # Amount $ FY Fund # Cost Center Object Code Project # Amount $ FY Fund # Cost Center Object Code Project # Amount $ FY Fund # Cost Center Object Code Project # Amount $ THIS PROFESSIONAL SERVICES AGREEMENT ( "Agreement ") is entered into and effective as of , 20 ( "Effective Date "), by and between the City of Petaluma, a city use on y) municipal corporation and a charter city ( "City ") and Coastland Civil Engineering, Inc., a California Corporation) ( "Consultant ") (collectively, the "Parties "). WHEREAS, the Parties enter into this Agreement for the purpose of Consultant providing professional services to City under the terms and conditions set forth herein. THEREFORE, in consideration of the mutual covenants contained in this Agreement, the Parties agree as follows: 1. Services. Consultant shall provide the services as described in and in accordance with the schedule set forth in Exhibit "A" attached hereto and incorporated herein ( "Services "). 2. Compensation; Business Tax Certificate. A. For the full performance of the Services as described herein, City shall compensate Consultant in accordance with the rates specified in Exhibit A. B. Consultant shall submit detailed monthly invoices reflecting all services performed during the preceding month, and including a revised schedule for performance and additional documentation requested by City, as applicable. C. Consultant shall be compensated for services in addition to those described in Exhibit A, only if Consultant and City execute a written amendment to this Agreement describing the additional services to be performed and the compensation to be paid for such services. In no case shall the total compensation under this Agreement exceed $227,600 (Two Hundred Twenty -seven Thousand Six Hundred Dollars) without prior written authorization of the City Manager. Further, no compensation for a section or work program component attached with a specific budget shall be exceeded without prior written authorization of the City Manager. Resolution No. 2016 -082 N.C.S. Page 2 D. Notwithstanding any provision herein, Consultant shall not be paid any compensation until such time as Consultant has on file with the City Finance Department a current W -9 form available from the IRS website (www.irs.goy} and has obtained a currently valid Petaluma business tax certificate. E. City's obligation to pay compensation to Consultant as provided herein is contingent upon Consultant's performance of the Services pursuant to the terms and conditions of this Agreement and any amendments thereto. 3. Term. The term of this Agreement commences on the Effective Date, and terminates on June 30. 2017, unless sooner terminated in accordance with Section 4. Upon termination, any and all of City's documents or materials provided to Consultant and any and all of the documents or materials prepared for City or relating to the performance of the Services, shall be delivered to the City as soon as possible, but not later than fourteen (14) days after termination of the Agreement. 4. Termination. City may terminate this Agreement without cause upon ten (10) days' written notice. City may immediately terminate or suspend this Agreement for cause. Cause for immediate termination or suspension shall include, but not be limited to, any breach of this Agreement by Consultant or Consultant's bankruptcy or insolvency. Upon receipt of notice of termination or suspension for cause, Consultant shall immediately stop all work in progress under this Agreement. In the event of early termination of this Agreement by City, Consultant shall be entitled to payment for all Services performed to the date of termination to the extent such Services were performed to the satisfaction of City in accordance with the terms and conditions of this Agreement. if City terminates this Agreement for cause, Consultant shall be liable to City for any excess cost City incurs far completion of the Services, 5. Consultant's Representation; Independent Contractor. Consultant represents that Consultant possesses distinct professional skills in performing the Services. City has relied upon said representation as a material inducement to enter into this Agreement. Consultant shall, therefore, provide properly skilled professional and technical personnel to perform all Services under this Agreement, It is expressly understood that Consultant and its agents and employees, shall act in an independent capacity and as an independent contractor and not as officers, employees or agents of City. This Agreement shall not be construed as an agreement for employment. b. Facilities and Equipment. Consultant shall, at its sole cost and expense, furnish all facilities and equipment that may be required for furnishing Services pursuant to this Agreement. City shall furnish to Consultant no facilities or equipment, unless the City otherwise agrees in writing to provide the same. 7. Licenses, Permits, Etc. Consultant shall, at Consultant's sole cost and expense, keep in effect at all times during the term of this Agreement any licenses, permits or other such approvals which are legally required for performing the Services. Resolution No. 2016 -082 N.C.S. Page 3 8. Time. Consultant shall devote such time to the performance of the Services as may be reasonably necessary for satisfactory performance of Consultant's obligations pursuant to this Agreement. 9. Inspection. Consultant shall provide the City every reasonable opportunity to ascertain that the Services are being performed in accordance with the requirements and intentions of this Agreement. All work done and materials Fumished, if any, shall be subject to inspection and approval by the City. The inspection of such work shall not relieve Consultant of any of its obligations pursuant to this Agreement. 10. Progress Reports. Upon the City's request, Consultant shall provide, in a form acceptable to City, written progress reports of all oral and written observations, opinions, recommendations, analyses, progress and conclusions related to Consultant's performance of the Services. 11. Confidentiality. In the course of Consultant's employment, Consultant may have access to trade secrets and confidential information, disclosure of which is protected or limited by law. Consultant shall not directly or indirectly disclose or use any such confidential information, except as required for the performance of the Services. 12. Conflict of Interest. Consultant represents that it presently has no interest, and covenants that it shall not acquire any interest, direct or indirect, financial or otherwise, which would conflict in any manner or degree with the performance of the Services hereunder. Consultant further covenants that, in the performance of this Agreement, it shall not employ any subcontractor or person having such a conflict of interest. Consultant represents that no one who has or will have any financial interest under the Agreement is an officer or employee of City. If such conflict of interest arises during this Agreement or any extension, Consultant will immediately advise City and City may, at its sole discretion, immediately terminate this Agreement. Certain Consultants are subject to the requirements, including the disclosure and reporting requirements, of the City's Conflict of Interest Code adopted pursuant to the Political Reform Act. Such Consultants subject to the City's Conflict of Interest Code include those whose work may involve: making government decisions regarding approval or adoption of rates, rules, or regulations, action on permits or other applications, authorization to enter into or modify contracts, or approval of plans, designs, reports, or studies. Consultant agrees to comply fully with all such requirements to the extent they apply to Consultant's performance of the Services. 13. Consultant No Agent. Except as City may specify in writing, Consultant shall have no authority, express or implied, to act on behalf of City in any capacity whatsoever as an agent. Consultant shall have no authority, express or implied, pursuant to this Agreement to bind City to any obligation whatsoever. 14. Standard: of Performance. Consultant shall perform all the Services in a manner consistent with the standards of Consultant's profession. All instruments of service of whatsoever nature, which Consultant delivers to City pursuant to this Agreement, shall be prepared in a substantial, workmanlike manner and conform to the standards of Resolution No. 2016 -082 N.C.S. Page 4 Consultant's profession. All such instruments of service shall become the sole and exclusive property of City upon delivery of the same. 15. Assign men t/Tra nsfer. No assignment or transfer in whole or in part of this Agreement shall be made without the prior written consent of City. 16. Subcontractors. Consultant shall directly perform all Services, and shall not subcontract any portion of performance of the Services without the prior written consent of City. Any such subcontractors shall be required to comply, to the full extent applicable, with the terms and conditions of this Agreement, including but not limited to, procuring and maintaining insurance coverage as required herein and which shall name City as an additional insured. 17. Compliance With All Laws. Consultant shall fully comply with all applicable local, state and federal rules, laws, regulations and ordinances pertaining to the performance of the Services required hereunder, including but not limited to, the California Building Standards Code as in effect in the City, the Americans with Disabilities Act, and any laws and regulations related to any copyright, patent, trademark or other intellectual property right involved in performance of the Services, Consultant's failure to comply with any law(s) or regulation(s) applicable to the performance of the Services hereunder shall constitute a material breach of this Agreement. To the extent that any other government agency or entity provides compensation for any Services, Consultant shall comply with all rules and regulations applicable to such fiscal assistance. 18. Prevailing Wages. This Agreement is subject to the requirements of the California Prevailing Wage Law, California Labor Code Section 1720 et seq., and the Services as described in Exhibit A will be performed in accordance with all applicable requirements of the California Prevailing Wage Law, including, but not limited to, all applicable requirements contained in Exhibit C, which is attached to and made a part of this Agreement. 19. Living Wage Ordinance. Without limiting the foregoing Section 17, Consultant shall comply fully with all applicable requirements of Petaluma Municipal Code, Chapter 8.36, Living Wage (the "Living Wage Ordinance "), as the same may be amended from time to time. Upon the City's request Consultant shall promptly provide to the City documents and information verifying Consultant's compliance with the requirements of the Living Wage Ordinance, and shall within fifteen (1 S) calendar days of the Effective Date of this Agreement, notify each of its affected employees as to the amount of wages and time off that are required to be provided to them pursuant to the Living Wage Ordinance. The Acknowledgement and Certification Pursuant to City of Petaluma Living Wage Ordinance, attached to this Agreement at Exhibit D, shall be a part of this Agreement for all purposes, and Consultants that are subject to Living Wage Ordinance requirements, as determined by the City, must provide a properly completed Exhibit 1) in accordance with the requirements of the Living Wage Ordinance. Consultant's noncompliance with the applicable requirements of the Living Wage Ordinance shall constitute cause for City's termination of this Agreement pursuant to Section 4 hereof. Resolution No, 2016 -082 N.C.S. Page 5 20. Discrimination. During the performance of this Agreement, Consultant shall not discriminate against any employee or applicant for employment because of race, religion, creed, color, national origin, ancestry, gender, sexual orientation, age or physical or mental disability in violation of any applicable law. 21. Notice. Except as otherwise specified in this Agreement, all notices to be sent pursuant to this Agreement shall be made in writing, and sent to the Parties at their respective addresses specified below or to such other address as a Party may designate by written notice delivered to the other Party in accordance with this Section. All such notices shall be sent by: (i) personal delivery, in which case notice is effective upon delivery; (ii) certified or registered mail, return receipt requested, in which case notice shall be deemed delivered on receipt if delivery is confirmed by a return receipt; (iii) nationally recognized overnight courier, with charges prepaid or charged to the sender's account, in which case notice is effective on delivery if delivery is confirmed by the delivery service; or (iv) facsimile transmission, in which case notice shall be deemed delivered upon transmittal, provided that (a) a duplicate copy of the notice is promptly delivered by first -class or certified mail or by overnight delivery, or (b) a transmission report is generated reflecting the accurate transmission thereof. Any notice given by facsimile shall be considered to have been received on the next business day if it is received after 5 :00 p.m. recipient's time or on a nonbusiness day. City: City Clerk City of Petaluma Post Office Box 61 Petaluma, California 94953 Phone: (707) 778 -4360 Fax: (707) 778 -4554 Email: cityclerk @ci.petaluma.ca.us And: Dan St. John, Director Deuartment of Public Works & Utilities 202 North McDowell Boulevard Petaluma CA 94954 Phone: (707) 778 -4546 Fax: (707) 778 -4508 Email: dst'ohn ci. etaluma.ca.us Consultant: John Wanner Coastland Civil Engineering, Inc. 1400 Neotomas Avenue Santa Rosa. CA. 95405 Phone: (707) 571 -8005 Resolution No. 2016 -082 N.C,S, Page 6 Fax: (707) 571 -8037 Email: wangeracoastlandeivil.com 22. Ownership of Documents. All original papers, documents or computer material on disk or microfilm, and copies thereof, produced as a result of this Agreement, shall be the property of City and may not be used by Consultant without the written consent of City. Copies of such documents or papers shall not be disclosed to others without the written consent of the City Manager or his or her designated representative. 23, Indemnification. To the maximum extent permitted by law, Consultant shall, at its own expense, indemnify, defend with counsel acceptable to the City, (which acceptance will not be unreasonably withheld), and hold harmless City and its officers, officials, employees, agents and volunteers ( "Indemnitees ") from and against any and all alleged liability, loss, damage, claims, suits, actions, arbitration proceedings, administrative proceedings, regulatory proceedings, civil penalties and fines, expenses and costs (including, without limitation, claims expenses, attorney's fees and costs and fees of litigation) (collectively, "Liability") of every nature, whether actual, alleged or threatened, arising out of or in connection with the Services or Consultant's failure to comply with any of the terms of this Agreement, regardless of any fault or alleged fault of the Indemnitees. The Consultant's obligation to indemnify, defend and hold harmless under this provision shall not be excused because of the Consultant's inability to evaluate Liability, or because the Consultant evaluates Liability and determines that the Consultant is not or may not be liable. The Consultant must respond within 30 calendar days to any tender for defense and indemnity by the City, unless the time for responding has been extended by an authorized representative of the City in writing, If the Consultant fails to accept tender of defense and indemnity within 30 calendar days, in addition to any other remedies authorized by law, so much of the money due or that may become due the Consultant under this Agreement as shall reasonably be considered necessary by the City, may be retained by the City until disposition has been made of the matter subject to tender, or until the Consultant accepts the tender, whichever occurs first. In the event that the City must file responsive documents in a matter tendered to Consultant prior to Consultant's acceptance of tender, Consultant agrees to fully reimburse all costs, including but not limited to attorney's fees and costs and fees of litigation, incurred by the City in filing such responsive documents. The Consultant waives any and all rights to express or implied indemnity against the Indemnitees concerning any Liability of the Consultant arising out of or in connection with the Services or Consultant's failure to comply with any of the terms of this Agreement. The Consultant's responsibility of such defense and indemnity obligations shall survive the termination or completion of this Agreement for the full period of time allowed by law. The defense and indemnification obligations of this Agreement are undertaken to, and shall not in any way be limited by, the insurance obligations contained in this Agreement. Resolution No. 2016 -082 N.C.S. Page 7 Notwithstanding the foregoing, to the extent this Agreement is a "construction contract" as defined by California Civil Code Section 2783, as may be amended from time to time, Consultant's duty to indemnify under this provision shall not apply when to do so would be prohibited by California Civil Code Section 2782, as may be amended from time to time. Notwithstanding the foregoing, to the extent that the Services include design professional services subject to California Civil Code Section 2782,8, as may be amended from time to time, Consultant's duty to indemnify shall only be to the maximum extent permitted by California Civil Code Section 2782.8. 24, Insurance. Consultant shall comply with the "Insurance Requirements for Consultants" in Exhibit B -2 attached hereto and incorporated herein by reference. [Indicate attached exhibit, e.g., "B -1, " "B -2, " ' +B -3, "or "B-4. „j 25. Amendment. This Agreement may be amended only by a written instrument executed by both Parties. 26. Litigation. if litigation ensues which pertains to the subject matter of Consultant's services hereunder, Consultant, upon request from City, agrees to testify therein at a reasonable and customary fee. 27. Construction, This Agreement is the product of negotiation and compromise on the part of both Parties and that the Parties agree that, notwithstanding Civil Code section 1654, any uncertainty in the Agreement shall not be construed against the drafter of the Agreement. 28. Governing Law; Venue. This Agreement shall be enforced and interpreted under the laws of the State of California and the City of Petaluma. Any action arising from or brought in connection with this Agreement shall be venued in a court of competent jurisdiction in the County of Sonoma, State of California. 29. Non - Waiver. The City's failure to enforce any provision of this Agreement or the waiver thereof in a particular instance shall not be construed as a general waiver of any part of such provision. The provision shall remain in full force and effect, 30. 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, 31, No Third Party Beneficiaries. The Parties do not intend to create, and nothing in this Agreement shall be construed to create any benefit or right in any third party. 32. Mediation. The Parties agree to make a good faith attempt to resolve any dispute arising out of this Agreement through mediation prior to commencing litigation. The Parties shall mutually agree upon the mediator and shall divide the costs of mediation equally. Resolution No. 2016 -082 N.C.S. Page 8 33. Consultant's Books and Records. A. Consultant shall maintain any and all ledgers, books of accounts, invoices, vouchers, canceled checks, and other records or documents evidencing or relating to charges for services, or expenditures and disbursements charged to the 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 pursuant to this Agreement. B. Consultant shall maintain all documents and records which demonstrate performance under this Agreement for a minimum period of three (3) years or for any longer period required by law, from the date of termination or completion of this Agreement. C. Any records or documents required to be maintained pursuant to this Agreement shall be made available for inspection or audit, at any time during regular business hours, upon written request by the City Manager, City Attorney, City Finance Director, or a designated representative of these officers. Copies of such documents shall be provided to the City for inspection at Petaluma City Hall when it is practical to do so. Otherwise, unless an alternative is mutually agreed upon, the records shall be available at Consultant's address indicated for receipt of notices in this Agreement. D. Where City has reason to believe that such records or documents may be lost or discarded due to dissolution, disbandment or termination of Consultant's business, City may, by written request by any of the above -named officers, require that custody of the records be given to the City and that the records and documents be maintained in Petaluma City Hall. Access to such records and documents shall be granted to any party authorized by Consultant, Consultant's representatives, or Consultant's successor in interest. 34. Headings. The headings used in this Agreement are for convenience only and are not intended to affect the interpretation or construction of any provisions herein 35. Survival. All obligations arising prior to the termination or expiration of this Agreement and all provisions of this Agreement allocating liability between City and Consultant shall survive the termination or expiration of this Agreement. 36. Entire Agreement. This Agreement, including the exhibits attached hereto and incorporated herein, constitutes the entire agreement between the Parties with respect to the Services, and supersedes all prior agreements or understandings, oral or written, between the parties in this regard. IN WITNESS WHEREON, the parties hereto have executed this document the day, month and year first above written. CITY OF PETALUMA City Manager CON ULTA T By__ N Resolution No. 2016 -082 N.C.S. Page 9 ATTEST: City Clerk APPROVED AS TO FORM: City Attorney APPROVED: Department Director APPROVED: Risk Manager APPROVED: Finance Director file name 060 Title J� A-0 (\i¢a urn o,5 kg, Address s .. R6sa— G� 954 5 City State Zip to g-- 0z5(1,2!35 Taxpayer I.D. Number Petaluma Business Tax Certificate Number CONSULTANT gy /,� 4-2 � C Name Tile Resolution No. 2016 -082 N.C.S. Page 10 EXHIBIT A CONSTRUCTION INSPECTION SERVICES FOR THE PETALUMA BOULEVARD NORTH WATER MAIN REPLACEMENT A. DELIVERABLES / DOCUMENTATION 1. Consultant inspector will prepare pre - construction photo log to identify pre - existing damage to the surface features (and the existing condition of areas that may be damaged by the Contractor) within Project limits. The inspector will give a duplicate copy to the City. Labeled digital photos on CD are preferred. 2. Daily Construction Reports shall be completed and submitted to the City for review. The prior week's Daily Reports shall be submitted by Monday morning at 9:00 a.m. unless requested otherwise by the City. 3. Weekly Statement of Working Days shall be completed and submitted to the City for review by Monday morning at 9:00 a.m the following week at the latest. 4. Consultant inspector will review Contractor's monthly payment requests, establish payment quantities, review materials on hand, prepare, sign, and date payment recommendations and submit to the City for payment. 5. Consultant inspector will document all warnings given to the Contractor regarding safety Hazards and provide copies to the City. 6. Digital Construction progress photos shall be taken, labeled, and stored in a logical manner to be turned over to the City in CD format at the project closeout. 7. Throughout the project the Consultant inspector will keep an up to date set of marked up drawings recording as -built conditions and ensure that the Contractor is doing so. S. Create Punch List of outstanding items to be completed by the Consultant inspector when the project is at substantial completion. The inspector will coordinate with the City when creating the punch list and meet to discuss as needed. 9. Consultant inspector will make "Record Plan" redline revisions to the original project drawings to show changes that occurred during construction. B. RESPONSIBILITY AND DUTIES 1. The Consultant inspector's responsibilities and duties are consistent with industry standard practice and are described in the Caltrans Construction Manual, and the American Public Works Association publication titled "Management of Public Works Construction Projects." 2. The inspector shall have OSHA - Hazardous Waste Operations and Emergency Response training with a minimum current certification as a 24 Hour Occasional Site Worker. 3, If contaminated or hazardous materials are encountered during construction, the inspector shall coordinate the handling and /or disposal of contaminated or hazardous materials with Resolution No. 2016 -082 N.C,S, Page 11 the contractor, specialty contractors, disposal sites, and City staff. Sign manifests as necessary. 4. Inspection services in confined spaces may be required. Inspectors entering confined spaces shall be properly trained and certified. Any confined space entry shall be carried out in accordance with Section 7-1.01L of City's specifications. Page 2 of 2 Revision Date 5/2712015 5. The inspector shall witness sewer and water pressure and vacuum testing and document results in Daily Reports. Inspector shall witness and document television inspection of sewer systems. 6. The inspector shall review connections of all new water service laterals to existing services prior to backfill and shall note the condition of the exposed portion of the existing water service piping. 7. The inspector will attend construction meetings as necessary during construction. The City will coordinate these meetings. C. WATER TESTING 1. The Consultant inspector shall perform water sampling for bacteriological clearance per the construction specifications. In the event that an inspector is unfamiliar with the procedure, the City will conduct the first sampling with Consultant as a training opportunity so the inspector can conduct any future bacteriological sampling that may be required. D. PUBLIC RELATIONS I. The Consultant inspector will act as the primary contact for the public during construction hours. The inspector will meet with property owners and businesses to keep them informed of anticipated construction activities which may affect them. The inspector will relay this information to the City so that follow -up may continue during non- construction working hours. 2. The inspector will address complaints by meeting with members of the public in a timely manner during construction hours with the City taking the lead during non - construction hours. The inspector will follow up with the Contractor to resolve any complaints as well as inform the City. The inspector will maintain a log of complaints which includes the date of the complaint, name of complainant, address, type of complaint, date Contractor notified, and date complaint resolvedlaction taken. 3. The inspector will ensure that the Contractor is providing the required public notifications for construction activities per the City contract. 4. The inspector will attend public meetings as necessary during construction. The City will coordinate the meetings. Resolution No. 2016 -082 N.C.S. Page 12 E. COMPENSATION Compensation shalt be based on actual time and materials expended to complete the project. Total compensation shall not exceed the total contract amount without an executed amendment to the contract. Resolution No. 2016 -082 N.C.S. Page 13 INSURANCE REQUIREMENTS FXWIRIT R -2 Consultant's performance of the Services under this Agreement shall not commence until Consultant shall have obtained all insurance required under this paragraph and such insurance shall have been approved by the City Attorney as to form and the Risk Manager as to carrier and sufficiency. All requirements herein provided shall appear either in the body of the insurance policies or as endorsements and shall specifically bind the insurance carrier. Consultant shall procure and maintain for the duration of the contract all necessary insurance against claims now and in the future for injuries to persons or damages to property which may arise from or in connection with the performance of the Services by the Consultant, the Consultant's agents, representatives, employees and subcontractors. Required professional liability insurance shall be maintained at the level specified herein for the duration of this Agreement and any extension thereof and for twelve additional months following the Agreement termination or expiration. A. Minimum Scope of Insurance Coverage shall be at least as broad as: 1. Insurance Services Office Commercial General Liability coverage: a. Personal injury; b. Contractual liability. 2. Insurance Services Ogee form covering Automobile Liability, code 1 (any auto). 3. Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 4. Professional Liability insurance. 5. Such other insurance coverages and limits as may be required by the City. B. Minimum Limits of Insurance Consultant shall maintain limits no less than: I, General Liability: $1,000,000 per occurrence for bodily injury, personal injury and property damage. if Commercial General Liability Insurance or other form with a general aggregate liability is used, either the general aggregate limit shall apply separately to this Agreement or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: $1,000,000 per accident for bodily injury and property damage. 3. Employer's Liability: Bodily Injury by Accident - $1,000,000 each accident. Bodily Injury by Disease - $1,000,000 policy limit. Bodily Injury by Disease - $1,000,000 each employee. 4. Professional Liability insurance: $1,000,000. 5. Such other insurance coverages and limits as may be required by the City. C. Deductibles and Self = Insured Retentions Any deductibles or self- insured retentions must be declared to and approved by the City. At the option of the City, either: the insurer shall reduce or eliminate such deductibles or Resolution No. 2016 -082 N.C.S. Page 14 self - insured retentions as respects the City, its officers, officials, employees, and volunteers; or the Consultant shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. D. Other Insurance Provisions The required general liability and automobile policies are to contain, or be endorsed to contain the following provisions: I. The City, its officers, officials, employees, agents and volunteers are to be covered as Additional insureds as respects: liability arising out of activities performed by or on behalf of the Consultant; products and completed operations of the Consultant; premises owned, occupied or used by the Consultant; or automobiles owned, leased, hired or borrowed by the Consultant. The coverage shall contain no special limitations on the scope of protection afforded to the City, its officers, officials, employees, agents or volunteers. 2. For any claims related to this project, the Consultant's insurance coverage shall be primary insurance as respects the City, its officers, officials, employees, agents and volunteers. Any insurance or self - insurance maintained by the City, its officers, officials, employees, agents or volunteers shall be excess of the Consultant's insurance and shall not contribute with it. 3. Any failure to comply with reporting or other provisions of the policies including breaches of warranties shall not affect coverage provided to the City, its officers, officials, employees, agents or volunteers. 4. The Consultant'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. 5. Each insurance policy required by this clause shall be endorsed to state that coverage shall not be suspended, voided, canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to the City. 6. Consultant agrees to waive subrogation rights against City regardless of the applicability of any insurance proceeds, and to require all contractors, subcontractors or others involved in any way with the Services to do likewise. 7. It shall be a requirement under this Agreement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirement and/or limits shall be available to the additional insured. Furthermore, the requirement for coverage and limits shall be (1) the minimum coverage and limits specified in this Agreement, or (2) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the named insured; whichever is greater. 8. The limits of insurance required in this Agreement may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non- contributory basis for the benefit of the City of Petaluma before the City of Petaluma's own insurance or self - insurance shall be called upon to protect it as a named insured. Resolution No. 2016 -082 N.C.S. Page 15 E. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best's rating of no less than ANIL F. Verification of Coverage Consultant shall furnish the City with original endorsements effecting coverage required by this clause, The endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All endorsements are to be received and approved by the City before the Services commence, Resolution No. 2016 -082 N.C.S. Page 16 PREVAILING WAGE EXHIBIT C HOURS OF WORK: A. In accordance with California Labor Code Section 1810, eight (8) hours of labor in performance of the Services shall constitute a legal day's work under this Agreement. B. In accordance with California Labor Code Section 1811, the time of service of any worker employed in performance of the Services is limited to eight hours during any one calendar day, and forty hours during any one calendar week, except in accordance with California Labor Code Section 1815; which provides that work in excess of eight hours during any one calendar day and forty hours during any one calendar week is permitted upon compensation for all hours worked in excess of eight hours during any one calendar day and forty hours during any one calendar week at not less than one - and - one -half times the basic rate of pay. C. The Consultant and its subconsultants shall forfeit as a penalty to the City $25 for each worker employed in the performance of the Services for each calendar day during which the worker is required or permitted to work more than eight (8) hours in any one calendar day, or more than forty (40) hours in any one calendar week, in violation of the provisions of California Labor Code Section 1810 and following. WAGES: A. In accordance with California Labor Code Section 1773.2, the City has determined the general prevailing wages in the locality in which the Services are to be performed for each craft or type of work needed to be as published by the State of California Department of Industrial Relations, Division of Labor Statistics and Research, a copy of which is on file with the City and shall be made available on request. The Consultant and subconsultants engaged in the performance of the Services shall pay no Iess than these rates to all persons engaged in performance of the Services. B. In accordance with Labor Code Section 1775, the Consultant and any subconsultants engaged in performance of the Services shall comply Labor Code Section 1775 which establishes a penalty of up to $50 per day for each worker engaged in the performance of the Services that the Consultant or any subconsultant pays less than the specified prevailing wage. The amount of such penalty shall be determined by the Labor Commissioner and shall be based on consideration of the mistake, inadvertence, or neglect of the Consultant or subconsultant in failing to pay the correct rate of prevailing wages, or the previous record of the Consultant or subconsultant in meeting applicable prevailing wage obligations, or the willful failure by the Consultant or subconsultant to pay the correct rates of prevailing wages. A mistake, inadvertence, or neglect in failing to pay the correct rate of prevailing wages is not excusable if the Consultant or subconsultant had knowledge of their obligations under the California Labor Code. The Resolution No. 2016 -082 N.C.S. Page 17 Consultant or subconsultant shall pay the difference between the prevailing wage rates and the amount paid to each worker for each calendar day or portion thereof for which each worker was paid less than the prevailing wage rate. If a subconsultant worker engaged in performance of the Services is not paid the general prevailing per diem wages by the subconsultant, the Consultant is not liable for any penalties therefore unless the Consultant had knowledge of that failure or unless the Consultant fails to comply with all of the following requirements: I . The Agreement executed between the Consultant and the subconsultant for the performance of part of the Services shall include a copy of the provisions of California Labor Code Sections 1771, 1775, 1776, 1777.5, 1813, and 1815. 2. The Consultant shall monitor payment of the specified general prevailing rate of per diem wages by the subconsultant by periodic review of the subconsultant's certified payroll records. 3. Upon becoming aware of a subconsultant's failure to pay the specified prevailing rate of wages, the Consultant shall diligently take corrective action to halt or rectify the failure, including, but not limited to, retaining sufficient funds due the subconsultant for performance of the Services. 4. Prior to making final payment to the subconsultant, the Consultant shall obtain an affidavit signed under penalty of perjury from the subconsultant that the subconsultant has paid the specified general prevailing rate of per diem wages employees engaged in the performance of the Services and any amounts due pursuant to California Labor Code Section IS 13, C. In accordance with California Labor Code Section 1776, the Consultant and each subconsultant engaged in performance of the Services, shall keep accurate payroll records showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed in performance of the Services. Each payroll record shall contain or be verified by a written declaration that it is made under penalty of perjury, stating both of the following: 1. The information contained in the payroll record is true and correct. 2. The employer has complied with the requirements of Sections 1771, 1811, and 1815 for any Services performed by the employer's employees on the public works project. The payroll records required pursuant to California Labor Code Section 1776 shall be certified and shall be available for inspection by the Owner and its authorized representatives, the Division of Labor Standards Enforcement, the Division of Apprenticeship Standards of the Department of Industrial Relations and shall otherwise be available for inspection in accordance with California Labor Code Section 1776. In addition, Consultant and sub - consultant shall be required to be registered with the Department of Industrial Relations pursuant to Labor Code section 1725.5. Consultant Resolution No. 2016 -082 N.C.S. Page 18 and any sub - consultant shall submit certified payroll records to the Department of Industrial Relations Labor Commissioner online: https: // apps .dir.ca.gov /ecpr /DAS /AItLogin. Consultant is responsible for ensuring compliance with this section. D. In accordance with California Labor Code Section 1777.5, the Consultant, on behalf of the Consultant and any subconsultants engaged in performance of the Services, shall be responsible for ensuring compliance with California Labor Code Section 1777.5 governing employment and payment of apprentices on public works contracts. E. In case it becomes necessary for the Consultant or any subeonsultant engaged in performance of the Services to employ on the Services any person in a trade or occupation (except executive, supervisory, administrative, clerical, or other non manual workers as such) for which no minimum wage rate has been determined by the Director of the Department of Industrial Relations, the Consultant shall pay the minimum rate of wages specified therein for the classification which most nearly corresponds to Services to be performed by that person. The minimum rate thus furnished shall be applicable as a minimum for such trade or occupation from the time of the initial employment of the person affected and during the continuance of such employment. rile name Resolution No. 2016 -082 N.C.S. Page 19 EXHIBIT D ACKNOWLEDGEMENT AND CERTIFICATION PURSUANT TO CITY OF PETALUMA LIVING WAGE ORDINANCE PETALUMA MUNICIPAL CODE CHAPTER 8.36 The City of Petaluma Living Wage Ordinance ( "Ordinance "), Petaluma Municipal Code Chapter 8.36, applies to certain service contracts, leases, franchises and other agreements or funding mechanisms providing financial assistance (referred to hereafter as an "Agreement ") between the City of Petaluma ( "City ") and /or the Petaluma Community Development Commission ( "PCDC ") and contractors, lessees, franchisees, and /or recipients of City and /or PCDC funding or financial benefits ( "covered entities "), Pursuant to Petaluma Municipal Code Section 8.36.120, as part of any bid, application or proposal for any Agreement subject to the Ordinance, the covered entity shall: • Acknowledge that the covered entity is aware of the Ordinance and intends to comply with its provisions. Complete the Report of Charges, Complaints, Citations and /or Findings contained in this Acknowledgement and Certification by providing information, including the date, subject matter and manner of resolution, if any, of all wage, hour, collective bargaining, workplace safety, environmental or consumer protection charges, complaints, citations, and /or findings of violation of law or regulation by any regulatory agency or court including but not limited to the California Department of Fair Employment and Housing, Division of Occupational Safety and Health (OSHA), California Department of Industrial Relations (Labor Commissioner), Environmental Protection Agency and /or National Labor Relations Board, which have been filed or presented to the covered entity within the ten years immediately prior to the bid, proposal, submission or request. Pursuant to Petaluma Municipal Code Section 8.36.120, before the beginning of the term of any covered Agreement, or prior to the execution of said Agreement by the City or the PCDC, each covered entity shall certify that its employees are paid a living wage that is consistent with Petaluma Municipal Code Chapter 8.36. By executing this Acknowledgement and Certification, the covered entity (i) acknowledges that it is aware of the Ordinance and intends to comply with its provisions, (ii) attests to the accuracy and completeness of information provided in the Report of Charges, Complaints, Citations and /or Findings contained herein, (iii) certifies that it pays its covered employees a Living Wage as defined in Petaluma Municipal Code Chapter 8.36 and (iv) attests that the person executing this Acknowledgement and Certification is authorized to bind the covered entity as to the matters covered in this Acknowledgment and Certification. Resolution No. 2016 -082 N.C.S. Page 20 SO ACKNOWLEDGED and CERTII~IED: Project or Contract LD: Petaluma Boulevard North Water Main Replacement Project e045TLAMD Ctt/rt. E Ij0gJ66,QtAJ6, jnjc, Date: 5-'3 -IS' (Print Name of Covered Entity/Business Capacity) (Print Name) /s/ Signature) Its 0,6o (Title /Capacity of Authorized Signer) Resolution No. 2016 -082 N.C.S. Page 21 REPORT OF CHARGES, COMPLAINTS, CITATIONS AND /OR FINDINGS PURSUANT TO PETALUMA MUNICIPAL CODE SECTION 8.36.120 FOR EACH WAGE, HOUR, COLLECTIVE BARGAINING, WORKPLACE SAFETY, ENVIRONMENTAL OR CONSUMER PROTECTION CHARGE, COMPLAINT, CITATION, AND /OR FINDING OF VIOLATION OF LAW Ott REGULATION BY ANY REGULATORY AGENCY OR COURT, INCLUDING BUT NOT LIMITED 1.0 THE CALIFORNIA DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING, DIVISION OF OCCUPATIONAL SAFETY AND HEALTH (OSHA), CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (LABOR COMMISSIONER), ENVIRONMENTAL PROTECTION AGENCY AND /OR NATIONAL LABOR RELATIONS BOARD, WHICH; • AFFECTS YOU AS A PROSPECTIVE CONTRACTOR, SUBCONTRACTOR, LESSEE, FRANCHISEE AND /OR PARTY TO ANY CITY OF PETALUMA AND /OR PETALUMA COMMUNITY DEVELOPMENT COMMISSION - FUNDED AGREEMENT OR BENEFIT SUBJECT TO PETALUMA MUNICIPAL CODE CHAPTER 8,36 (LIVING WAGE ORDINANCE), AND • HAS BEEN FILED OR PRESENTED TO YOU WITHIN THE TEN YEARS IMMEDIATELY PRIOR TO THE BID, PROPOSAL, SUBMISSION OR REQUEST FOR WHICH THIS ACKNOWLEDGEMENT AND CERTIFICATION IS MADE. PLEASE PROVIDE THE DATE, THE REGULATORY AGENCY OR COURT (MAKING THE CHARGE COMPLAINT, CITATION OR FINDING, T14E SUBJECT MATTER AND THE MANNER OF RESOLUTION, IF ANY, FOR EACH SUCH CHARGE COMPLAINT, CITATION OR FINDING. IF NONE, PLEASE STATE "NONE ": f& 06 ATTACH ADDITIONAL PAGES IF NEEDED. Date: S • 3- Ito Regulatory Agency or Court: Subject Matter: Resolution, if any: Expected resolution, if known: Resolution No, 2016 -082 N.C.S. Page 22 Client#: 1636 COASTCIVI ACORD. CERTIFICATE OF LIABILITY INSURANCE OAYR(MMMONYYY) 510312016 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 CE=RTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms And conditions of the policy, certaln policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In ileu of such endorsement(s). PRODUCER Dealey, Renton R Associates P. O. Box 12875 Oakland, CA 54604 -2675 310485 -3090 Stefanie Nardelli N A Doris A. Chambers E , ; 510 465 -3090 N, 510 452.2193 IL ADDRESS: dchambers@deateyrenton.com INSURER(S) AFFORDING COVERAGE NAIC0 INSURER A: Sentinel Insurance Co. LTD 11000 INSURED and Civil Engineering, Inc, INSURER e: Hartford Ins. Co of Midwest 37478 INSURER c: XL Specialty Insurance Co. 37885 1 400 1400 Neatomas Avenue INSURER D: Trumbull Insurance Company 27120 Santa Rosa, CA 95405 INSURER E, $Z OOO OOO INSURER F: PRODUCTS - COMPIOP AGG s2,000,000 COVERAGES CERTIFICATE NUMBE=R: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 TIME TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IN R TYPE OF INSURANCE ADDL 1 USR POLICY NUMBER POLICY EFF (MMIDO/YYYY1 PO x LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X X 57SBWBG9489 910112015 09101/2016 EEACCH��OECTCUR�RpENCE $1,000,000 pRgM18ES Ea om D 51,000,000 MEO EXP (Any*" person ) $10000 PERSONAL&AOVWJURY S1,000,000 GENERALAGGREGATE $Z OOO OOO GEN1 AGGREGATE LIMIT APPLIES PER: POLICY DRIP EICOT- LOC PRODUCTS - COMPIOP AGG s2,000,000 $ D AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED X HIRED AUTOS X AUTOS X X 57UEGZC7163 0910112015 0910112016 Dopiae deerrl OL 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) 5 PP t S $ A X UMBRELLALIAa EXCESS UAB IV I OCCUR CLApAS -MADE X X 57SBWBG9489 0910112016 09101/2016 EACHOCCURRENCE s4000000 AGGREGATE S4 000 000 OED I I RETENTIONS $ B WORKERS COMPENSATION ANDppEMIPLOYERS'LIABILITY YIN OFFICEPJME�M13ERREEXCLUDED ECUTNE� (Mandatory In NHS ifyyoos.dosoiba under DESCRIPTION OF OPERATIONS heiow NIA X 57WEGGG8117 9101/2015 09101/201 X "� 8TAT11 oTM- IM1 e.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1 OOO 000 E.L. DISEASE - POLICY LIMIT I S1,000,000 C Professional Liability DPR9725395 0910112015 09101120111 $1,000,000 per Claim $2,000,000 Anni Aggr, DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) GENERAL LIABILITY POLICY EXCLUDES CLAIMS ARISING OUT OF THE PERFORMANCE OF PROFESSIONAL SERVICES. REF: Petaluma Boulevard North Water Main Replacement Project. GENERAL LIABILITYIAUTOMOBILE LIABILITY ADDITIONAL INSURED: The City of Petaluma, its officers, officials, employees, agents and volunteers. Commercial General Liability Is primary and non contributory and Includes severability of Interests per policy form. Waiver of Subrogation applies to Commercial General Liability, Automobile Liability and (See Attached Descriptions) City of Petaluma Attn: City Clerk P. O. Box 61 Petaluma, CA 94953 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 13EFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W/,-° 3-0-' I e01988 -2010 ACORD CORPORATION, All rinhts reserved. Resolution No. 2016 -082 N.C.S. Page 23 RIPTIONS (Continue Workers Compensation. Cancellation provisions are solely as shown on this certiflcate. Cancellation: 30 Daytl0 Day for Non Payment of Premium. Resolution No. 2016 -082 N.C.S. Page 24 insured: coasiland Civil Engineering, Inc, Insurer: Sentinel Insurance Co. LTD Policy Number: 5?SBWBG9489 Policy Effective mate: 0910112016 Additional Insured: NAME OF PERSON OR ORGANIZATION CONTINUATION: The City of Petaluma, Its officers, officials, employees, agents and volunteers EXCERPTS FROM: Hartford Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM C. WHO IS AN INSURED 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) Identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written contract, written agreement or because of a permit Issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization Is an additional Insured under this provision only for that period of time required by the contract, agreement or permit. f. Any Other Party (1) Any other person or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily Injury, "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) in the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and Included within the "products- completed operations hazard, but only If (1) The written contract or written agreement requires you to provide such coverage to such additional Insured; and (11) This Coverage Part provides coverage for "bodily injury" or "property damage" Included within the "products - completed operations hazard. (2) With respect to the insurance afforded to these additional insureds, this Insurance does not apply to: "Bodily Injury, "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: inspection, or engineering E.S. Separation of Insureds Except with respect to the limits of Insurance, and any rights or duties specifically assigned In this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" Is brought. E.7.b.(7).(b) Primary And Non - Contributory To tither Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non - contributory with the additional Insured's own insurance, this Insurance Is primary and we will not seek contribution from that other insurance. E.B.b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, Including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the Insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. Resolution No. 2016 -082 N,C,S. Page 25 POLICY NUMBER: 67UEGZC7163 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement effective 09/0112015 Named Insured Countersigned by Coastland Civil Engineering, Ina Name of Person(s) or Organization (s): (Authorized Representative) NAME OF PERSON OR ORGANIZATION CONTINUATION: The City of Petaluma, its officers, of iclats, employees, agents and volunteers (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an 'Insured" under the Who Is An Insured Provision contained in Section 11 of the Coverage Form. Resolution No. 2016 -082 N.C.S. Page 26 Insured; Coastiand Civil Engineering, Inc. Policy Number: 57WEGGG8117 Effective Date: 09101/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees white engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description NAME OF PERSON OR ORGANIZATION CONTINUATION: The City of Petaluma, Its officers, City of Petaluma officials, employees, agents and volunteers Attu, City Clerk P. O. Box 61 Petaluma, CA 94953 Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date; Polley Expiration Date: Resolution No. 2016 -082 N.C.S. Page 27