Loading...
HomeMy WebLinkAboutAgreement 05/21/2012 (3) 1. PROFESSIONAL SERVICES AGREEMENT Contract Building Plan CheckBuilding,Inspection Services (Title of Project) FY 2012 Fund#6300. Exp.Acct.#63200 Project#54160 .Amount$74,500 For multi-year:contracts or contracts with multiple accounts: FY 2013 Fund#6300 Exp:.Acct.#63200 Project#54160 Amount$74 500 FY Fund# Exp.Acct.# Project# Amount$_ FY_ Fund.# Exp.Acct.# Project# Amount$ FY Fund# Exp.Acct.# Project# Amount$ FY Fund# Exp.Acct.# Project# Amount$ THIS PROFESSIONAL SERVICES AGREEMENT ("Agreement") is entered into and effective as of o-9 , 20 /?-("Effective Date"), by and between the City of Petaluma, a municipal co oration and a charter city ("City") and COA, Inc, a private Building Plan Check and Inspection Firm ("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 setforth herein. THEREFORE, in consideration of the mutual covenants contained inthis 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 performanceand 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:caseshall the total compensation under this Agreement exceed $74,500 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. 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 current information requested on the "Vendor Information" form available from City, and has obtained a currently valid Petaluma business tax certificate. PRr1FESSIr1NAI SERVICES MIR FFMFNT/CiNI 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, 2013,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 for 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 agreementfor employment. 6. 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. 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 furnished, if any; shall be subject to 2 PRnFFSSInrcA I.SPR V ICES AGR FF.MFNT(Cowl 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, director"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 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 Consultant's profession. All. such instruments of service shall become the sole and exclusive property of City upon delivery of the same. 15. Assignment/Transfer. No assignment or transfer in whole or in part of this Agreement shall be made without the prior written consent of City. 16. 'Subcontractors. Consnitantshall 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 3 PR(1FFS.SIONA I.CFR VICES AGR PPMFNT(CiNl • 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. 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 (15) 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 as Exhibit C, 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 C 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. 19. 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. 20. 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 4 PR(1FF.SS!ON AI..CFRVICES AGRFFMFNT(Citvl • (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: Chief Building Official. City of Petaluma P. O. Box 61 Petaluma CA. 94952 Phone: 707-778-4301 Fax: 707-7784498 Email: EHanier@,ci.petaluma.ca.us Consultant: Matt Stockton COA, Inc. P. 0. Box 12326 Santa Rosa, CA. 95406 Phone: 707-529-7152 Fax: 707-539-6321 Email:' CQA @Sonic.net 21. 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. 22. 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 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. 5 RR(1FFSSRINA I..SFR V ICRS ACRFFMFNT(Carol • 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 indenmity 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. Notwithstanding the foregoing, to the extent this Agreement is a "construction contract" as defined by California Civil Code Section 2783, as maybe amended from time to time, Consultant's duty todndemnify 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. 23. Insurance. Consultant"shall comply with the "Insurance Requirements for Consultants" in Exhibit B-1, B-2, attached hereto and incorporated herein by reference. [Indicate attached exhibit, e.g., "B-1, " "B-2, " "B-3, " or "B-4 "] 24. Amendment. This Agreement may be amended only by a written instrument executed by both Parties. 25. 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. 26. 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. 6 PR(1FF.SSi(1NA I.SF.R V ICFS'Af.RFFMFNT Way) • 27. 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. 28. 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. 29. 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. 30. 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. 31. 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. 32. 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. 7 PRnFFSSIONAI.SFRVICFS AGRFFMFNT(City) , 33. . Headings. The headings used;in this Agreement are for convenience only and are not intended to affect the interpretation or constructiorof any provisions herein. 34. 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. 35, 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 WHEREOF, the parties hereto have executed this document the day, month and year first above written. CITY OF PETALUMA C N LTANT r _. _ / MA-Tr tina a 13y City Manager Name ATTEST: P2!,t arik - ' 1 Title if j!sk t " G Gait A 9.0 . & 123 2-6 fly Clerk Address n -_ (A / APPROVE S TO FORM: �i ► 1�iA (A °k S4 (DC, c„„ City State Zip 6U ' 0469511 City Attorney Taxpayer I.D.Number APPROVED: L- 090297> 12-01 a Petaluma Business Tax Certificate N mbar D 1(-110r141 Department Directo AP OVED: ugh 516-�Z kik- c I M gar APPR • Finance.Director file name:Professional Service Agreement CQA 2011 8 PROFFSSICNAI..SFRV1CFS AGRF.PMFMr WCitvl ' CQAI CQA, Inc. Building Consulting Fire Consulting Plan Review Services Construction Inspection Building Inspection EXHIBIT"A" February 4, 2012 Edward Hamer- Chief Building Official City of Petaluma Community Development Department, Building Division 11 English Street Petaluma, CA 94952 RE: Building Inspection &Plan Check Services Dear Mr. Hamer, I have worked for The City of Petaluma Community Development for over 6 years and would be delighted to continue to do so. • The fee for,;Building Inspection is$110/hr. • The fee-for plan check is 70% of the Plan Check with a limit of two re-reviews. A"re- review"are plans'and calculations resubmitted forplan approval after plan check comments are corrected. • The fee for revisions to approved plans or 3 or-more "re-review" plan checks is $125/hr. If you have any questions or concerns, please let me know: . Best regards, la f34i. Matthew Stockton P.E. CQA; Inc. • • Matthew Stockton P.E. cqa @sonic.net P.O.Box 12326 Santa Rosa,CA 95406 Cell(707)529-7152 '' cQA, CQA, Inc. Building.Consulting Fire Consulting Plan Review Services Construction Inspection Building Inspection April 24, 2012 Dominique Kurihara Assistant Risk.Manager City of Petaluma, 1304 South Point.Blvd. Petaluma, CA 94954 RE: Workman's Comp Insurance& Automobile Insurance Hi Dominique, Thank you for your.assistance;on the phone today.In confirmation of our discussion, CQA, Inc. is my company and I am the sole employee of CQA, Inc. Therefore I should be exempt from Workman's Compensation Laws.Please waive the requirement for Workman's Compensation coverage. On a separate note, my automobile insurance company"is.going to send you the certificate you requested. However, since I am not performing in duties for the city which involve driving, I do not see a-relevance for the requirement of automobile insurance. If you could waive that requirement as well would probably be,best. Thank you very much.for your assistance and consideration regarding this issue: Best regards, Matthew Stockton PE President;/Plan Check Engineer Fyt,l hi t Clients:27950 - CSQAIN1 _ . • 4CORD. CERTIFICATE OF LIABILITY INSURANCE OATS OAWDDIYYYY) 4/0412012 iouDER THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION royo Insurance:Services ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE rr Beedle Hastin s 8 Dennis HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3 E. Huntington Or„#100 . ,adia,,CA 91006 INSURERS'AFFOROINGCOVERAGE NAIL Y. ;RED 'INSURER Ai..Atlantic Casualty _ CQA, Inc. INSURERLE'Darwin Select Insurance Co. P.O.Box 12326 INSURER Os •Santa.Rosa,CA 95406 INSURERDL - INSURER E VERAGES HE POLICIES OF INSURANCE LISTED BELOW.HAVE BEEN IBSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING NY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR IAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH OLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSII,�/.{i��.�, NEE" TYPE OF INSURANCE .POLICY NUMBER':' P'_Si;ll;�f.'!!•T•T+'AA' P•NtAI N4i7 LIMBS - _— GENERAL LIABILITY L204000102 04/03/12 04103/13'. EACH q�OCCURRENCE $1.000.400 X COMMERCIAL GENERAL LIABILITY Oi AICF9TeasM, 0100,000 • l CLAIMS MADE © OCCUR MEC LXP V,y onn jw un) $5AQ4 PERSOrjA.4 ADV INJURY s1,000,Q9 daiiiRAL hOGROO4rm 62,000,000 OWL AGGREGATE LIMIT APPLIES PER: • PRODUCTS COMPiOP AGO sinclud In Ana I POLICY E1 '( l LOC _ AUTOMOBILE LIABILITY COMBINED$INCAS LIMIT ANY AUTO (Es goings!) 6 AU.OWNED AUTOS BODILY INJURY _. . _ SCHEDULED AUTOS (P person) 6 HIRED AUTOS BODILY INJURY NON.OWNEO AUTOS (Per son!) $ PROPERTY DAMAGE $ (P$r aedlinl) GARAGE UABILITY AUTO ONLY:LA ACCIDENT B • ..� ANYAUTO OTHER THAN $AACC I -., AUTO ONLY: _ ADO $ EXCESSIUMSRELLA LIABILITY EACH OCCURRENCE 6 7 OCCUR CLAIMS MADE AGGREGATE $_ 5 DEDUCTIBLE 9 RETENTION $ I ddT S C W WORKERS COMPENSATION AND Yi?- OJr. .TORY BT MOB I l I;u. EMPLOYERS'LIABILITY ANY.FROPRIETOW Po PARTNEEXECUTIVE R.L EACH ACCIDENT $' OFFICER/MEMBER EXCLUDED? E.L.DISEASE.BA EMPLOYEE $ Ryw dL P ulber _.. SPECIAL PROVISIONO law E.L:DISEASE.POLICY LIMIT $ OTHER Errors 8 03081540 12/01/11 12/01/12 $1000,000 oach.occur Omissions $2,000,000 aggregate $2,500_deductibie :CRIPTION OF OPERATIONS f LOCATIONS I VEHICLES/BXC W$IONS ADDED BY.ENDORSEMENT IS PECIAL PROVISIONS y of Petaluma,.it's officers,agents,employees, coneultanti,•represontattvesiond representative's nsultants are Included as Additional Insured. Liver of Subrogation Is likewise Included. LIVICATE HOLDER GANQELJ.ATIOON SHOULD ANY OPINE ABOVE 0$5ORIBED POLICIES BB CANCELLED BEFORE THd EXPIRATION. City of Petaluma DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL _la_ DAYS WRITTEN Attn: Leslie Manning NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,SLIT.FAILURE TO DO SO SHALL 11 English Street IMPOSE MO OSUCATION OR LIABILITY OP ANY HIND UPON THE INSURER;NS AGENTS OR Petaluma;-CA 94952 REPRESENTATIVES, AUTHORIZEDREPRESENTATIE %Dr1 et • IMPORTANT • • If the certificate holder Is an ADDITIONAL INSURED, the p&icy(le8);must be endorsed, A statement on this certificate does not confer rights tothe;certifieate holderin lieu of such endorsement(s), If SUBROGATION IS WAIVED, subject to theiterms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s); DISCLAIMER • The Certificate of Insurance;on the reverse side of this.form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder; nor does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon, • • POLICY NUMBER: L204000102 COMMERCIAL GENERAL.LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE.READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Petaluma 11 English Street Petaluma,CA 94952 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED(Section II is amended to include as an`Insured.the person or organization shown in the Schedule, but only with respect to liability arising out of"your work"for that insured by or for you, City of Petaluma, its officers,agents, employees,consultants;representatives and representative's consultants, CG 20 10 11 85 Copyright, Insurance Seprice Office, Inc, 1984 POLICY NUMBER: L2040001,02 COMMERCIAL GENERAL LIABILITY CO 24 04 05 00 wAOVEl- OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS�TO US • This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL,LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization;.; City of Petaluma, its officers, agents, employees, consultants, representatives arts representative.' a consultants.. Information required to complete this'Schedule, if not shown above;will be:shown in'the Declarations: The following:is added to Paragraph 8. Transfer Of Rights. Of Recovery Against Others' To Us: of Section IV—Conditions: We waiv •any right of recovery':we mayyhave against the person or organization shown in the Schedule above because of payments we make for`injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the 'product's- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. • 4 III' ( ` STATE FARM INSURANCE COMPANIES® L'ylbj f l 1 DATE OF NOTICE: MAY 03 2012 9900 Old;River.Road Bakersfield CR93311-9501 CODE:. 16A 'AT 1 02 A e 000110 0093 CITY OF PETALUMA ;NOTE: PLEASE', NOTIFY STATE FARM AT THE I COMMUNITY DEVELOPMENT DEPT rADDRESSiLISTER'AT THE TOP, LEFT CORNER- e 11 ,ENGLISH ST OF ThIS PAGE REGARDING ANY CHANGE OF NNPETALUMA CA 96952-2610 ADDRESSINFORMATION. I A 0 Y 1- N • ADDITIONAL'INSURED'S NOTICE OF COVERAGE d State Farm Mutual Automobile Insurance Company 2606-F147-J NAMED INSURED: • - POLICY;NO 003'3485 A20-050 COVERAGE: . STOCKTON,MATTHEW&COSY YR/MAKE/MODEL: 2000 NISSAN 4DR BI AND PD LIABILITY rte:+ PO BOX 12326, VIN/CAMPER: JN1CA31 DOYT756924 $250DED:COMP.MIL SANTA.ROSA CA 95406-2326 AGENT NAME: CAROLYN.POLLARD; $500 DED.COLL. > AGENT'PHONE: (707)545-9014. cc ENDORSEMENT NO: 6028AU POLICY.EFFECTIVE g 'APR 20 2012 UNTIL TERMINATED a POLICY MESSAGES: This policy shown above supersedes policy*0033485-05P 1 The policy includes a loss payable clause protecting the additional insureds interest in,the descubed car to the extent of the insurance n provided and'subject to'all policy.provisions:The additional meured will;be given 20:days notice if the policy is.terminated::Until srwh notice is provid e p ,it shall bresumed that the required renewal.premiums have been paid; The additional insured,muet notify us within 10 days of ,N any change of interest or ownership coming to their attention Failure to do so will render this policy null and void. e ;q • 11• FRT