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HomeMy WebLinkAboutLawrence & Associates 2021-10-22 COU No. 2122-148 AGREEMENT FOR PROFESSIONAL CONSULTING SERVICES [Design Professional] This Agreement, made and entered into this 22nd day of October, 2021 ("Effective Date"), by and between CITY OF UKIAH, CALIFORNIA, hereinafter referred to as "City" and Lawrence & Associates, a corporation, organized and in good standing under the laws of the State of California, hereinafter referred to as "Consultant". RECITALS This Agreement is predicated on the following facts: a. City requires consulting services related to annual sampling of the gas-extraction system at the City of Ukiah Landfill. b. Consultant represents that it has the qualifications, skills, experience and properly licensed to provide these services, and is willing to provide them according to the terms of this Agreement. C. City and Consultant agree upon the Scope-of-Work and Work Schedule attached hereto as Attachment "A", describing contract provisions for the project and setting forth the completion dates for the various services to be provided pursuant to this Agreement. TERMS OF AGREEMENT 1.0 DESCRIPTION OF PROJECT 1.1 The Project is described in detail in the attached Scope-of-Work (Attachment "A"). 2.0 SCOPE OF SERVICES 2.1 As set forth in Attachment "A". 2.2. Additional Services. Additional services, if any, shall only proceed upon written agreement between City and Consultant. The written Agreement shall be in the form of an Amendment to this Agreement. 3.0 CONDUCT OF WORK 3.1 Time of Completion. Consultant shall commence performance of services as required by the Scope-of-Work upon receipt of a Notice to Proceed from City and shall complete such services within 60 days from receipt of the Notice to Proceed. Consultant shall complete the work to the City's reasonable satisfaction, even if contract disputes arise or Consultant contends it is entitled to further compensation. 4.0 COMPENSATION FOR SERVICES 4.1 Basis for Compensation. For the performance of the professional services of this Agreement, Consultant shall be compensated on a time and expense basis not to exceed a guaranteed maximum dollar amount of$6,586. Labor charges shall be based upon hourly billing rates for the various classifications of personnel employed by Consultant to perform the Scope of Work as set forth in the attached Attachment B, which shall include all indirect costs and expenses of every kind or nature, except direct expenses. The direct expenses and the fees to be charged for same shall be as set forth in Attachment B. Consultant shall complete the Scope of Work for the not-to-exceed guaranteed maximum, even if actual time and expenses exceed that amount. 4.2 Changes. Should changes in compensation be required because of changes to the Scope-of- Work of this Agreement, the parties shall agree in writing to any changes in compensation. "Changes to the Scope-of-Work" means different activities than those described in Attachment "A" and not additional time to complete those activities than the parties anticipated on the date they entered this Agreement. 4.3 Sub-contractor Payment. The use of sub-consultants or other services to perform a portion of the work of this Agreement shall be approved by City prior to commencement of work. The cost of sub-consultants shall be included within guaranteed not-to-exceed amount set forth in Section 4.1. 4.4 Terms of Payment. Payment to Consultant for services rendered in accordance with this contract shall be based upon submission of monthly invoices for the work satisfactorily performed prior to the date of invoice less any amount already paid to Consultant, which amounts shall be due and payable thirty (30) days after receipt by City. The invoices shall provide a description of each item of work performed, the time expended to perform each task, the fees charged for that task, and the direct expenses incurred and billed for. Invoices shall be accompanied by documentation sufficient to enable City to determine progress made and the expenses claimed. 5.0 ASSURANCES OF CONSULTANT 5.1 Independent Contractor. Consultant is an independent contractor and is solely responsible for its acts or omissions. Consultant (including its agents, servants, and employees) is not City's agent, employee, or representative for any purpose. It is the express intention of the parties hereto that Consultant is an independent contractor and not an employee, joint venturer, or partner of City for any purpose whatsoever. City shall have no right to, and shall not control the manner or prescribe the method of accomplishing those services contracted to and performed by Consultant under this Agreement, and the general public and all governmental agencies regulating such activity shall be so informed. Those provisions of this Agreement that reserve ultimate authority in City have been inserted solely to achieve compliance with federal and state laws, rules, regulations, and interpretations thereof. No such provisions and no other provisions of this Agreement shall be interpreted or construed as creating or establishing the relationship of employer and employee between Consultant and City. Consultant shall pay all estimated and actual federal and state income and self-employment taxes that are due the state and federal government and shall furnish and pay worker's compensation insurance, unemployment insurance and any other benefits required by law for himself and his employees, if any. Consultant agrees to indemnify and hold City and its officers, agents and employees harmless from and against any claims or demands by federal, state or local government agencies for any such taxes or benefits due but not paid by Consultant, including the legal costs associated with defending against any audit, claim, demand or law suit. Design—Prof vesA%reeinmt-November 20,2008 PAGE 2OF7 Consultant warrants and represents that it is a properly licensed professional or professional organization with a substantial investment in its business and that it maintains its own offices and staff which it will use in performing under this Agreement. 5.2 Conflict of Interest. Consultant understands that its professional responsibility is solely to City. Consultant has no interest and will not acquire any direct or indirect interest that would conflict with its performance of the Agreement. Consultant shall not in the performance of this Agreement employ a person having such an interest. If the City Manager determines that the Consultant has a disclosure obligation under the City's local conflict of interest code, the Consultant shall file the required disclosure form with the City Clerk within 10 days of being notified of the City Manager's determination. 6.0 INDEMNIFICATION 6.1 Insurance Liability. Without limiting Consultant's obligations arising under Paragraph 6.2 Consultant shall not begin work under this Agreement until it procures and maintains for the full period of time allowed by law, surviving the termination of this Agreement insurance against claims for injuries to persons or damages to property, which may arise from or in connection with its performance under this Agreement. A. Minimum Scooe of Insurance Coverage shall be at least as broad as: 1. Insurance Services Office ("ISO) Commercial General Liability Coverage Form No. CG 20 10 10 01 and Commercial General Liability Coverage— Completed Operations Form No. CG 20 37 10 01. 2. ISO Form No. CA 0001 (Ed. 1/87) covering Automobile Liability, Code 1 "any auto" or Code 8, 9 if no owned autos and endorsement CA 0025. 3. Worker's Compensation Insurance as required by the Labor Code of the State of California and Employers Liability Insurance. 4. Errors and Omissions liability insurance appropriate to the consultant's profession. Architects' and engineers' coverage is to be endorsed to include contractual liability. B. Minimum Limits of Insurance Consultant shall maintain limits no less than: 1. General Liability: $1,000,000 combined single limit per occurrence for bodily injury, personal injury and property damage including operations, products and completed operations. If Commercial General Liability Insurance or other form with a general aggregate limit is used, the general aggregate limit shall apply separately to the work performed under this Agreement, or the aggregate limit shall be twice the prescribed per occurrence limit. 2. Automobile Liability: $1,000,000 combined single limit per accident for bodily injury and property damage. Daipp-Pratt Apee nt-November 20,2008 PAGE 3OF7 3. Worker's Compensation and Employers Liability: Worker's compensation limits as required by the Labor Code of the State of California and Employers Liability limits of$1,000,000 per accident. 4. Errors and Omissions liability: $1,000,000 per occurrence. 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 self-insured retentions as respects to 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 policies are to contain, or be endorsed to contain, the following provisions: 1. General Liability and Automobile Liability Coverages a. The City, it officers, officials, employees 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, hired or borrowed by the Consultant for the full period of time allowed by law, surviving the termination of this Agreement. The coverage shall contain no special limitations on the scope-of-protection afforded to the City, its officers, officials, employees or volunteers. b. The Consultant's insurance coverage shall be primary insurance as respects to the City, its officers, officials, employees and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees or volunteers shall be in excess of the Consultant's insurance and shall not contribute with it. C. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its officers, officials, employees or volunteers. d. 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. 2. Worker's Compensation and Employers Liability Coverage The insurer shall agree to waive all rights of subrogation against the City, its officers, officials, employees and volunteers for losses arising from Consultant's performance of the work, pursuant to this Agreement. Design—Prof vcsAgreemenl--0nvember 20,2009 PAGE 4 OF 0 3. Professional Liability Coverage If written on a claims-made basis, the retroactivity date shall be the effective date of this Agreement. 4. All Coverages 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. E. Acceptability of Insurers Insurance is to be placed with admitted California insurers with an A.M. Best's rating of no less than A-for financial strength, AA for long-term credit rating and AMB-1 for short-term credit rating. F. Verification of Coverage Consultant shall furnish the City with Certificates of Insurance and with original Endorsements effecting coverage required by this Agreement. The Certificates and Endorsements for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The Certificates and Endorsements are to be on forms provided or approved by the City. All Certificates and Endorsements are to be received and approved by the City before Consultant begins the work of this Agreement. The City reserves the right to require complete, certified copies of all required insurance policies, at any time. If Consultant fails to provide the coverages required herein, the City shall have the right, but not the obligation, to purchase any or all of them. In that event, after notice to Consultant that City has paid the premium, the cost of insurance may be deducted from the compensation otherwise due the contractor under the terms of this Contract. G. Subcontractors Consultant shall include all sub-contractors or sub-consultants as insured under its policies or shall furnish separate certificates and endorsements for each sub-contractor or sub-consultant. All coverage for sub-contractors or sub-consultants shall be subject to all insurance requirements set forth in this Paragraph 6.1. 6.2 Indemnification. Notwithstanding the foregoing insurance requirements, and in addition thereto, Consultant agrees, for the full period of time allowed by law, surviving the termination of this Agreement, to indemnify the City for any claim, cost or liability that arises out of, or pertains to, or relates to any negligent act or omission or the willful misconduct of Consultant and its agents in the performance of services under this contract, but this indemnity does not apply to liability for damages for death or bodily injury to persons, injury to property, or other loss, arising from the sole negligence, willful misconduct or defects in design by the City, or arising from the active negligence of the City. "Indemnify," as used herein includes the expenses of defending against a claim and the payment of any settlement or judgment arising out of the claim. Defense costs include all costs associated with defending the claim, including, but not limited to, the fees of attorneys, investigators, consultants, experts and expert witnesses, and litigation expenses. Dnign-PmfS Ag.nt-N.,.n r20,2008 PAGE 5OF7 References in this paragraph to City or Consultant, include their officers, employees, agents, and subcontractors. 7.0 CONTRACT PROVISIONS 7.1 Documents and Ownership of Work. All documents furnished to Consultant by City and all documents or reports and supportive data prepared by Consultant under this Agreement are owned and become the property of the City upon their creation and shall be given to City immediately upon demand and at the completion of Consultant's services at no additional cost to City. Deliverables are identified in the Scope-of-Work, Attachment "A". All documents produced by Consultant shall be furnished to City in digital format and hardcopy. Consultant shall produce the digital format, using software and media approved by City. 7.2 Governing Law. Consultant shall comply with the laws and regulations of the United States, the State of California, and all local governments having jurisdiction over this Agreement. The interpretation and enforcement of this Agreement shall be governed by California law and any action arising under or in connection with this Agreement must be filed in a Court of competent jurisdiction in Mendocino County. 7.3 Entire Agreement. This Agreement plus its Attachment(s) and executed Amendments set forth the entire understanding between the parties. 7.4 Severability. If any term of this Agreement is held invalid by a court of competent jurisdiction, the remainder of this Agreement shall remain in effect. 7.5 Modification. No modification of this Agreement is valid unless made with the agreement of both parties in writing. 7.6 Assignment. Consultant's services are considered unique and personal. Consultant shall not assign, transfer, or sub-contract its interest or obligation under all or any portion of this Agreement without City's prior written consent. 7.7 Waiver. No waiver of a breach of any covenant, term, or condition of this Agreement shall be a waiver of any other or subsequent breach of the same or any other covenant, term or condition or a waiver of the covenant, term or condition itself. 7.8 Termination. This Agreement may only be terminated by either party: 1) for breach of the Agreement; 2) because funds are no longer available to pay Consultant for services provided under this Agreement; or 3) City has abandoned and does not wish to complete the project for which Consultant was retained. A party shall notify the other party of any alleged breach of the Agreement and of the action required to cure the breach. If the breaching party fails to cure the breach within the time specified in the notice, the contract shall be terminated as of that time. If terminated for lack of funds or abandonment of the project, the contract shall terminate on the date notice of termination is given to Consultant. City shall pay the Consultant only for services performed and expenses incurred as of the effective termination date. In such event, as a condition to payment, Consultant shall provide to City all finished or unfinished documents, data, studies, surveys, drawings, maps, models, photographs and reports prepared by the Consultant under this Agreement. Consultant shall be entitled to receive just and equitable compensation for any work satisfactorily completed hereunder, subject to off-set for any direct or consequential damages City may incur as a result of Consultant's breach of contract. Design—Pm�vcsAgreement-November 20,2008 PAGE60F7 7.9 Execution of Agreement. This Agreement may be executed in duplicate originals, each bearing the original signature of the parties. Alternatively, this Agreement may be executed and delivered by facsimile or other electronic transmission, and in more than one counterpart, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument. When executed using either alternative, the executed agreement shall be deemed an original admissible as evidence in any administrative or judicial proceeding to prove the terms and content of this Agreement. 8.0 NOTICES Any notice given under this Agreement shall be in writing and deemed given when personally delivered or deposited in the mail (certified or registered) addressed to the parties as follows: MR. TIM ERIKSEN CITY OF UKIAH LAWRENCE &ASSOCIATES DEPT. OF PUBLIC WORKS 3590 IRON COURT 300 SEMINARY AVENUE SHASTA LAKE, CA 96019 UKIAH, CALIFORNIA 95482-5400 9.0 SIGNATURES IN WITNESS WHEREOF, the parties have executed this Agreement the Effective Date: CONSULTANT BY: t > �1 , C.. ZZ -ZoZl David Kirk Date 94-2661102 IRS IDN Number CITY OF UKIAH BY: 5r-5 OU 22, 2021 SAGE SANGIACOMO Date CITY MANAGER ATTEST ��ifti�r2l?wC9,A- Oct 22 2021 Kristine lawler(Oct 22,202109.22 PDT) 7 KRISTINE LAWLER, CITY CLERK Date Desip—Prot3vcsA5reemenr-November 20,2008 PAGE 7OF7 City of Ukiah July 10,2021 ATTACHMENT A-Proposal for 2021 Annual Gas-Extraction Sampling Page I of 3 Introduction This proposal describes the scope of work and associated costs for conducting the annual emissions sampling of the perimeter gas-extraction system at the City of Ukiah Landfill (Landfill). In 1997, a perimeter gas-extraction system was installed at the Landfill to control the migration of landfill gases away from the Landfill. The system consists of vertical extraction wells (between the landfill and the property line) connected to a header pipe. Landfill gas that has migrated outside of the Landfill is collected by the wells, and then conveyed in the header pipe to the stack. The collected gas is discharged without treatment,because a screening-level health-risk assessment,conducted when the system was started, showed a less than 10-in-one-million excess cancer risk(the 10-in-one-million limit was established by Mendocino County Air Quality Management District[MCAQMD]). Monitoring since start up has shown similar results each year. The system is operating under a"Permit to Operate" issued by the MCAQMD. Condition XIV.B.2. requires annual testing of stack gas for methane and the"specified air contaminants" of the California Health and Safety Code, §41805.5, and reporting of the results to the MCAQMD 30 days before each permit renewal date (August 30 of each year). This condition requires sampling and analysis by EPA TO-15 methodology. TO-15 analysis,however, is not appropriate for methane and some of the specified air contaminants. The appropriate analytical methods are described in the Scope of Work,below. Special Condition XIV.B.3. states that if a health-risk assessment conducted by the MCAQMD shows a greater than 10-in-one-million excess cancer risk at the nearest receptor,the MCAQMD may require treatment of the effluent. A health-risk assessment conducted now or in the future would be based on the annual sampling conducted for Special Condition XIV.B.2. Scope of Work This scope of work addresses Special Condition XIV.B.2 (the annual emissions sampling) in the Permit to Operate. For all analyses,the system effluent will be sampled via a tee fitting attached to the sampling port on the stack, inside the blower building. All samples will be collected in duplicate. Formaldehyde samples will be collected using vacuum pumps constructed of stainless steel, Teflon,Viton rubber, and borosilicate glass, and designed for gas monitoring. Samples for P03148.00 Task 21 Lawrence&Associates City of Ukiah July 10,2021 ATTACHMENT A-Proposal for 2021 Annual Gas-Extraction Sampling Page 2 of 3 formaldehyde will be drawn through DNPH-coated silica-gel cartridges at about 1 liter/minute for 4-6 hours. A field blank will be analyzed for formaldehyde. The field blank will consist of a cartridge that remains in its culture tube next to the pumps during the duration of sampling. Hydrogen sulfide samples will be collected in tedlar bags, and volatile organic compounds and fixed gases will be collected in 6-liter SUMMA canisters cleaned at the laboratory. Before sampling, the canisters can hold a vacuum of up to -28 inches of mercury. The high vacuum allows sample(s) to be drawn into a canister, without the use of a pump,when the stainless-steel bellows valve on the canister is opened. All samples will be shipped overnight to Atmospheric Analysis and Consulting hie., Ventura, California. Atmospheric Analysis and Consulting is a California certified environmental laboratory. Fixed(natural)gases and total nonmethane hydrocarbons (non-methane organic compounds, NMOC)will be analyzed by ASTM Method D-1945. The specified air contaminants of the California Health and Safety Code, Part 4, Chapter 3,Article 2, Section 41805.5(i)(6) will be analyzed by EPA Method TO-11 (for formaldehyde), EPA Method TO-15 (for halogenated hydrocarbons),ASTM D-5504(for hydrogen sulfide), and EPA 25C for total non-methane organic compounds. Results will be presented in a written report containing field notes, laboratory sheets,tabulated summaries of the data, and a discussion of results. The results also will be used to evaluate compliance with Special Condition XIV.B.1, the emission limit for NMOC of 220 pounds/day. The work does not include a health-risk assessment. If results from the proposed sampling are similar to previous results(for which a health-risk assessment was conducted),presumably the excess cancer risk of 10-in-one million would not be exceeded. The City does not need to conduct a health-risk assessment unless specifically requested by the MCAQMD. P03148.00 Task 21 Lawrence&Associates City of Ukiah July 20,2021 ATTACHMENT A-Proposal for 2021 Annual Gas-Extraction Sampling Page 3 of 3 Cost Estimate The estimated cost of work is not to exceed$6,586. This includes laboratory analysis. A detailed cost estimate is shown below. ANNUAL GAS-EXTRACTION SYSTEM SAMPLING-2021 Item Qty Unit $/Unit Subtotal Labor Principal Geologist,review report 0.5 Hr $170.00 $85.00 Associate Geologist,prepare report 6 Hr $130.00 $780.00 Technician, order sampling supplies, 24 Hr $90.00 $2,160.00 prepare to sample, collect,package, and ship samples (requires 6-8 hours for formaldehyde) AutoCAD operator,prepare figures 1 Hr $95.00 $95.00 Clerical, edit and reproduce report 1 Hr $70.00 7 m Subtotal $3,190.00 Expenses Report materials 1 LS $100.00 $100.00 Equipment rental (pumps, manometer) 1 LS $100.00 $100.00 Laboratory(Atmospheric Analysis and Consulting, Inc.) Mod. TO-15 (volatile organics) 2 Ea $230.00 $460.00 EPA 25C 2 Ea $205.00 $410.00 Mod. TO-11 (formaldehyde) 3 Ea $175.00 $525.00 Mod. ASTM D-1945 (natural gas) 2 Ea $230.00 $460.00 Mod. ASTM D-5504 (1712S) 2 Ea $205.00 $410.00 Formaldehyde cartridges 3 Ea $25.00 $75.00 6-liter SUMA canister 2 Ea $45.00 $90.00 Shipping(samples and reports) 1 LS $350.00 $350.00 Per Diem 1 Dy $150.00 $150.00 Mileage 380 Mi $0.70 $266.00 Subtotal $3,396.00 Labor $3,190.00 Expenses $3,396.00 TOTAL 56.586.00 P03148.00 Task 21 Lawrence&Associates - UT LAWRENCE & ASSOCIA'TES ENGINEERS & GEOLOGISTS ATTACHMENT B-SCHEDULE OF FEES EFFECTIVE JOLY,2021 Professional Services Engineering Geologist/Hydrogeologist Principal ..................................................................................................... $170/hour Senior......................................................................................................... $150/hour Associate.................................................................................................... $130/hour Staff...................................................................................................:........ $115/hour Assistant..................................................................................................... $110/hour Engineer PrincipalEngineer...................................................................................... $180/hour Senior Registered Civil............................................................................... $165/hour Associate Registered Civil ......................................................................... $135/hour StaffCivil................................................................................................... $125/hour AssistantCivil............................................................................................ $115/hour EngineeringTechnician.............................................................................. $90/hour Project Manager............................................................................................... $130/hour Environmental Assessor.................................................................................. $115/hour AutoCAD Operator(Level 1)........................................................................... $95/hour AutoCAD Operator(Level H)......................................................................... $85/hour Field Technician.............................................................................................. $90//hour Laborer............................................................................................................. $70/hour Tank Fund Administrator........................................................................... $70/hour Clerical............................................................................................................. $70/hour Deposition and Court Appearances Minimum charge.............................................................................................. $1400 part or full day Deposition or Court Appearance Rate ............................................................ $250/hour Preparation at consulting-service rates............................................................ as listed above Drilling Services(CME-55 drilling rig) 7-5/8 and 9-5/8-inch OD augers with operator and helper............................... (See drilling Mobilization..................................................................................................... schedule of fees) Other In-House Equipment Test pumps(submersible,through 5 HP)......................................................... quoted/job Campbell 21X data loggers w/transducers(water and gas)............................ quoted/job Conductivity,oxygen,temperature and dissolved oxygen probes................... quoted/job Meteorological station(wind direction and velocity)...................................... quoted/job Gas-extraction and air-monitoring pumps....................................................... quoted/job Mileage............................................................................................................ $0.70 Mileage(drilling rig)....................................................................................... $I.00 Per diem—Northern CA(per person/day;may vary dep.upon location)........ $150/night Per diem—Southern CA(per person/day;may vary dep.upon location)........ $250/night Level D protection(per person/day)................................................................ $30/day Survey equipment(per day)............................................................................. $50/day GPSSurvey(per day)...................................................................................... $150/day Expenses,Materials,Outside Services (All direct job related expenses:reproduction,rental equipment, materials,subcontracted labor and equipment)................................................ at cost+ 15% 3590 Iron Court • Shasta Lake,Califomia 96019 • (530)275-4800 • fax(530)275-7970 www.lwrnc.com LAWR&AS-CL CSHEATS '4 o CERTIFICATE OF LIABILITY INSURANCE DA7M2l2021[MMIDDfYYYY) 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 policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NQNTACT George Petersen Insurance Agency,Inc. H 2920 Bechelli Lane (AIC, o,Ext):(530)244-9400 ja/c,No):(530)244-9444 Redding,CA 96002 MESS:,info@gpins.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:State Compensation Insurance Fund 35076 INSURED INSURER B: Lawrence&Associates Inc INSURER C: 3590 Iron Ct INSURER D: Shasta Lake City,CA 96019 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN MMIDDIYYYY MMID COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR DAMAGE TO RENTED PR MI a o,c r nce $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-JECT ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRE ONLY AUTOS-OWNED P�20PEFtTY AMAGE er accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION X SPTARTUTE OTRH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ X 1968162-21 7/1/2021 7/1/2022 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 19000,000 DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) WAIVER OF SUBROGATION APPLIES PER THE ATTACHED FORM 2570 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF UKIAH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 SEMINARY AVE. UKIAH,CA 95482-5400 AUTHORIZED REPRESENTATIVE Oy ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT AGREEMENT BROKER COPS' WAIVER OF SUBROGATION 1968162-21 FUND REMETWIAL 'T N A HOME OFFICE 0-79-85-40 SAN FRANCISCO EFFECTIVE JULY 1, 2021 AT 12.01 A.R. PAGE 5 OF 16 ALL EFFECTIVE DATES ARE AND EXPIRING JULY 1, 2022 AT 12.01 A.1-x. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME DAV I D A LAWRENCE INC 3590 IRON CT SHASTA LAKE, CA 96019 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF UKIAH WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, DAVID A LAWRENCE INC IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SANFRFRANCISCO: JULY 2, 2021 2570 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO SCIF FORM 10217 IREV.7-2014) OLD DP 217