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TC2017-0052
Vol 44 4dildi. j f jjjj ENCROACHMENT PERMIT SEP 07201? PUBLIC WORKS CONSTRUCTION CITY OF L4 QUINTA DESIGN AND DEVELOPMENT DE For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like PRUtTcT works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS. DATE: 9/7/2017 LOCATION OF CONSTRUCTION(Street address or Description): EISENHOWER AT COACHELLA DR PURPOSE OF CONSTRUCTION: POTHOLE FOR UTILITY DEPTH CHECK FOR PROPOSED STORM DRAIN DESCRIPTION OF CONSTRUCTION: EISENHOWER STORM DRAIN PROJECT DIMENSION OF INSTALLATION OR REMOVAL: 10" DIAMETER APPROXIMATE TIME WHEN WORK WILL BEGIN: 9/5/2017 TIME OF COMPLETION: 9/15/2017 ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing permanent resurfacing and/or replacing improvements) COMMENTS: In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or toss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. --- - Not if t(24)mhours the Administrative Authority at least twenty-four n inspection request1èave a message on the Ins prior to the anticipatedinspctiorj Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of and to pay for any additional replacement necessary as the result of this work. Signature of Applican or Agent KANA SUBSURFACE ENGINEERING 12620 MAGNOLIA AVE RIVERSIDE, CA 92503 Name of Applicant (please print) Business Address KANA SUBSURFACE ENGINEERING 12620 MAGNOLIA AVE RIVERSIDE, CA 92503 Name of Contractor and Job Foreman Business Address 1002768 Contractor's License No. City Business License No. (909)204-5987 Telephone No. (909)204-5987 Telephone No. hours Applicant's Insurance Company Finance Revenue Code PERMIT INSPECTION TRAFFIC CONTROL ONLY - 2-5 DAYS . $608.00 TECHNOLOGY ENHANCEMENT FEE $5.00 TOTAL: $613.00 Policy Number PERMIT NO: TC2017-0052 DATE ISSUED: .iZJ/7 / EXPIRATION DATE: BY: 1. WORK INSPECTED BY*: PERMIT COMPLETION DATE: *If the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council. PUBLIC WORKS DEPARTMENT APPLICATION FOR PERMIT Date: Tract No: Project Name: /j Vicinity:_________ Purposeof Construction (i.e.: Rouh Grading, Offsite Street, etc.) ,i. S Ffl/ hi Pt ~TD #i /Y4iN Description of Construction (i.e.: See Plan Set No. 01234) Dimension of Installation or Removal: /D" 6/4,141?V Approximate Construction Start Date: I ,If 17 Approximate Construction Completion Date: Estimated Construction Cost: $ // Jez o Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back-filling, compa c t i o n a n d placing permanent resurfacing and or replacing improvements Contact Name: L° j Name of Applicant/Owiier: /IAM# 1L Applicant Address: /2620 it44n.4'k4 Applicant Telephone Number: Applicant E-mail Address: //fFc Phone Number: le Name of Contractor: Contractor Address: Contractor Telephone Number: gF9.224- c'/90 Contractor State License Number: /?8 Contractor City Business License Number: Contractor E-mail Address: A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED4 plicant or Coiitractor General Liability Insurance Company: Applicant or Contractor General Liability Insurance Policy Number: Office Use Only: Inspection Fee: Permit Fee: As-13ui11 Deposit- Dust Control Deposit: Credit Amount: Office Use Only: A11uTb Approval Date: Expiration Date: Issue Date: Administrative Authority: TOTAL FEE DUE: Application EISENHOWER DR. G20-2 END ROAD WORK ROAD WORK AHEAD C 17 IMOWM SPEED LIMP 35 350 50 W4-2 LAGUNA DEL PAZ C17(CA SPEED 320' 25 NOTES; 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH THE 2014 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROLS (M.U.T.C.D.) TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUSLIC SAFETY AND TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LAQUINTA REPRESENTATIVE. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS. CONTRACTOR SHALL MAINTAIN A MINIMUM 12 TRAFFIC LANE WIDTH AT ALL TIMES. THERE SHALL BE A MINIMUM 5' BETWEEN THE EDGE OF CUT AND THE NEAREST TRAFFIC LANE. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. WORK HOURS SHALL BE WEEKDAYS BETWEEN 8:30 AND 2 PM UNLESS THE CONTRACTOR MAKES OTHER ARRANGEMENTS WITH THE CITY OF LA QUINTA. ROAD SHALL BE CLEARED OF DEBRIS AND TRAFFIC RETURNED TO NORMAL AT THE END OF WORK HOURS.. THE TRAFFIC SIGNAL AT EISENHOWER & COACHELLA DR AND EISENHOWER & AVD FERNANDO SHOULD BE PLACED ON RED FLASH WHILE THIS TRAFFIC CONTROL IS IN PLACE. KM1ewed my Date IMflh1It rlllmb& Pending Pothole Utilities for Future Storm Drain Conted KSE Underground Utilities Maio 909-767-5315 Traffic Contrd Design by Prepared By Cheded By Tops N Barricades, Inc. Ron Fifield r Phone Speed Umit Date Sheet N um ber 45 8/30/17 1 o 2REV -- APPROXIMATE POTHOLE LOCATION BEAR oo W20-1 No. 1784 -. Exp. 6 30 19 ROAD AHEAD C)F OF 1 /)COACHELLADR. R3.2 C38 (CA) (MOD) W20-1 ii FERNANDO AHEAD G20-2 R3-2 C30 (CA) C17 c C17 T)W2o5(LTN< AVE 50 SPEED ROAD W20-1 MO WORK (CA) CILO ED 25 AHEAD C30 WORK 11 1 AHEAD CrOIED MUST C17 (CA) TURN an SPEED LIMIT 35 RK AD N°', °° T aH 4Jo :H1 KEEP G20-2 LSEE NOTE 7 NO WO W20-1 ROAD WORK W20-1 L. Q. RESORT SANTA ROSACOVE ROAD '\A/) AHEAD KEEP RIGHT 1 HIDDEN /L • CANYON R3-7 / LEFT LANE / MUST I •...:-- TURILUTI / /I.ANE\ CLOSED 7 .IT SEENOTE71 C3 (CA) LANE W2)-1 CLOSED ROAD WORK AHEAD V. 6, 1,305 6q4 EXIST. 12" / WATER PROPOSED STDRH DRAIN PROP RETENTION STORM DRAIN / BASIN STORM DRHIN ---1i EXIST CATCH BASIN / t EXIST 10" (A OCR SEWER LEGEND POTHOLE -- E GA XIST. 4" SD X I NG ELEC A" SD X—ING DOMESTIC 1)1 (A PROP. WATER GRATED 03 SD X—ING [LECTRICA (FLOW-BY) SD X- ING DOME/ 'I EX I ST GRATED () SD X-ING SEWER INLET AIN. '"- SD X-INC DOMES; V,11 RS SD X—ING NATURAL 1" '95,o55.' SD X INS \1,/ 6, 544, 278 . b 2,195,629.67Z32 6,544,262.4307 AX) EXIST RCP SO EXIST 12 WIDE MEANDERING SIDEWALK EXIST .-. / WALL EXIST A"-- TIP WATER EXIST CATCH ,1 BASIN \ \ 7 / "-1---EXIST I / WALL I (A/ EXIST 10" . •// // ACE SEWER / I \\\\\\\ EXIST EXIST 4' '7 \ \ CXIV, ELEC- / GAS COt"ITS !EXIST R" \ / I WATER ' 1/ / EXIST / SIDEWALK I /T i I I/PROPOSED I i RETENTION I f / '" / !/I BASIN / / I / EXIST / I EXIST 18" I DIP WATER I l , N . 1 1-1 . ' 1 . 3225 49 98, .161017.10205''\/ IS V 00 PROP BASIN / - - (FLOW-BY) / -- 42 ITT CATCH PROP GRATED Acg N0 , V-. Tvpl I, 'AV. U: 201 I'i -BY) 1 2,1O4,687.6277( //// \ TM DRAIN 020.3220N - \ -. U \N 2,194,687.8136 E 544,002.30 54 . - .. I .-- S - -, ( 75410 G.,Id Fo.4 0,/v., Svit. ITO IITfflI:E1!?I1 Palm °-' CA 92211 Phon. (760) 548-7481 MBAIKERINTLCOM INTERN AT ION AL 40 20 S 45 95 120 SCALE. I"40' LA QUINTA, CA POTHOLING EXHIBIT August 10, 2017 20-2 ND WORK LIT 350 W20-5 (LT) *350 W4-2 LAGUNA DEL PAZ 320 4 W20-1 A ROAD WORK AHEAD 17(CA) (2 EISENHOWER DR. W4-2 W20-' WORK AHEAD W20-5 (LT ) AVE. 50 CLOSED AHEAD C17 WEED ON! 35 350' U 020-2 END W20-1 7 ( WORK END W20-1 ROAD WORK W20-1 L. Q. RESORT SANTA ROSA COVE *AHEAD NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH THE 2014 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROLS (M.U.T.C.D.) TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETY AND TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LAQUINTA REPRESENTATIVE. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS. CONTRACTOR SHALL MAINTAIN A MINIMUM 12' TRAFFIC LANE WIDTH AT ALL TIMES. THERE SHALL BE A MINIMUM 5' BETWEEN THE EDGE OF CUTAND THE NEAREST TRAFFIC LANE. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. WORK HOURS SHALL BE WEEKDAYS BETWEEN 8:30 AND 3 PM UNLESS THE CONTRACTOR MAKES OTHER ARRANGEMENTS WITH THE CITY OF LA QUINTA. ROAD SHALL BE CLEARED OF DEBRIS AND TRAFFIC RETURNED TO NORMAL AT THE END OF WORK HOURS.. THE TRAFFIC SIGNAL AT EISENHOWER & COACHELLA DR SHOULD BE PLACED ON RED FLASH WHILE THIS TRAFFIC CONTROL IS IN PLACE. Pending 94 tfic ConEd Plan for Pothole Utilities for Future Storm Drain Pone Corkacor Conted KSE Underground Utilities Malo 909-767-5315 Trdft Conbd Design by PrepatedBy OedBy NO SCALE Tops N Barricades, Inc. Ron Fifield - peed LkT1d We SteetNtsnEer (800)852-TOPS 45 8/28/17 1 of 2 - APPROXIMATE POTHOLE LOCATION 41, CS (CA) LANE CLOSED 0' W20-1 ROAD WORK AHEA COACHELLA DR. am AVD. FERNANDO W20-1 LANE ROAD ED LIM9 CLOSED WORK 35 AHEAD C30 CA) R3-7 LErTLANE LANE MUST CLOSED - A f C3 CA) 6 . - A CLOSED LANE :H PH 1 KEEP RIGHT HIDDEN lA CANYON ImIum rr Err C30 (CA --- 6' LANE CLOSED / SEE NOTE 7 W2 -1 ROAD WORK AHEAD AVD. FERNANDO W20-1 AHEAD AVE. 50 SANTA ROSA COVE W20-1 ROAD WORK AHEAD 500' 0'3~ 020-2 END ROADWORK L. Q. RESORT W20-1 W20-1 *(CA C17) 15 J 3u1 W20-5 (RT) \7 3}W4-2 op LAGUNA DEL PAZ 350 '. R3-7 I EI MUST ---- EISENHOWER DR. NOTES: 1 ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH THE 2014 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROLS (M.U.T.C.D.) TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETY AND TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LAQUINTA REPRESENTATIVE. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS. CONTRACTOR SHALL MAINTAIN A MINIMUM 12' TRAFFIC LANE WIDTH ATALL TIMES. THERE SHALL BE A MINIMUM 5' BETWEEN THE EDGE OF CUT AND THE NEAREST TRAFFIC LANE. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. WORK HOURS SHALL BE WEEKDAYS BETWEEN 8:30 AND 3 PM UNLESS THE CONTRACTOR MAKES OTHER ARRANGEMENTS WITH THE CITY OF LA QUINTA. ROAD SHALL BE CLEARED OF DEBRIS AND TRAFFIC RETURNED TO NORMAL AT THE END OF WORK HOURS.. Pending Traffic CcmW Plan for - Pothole Utilities for Future Storm Drain Prime Coi*actor Canted KSE Underground Utilities Malo 909-767-5315 Traffic Confrol Design by Pre9arad By Ctredrad By NO SCALE Tops N Barricades, Inc. Ron Fifield i'tiane Speed iI[ Date Street Nuth& (800)852-TOPS 45 8/28/17 2 of 2 - APPROXIMATE POTHOLE LOCATION W20-1 411 WORK AHEAD / . LAN /E * COACHELLA DR. CLOSED HIDDEN CANYON .. .. k3- 7 /\ CLOSED . ClJ(CA) C3 1351 LANE CLOSED A3RIJ . . CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDNYYY) I 8/30/2017. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. This CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate lieu such_endorsement(s). _holder _In_ _of poouce Alliant Insurance Services, Inc. 1301 Dove Street Suite 200 Newport Beach CA 92660-2436 Nick Parizino PHONE OAO n FAX Ho Ft)' - (Ac. Nol: A BESS: Nick.Parizino@alliant.com INSURER(S) AFFORDING COVERAGE NAIC I INSURER A:AXIS Surplus Insurance Company 26620 INSURED . INSURER B :Federal Insurance Company 20281 Kana Subsurface Engineering INSURER C :AmeriCEn Guarantee & Liability 26247 2620,Magnolia Ave Riversde CA 92503 INSU o:Executive Risk Indemnity Inc 35181 INSURER B INSURER F COVERAGES CERTIFICATE NUMBER: 1062087168 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 LTR -. TYPE OF INSURANCE s. INSD SUOR - POLICY NUMBER POLICY EFF. 1MMIDDffYYY) POLICY EXP IMMIDDIYYY UMITS______________ D x[ COMMERCIAL GENERAL LIABILITY . Y Y 54303188 811/2017 8/1/2018 EACH OCCURRENCE $1,000,000 I CLAIMS-MADE [] OCCUR . .PREMISES (Ea oommym $100,000 MED EXP (My one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GEL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE. $2,000,000 POLICY [] '& []LOC PRODUCTS - COMPS'OP AGG $2,000,000 Deductible $25,000 [OTHER: B AUTOMOBILE LIABILITY V V 54303187 8/1/2017 8/1/2018 COMBINEOSINGLELIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO - ALL AUT&ED [] 5)jIULED BODILY INJURY (Per accident) $ - NON-OWNED . - HIRED AUTOS AUTOS . . PROPERTY DAMAGE (Per aeddere) Camp/Coil Deductibles $1 .000 C X UMBRW.ALIAB LJ OCCUR V V AUC019983401 8/1/2017 8/1/2018 EACH OCCURRENCE $9,000,000 - AGGREGATE $9,000,000 EXCESS UAB _I_CLAIMS-MADE DED I_I_RETENTIONS Products-Comp/OpAg $9.000,000 - - B WORKERS COMPENSATION ANY PROPRIETORIPARTNERIEXECUT1VE OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) NIA Y AND EMPLOYERS LIABILITY YIN 54303189 8/1/2017 8/1/2018 x( STATUTE PER_I_I ER " E.L. EACH ACCIDENT $1,000,000 EL DISEASE - GA EMPLOYEE $1,000,000 - if yes, describe under 0SCRIPTION OF OPERATIONS below - - E.L. DISEASE - POLICY LIMIT $1,000,000 A Professional Liability and Y Y CM002660012017 8/1/2017 8/1/2018 Each Claim Limit 2,000,000 Pollution Liability Aggregate Limit 2,000,000 SIR . $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) City of La Quinta is named as additional insured per the attached endorsements. CERTIFICATE HOLDER CANCELLATION 30 City of La Quinta 78495 CaIle Tampico La Quinta CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 54303188 COMMERCIAL GENERAL LIABILITY CG 20 12 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the folIo fing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Politics Where required by written permit Information required to complete this Schedule, if not shown Section II - Who I. An Insured is amended to in- clude as an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to opera- tions performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or au- thorization. 2. This insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injurf arising out of operations performed for the federal government, state or municipality: or "Bodily injury" or "property damage" included within the "products-completed operations hazard". 0 -. .CG20120509 C Insurance Services Office. Inc.. 2008 Page lofI 0 POLICY NUMBER: 54303188 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): S Location(s) Of Covered Operations Where required by written contract Where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "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; in the performance of your ongoing operations for the additional insured(s) at the. location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after All work, including materials, parts or equip- ment furnished in connection with such work, On the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 0 ISO Properties, Inc., 2004 Page, 1 of I 0 POLICY NUMBER: 54303188 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): S Location And Description Of Completed Operations Where required by written contract I Where required by written contract Information required to complete this Schedule; if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included - in the "products-completed operations hazard". CG 20 37 07 04 0 ISO Properties, lnc.,.2004 S Page 1 of 1 0 POLICY NUMBER: 54303188 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Designated Construction Project(s): where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which -the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by "occur- damages or under Coverage C for medical rences" under Section I - Coverage A, and for all expenses shall reduce the Designated Con- medical expenses caused by accidents under struction Project General Aggregate Limit for Section I - Coverage C, which can be attributed that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General Ag- construction project shown in the Schedule . gregate Limit shown in the Declarations nor above: . . . shall they reduce any other Designated Con- 1. A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- any other designated construction project ignated construction project, and that limit is shown in the Schedule above. equal to the amount of the General Aggregate . 4. The limits shown in the Declarations for Each Limit shown in the Declarations. . Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the • However, instead of being subject . to the sum of all damages under Coverage A, ex- General Aggregate Limit shown in the Decla- cept damages because of "bodily injury" or rations, such limits will be subject to the appli- "propety damage" included in the "products- cable Designated Construction Project Gen- completed operations hazard", and for medi- eral Aggregate Limit. cal expenses under Coverage C regardless of . the number of: Insureds; • Claims made or "suits" brought; or Persons or organizations making claims or bringing "suits". . • . CG 25 03 05 09 • ©Insurance Services Office, Inc., 2008 • Page 1 of 2. 13 B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attrib- uted only to ongoing operations at a single des- ignated construction project shown in the Sched- ule above: Any payments made under Coverage A for damages or under Coverage C .for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-completed Operations Aggregate Limit, whichever is applicable; and Such payments shall not reduce any Desig- nated Construction Project General Aggre- gate Limit. When coverage for liability arising out of the "products-completed operations hazard" is pro- vided, any payments for damages because of "bOdily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag- gregate Limit, and not reduce the General Ag- gregate Limit nor the Designated Construction Project General Aggregate Limit. If the applicable designated construction project has been. abandoned, delayed, or abandoned and then restarted, or if the authorized contract- ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction pro- ject. The provisions of Section HI - Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 . . 0 Insurance Services Office, Inc., 2008 CG 25 03 0509 13 Policy Number: 54303188 c. Method Of Sharing If all of the other.insurance permits contribution by equal shares, we will follow this method al- so. Under this approach each insurer contrib- utes equal amounts until it has paid its appli- cable limit of insurance or hone of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable lim- it of insurance to the total applicable* limits of insurance of all insurers. 5. Premium Audit We will compute all premiums for this Cover- age Part in accordance with our rules and rates. We may audit your books and records as they relate to this insurance at any time during the term of this policy and up to three years after- wards. The first Named Insured must keep records of the information we need for premium computa- tion, and send us. copies at such times as we may request. 6. Representations By accepting this policy, you agree: The statements in the Declarations, are accu- 'rate and complete; Those statements are based upon representa- tions you made to us; and We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits' of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this in- surance applies: As if each Named Insured, were the only Named Insured; and Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Or Waiver Of Rights Of Recovery Against Others To Us We will waive the right of recovery we would oth- erwise have had against another person or organ- ization, for loss to which this insurance applies, provided the insured has waived their rights of re- covery against such person or organization in a contract or agreement that is executed before such loss. COMMERCIAL GENERAL LIABILITY' Form 10-02-1800 (Rev. 6-09) To the extent that the insured's rights to recover all or part of any payment made under this Cover- age Part have not been waived, those rights are transferred to us. The insured must do nothing af- ter loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Coverage C. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than, 30 days before the expi- ration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V - DEFINITIONS 1. "Advertisement" means an electronic, oral, written or other notice, about goods, products or services, designed for the specific purpose of attracting the general public or a specific market segment to use such goods, products or services. "Advertisement" does not include any e-mail ad- dress, Internet domain name or other electronic address or metalanguage. 2. "Advertising injury" means injury, other than "bodi- ly injury", "property damage" or "personal injury", sustained by a person or organization and caused by an offense of infringing, in that particular part of your "advertisement" about your goods, products or services, upon their: Copyrighted "advertisement"; or Registered collective mark, registered service mark or other registered trademarked name, slogan, symbol or title. 3. "Asbestos" means asbestos in any form, including its presence or. use in any alloy, by-product, com- pound or other material or "waste". 4. "Auto" means: A land motor vehicle, trailer or semitrailer de- signed for travel on public roads, including any attached machinery or equipment; or Any other land vehicle that is subject to a com- pulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However, "auto" does not include "mobile equip- merit". 5."Bodily injury" means physical: Injury; Sickness; or c. Disease; Includes copyrighted material of ISO Properties, Form 10.02-1800 (Rev. 6-09) Inc., with its permission ' , , Policy Number: 54303187 COMMERCIAL AUTOMOBILE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAI FORM ENDORSEMENT This endorsement modifies insüance provided under the following: - I. ..borrow2in;your business or your personal affairs. - 4 • - 1 C Lessors as:hsureds. S - Pagraph.A.1. -WHO IS AN INSURED.:--of SECTION lI—LIABILITY CORAGE.i ... . .to.2.t•follpwing:. e. The lessor of a covered "auto" while the "atIeedcto4you tnde!a ritten agreement If.. r :. •' (1) Theagreement;requires youo-. provide direct primary insurance for the Iessor;and o. - (2)Theauto"js leased without-a driver-. Such leased "auto" will be considered a. covered "auto" you own.and nota coverd "autoyoLhire. S However;,the,lessor. is an:'insued" only S S S - S• - •_5 — 5 _4 2. - f6_ . or 'bodily injury" or "property damage" ,,• resuItingfrorn the actsor omissions by: - • ,.2 ny, 9fyQur :'eplpyeesor agents; j. - • - •.4 .• -" 3. Any person, .excep heessor or - 5- . - .-• anyjemploye& or gent of the Iesspr,. cperatng an "áuto' with the - -permission -ofanv of1. and/or 2. 'I. • 0. Persons And Organizations As Insureds .Under. A Written Insured Contractj Paragraph A.1 WHO IS AN INSURED —f SECTION H -,LiABlLiiQQVER&GE is • amended to add the foIIowing:. f. , Any perspn,pr-organlzation,with respect to - the, maintenance or use a covered. "auto,, pov1ded that:yu.and such persopor orgañization,hay.eagreed under an express provisionin avritten 'Insured contract", written 'a or a written permit issued to you by a 2 governmental or public authority.o add such person or organization to This1 p01icy as an 'inured". . However,, such person or organization i an 'insured only: .- - BUSINESS AUTO COVERAGE FORM This endorsement modifiesthe Busines Auto Coverage Form. EXTENDED CANCELLATION CONDITION Pargraph..A.2.b. - CANCELLATiON -.pfhe COMI9N POLI CY ço.NDITlors. form IL 0017 is deleted andr4epI6ced with the following: b. 60 days before.the effective date of cancellation if Ne cancel lr any other reason. BROAD FORM INSURED , A. Subsulianes and Newly Acqted oi-Fomed Organizations As lnsurec, The NamedInsuredshown ;fl the Declarations is aende1to Include;. .. 1... Any IgalIy Incorporated subsidiary-in which you wn .moiean 50% of thyopg stock on the effective date qf the Coverage Form. . However,, the Named Insured does-not include any subsidiary is n-i12sur',under any other automobile poIcyor.,would be.an -: 'nsuredurdersucha poliybut,for.its - termination or theexhaustion'ofJts1Limit.of Insurance. Z. Anyganiztion ttat is acquir4,,or fo?red by over which youmaintain -majority ownerhi W. p.. However, the Narned.Insured does not includeany.newly formedor 2 J..5 ( _4 p .2 •1•• - acquired organization:.. •. . - .42,..•. '- ._ $ J (a) That s an nsured" under any.other ,autobiIepIy;. , . (b) That has e aiisted its Limit of lasurance wider any other i5olicy: or (c)180 days or , nore ifter its acquisition or forthtion by yo u unless you have given I *Ausvritten.notic of the àctiiition or fór'riiatioi{. ., - .1 Coverage dóesno,t'applytó'bddily injury" or "property ddrnage"hat results from an "accident" thatddcurred before you formed or aôquirèd the ôrganiticn .- B. Employees as insureds IS AN INSURED —of SECTION Il —LIABILITY COVERAGE is amended to add the following: d. Any "employee" of yours while using a covered "auto" you don't own, hire or Form:' 16-02-0292 (Rev. 4-11) Page 1 of 3. "Includes copyrighted material of Insurance Services Office, Inc. with its permission" (1) with respect to the operation, maintenance or use of a covered "auto"; ihd (2) for "bodily injury" or "property damage" caused by an "accident" which takes place after: You executed the 'Insured contract" or written agreement; or The permit has been issued to you. 3. FELLOW EMPLOYEE COVERAGE EXCLUSION 6.5. - FELLOW EMPLOYEE -of SECTION 11 -LIABILITY COVERAGE does not apply. 4. PHYSICAL DAMAGE -ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A:4.a. -TRANSPORTATION EXPENSES - of SECTION III -PHYSICAL DAMAGE COVERAGE is amended to provide a IimlIof $50 per day for temporary transportation expense, subject to a maximum limit of $1,000. 5. AUTO LOANILEASE GAP COVERAGE Paragraph A. 4. -COVERAGE EXTENSIONS - of SECTION lii -PHYSICAL DAMAGE COVERAGE is amended to add the following: c. Unpaid Loan or Lease Amounts In the event of a total 'loss" to a covered "auto", we will pay any unpaid amount due on the loan or lease for a covered "auto" minus: The amount paid under the Physical Damage Coverage Section of the policy; and Any: a Overdue loan /lease payments at the time of the 'loss"; Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;• Security deposits not returned by the lessor: Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and Carry-over balances from previous loans or leases. We will pay for any unpaid amount due on the loan or lease If caused by: Other than Collision Coverage only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; Specified Causes of Loss Coverage only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto", or Collision Coverage only if the Declarations Indicate that Collision Coverage is provided for any covered "auto. 6. RENTAL AGENCY EXPENSE Paragraph A. 4. -COVERAGE EXTENSIONS -of SECTION Ill -PHYSICAL DAMAGE COVERAGE is amended to add the following: d. Rental Expense We will pay the following expenses that you or any of your"employees" are legally obligated to pay because of a written contract or agreement entered into for use of a rental vehicle in the conduct of youf business: MAXIMUM WE WILL PAY FOR-ANY ONE CONTRACT OR AGREEMENT: $2,500 for loss of income incurred by the rental agency during the period of time that vehicle is-out of use because of actual damage to, or 'loss" of, that vehicle','including income lost due to absence of that vehicle for use as a replacement; $2,500 for decrease in trade-in value of the rental vehicle because of actual damage to that vehicle arising out of a covered 'loss"; and $2,500 for administrative expenses ináurred by the rental agency, as stated in the contract or agreement. $7,500 maximum total amount for paragraphs 1., 2. and 3. combined. 7. EXTRA EXPENSE -BROADENED COVERAGE Paragraph A.4. -COVERAGE EXTENSIONS -of SECTION III -PHYSICAL DAMAGE COVERAGE Is amended to add the f011owing: e. Recoeiy Expense We will pay for the expense of returning a stolen covered "auto" to you. AIRBAG COVERAGE Paragraph 13.36. :EXCLUSIONS -of SECTION III -PHYSICAL DAMAGE COVERAGE does not apply to the accidental or unintended discharge of an airbag. Coverage is excess over any other collectible insurance or warranty specifically designed to provide this coverage. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT - BROADENED COVERAGE Paragraph C.2. -LIMIT OF INSURACE -of SECTION III -PHYSICAL DAMAGE is deleted and replaced with the following: 2. $2,000 is the most we will pay for 'loss" in any one "accident" to all electronic equipment that reproduces, receives or transmits audio, visual or data signals which, at the time of 'loss", is: Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; Removable from a permanently installed housing unit as described in Paragraph 2.a. above or Is an integral part of that equipment; or Form: 16-02-0292 (Rev. 4.11) • Page 2 of 3 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" C. An integral part of such equipment. 10. GLASS REPAIR —WAIVER OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE —of SECTION III —PHYSICAL DAMAGE COVERAGE the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 11. TWO OR MORE DEDUCTIBLES Paragraph D.- DEDUCTIBLE —of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to add the following: If this Coverage Form and any other Coverage Form or policy issued to you by us that is not an automobile policy or Coverage Form applies to the same "accident", the following applies: If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived: or If the deductible under this Business Auto Coverage Form Is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUITOR LOSS Paragraph A.2-a. - DUTIES IN THE EVENT OF AN ACCIDENT, CLAIM, SUIT OR LOSS of SECTION IV- BUSINESS AUTO CONDITIONS is deleted and replaced with the following: a. In the event of "accident", claim, "suit" or 'loss", you must promptly notify us when the "accident" is known to: You or your authorized representative, if you are an individual; A partner, or any authorized representative, if you are a partnership; A member, if you are a limited liability company; or An executive officer, insurance manager, or authorized representative, if you are an organization other than a partnership or limited liability company. Knowledge of an "accident", claim, "suit" or loss" by other persons does not imply that the persons listed above have such knowledge. Notice to us should include: How, when and where the "accident" or loss" occurred; The 'insured's" name and address; and To the extent possible, the names and addresses of any injured persons or witnesses. 13 WAIVER OFSUBROGATION Paragraph A.5. - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US of SECTION IV —BUSINESS AUTO CONDITIONS is deleted and replaced with the following: 5. We will waive the right of recovery we would otherwise have against another person or organization for 'loss" to which this insurance applies, provided the 'Insured" has waived their rights of recovery against such person or organization under a contract or agreement that is entered into before such loss". To the extent that the 'insured's" rights to recover damages for all or part of any payment made under this Insurance has not been waived, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or loss" to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph B.2. —CONCEALMENT, MISREPRESENTATION or FRAUD of SECTION IV -BUSINESS AUTO CONDITIONS - is deleted and replaced with the following: If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not void coverage under this Coverage Form because of such failure. AUTOS RENTED BY EMPLOYEES Paragraph 8.5. -OTHER INSURANCE of SECTION lV—BUSINESS AUTO CONDITIONS - is amended to add the following: a. Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire. If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the 'mploee's" personal insurance. HIRED AUTO.— COVERAGE TERRITORY Paragraph 13.7.b.(5).(a) - POLICY PERIOD, COVERAGE TERRITORY of SECTION IV - BUSINESS AUTO CONDITIONS Is deleted and replaced with the following: (a) A covered "auto" of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 45 days or less; and RESULTANT MENTAL ANGUISH COVERAGE Paragraph C. of-SECTION V— DEFINITIONS is deleted and replaced by the following: 'Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death as a result of the "bodily injury" sustained by that person. Form: 16-02-0292 (Rev. 4-11) Page 3 of 3 'Includes copyrighted material of Insurance Services Office, Inc. with its permission" POLICY NUMBER: 54303187 COMMERCIAL AUTO 16.02.0316 Ed. 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY LIABILITY INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated• below. Named Insured: Kana Subsurface Engineering Endorsement Effective Date: 08/01/2017 SCHEDULE Name(s) Of Person(s) Or Organization(s): S Where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Item 5.— "Other Insurance" of Item B. - "General Conditions" under Section IV -"Business Auto Conditions": e. Regardless of the provisions of Paragraph 5.a. through d. above, for any liability arising out of the ownership, maintenance, use, rental, lease, loan, hire or borrowing by an "insured" of a covered "auto" for which an "insured" is contractually obligated to. provide primary insurance coverage to a client, this Coverage Form will be primary and non-contributory with respect to the Persons or Organizations in the schedule, regardless of the availability or existence of other collectible insurance under any. other Coverage Form or policy that applies on a primary basis. 16.02.0316 Ed. 1014 • • S • •• Pagel ofi WORKERS COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC99 03 04.(Ed. 7-08) WAIVER OF OUR RIGHT TO RECOVER FROM. OTHERS ENDORSEMENT— CALIFORNIA This endorsement changes the policy to which it is attached effective on the inception date. of the policy unless a different date is indicated below. (The following "attaching clause need to be completed only when this endorsement is issued subsequent to preparation of the policy.) . . . This endorsement, effective on 8/1/2017 at 12:01 A.M. standard time, forms apart of (DATE) . S Policy No. 54303189 of the •' Federal Insurance Company (NAME OF INSURANCE COMPANY) issued to Kana Subsurface Engineering Endorsement No. S Authorized Representative 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. The additional premium for the blanket waiver offered by this endorsement shall be 0.00 % of total California premium. Schedule Person or Organization Job Description Where required by written contract Where required by written contract e WC 99 03 04 (Ed. 7.08) POLICY NUMBER: 54303188. .. . COMMERCIAL GENERAL LIABILITY 10-02-2461 (Ed. 7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE FOR SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: . .• COMMERCIAL GENERAL LIABILITY COVERAGE PART . . SCHEDULE . Additional Insured: S. Location Of Covered Operations: WHERE REQUIRED BY WRITTEN CONTRACT. ALL LOCATIONS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect only to the Additional Insured and at the Location Of Covered Operations shown in the Schedule, the following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, S Paragraph 4. Other Insurance and supersedes any provisiOn to the contrary: . . Primary And Noncontributory Insurance This insurance Is primary to and will not seek contribution from any other insurance available to the Additional Insured with respect to the Location Of Covered Operations shown in the Schedule under this policy provided that: . • . S The Additional Insured is a named insured under such other insurance; and You have agreed in writing in a contract or agreement that this • insurance would be . primary and would not seek contribution from . • any other insurance . available to the Additional Insured. 10.02-2461 (Ed. 7-15) Includes copyrighted material of Insurance Services Office, Inc., Page 1 of I with its permission. . . Policr # CM002660012017 Environmental Laws means any federal, state, provincial or local laws (including, but not limited to statutes, standards, rules, regulations, ordinances, governmental, judicial, or administrative orders and directives) that are applicable to a Pollution Condition. .(irdmeaI) .: the Named Insured' your current or former principals, partners, executive officers, directors, stockholders or trustees while acting on your behalf and within the scope of their duties as such; your current-or former employees, including leased personnel under your supervision, but only for acts within the scope of their employment or lease agreement; . . .4. a retired principal, partner, officer, director or employee, but only while acting within their duties as a• consultant for you. iiirespecft crjéBonly'T In idmayalsi (J Ciiti résectiothèli oTirCvered 6. a joint-venture to which you are a party, but only to the extent the joint venture's legal liability arises out of your performance of Professional Services or Covered Operations under such joint venture; 0. Loss means a monetary judgment, award -or settlement of compensatory damages, arising from, Bodily Injury or Property Damage due to a Pollution Condition. Loss includes Cleanup Costs. Mediation means a formal non-binding process in which a neutral panel or third party assists the parties in resolving their dispute and reaching their own settlement. We may, at our sole option recognize any process or forum that Is presented to us for our approval prior to any Mediation taking plaèe, and to which we give our written acceptance. Mold(s) includes but is not limited to. any superficial growth of fungus or spore-producing organism present on any matter; or produced on damp or decaying organic matter or on living organisms, fungi that'produce molds, mildew and associated spores and mycotoxins. Natural Resource Damage means the physical injury to, or the destruction of, including the resulting loss of use or loss of value of, land, fish, wildlife, biota, air, water, groundwater, drinking water supplies, and other such resources belonging to, managed by, held in trust by, appertaining to, or otherwise controlled by the United States of America (including* the resources of the fishery conservation zone established by the, Magnuson- Stevens Fishery Conservation and Management Act (16 U.S.C. 1801 et seq.),.ány state or loal government, any . Native American tribe, or if such resources are subject to'a trust restriction on alienation, any member of a Native American tribe. . . . .. . . .. . ... . Named Insured means the person or legal entity designated in Item 1. of the Declarations; Nuclear Facility means a site where a nuclear reactor is or was located, or where nuclear or radioactive waste or material is or was disposed, processed, handled or stored: . . Policy Period means the period set forth in the Declarations, or any shorter' period resulting from a termination of this Policy. Pollutant means any solid, liquid, gaseous or thermal irritant or contaminant, including Mold, smoke, soot, vapors, fumes, acids, alkalis, chemicals, hazardous substances, hazardous, materials, and waste. Pollution Condition means the discharge, dispersal, migration, seepage, release, or escape of any Pollutant into or upon land, or any structure on land, the atmosphere, or any watercourse or water body, that arises out of Covered Operations and results in Bodily Injury or Property Damage. A Pollution Condition does 'not include conditions that are naturally present in the environment in the concentration Or amounts discovered, CM 0001 (Ed. 07 13) PERMIT NO. TC2017.0052 Kana Engineering / Pothole for Utilities / Eisenhower Drive between Avenue 50 and Avenida Fernando for City Storm Drain Project In addition to the standard permit conditions, the following, shall apply: Pursuant to Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all work shall be performed in accordance with the latest edition of the Standard Specifications For Public Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer. This permit or copy of it shall be on the work site (usually the job trailer) for inspection during the actual work performed. The permittee must compact any disturbed soil within the paved right of way back to its original condition or compact to a minimum density of 95% based on AS1'MD 1557 and be placed while the soil is at +1-2% of optimum moisture, which ever compacting effort produces the greatest density. Any asphalt removed during potholing shall be replaced with City approved mix asphalt or equivalent. Temporary (Cold Patch) is not acceptable as an approved asphalt mix. The asphalt shall have a thickness equivalent or-greater than the removed asphalt thickness and shall obtain a density of 95% or greater based on maximum 'density obtained by the ASTM Marshall Mix Design Method. Kana Subsurface Engineering (Malo Tauaese); hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently, if required. The permittee shall submit inspection requests by calling the City Inspection Hotline at (760) 777-7097 before .l:30 p.m. and at least twenty-four (24) hours prior to the anticipated inspection. The permittee shall block off the work area to prevent access and provide alternate pathways if applicable. Pursuant to Section 6.08.050 of the La Quinta Municipal.Code (Ordinance 18 § 1, 1982), throughout the work site, the Permittee shall comply with City regulated work hours. Operation and maintenance of equipment within one-half mile of human occupancy shall be performed only during the following time periods: October 1st to April 30: Monday-Friday 7:00 a.m. to 5:30 p.m. Saturday 8:00 a.m. to 5:00 p.m. May lst.to September 30: Monday-Friday 6:00 a.m. to 7:00 p.m. Saturday 8:00 a.m. to 5:00 p.m. Work shall be prohibited on legal holidays and Sundays. Special Conditions Page 1 of 4 PERMIT NO. TC2017-0052 Kana Engineering / Pothole for Utilities / Eisenhower Drive between Avenue 50 and Avenida Fernando for City Storm Drain Project Note: Construction work (including setting up traffic control devices) is not permitted on any Arterial Street (ie any 4 lane street) before 8:00 a.m. 10. Work within 500 feet of a signalized intersection shall be performed between the hours of 9 a.m. - 3 p.m. Traffic control shall be set up after 9 a.m. and removed before 3 p.m. The Permittee shall contact the City Traffic Signal Maintenance Division at (760) 777-7070 if signal operation at the intersection is to be altered in any way. Ii. Pursuant to Section 14.16.110 of tile La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), Permittee shall assume responsibility for repair of any pavement damage to any public or private Street and for any damage to other City streets or facilities as a result of work performed under this permit. The permittee shall place temporary no parking signs along the parking area affected by the construction. The signs shall be placed along the area 48hrs prior to the start of closing the area, and removed immediately after the consttuction completion date. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), at residential streets, advance warning signs and traffic control shall be installed and maintained 'in accordance the latest edition of the California Manual of Uniform Traffic Control Devices (CA MUTCD) or the latest edition of the Work Area Traffic Control Handbook (WATCH). On Collectors to Arterial Streets, the permittee must submit a trafflc control plan which shall be from or prepared under the guidance of the latest edition of the California Manual of Uniform Traffic Control Devices (CA MUTCD) or the latest edition of the Work Area Traffic Control Handbook (WATCH). Traffic Control plans not from the CA MUTCD or the WATCH shall be signed and stamped by a civil or traffic engineer registered in the State of California. It shall be the Permittee's responsibility to appropriately detour and barricade all construction sites. Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), Street closures shall not be permitted. A minimum of two (2) travel lanes of paved surface shall be maintained at all times. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1-800-422- 4133. It shall be the Permittee's responsibility to notify the Public Works Department of anticipated excavation which impact City facilities, including but not limited to traffic signal conduits and loops,. irrigation lines, electrical conduits, and storm drain facilities. Should additional work, materials, or modifications of the work be required in order to meet City standards, safety requirements, signage requirements, or to fit actual field conditions, the work shall be performed by the Permittee as directed by and to the satisfaction of the City Engineer at no cost to the City of La Quinta. The permittee shall be responsible for calling the city inspector to arrange the city inspector to observe random pothole backfill compaction and testing if requested by the inspector, lithe inspector's phone Special Conditions . Page 2 of 4 PERMIT NO. TC2017-0052 Kana Engineering I Pothole for Utilities I Eisenhower Drive between Avenue 50 and Avénida Fernando for City Storm Drain Project number is unknown, the permittee shall call the Public Works front counter phone at 777-7075 or the Associate Engineer at 777-7047 to determine the city inspector's phone number. The inspector shall determine the number and location of the test location/s. The above testing does not relieve the permittee's responsibility for future repairs due to settlement at and near the locations of the work area. Materials testing must be performed under direct supervision of a California Registered Civil Engineer. 17. The issuance of this permit and the City approval of the related construction improvement plans do not provide a vested entitlement for all design parameters that may have been utilized for the plans. As such, plans approved for this perthit may be "at risk" for furfher modifications as it relates to any follow up improvement plan requirements as required by the city or existing errors & omissions by the architect or engineer of record. 18. This permit is not valid until the permittee submits, to the Public Works Department 2 weeks prior to start of construction, the name of the City approved contractor, who shall submit to the City the followihg items: General Liability Insurance Company and Policy Number City Business License Contractors State License Number 19. The Applicant or Contractor shall furnish the City satisfactory evidence of insurance in the amounts provided in Engineering Bulletin for Indemnification & Insurance Requirements. This insurance shall be kept in full force and effect at all times by Applicant or Contractor during the prosecution of the permitted work and updated Certificate of Liability Insurance shall be submitted to the City. Each policy shall name the City as an additional insured. 20. If public traffic lanes are required to be closed, this permit is not valid until the permittee submits, to the Public Works Department, a traffic control plan for review and approval prior to start of construction or parking on the paved RJW. 21. All excavations within City of La Quinta right-of-way shall be backfilled, and temporarily paved if within the existing travel way, at the end of every workday as directed by and to the satisfaction of the City. Engineer for the protection of the public. Lengths of open trench shall not greatly exceed that which can not be backfilled in the same day. Excavated trenches shall not be allowed open overnight; however, Permittee may leave a length of excavated trench, not to exceed twenty (20) feet in length, open overnight at a point where construction will begin the next day, provided that this length of trench is completely covered by steel plating. 22. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its original condition. 23. Access and egress to all local properties shall be maintained at all times. Special Conditiàns Page 3 of 4 PERMIT NO. TC2017-0052 Kana Engineering / Pothole for Utilities / Eisenhower Drive between Avenue 50 and Avenida Fernando for City Storm Drain Project 24. Pursuant to Section 14.16.375 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), permanent pavement replacement shall be completed no later than seven (7) days after the completion of the work. Permanent pavement replacement shall conform to the following conditions: Existing asphalt concrete pavement shall be sawcut one (1) foot beyond trench edges. Edges shall be straight and clean. Permanent pavement replacement structural section, within all trenches, shall be 1" thicker than existing of asphalt concrete over the same existing thickness of crushed aggregate base or crushed miscellaneous base, meeting the requirements of Sections 200-2.2 and 200-2.4 of the Standard Specifications for Public Works Construction. The replaced pavement and base material shall be compacted to 95% relative compaction and respectively tested, for each 300 linear feet of trench. Verify exact structural replacement section thicknesses with the City prior to installation. Permanent pavement replacement shall be installed using a City approved 34" max medium asphalt concrete as the base course lift and a City approved Y2" max medium finish course lift for capping. Asphalt concrete mix design shall be approved by the City prior to its placement. Any existing lane striping or any existing detour lane striping affected by this resurfacing shall be replaced in kind by the Permittee, as directed by and to the satisfaction of the City Engineer. Affected traffic signal loops shall be removed and replaced in kind. The finished pavement surface shall be smooth, consistent, and shall conform to the surrounding grades. Permittee shall permanently stabilize any and all soil that was disturbed as a result of work performed under this permit with an approved dust control treatment. Soil stabilization shall be done immediately after completing the operation. Pursuant to Chapter 12.56 of the La Quinta Municipal Code* (Ordinance 10 § 1 (part), 1982) the City has designated certain city streets as Truck Routes. The weight limit for restricted streets (i.e., streets not part of the Truck Route network) is three (3) tons; trucks exceeding the weight limit may use a restricted Street if making a delivery or pickup on the subject street, or if this permit specifically grants permission to use the street to deliver street construction materials and/or equipment. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time.. The permittee shall indemnify, hold harmless and assume the defense of the City from all damages, delay costs, costs or expenses in law or equity that may arise out of work under this permit. If it is the intent of the permittee to cut the pavement and have it restored by a third party, the permittee shall postpone cutting the pavement until the intended third party has acquired a permit from the City to perform the required restoration work. Special Conditions . . Page 4 of 4 City of La Quinta The following General and Special Provisions are attached to and made a part of Permit Number 1C2017..0052 The following shall always apply: ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within the City of La Quinta's right of way Whenever construction extends within private property, it is the responsibility of the permittee for his contractors to secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work. TRACK-LAYING CONSTRUCTION EQUIPMENT: Cleated track-laying construction equipment shall not be permitted to operate on any paved surface unless fitted with smoother-faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect the paving during excavations. Rubber-tired equipment only shall be used in backfill operation in paved areas. If the existing pavement is scarred, spalled, or broken during the term of this contract or if the pavement is marred, City of La Quinta shall request that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches (2") of A.C. surfacing plus appropriate seal coat as specified above. PROTECTION OF TRAFFIC: All excavations and work areas shall be property lighted and barricaded as deemed necessary by the City Engineer or City of La Quinta Public Works Inspectors. Suitable detours and detour signs shall be placed and maintained for the duration of the project. The City shall be notified twenty-four hours (24) in advance of any traffic detours or delineation. CARE OF DRAINAGE STRUCTURES: Any drainage structure to include corrugated metal pipe, concrete pipe, steel culvert and concrete structures encoantered during excavation which ne'cessitate removal shall be replaced in kind. In the event it becomes necessary to remove or cut existing drainage structures, City of La Quinta shall be notified prior to commencement of this work. Drainage structures and open drains shall be kept free of debris at all times for proper drainage. RIGHT-OF-WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right of way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction. Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used immediately after backfill. DE-WATER OPERTATIONS: If de-watering operations are required and pumps are forcing water on City of La Quinta roads, it shall be the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary. CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited access for the adjoining property owners and emergency vehicles. In the event it is felt by the permittee that he must close a street for any length of time, permittee shall contact this office to obtain the necessary permission. SPECIAL PROVISIONS The following shall apply when indicated 0 RI NOTIFICATION: Permittee shall notify the City at (760) 777 - 7097 at least forty-eight hours (48) in advance of starting construction. 0 R2 UTILITY CLEARANCE: (Substructures) Prior to making any excavations within the City of La Quinta right-of-way authorized by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures. Damage to existing substructures resulting from operations conducted under this permit shall be the sole responsibility of the permittee. 0 R3 UTILITY CLEARANCE (Surface Structures) No work shall be done under this permit until all utilities are clear of the proposed work site. The permittee shall notify all concerned utility companies of the proposed work. R4 - PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be surfaced with (** N/A ) inches of A.C. paving placed on ( N/A ) inches of ( N/A ) aggregate sub-base course having an "R" value of not less than (** N/A ) and in conformance with the City of La Quinta Road Improvement Standards and Specifications, Ordinance #461. 0 R5 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of one-fourth inch (1h") to one foot (1'). R6 GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by a licensed engineer. Ri CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( N/A ) feet shall be removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of La Quinta Standard #207. 0 R8 DRIVEWAYS: A.C. driveways shall be constructed as not to alter existing drainage pattern. Surfacing between the property line and the existing road paving shall be two and a half inches (2 W) of A.C. paving on (" N/A ) of class ( N/A ) aggregate base. 10 IR9 SIGHT CLEARANCE: Sight Clearance of six-hundred feet (600') in all directions shall be assured and maintained at all times. RIO SOIL STERILIZER: The area to be surfaced shall be treated with soil strerilizer. Rate of application shall comply with the manufacturer's specifications. • • . City of La Quinta 0 R11 COORDINATE WORK: The proposed work shall be subordinated to any operation, which the State of California or City of La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or City of La Quinta forces to preclude delay or interference with State or City of La Quinta projects. 0 R12 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the centerline of all streets or property lines when included shall be completely tied out so they may be readily and correctly, replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the ties to these monuments shall be furnished to the City Engineer prior to the removal of any monuments. This office shall be notified upon completion or replacement of all survey monuments for proper clearance. 0 .R13 PAVEMENT CUTTING: Pavement will be mechanically saw cut to a straight edge prior to excavation. Method of pavement cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating equipment be used to excavate prior to cutting or pavement.) Excavation material shall be placed in such a position as to best facilitate the general flow traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected. R14 LIMIT OF EXCAVATIONS: Excavations shall be limited to one-thousand feet (1000') of open trench before backfill operations must begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of the traveling public. The Public Works Inspector shall determine the suitability of excavation barricading in each case. No excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction material is actually on the work site. 0 R15 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes of producing and adequately consolidated backfill. Ant material which the City of La Quinta deems unsuitable (spongy or saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or replaced by an approved sand or gravel. RIB BACKFILL SAND: Backfill shall be approved transit-mix sand or equivalent and shall be placed on lifts not greater than three feet (3') and vibrated using vibrostamper or equivalent equipment. Alternate methods may be substituted, but in any case, a relative compaction of ninety-five percent (95%) shall be maintained with the structural section of the roadway. 0 R17 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than fifty percent (50%) of the total depth of the trench before flooding or a maximum of five feet (5') lifts where trenches are of excessive depths. Care is to be exercised that the backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the resulting compaction shall not be less than ninety percent (90%) or equivalent to the surrounding ground, whichever is the greater compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain the water. Where jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water supply shall be continuos. RIB COMPACTION TESTS: If so required by the inspector, compaction test shall be made at intervals of not more than one- thousand (1000') feet and a maximum of one (1) test on each road. One (1) copy of each test shall be forwarded tot the City Engineer for approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973. 0 R19 COMPACTION TESTS: If so required by the Inspector, compaction tests shall be made for each crossing or service line. One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Sections 6.3.001 of the Standard Specifications, Division of Highways, State of California, dated January 1973. 0 R20 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch consisting of two inches (2') of SC-800 shall be placed on a prepared sub-grade. The SC-800 temporary paving shall be placed after a maximum of three-thousand linear feet (3000') or trench has been excavated and backfill operations completed, but in no case shall the placement of the temporary pavement exceed a five (5) day limit. 0 R21 PERMANENT PAVEMENT REPAIR: After backfili and compaction have been completed, a temporary patch consisting of three inches (31 of SC-800 shall be placed immediately. A permanent patch of Asphalt Concrete surfacing per City of La Quinta Standard 600 shall be placed no later than (5 ) days after completion of temporary road repair. R22 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as determined by the City Engineer. 0 R23 STREET RESTRIPING: Where street striping is still visible on street to be excavated, such striping shall be replaced upon completion of permanent repairs. R24 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right-of-way shall be accomplished by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling public. It shall be the responsibility of the permitte to maintain the tree in a vigorous growing condition at its new location. Trees to be removed shall be in sections, which can be handled safely without interference or hazard to highway traffic. The entire width of the tree stump, shall be removed and disposed of so that no debris remains in view of the highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where it becomes necessary to restrict traffic, the work shall be restricted to a maximum of five-hundred feet (500') at any one time. Adequate signs, flagmen and or barricades shall be provided to protect the traveling public at all times. Large holes resulting from tree removal shall be backfilled and compacted to not less than ninety percent (90%) or equivalent tot the surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction tests shall comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973. . . . . . . •