Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
ENC2022-0088
owkra G F M ofibe 1)I.M-I I- — ENCROACHMENT PERMIT PUBLIC WORKS CONSTRUCTION See below for Finance Revenue Codes For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS. DATE: 10/25/2022 LOCATION OF CONSTRUCTION (Street address or Description): 81345 AVENUE 54; MERV GRIFFIN ESTATES PURPOSE OF CONSTRUCTION: NO CONSTRUCTION. THIS IS FOR TEMPORARY BUS DROP OFF AND PICK UP OF GUESTS FOR A PRIVATE WEDDING EVENT DESCRIPTION OF CONSTRUCTION: TRAFFIC CONTROL FOR PRIVATE WEDDING EVENT ON 10/29/22 DIMENSION OF INSTALLATION OR REMOVAL: SEE TRAFFIC CONTROL PLAN APPROXIMATE TIME WHEN WORK WILL BEGIN: 10/29/2022 TIME OF COMPLETION: 10/30/2022 ESTIMATED CONSTRUCTION COST: $1.00 (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 loss 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. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started at (760) 777-7097. To submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 prior to 1:30 P.M. at least twenty-four (24) hours prior to the anticipated inspection. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. APPLIED ON ETRAKIT Signature of Applicant or Agent GRIFFIN ESTATE INVESTORS LP - MARK MAJER 23 CORPORATE PLZ #150 NEWPORT BEACH, CA, CA 92660 (949)629-2582 Name of Applicant (please print) TOPS N BARRICADES INC Business Address 44631 Jackson Street Indio, CA 92201 Name of Contractor and Job Foreman Business Address 787664 Contractor's License No. ADMIRAL INSURANCE COMPANY Applicant's Insurance Company Finance Revenue Code PERMIT INSPECTION TRAFFIC CONTROL $353.00 TECHNOLOGY ENHANCEMENT FEE $8.00 TOTAL: $0.00 103875 City Business License No. W HO13816 Policy Number PERMIT NO: ENC2022-0088 DATE ISSUED: 10/25/2022 EXPIRATION DATE: 10/25/2023 BY: AMY YU Y/ WORK INSPECTED BY*: PERMIT COMPLETION DATE*: Telephone No. (760)347-2111 Telephone No. *If the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council. City of La Quinta The following General and Special Provisions are attached to and made a part of Permit Number ENC2022-0088 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 ONLY. 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 properly 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 encountered during excavation which necessitate 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: ® R1 NOTIFICATION: Permittee shall notify the City at (760) 777 - 7097 at least forty-eight hours (48) in advance of starting construction. ® 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. ® 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. ❑ 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 ('/d') 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. ❑ R7 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. ❑ 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 ''/2") of A.C. paving on (** N/A **) of class (** N/A ** ) aggregate base. ® R9 SIGHT CLEARANCE: Sight Clearance of six -hundred feet (600') in all directions shall be assured and maintained at all times. ❑ R10 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 ® 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. ❑ 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. ❑ 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. ❑ 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. ❑ R16 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. ❑ 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. ❑ R18 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. ❑ 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. ❑ 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. ❑ R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of two inches (2") of SC-800 shall be placed immediately. A permanent patch of ( 4 ) inches of A.0 surfacing placed on a ( 6 ) inch ( crushed ) aggregate base shall be placed no later than ( 1 ) 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. ❑ 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. 1. 2. 3. PERMIT NO. ENC2022-0088 Mery Griffin Estates Wedding / Traffic Control for Buses to Drop -Off and Pick Up Guests/ Ave 54 East of Madison St (No asphalt or earthwork permitted) 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 shall submit inspection requests by calling the City Inspection Hotline at (760) 777-7097 before 1:30 p.m. and at least twenty-four (24) hours prior to the anticipated inspection. 4. The City of La Quinta reserves the right to require modifications of the work be made at permittee's sole cost for proper sight distance requirements per guidelines in the AASHTO "A Policy on Geometric Design of Highways and Streets, 5th Edition" or latest, in the installation of all appurtenances abutting and within the public street right-of-way. 5. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently, if required. 6. 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. 7. 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 1 st 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 1 st 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. Note: Construction work (including setting up traffic control devices) is not permitted on any Arterial street (ie any 4 lane street) neither before 8:30 a.m. nor after 4:30 p.m. 8. Pursuant to Section 14.16.110 of the 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. 9. The permittee must maintain proper stopping and sight distances for the vehicular traffic users using the public right of way. Special Conditions Pagel of 3 PERMIT NO. ENC2022-0088 Mery Griffin Estates Wedding / Traffic Control for Buses to Drop -Off and Pick Up Guests/ Ave 54 East of Madison St (No asphalt or earthwork permitted) 10. The Applicant or Contractor shall furnish the City satisfactory evidence of insurance in the amounts listed below and provided in the 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. - General Liability — $ 1 M per occurrence / $2M general aggregate - General Liability — Additional Insured Endorsement (for ongoing and completed operations) - General Liability — Primary / Non-contributory Endorsement - Automobile Liability — $1 M combined single limit - Workers' Compensation — Statutory Limits / Employer's Liability $1 M per accident or disease - Workers' Compensation — Waiver of Subrogation Endorsement 11. 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 traffic 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. 12. 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 R/W. 13. 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. 14. 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. 15. The permittee shall not encroach upon private property without prior written approval (submit to the Public Works Department, attention to the Associate Engineer) of the private land owner whom is being encroached upon. Special Conditions Page 2 of 3 PERMIT NO. ENC2022-0088 Mery Griffin Estates Wedding / Traffic Control for Buses to Drop -Off and Pick Up Guests/ Ave 54 East of Madison St (No asphalt or earthwork permitted) 16. All landscaping, irrigation, decorative rock, decorative concrete, sidewalk, lighting, etc., shall be replaced to its original condition. 17. Access and egress to all local properties shall be maintained at all times. 18. 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. 19. 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. 20. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. 21. 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. Special Conditions Page 3 of 3 ,a`oRo° CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/21/2022 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 CONTACT NAME: Kerry Wakel Bannister & Associates Insurance Agency PHONE FAX CA License #0691071 A/C No Ext: (714) 536-6086 A/C No: (714) 536-4054 E-MAIL ADDRESS: kerry@bai-ins.com 305 17th Street Huntington Beach CA 92648 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Guideone National Insurance Co INSURED (714) 847-8080 INSURER B: Nationwide Mutual Insurance Co Golden Construction, Inc. INSURER C: RSUI Indemnity Company INSURER D:insurance Company of the West 7271 Mars Drive INSURERE: Huntington Beach CA 92647 INSURER F : COVERAGES CERTIFICATE NUMBER: Cert ID 11615 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR Y 563000293-01 02/28/2022 02/28/2023 RENTE FRMMSES AGE ToE.occurence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE� LOC PRODUCTS - COMP/OP AGG $ 2,000,000 IDeductible $ 2,500 OTHER: I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ACP 7843114401 12/17/202112/17/2022 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L $ C X UMBRELLA LIAB X OCCUR NHN253271 02/28/2022 02/28/2023 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 25,000 $ D AND EMPLOYERS' LIABILITY AND YERS'LIATIONILIT Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE WVE 5038878 04 01/01/2022 01/01/2023 PER X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of La Quinta is named as additional insured with respects general liability policy limits. Primary and non-contributory wording applies with respects general liability policy limits. Waiver of subrogation applies with respects workers compensation liability policy limits. CERTIFICATE HOLDER CANCELLATION City of La Quinta 78495 Calle 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1 POLICY NUMBER: 563000293-01 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) Locations Of Covered Operations Any Location As required by written contract. If anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV — COMMERCIAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. The inclusion of one or more Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. 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 B. 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: 1. Your acts or omissions; or 2. 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) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to C. provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment 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 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: CG 20 10 04 13 © ISO Properties, Inc., 2004 Page 1 of 2 If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 04 13 © ISO Properties, Inc., 2004 Page 2 of 2 POLICY NUMBER: 563000293-01 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All locations. As required by written contract. If anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV — COMMERCIAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. The inclusion of one or more Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © ISO Properties, Inc., 2004 CG 20 37 04 13 ❑ POLICY NUMBER: 563000293-01 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 IN: I[I4111Biel Z614MI4ki III to]:/_1zEel *a9:I:81*]I[WAIIIIaW-MA0 =F_1971097_1:7=1WA PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition 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 an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) 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. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON / ORG WHEN REQUIRED BY WRITTEN CONTRACT 2 % of the total California Workers' Compensation premium Schedule Job Description ALL CA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/01/2022 Policy No. WVE 5038878 04 Endorsement No. Insured GOLDEN CONSTRUCTION INC Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST WC 99 06 34 (Ed. 8-00) Countersigned By INSURED Amy Yu From: Alex Mellor <amellor@cjpia.org> Sent: Monday, October 24, 2022 7:14 AM To: Monika Radeva Cc: Amy Yu; Laurie McGinley Subject: RE: RUSH: La Quinta: Urquhart Wedding - 10/29/22 EXTERNAL: This message originated outside of the City of La Quinta. Please use proper judgement and caution when opening attachments, clicking links or responding to requests for information. Hi Monika: It appears that Tops N Barricades designed the traffic control zone and will be performing traffic control. Assuming that is correct, you can require them to provide evidence of GL insurance and name the City additional insured in lieu of the event holder doing so. That is probably the best solution here. I am available today if you want to discuss further. Thanks. Alex Mellor, ARM Senior Risk Manager Oalifomia Joira PiDwers Insurance Authority 8081 Moody Street. La Palma, CA 90623 rn 562.631.0814 1 !. 1 FOR N I A aI eI1or(§cjpi@.or9 t . f . I . � cjpia.org ,rRECIaim Define. Educate. Mitigate. _ in s Risk Management Strategies For Your Agency From: Monika Radeva <mradeva@laquintaca.gov> Sent: Monday, October 24, 2022 7:00 AM To: Alex Mellor <amellor@cjpia.org> Cc: Monika Radeva <mradeva@laquintaca.gov>; Amy Yu <Ayu@laquintaca.gov>; Laurie McGinley <Imcginley@laquintaca.gov> Subject: RUSH: La Quinta: Urquhart Wedding - 10/29/22 Importance: High *CAUTION: External Sender. Do not click links or open attachments unless you recognize the sender and know the content is safe.* Good morning Alex, Please see inquiry below from the City's Engineering Division. An encroachment permit is being issued for the closure of a lane to allow for guests shuttling into the Mery Griffin Estate for a wedding event. 1 Attached is the COI provided, they claim the insurer will not issue endorsements - is this something they can obtain from CJPIA? Your guidance and direction are greatly appreciated. Thank you. Monika Radeva, CMC I City Clerk City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Tel: (760) 777-7035 MRadeva@laguintaca.gov From: Amy Yu <Ayu@laquintaca.gov> Sent: Friday, October 21, 2022 4:38 PM To: Monika Radeva <mradeva@laguintaca.gov> Subject: FW: Urquhart Wedding - 10/29/22 Hi Monika, I'm issuing an encroachment permit for this event to close a lane on Ave 54 to let the buses drop off and pick up guests. The COI she emailed me is different than the ones I typically get and she said the Insurer doesn't do additional insured. I told Cathy I'll talk to the Risk Manager and get back to her on Monday. What do you think? Can you run this by that guy at JPIA? Amy Yu I Associate Engineer w City of La Quinta - Public Works 78495 Calle Tampico - La Quinta, CA 92253 Ph. 760.777.7047 Main: 760.777.7000 www.laquintaca.gov www.playiniaguinta.com From: Cathy O'Connell <cathv@coievents.com> Sent: Friday, October 21, 2022 3:15 PM To: Amy Yu <Avu@laquintaca.gov> Cc: Mark Majer <mark@experiencemge.com>; Michael Wanderman <mw@mdminvestment.com> Subject: Re: Urquhart Wedding - 10/29/22 Hi Amy, Here is the signed form - sorry about the missing lines! Please call me to discuss the additional insured. Mary is a private individual without business liability insurance, and she obtained event insurance from one of Mery Griffin's Recommended Insurers wedsafe.com they don't do additional insured insurance. What I sent you is the only way they do it. Give me a call at 310-795-7305 THANKS! With Joy, Cathy O'Connell CEO, Creative Director at COJ Events P: 3107957305 E: cathy(a)_coievents. com She/Her/Hers Schedule a Chat with Me On Fri, Oct 21, 2022 at 2:51 PM Amy Yu <Avu@laguintaca.gov> wrote: Hi Cathy, Please also provide the additional insured endorsement and primary/non-contributory endorsement for the general liability policy. On the Declaration Regarding California Workers' Comp form, please ask Mary Urquhart to initial the top and bottom items also. Please also provide proof of auto insurance policy for the buses. Thankyou Amy Yu I Associate Engineer City of La Quinta - Public Works i:�lllllr 78495 Calle Tampico - La Quinta, CA 92253 Ph. 760.777.7047 On,� Main: 760.777.7000 Q www.laquintaca.gov z I .. "" >- www.playinlaquinta.com From: Cathy O'Connell <cathv@coievents.com> Sent: Friday, October 21, 2022 2:36 PM To: Mark Majer <mark@experiencemge.com> Cc: Amy Yu <Avu@laquintaca.gov>; Michael Wanderman <mw@mdminvestment.com> Subject: Re: Urquhart Wedding - 10/29/22 Hi Mark & Amy, Here you go - COI and signed waiver. Let me know if you need anything else! With Joy, Cathy O'Connell CEO, Creative Director at COJ Events P: 3107957305 E: cathy(c)coievents. corn She/Her/Hers i1 Schedule a Chat with Me On Fri, Oct 21, 2022 at 2:17 PM Cathy O'Connell <cathy@coievents.com> wrote: Will do. Sent to Mary. With Joy, Cathy O'Connell CEO, Creative Director at COJ Events P: 3107957305 E: cathy(a�coievents. com She/Her/Hers Schedule a Chat with Me On Fri, Oct 21, 2022 at 11:07 AM Mark Maier <mark@experiencemge.com> wrote: Cathy, Can you please fill out the workers comp waiver and send back to Amy. Can you also get her all the GL COls and request same from the transportation company that is providing the bus service. Thanks. P: 888-305-5053 C: 949-300-9579 mark@experienceMGE.com MARK MAJER www.experienceMGE.com Nit 81345 Avenue 54 ,rt .J,r%r La Quinta, CA 92253 From: Amy Yu <Ayu@laquintaca.gov> Sent: Friday, October 21, 2022 10:43 AM To: Mark Maier <mark@experiencemge.com> 4 Cc: Michael Wanderman <mw@mdminvestment.com>; Cathy O'Connell <cathv@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 Hi Mark, The general liability insurance with the additional insured endorsement and primary/non-contributory endorsement are still pending. Also, please provide proof of auto insurance policy for the buses. Since the general liability insurance is coming from your client, please have your client fill out the attached Declaration Regarding California Workers' Comp form. Thankyou Amy Yu I Associate Engineer City of La Quinta - Public Works 78495 Calle Tampico - La Quinta, CA 92253 4 Ph, 760,777,7047 OMain: 760.777.7000 www.laquintaca.gov www.playinlaquinta.com From: Mark Maier <mark@experiencemge.com> Sent: Thursday, October 20, 2022 4:35 PM To: Amy Yu <Avu@laquintaca.gov> Cc: Michael Wanderman <mw@mdminvestment.com>; Cathy O'Connell <cathv@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 EXTERNAL: This message originated outside of the City of La Quinta. Please use proper judgement and caution when opening attachments, clicking links or responding to requests for information. Amy, Please find attached and let me know once the permit has been approved. Thanks. P: 888-305-5053 C: 949-300-9579 mark@experienceMGE.com MARK MAJER www•experienceMGE.com 81345 Avenue 54 r, . r1r La Quinta, CA 92253 From: Amy Yu <Avu@laquintaca.gov> Sent: Wednesday, October 19, 2022 4:02 PM To: Mark Maier <mark@experiencemge.com> Cc: Michael Wanderman <mw@mdminvestment.com>; Cathy O'Connell <cathv@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 Hi Mark, Attached is the form to fill out if your client doesn't carry Workers' Comp insurance. Please also state on your reply email that your client will not be using their own vehicles for this event. Thank you Amy Yu I Associate Engineer City of La Quinta - Public Works a 78495 Calle Tampico - La Quinta, CA 92253 U) Ph. 760.777.7047 0 2� Main: 760.777.7000 www.laquintaca.gov 1�4 www.playinlaquinta.com From: Mark Maier <mark@experiencemge.com> Sent: Wednesday, October 19, 2022 3:35 PM To: Amy Yu <Avu@laquintaca.gov> Cc: Michael Wanderman <mw@mdminvestment.com>; Carlos Flores <cflores@lag uintaca.gov>; Cathy O'Connell <cathv@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 Amy, Here is the revied TCP reflecting the notes on begin and end time. I will try calling you now. P: 888-305-5053 C: 949-300-9579 mark@experienceMGE.com MARK MAJER www.experienceMGE.com 81345 Avenue 54 La Quinta, CA 92253 0 From: Amy Yu <Avu@laquintaca.gov> Sent: Wednesday, October 19, 2022 2:47 PM To: Mark Maier <mark@experiencemge.com> Cc: Michael Wanderman <mw@mdminvestment.com>; Carlos Flores <cflores@lag uintaca.gov>; Cathy O'Connell <cathy@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 Hi Mark, I'm here until 5:30pm. Feel free to call me. Amy Yu I Associate Engineer N City of La Quinta - Public Works 78495 Calle Tampico - La Quinta, CA 92253 0Ph. 760.777.7047 Q4Main: 760.777.7000 www.laquintaca.gov www.playinlaquinta.com 6 From: Mark Maier <mark@experiencemge.com> Sent: Tuesday, October 18, 2022 5:02 PM To: Amy Yu <Avu@laquintaca.gov> Cc: Michael Wanderman <mw@mdminvestment.com>; Carlos Flores <cflores@lag uintaca.gov>; Cathy O'Connell <cathv@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 EXTERNAL: This message originated outside of the City of La Quinta. Please use proper judgement and caution when opening attachments, clicking links or responding to requests for information. Amy, Thanks for your email. I have requested a revised version of the TCP from Tops N Barricades based your comment below and will re -submit asap. I will also jump into the E-trakit right now and pay the fee. Michael and Cathy (CC'd on this email will be sending you the GL insurance requirements shortly) but I still need to speak with you about the Workmen's Comp requirements. Please let me know a good time. Thanks. P: 888-305-5053 C: 949-300-9579 mark@experienceMGE.com MARK MAJER www.experienceMGE.com 81345 Avenue 54 La Quinta, CA 92253 f` J From: Amy Yu <Avu@laquintaca.gov> Sent: Tuesday, October 18, 2022 12:03 PM To: Mark Majer <mark@experiencemge.com> Cc: Michael Wanderman <mw@mdminvestment.com>; Carlos Flores <cflores@lag uintaca.gov>; Cathy O'Connell <cathy@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 Hi Mark, Please note on the traffic control plan the hours the traffic control will be in place that day. The encroachment permit fee is $361. You can drop off a check or pay on eTrakit by credit card. There's a 2.5% service fee on credit/debit card payments. Sincerely, Amy Yu I Associate Engineer City of La Quinta - Public Works N 78495 Calle Tampico - La Quinta, CA 92253 OPh. 760.777.7047 Q < Main: 760.777.7000 4www.laquintaca.gov www.playinlaquinta.com From: Mark Maier <mark@experiencemge.com> Sent: Friday, October 14, 2022 3:14 PM To: Amy Yu <Ayu@laguintaca.gov> Cc: Michael Wanderman <mw@mdminvestment.com>; Carlos Flores <cflores@lag uintaca.gov>; Cathy O'Connell <cathy@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 Amy, Please find attached the traffic control plan prepared by TNB. In the end, they used this instead of the page from the watch book. Please review and let me us know if you have any comments. I will also upload it to the e-trakit portal. Re the insurance requirements for workers comp coverage, which party is usually responsible to obtain these coverages, considering it's for a private wedding event. Please let me know. Thanks. P: 888-305-5053 C: 949-300-9579 mark@experienceMGE.com MARK MAJER www.experienceMGE.com 81345 Avenue 54 La Quinta, CA 92253 From: Mark Maier Sent: Friday, October 14, 2022 10:22 AM To: Amy Yu <Avu@laquintaca.gov> Cc: Michael Wanderman <mw@mdminvestment.com>; Carlos Flores <cflores@lag uintaca.gov>; Cathy O'Connell <cathy@coievents.com> Subject: RE: Urquhart Wedding - 10/29/22 Amy, Per our call from yesterday, I have just submitted the initial app for the encroachment permit but without any attachments. I will speak with Victoria from Tops N Barricades later today to receive the page from the watch book (as we also discussed yesterday) and will also be speaking to my client about all the insurance requirements as well. I will update the e-trakit portal with all attachments asap. In the meantime, please let me know how and when to pay the app fee. Thank you. P: 888-305-5053 C: 949-300-9579 mark@experienceMGE.com MARK MAJER www.experienceMGE.com 81345 Avenue 54 ,f La Quinta, CA 92253 From: Amy Yu <Avu@laquintaca.gov> Sent: Wednesday, September 7, 2022 8:31 AM To: Mark Majer <mark@experiencemge.com> Cc: Michael Wanderman <mw@mdminvestment.com>; Carlos Flores <cflores@lag uintaca.gov> Subject: RE: Urquhart Wedding - 10/29/22 Mark, Carlos is correct. You'll need to apply for an encroachment permit on eTrakit to block off the road for the buses to pull over. Please upload a traffic control plan and the following insurance documents. The encroachment permit fee is $342 for one day of traffic control. Sincerely, O General Liability — $1M per occurrence / $2M general aggregate O General Liability — Additional Insured Endorsement (for ongoing and completed operations) 0 General Liability — Primary / Non-contributory Endorsement O Automobile Liability—$1M combined single limit 0 Workers' Compensation — Statutory Limits / Employer's Liability $1M per accident or disease O Workers' Compensation — Waiver of Subrogation Endorsement Amy Yu I Associate Engineer ®- City of La Quinta - Public Works 78495 Calle Tampico - La Quinta, CA 92253 Ph. 760.777.7047 Main: 760.777.7000 www.laquintaca.gov 41 www.playinlaquinta.com From: Carlos Flores <cflores@laquintaca.gov> Sent: Wednesday, September 7, 2022 8:24 AM To: Mark Majer <mark@experiencemge.com> Cc: Michael Wanderman <mw@mdminvestment.com>; Amy Yu <Avu@laquintaca.gov> Subject: RE: Urquhart Wedding - 10/29/22 Mark, It sounds like what you would need is to stop traffic for a period of time? If so, it requires a traffic control plan and encroachment permit, to allow for the buses to pull over and block off the road for a period of time. It's what we require for example on landscape projects when trucks pull over to do landscape work. I have cc'd Amy Yu to add anything more to that. I would get on it as soon as possible to have a traffic control company draw it up for you or client. Carlos Flores I Senior Planner Design and Development City of La Quinta 78495 Calle Tampico I La Quinta, CA 92253 Ph. 760.777.7069 www.laquintaca.gov From: Mark Maier <mark@experiencemge.com> Sent: Thursday, September 1, 2022 11:34 AM To: Carlos Flores <cflores@laquintaca.gov> Cc: Michael Wanderman <mw@mdminvestment.com> Subject: Urquhart Wedding - 10/29/22 EXTERNAL: This message originated outside of the City of La Quinta. Please use proper judgement and caution when opening attachments, clicking links or responding to requests for information. Hi Carlos, I need to speak with you re the above wedding. It has just been brought to my attention that they will be bussing in all their guests on full size coach buses. There will be about 10 buses coming and going for drop-off and pick up. Unfortunately, these buses are too large to accommodate for internal traffic circulation, so they will need to line up outside our main gate to unload and load passengers. Will we need a permit for this? If so, what kind? Please let me know. Thanks. P: 888-305-5053 C: 949-300-9579 mark@experienceMGE.com MARK MAJER www.experienceMGE.com 81345 Avenue 54 f,rr. La Quinta, CA 92253 10