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PWP2023-0004
ta QaV Kra GEM oftbe DESERT - - PUBLIC WORKS 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: 7/24/2023 LOCATION OF CONSTRUCTION (Street address or Description): NORTHEAST CORNER OF AVE 60 AND MADISON ST: WITHIN ANDALUSIA PURPOSE OF CONSTRUCTION: ONSITE STREET AND STORM DRAIN FOR TM 38188 DESCRIPTION OF CONSTRUCTION: ANDALUSIA TM38188 ONSITE STREET AND STORM DRAIN IMPROVEMENTS DIMENSION OF INSTALLATION OR REMOVAL: PER APPROVED PLAN SET # ONST2022-0003 APPROXIMATE TIME WHEN WORK WILL BEGIN: 7/17/2023 TIME OF COMPLETION: 10/31/2023 ESTIMATED CONSTRUCTION COST: $350,000.00 (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing permanent resurfacing and/or replacing improvements) P101L IL la►r161 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. SUNRISE LQ, LLC - NOLAN SPARKS Name of Applicant (please print) COOLEY CONSTRUCTION JAMES A SHIRLEY CONSTRUCTION 81570 CARBONERAS LA QUINTA, CA 92253 Business Address P O BOX 401810, HESPERIA, CA 92340 59160 MESA DR, YUCCA VALLEY, CA 92284 Name of Contractor and Job Foreman Business Address 348038 710357 Contractor's License No. UNITED SPECIALTY INSURANCE COMPANY VALLEY FORGE INSURANCE COMPANY Applicant's Insurance Company Finance Revenue Code PERMIT INSPECTION SIGNING AND STRIPING $1,751.00 STORM DRAIN $5,077.00 STREET IMPROVEMENTS - ON -SITE $12,254.00 TECHNOLOGY ENHANCEMENT FEE $8.00 TOTAL: $19,090.00 LIC-770994 LIC-0006432 City Business License No. ATN2375576 7034790445 Policy Number Signature of Applicant or Agent (760)408-0106 Telephone No. 760-948-8400 760-401-2619 Telephone No. PERMIT NO: PWP2023-0004 DATE ISSUED: 8-9-2023 EXPIRATION DATE: 8-9-2024 BY: 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. N W-�-E S NO SCALE MADISON ST G20-2 R9-11A RT END EWALKCLOSED ROADWORK AHEAD R1-1 CROSS HERE lJJ 11 ollor't E G 44 m _dddi R1 1 MALAGA Mop ESTATES ex G I m]di" 1i1�1� ■ 500, 0-1 NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH REVISION 7 OF THE 2014 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (CALIFORNIA M.U.T.C.D.) 2. 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. 3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS. 4. CONTRACTOR SHALL MAINTAIN A MINIMUM 10' (12' TYP.) TRAFFIC LANE WIDTH ATALL TIMES. THERE SHALL BE A MINIMUM 2' BETWEEN THE EDGE OF CUT AND THE NEAREST TRAFFIC LANE. 5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED ATALL TIMES. 6. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF WORK HOURS, THE ROAD SHALL BE CLEARED OF DEBRIS AND TRAFFIC RETURNED TO NORMAL UNLESS THE CONTRACTOR OBTAINS. PERMISSION FROM THE CITY OF LA QUINTATO LEAVE IN PLACE OVERNIGHT. 7. ALL TRAFFIC CONTROL DEVICES USED DURING HOURS OF DARKNESS SHALL BE RETRO-REFLECTIVE AND ALL BARRICADES SHALL BE EQUIPPED WITH FLASHING LIGHT. W20-5 (RT) t�7 / RIGHT LAW\ CLOSED MONROE ST Pending) Water Connection for Andalusia C C Prime Contractor Contact Andalusia C. C. Chris (760) 408-1164 Tops N Barricades, Inc. Ron Fifield Phone Speed UmK Date She (800)852-TOPS 50 10/26/23 1 REV City of La Quinta The following General and Special Provisions are attached to and made a part of Permit Number PWP2023-0004 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 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. ® 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. PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia In addition to the standard permit conditions, the following shall apply: 1. 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. 2. This permit or copy of it shall be on the work site (usually the job trailer) for inspection during the actual work performed. 3. 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. Prior to commencing the excavation of a trench 5 feet in depth or greater and into which a person will be required to descend, the Contractor shall first obtain a permit to do so from the Division of Industrial Safety pursuant to 7-10.4.1. 5. Sunrise LO, LLC (Nolan Sparks) and/or Cooley Construction and/or James A Shirley Construction, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. 6. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently, if required. 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. 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. Special Conditions Page 1 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia 9. The permittee and/or contractor placing engineered fill must provide adequate time and safety for the Geotechnical Engineer of Record to perform soils testing during engineered fill placement. The testing frequency shall be determined by the Geotechnical Engineer of Record such that the fill can be determined to be placed according to the city approved plans. 10. The permittee and/or contractor shall provide surveyor staking information adequate for the City Inspector to determine horizontal and vertical locations relative to the approved city plans. The minimum required wood lath type stakes shall be placed at all proposed building corners, and they shall state the horizontal location relative to building corner and the elevation of the top of hub next to the lath. 11. 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. 12. This permit is not valid until the permittee submits, to the Public Works Department 2 weeks prior to start of construction, a letter from any owners of the driveways/access ways that will be closed down due to the construction. The letter must be approved by the city and at minimum state from the owner the following: A. Approval of the construction B. Plan identification C. Time Frame of Closure D. Alternative Routes 13. 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 construction completion date. 14. Sunrise LO. LLC (Nolan Sharks) and/or Coolev Construction and/or James A Shirle Construction, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control during construction material hauling procedures. The following Fugitive Dust Control rules shall apply during soil import/export activities: a. A valid grading permit shall be active at both the import and export site b. The import/export material during hauling shall be near 70% optimum moisture content. c. Street cleaning shall occur, as necessary, at import and export location. d. Trucks hauling export or import material must maintain 6 inches of freeboard and be tarped. e. The haul route shall be attached to this permit or a City approved plan. 15. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 811. 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. Special Conditions Page 2 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia 16. 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. 17. 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. 18. 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. 19. The permittee shall be responsible for notifying the inspection staff of import fill and overexcavated areas on a daily base's. If the inspector's phone number is unknown, the permittee shall call the Public Works front counter phone at 777-7075 or the Assistant Civil Engineer at 777-7047 to determine the city inspector's phone number. If the imported fill or overexcavated locations indicate to the inspector that inadequate soils exist based on the criteria set forth in the Project Soils Report, Public Works Greenbook, or California Building Code, the Public Works inspector may halt grading operations until the inadequate soil has either been removed or the Public Works Director authorizes grading to continue. The above testing or observations does not relieve the permittee's responsibility for future repairs due to settlement at and near the locations of the work area. Prior to the city issuing a building permit, the permittee's Geotechnical Engineer of Record shall submit a certified letter indicating that the grading has been completed per the approved plan. A compaction report on all fill is required following pad certification and prior to building permit issuance. Special Conditions Page 3 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia 20. The permittee shall be responsible for calling the city inspector to arrange the city inspector to observe random trench compaction testing performed by a city approved material testing firm. If the inspector's phone number is unknown, the permittee shall call the Public Works front counter phone at 777-7075 or the Assistant Civil 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. 21. 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 permit may be "at risk" for further 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. 22. The permittee is responsible for obtaining a valid separate permit from other Cities, County jurisdictions, or other agencies if any of the work or traffic control devices extend into the other Cities, County, or agencies right of way. 23. 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 following items: a. General Liability Insurance Company and Policy Number b. City Business License c. Contractors State License Number 24. The Applicant or Contractor shall furnish the City satisfactory evidence of insurance in the amounts 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. Each policy shall name the City as an additional insured. 25. Work within 500 feet of any designated School Zone shall be performed between the hours of 8 a.m. — 1:30 p.m. Traffic control shall be set up after 8 a.m. and removed before 1:30 p.m. 26. The permittee shall not encroach upon private property without prior written approval (submit to the Public Works Department, attention to the Assistant Civil Engineer) of the private land owner whom is being encroached upon. 27. Prior to excavating in native soils, the owner of the project shall have employed by proposal contract an archaeological observer for the site excavations within native undisturbed soils. A copy of the contract must be submitted to the Public Works Department and attention this to the Associate Engineer. If the archaeologist determines the site note to be required to be observed, please submit a letter signed by the archaeologist stating their determination. Special Conditions Page 4 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia 28. During work hours, the permittee shall provide and maintain a traffic lane that diverts traffic off the paved roadway. The traffic lane must be located within the existing R/W with the following requirements: a. Class II Base with a minimum depth of 2" b. A 12 inch thick subgrade layer compacted to 95% based on ASTM D1557 c. An unobstructed travel width of 10 feet. d. In addition, a minimum of 5 feet clearance from open trenches. e. A minimum of 2 feet from vertical obstructions like curbs. f. Maximum speed of 25 mph 29. The permittee shall haul all offsite debris to a certified landfill. Prior to hauling debris, the permittee shall inform the City (Inspection staff or 777-7047) of the name and location of the certified dump site. 30. 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. 31. The permittee is required to provide an informative message board (approved by the City Engineer) informing the commuters using the affected roadways of a. Possible traffic delays b. Time of construction c. Alternate routes. The message board shall be provided for the commuters 48 hours prior to the start of traffic delays, and the entire message should be readable at the posted speed limit. 32. Pursuant to Section 14.16.370 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), backfill compaction within street rights -of -way shall conform with Section 306-1.3 of the latest edition of the Standard Specifications For Public Works Construction (SSPWC), except as otherwise specified herein. Native material may be used as backfill material provided that minimum compaction, achieved in the manner prescribed herein, is achieved. Backfill shall be performed by mechanical means; no water densified compaction via jetting or flooding or other means shall be allowed. It shall be the Permittee's responsibility to provide appropriate geotechnical supervision, testing, and inspection, onsite, at all times during backfill operations. Backfill compaction shall be achieved by the following conditions: A. When a firm foundation is not encountered due to soft, spongy or other unsuitable material, such material shall be removed to the limits directed by the Geotechnical Inspector and/or the City Inspector and the resulting excavation backfilled with pipe bedding material. Special Conditions Page 5 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia B. Backfill materials shall be brought to or maintained at appropriate moisture content for compaction. The appropriate moisture content range shall be established at the onset of the project and ensured prior to use of the materials through progress testing on the stockpiles. C. The first length of trench backfilled shall be backfilled in the presence of the City Inspector. Compaction shall be tested at random depths at approximate three-foot vertical intervals as backfill is placed to ensure the effectiveness of the compaction methods and to establish the depth of lift that can be compacted. D. If lifts greater than one foot are attempted in this trial length of trench, compaction tests shall be taken within the lifts to ensure that the full depth of the lift is compacted. Upon satisfactory completion of this portion of trench, the City Inspector shall establish the maximum lift thickness to be compacted for the remainder of the project. E. In subsequent lengths of trench, the frequency of compaction tests shall equal one per each lift of backfill, per 300 linear feet of open trench, at randomly selected locations within the open length of trench. F. The depth of the randomly selected compaction tests shall also be randomly selected except that where multiple tests are required in a given length of trench, the tests shall be no closer than three feet (vertically) from each other. G. If any compaction test fails, previously placed backfill (in the same length of open trench or previous lengths of trench) which is represented by the failing test (as determined by the City Inspector), shall be tested for compliance with compaction requirements. H. All costs incurred due to the conditions above shall be borne by the Permittee. Copies of all test results shall be furnished to the City Inspector. 33. 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. 34. All landscaping, irrigation, decorative rock, decorative concrete, sidewalk, lighting, etc., shall be replaced to its original condition. 35. Access and egress to all local properties shall be maintained at all times. 36. 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: Special Conditions Page 6 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia A. Existing asphalt concrete pavement shall be sawcut one (1) foot beyond trench edges. Edges shall be straight and clean. B. 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. C. Permanent pavement replacement shall be installed using a City approved 3/4" max medium asphalt concrete as the base course lift and a City approved 1/2" max medium finish course lift for capping. Asphalt concrete mix design shall be approved by the City prior to its placement. D. Cold -Mill and Overlay - The existing pavement which was properly protected in place during the trenching operation located adjacent to the trench saw cut shall be cold -milled to a depth of 0.10 feet with butt joint created next to the existing unmilled pavement surface. The cold -milled area and base asphalt concrete in the trench area shall be overlaid with a City approved C2-AR-4000 asphalt concrete mix. The width of the cold milling area shall be as follows: • For longitudinal trenches located in a parking lane: three (3) feet outside the sawcut removal lines. • For longitudinal trenches located in a traffic lane: three (3) feet outside the sawcut removal lines, or to the lane line striping, whichever is greater. • For transverse trenches across existing street: two (2) feet outside the sawcut removal lines. E. If grinding and capping operations are not performed in the same day as base paving operations, the base course lift of 3/4" max medium asphalt concrete shall be installed from saw -cut edge to saw -cut edge flush with the existing street surface. The base course lift of paving shall not be left 0.10' low in anticipation of grinding and capping. F. 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. 37. 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. Special Conditions Page 7 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia 38. 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. 39. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. 40. 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. 41. 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. 42. Flagger Requirements A. Minimum Requirements 1. Receive and communicate specific instructions clearly, firmly, and courteously; 2. Move & maneuver quickly; 3. Provide clear and positive guidance; 4. Understand and apply safe traffic control practices; 5. Recognize dangerous traffic situations in sufficient time to avoid injury. B. Flagger Safety Apparel 1. Background a. Fluorescent orange -red, or b. Fluorescent yellow -green 2. Retroreflective material (Orange, yellow, white, silver, yellow -green, or fluorescent version. 3. Material shall be visible at 1000 ft 4. Apparel shall be designed to identify the wearer as a person 5. Law enforcement personnel should adhere to the same standard C. Hand -Signaling Devices 1. Stop/Slow paddle octagonal in shape with minimum 18" width and 6" letters. Must have white legend on red background. Special Conditions Page 8 of 9 PERMIT NO. PWP2023-0004 Andalusia /On -Site Street and Storm Drain Improvements / TM 38188; Northeast Corner of Ave 60 and Madison St; Within Andalusia D. Directing Traffic 1. Only three (3) signals are required. 1' SLOW PROCEE1 STUP ■ E. Flagger Communications 1. If work area is too long for relay (2 flaggers can't see each other) a. One flagger given the responsibility to coordinate b. Use Radios or c. Field phones F. Flagger warning signs must be removed or covered when flagging is finished, when work is not going to start immediately, or when work is completed. Special Conditions Page 9 of 9 / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (M M/DD/YYYY) 06/30/2023 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 Carrie Stubblefield CISR NAME: James G. Parker Insurance ACC Ext : (559) 222-7722 A/XC, No): (559) 222-1724 E-MAIL CarrieStubblefield@jgparker.com ADDRESS: License #0554959 INSURER(S) AFFORDING COVERAGE NAIC # P O Box 3947 INSURERA: Valley Forge Insurance Company 20508 Fresno CA 93650 INSURED INSURER B: The Continental Insurance Co 35289 INSURER C : Palomar Specialty Ins Co 20338 James A Shirley Construction Inc INSURER D : 59-160 Mesa Drive INSURER E : INSURER F : Yucca Valley CA 92284 COVERAGES CERTIFICATE NUMBER: 23-24 GL BA IM UMB WC 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 INSURANCEADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �X OCCUR DAMAGE TO PREM SES Ea oNcRETE ante $ 100,000 _7CLAIMS-MADE MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 A Y 7034790445 01/01/2023 01/01/2024 LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO ❑ LOC JECT: MOTHER PRODUCTS-COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS BUA7034790431 01/01/2023 01/01/2024 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED �/ NON -OWNED AUTOS ONLY /� AUTOS ONLY X UMBRELLA LIAB M OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 B EXCESS LABCLAIMS-MADE CUE7034790462 01/01/2023 01/01/2024 DED I X1 RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) NIA PSIC1059303 01/01/2023 01/01/2024 X STATUTE ERH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ A ed Equipment Equipment Rented Scheduled 7034790445 01/01/2023 01/01/2024 $2,500 Deductible $2,500 $400,000 Per Schedule DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: ACC Tract 38188 - Sewer, Water, Storm Drain, Andalusia Country Club, La Quinta, CA. Developer: Sunrise LQ, LLC. City of La Quinta is included as Additional Insured as per form CNA75079 1016 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of La Quinta ACCORDANCE WITH THE POLICY PROVISIONS. 78-495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta CA 92253 A� eo" @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors -with Products -Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products -completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10- 01 edition of CG2037; or B. additional insured coverage with "arising out of language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX (10-16) Policy No: 7034790445 Page 1 of 2 Endorsement No: 5 Valley Forge Insurance Company Effective Date: 01/01/2023 Insured Name: James A Shirley Construction Inc Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors -with Products -Completed Operations Coverage Endorsement Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (10-16) Policy No: 7034790445 Page 2 of 2 Endorsement No: 5 Valley Forge Insurance Company Effective Date: 01/01/2023 Insured Name: James A Shirley Construction Inc Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CERTIFICATE OF LIABILITY INSURANCE ATE (MM/DDNYYY) D7/24/2023 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 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 Matthew Evans NAME: , NNo Ext: (909)795-9885 ac No: (909)795-9886 WAYNE EVANS INSURANCE AIL ADDRESS: mattryanevans@aol.com 34590 County Line Road, #6 INSURERS AFFORDING COVERAGE NAIC # INSURERA:United Specialty Insurance Company 12537 Yucaipa CA 92399 INSURED INSURER B: Travelers Property Casualty Co of 25674 INSURERC: Cooley Construction, Inc. INSURERD: P.O. BOX 401810 INSURER E : INSURER F: Hesperia CA 92340 COVERAGES CERTIFICATE NUMBER:CL22122801310 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/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 01/01/2023 01/01/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR ATN2375576 PRE EES ES a occurrencRENTED e PREMIS $ 50,000 X MED EXP (Any one person) $ 5,000 Contractual Liability X PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 1 PEA ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Deductible $ 5,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ B X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS 810-2NB86768-23-26-G 8/1/2023 8/1/2024 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) ccident $ NON -OWNED X HIRED AUTOS X AUTOS A UMBRELLA LIAB X OCCUR BTN2349591 01/01/2023 01/01/2024 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X PER OTH- STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y❑ (Mandatory in NH) N /A Y UB-8K36922A-23-26-G 8/1/2023 8/1/2024 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B CONTRACTORS EQUIPMENT QT-660-6E423058-TIL-23 6/1/2023 6/1/2024 LIMIT 350,000 DEDUCTIBLE 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF LA QUINTA AND SUNRISE LQ LLC ARE ADDITIONAL INSURED AS REGARDS GENERAL LIABILITY FOR ONGOING AND COMPLETED OPERATIONS AND PROVIDED WAIVER OF SUBROGATION ON WORKERS COMPENSATION PER FORMS ATTACHED. PRIMARY AND NON-CONTRIBUTORY PER FORM ATTACHED. RE: ACC TRACT 38188 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF LA QUINTA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 78-495 CALLE TAMPICO ACCORDANCE WITH THE POLICY PROVISIONS. LA QUINTA, CA 92253 AUTHORIZED REPRESENTATIVE Matthew Evans/MATT ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 38 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 2. "Bodily injury" or "property damage" occurring after: a. 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 CG 20 38 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 b. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.L; or 2. 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 © Insurance Services Office, Inc., 2012 CG 20 38 04 13 POLICY NUMBER: ATN2375576 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 As Required By Written Contract, Fully Executed Prior To The Named Insured's Work As Required By Written Contract, Fully Executed Prior To The Named Insured's Work 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. 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 2. 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 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 United Specialty Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VEN 051 00 (02/20) PRIMARY AND NON-CONTRIBUTING INSURANCE ENDORSEMENT This endorsement modifies the Conditions provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS of the COMMERCIAL GENERAL LIABILITY COVERAGE PART, and supersedes any provision to the contrary Primary and Non -Contributory Insurance Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless: a. (1) The Additional Insured is a Named Insured under such other insurance; and (2) A fully written contract fully executed prior to the Named Insured's commencement of work for such Additional Insured for the specific project that is the subject of the claim, "suit," or "occurrence" expressly requires that this insurance: (1) apply on a primary and non-contributory basis; and (11) would not seek contribution from any other insurance available to the additional insured. or b. Prior to a loss, you request in writing and we agree in writing that this insurance shall apply on a primary and non-contributory basis Name Of Person(s) Or Organization(s) As Required By Written Contract, Fully Executed Prior To The Named Insured's All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. VEN 051 00 (02120) Page 1 of 1 T�4AI�EV_E14� J� WORKERS CaMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76 ( A) — 001 POLICYNUMBE:R: (UB-8K36922A-23-26-G) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT•- CALIFORNIA (BLANKET INAIVER) 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 this endorsement shall be 01. 000 %, of the California workers compensation pre- mium. Schedule Person or Organization .lob Description ANY PERSON OR ORGANIZATION' FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 Insured Policy No. Endorsement No. Premium Insurance Company Countersigned by