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ENC2024-0078
ta Qwkra CAT FORM .% - ENCROACHMENT PERMIT PUBLIC WORKS CONSTRUCTION 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/or APPROVED SUBDIVISIONS. DATE: 7/23/2024 LOCATION AND CONSTRUCTION: Crossing Dune Palms at Corporate Center Drive PURPOSE OF CONSTRUCTION: IID Conduit Installation as agreed to by City of La Quinta DESCRIPTION OF CONSTRUCTION: Blackpoint Properties PM 38668; IID work including demo/trenching, conduits installation, and road repair per IID plan dated 07.03.2024 APROXIMATE TIME WHEN WORK WILL BEGIN: 8/5/2024 DATE OF COMPLETION: 9/20/2024 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. BLACKPOINT PROPERTIES LLC Clement Balser Name of Applicant J.H. THOMPSON & SONS INC Name of Contractor 734478 Contractor's License No. Greenwich Ins Co Applicant's Insurance Company FEES Total: 1129 INDUSTRIAL AVE STE 205 PETALUMA, CA 94952 Business Address 79-607 COUNTRY CLUB DR #2 BERMUDA DUNES, CA 92201 Business Address LIC-0005205 (415) 497-1431 Telephone No. (760) 345-6003 Telephone No. City Business License No. N PC 100187504 Policy Number PERMIT NO: ENC2024-0078 DATE ISSUED: 7/25/2024 EXPIRATION DATE: 7/25/2025 BY: Amy Yu If the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council. 7/25/2024 1:49:40 PM WESTWARD HO DR. WSTING EXISTING C NCRE K RAIL BARRIER �G W2B-1 POST 350' SOUTH OF THE W20-1 LEFT LANE CLOSED AHEADq &4 NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH REVISION 8 OF THE 2014 CALIFORNIA MANUAL ON UN4FORM TRAFFIC CONTROL DEVICES (Ca.M.U.T.C.D.) 2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETYAND TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LA QUINTA REPRESENTATIVE., 3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADESAND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS., 4. CONTRACTOR SHALL MAINTAIN A MINIMUM 10 (TYP. 12')' TRAFFIC LANE WIDTH AT ALL 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 AT ALL TIMES, 6. CONTRACTOR SHALL MAINTAIN PROPER SIGHT DISTANCE AT ALL INTERSECTIONS 7. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF WORK DAY, THE TRENCH SHALL BE BACKFILLED OR COVERED WITH STEEL TRAFFIC PLATES ("STEEL PLATES AHEAD' SIGNS ON BARRICADES WITH FLASHING LIGHTS SHALL BE POSTED),THE ROAD SHALL BE CLEAR OF DEBRIS AND TRAFFIC RETURNED TO NORMAL 8. ANY CONFLICTING EXISTING TRAFFIC CONTROL DELINEATION AND/OR SIGNS FROM THE BRIDGE CONSTRUCTION SHALL BE MOVED OUT OF THE WAY OR TURNED AWAY FROM TRAFFIC WHILE THIS TRAFFIC CONTROL IS IN PLACE AND RESTORED TO CURRENT CONDITION WHEN THIS TRAFFIC CONTROL IS REMOVED. S. ALL TRAFFIC CONTROL DEVICES USED DURING HOURS OF DARKNESS SHALL BE RETRO-REFLECTIVE AND ALL BARRICADES SHALL BE EQUIPPED WITH FLASHING LIGHTS. -7l-J-4i %so" Pendin TMIftcu" PIN for z 'A Install Electrical Crossing for New Center H Th ompson Const. Eric 760-345-6 0 NO SCALE TreficCmWDWgnby P>av&IvaBr CMftaEy Tops N Barricades, Inc. Ron Fifield (800)852-TOPS 45 7/22/24 1 WESTWARD HO DR. STING EXISTING CONCRETE K RAIL BARRIER W20-1 POST 350' SOUTH OF THE W20-1 LEFT LANE CLOSED AHEAD NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH REVISION 8 OF THE 2014 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (Ca.M.U.TC.D.) 2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAYBE REQUIRED TO FACILITATE PUBLIC SAFETY AND TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LA QUINTA 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 (TYP. 12')'TRAFFIC LANE WIDTH AT ALL 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 AT ALL TIMES. 6. CONTRACTOR SHALL MAINTAIN PROPER SIGHT DISTANCE AT ALL INTERSECTIONS 7. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF WORK DAY, THE TRENCH SHALL BE BACKFILLED OR COVERED WITH STEELTRAFFIC PLATES ("STEEL PLATES AHEAD' SIGNS ON BARRICADES WITH FLASHING LIGHTS SHALL BE POSTED),THE ROAD SHALL BE CLEAR OF DEBRIS AND TRAFFIC RETURNED TO NORMAL 8. ANY CONFLICTING EXISTING TRAFFIC CONTROL DELINEATION AND/OR SIGNS FROM THE BRIDGE CONSTRUCTION SHALL BE MOVED OUT OF THE WAY OR TURNED AWAY FROM/ TRAFFIC WHILE THIS. TRAFFIC CONTROL IS IN PLACE AND RESTORED TO CURRENT CCNDITION WHEN THIS TRAFFIC CONTROL IS REMOVED. 9, ALLTRAFFIC CONTROL DEVICES USED DURING HOURS OF DARKNESS SHALL BE RETRO-REFLECTIVE AND ALL BARRICADES SHALL BE EQUIPPED WITH FLASHING LIGHTS. w Pending Tmft Coal Pin IN z Install Electrical Crossing for New Center � J H Thompson Const. Eric 760-345-6 03 N O SCALE Tragic Coft Deso by ftpw d By Cneftd By Tops N Barricades, Inc. Ron Fifield (800)862-TOPS 45 7/23/24 2 W20-1 HWY.ROAD � Y' 111 WESTWARD HO DR. waRK" AHFACS: W1-4 (RT) W1-4 (LT) cznz W2 RUAo -. VVMR -- 62o.z EXISTING AHEAD' 1 EXISTING EXISTING KINGDOM SEE C30 CA) 3�0 G2o-2 HALL NOTE R3-2 C30 CA 1 END 8 W+913C.1 R3-7o', RORD- 2d W16 ® RpNT1AME �. EXI TING x.R.R � E G DUNE PALMS RD EXISTING EXISTIN75 " I ! AREA C sa -, �J aAIN Q F d 1 EXISTING 73-i EXISTING CONCRETE - b j Rs-1 04 25 K RAIL BARRIER 7 ®' R1.1 �PN �] I DUNE PALMS RD W20-1 G20.5.P7 EXISTING � (i 7 Jam/ USA j ROAD �� E G E G c GAS _ C30 (CA) �� ROAD EP® 'NARROWS' DOUBLE WED ULTRA STATION woRoc 5sl�e IPri C[/p� AHfAO Lwy PANEL (NARROW W H) `� % LANE 20.50 ExIstlNc 35 LA QUINTA WORK 014.Y cLosEo ZONE 44 02M �-1 HIGH SCHOOL � - urR wzR-t READ w6RK. �� 350' W20-1 EXISTING a R2-1 11 EXI CORPORATE CENTER DR. NOTES; 1. ALLTRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH REVISION 8 OF THE 2014 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (Ca.M.U.T.C.D.) 2, TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETYAND TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LA QUINTA REPRESENTATIVE.. 3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRiCADESAND DELINEATORS)AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS.. 4. CONTRACTOR SHALL MAINTAIN A MINIMUM 10 (TYR 121)' TRAFFIC LANE WIDTH ATALL TIMES. THERE SHALL BEA MINIMUM 2' BETWEEN THE EDGE OF OUT AND THE NEAREST TRAFFIC LANE. z y 5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED ATALL TIMES. 6. CONTRACTOR SHALL MAINTAIN PROPER SIGHT DISTANCE AT ALL INTERSECTIONS 7. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY, AT END OF WORK DAY, THE TRENCH SHALL BE BACKFILLED OR COVERED WITH STEEL TRAFFIC PLATES ("STEEL PLATES AHEAD". NO SCALE SIGNS ON BARRICADES WITH FLASHING LIGHTS SHALL BE POSTED),THE ROAD SHALL BE CLEAR OF DEBRIS AND TRAFFIC RETURNED TO NORMAL. 8. ANY CONFLICTING EXISTING TRAFFIC CONTROL DELINEATION AND/OR SIGNS FROM THE BRIDGE CONSTRUCTION SHALL BE MOVED OUT OF THE WAY OR TURNED AWAY FROM TRAFFIC WHILE THIS TRAFFIC CONTROL IS IN PLACE AND RESTORED TO CURRENT CONDITION WHEN THIS TRAFFIC CONTROL IS REMOVED. 9 ALL TRAFFIC CONTROL DEVICES USED DURING HOURS OF DARKNESS SHALL BE RETRO-REFLECTIVEAND ALL BARRICADES SHALL BE EQUIPPED WITH FLASHING LIGHTS. W20-1 POST 350' SOUTH OF THE ROAD RIGHT LANE CLOSED AHEAD�� AWEAU W20.1 MINI STORAGE S2. 20.5 (RT) I I FESSIn,�,4 4�0 SRO f el .. a r2A. 7 `9 W20-1 Pend Install Electrical Crossing for New Center P*m Carthecbr Cow J H Thompson Const. Eric 760-345-6003 Tops N Barricades, Inc. Ron Fifield PhW Speed Lo* D-ta (800)852-TOPS 45 7/23124 3 UN1241302V ; L__..L!I __ CR i*wp,\\ 1210783-3 255' UN1103106H .. III JI NE'VV PMH-11 UN1247106S UN1036969S� L ._ _ .l .i. __ - _I M'ENT_TC BE GRANTED & At is 1 10' EASEMENT ---- ...—- —.�_— ---� HIGHWAY 111 UN1247335S LIN1171064P r---i FZ71ML_-J -J UN11710QL3H zco o � - N X N Lu Il- r ; A 7#.+ r" UN1171062S r---n , ■■ L --- J CONDUIT NOTES: 1) TYPICAL, STUBOUTS ARE REQUIRED TO AVOID UNDERMINING TRANSFORMER PADS AND SEC. PULLBOXES IN THE FUTURE. INSTALL 2-5" CND SCH.40 PVC PER SHOWN LENGTH. /2\5 (REFER TO SHEETS 10-11,111-123 OF THE D.E.P.G. REV. 5.24 2020) P INSTALL 2-5" CND SCH.40 PVC PER SHOWN LENGTH. /2\5 (REFER TO SHEETS 10-11,111-123 OF THE D.E.P.G. REV. 5.24 2020) P STUB -OUT AINSTALL 4-6" CND SCH.40 PVC PER SHOWN LENGTH. 46 (REFER TO SHEETS 10-11,111-123 OF THE D.E.P.G. REV. 5.24 2020) P AINSTALL 6-6" CND SCH.40 PVC PER SHOWN LENGTH. 66 (REFER TO SHEETS 10-11,111-123 OF THE D.E.P.G. REV. 5.24 2020) P AINSTALL 6-6" CND SCH.40 PVC PER SHOWN LENGTH. 66 (REFER TO SHEETS 10-11, 111-123 OF THE D.E.P.G. REV. 5.24 2020) P STUB -OUT TRENCHING DETAILS: F-� 2-4 PRI. DUCT CONC. ENCASED D D REFER TO SHEETS 116 & 122-123 OF THE D.E.P.G. REV. 5.24 2020 Fi_-� 5-9 PRI. DUCT CONC. ENCASED E E REFER TO SHEETS 116 & 122-123 OF THE D.E.P.G. REV. 5.24 2020 Fm� COMPACTION BACK FILL MULTI PRI. DUCT G G REFER TO SHEETS 116 & 122-123 OF THE D.E.P.G. REV. 5.24 2020 CURVE DATA TABLE # RADIUS < LENGTH R1 12.5' 900 19.63' R2 12.5' 450 9.81' 4 25.0' 900 39.26' 4 25.0' 450 19.63' TRENCHING NOTES: TYPICAL: CONTRACTOR SHALL INSTALL 2" LINE GUARD TAPE (RED) "CAUTION: BURIED ELECTRIC LINE BELOW." (REFER TO SHEET 122 OF THE D.E.P.G. REV. 5.24 2020) TYPICAL: 7'-8" FROM FACE OF CURB TO CENTER OF TRENCH. CONDUITS SHALL BE INSTALLED WITHIN 10' P.U.E. UNLESS OTHERWISE NOTES. (REFER TO SHEET 113 OF THE D.E.P.G. REV. 5.24 2020) STRUCTURAL DETAILS: m SUBSTRUCTURE MEDIUM VAULT EQUIPMENT ENCLOSURE REFER TO SHEETS 184-185, 210-212, & 235-240 OF THE D.E.P.G. REV. 5.24 2020 r-------I a I LARGE SWITCH PAD REFER TO SHEETS 192-193, 210-212, 219-221 OF THE D.E.P.G. REV. 5.24 2020 PRIMARY RISER POLE REFER TO SHEET 120 & 262 OF THE D.E.P.G. REV. 5.24 2020 m STUB OUT MARKER DETAIL REFER TO SHEETS 124 & 125 OF THE D.E.P.G. REV. 5.24 2020 ® CAUTION- IID ENERGIZED STRUCTURES & CABLE VAULT DETAIL: VAULT: U N 1159212S LOOKING: NORTH VAULT DETAIL: VAULT: U N 1247335S LOOKING: EAST VAULT DETAIL: /A._ VAULT: UN1247106S LOOKING: NORTH VAULT DETAIL: VAULT: U N 1247336S LOOKING: NORTH IID n SCALE:1:50 T.5, R.7, SEC.29 City of La Quinta The following General and Special Provisions are attached to and made a part of Permit Number ENC2024-0078 The followina shall always avvly: 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 ('/4") 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 (6) 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 three inches (Y) 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. ENC2024-0078 Blackpoint Properties/ IID Work Including Demo, Trench, Install Conduits, and Road Repair / Dune Palms Rd at Corporate Centre Dr 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. Blackpoint Properties, LLC (Clement Balser) and/or J.H. Thompson & Sons Inc., hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. 5. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently, if required. 6. The City of La Quinta reserves the right to require modifications of the work be made at permittee's sole cost for further modifications as it relates to any sight distance concerns and/or improvement plan requirements as required by the City Engineer. 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 1st to April 30: Monday -Friday 7:00 a.m. to 5:30 p.m. Saturday 8:00 a.m. to 5:00 p.m. May 1st 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 (i.e. any 4 lane street) before 8:00 a.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 5 PERMIT NO. ENC2024-0078 Blackpoint Properties/ IID Work Including Demo, Trench, Install Conduits, and Road Repair / Dune Palms Rd at Corporate Centre Dr 9. 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 with 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. 10. 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. 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. Any land on which Williamson Act contracts apply shall remain undisturbed. 14. 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. 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 5 PERMIT NO. ENC2024-0078 Blackpoint Properties/ IID Work Including Demo, Trench, Install Conduits, and Road Repair / Dune Palms Rd at Corporate Centre Dr 16. 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. 17. 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. 18. 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 Associate Engineer at 777-7047 to determine the city inspector's phone number. The inspector shall determine the number and location of the test location/s. The above testing does not relieve the permittee's responsibility for future repairs due to settlement at and near the locations of the work area. Materials testing must be performed under direct supervision of a California Registered Civil Engineer. 19. 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. 20. 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 21. The Applicant or Contractor shall furnish the City satisfactory evidence of insurance in the amounts provided in Engineering Bulletin for Indemnification & Insurance Requirements. This insurance shall be kept in full force and effect at all times by Applicant or Contractor during the prosecution of the permitted work and updated Certificate of Liability Insurance shall be submitted to the City. Each policy shall name the City as an additional insured. 22. 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. 23. 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. Special Conditions Page 3 of 5 PERMIT NO. ENC2024-0078 Blackpoint Properties/ IID Work Including Demo, Trench, Install Conduits, and Road Repair / Dune Palms Rd at Corporate Centre Dr 24. If traffic lanes are closed on an any Arterial street (any street with more than 2 lanes) within the City of La Quinta right of way, The permittee is required to provide an informative message board (approved by the City Engineer). It shall inform the commuters using the affected roadways of possible traffic delays, time of construction, and if possible alternate routes. The message board shall be provided for the commuters 48 hours prior to the start of traffic delays. The board does not have to be electrical or solar powered. 25. 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 to 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. 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. Special Conditions Page 4 of 5 PERMIT NO. ENC2024-0078 Blackpoint Properties/ IID Work Including Demo, Trench, Install Conduits, and Road Repair / Dune Palms Rd at Corporate Centre Dr 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. 26. 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. 27. All landscaping, irrigation, decorative rock, decorative concrete, lighting, sidewalk, etc., shall be replaced to its original condition. 28. Access and egress to all local properties shall be maintained at all times. 29. 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. 30. 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. 31. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. 32. 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. 33. If it is the intent of the permittee to cut the pavement and have it restored by a third parry, the permittee shall postpone cutting the pavement until the intended third parry has acquired a permit from the City to perform the required restoration work. Special Conditions Page 5 of 5 / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 03/14/2024 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 Cindy Hullender CISR NAME: James G. Parker Insurance ACC Ext : (559) 222-7722 A/XC, No): (559) 222-1724 E-MAIL clhullender@jgparker.com ADDRESS: License #0554959 INSURER(S) AFFORDING COVERAGE NAIC # P O Box 3947 INSURERA: Greenwich Ins Co 22322 Fresno CA 93650 INSURED INSURER B : XL Specialty Insurance Company 37885 INSURER C : J H Thompson & Sons Inc INSURER D : 79-607 Country Club Dr INSURER E : Suite 2 INSURER F : Bermuda Dunes CA 92203 COVERAGES CERTIFICATE NUMBER: 23-24 GL BA UMB 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) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 A NPC100187504 10/14/2023 10/14/2024 LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO ❑ LOC JECT: MOTHER PRODUCTS-COMP/OP AGG $ 2,000,000 Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS NBA100187704 10/14/2023 10/14/2024 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accidHent $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Medical payments $ 5,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 X AGGREGATE $ 2,000,000 A EXCESS LAB CLAIMS -MADE NEC600665202 10/14/2023 10/14/2024 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) BP Dune Palms LP, Blackpoint Properties LLC, and Texas Exchange Bank are included as additional insured as required by written contract per the attached forms CG2010 1219 & CG2037 1219, Waiver of Subrogation applies per form XLPIus Endorsement 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 I I d�A� vt @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) Acct#: 2530204 3/18/2024 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: USI Insurance Services, LLC PHOAIC NNE Ext : 844-290-4908 FAX o (A/C, No 2502 N Rocky Point Drive E-MAIL certs octonant BBSllkffii ADDRESS: @ Y.com Tampa, FL 33607 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Ace American Insurance Company 22667 INSURED J.H. THOMPSON & SONS, INC. INSURER B : 79-607 COUNTRY CLUB DRIVE, SUITE 2 INSURER C INDIO, CA 92203 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE1:1 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT ❑ LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A X C55571806 12/1/2023 12/1/2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Policy State = CA Waiver of Subrogation in favor of certificate holder when required by written contract 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 78495 Calle Tampico IN ACCORDANCE WITH THE POLICY PROVISIONS. La Quinta , CA 92253 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number J.H. THOMPSON & SONS, INC. Policy Number 79-607 COUNTRY CLUB DRIVE, SUITE 2 INDIO, CA 92203 Symbol: WLR Number: C55571806 Policy Period Effective Date of Endorsement 12/1/2023 TO 12/1/2024 3/18/2024 Issued By (Name of the Insurance Company) Ace American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization: (x) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL CALIFORNIA OPERATIONS 3. Premium: The premium charge for this endorsement shall be 1.0 percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: $0 Authorized Agent WC 90 03 75 (05/18) COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. 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 CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Blanket as required by written contract. Blanket as required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 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 provide for such additional insured. B. 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. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 C. 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; whichever is less. This endorsement shall applicable limits of insurance. not increase the Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG20371219 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 Blanket as required by written contract. Blanket as required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 ENDORSEMENT# This endorsement, effective 12:01 a.m. , forms a part of Policy No. issued to by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY XL Plus Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read this endorsement carefully to determine rights, duties, and what is and is not covered. A. Reasonable Force — Bodily Injury or Property Damage B. Damage To Premises Rented To You Extension • Perils of fire, lightning, explosion, smoke, aircraft or vehicles, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage • Limit increased to $300,000 C. Aircraft Chartered with Crew D. Non -Owned Watercraft E. Personal and Advertising Injury — Assumed by Insured Contract F. Increased Supplementary Payments • Cost for bail bonds increased to $5,000 • Loss of earnings increased to $1,000 per day G. Broadened Named Insured H. Blanket Additional Insured — Managers or Lessors of Premises I. Blanket Additional Insured — Lessor of Leased Equipment J. Injury to Co -Employees and Co -Volunteer Workers K. Knowledge and Notice of Occurrence or Offense L. Unintentional Omission M. Liberalization N. Blanket Waiver of Subrogation O. Incidental Medical Malpractice Injury P. Extension of Coverage — Bodily Injury Q. Coverage Territory Form XIL 436 1208 © 2008, XL America, Inc. Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. A. REASONABLE FORCE — BODILY INJURY OR PROPERTY DAMAGE Exclusion a. Expected Or Intended Injury of Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I — Coverages is deleted in its entirety and replaced by the following: [This insurance does not apply to:) Expected or Intended Injury or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. B. DAMAGE TO PREMISES RENTED TO YOU EXTENSION 1. The last paragraph of 2. Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I - Coverages is deleted in its entirety and replaced by the following: Exclusions c. through In. do not apply to damages to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by fire, lightning, explosion, smoke, aircraft or vehicles, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage. A separate limit of insurance applies to this coverage as described in Section III- Limits of Insurance. 2. This insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Rupture, bursting, or operation of pressure relief devices; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; or c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 3. Paragraph 6. of Section III- Limits of Insurance is deleted in its entirety and replaced by the following: 6.a. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises while rented to you, or temporarily occupied by you with permission of the owner, caused by fire, explosion, lightning, smoke, aircraft or vehicle, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same "occurrence", whether such damage results from fire, explosion, lightning, smoke, aircraft or vehicle or riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage or any combination of any of these. b. The Damage to Premises Rented to You Limit will be the higher of: (1) $300,000; or (2) The amount shown on the Declarations for Damage to Premises Rented to You Limit. Form XIL 436 1208 © 2008, XL America, Inc. Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 4. Paragraph 9.a. of the definition of "insured contract' under Section V- Definitions, is deleted in its entirety and replaced by the following: ["Insured contract' means:] a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, aircraft or vehicle, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage to premises while rented to you, or temporarily occupied by you with the permission of the owner is not an "insured contract'. 5. This Article B. does not apply if coverage for Damage to Premises Rented to You of Coverage A. Bodily Injury And Property Damage Liability of Section I — Coverages is excluded by endorsement. C. AIRCRAFT CHARTERED WITH CREW 1. The following is added to the exceptions contained in Exclusion g., Aircraft, Auto or Watercraft in Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage of Section I — Coverages: [This exclusion does not apply to:) Aircraft chartered with crew to any insured. 2. This Article C. does not apply if the chartered aircraft is owned by any insured. 3. The insurance provided by this Article C. shall be excess over any valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. D. NON -OWNED WATERCRAFT 1. The exception contained in Subparagraph (2) of Exclusion g. Aircraft. Auto or Watercraft in Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I — Coverages is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) 50 feet long or less; and (b) Not being used to carry persons or property for a charge; This Article D. applies to any person who, with your expressed or implied consent, either uses or is responsible for the use of the watercraft. 3. This insurance provided by this Article D. shall be excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. E. PERSONAL AND ADVERTISING INJURY —ASSUMED BY INSURED CONTRACT 1. Exclusion e. Contractual Liability in Part 2., Exclusions of Coverage B. Personal And Advertising Injury Liability of Section I — Coverages is deleted in its entirety and replaced by the following: Form XIL 436 1208 © 2008, XL America, Inc. Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. [This insurance does not apply to:) e. Contractual Liability "Personal and Advertising Injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages: 1. That the insured would have in the absence of the contract or agreement; or 2. Assumed in a written contract or agreement that is an "insured contract"; provided the "personal and advertising injury" is caused by an offense which occurs subsequent to the execution of the contract or agreement. 2. Subparagraph f. of the definition of "insured contract" Section V.- Definitions is deleted in its entirety and replaced by the following: If. That part of any other contract or agreement pertaining to your business, including an indemnification of a municipality in connection for work performed for a municipality, under which you assume the tort liability of anther party to pay for "bodily injury", "property damage" or "personal and advertising injury" to a third party or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. 2. This Article E. does not apply if Coverage B. Personal And Advertising Injury Liability is excluded by endorsement. F. INCREASED SUPPLEMENTARY PAYMENTS Subparagraphs 1. b. and d. of Supplementary Payments — Coverages A And B of Section I - Coverages are amended as follows: 1. In Subparagraph b., the amount we will pay for the cost of bail bonds is increased up to $5,000. 2. In Subparagraph d., the amount we will pay for a loss of earnings is increased up to $1,000 a day. G. BROADENED NAMED INSURED 1. The Named Insured in Item 1. of the Declarations is as follows: The person or organizations named in Item 1. of the Declarations and any organization, other than a partnership or joint venture, over which you maintain ownership or majority interest on the effective date of the policy. However, coverage for any such organization will cease as of the date that you no longer maintain ownership of, or majority interest in, such organization. 2. This Article G. does not apply to any person or organization for which coverage is excluded by endorsement. Form XIL 436 1208 © 2008, XL America, Inc. Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. H. BLANKET ADDITIONAL INSURED —MANAGERS OR LESSORS OF PREMISES 1. Section II -Who Is An Insured is amended to include as an insured any person or organization with whom you have agreed in a written contract executed prior to loss (an "additional insured"), but only with respect to liability arising out of the ownership, maintenance or use of that part of any premises leased to you, subject to the following provisions: a. Limits of Insurance. The Limits of Insurance afforded to the "additional insured" shall be the limits you agreed to provide, or the limits shown on the Declarations, whichever is less. b. The insurance afforded to the "additional insured" does not apply to: (1) Any "occurrence" that takes place after you cease to be a tenant in that premises; (2) Any premises for which coverage is excluded by endorsement; or (3) Structural alterations, new construction or demolition operations performed by or on behalf of such "additional insured". 2. The insurance afforded to the "additional insured" is excess over any valid and collectible insurance available to such "additional insured", unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. I. BLANKET ADDITIONAL INSURED —LESSOR OF LEASED EQUIPMENT 1. Section II -Who Is An Insured is amended to include an "additional insured" (as defined in Article H. above), but only with respect to their liability arising out of maintenance, operation or use by you of equipment leased to you by such "additional insured", subject to the following provisions: a. Limits of Insurance. The Limits of Insurance afforded to the "additional insured" shall be the limits which you agreed to provide, or the limits shown on the Declarations, whichever is less. b. The insurance afforded to the "additional insured" does not apply to: (1) Any "occurrence" that takes place after the equipment lease expires; or (2) "Bodily injury" or "property damage" arising out of the sole negligence of such additional insured. 2. The insurance provided to the "additional insured" is excess over any valid and collectible insurance available to such "additional insured", unless you have a written contract for this insurance to apply on a primary or contributory basis. J. INJURY TO CO -EMPLOYEES AND CO -VOLUNTEER WORKERS 1. Section II- Who Is An Insured is amended to include your "employees" as insureds with respect to "bodily injury" to a co -"employee" in the course of the co -"employee's" employment by you, or to your "volunteer workers" while performing duties related to the conduct of your business, provided that this coverage for your "employees" does not apply to acts outside the scope of their employment by you or while performing duties unrelated to the conduct of your business. Form XIL 436 1208 © 2008, XL America, Inc. Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2. Section II — Who Is An Insured is amended to include your "volunteer workers" as insureds with respect to "bodily injury" to a co -"volunteer worker" while performing duties related to the conduct of your business, or to your "employees" employment by you, provided that this coverage for your "volunteer workers" does not apply while performing duties unrelated to the conduct of your business. K. KNOWLEDGE AND NOTICE OF OCCURRENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit of the Section IV - Commercial General Liability Conditions: Notice of an `occurrence" or of an offense which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the "occurrence" or offense has been reported to any insured listed under Paragraph 1. of Section II -Who Is An Insured or any "employee" (such as insurance, loss control, risk manager or administrator) designated by you to give such notice. Knowledge of any other "employee(s)" of an "occurrence" or of an offense does not imply that you also have such knowledge. Notice shall be deemed prompt if given in good faith as soon as practicable to your workers compensation insurer. This applies only if you subsequently give notice to us as soon as practicable after any insured listed under Paragraph 1. of Section II — Who Is An Insured or an "employee" (such as an insurance, loss control, or risk manager or administrator) designated by you to give such notice discovers that the "occurrence", offense or claim may involve this policy. L. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Representations, of Section IV- Commercial General Liability Conditions: The unintentional omission of, or unintentional error in, any information provided by you shall not prejudice your rights under this insurance. However, this Article L. does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable state insurance laws or regulations. M. LIBERALIZATION The following is added to Section IV -Commercial General Liability Conditions: Liberalization After the issuance of this policy, if we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part of this policy without a premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. Form XIL 436 1208 © 2008, XL America, Inc. Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. N. BLANKET WAIVER OF SUBROGATION The following is added to Section IV -Commercial General Liability Conditions: Waiver of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a contract with that person or organization; "your work"; or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you prior to loss. O. INCIDENTAL MEDICAL MALPRACTICE INJURY 1. For insurance applicable to this Article O, the definition of "bodily injury" in Section V - Definitions is amended to include, "Incidental Medical Malpractice Injury". 2. The following definition is added to Section V- Definitions: "Incidental medical malpractice injury" means "bodily injury", mental anguish, sickness or disease sustained by a person, including death resulting from any of these at any time, arising out of the rendering of, or failure to render, the following services: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; b. The furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances; c. First aid; or d. "Good Samaritan Services". As used in this Article O., "Good Samaritan Services" are those medical services rendered or provided in an emergency and for which no remuneration is demanded or received. 3. Paragraph 2.a.(1)(d) of Section II -Who Is An Insured does not apply to any registered nurse, licensed practical nurse, emergency medical technician or paramedic employed by you, but only while performing the services described in Paragraph 2. above and while acting within the scope of their employment by you. Any "employees" rendering "Good Samaritan Services" will be deemed to be acting within the scope of their employment by you. 4. The following exclusion is added to Paragraph 2. Exclusions of Coverage A. — Bodily Injury And Property Damage Liability of Section I — Coverages: [This insurance does not apply to:) Willful Violation of Penal Statute Liability arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals by or with the knowledge or consent of the insured. 5. For the purposes of determining the applicable Limits of Insurance, any act or omission, together with all related acts or omissions in the furnishing of services described in Paragraph 2.a. through 2.d. above to any one person, will be considered one "occurrence". 6. This Article O. does not apply if you are in the business or occupation of providing any of the services described in Paragraph 2. above. Form XIL 436 1208 © 2008, XL America, Inc. Page 7 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 7. The insurance provided by this Article O. shall be excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. P. EXTENSION OF COVERAGE — BODILY INJURY The definition of "bodily injury" Section V- Definitions is deleted in its entirety and replaced by the following: 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. Q. COVERAGE TERRITORY The definition of "coverage territory" Section V- Definitions is deleted in its entirety and replaced by the following: 4. "Coverage territory" means anywhere in the world. This insurance does not apply to: a. "bodily injury" or "property damage" that takes place; or b. "personal and advertising injury" caused by an offense committed outside the United States of America (including its possessions and territories), Canada and Puerto Rico, unless a "suit" on the merits (to determine the insured's responsibility to pay damages to which this insurance applies) is brought in the United States of America (including its possessions and territories), Canada or Puerto Rico. This insurance does not apply to damage, loss, cost or expenses in connection with any "suit" brought outside the United States of America (including its possessions and territories), Canada or Puerto Rico. Form XIL 436 1208 © 2008, XL America, Inc. Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission.