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2015 NV5, Inc - Suvey & Mapping ServicesJuly 21, 2015 Jay Fahrion, Survey Manager NV5, Inc. 42829 Cook Street Palm Desert, CA 92211 Re: Professional Services Contract Dear Mr Fahrion: This letter will memorialize a Contract for Services between NV5, Inc. ("Consultant") and the City of La Quinta ("City") for survey and mapping services as related to the completion of Lot Line Adjustment 2015-0005 to create a two -acre fire station site ("Services") on property located at the northeast corner of Avenue 60 and Monroe Street as shown in Exhibit E (APNs: 764-240-026 and 764-240-022). Consultant shall provide Services as specified in the Scope of Work set forth in Exhibit A which is incorporated herein by this reference and expressly made a part hereof, at the rate set forth therein. Total project cost, including all reimbursable expenses and any contingencies, shall not exceed Seven Thousand, Five Hundred Dollars ($7,500.00) as based on the Schedule of Compensation set forth in Exhibit B which is incorporated herein by this reference and expressly made a part hereof. Consultant shall submit monthly invoices pursuant to the terms set forth in Exhibit B, until completion of the Services. Consultant is an independent contractor. Neither City nor any of its employees shall have any control over the manner, mode, or means by which Consultant, its agents or employees, perform the Services required herein, except as otherwise set forth herein. Consultant shall perform all Services required herein as an independent contractor of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role. Consultant shall have no power to incur any debt, obligation, or liability on behalf of City. Consultant shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of City. Consultant and any of its employees, agents, and subcontractors providing Services under this contract shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by City, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of City and entitlement to any contribution to be paid by City for employer contributions and/or employee contributions for PERS benefits. Consultant agrees to pay all required taxes on amounts paid to Consultant under this contract, and to indemnify and hold City harmless from any and all taxes, assessments, penalties, and interest asserted against City by reason of the independent contractor relationship NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 2 of 14 created by this contract. Consultant shall fully comply with the workers' compensation laws regarding Consultant and Consultant's employees. Consultant further agrees to indemnify and hold City harmless from any failure of Consultant to comply with applicable workers' compensation laws. City shall have the right to offset against the amount of any fees due to Consultant under thiscontractany amount due to City from Consultant as a result of Consultant's failure to promptly pay to City any reimbursement or indemnification arising under this paragraph. Prior to the beginning of any Services under this contract and throughout the duration of the term of this contract, Consultant shall procure and maintain, at its sole cost and expense, and submit concurrently with its execution of this contract, policies of insurance as specified in the Insurance Requirementssetforth in Exhibit C which is incorporated herein by this reference and expressly made a part hereof. To the fullest extent permitted by law, Consultant shall indemnify, protect, defend and hold harmless City and any and all of its officers, employees, agents, and volunteers as specified in the Indemnification set forth in Exhibit D which is incorporated herein by this reference and expressly made a part hereof. City may at any time, for any reason with or without cause suspend or terminate this contract upon the issuance of a ten (10) day notice by City. Upon receipt of such notice, Consultant shall cease all Services under this contract. City shall pay Consultant for Services performed up to the time of termination and all work products shall be provided to City. This contract shall commence on July 21, 2015, and shall remain and continue in effect until the Services are completed or it is terminated, but no later than October 31, 2015, without written approval of the City Manager. Should you find this contract acceptable, please sign both original copies where indicated below and return to me. An original fully -executed copy of this contract will be forwarded to you. Sincerely, Digitally signedby Frank .Spevacek ON: serialNumber=l ln6l5n615nh01202cvmj, c=US, st=California, l=La Quinta, o=Frank J. Spevacek, cn=Frank J. Spevacek Date: 2015.08.11 11:19:00 -07'00' Frank J. Spevacek, City Manager NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 3 of 14 APPROVED AS TO FORM: WILLIAM H. IHRKE City Attorney AGREED AND ACCEPTED: ATTEST: SUSAN MAYSELS City Clerk Consultant: NV5, Inc. Dated By: Paul Robotta Su ey Group Director, Vice President Dated: . JAA By aryJonen Executi Vice President, Chief Administrative Officer, and Secretary, NV5, Inc, Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 3 of 14 in" WILLIAM H. IHRKE City Attorney 07= q -1 - Dated, Digitally signed by City of La Quinta DN: enalNumber=6fnnhzhdhvfJz93cr, -US , t=California, I–La Quinta, _City of La Quinta, —City of La Quint Dab,; 2015.08.11 13:36:36 -07'00' SUSAN MAYSELS City Clerk By: Paul Robofta /7S rvey Group Director, Vice President '/'�JbL4 1111AA __q_ -iy aryJ0 Q%rien Executive Vice President, Chief Administrative Officer, and Secretary, NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 4 of 14 Exhibit A Scope of Services Consultant will prepare one Lot Line Adjustment Application (LLA2015-0005) to adjust the location of Parcel 3 to the proposed location as shown on the exhibit of LLA No. 2005-446 and incorporated hereto as Exhibit E. Included in this task are all research, record mapping, field topographic surveys to locate the existing walls, preparation of a legal description and plat and submittal of the Lot Line Adjustment Application to the City of La Quinta. TASK 2 CERTIFICATE OF COMPLIANCE ($1,750) Consultant will prepare one Application for Certificate of Compliance to complete the process of bringing the adjusted parcels compliant with the Subdivision Map Act, created by the Lot Line Adjustment (Task 1). Included in this task are all research, record mapping, preparation of a legal description and plat andsubmittalof the Certificate of Compliance Application. iI 1 11 iii i;i'F1111-151111111111 Consultant will provided consultation and project coordination relative to the processing of the Lot Line Adjustment and Certificate of Compliance Applications. This task is based on an estimated 8 hours of Survey Manager project assistance. NV5, Inc. July 21, 2015 -. ge 5 of 14 Exhibit B TASK I LOT LINE ADJUSTMENT • ($3,500) TASK 2 CERTIFICATE OF • 1' NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 6 of 14 Exhibit C Insurance Requirements C.1 Insurance. Prior to the beginning of and throughout the duration of this agreement, the following policies shall be maintained and kept in full force and effect providing insurance with minimum limits as indicated below and issued by insurers with A.M. Best ratings of no less than A -:VI: Commercial General Liability (at least as broad as ISO CG 0001) $1,000,000 (per occurrence) $2,000,000 (general aggregate) Commercial Auto Liability (at least as broad as ISO CA 0009) $1,000,000 (per accident) Errors and Omissions Liability $1,000,000 (per claim and aggregate) Workers' Compensation (per statutory requirements) Consultant shall procure and maintain, at its cost, and submit concurrently with its execution of this Agreement, Commercial General Liability insurance against all claims for injuries against persons or damages to property resulting from Consultant's acts or omissions rising out of or related to Consultant's performance under this Agreement. The insurance policy shall contain a severability of interest clause providing that the coverage shall be primary for losses arising out of Consultant's performance hereunder and neither City nor its insurers shall be required to contribute to any such loss. A certificate evidencing the foregoing and naming City and its officers and employees as additional insured (on the Commercial General Liability policy only) shall be delivered to and approved by City prior to commencement of the services hereunder. Consultant shall carry automobile liability insurance of $1,000,000 per accident against all claims for injuries against persons or damages to property arising out of the use of any automobile by Consultant, its officers, any person directly or indirectly employed by Consultant, any subcontractor or agent, or anyone for whose acts any of them may be liable, arising directly or indirectly out of or related to Consultant's performance under this Agreement. If Consultant or Consultant's employees will use personal autos in any way on this project, Consultant shall provide NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 7 of 14 evidence of personal auto liability coverage for each such person. The term "automobile" includes, but is not limited to, a land motor vehicle, trailer or semi -trailer designed for travel on public roads. The automobile insurance policy shall contain a severability of interest clause providing that coverage shall be primary for losses arising out of Consultant's performance hereunder and neither City nor its insurers shall be required to contribute to such loss. Professional Liability or Errors and Omissions Insurance as appropriate shall be written on a policy form coverage specifically designed to protect against acts, errors or omissions of the consultant and "Covered Professional Services" as designated in the policy must specifically include work performed under this agreement. The policy limit shall be no less than $1,000,000 per claim and in the aggregate. The policy must "pay on behalf of the insured and must include a provision establishing the insurer's duty to defend. The policy retroactive date shall be on or before the effective date of this agreement. Consultant shall carry Workers' Compensation Insurance in accordance with State Worker's Compensation laws with employer's liability limits no less than $1,000,000 per accident or disease. Consultant shall provide written notice to City within ten (10) working days if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required policies are reduced; or (3) the deductible or self-insured retention is increased. In the event any of said policies of insurance are cancelled, Consultant shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Exhibit to the Contract Officer. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of Consultant's obligation to indemnify City, its officers, employees, contractors, subcontractors, or agents. C.2 Remedies. In addition to any other remedies City may have if Consultant fails to provide or maintain any insurance policies or policy endorsements to the extent and within the time herein required, City may, at its sole option: a. Obtain such insurance and deduct and retain the amount of the premiums for such insurance from any sums due under this Agreement. NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 8 of 14 b. Order Consultant to stop work under this Agreement and/or withhold any payment(s) which become due to Consultant hereunder until Consultant demonstrates compliance with the requirements hereof. C. Terminate this Agreement. Exercise of any of the above remedies, however, is an alternative to any other remedies City may have. The above remedies are not the exclusive remedies for Consultant's failure to maintain or secure appropriate policies or endorsements. Nothing herein contained shall be construed as limiting in any way the extent to which Consultant may be held responsible for payments of damages to persons or property resulting from Consultant's or its subcontractors' performance of work under this Agreement. C.3 General Conditions Pertaining --to,, Provisions of Insurance Coverage b Consultant. Consultant and City agree to the following with respect to insurance provided by Consultant: 1 Consultant agrees to have its insurer endorse the third party general liability coverage required herein to include as additional insureds City, its officials, employees, and agents, using standard ISO endorsement No. CG 2010 with an edition prior to 1992. Consultant also agrees to require all contractors, and subcontractors to do likewise. 2. No liability insurance coverage provided to comply with this Agreement shall prohibit Consultant, or Consultant's employees, or agents, from waiving the right of subrogation prior to a loss. Consultant agrees to waive subrogation rights against City regardless of the applicability of any insurance proceeds, and to require all contractors and subcontractors to do likewise. 3. All insurance coverage and limits provided by Consultant and available or applicable to this Agreement are intended to apply to the full extent of the policies. Nothing contained in this contract or any other contract relating to City or its operations limits the application of such insurance coverage. 4. None of the coverages required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved of in writing. NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 9 of 14 5. No liability policy shall contain any provision or definition that would serve to eliminate so-called "third party action over" claims, including any exclusion for bodily injury to an employee of the insured or of any contractor or subcontractor. 6. All coverage types and limits required are subject to approval, modification and additional requirements by City, as the need arises. Consultant shall not make any reductions in scope of coverage (e.g. elimination of contractual liability or reduction of discovery period) that may affect City's protection without City's prior written consent. 7. Proof of compliance with these insurance requirements, consisting of certificates of insurance evidencing all of the coverages required and an additional insured endorsement to Consultant's general liability policy, shall be delivered to City at or prior to the execution of this Agreement. In the event such proof of any insurance is not delivered as required, or in the event such insurance is canceled at any time and no replacement coverage is provided, City has the right, but not the duty, to obtain any insurance it deems necessary to protect its interests under this or any other agreement and to pay the premium. Any premium so paid by City shall be charged to and promptly paid by Consultant or deducted from sums due Consultant, at City option. 8. It is acknowledged by the parties of this agreement that all insurance coverage required to be provided by Consultant or any subcontractor, is intended to apply first and on a primary, non-contributing basis in relation to any other insurance or self-insurance available to City. 9. Consultant agrees to ensure that subcontractors, and any other party involved with the project that is brought onto or involved in the project by Consultant, provide the same minimum insurance coverage required of Consultant. Consultant agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Consultant agrees that upon request, all agreements with subcontractors and others engaged in the project will be submitted to City for review. 10. Consultant agrees not to self -insure or to use any self-insured retentions or deductibles on any portion of the insurance required herein (with the exception of professional liability coverage, if required) and further agrees that it will not allow any contractor, subcontractor, Architect, Engineer or other entity or person in any way involved in the performance of work on the project contemplated by this agreement to self -insure its obligations to City. If Consultant's existing coverage includes a deductible or self-insured retention, the deductible or self-insured retention must be declared to City. At that time City shall review options with Consultant, which may include reduction NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 10 of 14 or elimination of the deductible or self-insured retention, substitution of other coverage, or other solutions. 11 City reserves the right at any time during the term of this Agreement to change the amounts and types of insurance required by giving Consultant ninety (90) days advance written notice of such change. If such change results in substantial additional cost to Consultant, City will negotiate additional compensation proportional to the increased benefit to City. 12. For purposes of applying insurance coverage only, this Agreement will be deemed to have been executed immediately upon any party hereto taking any steps that can be deemed to be in furtherance of or towards performance of this Agreement. 13. Consultant acknowledges and agrees that any actual or alleged failure on the part of City to inform Consultant of non-compliance with any insurance requirement in no way imposes any additional obligations on City nor does it waive any rights hereunder in this or any other regard. 14. Consultant will renew the required coverage annually as long as City, or its employees or agents face an exposure from operations of any type pursuant to this agreement. This obligation applies whether or not this agreement is canceled or terminated for any reason. Termination of this obligation is not effective until City executes a written statement to that effect. 15. Consultant shall provide proof that policies of insurance required herein expiring during the term of this Agreement have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. A coverage binder or letter from Consultant's insurance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City within five (5) days of the expiration of coverages. 16. The provisions of any workers' compensation or similar act will not limit the obligations of Consultant under this agreement. Consultant expressly agrees not to use any statutory immunity defenses under such laws with respect to City, its employees, officials, and agents. 17. Requirements of specific coverage features or limits contained in this section are not intended as limitations on coverage, limits or other requirements nor as a waiver NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 11 of 14 of any coverage normally provided by any given policy. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue, and is not intended by any party or insured to be limiting or all-inclusive. 18. These insurance requirements are intended to be separate and distinct from any other provision in this Agreement and are intended by the parties here to be interpreted as such. 19. The requirements in this Exhibit supersede all other sections and provisions of this Agreement to the extent that any other section or provision conflicts with or impairs the provisions of this Exhibit. 20. Consultant agrees to be responsible for ensuring that no contract used by any party involved in any way with the project reserves the right to charge City or Consultant for the cost of additional insurance coverage required by this agreement. Any such provisions are to be deleted with reference to City. It is not the intent of City to reimburse any third party for the cost of complying with these requirements. There shall be no recourse against City for payment of premiums or other amounts with respect thereto. 21. Consultant agrees to provide immediate notice to City of any claim or Joss against Consultant arising out of the work performed under this agreement. City assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve City. NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 12 of 14 Exhibit D Indemnification D.1 General Indemnification Provision, a. Indemnification for Professional Liability. When the law establishes a professional standard of care for Consultant's Services, to the fullest extent permitted by law, Consultant shall indemnify, protect, defend (with counsel selected by City), and hold harmless City and any and all of its officials, employees, and agents ("Indemnified Parties") from and against any and all claims, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of an employee of Consultant or of any subcontractor), costs and expenses of any kind, whether actual, alleged or threatened, including court costs, attorneys' fees, litigation expenses, and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation, to the extent same are cause in whole or in part by any negligent or wrongful act, error or omission of Consultant, its officers, agents, employees or subcontractors (or any entity or individual that Consultant shall bear the legal liability thereof) in the performance of professional services under this agreement. With respect to the design of public improvements, the Consultant shall not be liable for any injuries or property damage resulting from the reuse of the design at a location other than that specified in Exhibit A without the written consent of the Consultant. b. Indemnification for Other Than Professional Liability. Other than in the performance of professional services and to the full extent permitted by law, Consultant shall indemnify, defend (with counsel selected by City), and hold harmless the Indemnified Parties from and against any liability (including liability for claims, suits, actions, arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, court costs, attorneys' fees, litigation expenses, and fees of expert consultants or expert witnesses) incurred in connection therewith and costs of investigation, where the same arise out of, area consequence of, or are in any way attributable to, in whole or in part, the negligent performance of this Agreement by Consultant or by any individual or entity for which Consultant is legally liable, including but not limited to officers, agents, employees, or subcontractors of Consultant. O.2 Standard Indemnification Provisions. Consultant agrees to obtain executed indemnity agreements with provisions identical to those set forth herein this section from each and every subcontractor or any other person or entity involved by, for, with or on behalf of Consultant in the performance of this Agreement. In the event Consultant fails to obtain such indemnity obligations from others as required herein, Consultant agrees NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 13 of 14 to be fully responsible according to the terms of this Exhibit. Failure of City to monitor compliance with these requirements imposes no additional obligations on City and will in no way act as a waiver of any rights hereunder. This obligation to indemnify and defend City as set forth herein is binding on the successors, assigns or heirs of Consultant and shall survive the termination of this agreement or this section. a. Indemnity, Provisions for Contracts Related to Construction. Without affecting the rights of City under any provision of this agreement, Consultant shall not be required to indemnify and hold harmless City for liability attributable to the active negligence of City, provided such active negligence is determined by agreement between the parties or by the findings of a court of competent jurisdiction. In instances where City is shown to have been actively negligent and where City's active negligence accounts for only a percentage of the liability involved, the obligation of Consultant will be for that entire portion or percentage of liability not attributable to the active negligence of City. b. Indemnification Provision for Design Professionals..: 1. Applicability of Section D.2(b). Notwithstanding Section D.2(a) hereinabove, the following indemnification provision shall apply to Consultants who constitute "design professionals" as the term is defined in paragraph 3 below. 2. Scope of Indemnification. To the fullest extent permitted bylaw, Consultant shall indemnify, defend (with counsel selected by City), and hold harmless the Indemnified Parties from and against any and all claims, losses, liabilities of every kind, nature and description, damages, injury (including, without limitation, injury to or death of an employee of Consultant or of any subcontractor), costs and expenses of any kind, whether actual, alleged or threatened, including, court costs, attorneys' fees, litigation expenses, and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation, that arise out of, pertain to, or relate to, directly or indirectly, in whole or in part, the negligence, recklessness, or willful misconduct of Consultant, any subcontractor, anyone directly or indirectly employed by them or anyone that they control. 3. Design Professional Defined. As used in this Section D.2(b), the term "design professional" shall be limited to licensed architects, registered professional engineers, licensed professional land surveyors and landscape architects, all as defined under current law, and as may be amended from time to time by Civil Code § 2782.8. NV5, Inc. Professional Services Contract Lot Line Adjustment 2015-0005 July 21, 2015 Page 14 of 14 Exhibit E EXITiIB IT "B POR.. OF SEC. 26, T 6- S, R 7 E; S.B.M. LOT LINE ADJUSTMENT NO. 2005-446 X11100 ° � N D' 333 . �.. � 333.. 25' 771.85' PA�G�L C N -YA NAY 1/4, SW U4 elm PARCEL B 1' S 1.2, NW -Y4, Sal 14 2 W n n 55.210 AC. 93.24 o� Vim- IO PMOL A s SW 1/A Swi U4 3 0.507 AC. 90.02' 1`20;0(fW 109.86' v'N B940'00" E \889.04' 1 dao F J. SHEET 1 OF 2 SHEETS 6954•'40" E 1317. f PAROL D 4 j 11415 AC. I OTD SEE DETAIL I F KIM LOT LINE I NS NO.2 I 1225-.38' N 89'00'39" E 1318.63' n b z PARCEL MERGER LOT LINEADJUST. BY CITY No. (3S• 406 N b .LA OUINTA TIENT DEPART MENT `DATE 1- 7 -9 - SCALE 1"=40Q' O CURVE DATA N0. 6 R _ L 1 47'43'13` 11 58.50' 48.72'-j 2 (Y39 -Dir I 1982.50' 22.56' 11 L.E©END TJ x --------- EXISTING LOT UNE TO BE ADJUSTED cHRi5 J. 8ER , L:S. 6 8 TE �r} �4 "' NEW LOT LINE EXP. 12/3i/0 9 Cr �L`1 f3 OLD LOT NO. B NEIN PARCEL NO N O!iI MINA -"/7 Srtk I YOIIICU wwr�rr� LOT LINE ADJUSTMENT NO 2005-446 .� rro-nt.aarr CITY OF LA QUINTA l[A""IRi tMGIWft41 JOIYl70JJ IN63100\LlA-WEDN 4/18/05 11.787 AC. C, P.O.B. PAR. 1 2P.O.C. PAR. 2 z 2-1 900.07' 420.08' 89'O6'3T E 1320.15' 06N C/L AVENUE 60 - PREPARED 'UNDER -THE SUPFf1VISION OR F J. SHEET 1 OF 2 SHEETS 6954•'40" E 1317. f PAROL D 4 j 11415 AC. I OTD SEE DETAIL I F KIM LOT LINE I NS NO.2 I 1225-.38' N 89'00'39" E 1318.63' n b z PARCEL MERGER LOT LINEADJUST. BY CITY No. (3S• 406 N b .LA OUINTA TIENT DEPART MENT `DATE 1- 7 -9 - SCALE 1"=40Q' O CURVE DATA N0. 6 R _ L 1 47'43'13` 11 58.50' 48.72'-j 2 (Y39 -Dir I 1982.50' 22.56' 11 L.E©END TJ x --------- EXISTING LOT UNE TO BE ADJUSTED cHRi5 J. 8ER , L:S. 6 8 TE �r} �4 "' NEW LOT LINE EXP. 12/3i/0 9 Cr �L`1 f3 OLD LOT NO. B NEIN PARCEL NO N O!iI MINA -"/7 Srtk I YOIIICU wwr�rr� LOT LINE ADJUSTMENT NO 2005-446 .� rro-nt.aarr CITY OF LA QUINTA l[A""IRi tMGIWft41 JOIYl70JJ IN63100\LlA-WEDN 4/18/05 TO: Frank J. Spevacek, City Manager FROM: Monika Radeva, Executive Secretary DATE: August 5, 2015 RE: Professional Services Agreement between the City of La Quinta and NV5, Inc. – Future Fire Station Site (Barton) Attached for your signature is the agreement with NV5, Inc. for survey and mapping services as related to the completion of Lot Line Adjustment 2015-0005 to create a two-acre fire station site on property located at the northeast corner of Avenue 60 and Monroe Street (APNs: 764-240-026 and 764-240-022). Please sign the attached agreement(s) and return it to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: XXX Contract payments will be charged to account number: PAID OUT OF ESCROW NO. FS-875 XXX A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with XXX no reportable interests in LQ or ____ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: XXX Approved by the City Council on (date) CC RESO 13-043; Adopted 09/17/2013 N/A City Manager’s signature authority provided under Resolution No. 2005-095 Public Works projects for $30,000 or less. N/A City Manager’s signature authority provided under Resolution No. 2005-096 Service agreements for $30,000 or less. N/A City Manager’s signature authority provided under Contract Change Order Policy Contracts under $100,000= 10% max, contracts over $100,000= $25,000 max The following required documents are attached to the agreement: XXX Insurance certificates as required by the agreement (initialed by Risk Manager on (date) JULY 22, 2015 N/A Performance bonds as required by the agreement (originals) XXX City of La Quinta Business License (copy or note number & expiration date here LIC-762389; 09/30/15 BUSINESS LOCATION OUTSIDE CITY LIMITS BUSINESS NAME: NV5 INC Twit 4 �P' Qamroj 78-495 Calle Tampico La Quinta, California 92253 (760)777-7000 CERTIFICATE NON -TRANSFERABLE BUSINESS ADDRESS: 200 SOUTH PARK ROAD SUITE 350 HOLLYWOOD, FL 33021 By Itfl_ CC17WA,�76 FINANCE DIRECTOR BUSINESS LOCATION OUTSIDE CITY LIMITS BUSINESS NAME: NV5 INC Titr °F Dear Business Owner: Please be aware that issuance of a business license by the City does not authorize you to conduct business in a building or tenant space that has not been approved for occupancy by the Building and Safety Department. If you have any questions regarding this issue, or if you are not sure if a Certificate of Occupancy has been Issued for your place of business, please contact Building and Safety at (760)7774012, The Licensee named herein having paid to the City of La Quinta all fees required, license is hereby granted said licensee to transact the business herein set forth, for the period stated, in conformity with the Provisions of Ordinance No. 2 of this City. This Licensee is issued without verfication that the licensee is subject to or exempt from licensing by the State of California. BUSINESS LIC NO: LIC -762389 CLASSIFICATION: ENGINEERING SERVICES EXPIRATION DATE: 9/30/2015 78-495 Calle Tampico La Quinta, California 92253 (760) 777-7000 CERTIFICATE NON -TRANSFERABLE BUSINESS ADDRESS: 200 SOUTH PARK ROAD SUITE 350 HOLLYWOOD, FL 33021 By � C� FINANCE DIRECTOR Dear Business Owner: Please be aware that issuance of a business license by the City does not authorize you to conduct business in a building or tenant space that has not been approved for occupancy by the Building and Safety Department. If you have a<<y questions regarding this issue, or if you are not sure if a Certificate of Occupancy has been issued for your place of business, please contact Building and Safety at (760)777-7012. The Licensee named herein having paid to the City of La Quinta all fees required, license is hereby granted said licensee to transact the business herein set forth, for the period stated, in conformity with the Provisions of Ordinance No. 2 of this City. This Licensee is issued without verfication that the licensee is subject to or exempt from licensing by the State of Californla. BUSINESS LIC NO: LIC -762389 CLASSIFICATION: ENGINEERING SERVICES EXPIRATION DATE: 9/30/2015 STATEMENT OF ECONOMIC INTERESTS COVER PAGE Please type or print in ink. NAME of FILER (LAST) (FIRST) (MIDDLE) NV5 - NOLTE VERTICALFIVE, INC. FAHRION JAY 1. Office, Agency, or Court Agency Name (Do not use acronyms) Division, Board, Department, District, if applicable CITY OF LA QUINTA Your Position (- 0 r"s ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: 2. Jurisdiction of Office (Check at feast one box) Position: ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi -County City of t -A Qv. 1V%4o— ❑ County of ❑X Other CONSULTANT 3. Type of Statement (Check at least one box) 0-Ain—nual: The period covered is January 1, 2014, through ❑ Leaving Office: Date Left I I -or. December 31, 2014. (Check one) The period covered is I I through O The period covered is January 1, 2014, through the date of December 31, 2014. leaving office. Assuming Office: Date assumed 07 /20 2015 O The period covered is , through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1: 4. Schedule Summary Check applicable schedules or "None." ► Total number of pages including this cover page: ❑ Schedule A-1 - Investments - schedule attached ❑ Schedule C - Income. Loans, 8 Business Positions - schedule attached ❑ Schedule A-2 - Investments - schedule attached ❑ Schedule D - Income - Gifls - schedule attached ❑ Schedule B - Real Property - schedule attached ❑ Schedule E - Income - Gifls - Travel Payments - schedule attached -or- Hone - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended - Public DonmtenQ 2-5253o0 50,L omev\To �';� Cl J a33 DAYTIME TELEPHONE NUMBER E-NIAIL ADDRESS (L7/(- ) ("4/ - 9J 0 1 9J -3- q . rL. tj NVS- C.ori,-. I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed 7 r Z -U I Signaturl_�L•����- (month, day, year) I (File'li m signed slalement wilh your riling official) FPPC Form 700 (2014/2015) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov CPi s.'1GN C r:i ASSOCL ,'ES INSURANCE BROKERS License No. OA99520 450 B Street, Suite 1800 San Diego, CA 92101-8005 Tel. 619.234.6848 • Fax 619.234.1239 ■ Web www.cavignac.com City of La Quinta ATTN: Public Works Department 78-495 Calle Tampico La Qu i nta, CA, 92253 Apr 28, 2015 Re: NV5 Holdings, Inc.; NV5, Inc. (formerly Vertical V - Southeast, Inc.) To Whom It May Concern: Enclosed is a certificate of insurance, as requested. If you have questions or require changes, please contact our office via email (certificates@cavignac.com) or fax (619-234-1239). Please include a copy of the certificate with your request or reference ID number 315529. Sincerely, Cavignac & Associates Certificate Department certificates@cavignac.com 619-234-1239 (fax) cc: Jeantees Baylon (JEANTEES.BAYLON@nv5.com) NV5 Holdings, Inc.; NV5, Inc. (formerly Vertical V - Southeast, Inc.) - Certificate of Insurance Page 1 of 7 A� oR0 CERTIF -ATE OF LIABILITY INS' DANCE DATE (MM/DD/YYYY) 4/28/2015 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 Cavignac & Associates 450 B Street, Suite 1800 San Diego, CA 92101-8005 License No. OA99520 CONTA TCertificate De artmerit NAME: p PHON1EoE ;619-234-6848 *q�jC,Nv:619-234-8601 E-MAIL ADEMESSt certif icates@cavignac.com INSURERS AFFORDING COVERAGE NAIL# .INSURER A INSURED NV5 Holdings, Inc.; NV5, Inc. (formerly Vertical V - Southeast, Inc.) 200 South Park Road, Suite #350 Hollywood, FL 33021 United States INSURER B : ENIX TNq CO 25623 N INSURERC: TRAVELERS PROP CAS CO OF AMER 25674 INSURERD: HUDSON INS CO 25054 INSURER E: INSURER F: nwoown_oc /`CDTICIf%ATP NI IMRFR• 9i7'A An7 REVISION NUMESER:315529 vTHIS 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 DDL POLICY NUMBER MM DICY DIYYYY POLICY EXP MWDD/YYYY LIMITS B GENERAL LIABILITY 6803920TO44 5/1/2015 '5/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE ED 1,000, 000 PREMISES Ea occurrence $ X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 10, 000 CLAIMS -MADE L11 OCCUR PERSONAL &ADV INJURY $ 1,000,000 X Cross Liab/Sev of Int X X GENERAL AGGREGATE $ 2,000,000 GENI AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000, Deductible $ 0 . POLICYX PRO• LOC ,p AUTOMOBILE LIABILITY 810927K6534 : /1/2015 > 5/1/2016 Eaacccidentl LE LIMIT 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED X X ( AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ Perauadent HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION S C .$ WORKERS COMPENSATION UB3893T34A 5/1/2015 5/1/2016 X WC STAT T- OTH- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVEEL EACH ACCIDENT $ 1,000,000 E.LDISEASE- EAEMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑ (Mandatory In NH) NIA X E.L. DISEASE -POLICY LIMIT $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below D Professional Liability AEE7246005 5/1/2015 5/1/2016 Ea. Claim $5,000,000 Aggreg $10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) :Re: City of La Quinta - On Call Construction Surveying Services. Additional Insured coverage applies to General and ,Automobile Liability for City of La Quinta, its officials, employees, and agents per policy form. Primary coverage ,applies to General and Automobile Liability per policy form. Waiver of subrogation applies to General and Automobile :Liability and Workers Compensation per policy form. Prof. Liab. - Claims made, defense costs included within limit; Pollution Liability is included in policy form #ADI0510002. Cavignac & Associates will provide 30 days notice of cancellation to the Certificate Holder in the event of policy cancellation. I+G1T 1^Al C unl ncb CANCFI I ATICSN City of La Quinta SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 78-495 Calle Tampico THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN La Quinta, CA 92253 ACCORDANCE WITH THE POLICY PROVISIONS. United States AUTHORIZED REPRESENTATIVE Jeffrey W. Cavignac V 9`Jtftf-2U9U HIiVKV I+VRrVRHI lvrv. Mn nynw IeaclvCu. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Page 2 of 7 EXIGIS - CAVIGNAC 8 ASSOCIATES 315529 Policy No. 810927K6534 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS E. TRAILERS — INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES —INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. B. EMPLOYEE HIRED AUTO The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LI- ABILITY COVERAGE: H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT — INCREASED LIMIT I. WAIVER OF DEDUCTIBLE —GLASS J. PERSONAL EFFECTS K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED operating a covered "auto" hired or rented The following is added to Paragraph A.1., Who Is under a contract or agreement in that "em- An Insured, of SECTION II — LIABILITY COV- ployee's" name, with your permission, while ERAGE: CA T4 20 07 10 © 2010 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 3 of 7 Policy No. 810927K6534 COMMERCIAL AUTO Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. D. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION II — LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION II — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. E. TRAILERS — INCREASED LOAD CAPACITY The following replaces Paragraph C.I. of SEC- TION I — COVERED AUTOS: 1. "Trailers" with a load capacity of 3,000 pounds or less designed primarily for travel on public roads. F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph AA., Cover- age Extensions, of SECTION III 4Y PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage If hired "autos" are covered "autos" for Liability Coverage but not covered "autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an owned "auto", then the Physical Damage Coverage is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" in any one "accident" to a hired, rented or borrowed "auto" is the lesser of: (a) $50,000; (b) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "loss". (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or bor- rowed with a driver; or (b) Any "auto" that is hired, rented or bor- rowed from your "employee". G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES —INCREASED LIMIT The following replaces the first sentence in Para- graph AA.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT — INCREASED LIMIT Paragraph C.2.. Limit Of Insurance, of SEC- TION III — PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVER OF DEDUCTIBLE —GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. J. PERSONAL EFFECTS The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Effects Coverage We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage only applies in the event of a total theft of your covered "auto". No deductibles apply to Personal Effects cover- age. Page 2 of 3 © 2010 The Travelers Indemnity Company. All rights reserved. CA T4 20 07 10 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 4 of 7 Policy No. 810927K6534 K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.1.1b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total 'loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto"; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of the 'loss"; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor; (d) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior to any "accident' or 'loss", pro- vided that the "accident' or "loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. CA T4 20 07 10 © 2010 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 5 of 7 POLICY NUMBER: 6803920TO44 COMMERCl/ JENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section Any person or organization that you agree in a "contract or agreement requiring insurance" to include as an additional insured on this Coverage Part, but only with respect to liability for "bodily injury', "property damage" or "personal 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; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products -completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury', "property damage" or "personal injury" for which that person or organization has assumed liability in a contract or agreement. The insurance provided to the additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. e. This insurance does not apply to the rendering of or failure to render any "professional services". f. The limits of insurance afforded to the additional insured shall be the limits which you agreed in that "contract or agreement requiring insurance" to provide for that additional insured, or the limits shown in the Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury' or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance". But this insurance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury' arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with such person or organization entered into by you before, and in effect when, the "bodily injury' or "property damage" occurs, or the "personal injury' offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal injury' is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and C. Before the end of the policy period. C 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Page 6 of 7 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 0313 (00) POLICY NUMBER: UB3893T34A WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an in)ury covered by this policy. We will not enforce our right against the person or organization named In the Schedule. (This agreement applies only to the Went that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule, SCHEDULE DESIGNATED PERSON. ANY PERSON OR ORGANIZATION FOR WHICH THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DESIGNATED ORGANIZATION: Page 7 of 7