Loading...
HomeMy Public PortalAboutC-18-078 - Law Offices of Dabbah, Haddad, Suleiman, APC Amendment No. 1, Workers Compensation Attorney Servicesr.; AMENDMENT NO. 1 TO AGREEMENT FOR CONTRACT SERVICES THIS AMENDMENT TO THE AGREEMENT FOR CONTRACT SERVICES ("Amendment") by and between the CITY OF CARSON, a California municipal corporation ("City"), and LAW OFFICES OF DABBAH, HADDAD & SULEIMAN, A PROFESSIONAL LAW CORPORATION, a professional law corporation ("Consultant"), is entered into effective as of the 18th day of March, 2020. RECITALS A. City and Consultant entered into that certain Agreement for Contractual Services dated May 2, 2018 ("Agreement") whereby Consultant agreed to provide City with worker's compensation litigation defense services ("Litigation Services"), among other related ancillary legal services. B. At the time City and Consultant entered into the Agreement, both parties severely underestimated the amount of Litigation Services that would be needed for Consultant to perform the agreed upon services. C. The Contract Sum, as defined in the Agreement, will now need to be increased in order for Consultant to continue to provide City with the Litigation Services described in the Agreement. as follows: TERMS Contract Changes. The Agreement is amended as provided herein. a. Section 2.1, "Contract Sum," of the Agreement is hereby amended to read Subject to any limitations set forth in this Agreement, City agrees to pay Consultant the amounts specified in the "Schedule of Compensation" attached hereto as Exhibit "C" and incorporated herein by this reference. The total compensation, including reimbursement for actual expenses, shall not exceed Seven Hundred Sixty Thousand Dollars ($760,000) Three Hundr-ed Sixty Thousand Dollars (960,-0" (the "Contract Sum"), unless additional compensation is approved pursuant to Section 1.8. tj b. Section V of Exhibit "C" of the Agreement, "Schedule of Compensation," Cs hereby amended to read as follows: itv The total compensation for the Services shall not exceed $760,000 $369,00 as provided in Section 2.1 of this Agreement. 2. Continuing Effect of Agreement. Except as amended by this Amendment, all provisions of the Agreement shall remain unchanged and in full force and effect. From and after -1- the date of this Amendment, whenever the term "Agreement" appears in the Agreement, it shall mean the Agreement, as amended by this Amendment to the Agreement. 3. Affirmation of Agreement; Warranty Regarding Absence of Defaults. City and Consultant each ratify and reaffirm each and every one of the respective rights and obligations arising under the Agreement. Each party represents and warrants to the other that there have been no written or oral modifications to the Agreement other than as provided herein. Each party represents and warrants to the other that the Agreement is currently an effective, valid, and binding obligation. Consultant represents and warrants to City that, as of the date of this Amendment, City is not in default of any material term of the Agreement and that there have been no events that, with the passing of time or the giving of notice, or both, would constitute a material default under the Agreement. City represents and warrants to Consultant that, as of the date of this Amendment, Consultant is not in default of any material term of the Agreement and that there have been no events that, with the passing of time or the giving of notice, or both, would constitute a material default under the Agreement. 4. Adequate Consideration. The parties hereto irrevocably stipulate and agree that they have each received adequate and independent consideration for the performance of the obligations they have undertaken pursuant to this Amendment. 5. Authority. The persons executing this Amendment on behalf of the parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Amendment on behalf of said party, (iii) by so executing this Amendment, such party is formally bound to the provisions of this Amendment, and (iv) the entering into this Amendment does not violate any provision of any other agreement to which said party is bound. [SIGNATURES ON FOLLOWING PAGE] -2- IN WITNESS WHEREOF, the pate hereto have executed this Amendment on the date and year first -above Witten. City Klerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney 0) CITY: CONSULTANT: LAW OFFICES OF DAEBAH, HADDAD & SULEIMAN, A PROFESSIONAL. LAW CORPORATION, a Cali rrrnia corporation By: Name: {was r(, 'Title: %s &;;k)' Name: v Tide: �-�- Adddress:3�il,- jiPa/�}J Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: I) Chairman of the Board, President or any Vice President; and 2) Secretary, any Assistant Secretary, Chief Financial Officer or any Assistant Treasurer. CONSULTANT'S SIGNATURES SHALL BE DULY NOTARIZED, AND APPROPRIATE ATTESTATIONS SHALL BE INCLUDED AS MAY BE REQUIRED BY THE BYLAWS, ARTICLES OF INCORPORATION, OR OTHER RULES OR REGULATIONS APPLICABLE TO CONSULTANT'S BUSINESS ENTITY. -3- CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that document. STATE OF CALIFORNIA COUNTY OF LOS ANGELES OnM([I 2020 before me H'�h�Y pp 1 P ersonall a eared /%%Yirale /l an, roved to me on the basis of satisfactory evidence to be the person(s) whose names(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. �°Fr�B YOUNG H. SHIN - "�' Comas. # 2289525 N x + o Kouurr Pueuc-cALIFORMIA Signature: �'�� GC ` Los AXIMS Coin MY Comm. EXP. JuME 19, 2023" OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE 4CER ❑ PARTNER( ❑ ATTORN ❑ TRUSTE ❑ GUARD AP ❑ OTHER ITLE(S) ❑ LIMITED ❑ GENERAL -IN-FACT OKI 0114 SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) 01007.0001/633598.1 DESCRIPTION OF ATTACHED DOCUMENT Alnehdnkvf A�. l -10'A Ireemed rv- Cod m& LSeE ,,'ce5 TITLE OR TYPE OF DOCUMENT PGc�eS �f 6S S Cevt;P�c4hc NUMBER OF PAGES /far -4.- /R, 1_)_D� DATE OF DOCUMENT %�a� �%ces Cf f - bVA,/fado(Qoi� Sit/einem► a Pkv f es -r, lav Grp OTHER THAN NAMED ABOVE CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that document. STATE OF CALIFORNIA COUNTY OF LOS ANGELES Onl�ar 2 �! , 2020 before me, 7� / H' ��`�' '�, personally appearedLiUX P69" PgbbM proved to me on the basis of satisfactory evidence to be the person(s) whose names(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. oc�o,t' YOUNG H. SHIN COMM. # 2,289525 to G C G4 N NOTARY PUBLIC -CALIFORNIA M+ Signature: Los ANGELES CouNTY MY Cow. UP. JUNE 19, 2023"' OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) 01007.0001/633598.1 DESCRIPTION OF ATTACHED DOCUMENT Amendixott A'` I Ayree &,t f%YG 'Rd 'S�vv)"Ces TITLE OR TYPE OF DOCUMENT ::�ffg5 A% (a NUMBER OF PAGES Nar, , / tf , -2-020 DATE OF DOCUMENT f �l��i11'Qe7� DOPC`dUfMESfN, tT ZaWWce_; a� PiabX,f�/i'1.�/4Ll-WiW�v,- CWLy�J- . SIGNER(S) OTHER THAN NAMED ABOVE TITLES) ❑ PARTNER(S) ❑ IMI' ❑ GEN ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONS VATOR ❑ OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) 01007.0001/633598.1 DESCRIPTION OF ATTACHED DOCUMENT Amendixott A'` I Ayree &,t f%YG 'Rd 'S�vv)"Ces TITLE OR TYPE OF DOCUMENT ::�ffg5 A% (a NUMBER OF PAGES Nar, , / tf , -2-020 DATE OF DOCUMENT f �l��i11'Qe7� DOPC`dUfMESfN, tT ZaWWce_; a� PiabX,f�/i'1.�/4Ll-WiW�v,- CWLy�J- . SIGNER(S) OTHER THAN NAMED ABOVE 1 u#komA-T '4��R© CERTIFICATE OF LIABILITY INSURANCE —v OP ID: DATE(M241202YYY} - 03!24!2020 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(les) 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 310-473-9011 Gros Insurance, Inc. License # 1333 Westwood Blvd Los Anpeiea, CA 90024 Margo Milman NO E CT_ Margo Milman PHONE, 390-473-961 1 —310-312.4093 (AC, NoEX( , No): —__._---Ac ADDRIE INSURERS AFFORDING COVERAGE NAIC # -- INSURER A: QBE Ins Corp 39217 INSURED Dabbah, Haddad 6 Suleiman Gary Dabbah/Andrea Hill 3710 N. Verdugo Road Montrose, CA 91020 INSURER B: INSURER C INSURER D : j I INSURER E: I INSURER F: 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. ILTR NSR TYPE OF INSURANCE DDL UBR J POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR i EACHOCCURRENCE S i DAMAGE TO RENTED _P3EM-1E$ LF,g oCcurrrncai $ ! MED EXP Aone person S � - PERSONAL & ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PEST E LOC GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG S S OTHER: AUTOMOBILE LIABILITY ♦ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUEE .qWN TOD5 ONLY AUUTOS ONLDY , COMBINED SINGLE LIMIT I�E30_DILY INJURY Per ersoh S BODILY INJURY (Per accident $ _ P�20PERTY pAMAGE er acpdent) ;_ �— is i UMBRELLA LIAB EXCESS LIAR I J OCCUR I CLAIMS -MADE EACH OCCURRENCE S AGGREGATE ; DED ( I RETENTION $ 1. WORKERS ND EMPLOYERS COMPENSATION Y! N ''ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICEZEMBEREXCLUDED? ( amatory In NH) it yes, describe under !DESCRIPTION F OPERATIONS below 'Prof. Liability NIA �LAW2034500 09!20/2019 I j_E.L.EACHACCIDENT i�E.L. 08120!2020 iPer I PTA OTH- I ; DISEASE - EA EMPLOYE S — E. L. DISEASE -POLICY LIMIT S Claim •1,000,000 i I I i !Aggregate I 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Proof of Coverage City of Carson 701 E Carson St Carson, CA 90745 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE � Amy .._,,..- _„ t-„ ,,,,,,,,I W l V00 -,4U10 AUUKU UUKPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ApPd-OV4(0 Y-6—zo'?v A4CC)Rtf CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDONYYY) 116 03/19/2020 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 policyroes) 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 StateFFaf m Matt Flynn, Agent 1931 W Glenoaks Blvd 441. Glendale, CA 91201 License 0882245, ECT Matt Flynn W PHONE 818-95&0111 FAX !C ND 818-240-3352 I -,M Re matt.fiynn.iCk8@sta#efarm.com -.INSUREP4SI AFFORDING.COVERAGE NAiC # INsuRER A. State Farm General Insurance Company 25151 INSURED INSURER a; State Farm Mutual Automobile Insurance Company 25178 Dabbah, Haddad & Suleiman 3710 Verdugo Rd Montrose, CA 91020-1640 INSURER C: W SURER D I INSURER E, INSURER F: EACH OCCURRENCE $ 1.000,DDA %1WVCMAVC0 t;ERN IGAI-E NUMBER: [u[ut53586i RRVIC(ntd nululRctD. THIS ISTOCERTIFY 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. LTR t - TYPE OF INSURANCE f ADD 09 POLICY NUMIBER MMb�YEFF M*POLIICYEXP ONYM LIM175 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ® OCCURkNTt:U EACH OCCURRENCE $ 1.000,DDA R All 'S (Ea 0=rrame, b K MED EXP (An one Person) $ 10,000 A Y X 92-E3h426-2 09/13/2019 09f13f2020 Business OfticePolicy PERSONAL& ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIE&PER: POLICY ❑ PRO- JECT 7 LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGO i 1,000,000 S OTHER: AUTOMOBILE LIABILITY Y X 591-3849-D17-75 10/17/2019 10/17/2020 EO,,B d I UMIT $ 1 OOO OOD B ANY AUTO OWNEDSCHEDULED AUTOS ONLY AUTOS HIRED NON-O'A'NED AUTOS ONLY AUTOS ONLYden BODILY INJURY (Per person) S - --- 13004LY INJURY (Per acddeni) $ PROPERTY DAMAGE $ S UMBRELLA UAB OCCUR j EACH OCCURRENCE $ EXCESS LAB CLAIMS -MADE N/A AGGREGATE $ Y OED I I RETENTIONS S III WORKERS COMPENSATION ) AND EMPLOYERS' LIABWTY YIN ANY PROPRIETOROARTNER,EXECUTIVEi OFFlCERIMEMBER EXCLUDED? F-1 (Mandatory In NH) r y6E dd5cribe LNlOFde( DESCRIPTION OPERATIONS below NIA NIA STATiITE ER. E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE $ E.L DISEASE - POLICY LIMIT S NIA DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (ACORD 101, Addldonal Remarke Schedule, may M attached it mora epaea Is raquimd) Business Office General Liability Policy for a Law Firm. Auto Non -Owned Hired Auto Liability Policy. Primary and Non-contributory endorsement. Waiver of Subrogation endorsement in favor of City of Carson. (:tR11FIGA I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carson, its elected and appointed officers, employees, ACCORDANCE WITH THE POLICY PROVISIONS. volunteers and agents are additional Insureds. City of Carson AUTHORIZED REPRESENTATIVE 701 E. Carson St. Carson CA 90745 7 4�q PJ 198 015 A O CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered mark of ACO D 1001458 132849.12 03-16-2016 f i pp-ov,,� u—�, —2_,o_o ACORbr CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDWYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 03124/2020 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(les) 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 Jeff Utz NAME: PHONE c/o Arthur J. Gallagher Risk Management Services IA1C IVs. Extt:_ AIC No _ E-MAIL karla_parnes@ajg.com _ @ajg.com 6967 South River Gate Drive; Suite 200 Salt Lake City, UT 84047 -_.-INSURER($) AFFORDING COVERAGE NAIC X INSURER A: American Zurich Insurance Company 40142 _ INSURED StaffPay, Inc. dba- Emplicity Labor Contractor, for co -employees of: LAW OFFICES OF INSURER 6: INSURERC: DABBAH, HADDAD & SULEIMAN, APC 9851 Irvine Center Dr INSURER D : Irvine, CA 92618 INSURER E: INSURER F: 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, EXCLUSiONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS - IN _ TYPE OF INSURANCE ADDLI INnn UBRPOLICY POLJCYNUMBER EFF MmoorYYYY POLICY EXP MWDD/YYYY i LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE U OCCUR EACH OCCURRENCE $ _ PREMISES 'Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY El PRO- JECTJECT �' LJ LOC k PRODUCTS - COMP/OP AGG S OTHER: S AUTOMOBILE LIABILITYNED IN L LIMIT S {Ea ade ccint! ANY AUTO BODILY INJURY (Per person) S OWNED SCHEDULED BODILY INJURY (Per aoddent) $ AUTOS ONLY AUTOS HIRED NON-OWNEDPROPERTY AUTOS ONLY AUTOS ONLY DAMAGE Per accident S S UMBRELLALIABOCCUR HCLAIMS-MADE EACH OCCURRENCE $ EXCESS LIAR AGGREGATE $ DEO i RETENTIONS $ WORKERS COMPENSATIONPER X H- AND EMPLOYERTLIABILITY YIN TAT TE ER E.L. EACHACCIDEM00,000 ,0 A ANYPROPRIETORIOF IC RiMEM ERPEXCLUDED? ECUTIVE a NIA X WC 58-97-166-03 12!01!2019 12/01/2020-S-1 E.L DISEASE - EA EMPLOYEE $ 1,0_0_0,000 (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT S 11000,000 DESCRIPTION OF OPERATIONS below t I Location Coverage Period: 12/01/2019 12/01/2020 Client# 10952 -CA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mora space is required) Coverage is provided for LAW OFFICES OF DABBAH, HADDAD & SULEIMAN, Waiver of Subrogation issued in favor of City of Carson, its elected and appointed only those co -employees APC officers, employees, volunteers and agents. of, but not subcontractors 3710 N Verdugo Rd RE: All Operations. to: Montrose, CA 91020 Endorsements: Waiver of Subrogation, 30 days written cancel notice (10 days for non payment of premium) CITY OF CARSON 701 E Carson St. Carson, CA 90745 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED 01988-2015 ACORD CORPORATION. All riahta rwconrna ACURD 25 (2016/03) The ACORD name and loan are registered marks of ACORD 6738.1 ADDITIONAL INSURED Policy 591-3849-D17-75 Insured: Dabbah, Haddad and Suleiman This endorsement is a part of your policy. Except for the changes it makes, all other terms of the policy remain the same and apply to this endorsement. It is effective at the same time as your policy unless a different effective date is specified by us in writing. In consideration of the premium charged for your policy, it is agreed that as of the effective date hereof the policy is amended in the following particulars: (1) The City of Carson, its elected and pointed officers, employees, volunteers and agents are included as additional insureds, but only insofar as the operations under this contract are concerned. (2) The insurer will not cancel the insured's coverage without 15 days' prior written notice to the State. (3) The City of Carson will not be responsible for any premiums or assessments on the policy. Page 1 of 16738.1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GMP -4860.1 ADDITIONAL INSURED -- DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Schedule Policy Number: 92 -E3 -H426-2 Named Insured: Dabbah, Haddad & Suleiman City of Carson, its elected and appointed officers, employees, volunteers and agents. City of Carson, 701 E Carson Street, Carson CA 90745 1. SECTION II — WHO IS AN INSURED of SECTION II — LIABILITY is amended to include, as an additional insured, any person or organization 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: a. Premises and Ongoing Operations Your acts or omissions or the act or omissions of those acting on your behalf: (1) In connection with your premises; or (2) In the performance of your ongoing operations; or b. Products -Completed Operations "Your work" performed for that additional insured and included in the "products - completed operations hazard". However, Paragraph 1. above is subject to the following: a. The insurance afforded to the additional insured only applies to the extent permitted by law; CMP -4860.1 Page 1 of 2 b. If coverage provided to the additional insured is required by a contract or agreement, the insurance provided to the additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured; and c. If the contract or agreement between you and the additional insured is governed by California Civil Code Section 2782 or 2782.05, the insurance provided to the additional insured is the lesser of that which: (1) Is allowed for the satisfaction of a defense or indemnity obligation by California Civil Code Section 2782 or 2782.05 for your sole liability; or (2) You are required by contract or Agreement to provide for such additional insured. We have no duty to defend or indemnify the additional insured under this endorsement until a claim or "suit" is tendered to us. ©, Copyright, State Fane Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CONTINUED 2. Any insurance provided to the additional Insureds hall only apply with respect to a claim made or a "suit' brought for damages for which you are provided coverage. This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations. 3. With respect to the insurance afforded to the Additional insured, the following is added to SECTION 11— LIMITS OF INSURANCE: If coverage provided to the additional insured is required by contract or agreement, the most we will pay on behalf of the additional insured will be the lesser of the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits Of Insurance shown in the Declarations. This endorsement shall not increase the applicable 4. With respect to the insurance afforded to the additional insured, the following is added to Paragraph 3. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION II — GENERAL CONDITIONS: The additional insured must: a. See to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place (2) addresses of any injured persons and witnesses, and 3) The nature and location of any injury or damage arising out of the "occurrence" or offense; b. Tender the defense and indemnity of any claim or "suit" to us and to all other insurers who may have insurance potentially available to the additional insured; and c. Agree to make available any other insurance the additional insured has for defense or damages for which we would provide coverage under SECTION II — LIABILITY. 5. With respect to the insurance afforded the additional insured, the following replaces SECTION 11— LIABILITY of Paragraph 7. -Other Insurance of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: a. This insurance is primary to and will not seek contribution from any other insurance available to the additional insured, provided that the additional insured is a named insured under such other insurance. b. Regardless of any agreement between you and the additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. There will be no refund of premium in the event this endorsement is cancelled. All other policy provisions apply. m, Copyright, State Farm Mutual Automobile Insurance Company, 2013 CMP -4860.1 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Policy No. G 92 E31-1426 2 CMP -4787 WAIVER OF TRANSFER OF RIGHTS OR RECOVERY AGAINST OTHERS TO US THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 92 E31-1426 2 Named Insured: Dabbah, Haddad & Suleiman 3720 Verdugo Rd. Montrose, CA. 91020 Name And Address Of Person Or Organization: City of Carson, its elected and appointed officers, employees, volunteers and agents are additional insureds. The following is added to Paragraph 10.b. of— SECTION I AND SECTION It - COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "productscompleted operations hazard This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. Capyright State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Policy No. 5913849-1317-75 6196AA WAIVER OF SUBROGATION UNDER THE LIABILITY COVERAGE This endorsement is part of the policy. Except for the changes it makes, all other terms of the policy remain the same and apply to this endorsement. It Is effective at the same time as the policy unless a different effective date is specified by us in writing. It is agreed that we have no right of subrogation under Liability Coverage against the person or organization whose name is shown immediately following the title of this endorsement on the Declarations Page to the extent that you have waived your legal right to recover from that person or organization pursuant to a written contract you had duly executed with that person or organization prior to the accident or loss COVERAGE ONLY IN FAVOR OF: City of Carson, its elected and appointed officers, employees, volunteers and agents are additional insureds. Page 1 of 1 6196AA ©, Copyright, State Farm Mutual Automobile Insurance Company, 2013 WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA WC 04 03 06 (Ed. 4-84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the schedule (This agreement applies only to the extent that you per- form work under a written contract that requires you to obtain this agreement from us,) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be $o of the California workers' compensation premium otherwise due on such remuneration. Person or Organization IN FAVOR OF: CITY OF CARSON 701 E Carson St. Carson, CA 90745 SCHEDULE Job Description Waiver of Subrogation issued in favor of City of Carson, its elected and appointed officers, employees, volunteers and agents. RE: All Operations. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 03/24/2020 Policy No: WC 58-97-166-03 Endorsement No: Insured: StaffPay. Inc. dba: Emplicity Labor Contractor, for co -employees of: LAW OFFICES OF DABBAH, HADDAD & SULEIMAN, APC Insurance Company. American Zurich Insurance Company Countersigned by WC 04 03 06 Copyright 1983 National Council on Compensation Insurance A4C"RDr CERTIFICATE OF LIABILITY INSURANCE 11. ------ DATE(MMIDDIYYYY) F � 03124/2020 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 WANED, 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 St�cftFaI7ff Matt Flynn, Agent 1931 W. Glenoaks Blvd, m Glendale, CA. 91201 License # OB82245 NMIl3. T Matt Flynn PHONE (818} 956-0111 F n . (818) 240.3352 Matt@agentmatiifynn.com INSUR 5 AFFORDING COVERAGE NAIC 4 INSURER A: State Farm General Insurance Company 25151 WsuReD Dabbah, Haddad &Suleiman 3710 Verdugo Rd. Montrose, CA. 91020-1640 INSURERS; State Farm Mutual Automobile Insurance Company 25178 INSURER C • INSURER o INSURER E.- INSURER F MED EXP yore i 10,000 t RCYIA7UIY IYUMtdtK: L 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INS" LT TYPEOFINSURANCE U POLICY NUMBER MKmonym POLICY EFF PO(JCYEXP LIMITSCOMMERCIAL GENERAL LIABILITY CU;lMS MADE ® OCCUR EACH OCCURRENCE S 1,000 OQO E611SEalEa oesaMML MED EXP yore i 10,000 t A Y Y 92-E3-11426-2 0911 3CL019 09!13!2020 Business Office Policy --(Any-- —" - PERSONAL a ADV INJURY ; GEN'L AGGREGATE LIMIT APPLIES ?ER: POLICY D JRERCT LOC GENERAL AGGREGATE ; 2,000,000 PRODUCTS -COMPIOPAGG f 2,000,000 OTHER THER. S BAOIJt AUTO LIABILITY ANY AUTO OSQNLYAUTOSULEO HIRED NQN-0WNED AUTOS ONLY AUTOS ONLY Y Y 591 3649-1317-75 10/17,2019 1O/17/2020t8001Y INGLELIMIT f 1,000,000 RY (Per paraoN S RY (Peracdde-M) S AMAGE ; f UMBRELLALIAO EXCESS LIAa OCCUR CLAIMS -MADE N!A EACH. OCCURRENCE f AGGREGATE f orm RErENT f WORKERS COMPENSATION AND EMPLOYERS' LIABLUTY ANY PROPRtETOR/PARTNER/PXECUnVE YIN OFFICERNEMSEREXCLUDED? (Mandatory In u Hj ea, desdrlr4 4er be urxlSCRIPMNOFOPE TIONS $ ,. STATUTE ERH E.LEACH ACCIDENT S E.L. DISEASE - EA EMPLOYE S - E.LDISEASE '-POLICY LIMIT S _ DESCRIPTION OF OPERATIONS I LOCATKINS I VEHICLES (ACORD 101, Additnal Ran urks Sdiedute, ntay be attached If tom space is raqulted) Business Office General Liability Policy for a Law Firm Auto Non -Owned Hired Auto Liability Policy Primary and Non-contributory endorsement Waiver of Subrogation endorsement in favor of City of Carson Additional Insured: City of Carson, its elected and appointed officers, employees, volunteers and agents. City of Carson 701 E Carson Street Carson, CA. 90745 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE Wrn4 THE POLICY PROvIsIONS. AUTHORS" 19M2015 ACORD CORPORATION, All rights reserved. n6.URU LJ tAU 101W? I ne AcvRo name and logo are registered marks of ACORD 1001480 132949.12 03-16-201e