Loading...
HomeMy Public PortalAboutC-18-078 - DABBAH HADDAD SULEIMAN AMENDMENT NO. 4 2023 MARCH 099th March E. The Parties again underestimated, at the time they entered into Amendment No. 3, the amount of Litigation Services that would be needed for Consultant to perform the agreed - upon services for the one-year extension period authorized pursuant thereto. Now, the Parties desire to amend the Agreement to increase the not -to -exceed contract sum by $70,000, from $1,160,000 to $1,230,000, to ensure there is sufficient authorized funding to cover the needed amount of agreed -upon services from the date of this Amendment until the scheduled date of expiration of the existing term of the Agreement, which is May 2, 2023. F. Pursuant to Carson Municipal Code Section 2611(i)(4), the purchase of legal services by the City shall not require compliance with the bidding provisions of the City's Purchasing Ordinance (Chapter 6 of Article II of the Carson Municipal Code), so long as funds have been properly appropriated and such purchases conform with all other requirements of the Purchasing Ordinance. Accordingly, the City is not required to issue a request for proposals or otherwise engage in a competitive bidding or competitive proposals process under the Purchasing Ordinance in order to procure continued services (as set forth in the Agreement's current Scope of Services) from Consultant for a new/additional contract term. G. Pursuant to the foregoing exemption, without issuing an RFP, the City now desires to continue its contractual relationship with Consultant for an additional initial three-year term, with City options to extend the term for up to two additional one-year periods, mirroring the term structure of the existing Agreement. Consultant is agreeable to this continuation of services provided City agrees to an increased hourly billable rate structure as specified below for the additional five-year term (inclusive of the two optional extension periods if such options are exercised by the City), and City is agreeable to same. The Parties are otherwise agreeable to continuing the contractual relationship for the additional term on the same terms/provisions set forth in the Agreement, except as amended below. Due to the existing need for an amendment to the Agreement irrespective of any extension as detailed in Recital E above, for the sake of efficiency, the Parties desire to effectuate the extension of their contractual relationship as detailed above for the additional term, commencing May 2, 2023, pursuant to this Amendment, rather than entering into a new contract to do so. TERMS 1. Recitals. The foregoing recitals are true and correct, and the same are incorporated herein by this reference. 2. Contract Changes. The Agreement is amended as provided herein (additions shown in bold italics, deletions shown in sti44Eethreugh format). a. Section 2.1, "Contract Sum," of the Agreement is hereby amended to read in its entirety as follows: "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 One Million Two One Hundred Thirty y Thousand 2 01007.0001/856032.2 Dollars ($1,230,000) ($1,160,000) for the period ending on May 2, 2023, and an additional One Million Fifty Thousand Dollars ($1,050,000) for the period from May 2, 2023 until May 2, 2026, for a total not -to -exceed amount of Two Million Two Hundred Eighty Thousand Dollars ($2,280,000) for the entire term of the Agreement until May 2, 2026 (the `Contract Sum'), unless additional compensation is approved pursuant to Section 1.8." b. Section 3.4, "Term," of the Agreement is hereby amended to read in its entirety as follows: "Unless earlier terminated in accordance with Article 7 of this Agreement, this Agreement shall continue in full force and effect until completion of the services but not exceeding eight (8) five (5) years from the date hereof. City may, at its sole and absolute option, extend the Term by an additional two (2) one-year increments at the same hourly rates as set forth in Exhibit "C-1" by delivering to Consultant a notice of City's election thirty (30) days prior to Term expiration. However, failure of City to deliver the notice of election to Consultant timely in accordance with the preceding sentence shall not affect the City's right or entitlement to exercise either of its options to extend at the same hourly rates as set forth in Exhibit "C-1." c. Section II of Exhibit "C" of the Agreement, "Schedule of Compensation," is hereby amended to read as follows: "[Reserved] A _ete„tion of t___ p rce„t (4%) y1,µ11 be held from `act: upon satisfactory completion of services." d. Section V of Exhibit "C" of the Agreement, "Schedule of Compensation," is hereby amended to read as follows: "The total compensation for the Services shall not exceed $2,280,000 $1,160,000 as provided in Section 2.1 of this Agreement." e. Exhibit "C-1" of the Agreement, "Personnel Hourly Rates," is hereby amended to read as follows: "Additional or On -Call services, as requested, will be billed at the following hourly rates (General overhead and administrative services are included in the hourly rates below): - Partner: $210 X9-5 per hour - Associate: $195 $4 per hour - Paralegal: $110 $90 per hour -3- 01007.0001/856032.2 - Legal Assistant: $95 $90" 3. Continuing Effect of Agreement. Except as amended by this Amendment No. 4, all provisions of the Agreement, Amendment No. 1, Amendment No. 2, and Amendment No. 3 shall remain unchanged and in full force and effect. From and after the date of this Amendment No. 4, whenever the term "Agreement" appears in the Agreement, it shall mean the Agreement, as amended by this Amendment No. 4, Amendment No. 3, Amendment No. 2, and Amendment No. 1. 4. Affirmation of Agreement; Warranty Re Absence of Defaults. The Parties each ratify and reaffirm each and every one of the respective rights and obligations arising under the Agreement, Amendment No. 1, Amendment No. 2, and Amendment No. 3. 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 and Amendment No. 1, Amendment No. 2, and Amendment No. 3. Each Party represents and warrants to the other that the Agreement, as amended by Amendment No. 1, Amendment No. 2, Amendment No. 3, and this Amendment No. 4, is currently an effective, valid, and binding obligation. Consultant represents and warrants to City that, as of the date of this Amendment No. 4, 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 No. 4, 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. 5. Adequate Consideration. The Parties 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 No. 4. 6. Authority. The persons executing this Amendment No. 4 on behalf of the respective Parties represent and warrant that (i) such Party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Amendment No. 4 on behalf of said Party, (iii) by so executing this Amendment No. 4, such Party is formally bound to the provisions of this Amendment No. 4, and (iv) the entering into this Amendment No. 4 does not violate any provision of any other agreement to which said Party is bound. [SIGNATURES ON FOLLOWING PAGE] -4- 01007.0001!856032.2 IN WITNESS WHEREOF, the Parties have executed this Amendment No. 4 on the date and year first -above written. CITY: CITY QF CARSON, a municipal corporation ATTEST: Dr. Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney [brj] corporati By: Davis -Holmes, Mayor CONSULTANT: DABBAH HADDAD SULEIMAN, A PROFESSIOy L \ORPOZATION, a California Name: iEli). 1 Dean Dabbah Title: President By: Name: Munir Suleiman 1 J Title: CFO Address: 370 N. Verdugo Rd. Montrose, CA Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: 1) 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. -5- 01007.0001; 856032.2 IN WITNESS WHEREOF, the Parties have executed this Amendment No. 4 on the date and year first -above written. CITY: CITY OF CARSON, a municipal corporation Lula Davis -Holmes, Mayor ATTEST: Dr. Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney [brj] CONSULTANT: DABBAH PROFESSIO corp Or By: By: HADDAD Name: Dean Dabbah Title: President Name: Munir Suleiman Title: CFO Address: 370 N. Verdugo Rd. Montrose, CA SULEIMAN, A .TION, a California Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: 1) 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, 5 01007.0001/856032.2 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 On , 2023 before me, , personally appeared , 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. Signature: 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 TITLE(S) PARTNER(S) 0 LIIVIITED GENERAL ATTORNEY -IN -FACT TRUSTEE(S) GUARDIAN/CONSERVATOR OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNERt S ! OTHER THAN NAMED ABOVE 01007.0001/856032.2 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 On , 2023 before me, , personally appeared , 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. Signature: 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 ❑ INNDIVIDUAL ❑ CORPORATE OFFICER TITLE(S) PARTNER(S) ❑ LIMITED 0 GENERAL ATTORNEY -IN -FACT TRUSTEE(S) GUARDIAN/CONSERVATOR OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER S) OTHER THAN NAMED ABOVE 01007.0001/856032.2 ACQRII� O CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 02/07/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Jeff Utz c/o Arthur J. Gallagher Risk Management Services 6967 South River Gate Drive; Suite 200 Salt Lake City, UT 84047 CONTACT NAME: PHONE FAX Ext): (A/C, No): E MAIo, ADDRESS: brittney_sheldon@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: American Zurich Insurance Company 40142 INSURED StaffPay, Inc. dba: Emplicity Labor Contractor, for co -employees of: LAW OFFICES OF DABBAH, HADDAD & SULEIMAN, APC 9851 Irvine Center Dr Suite 200 Irvine , CA 92618 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:22CA756945935 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 INSD WVDR POLICY NUMBER M/POLICY EFF (M DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? XECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ N N/A X WC 58-97-166-06 12/01/2022 12/01/2023 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 12/01/2022 12/01/2023 Client# 10952 -CA DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) LAW OFFICES OF DABBAH, HADDAD & SULEIMAN, Waiver of Subrogation issued in favor of City of Carson, its elected and appointed Coverage is provided for APC officers, employees, volunteers and agents. only those co -employees 3710 N Verdugo Rd RE: At Operations. of, but not subcontractors 9 to: Montrose, CA 91020 Endorsements: Waiver of Subrogation, 30 days written cancel notice (10 days for non payment of premium) CERTIFICATE HOLDER CANCELLATION CITY OF CARSON 701 E Carson St. Carson, CA 90745 INSURANCE APPROVED RG 2/22/2023 1 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DABBHAD-01 MGODOY CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 2/3/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0L78680 Grosslight Insurance 21300 Victory Blvd Ste 700 Woodland Hills, CA 91367 INSURED Dabbah, Haddad & Suleiman Gary Dabbah/Andrea Hill 3710 N. Verdugo Road Montrose, CA 91020 COVERAGES • CONTACT Maria Godoy PHONE FAX (A/C, No, Ex9: (A/C, No): El SS: Maria_Godoy@grosslight.com INSURER(S) AFFORDING COVERAGE INSURER A:QBE insurance Corporation INSURER B : NAIL # 39217 INSURER C INSURER D : 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL TYPE OF INSURANCE 'SND POLICY NUMBER POLICY EFF POLICY EXP LTR 1NS0 WVD. '' (MMlDQlYYYY) (MM1QDlYYYYj„ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ' OCCUR DAMAGE ORENTED PREMISES (Ea rrrence)._ $ MED EXP (Any one $ person) PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ' PRO- ! j LOC PRODUCTS - COMP/OP AGG $ I OTHER: S AUTOMOBILE LIABILITY (OMa6IEeDEa tSINGLE LIMIT $ ANY AUTO _ BODILY INJURY (Per person) $ AUTEOS ONLY SCHEDULEDNED BODILY INJURY (Per accident) $ __ AUTOS ONLY U AUTOS ONLYY PROPERTY DAMAGE (Per accident) $ ! S UMBRELLA LIAB O OCCUR EACH OCCURRENCE _ $ EXCESS LIAB CLAIMS -MADE I AGGREGATE DED ; I RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY t N ( i STATUTE E RY ANY OFFICER/MEM ER EXCLUDED? ECUTIVE 1 N / A E.L. EACH ACCIDENT $ (Mandatory in NH) L ( If describe I E.L. DISEASE - EA EMPLOYE $ yes, under 1 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT -- $ A Profess. Liability A Profess. Liability LAW2034503 I LAW2034503 8/20/2022 8/20/2023 Per Claim 8/20/2022 8/20/2023 Aggregate 2,000,000 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) OLDER City of Carson 701 E Carson Street Carson, CA 90745 INSURANCE APPROVED 2/22/2023 CANCELLATION 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD � A � 9 � f-a�-�-i/� CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDD/YYYY) 0207/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Stc? @ Fri17t7 Matt Flynn, Agent © Lic.#0B82245 CONTACT Matt Flynn NAME: y PHONE (Aric, o. Extc (818) 956-0111 FAX No): (818) 240-3352 AIL ADDRESS: matt@agentmattflynn.com Q©;. 1931 W. Glenoaks Blvd. Glendale, CA 91201 INSURER(S) AFFORDING COVERAGE 1 NAIC;!t INSURER A : State Farm General Insurance Company 25151 INSURED Dabbah, Haddad & Suleiman 3710 Verdugo Rd Montrose, CA 91020-1640 INSURER B : State Farm Mutual Automobile Insurance Company 25178 INSURER C: 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 ADD INSD SUB WVD POLICY NUMBER POLICYEFF (MM/DD/YYYY) POLICY EXP ,IMM/DD/YYYY) LIMITS . A X COMMERCIAL GENERALLIABILITY Y Y 92 -E3 -H426-2 09/23/2022 09/23/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE /� OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) § 10,000 X Business Office Policy PERSONAL 8 ADV INJURY 5 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO - JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG g 2,000,000 5 B AUTOMOBILE _ X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY V /% SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y Y 591 3849 -D17 -75A 10/17/2022 10/17/2023 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PHOPERIY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE 5 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFRCERJMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- STATUTE ER $ E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requi ed) 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 CERTIFICATE HOLDER City of Carson 701 E Carson St Carson, CA 90745 INSURANCE APPROVED 2/22/2023 ACORD 25 (2016/03) CANCELLATION 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/ EPRESENTATIVE i// 2 © 1988- 15 ACORCORPORATION. AU rights reserved. The ACORD name and logo are registered marks of CORD 1001486 132849.14 04-13-2022 WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA 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. SCHEDULE Person or Organization Job Description IN FAVOR OF: CITY OF CARSON 701 E Carson St. Carson, CA 90745 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: 12/01/2022 Policy No: WC 58-97-166-06 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 I